Browsing by Author "Bamford, C"

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    National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumonia isolates in South Africa 2010-2012
    (Health and Medical Publishing Group, 2014) Perovic, O; Singh-Moodley, A; Duse, A; Bamford, C; Elliott, G; Swe Swe-Han, K; Kularatne, R; Lowman, W; Whitelaw, A; Nana, T; Wadula, J; Lekalakala, Ruth; Saif, A; De-Smidt, M F; Marais, A
    BACKROUND: The increasing rates of antimicrobial resistance observed in the nosocomial pathogen Klebsiella pneumoniae are of major public health concern worldwide. OBJECTIVES: To describe the antibiotic susceptibility profiles of K. pneumoniae isolates from bacteraemic patients submitted by sentinel laboratories in five regions of South Africa from mid-2010 to mid-2012. Molecular methods were used to detect the most commonly found extended-spectrum beta-lactamase (ESBL) and carbapenemase resistance genes. METHODS: Thirteen academic centres serving the public healthcare sector in Gauteng, KwaZulu-Natal, Free State, Limpopo and Western Cape provinces submitted K. pneumoniae isolates from patients with bloodstream infections. Vitek 2 and MicroScan instruments were used for organism identification and susceptibility testing. Multiplex polymerase chain reactions (PCRs) were used to detect blaCTX-M, blaSHV and blaTEM genes in a proportion of the ESBL isolates. All isolates exhibiting reduced susceptibility to carbapenems were PCR tested for blaKPC and blaNDM-1 resistance genes. RESULTS: Overall, 68.3% of the 2 774 isolates were ESBL-positive, showing resistance to cefotaxime, ceftazidime and cefepime. Furthermore, 46.5% of all isolates were resistant to ciprofloxacin and 33.1% to piperacillin-tazobactam. The major ESBL genes were abundantly present in the sample analysed. Most isolates (95.5%) were susceptible to the carbapenems tested, and no isolates were positive for blaKPC or blaNDM1 There was a trend towards a decrease in susceptibility to most antibiotics. CONCLUSION: The high proportion of ESBL-producing K. pneumoniae isolates observed, and the prevalence of ESBL genes, are of great concern. Our findings represent a baseline for further surveillance in SA, and can be used for policy and treatment decisions.
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    Streptococcus pneumoniae infection on Noenates
    (Health and Medical Publishing Group, 2007) Bamford, C; Haffejee, S; Whitelaw, A C
    WWhile Streptococcus pneumoniae bacteraemia is not uncommon, clinicians and microbiologists might not think of it in terms of neonatal sepsis. Our interest was aroused recently by two cases of S. pneumoniae bacteraemia in neonates. A 21-year-old primigravida had a spontaneous rupture of membranes at 34 weeks’ gestation with clear liquor and no clinical or laboratory features of sepsis. She received intravenous ampicillin and metronidazole, and had a normal vaginal delivery approximately 40 hours after the rupture of membranes. At delivery the baby had good Apgar scores of 9 and 9, but was noted to be in respiratory distress with tachypnoea (respiratory rate of 72 breaths/minute), grunting and subcostal and intercostal recession. He was commenced on intravenous penicillin and gentamicin. S. pneumoniae was cultured from the blood, susceptible to penicillin (MIC as determined by Etest of 0.016 µg/ml). He had a good clinical response to 10 days of intravenous penicillin.