WorldWideScience

Sample records for ceftriaxone

  1. Cholestatic hepatitis with intravenous ceftriaxone

    Directory of Open Access Journals (Sweden)

    Inderpal Kaur

    2011-01-01

    Full Text Available Drug-induced liver injury is a major health problem. Its predominant forms include acute hepatitis, cholestasis, and a mixed pattern. Ceftriaxone is a third-generation cephalosporin and is widely used in the postoperative period due to its wider spectrum, longer half-life, and better tissue penetrability. Earlier cases of high aminotransferase levels and hepatitis have also been reported with the use of ceftriaxone. Here we report a case of cholestatic hepatitis with intravenous ceftriaxone.

  2. Ceftriaxone-induced toxic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Erdal Peker; Eren Cagan; Murat Dogan

    2009-01-01

    Toxic hepatitis or drug-induced liver injury encompasses a spectrum of clinical disease ranging from mild biochemical abnormalities to acute liver failure. The advantages of a long half-life, wide spectrum, high tissue penetration rate, and a good safety profile,make ceftriaxone, a third-generation cephalosporin,a frequent choice in the treatment of childhood infections. Previous studies have reported a few cases of high aspartate aminotransferase and alanine aminotransferase levels, along with three cases ofhepatitis caused by ceftriaxone. Here, we report a case of drug-induced toxic hepatitis in a patient who was treated with ceftriaxone for acute tonsillitis.

  3. Ceftriaxone: in vitro studies and clinical evaluation.

    OpenAIRE

    Gnann, J. W.; Goetter, W E; Elliott, A M; Cobbs, C G

    1982-01-01

    The in vitro activity of ceftriaxone against 437 clinical isolates of gram-negative bacilli was determined. Ceftriaxone was found to have high in vitro activity against Enterobacteriaceae, with the exception of Enterobacter cloacae. Ceftriaxone was only minimally active against Pseudomonas aeruginosa and Acinetobacter calcoaceticus. We evaluated the clinical efficacy and toxicity of ceftriaxone in 55 adult patients. Bacterial infection was confirmed by the isolation of etiological bacteria in...

  4. Acute urine retention induced by ceftriaxone

    Directory of Open Access Journals (Sweden)

    Kamal F Akl

    2011-01-01

    Full Text Available Ceftriaxone is known to cause biliary pseudolithiasis and, rarely, nephrolithiasis. When used in neonates receiving intravenous calcium, fatal lung and kidney calcifications occur. There is no satisfactory explanation for the pseudolithiasis, and the mechanism of stone formation remains unknown. Herein, we report a child with acute urinary retention (AUR secondary to ceftriaxone therapy. The AUR developed on the second hospital day. The urinary excretion of uric acid was elevated. In retrospect, there was a positive paternal family history of gout and stones. A positive family history of gout or stones is a pointer to the possibility of AUR or urolithiasis in patients on treatment with ceftriaxone. If urinary symptoms develop, it is worth checking for crystalluria. This will avoid many unnecessary investigations and procedures.

  5. Ceftriaxone-associated nephrolithiasis and biliary pseudolithiasis in a child

    International Nuclear Information System (INIS)

    Ceftriaxone is a widely used third-generation cephalosporin. It is generally very safe, but complications of biliary pseudolithiasis and, rarely, nephrolithiasis have been reported in children. These complications generally resolve spontaneously with cessation of the ceftriaxone therapy; however, they may symptomatically mimic more serious clinical problems, such as cholecystitis. We report a case of both ceftriaxone-induced biliary pseudolithiasis and nephrolithiasis. (orig.)

  6. Ceftriaxone-associated nephrolithiasis and biliary pseudolithiasis in a child

    Energy Technology Data Exchange (ETDEWEB)

    Prince, Jeffrey S. [Department of Radiology, UCSD Medical Center, 200 West Arbor Dr., Mail Code 8756, San Diego, CA 92103-8756 (United States); Senac, Melvin O. [Department of Radiology, Children' s Hospital and Health Center, 3020 Children' s Way, San Diego, CA 92123-4282 (United States)

    2003-09-01

    Ceftriaxone is a widely used third-generation cephalosporin. It is generally very safe, but complications of biliary pseudolithiasis and, rarely, nephrolithiasis have been reported in children. These complications generally resolve spontaneously with cessation of the ceftriaxone therapy; however, they may symptomatically mimic more serious clinical problems, such as cholecystitis. We report a case of both ceftriaxone-induced biliary pseudolithiasis and nephrolithiasis. (orig.)

  7. EFFECTS OF CEFTRIAXONE ON FECAL FLORA - ANALYSIS BY MICROMORPHOMETRY

    NARCIS (Netherlands)

    MEIJER, BC; KOOTSTRA, GJ; GEERTSMA, DG; WILKINSON, MHF

    1991-01-01

    In order to elucidate the effect of ceftriaxone therapy on the morphology of gut microflora, 11 human volunteers were treated with ceftriaxone, 1 g daily, given intramuscularly in one dose. Treatment continued for 5 days. Faecal microflora was analysed by digital image processing before, during and

  8. In vitro activity of ertapenem versus ceftriaxone against Neisseria gonorrhoeae isolates with highly diverse ceftriaxone MIC values and effects of ceftriaxone resistance determinants: ertapenem for treatment of gonorrhea?

    Science.gov (United States)

    Unemo, Magnus; Golparian, Daniel; Limnios, Athena; Whiley, David; Ohnishi, Makoto; Lahra, Monica M; Tapsall, John W

    2012-07-01

    Clinical resistance to the currently recommended extended-spectrum cephalosporins (ESCs), the last remaining treatment options for gonorrhea, is being reported. Gonorrhea may become untreatable, and new treatment options are crucial. We investigated the in vitro activity of ertapenem, relative to ceftriaxone, against N. gonorrhoeae isolates and the effects of ESC resistance determinants on ertapenem. MICs were determined using agar dilution technique or Etest for international reference strains (n = 17) and clinical N. gonorrhoeae isolates (n = 257), which included the two extensively drug-resistant (XDR) strains H041 and F89 and additional isolates with high ESC MICs, clinical ESC resistance, and other types of clinical high-level and multidrug resistance (MDR). Genetic resistance determinants for ESCs (penA, mtrR, and penB) were sequenced. In general, the MICs of ertapenem (MIC(50) = 0.032 μg/ml; MIC(90) = 0.064 μg/ml) paralleled those of ceftriaxone (MIC(50) = 0.032 μg/ml; MIC(90) = 0.125 μg/ml). The ESC resistance determinants mainly increased the ertapenem MIC and ceftriaxone MIC at similar levels. However, the MIC ranges for ertapenem (0.002 to 0.125 μg/ml) and ceftriaxone (ceftriaxone-resistant isolates (MIC = 0.5 to 4 μg/ml) had ertapenem MICs of 0.016 to 0.064 μg/ml. Accordingly, ertapenem had in vitro advantages over ceftriaxone for isolates with ceftriaxone resistance. These in vitro results suggest that ertapenem might be an effective treatment option for gonorrhea, particularly for the currently identified ESC-resistant cases and possibly in a dual antimicrobial therapy regimen. However, further knowledge regarding the genetic determinants (and their evolution) conferring resistance to both antimicrobials, and clear correlates between genetic and phenotypic laboratory parameters and clinical treatment outcomes, is essential.

  9. Novel Genes Related to Ceftriaxone Resistance Found among Ceftriaxone-Resistant Neisseria gonorrhoeae Strains Selected In Vitro.

    Science.gov (United States)

    Gong, Zijian; Lai, Wei; Liu, Min; Hua, Zhengshuang; Sun, Yayin; Xu, Qingfang; Xia, Yue; Zhao, Yue; Xie, Xiaoyuan

    2016-04-01

    The emergence of ceftriaxone-resistantNeisseria gonorrhoeaeis currently a global public health concern. However, the mechanism of ceftriaxone resistance is not yet fully understood. To investigate the potential genes related to ceftriaxone resistance inNeisseria gonorrhoeae, we subcultured six gonococcal strains with increasing concentrations of ceftriaxone and isolated the strains that became resistant. After analyzing several frequently reported genes involved in ceftriaxone resistance, we found only a single mutation inpenA(A501V). However, differential analysis of the genomes and transcriptomes between pre- and postselection strains revealed many other mutated genes as well as up- and downregulated genes. Transformation of the mutatedpenAgene into nonresistant strains increased the MIC between 2.0- and 5.3-fold, and transformation of mutatedftsXincreased the MIC between 3.3- and 13.3-fold. Genes encoding the ABC transporters FarB, Tfq, Hfq, and ExbB were overexpressed, whilepilM,pilN, andpilQwere downregulated. Furthermore, the resistant strain developed cross-resistance to penicillin and cefuroxime, had an increased biochemical metabolic rate, and presented fitness defects such as prolonged growth time and downregulated PilMNQ. In conclusion, antimicrobial pressure could result in the emergence of ceftriaxone resistance, and the evolution of resistance ofNeisseria gonorrhoeaeto ceftriaxone is a complicated process at both the pretranscriptional and posttranscriptional levels, involving several resistance mechanisms of increased efflux and decreased entry. PMID:26787702

  10. Novel Genes Related to Ceftriaxone Resistance Found among Ceftriaxone-Resistant Neisseria gonorrhoeae Strains Selected In Vitro.

