Background: The incidence of Pseudomonas aeruginosa bacteremia has not been defined in a population-based investigation. Methods: We performed a retrospective, population-based incidence study using resources of the Rochester Epidemiology Project of Olmsted County, Minnesota. We identified all Olmsted County residents with P. aeruginosa bacteremia between January 1, 1997, and December 31, 2006, by microbiology records in the only 2 laboratories in the county. Medical records were reviewed to confirm diagnosis, residency status, and clinical characteristics. Results: Age-adjusted incidence per 100,000 person-years was 10.8 (95% confidence interval [CI], 7.5-14.0) in men and 3.7 (95% CI, 2.2-5.2) in women for total P. aeruginosa bacteremia, and 8.4 (95% CI, 5.5-11.2) in men and 2.5 (95% CI, 1.3-3.8) in women for monomicrobial P. aeruginosa bacteremia. There was no significant change in incidence of total P. aeruginosa bacteremia during the past decade (P = .418). Incidence increased exponentially with age, with a greater magnitude of increase in men compared with women for total and monomicrobial P. aeruginosa bacteremia (P = .007 and P = .015, respectively). In patients with monomicrobial P. aeruginosa bacteremia, the median age was 69 years, and 78.4% of cases were either nosocomial or health care associated. Most patients had multiple comorbid conditions. The urinary tract was the most common primary source of infection. The 28-day all-cause mortality of monomicrobial P. aeruginosa bacteremia was 25.5%. In vitro susceptibility to ciprofloxacin was 95.3%. Conclusion: To our knowledge, this is the first population-based incidence study of P. aeruginosa bacteremia. The incidence of P. aeruginosa bacteremia has remained stable during the past decade. Fluoroquinolone susceptibility is high among local P. aeruginosa bacteremia isolates.

The objective of the work reported in this paper is one of a two-fold nature. The first objective is to develop a disk-plate sensitivity test that is more rapid than that of existing methods. The second requisite is that the materials, techniques, interpretation, and reporting of results be the sane as those required for the disk-plate method described in the Difco Manual.

Objectives: To compare and contrast the geographic and demographic distribution of bro β-lactamase and antibiotic MIC50/90 for 1440 global Moraxella catarrhalis isolates obtained from children and adults between 2001 and 2002. Methods: One thousand four hundred and forty M. catarrhalis isolates originating from seven world regions were investigated. The isolates were recovered from 411 children <5 years of age and 1029 adults >20 years of age. PCR-restriction fragment length polymorphism (RFLP) was performed to determine bro prevalence and to distinguish between bro types. MIC values of 12 different antibiotics were determined using the CLSI (formerly NCCLS) broth microdilution method. Results: Of the 1440 isolates, 1313 (91%) possessed the bro-1 gene and 64 (4%) possessed the bro-2 gene. Additionally, the prevalence of bro positivity between the child and adult age groups was significantly different (P<0.0001), though bro-1 and bro-2 prevalences within age groups were not significantly different. Consistently higher β-lactam MICs were observed for M. catarrhalis isolates originating in the Far East. Significant correlations in MICs were observed for several antibiotic combinations, including all five β-lactams with each other, and among the two quinolones. Conclusions: The worldwide prevalence of bro gene carriage in clinical isolates of M. catarrhalis is now approaching 95%, with children significantly more likely to harbour bro-positive isolates than adults. Further, statistically significant differences in the distribution of β-lactam MICs were observed between different world regions, particularly with respect to the Far East.

In this report, we describe a case of a 61-year-old male patient who had the bacterium growing in a blood culture. It was susceptible to ampicillin, ceftriaxone, levofloxacin, and vancomycin but was intermediately resistant to erythromycin. The patient did not have a negative outcome as a consequence of this bacterium, which retrospectively could have been predicted based on the epidemiological data within the patient's profile.

Introdução - Vibrio metschnikovii é um bacilo gram-negativo, potencialmente patogênico, amplamente distribuído e isolado de ecossistemas aquáticos e raramente de amostras clínicas de humanos. Na triagem laboratorial para espécies do gênero Vibrio, Vibrio metschnikovii é descartado por ser oxidase negativa, característica que o diferencia das demais espécies patogênicas. Em relação à pesquisa do perfil de suscetibilidade a antibióticos, esta é pouco realizada com isolados de origem ambiental. Objetivos - Isolar e identificar genotipicamente Vibrio metschnikovii de amostras ambientais e caracterizar seu perfil de suscetibilidade a antibióticos. Métodos - Um total de dez amostras foram obtidas de Março a Agosto de 2009, sendo uma de molusco (vôngole), três de peixe (pescada, sardinha e tainha) e seis de esgoto (três de esgoto bruto e três de esgoto tratado). O isolamento foi inicialmente realizado em meio seletivo para Vibrio (ágar TCBS) e a confirmação da espécie foi feita com iniciadores específicos através da PCR utilizando o DNA extraído pela técnica de choque térmico. O antibiograma foi realizado com base no documento M45-A CLSI 2006, seguindo a técnica de disco difusão, empregando quinze antibióticos. Foi realizada a pesquisa de genes de resistência a beta-lactâmicos e aminoglicosídeos. Resultados - De 123 isolados com características típicas para a espécie, 70 foram confirmados como Vibrio metschnikovii através da PCR, sendo 43 de amostras de molusco e peixes e 27 de esgoto. Um total de 66 isolados foi resistente a pelo menos um antibiótico, mas nenhum gene de resistência foi detectado. Conclusões - Os resultados indicam que Vibrio metschnikovii pode ser isolado de diferentes amostras de origem ambiental, demonstrando que esses microrganismos podem ter distribuição mais ampla que o descrito na literatura. A PCR foi uma ferramenta fundamental para superar a fragilidade da identificação da espécie segundo o método fenotípico. Além disso, a resistência observada mostra que Vibrio metschnikovii pode atuar como um reservatório de genes de resistência que podem ser facilmente transferidos entre microrganismos em um mesmo ambiente. O perfil de suscetibilidade a antibióticos pode ser utilizado como referência na caracterização clínica deste patógeno em potencial, auxiliando na conduta terapêutica em casos de ocorrência de doentes acometidos pelo microrganismo em questão / Introduction - Vibrio metschnikovii is a gram-negative bacillus, potentially pathogenic, widely distributed and isolated from aquatic ecosystems and rarely from human clinical samples. At laboratorial screening for the species of the Vibrio genus, Vibrio metschnikovii is discarded for being oxidase negative, characteristic that differentiates it from the others pathogenic species. With regard to the research of antibiotic susceptibility profile, this is seldom done with environmental isolates. Objectives - To isolate and genotypically identify Vibrio metschnikovii from environmental samples and characterize the antibiotic susceptibility profile. Method - A total of ten samples were obtained from March to August 2009, with one of them originated from mussel (vongole), tree of fish (whitefish, sardine and mullet) and six from sewage (three from raw sewage and three from treated sewage). The isolation was initially performed in a selective medium for Vibrio (TCBS agar) and the specie confirmation was done with specific primers through PCR using DNA extracted by the thermal shock technique. The antibiogram was performed according to the document M45-A from CLSI 2006, following the technique of disk diffusion, using fifteen antibiotics. The research for beta-lactams and aminoglycosides resistance genes was also performed. Results Seventy out of 123 isolates, with typical characteristics for the specie, were confirmed as Vibrio metschnikovii by PCR, with 43 originated from mussel and fish and 27 from sewage. A total of 66 isolates were resistant to at least one antibiotic, however no resistance gene was detected. Conclusions The results indicate that Vibrio metschnikovii can be isolated from different samples of ambient origin, demonstrating that these microorganisms can have wider distribution than the described in literature. The PCR was a fundamental tool to overcome the fragility of the specie identification according to the phenotypic method. Furthermore, the resistance found shows that Vibrio metschnikovii can act as a reservoir of resistance genes that can easily be transferred between microorganisms in the same environment. The antibiotic susceptibility profile can be used as reference at the clinical characterization of this potential pathogen, assisting therapeutic management in cases of patients affected by this microorganism

Introdução - Vibrio metschnikovii é um bacilo gram-negativo, potencialmente patogênico, amplamente distribuído e isolado de ecossistemas aquáticos e raramente de amostras clínicas de humanos. Na triagem laboratorial para espécies do gênero Vibrio, Vibrio metschnikovii é descartado por ser oxidase negativa, característica que o diferencia das demais espécies patogênicas. Em relação à pesquisa do perfil de suscetibilidade a antibióticos, esta é pouco realizada com isolados de origem ambiental. Objetivos - Isolar e identificar genotipicamente Vibrio metschnikovii de amostras ambientais e caracterizar seu perfil de suscetibilidade a antibióticos. Métodos - Um total de dez amostras foram obtidas de Março a Agosto de 2009, sendo uma de molusco (vôngole), três de peixe (pescada, sardinha e tainha) e seis de esgoto (três de esgoto bruto e três de esgoto tratado). O isolamento foi inicialmente realizado em meio seletivo para Vibrio (ágar TCBS) e a confirmação da espécie foi feita com iniciadores específicos através da PCR utilizando o DNA extraído