    Science.gov (United States)

    Gong, Zijian; Lai, Wei; Liu, Min; Hua, Zhengshuang; Sun, Yayin; Xu, Qingfang; Xia, Yue; Zhao, Yue; Xie, Xiaoyuan

    2016-04-01

    The emergence of ceftriaxone-resistantNeisseria gonorrhoeaeis currently a global public health concern. However, the mechanism of ceftriaxone resistance is not yet fully understood. To investigate the potential genes related to ceftriaxone resistance inNeisseria gonorrhoeae, we subcultured six gonococcal strains with increasing concentrations of ceftriaxone and isolated the strains that became resistant. After analyzing several frequently reported genes involved in ceftriaxone resistance, we found only a single mutation inpenA(A501V). However, differential analysis of the genomes and transcriptomes between pre- and postselection strains revealed many other mutated genes as well as up- and downregulated genes. Transformation of the mutatedpenAgene into nonresistant strains increased the MIC between 2.0- and 5.3-fold, and transformation of mutatedftsXincreased the MIC between 3.3- and 13.3-fold. Genes encoding the ABC transporters FarB, Tfq, Hfq, and ExbB were overexpressed, whilepilM,pilN, andpilQwere downregulated. Furthermore, the resistant strain developed cross-resistance to penicillin and cefuroxime, had an increased biochemical metabolic rate, and presented fitness defects such as prolonged growth time and downregulated PilMNQ. In conclusion, antimicrobial pressure could result in the emergence of ceftriaxone resistance, and the evolution of resistance ofNeisseria gonorrhoeaeto ceftriaxone is a complicated process at both the pretranscriptional and posttranscriptional levels, involving several resistance mechanisms of increased efflux and decreased entry.

  11. Evaluation of a Potential Clinical Interaction between Ceftriaxone and Calcium▿

    Science.gov (United States)

    Steadman, Emily; Raisch, Dennis W.; Bennett, Charles L.; Esterly, John S.; Becker, Tischa; Postelnick, Michael; McKoy, June M.; Trifilio, Steve; Yarnold, Paul R.; Scheetz, Marc H.

    2010-01-01

    In April 2009, the FDA retracted a warning asserting that ceftriaxone and intravenous calcium products should not be coadministered to any patient to prevent precipitation events leading to end-organ damage. Following that announcement, we sought to evaluate if the retraction was justified. A search of the FDA Adverse Event Reporting System was conducted to identify any ceftriaxone-calcium interactions that resulted in serious adverse drug events. Ceftazidime-calcium was used as a comparator agent. One hundred four events with ceftriaxone-calcium and 99 events with ceftazidime-calcium were identified. Adverse drug events were recorded according to the listed description of drug involvement (primary or secondary suspect) and were interpreted as probable, possible, unlikely, or unrelated. For ceftriaxone-calcium-related adverse events, 7.7% and 20.2% of the events were classified as probable and possible for embolism, respectively. Ceftazidime-calcium resulted in fewer probable embolic events (4%) but more possible embolic events (30.3%). Among cases that considered ceftriaxone or ceftazidime and calcium as the primary or secondary drug, one case was classified as a probable embolic event. That patient received ceftriaxone-calcium and died, although an attribution of causality was not possible. Our analysis suggests a lack of support for the occurrence of ceftriaxone-calcium precipitation events in adults. The results of the current analysis reinforce the revised FDA recommendations suggesting that patients >28 days old may receive ceftriaxone and calcium sequentially and provide a transparent and reproducible methodology for such evaluations. PMID:20086152

  12. Ceftriaxone attenuates hypoxic-ischemic brain injury in neonatal rats

    Directory of Open Access Journals (Sweden)

    Huang Yen

    2011-09-01

    Full Text Available Abstract Background Perinatal brain injury is the leading cause of subsequent neurological disability in both term and preterm baby. Glutamate excitotoxicity is one of the major factors involved in perinatal hypoxic-ischemic encephalopathy (HIE. Glutamate transporter GLT1, expressed mainly in mature astrocytes, is the major glutamate transporter in the brain. HIE induced excessive glutamate release which is not reuptaked by immature astrocytes may induce neuronal damage. Compounds, such as ceftriaxone, that enhance the expression of GLT1 may exert neuroprotective effect in HIE. Methods We used a neonatal rat model of HIE by unilateral ligation of carotid artery and subsequent exposure to 8% oxygen for 2 hrs on postnatal day 7 (P7 rats. Neonatal rats were administered three dosages of an antibiotic, ceftriaxone, 48 hrs prior to experimental HIE. Neurobehavioral tests of treated rats were assessed. Brain sections from P14 rats were examined with Nissl and immunohistochemical stain, and TUNEL assay. GLT1 protein expression was evaluated by Western blot and immunohistochemistry. Results Pre-treatment with 200 mg/kg ceftriaxone significantly reduced the brain injury scores and apoptotic cells in the hippocampus, restored myelination in the external capsule of P14 rats, and improved the hypoxia-ischemia induced learning and memory deficit of P23-24 rats. GLT1 expression was observed in the cortical neurons of ceftriaxone treated rats. Conclusion These results suggest that pre-treatment of infants at risk for HIE with ceftriaxone may reduce subsequent brain injury.

  13. Neuroprotective potential of ceftriaxone in in vitro models of stroke.

    Science.gov (United States)

    Lipski, J; Wan, C K; Bai, J Z; Pi, R; Li, D; Donnelly, D

    2007-05-11

    Astrocytic glutamate transporters are considered an important target for neuroprotective therapies as the function of these transporters is abnormal in stroke and other neurological disorders associated with excitotoxicity. Recently, Rothstein et al., [Rothstein JD, Patel S, Regan MR, Haenggeli C, Huang YH, Bergles DE, Jin L, Dykes Hoberg M, Vidensky S, Chung DS, Toan SV, Bruijn LI, Su ZZ, Gupta P, Fisher PB (2005) Beta-lactam antibiotics offer neuroprotection by increasing glutamate transporter expression. Nature 433:73-77] reported that beta-lactam antibiotics (including ceftriaxone, which easily crosses the blood-brain barrier) increase glutamate transporter 1 (GLT-1) expression and reduce cell death resulting from oxygen-glucose deprivation (OGD) in dissociated embryonic cortical cultures. To determine whether a similar neuroprotective mechanism operates in more mature neurons, which show a different pattern of response to ischemia than primary cultures, we exposed acute hippocampal slices obtained from rats treated with ceftriaxone for 5 days (200 mg/kg; i.p.) to OGD. Whole-cell patch clamp recording of glutamate-induced N-methyl-d-aspartate (NMDA) currents from CA1 pyramidal neurons showed a larger potentiation of these currents after application of 15 microM dl-threo-beta-benzyloxyaspartic acid (TBOA; a potent blocker of glutamate transporters) in ceftriaxone-injected animals than in untreated animals, indicating increased glutamate transporter activity. Western blot analysis did not reveal GLT-1 upregulation in the hippocampus. Delay to OGD-induced hypoxic spreading depression (HSD) recorded in slices obtained from ceftriaxone-treated rats was longer (6.3+/-0.2 vs. 5.2+/-0.2 min; Paction of the antibiotic in this model. The effect of ceftriaxone was also tested in organotypic hippocampal slices obtained from P7-9 rats (>14 days in vitro). OGD or glutamate (3.5-5.0 mM) damaged CA1 pyramidal neurons as assessed by propidium iodide (PI) fluorescence. Similar

  14. Influence of dexamethasone on efficacy of ceftriaxone and vancomycin therapy in experimental pneumococcal meningitis.

    OpenAIRE

    Cabellos, C; Martinez-Lacasa, J; A. Martos; Tubau, F.; Fernández, A.; Viladrich, P F; Gudiol, F.

    1995-01-01

    Using a rabbit model of meningitis, we sought to determine whether concomitant use of dexamethasone affects the penetration and efficacy of ceftriaxone or vancomycin in cerebrospinal fluid. Rabbits were inoculated with a penicillin-sensitive strain of Streptococcus pneumoniae and treated with ceftriaxone or vancomycin with or without dexamethasone. In the ceftriaxone-treated groups, no statistically significant differences were seen between the group treated with dexamethasone and that withou...

  15. Intraoperative Anaphylaxis to Inj Ceftriaxone: Here We Go Again

    Directory of Open Access Journals (Sweden)

    Amit G Bhagwat

    2008-01-01

    Full Text Available Anaphylactic reactions to intraoperative antibiotics are rare events and reactions after a negative intradermal skin testing are even rarer. We are reporting a case of grade V anaphylactic reaction to ceftriaxone, which occurred inspite of a negative skin testing preoperatively. Despite of the treatment along the established guidelines, patient suffered hypoxic brain damage ultimately having a fatal outcome 7 days later. This case highlights the limits of the screening test done preoperatively for antibiotic sensitivity and also the difficulty in resuscitating anaphylactic reac-tions when patient is on B blocker and under spinal anaesthesia.