pela técnica de choque térmico. O antibiograma foi realizado com base no documento M45-A CLSI 2006, seguindo a técnica de disco difusão, empregando quinze antibióticos. Foi realizada a pesquisa de genes de resistência a beta-lactâmicos e aminoglicosídeos. Resultados - De 123 isolados com características típicas para a espécie, 70 foram confirmados como Vibrio metschnikovii através da PCR, sendo 43 de amostras de molusco e peixes e 27 de esgoto. Um total de 66 isolados foi resistente a pelo menos um antibiótico, mas nenhum gene de resistência foi detectado. Conclusões - Os resultados indicam que Vibrio metschnikovii pode ser isolado de diferentes amostras de origem ambiental, demonstrando que esses microrganismos podem ter distribuição mais ampla que o descrito na literatura. A PCR foi uma ferramenta fundamental para superar a fragilidade da identificação da espécie segundo o método fenotípico. Além disso, a resistência observada mostra que Vibrio metschnikovii pode atuar como um reservatório de genes de resistência que podem ser facilmente transferidos entre microrganismos em um mesmo ambiente. O perfil de suscetibilidade a antibióticos pode ser utilizado como referência na caracterização clínica deste patógeno em potencial, auxiliando na conduta terapêutica em casos de ocorrência de doentes acometidos pelo microrganismo em questão / Introduction - Vibrio metschnikovii is a gram-negative bacillus, potentially pathogenic, widely distributed and isolated from aquatic ecosystems and rarely from human clinical samples. At laboratorial screening for the species of the Vibrio genus, Vibrio metschnikovii is discarded for being oxidase negative, characteristic that differentiates it from the others pathogenic species. With regard to the research of antibiotic susceptibility profile, this is seldom done with environmental isolates. Objectives - To isolate and genotypically identify Vibrio metschnikovii from environmental samples and characterize the antibiotic susceptibility profile. Method - A total of ten samples were obtained from March to August 2009, with one of them originated from mussel (vongole), tree of fish (whitefish, sardine and mullet) and six from sewage (three from raw sewage and three from treated sewage). The isolation was initially performed in a selective medium for Vibrio (TCBS agar) and the specie confirmation was done with specific primers through PCR using DNA extracted by the thermal shock technique. The antibiogram was performed according to the document M45-A from CLSI 2006, following the technique of disk diffusion, using fifteen antibiotics. The research for beta-lactams and aminoglycosides resistance genes was also performed. Results Seventy out of 123 isolates, with typical characteristics for the specie, were confirmed as Vibrio metschnikovii by PCR, with 43 originated from mussel and fish and 27 from sewage. A total of 66 isolates were resistant to at least one antibiotic, however no resistance gene was detected. Conclusions The results indicate that Vibrio metschnikovii can be isolated from different samples of ambient origin, demonstrating that these microorganisms can have wider distribution than the described in literature. The PCR was a fundamental tool to overcome the fragility of the specie identification according to the phenotypic method. Furthermore, the resistance found shows that Vibrio metschnikovii can act as a reservoir of resistance genes that can easily be transferred between microorganisms in the same environment. The antibiotic susceptibility profile can be used as reference at the clinical characterization of this potential pathogen, assisting therapeutic management in cases of patients affected by this microorganism

Staphylococcus epidermidis has emerged in recent years as an important nosocomial pathogen, especially in infections associated with implanted foreign body materials (e.g., prosthetic joints and heart valves) and in individuals with a compromised immune system (e.g., cancer patients and neonates). Although rare, implant infections are long lasting and cause severe suffering for the patient that includes pain and disability and even increased mortality. One aim of the present thesis was to develop and evaluate a genetic method for species identification and simultaneous detection of rifampicin resistance in staphylococci. A second aim was to examine S. epidermidis isolated from prosthetic joint infections (PJIs) and from wrists and nares of healthy individuals regarding their antibiotic susceptibility, biofilm production, virulence factors, and epidemiology. Comparison with phenotypic diagnostics revealed that 8 (16%) of 49 isolates differed in their species identification in favour of the genetic method. In addition, mutations associated with rifampicin resistance, including two not previously reported, were possible to detect in all isolates resistant to rifampicin. Antibiotic susceptibility testing of 61 PJI isolates showed multi-drug resistance in 91%. Furthermore, the results of the synergy testing revealed that no antibiotic combination was significantly better than the others. Hence, the effects that were possible to detect were isolate dependent. To find a method for discriminating between invasive (n=61) and commensal (n=24) isolates of S. epidermidis genotypic and phenotypic characterisations of biofilm production (including the ica and aap genes), antibiotic susceptibility, virulence-related genes (such as agr and ACME) and epidemiology were performed (using multilocus sequence typing [MLST], typing of the staphylococcal chromosome cassette mec [SCCmec] and PhenePlate). Significant differences were found in antibiotic susceptibility, i.e. there was more resistance among invasive isolates. MLST sequence types (ST) ST2 and ST215 dominated the invasive isolates.

Orientador: Caio Cezar Randi Ferraz / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-27T14:28:56Z (GMT). No. of bitstreams: 1 Sousa_EzilmaraLeonorRolimde_M.pdf: 8004287 bytes, checksum: 8e91f001cb2546659e03541d7dc0ebe7 (MD5) Previous issue date: 2000 / Resumo: Canais radiculares infectados tipicamente abrigam uma microbiota mista, composta principalmente por espécies anaeróbias. O papel das bactérias e seus subprodutos no desenvolvimento e perpetuação das infecções endodônticas já está bem estabelecido. Pesquisas têm sido realizadas para correlacionar a presença de bactérias em canais radiculares infectados com sinais e sintomas clínicos. A proposta do presente estudo foi investigar a composição da microbiota de canais radiculares infectados, associados a abscessos periapicais, e a possível correlação entre espécies bacterianas específicas com as fases dos abscessos, além de realizar testes de sensibilidade antimicrobiana das bactérias isoladas. As amostras microbiológica foram coletadas de 30 canais radiculares usando pontas de papel estéreis, transportadas em VMGA, diluídas, plaqueadas e incubadas em câmara de anaerobiose. Colônias microbianas foram isoladas, caracterizadas e identificadas por métodos padronizados. Cento e dezessete bactérias foram encontradas, sendo 75 (64,1 %) anaeróbias estritas. Uma ou mais (máximo de 10) espécies bacterianas foram encontradas em 29 (96,6%) canais radiculares infectados associados a abscessos periapicais, confirmando a característica polimicrobiana das infecções endodônticas. As bactérias anaeróbias mais freqüentemente isoladas foram: Peptostreptococcus prevotii (43,3%), Peptostreptococcus micros (30%), Fusobacterium necrophorum (23,3%). Embora menos freqüentes, bactérias facultativas como Gemella morbillorum (30%) e Streptococcus mitis (20%) também foram encontradas. Contudo, a análise estatística não encontrou relação entre presença dos abscessos periapicais com qualquer das espécies bacterianas identificadas (p>0,05). As espécies mais prevalentes Peptostreptococcus prevotii e Fusobacterium necrophorum foram testadas quanto à suscetibilidade antimicrobiana através do método do E­test, utilizando os seguintes antibióticos: benzilpenicilina, amoxicilina, amoxicilina + ácido clavulânico, metronidazol e clindamicina. Ps. prevotii e F. necrophorum apresentaram-se sensíveis a todos os antibióticos testados. Apesar da ausência de significância estatística, nossos resultados indicaram predominância de bactérias anaeróbias Gram-positivas e a presença de microbiota mista nos canais radiculares infectados associados a abscessos periapicais. Os testes de suscetibilidade antimicrobiana revelaram a presença de sensibilidade bacteriana entre as espécies Peptostreptococcus prevotii e Fusobacterium necrophorum aos antibióticos benzilpenicilina, amoxicilina, amoxicilina + ácido clavulânico, metronidazol e clindamicina / Abstract: Infected dental root canais typically harbour a mixed flora, including many anaerobic species. The role of these microorganisms and their by-products in the development and perpetuation of pulp and periapical diseases has already been well established. Efforts have been made in order to correlate bacteria present in infected dental root canais to clinical signs and symptoms. The present study was outlined to identify microorganisms present in root canais associated to periapical a bscesses , the correlation specific bacteria species with the phases of this inflammatory acute process, signs and symtoms and, to test the susceptibility of this microbiota to antibiotics. Microbiological samples were collected from 30 root canais using sterile paper points, transported in VMGA and diluted, plated and incubated in an anaerobic chamber. Microbial colonies were then purified, characterised and identified by established methods. One hundred seven different bacterial species were recovered, being 75 (64.1 %) strict anaerobes or microphilic species. One or more (maximum of 10) bacterial species were recovered from 29 (96.6%) root canais, showing the polymicrobial characteristic of dental infections. The anaerobes most frequently isolated were: Peptostreptococcus prevotii (43.3%), Peptostreptococcus micros (30%), Fusobacterium necrophorum (23.3%). Although less frequent, facultative bacteria as Gemella morbillorum (30%) e Streptococcus mitis (20%) were also found. However, statistical analysis by a Pearson X2 test or a one-sided Fisher's exact test did not find statistical relationship between any bacterial specie identified and the presence of periapical abscesses (p>0.05). Antibiotic sensitivity of Peptostreptococcus prevotii e Fusobacterium necrophorum was accomplished with the E-test System. These bacterial isolates were tested for their susceptibility/resistance to benzylpenicilin, amoxiciln, amoxicilin combined with clavulanate and clindamycin. The species Peptostreptococcus prevotii and Fusobacterium necrophorum were susceptible to ali tested antibiotics. In spite of the lack of statistical significance, our results indicated predominance of Gram-positive anaerobic bacteria at the mixed microflora present in dental root canais associated with periapical abscesses. Antibiotic susceptibility data showed Peptostreptococcus prevotii and Fusobacterium necrophorum susceptibility to ali tested antibiotics / Mestrado / Endodontia / Mestre em Clínica Odontológica

Orientador: Caio Cezar Randi Ferraz / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-02T20:01:54Z (GMT). No. of bitstreams: 1 Sousa_EzilmaraLeonorRolimde_D.pdf: 6699561 bytes, checksum: a7e05e747b868e98926396a2a1fc5d99 (MD5) Previous issue date: 2003 / Resumo: O objetivo deste estudo foi investigar a composição da microbiota de canais radiculares infectados associados a abscessos periapicais; analisar a correlação entre espécies bacterianas específicas com a localização clínica dos abscessos periapicais, sinais e sintomas e testar a suscetibilidade de bactérias anaeróbias estritas prevalentes. As amostras microbiológicas foram coletadas de 60 canais radiculares usando pontas de papel estéreis, transportadas em RTF, diluídas, plaqueadas e incubadas em câmara de anaerobiose. Colônias microbianas foram isoladas, caracterizadas e identificadas por métodos padronizados. Das 287 diferentes espécies bacterianas, 201 eram anaeróbias estritas. Uma ou mais (máximo de 14) espécies bacterianas foram recuperadas de 59 (98,3%) canais radiculares, confirmando a característica polimicrobiana das infecções endodônticas. As bactérias anaeróbias estritas mais freqüentemente isoladas foram: Peptostreptococcus prevotii (22/60), Peptostreptococcus micros (19/60), Fusobacterium necrophorum (19/60). Embora menos freqüentes, bactérias facultativas como Gemella morbillorum (19/60), Streptococcus mitis (13/60), e Streptococcus sanguis (11/60)também foram encontradas. O teste de Pearson ou teste exato de Fisher mostrou que houve relação positiva de algumas espécies bacterianas com a localização do abscesso periapical, bem como, com alguns sinais e sintomas de origem endodôntica (p<0,05). Os resultados indicaram predominância de bactérias anaeróbias Gram-positivas e a presença de microbiota mista nos canais radiculares infectados associados a abscessos periapicais. O método do E-test revelou sensibilidade bacteriana das espécies testadas aos antibióticos benzilpenicilina, amoxicilina, amoxicilinalclavulanato de potássio, metronidazol, clindamicina e cefaclor, contudo, certos microrganismos foram resistentes a azitromicina e eritromicina. Enquanto que, nenhum dos microrganismos testados produziu 'beta¿-lactamase / Abstract: The aim of this study was to investigate the composition of the microbiota of infected root canaIs associated with periapical abscesses, to investigate the correlation of specific species of bacteria with the clinical localization of the periapical abscesses, signs, and symptoms, and to test the susceptibility of prevalent strict anaerobic bacteria isolated. Microbiological samples were collected from 60 root canals using sterile paper points, transported in RTF and diluted, plated and incubated in an anaerobic chamber. Microbial colonies were then purified, characterized and identified by established methods. Of the 287 different bacterial species recovered, 201 were strict anaerobes or microphilic species. One or more (maximum of 14) bacterial species were recovered from 59 (98.3%) root canals, showing the polymicrobial characteristic of endodontic infections. The most frequently