  16. Quality of ceftriaxone in Pakistan: reality and resonance.

    Science.gov (United States)

    Obaid, Ali

    2009-04-01

    The quality of pharmaceuticals is a global concern, counterfeit/ poor quality/ substandard medicines can cause harms in various ways: In a number of developing countries including Pakistan there is reportedly a high incidence of the availability of substandard drugs. The majority of these reports do not contain quantitative data to support these claims, nor do they describe the methodology employed for the quality assessment. Quality of drugs available in Pakistan are being questioned and topic of discussion in local news paper, TV channels in general public including journalist and physicians due to disparity of price among same generics, lack of knowledge for such science and unknown reasons. Since, quality of drugs can neither be assessed by naked eye or by every one therefore, randomly selected, 96 samples of different strength of injection ceftriaxone sodium and its generic, a widely used third generation cephalosporin in Pakistan since 1982 and 1994 till date respectively included in the said study to know the reality. 15.62% of ceftriaxone injection was found to be out of specification, however, not a single sample was found fake (spurious) out of 96 tested samples. Nevertheless, quality is a wide ranging concept covering all matters that individually or collectively influence the excellence of a product hence price and other related issues are also analyzed in the study. PMID:19339236

  17. Agar diffusion tests with cefuroxime disks for predicting ceftriaxone susceptibility among isolates of Streptococcus pneumoniae

    Directory of Open Access Journals (Sweden)

    Dias Cícero A.G.

    1998-01-01

    Full Text Available The performance of agar diffusion tests using disks of cefuroxime (30µg for predicting ceftriaxone susceptibility in 33 isolates of Streptococcus pneumoniae was studied. All 7 resistant isolates to ceftriaxone (MIC ³1.0 µg/ml exhibited zones of inhibition <28mm. The procedure can be easily adapted to clinical laboratories.

  18. Ceftriaxone attenuates cocaine relapse after abstinence through modulation of nucleus accumbens AMPA subunit expression.

    Science.gov (United States)

    LaCrosse, Amber L; Hill, Kristine; Knackstedt, Lori A

    2016-02-01

    Using the extinction-reinstatement model of cocaine relapse, we and others have demonstrated that the antibiotic ceftriaxone attenuates cue- and cocaine-primed reinstatement of cocaine-seeking. Reinstatement is contingent on the release of glutamate in the nucleus accumbens core (NAc) and manipulations that reduce glutamate efflux or block post-synaptic glutamate receptors attenuate reinstatement. We have demonstrated that the mechanism of action by which ceftriaxone attenuates reinstatement involves increased NAc GLT-1 expression and a reduction in NAc glutamate efflux during reinstatement. Here we investigated the effects of ceftriaxone (100 and 200 mg/kg) on context-primed relapse following abstinence without extinction training and examined the effects of ceftriaxone on GluA1, GluA2 and GLT-1 expression. We conducted microdialysis during relapse to determine if an increase in NAc glutamate accompanies relapse after abstinence and whether ceftriaxone blunts glutamate efflux. We found that both doses of ceftriaxone attenuated relapse. While relapse was accompanied by an increase in NAc glutamate, ceftriaxone (200 mg/kg) was unable to significantly reduce NAc glutamate efflux during relapse despite its ability to upregulate GLT-1. GluA1 was reduced in the NAc by both doses of ceftriaxone while GluA2 expression was unchanged, indicating that ceftriaxone altered AMPA subunit composition following cocaine. Finally, GLT-1 was not altered in the PFC by ceftriaxone. These results indicate that it is possible to attenuate context-primed relapse to cocaine-seeking through modification of post-synaptic receptor properties without attenuating glutamate efflux during relapse. Furthermore, increasing NAc GLT-1 protein expression is not sufficient to attenuate glutamate efflux.

  19. Ceftriaxone attenuates cocaine relapse after abstinence through modulation of nucleus accumbens AMPA subunit expression.

    Science.gov (United States)

    LaCrosse, Amber L; Hill, Kristine; Knackstedt, Lori A

    2016-02-01

    Using the extinction-reinstatement model of cocaine relapse, we and others have demonstrated that the antibiotic ceftriaxone attenuates cue- and cocaine-primed reinstatement of cocaine-seeking. Reinstatement is contingent on the release of glutamate in the nucleus accumbens core (NAc) and manipulations that reduce glutamate efflux or block post-synaptic glutamate receptors attenuate reinstatement. We have demonstrated that the mechanism of action by which ceftriaxone attenuates reinstatement involves increased NAc GLT-1 expression and a reduction in NAc glutamate efflux during reinstatement. Here we investigated the effects of ceftriaxone (100 and 200 mg/kg) on context-primed relapse following abstinence without extinction training and examined the effects of ceftriaxone on GluA1, GluA2 and GLT-1 expression. We conducted microdialysis during relapse to determine if an increase in NAc glutamate accompanies relapse after abstinence and whether ceftriaxone blunts glutamate efflux. We found that both doses of ceftriaxone attenuated relapse. While relapse was accompanied by an increase in NAc glutamate, ceftriaxone (200 mg/kg) was unable to significantly reduce NAc glutamate efflux during relapse despite its ability to upregulate GLT-1. GluA1 was reduced in the NAc by both doses of ceftriaxone while GluA2 expression was unchanged, indicating that ceftriaxone altered AMPA subunit composition following cocaine. Finally, GLT-1 was not altered in the PFC by ceftriaxone. These results indicate that it is possible to attenuate context-primed relapse to cocaine-seeking through modification of post-synaptic receptor properties without attenuating glutamate efflux during relapse. Furthermore, increasing NAc GLT-1 protein expression is not sufficient to attenuate glutamate efflux. PMID:26706696

  20. New Ceftriaxone- and Multidrug-Resistant Neisseria gonorrhoeae Strain with a Novel Mosaic penA Gene Isolated in Japan.

    Science.gov (United States)

    Nakayama, Shu-Ichi; Shimuta, Ken; Furubayashi, Kei-Ichi; Kawahata, Takuya; Unemo, Magnus; Ohnishi, Makoto

    2016-07-01

    We have characterized in detail a new ceftriaxone- and multidrug-resistant Neisseria gonorrhoeae strain (FC428) isolated in Japan in 2015. FC428 differed from previous ceftriaxone-resistant strains and contained a novel mosaic penA allele encoding a new mosaic penicillin-binding protein 2 (PBP 2). However, the resistance-determining 3'-terminal region of penA was almost identical to the regions of two previously reported ceftriaxone-resistant strains from Australia and Japan, indicating that both ceftriaxone-resistant strains and conserved ceftriaxone resistance-determining PBP 2 regions might spread. PMID:27067334

  1. New Ceftriaxone- and Multidrug-Resistant Neisseria gonorrhoeae Strain with a Novel Mosaic penA Gene Isolated in Japan.

    Science.gov (United States)

    Nakayama, Shu-Ichi; Shimuta, Ken; Furubayashi, Kei-Ichi; Kawahata, Takuya; Unemo, Magnus; Ohnishi, Makoto

    2016-07-01

    We have characterized in detail a new ceftriaxone- and multidrug-resistant Neisseria gonorrhoeae strain (FC428) isolated in Japan in 2015. FC428 differed from previous ceftriaxone-resistant strains and contained a novel mosaic penA allele encoding a new mosaic penicillin-binding protein 2 (PBP 2). However, the resistance-determining 3'-terminal region of penA was almost identical to the regions of two previously reported ceftriaxone-resistant strains from Australia and Japan, indicating that both ceftriaxone-resistant strains and conserved ceftriaxone resistance-determining PBP 2 regions might spread.

  2. Simultaneous processes of electricity generation and ceftriaxone sodium degradation in an air-cathode single chamber microbial fuel cell

    Science.gov (United States)

    Wen, Qing; Kong, Fanying; Zheng, Hongtao; Yin, Jinling; Cao, Dianxue; Ren, Yueming; Wang, Guiling

    2011-03-01

    A single chamber microbial fuel cell (MFC) with an air-cathode is successfully demonstrated using glucose-ceftriaxone sodium mixtures or ceftriaxone sodium as fuel. Results show that the ceftriaxone sodium can be biodegraded and produce electricity simultaneously. Interestingly, these ceftriaxone sodium-glucose mixtures play an active role in production of electricity. The maximum power density is increased in comparison to 1000 mg L-1 glucose (19 W m-3) by 495% for 50 mg L-1 ceftriaxone sodium + 1000 mg L-1 glucose (113 W m-3), while the maximum power density is 11 W m-3 using 50 mg L-1 ceftriaxone sodium as the sole fuel. Moreover, ceftriaxone sodium biodegradation rate reaches 91% within 24 h using the MFC in comparison with 51% using the traditional anaerobic reactor. These results indicate that some toxic and bio-refractory organics such as antibiotic wastewater might be suitable resources for electricity generation using the MFC technology.

  3. Antimicrobial Activity of Ceftriaxone Compared with Cefotaxime in the Presence of Serum Albumin

    Directory of Open Access Journals (Sweden)

    Swapan K Nath

    1995-01-01

    Full Text Available The effect of serum albumin on the antimicrobial activity of ceftriaxone, cefotaxime, and a 1:1 ratio of cefotaxime and its desacetyl metabolite against nonpseudomonal Gram-negative bacilli was determined. Antimicrobial activity of drugs was evaluated by measuring minimum inhibitory (mic and bactericidal (mbc concentrations in broth with and without human serum albumin. The analysis of logarithmically transformed mean mics and mbcs showed that there was a highly significant interaction between drug and serum albumin (P<0.0001. The inhibitory and bactericidal activities were greatest for cefotaxime followed by cefotaxime/desacetylcefotaxime and ceftriaxone (P<0.01. Time-kill kinetics demonstrated that ceftriaxone was less bactericidal than cefotaxime in broth with albumin. On the basis of these results it was concluded that the in vitro antimicrobial activity of ceftriaxone compared with that of cefotaxime was significantly diminished in the presence of serum albumin.