strict anaerobes isolated were: Peptostreptococcus prevotii (22/60), Peptostreptococcus micros (19/60), Fusobacterium necrophorum (19/60). Although less frequent, facultative bacteria such as Gemella morbillorum (19/60), Streptococcus mitis (13/60), and Streptococcus sanguis (11/60) were also found. The Pearson X 'POT. 2¿ test or Fisher's exat test showed positive relationship among some bacterial species and the localization of periapical abscesses as well as with some endodontic signs and symptoms (p<0.05). Results indicated predominance of Gram-positive anaerobic bacteria in the mixed microbiota of dental root canals associated with periapical abscesses. The E-test revealed bacterial susceptibility to benzylpenicillin, amoxicillin, amoxicillin/potassium clavulanate, clindamycin and cefaclor. All microorganisms tested did not produce 'beta¿-lactamase / Doutorado / Endodontia / Doutor em Clínica Odontológica

Au cours des dernières années, l’automatisation en bactériologie clinique est devenue très importante du fait de l’augmentation constante du nombre d’échantillons mais nécessite tout de même des améliorations. Une revue a été rédigée pour présenter les nouveaux challenges et opportunités dans la surveillance et la détection des bactéries multi-résistantes. Premièrement nous avons testé de nouveaux outils technologiques innovants permettant la lecture plus précoce des antibiogrammes grâce à des scanners de haute résolution d’images: scanner Advencis Bio-System Incubator et le Scan® 1200 et de réaliser l’ensemencement des antibiogrammes en automatique sur un automate déjà existant le PREVI® Isola (bioMérieux, Marcy l’Etoile, France). Dans un second temps, une analyse rétrospective de la résistance aux antibiotiques observés sur l’hôpital la Timone à Marseille a été réalisé entre 2014 et 2016. Nous avons développer un logiciel d’interprétation automatique des phénotypes basé sur la reconnaissance d’images pour lequel un brevet a été rédigé : le logiciel « ANTI-LOGIC ». Le but de notre troisième travail a été de participer au développement d’une PCR en temps réel permettant de détecter le gène mcr-1. Puis, nous avons travaillé sur des souches multi-résistantes afin de tester un panel constitué de 29 à 32 antibiotiques. Pour la détection des souches résistantes à la colistine, un milieu de culture sélectif a été mis au point et nous avons essayé de trouver une alternative thérapeutique par l’étude de combinaisons d’anciens antibiotiques (colistine-sulfadiazine) pour le traitement et la décolonisation avant greffe fécale de patients infectés ou colonisés par des BMR. / In the last few years, automation in clinical microbiology has become very important due to the constant increase of samples but they need to be improved. A review of the literature was performed to expose the new challenges and the new opportunities in the surveillance and the detection of multi-drug resistance bacteria.For that purpose, we conduct a thorough search to test new innovative technological tools for reading earlier AST with high-resolution image scanner: Advencis Bio-System Incubator and the Scan® 1200 and to carry out the automatic seeding of AST with the PREVI® Isola system (bioMérieux, Marcy l’Etoile, France). In a second step, the retrospective analysis of antibiotic resistance and phenotypes observed at La Timone hospital in Marseille was carried out between 2014 and 2016. We have developped a new software for the automatic interpretation of phenotypes based on image recognition protected by a patent: the "ANTI-LOGIC" software. The aim of our third work was to participate on the development of a real-time PCR to detect the mcr-1 gene. We then worked on multi-resistant strains with Gram-negative bacteria, we have tested a large panel of 29-32 antibiotics to see if we are in a therapeutic stalemate. For the detection of colistin resistant strains, a selective culture medium has been developed. In order to finish this part, with the appearance of colistin-resistant strains, we tried to find a therapeutic alternative by studying combinations of old antibiotics (colistin-sulfadiazine) for the treatment and decolonization before faecal transplantation of patients infected or colonized by multi-resistant bacteria