  4. A drug interaction study of ceftriaxone and frusemide in healthy volunteers.

    Science.gov (United States)

    Korn, A; Eichler, H G; Gasic, S

    1986-05-01

    Ceftriaxone, a recently developed cephalosporin significantly reduced the diuretic activity of frusemide in rats. For this reason and because an interaction of unknown mechanism is well established between frusemide and some cephalosporins, we studied the interference of ceftriaxone with the diuretic effect of frusemide in healthy volunteers. Twelve subjects received frusemide (40 mg p.o.) or placebo in combination with ceftriaxone (2 g i.v.) or saline on 4 different days (cross-over, randomized, single-blind study). Urine was collected in small portions during 24 hours after medication and analyzed for volume, osmolality, Na+, K+, Cl- and creatinine concentration. Ceftriaxone had neither an effect on basal urinary output and electrolyte excretion nor on the specific diuretic action of frusemide.

  5. The beta-lactam antibiotic, ceftriaxone, inhibits the development of opioid-induced hyperalgesia in mice.

    Science.gov (United States)

    Chen, Zhijun; He, Ying; Wang, Zaijie Jim

    2012-02-16

    The glutamate transporter GLT-1 is primarily responsible for glutamate clearance in the spinal cord. beta-Lactam antibiotics have been shown to attenuate neuropathic pain behaviors by promoting GLT-1 expression and function in the CNS. The present study tested the hypothesis that ceftriaxone, a prototype beta-lactam antibiotic, can prevent the development of opioid-induced hyperalgesia (OIH) in mice. Repeated morphine administration produced mechanical allodynia and thermal hyperalgesia, signs of OIH, and reduced spinal GLT-1 expression in mice. Ceftriaxone (200mg/kg/d, i.p., for 7 d) inhibited OIH. Correlating with the behavioral effects, ceftriaxone reversed downregulation of GLT-1 expression that was induced by OIH. These results suggest that ceftriaxone inhibited the development of OIH by up-regulating spinal GLT-1 expression.

  6. Efficacy of a twelve-hourly ceftriaxone regimen in the treatment of serious bacterial infections.

    Science.gov (United States)

    Maslow, M J; Levine, J F; Pollock, A A; Simberkoff, M S; Rahal, J J

    1982-01-01

    Eighteen patients with 21 serious infections were treated with ceftriaxone, 1 g intravenously every 12 h, for a mean duration of 8 days. Eighteen gram-negative and two gram-positive organisms were isolated. Sites of infection included blood (three patients), urinary tract (six patients), respiratory tract (seven patients), biliary tract (three patients), ascitic fluid (one patient), and skin (one patient). Serum, bile, and ascitic fluid concentrations of ceftriaxone were in excess of the minimal bactericidal concentration required for the infecting organism in all cases. A bacteriological response was demonstrated in 94% of the infections. A clinical response occurred in four infections from which no pathogens were recovered. In one patient, ceftriaxone failed to eradicate a peritoneal infection due to Bacteroides fragilis. In two patients, superinfection with enterococci developed both during and after therapy. Systemic tolerance to ceftriaxone was excellent. PMID:6289735

  7. Efficacy of tigecycline versus ceftriaxone plus metronidazole for the treatment of complicated intra-abdominal infections

    DEFF Research Database (Denmark)

    Qvist, Niels; Warren, Brian; Leister-Tebbe, Heidi;

    2012-01-01

    This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone-metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections (cIAI).......This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone-metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections (cIAI)....

  8. A RARE CASE OF CEFTRIAXONE INDUCED CORONARY SPASM WITH ACUTE MYOCARDIAL ISCHEMIA

    OpenAIRE

    Basavaraj; Ravikumar; Sandeep; Shreyas

    2014-01-01

    : Kounis syndrome has been known as allergic angina and/or allergic myocardial infarction. Allergic insults usually may include drugs, latex, and food. Although ceftriaxone administration has been associated with various allergic reactions such as urticaria, angioedema, erythema, rash and anaphylactic shock, there are very few published report that has shown an association between ceftriaxone use and Kounis syndrome. Here, we describe a case report of allergic vasospasm, l...

  9. Efficacy of a twelve-hourly ceftriaxone regimen in the treatment of serious bacterial infections.

    OpenAIRE

    Maslow, M J; Levine, J F; Pollock, A A; Simberkoff, M S; Rahal, J J

    1982-01-01

    Eighteen patients with 21 serious infections were treated with ceftriaxone, 1 g intravenously every 12 h, for a mean duration of 8 days. Eighteen gram-negative and two gram-positive organisms were isolated. Sites of infection included blood (three patients), urinary tract (six patients), respiratory tract (seven patients), biliary tract (three patients), ascitic fluid (one patient), and skin (one patient). Serum, bile, and ascitic fluid concentrations of ceftriaxone were in excess of the mini...

  10. Resistance of undisturbed soil microbiomes to ceftriaxone indicates extended spectrum β-lactamase activity

    Directory of Open Access Journals (Sweden)

    Joao eGatica

    2015-11-01

    Full Text Available Emergence and spread of antibiotic resistance, and specifically resistance to third generation cephalosporins associated with extended spectrum β-lactamase (ESBL activity, is one of the greatest epidemiological challenges of our time. In this study we addressed the impact of the third generation cephalosporin ceftriaxone on microbial activity and bacterial community composition of two physically and chemically distinct undisturbed soils in highly regulated microcosm experiments. Surprisingly, periodical irrigation of the soils with clinical doses of ceftriaxone did not affect their microbial activity; and only moderately impacted the microbial diversity (α and β of the two soils. Corresponding slurry experiments demonstrated that the antibiotic capacity of ceftriaxone rapidly diminished in the presence of soil, and approximately 70% of this inactivation could be explained by biological activity. The biological nature of ceftriaxone degradation in soil was supported by microcosm experiments that amended model Escherichia coli strains to sterile and non-sterile soils in the presence and absence of ceftriaxone and by the ubiquitous presence of ESBL genes (blaTEM, blaCTX-M and blaOXA in soil DNA extracts. Collectively, these results suggest that the resistance of soil microbiomes to ceftriaxone stems from biological activity and even more, from broad-spectrum β-lactamase activity; raising questions regarding the scope and clinical implications of ESBLs in soil microbiomes.

  11. Development of ceftriaxone resistance affects the virulence properties of Salmonella enterica serotype Typhimurium strains.

    Science.gov (United States)

    Li, Liang; Yang, Yu-Rong; Liao, Xiao-Ping; Lei, Chun-Yin; Sun, Jian; Li, Lu-Lu; Liu, Bao-Tao; Yang, Shou-Shen; Liu, Ya-Hong

    2013-01-01

    Development of antibiotic resistance may alter the virulence properties of bacterial organisms. In this study, nine clinical ceftriaxone-susceptible Salmonella enterica serotype Typhimurium strains were subjected to stepwise selection with increasing concentrations of ceftriaxone in culture media. Mutations in virulence-associated genes and antibiotic efflux genes were analyzed by polymerase chain reaction (PCR) and DNA sequencing. The expression levels of virulence genes invA and stn as well as efflux pump genes tolC, arcA, and arcB before and after the selection were measured by real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The stepwise selection resulted in the development of Salmonella strains that were highly resistant to ceftriaxone. Sequence analysis did not reveal any mutations or deletions in the examined virulence genes and regulatory gene, but a silent mutation (T423C) in acrR (encoding a repressor for the efflux pump) was detected in most of the ceftriaxone-resistant strains. The qRT-PCR revealed increased expression of the AcrAB-TolC efflux pump and decreased expression of invA and stn in the ceftriaxone-resistant strains. Moreover, decreased invasion into cultured epithelial cells and reduced growth rates were observed with the resistant strains. These results suggest that acquisition of ceftriaxone resistance is associated with the overexpression of the AcrAB-TolC efflux pump and leads to reduced virulence in Salmonella Typhimurium.

  12. A comparative study of Sulbactomax versus Ceftriaxone and betalactamase inhibitor and their effect on mutant prevention in ESBL producing organisms

    Directory of Open Access Journals (Sweden)

    Anurag Payasi

    2011-06-01

    Full Text Available Objective: In the present investigation, MPC of Sulbactomax was compared with ceftriaxone+sulbactam and ceftriaxone against ESBL producing Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Proteus vulgaris, Escherichia coli and Citrobacter braakii. Methods:The MPC of each antibacterial agent was determined using agar dilution method with a final inoculum size of 1010 CFU/ml of each organism. Result: The Sulbactomax MPC for ESBL organisms was in the range from 32 to 128 μg/ml and for ceftriaxone+sulbactam and ceftriaxone, it ranged from >256 and >512, respectively. The results suggest that Sulbactomax is highly efficacious in-vitro against selected ESBL producing organisms with lower MPC values, when compared with the ceftriaxone+sulbactam and ceftriaxone. Conclusion: Sulbactomax is one of the best choice to treat the infections caused by the above said ESBL producing micro-organisms, indicating to be effective in the prevention of disease caused by these ESBL organisms.

  13. Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease

    Directory of Open Access Journals (Sweden)

    Daniyeh Khurram

    2015-01-01

    Full Text Available Drugs are a significant cause of liver injury. Drug-induced liver injury (DILI can cause acute hepatitis, cholestasis, or a mixed pattern. Ceftriaxone is a commonly used antibiotic and has been associated with reversible biliary sludge, pseudolithiasis, and cholestasis. A 32-year-old male with sickle cell disease was admitted to the hospital for acute sickle cell crisis. On the second day of hospitalization, he developed cough and rhonchi with chest X-ray revealing right middle lobe infiltrates. Ceftriaxone and azithromycin were initiated. Subsequently, he developed conjugated hyperbilirubinemia and mild transaminitis. His total bilirubin trended upwards from 3.3 mg/dL on admission to 17 mg/dL. It was predominantly conjugated bilirubin, with preadmission bilirubin levels of 3-4 mg/dL. His transaminases were mildly elevated as well compared to previous levels. Extensive workup for bilirubin elevation was unremarkable. Ceftriaxone was switched to levofloxacin and the hyperbilirubinemia improved. On ambulatory follow-up, his bilirubin remained below 4 mg/dL. Ceftriaxone may be associated with marked direct hyperbilirubinemia particularly in sickle cell patients with chronic liver chemistry abnormalities. In the case of elevated bilirubin with concomitant ceftriaxone use, elimination of the offending agent should be considered.

  14. Meta-analysis of ceftriaxone compared with penicillin for the treatment of syphilis.

    Science.gov (United States)

    Liang, Zhen; Chen, Ya-Ping; Yang, Chun-Sheng; Guo, Wen; Jiang, Xiao-Xiao; Xu, Xi-Feng; Feng, Shou-Xin; Liu, Yan-Qun; Jiang, Guan

    2016-01-01

    Penicillin is the gold standard for treating syphilis. However, allergic reactions, poor drug tolerance and limited efficacy in patients remain a challenging problem. The objective of this meta-analysis was to compare the efficacy of ceftriaxone and penicillin based on data obtained from published randomised controlled trials (RCTs). The Cochrane Library, Medline, EBSCO, EMBASE and Ovid databases were searched for RCTs of ceftriaxone vs. penicillin for the treatment of syphilis. Estimated risk ratios (RRs) and 95% confidence intervals (CIs) were used to investigate the following outcome measures: 3-month response rate; 6-month response rate; 12-month response rate; relapse rate; serofast rate; and failure rate. Seven RCTs involving 281 participants (159 patients who received ceftriaxone and 122 patients who received penicillin) were included in the meta-analysis. There were no significant differences in 3-month response rate (RR=1.12, 95% CI 0.89-1.42), 6-month response rate (RR=1.02, 95% CI 0.75-1.38), 12-month response rate (RR=1.04, 95% CI 0.82-1.32), relapse rate (RR=0.91, 95% CI 0.45-1.84), serofast rate (RR=0.69, 95% CI 0.22-2.12) or failure rate (RR=0.66, 95% CI 0.03-15.76) in patients treated with ceftriaxone compared with those treated with penicillin. In conclusion, there is no evidence in the literature that ceftriaxone is less efficient than penicillin.

  15. Response of HIV-infected patients with syphilis to therapy with penicillin or intravenous ceftriaxone

    Directory of Open Access Journals (Sweden)

    Spornraft-Ragaller P

    2011-02-01

    Full Text Available Abstract Background Ceftriaxone is commonly used as an alternative antibiotic drug in treating syphilis but clinical data on its efficacy are limited. Objective: To evaluate the response of HIV-infected patients with active syphilis to treatment with penicillin or ceftriaxone. Methods A retrospective study involving 24 consecutive patients with a positive Veneral Disease Research Laboratory test (VDRL and at least one specific treponemal test. 12 patients were treated with different regimens of high-dose penicillin G for at least 2 weeks. Another 12 patients were treated with ceftriaxone 1-2 g per day intravenously for 10-21 days. Results After a median follow up of 18,3 months all patients of the penicillin-treated group and 11 of 12 ceftriaxone-treated patients showed a ≥ 4-fold decline in VDRL-titers; 91% of them already within 6 months after therapy. Conclusion Our serological data demonstrate a comparable efficacy of currently recommened penicillin and ceftriaxone treatment regimens for active syphilis in HIV-infected patients.

  16. DRUG USE EVALUATION OF CEFTRIAXONE: THE CASE OF AYDER REFERRAL HOSPITAL, MEKELLE, ETHIOPIA

    Directory of Open Access Journals (Sweden)

    Derbew Fikadu Berhe

    2012-07-01

    Full Text Available Assessment of antimicrobial use can be performed by evaluating their use. Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. The objective of this study was to evaluate the rational use of ceftriaxone in Ayder referral Hospital, Mekelle-Ethiopia. Retrospective cross sectional study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 296 patients who received ceftriaxone during hospitalization at Ayder referral Hospital from September 11, 2009 to September 10, 2010. A systematic sampling method was used to select inpatient prescriptions with ceftriaxone and patient cards were located based on the medical record number on the prescription papers. Data was collected by using structured format and evaluated against WHO criteria for drug use evaluation as per standard treatment guideline of Ethiopia. Most patients were dosed as 2 g/day (79.4%. The duration of therapy was found to be high in the range 2-7 days (51.69%. Ceftriaxone was mainly used as preoperative prophylaxis (38.8%. Maintenance fluids were the most commonly co-administered medications with a frequency of 62.16%. The use of ceftriaxone was appropriate only in 106 cases (35.8% for the justification of use. Most of inappropriate uses were seen in terms of duration. Consistency of prescriber to the national standard treatment guideline was found to be low. To improve rational use and prevent the development of resistance; prescribers should adhere to the national standard treatment guideline. Intensification of short term trainings and antibiotic control systems are some of the possible solutions the hospital has to do.

  17. In vitro susceptibilities of Borrelia burgdorferi to five oral cephalosporins and ceftriaxone.

    OpenAIRE

    Agger, W A; Callister, S M; Jobe, D A

    1992-01-01

    We determined the in vitro susceptibilities of eight Borrelia burgdorferi isolates to five oral cephalosporins. MICs for B. burgdorferi 297 were 23 micrograms/ml (cephalexin), 45 micrograms/ml (cefadroxil), 91 micrograms/ml (cefaclor), 0.13 microgram/ml (cefuroxime), 0.8 microgram/ml (cefixime), and 0.02 microgram/ml (ceftriaxone). When B. burgdorferi isolates were exposed to concentrations twice the MIC of cefuroxime, cefixime, or ceftriaxone, at least 72 h of incubation was required to kill...

  18. Comparison of efficacy of levofloxacin-metronidazole combination versus ceftriaxone in cases of moderate diabetic foot infection

    Directory of Open Access Journals (Sweden)

    Swati V. Patil

    2016-10-01

    Conclusions: Even though combination of levofloxacin-metronidazole and ceftriaxone alone had similar outcomes in terms of efficacy, on contrary in comparison of cost and convenience, levofloxacin - metronidazole therapy was proved better than ceftriaxone in treatment of diabetic foot ulcers. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1775-1779

  19. Design and initial results of a multi-phase randomized trial of ceftriaxone in amyotrophic lateral sclerosis.

    Directory of Open Access Journals (Sweden)

    James D Berry

    Full Text Available Ceftriaxone increases expression of the astrocytic glutamate transporter, EAAT2, which might protect from glutamate-mediated excitotoxicity. A trial using a novel three stage nonstop design, incorporating Phases I-III, tested ceftriaxone in ALS. Stage 1 determined the cerebrospinal fluid pharmacokinetics of ceftriaxone in subjects with ALS. Stage 2 evaluated safety and tolerability for 20-weeks. Analysis of the pharmacokinetics, tolerability, and safety was used to determine the ceftriaxone dosage for Stage 3 efficacy testing.In Stage 1, 66 subjects at ten clinical sites were enrolled and randomized equally into three study groups receiving intravenous placebo, ceftriaxone 2 grams daily or ceftriaxone 4 grams daily divided BID. Participants provided serum and cerebrospinal fluid for pharmacokinetic analysis on study day 7. Participants continued their assigned treatment in Stage 2. The Data and Safety Monitoring Board (DSMB reviewed the data after the last participants completed 20 weeks on study drug.Stage 1 analysis revealed linear pharmacokinetics, and CSF trough levels for both dosage levels exceeding the pre-specified target trough level of 1 µM (0.55 µg/mL. Tolerability (Stages 1 and 2 results showed that ceftriaxone at dosages up to 4 grams/day was well tolerated at 20 weeks. Biliary adverse events were more common with ceftriaxone but not dose-dependent and improved with ursodeoxycholic (ursodiol therapy.The goals of Stages 1 and 2 of the ceftriaxone trial were successfully achieved. Based on the pre-specified decision rules, the DSMB recommended the use of ceftriaxone 4 g/d (divided BID for Stage 3, which recently closed.ClinicalTrials.gov NCT00349622.

  20. Nissl arteritis in meningovascular syphilis and ceftriaxone therapeutic failure. Case report and review

    Directory of Open Access Journals (Sweden)

    Maria Isabel Montes

    2006-08-01

    Full Text Available The authors report a case of a 45 year old patient, negative VIH,with recurrent stroke, secondary to meningovascular syphilis andtherapeutic failure with ceftriaxone. The neurosyphilis is due to impairment of the nervous central system for the Treponema pallidumin any stadium of the condition, and includes both asymptomatic andsymptomatic forms of the infection. The forms of presentation arediverse and depend of the location and extension of the lesions. TheMRI shown multiple vascular injuries which reflects the impairment ofsmall blood vessels (Nissl arteritis caused by the Treponema .Thecurrent recommendation of the treatment is with crystalline penicillin G intravenously 4 millions every 4 hours for 14 days. The evidence up to the present time in people’s positive VIH with latent syphilis with or without neurosyphilis treated with ceftriaxone has showned up to 23% of therapeutic failures. There is a lack of information in immunocompetent patients.

  1. Ceftriaxone and tetracycline effect on biofilm-formation strains of Staphylococcus epidermidis

    Directory of Open Access Journals (Sweden)

    O. I. Sidashenko

    2014-04-01

    Full Text Available 122 strains of staphylococci were identified. Among the examined 122 clinical strains of staphylococci, 67 strains belonged to coagulase-positive, and 55 strains to the coagulase-negative ones. According to the study of physiological and biochemical properties, it was found that 37 strains (30.3% belonged to S. epidermidis species. One of the biological properties of many bacteria is the ability to film formation and these strains attract special attention, since it is known that the film antibiotic resistance is higher than in planktonic cultures. It was determined that 20 strains of those under study were film-forming, 17 strains – non-biofilm forming ones. The film was formed during three days, and settled to the bottom of the plate holes. The clinical (Cl strain of S. epidermidis was sensitive to ceftriaxone and tetracicline. The control (C strains of S. epidermidis were sensitive to ceftriaxone, tetracycline and sizomicine. The study of biofilm growth for 2, 3 and 4 days of incubation was carried out. The maximum rate of biofilm S. epidermidis C was observed during 2–3 days; there is the most intense increase of cells number from 5.2 × 108 CFU/ml, for S. epidermidis Cl to 5.6 × 108 CFU/ml. The effect of ceftriaxone and tetracycline on biofilm formation by 2 investigation strains of S. epidermidis was found. We determined differences in minimal inhibitory concentrations (MIC for planktonic cultures and biofilm of strains under study. It was established that MIC antibiotics inhibited the growth of planktonic cultures on average 2 times lower compared to the MIC which inhibited the biofilm formation. MIC for planktonic culture of S. epidermidis Cl defined for ceftriaxone was equal to 10 mg/ml, and for tetracycline – 1 mg/ml. MIC of ceftriaxone for the control strain was equal to 12 mg/ml, MIC of tetracycline – 0.7 mg/ml. MIC values for dynamics biofilm formation of S. epidermidis Cl strain on the plater were as follows: to

  2. Ceftriaxone-induced toxic epidermal necrolysis mimicking burn injury: a case report

    Directory of Open Access Journals (Sweden)

    Billig Allan

    2009-12-01

    Full Text Available Abstract Introduction Toxic epidermal necrolysis is a rare exfoliative disorder with a high mortality rate. Case presentation We present a 70-year-old woman of Iranian descent who presented with toxic epidermal necrolysis that was initially diagnosed as a scald burn. Further anamnesis prompted by spread of the lesions during hospitalization revealed that the patient had been receiving ceftriaxone for several days. To the best of our knowledge, this is the first case of ceftriaxone-induced toxic epidermal necrolysis in the English literature. Conclusion Toxic epidermal necrolysis is an acute, life-threatening, exfoliative disorder with a high mortality rate. High clinical suspicion, prompt recognition, and initiation of supportive care is mandatory. Thorough investigation of the pathogenetic mechanisms is fundamental. Optimal treatment guidelines are still unavailable.

  3. Enhancement of antibacterial properties of silver nanoparticles-ceftriaxone conjugate through Mukia maderaspatana leaf extract mediated synthesis.

    Science.gov (United States)

    Harshiny, Muthukumar; Matheswaran, Manickam; Arthanareeswaran, Gangasalam; Kumaran, Shanmugam; Rajasree, Shanmuganathan

    2015-11-01

    Green synthesis of nanoparticles with low range of toxicity and conjugation to antibiotics has become an attractive area of research for several biomedical applications. Nanoconjugates exhibited notable increase in biological activity compared to free antibiotic molecules. With this perception, we report the biosynthesis of silver nanoparticles using aqueous extract of leaves of Mukia maderaspatana and subsequent conjugation of the silver nanoparticles to antibiotic ceftriaxone. The leaves of this plant are known to be a rich source of phenolic compounds with high antioxidant activity that are used as reducing agents. The size, morphology, crystallinity, composition of the synthesized silver nanoparticles and conjugation of ceftriaxone to silver nanoparticles were studied using analytical techniques. The activity of the conjugates against Bacillus subtilis (MTCC 1790), Klebsiella pneumoniae (MTCC 3384), Staphylococcus aureus (ATCC 25923), and Salmonella typhi (MTCC 3224) was compared to ceftriaxone and unconjugated nanoparticles using disc diffusion method. The effect of silver nanoparticles on the reduction of biofilms of Pseudomonas fluorescens (MTCC 6732) was determined by micro plate assay method. The antioxidant activities of extract, silver nitrate, silver nanoparticles, ceftriaxone and conjugates of nanoparticles were evaluated by radical scavenging 1, 1- diphenyl-2-picrylhydrazyl test. Ultraviolet visible spectroscopy and Fourier transform infrared spectroscopy confirmed the formation of metallic silver nanoparticles and conjugation to ceftriaxone. Atomic force microscopy, transmission electron microscopy and particle size analysis showed that the formed particles were of spherical morphology with appreciable nanosize and the conjugation was confirmed by slight increase in surface roughness. The results thus showed that the conjugation of ceftriaxone with silver nanoparticles has better antioxidant and antimicrobial effects than ceftriaxone and unconjugated

  4. Successful outpatient management of pelvic actinomycosis by ceftriaxone: a report of three cases

    Directory of Open Access Journals (Sweden)

    Eda Demir Onal

    2009-10-01

    Full Text Available Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by actinomyces israeli. Intravenous penicillin is the preferred antimicrobial but it requires hospitalization up to one month. An outpatient treatment strategy would be cost effective and a good choice for patients. Here we present three cases in which intramuscular ceftriaxone was successfully used in the outpatient settings following surgery and IV penicillin treatment in the hospital.

  5. Empyema Secondary to Actinomyces meyeri Treated Successfully with Ceftriaxone Followed by Doxycycline

    Science.gov (United States)

    Piscopo, Tonio; Cassar, Karen

    2016-01-01

    Actinomycosis is a relatively rare infection caused by Gram-positive bacteria. We present the case of a 54-year-old, previously healthy, male patient with a history of severe penicillin allergy who developed severe pneumonia and empyema caused by Actinomyces meyeri. Presenting symptoms included productive cough, right upper quadrant pain, and chills and rigors. He required drainage of the empyema via tube and prolonged antibiotic treatment with intravenous ceftriaxone for 2 weeks followed by oral doxycycline for 6 months. PMID:27752374

  6. Effects of ceftriaxone induced intestinal dysbacteriosis on lymphocytes in different tissues in mice.

    Science.gov (United States)

    Luo, Xia; Zheng, Yanyi; Wen, Ruyan; Deng, Xiangliang; Zhou, Lian; Liao, Haifeng

    2016-09-01

    The close relationship between intestinal microflora and immune system has been confirmed, stimulus from intestinal flora plays an important role in the development of the immune system and its dynamic balance. Current research is still inadequate to determine how local bacteria in gut influence the whole body. In this study, influence of ceftriaxone sodium induced intestinal dysbacteriosis on local and overall immune function was investigated. We found that the beneficial bacteria decreased significantly compared with control after oral administration of ceftriaxone; Moreover, the proportion of T cells are higher and B cells are lower in the dysbacteriosis mice, activation and proliferation of T and B cells was decreased significantly in gut-associated lymphoid tissues (GALTs), such as Peyer's patches (PPs) and mesenteric lymph nodes(MLNs)with ceftriaxone treatment; The secreted sIgA in intestinal was reduced in dysbacteriosis mice than that of control as well. The similar results above are also shown on the spleen. In addition, the delayed type hypersensitivity (DTH) reaction decreased in dysbacteriosis mice. The present data suggested that intestinal microflora had impact on immune system by influencing the proportion and function of lymphocytes in PPS-MLN-spleen. PMID:27256989

  7. Effects of ceftriaxone-induced intestinal dysbacteriosis on dendritic cells of small intestine in mice.

    Science.gov (United States)

    Li, Ming; Li, Weihua; Wen, Shu; Liu, Yinhui; Tang, Li

    2013-08-01

    Intestinal microflora plays a pivotal role in the development of the innate immune system and is essential in shaping adaptive immunity. Dysbacteriosis of intestinal microflora induces altered immune responses and results in disease susceptibility. Dendritic cells (DCs), the professional antigen-presenting cells, have gained increasing attention because they connect innate and adaptive immunity. They generate both immunity in response to stimulation by pathogenic bacteria and immune tolerance in the presence of commensal bacteria. However, few studies have examined the effects of intestinal dysbacteriosis on DCs. In this study, changes of DCs in the small intestine of mice under the condition of dysbacteriosis induced by ceftriaxone sodium were investigated. It was found that intragastric administration of ceftriaxone sodium caused severe dysteriosis in mice. Compared with controls, numbers of DCs in mice with dysbacteriosis increased significantly (P = 0.0001). However, the maturity and antigen-presenting ability of DCs were greatly reduced. In addition, there was a significant difference in secretion of IL-10 and IL-12 between DCs from mice with dysbacteriosis and controls. To conclude, ceftriaxone-induced intestinal dysbacteriosis strongly affected the numbers and functions of DCs. The present data suggest that intestinal microflora plays an important role in inducing and maintaining the functions of DCs and thus is essential for the connection between innate and adaptive immune responses.

  8. The Role of an Impurity in Ceftriaxone Sodium Preparation for Injection in Determining Compatibility with Calcium-Containing Solutions.

    Science.gov (United States)

    Tange, Mio; Yoshida, Miyako; Nakai, Yuka; Uchida, Takahiro

    2016-01-01

    Ceftriaxone sodium preparation for injection is known to form insoluble microparticles with calcium. The purpose of this study was to evaluate the role of an impurity in the ceftriaxone sodium preparation on this incompatibility. Firstly, using HPLC, two impurities were identified in the ceftriaxone sodium solution. The major impurity (impurity 1) was identified as tetrahydro-2-methyl-3-thioxo-1,2,4-triazine-5,6-dione by LC/MS. Secondly, the role played by this impurity in the incompatibility with calcium was examined. Using seven different ceftriaxone preparations for injection, the effect of adding impurity 1 to mixed solutions of ceftriaxone sodium and calcium chloride on the appearance of insoluble microparticles, was examined using a light obscuration particle counter. Although incompatibility was not completely suppressed by the addition of impurity 1, the number of insoluble microparticles formed with calcium chloride solution was decreased in proportion to the concentration of impurity 1, and the concentration of calcium ion decreased as the concentration of added impurity 1 increased. These results show that impurity 1 plays a concentration-dependent role in incompatibility between ceftriaxone sodium preparation for injection and calcium-containing solutions. PMID:26936047

  9. Ceftriaxone, a Beta-Lactam Antibiotic, Modulates Apoptosis Pathways and Oxidative Stress in a Rat Model of Neuropathic Pain

    Directory of Open Access Journals (Sweden)

    Bahareh Amin

    2014-01-01

    Full Text Available Purpose. In our previous study, ceftriaxone, a beta-lactam antibiotic, elicited antinociceptive effects in the chronic constriction injury (CCI of neuropathic pain. In this study, we assessed apoptosis and oxidative stress in the spinal cord of neuropathic rats treated with ceftriaxone. Methods. 45 male Wistar rats were divided as naïve, sham, normal saline-treated CCI rats, and CCI animals treated with the effective dose of ceftriaxone. Involvement of Bax, Bcl2, and caspases 3 and 9, important contributors of programmed cell death (apoptosis, was determined using western blotting at days 3 and 7. The markers of oxidative stress including malondialdehyde (MDA and reduced glutathione (GSH were measured on days 3 and 7. Results. Increased Bax/Bcl2 ratio and cleaved active forms of caspases 3 and 9 were observed in the spinal cord of CCI rats on day 3. Ceftriaxone attenuated the increased levels of Bax and cleaved forms of caspases 3 and 9, while it increased Bcl2 levels. Bax and active forms of caspases declined by day 7. Consequently, comparison among groups showed no difference at this time. CCI enhanced MDA and decreased GSH on days 3 and 7, while ceftriaxone protected against the CCI-induced oxidative stress. Conclusion. Our results suggest that ceftriaxone, an upregulator/activator of GLT1, could concomitantly reduce oxidative stress and apoptosis and producing its new analogs lacking antimicrobial activity may represent a novel approach for neuropathic pain treatment.

  10. Ceftriaxone Injection

    Science.gov (United States)

    ... the female reproductive organs that may cause infertility), meningitis (infection of the membranes that surround the brain ... will not work for colds, flu, or other viral infections.Using antibiotics when they are not needed ...

  11. Comparison of Infection and Urosepsis Rates of Ciprofloxacin and Ceftriaxone Prophylaxis before Percutaneous Nephrolithotomy: A Prospective and Randomised Study

    Directory of Open Access Journals (Sweden)

    Abdullah Demirtas

    2012-01-01

    Full Text Available This study aimed at determining the choice and administration duration of ideal antibiotic prophylaxis before percutaneous nephrolithotomy (PNL operation, a treatment modality for nephrolithiasis. The study included 90 patients who had no internal problem, yet had a negative urine culture and underwent a PNL operation. We compared infection rates between ciprofloxacin and ceftriaxone groups and their subgroups. The results showed no statistical difference between ciprofloxacin and ceftriaxone groups in terms of systemic inflammatory response syndrome (SIRS (CIPP=0.306, CTX P=0.334. As a result of this study no statistical difference was observed between ciprofloxacin and ceftriaxone in terms of SIRS. It seems, however, reasonable to choose ceftriaxone, considering antibiotic sensitivity of microorganisms and detection of three cases accepted as urosepsis in the ciprofloxacin group. As there is no difference between short, and long-term prophylactic use of these antibiotics, preference of short-term prophylaxis for patients with no risk of infection will be important to avoid inappropriate antibiotic usage.

  12. Comparison of Neisseria gonorrhoeae MICs obtained by Etest and agar dilution for ceftriaxone, cefpodoxime, cefixime and azithromycin.

    Science.gov (United States)

    Gose, Severin; Kong, Carol J; Lee, Yer; Samuel, Michael C; Bauer, Heidi M; Dixon, Paula; Soge, Olusegun O; Lei, John; Pandori, Mark

    2013-12-01

    We evaluated Neisseria gonorrhoeae Etest minimum inhibitory concentrations (MICs) relative to agar dilution MICs for 664 urethral isolates for ceftriaxone (CRO) and azithromycin (AZM), 351 isolates for cefpodoxime (CPD) and 315 isolates for cefixime (CFM). Etest accurately determined CPD, CFM and AZM MICs, but resulted in higher CRO MICs.

  13. A randomised controlled trial of prophylaxis of post-abortal infection: ceftriaxone versus placebo

    DEFF Research Database (Denmark)

    Henriques, C U; Wilken-Jensen, C; Thorsen, P;

    1994-01-01

    days postoperatively, underwent pelvic examination. Clinical endpoints were noted. MAIN OUTCOME MEASURES: Post-operative pelvic inflammatory disease in women applying for legal first trimester abortion. RESULTS: Seven hundred and eighty-six women fulfilled the criteria for evaluation. A tendency toward......OBJECTIVE: To investigate the incidence of post-operative infection after first trimester abortion in women treated with a long-acting cephalosporin (ceftriaxone) compared with low risk patients receiving no treatment and with high risk patients receiving our standard treatment of ampicillin...... of ampicillin and metronidazole, followed by oral doses of metronidazole and pivampicillin three times daily for four days. No prophylactic antibiotics were given to the women randomised to standard treatment in the low risk group. INTERVENTIONS: All women were kept under observation, and, between six and 14...

  14. Ceftriaxone and cefazolin attenuate the cue-primed reinstatement of alcohol-seeking.

    Science.gov (United States)

    Weiland, Ana; Garcia, Steven; Knackstedt, Lori A

    2015-01-01

    Alcohol consumption and the reinstatement of alcohol-seeking rely on glutamate and GABA transmission. Modulating these neurotransmitters may be a viable treatment strategy to prevent alcohol relapse. N-acetylcysteine (NAC) and the antibiotic ceftriaxone (CEF) alter the glial reuptake and release of glutamate while the antibiotic cefazolin (CEFAZ) modulates GABA signaling without affecting glutamate. Here, we used the extinction-reinstatement model of relapse to test the ability of these compounds to attenuate the reinstatement of alcohol-seeking. Male Sprague-Dawley rats were trained to self-administer 20% (v/v) alcohol in the home cage using an intermittent schedule (24 h on, 24 h off) for 12 sessions. Subsequently, animals self-administered alcohol during daily 45-min operant sessions for 26 sessions, followed by extinction training. We tested whether chronic administration of NAC, CEF, or CEFAZ attenuated the cue-primed reinstatement of alcohol-seeking. CEF and CEFAZ attenuated cue-primed reinstatement of alcohol-seeking while NAC had no effect. We subsequently investigated whether CEF and CEFAZ alter the self-administration of sucrose and chow pellets and if CEFAZ attenuates the reinstatement of cocaine-seeking. The operant self-administration of regular chow and sucrose was not altered by either CEF or CEFAZ. CEFAZ had no effect on cocaine reinstatement, a behavior that has been strongly tied to altered glutamate homeostasis in the nucleus accumbens. Thus the ability of CEFAZ to attenuate alcohol reinstatement likely does not involve the glial modulation of glutamate levels. The dampening of GABA transmission may be a common mechanism of action of cefazolin and ceftriaxone.

  15. Cefazolin and ceftriaxone attenuate the cue-primed reinstatement of alcohol-seeking

    Directory of Open Access Journals (Sweden)

    Ana eWeiland

    2015-03-01

    Full Text Available Alcohol consumption and the reinstatement of alcohol-seeking rely on glutamate and GABA transmission. Modulating these neurotransmitters may be a viable treatment strategy to prevent alcohol relapse. N-acetylcysteine (NAC and the antibiotic ceftriaxone (CEF alter the glial reuptake and release of glutamate while the antibiotic cefazolin (CEFAZ modulates GABA signaling without affecting glutamate. Here we used the extinction-reinstatement model of relapse to test the ability of these compounds to attenuate the reinstatement of alcohol-seeking. Male Sprague-Dawley rats were trained to self-administer 20% (v/v alcohol in the home cage using an intermittent schedule (24 hr on, 24 hr off for 12 sessions. Subsequently, animals self-administered alcohol during daily 45-min operant sessions for 26 sessions, followed by extinction training. We tested whether chronic administration of NAC, CEF or CEFAZ attenuated the cue-primed reinstatement of alcohol-seeking. CEF and CEFAZ attenuated cue-primed reinstatement of alcohol-seeking while NAC had no effect. We subsequently investigated whether CEF and CEFAZ alter the self-administration of sucrose and chow pellets and if CEFAZ attenuates the reinstatement of cocaine-seeking. The operant self-administration of regular chow and sucrose was not altered by either CEF or CEFAZ. CEFAZ had no effect on cocaine reinstatement, a behavior that has been strongly tied to altered glutamate homeostasis in the nucleus accumbens. Thus the ability of CEFAZ to attenuate alcohol reinstatement likely does not involve the glial modulation of glutamate levels. The dampening of GABA transmission may be a common mechanism of action of cefazolin and ceftriaxone.

  16. A simple broth-disk method to determine the minimum inhibitory concentration of ceftriaxone on Salmonella enterica serovar typhi and paratyphi

    Directory of Open Access Journals (Sweden)

    Bhat K

    2009-04-01

    Full Text Available Background and Purpose: Resistance to fluoroquinolones and cephalosporins is a major problem with Salmonella enterica serovar Typhi and Paratyphi. An accurate determination of antibiotic susceptibility requires tests for minimum inhibitory concentration (MIC of antibiotics. We describe a simple broth-disk method to determine the MIC of ceftriaxone on S. typhi and S. paratyphi . Materials and Methods: Sixteen strains of S. typhi and two strains each of S. paratyphi A and S. paratyphi B were used in the study. The MIC of ceftriaxone was determined using the simple broth-disk method and the conventional broth macrodilution method and the results were compared. Results: All salmonella strains were susceptible to ceftriaxone. The results of the broth-disk and the conventional broth macrodilution method were similar. Conclusion: The broth-disk method is a simple, reliable and cost-effective method to determine the MIC of ceftriaxone on S. typhi and S. paratyphi A.

  17. High-Level Cefixime- and Ceftriaxone-Resistant Neisseria gonorrhoeae in France: Novel penA Mosaic Allele in a Successful International Clone Causes Treatment Failure

    OpenAIRE

    Unemo, Magnus; Golparian, Daniel; Nicholas, Robert; Ohnishi, Makoto; Gallay, Anne; Sednaoui, Patrice

    2012-01-01

    Recently, the first Neisseria gonorrhoeae strain (H041) highly resistant to the expanded-spectrum cephalosporins (ESCs) ceftriaxone and cefixime, which are the last remaining options for first-line gonorrhea treatment, was isolated in Japan. Here, we confirm and characterize a second strain (F89) with high-level cefixime and ceftriaxone resistance which was isolated in France and most likely caused a treatment failure with cefixime. F89 was examined using six species-confirmatory tests, antib...

  18. Beta Lactams Antibiotic Ceftriaxone Modulates Seizures, Oxidative Stress and Connexin 43 Expression in Hippocampus of Pentylenetetrazole Kindled Rats

    Science.gov (United States)

    Hussein, Abdelaziz M.; Ghalwash, Mohammed; Magdy, Khaled; Abulseoud, Osama A.

    2016-01-01

    Background and Purpose: This study aimed to investigate the effect of ceftriaxone on oxidative stress and gap junction protein (connexin 43, Cx-43) expression in pentylenetetrazole (PTZ) induced kindling model. Methods: Twenty four Sprague dawely rats were divided into 3 equal groups (a) normal group: normal rats. (b) PTZ kindled group: received PTZ at the dose of 50 mg/kg via intraperitoneal injection (i.p.) every other day for 2 weeks (c) ceftriaxone treated group: received ceftriaxone at the dose 200 mg\\kg/12 hrs via i.p. injection daily from the 6th dose of PTZ for 3 days. Racine score, latency before beginning the first myoclonic jerk and duration of the jerks used as parameters of behavioral assessment. Immunohistopathological study for Cx-43 expression in hippocampus and measurement of markers of oxidative stress (malondialdehyde [MDA], low reduced glutathione [GSH] and catalase [CAT]) in hippocampal neurons were done. Results: PTZ kindling was associated with behavioral changes (in the form high stage of Racine score, long seizure duration and short latency for the first jerk), enhanced oxidative stress state (as demonstrated by high MDA, low GSH and CAT) and up regulation of Cx43 in hippocampal regions. While, ceftriaxone treatment ameliorated, significantly, PTZ-induced convulsions and caused significant improvement in oxidative stress markers and Cx-43 expression in hippocamal regions (p < 0.05). Conclusions: These findings support the anticonvulsive effects of some beta-lactams antibiotics which could offer a possible contributor in the basic treatment of temporal lobe epilepsy. This effect might be due to reduction of oxidative stress and Cx43 expression. PMID:27390674

  19. Pharmacokinetics and bacteriological efficacy of cefoperazone, ceftriaxone, and moxalactam in experimental Streptococcus pneumoniae and Haemophilus influenzae meningitis.

    OpenAIRE

    McCracken, G H; Nelson, J.D.; Grimm, L

    1982-01-01

    The pharmacokinetics and bacteriological efficacy of cefoperazone, cefuroxime, ceftriaxone, and moxalactam were evaluated in the experimental rabbit meningitis model of Haemophilus influenzae type b or Streptococcus pneumoniae infection. The cerebrospinal fluid penetration of these beta-lactam antibiotics was from 3 to 14% and was greater in Haemophilus-infected that in pneumococcus-infected animals. With the exception of moxalactam, the antibacterial activity in cerebrospinal fluid and chang...

  20. Cefditoren and ceftriaxone enhance complement-mediated immunity in the presence of specific antibodies against antibiotic-resistant pneumococcal strains.

    Directory of Open Access Journals (Sweden)

    Elisa Ramos-Sevillano

    Full Text Available BACKGROUND: Specific antibodies mediate humoral and cellular protection against invading pathogens such as Streptococcus pneumoniae by activating complement mediated immunity, promoting phagocytosis and stimulating bacterial clearance. The emergence of pneumococcal strains with high levels of antibiotic resistance is of great concern worldwide and a serious threat for public health. METHODOLOGY/PRINCIPAL FINDINGS: Flow cytometry was used to determine whether complement-mediated immunity against three antibiotic-resistant S. pneumoniae clinical isolates is enhanced in the presence of sub-inhibitory concentrations of cefditoren and ceftriaxone. The binding of acute phase proteins such as C-reactive protein and serum amyloid P component, and of complement component C1q, to pneumococci was enhanced in the presence of serum plus either of these antibiotics. Both antibiotics therefore trigger the activation of the classical complement pathway against S. pneumoniae. C3b deposition was also increased in the presence of specific anti-pneumococcal antibodies and sub-inhibitory concentrations of cefditoren and ceftriaxone confirming that the presence of these antibiotics enhances complement-mediated immunity to S. pneumoniae. CONCLUSIONS/SIGNIFICANCE: Using cefditoren and ceftriaxone to promote the binding of acute phase proteins and C1q to pneumococci, and to increase C3b deposition, when anti-pneumococcal antibodies are present, might help reduce the impact of antibiotic resistance in S. pneumoniae infections.

  1. Polymerase chain reaction-based screening for the ceftriaxone-resistant Neisseria gonorrhoeae F89 strain.

    Science.gov (United States)

    Goire, N; Lahra, M M; Ohnishi, M; Hogan, T; Liminios, A E; Nissen, M D; Sloots, T P; Whiley, D M

    2013-04-04

    Emergence and spread of Neisseria gonorrhoeae resistant to extended spectrum cephalosporins is a major problem threatening treatment of gonorrhoea and is further highlighted by the recent report of a second ceftriaxone-resistant N. gonorrhoeae strain (F89) in Europe, initially observed in France and subsequently identified in Spain. N. gonorrhoeae antimicrobial resistance (AMR) surveillance has acquired new importance and molecular tools have the potential to enhance bacterial culture-based methods. In this study, we established a polymerase chain reaction (PCR) protocol for direct detection of the F89 strain. A key component of this screening protocol was the development of a hybridisation probe-based melting curve analysis assay (mosaic501-hybPCR) to detect the presence of an A501P substitution on the N. gonorrhoeae mosaic penicillin binding protein 2 (PBP2) sequence, an important characteristic of the F89 strain. The mosaic501-hybPCR was evaluated using plasmid-derived positive controls (n=3) and characterised gonococcal (n=33) and non-gonococcal (n=58) isolates. The protocol was then applied to 159 clinical specimens from Sydney, Australia, collected during the first half of the year 2012 that were N. gonorrhoeae PCR-positive. Overall, the results indicate that the PCR-based protocol is suitable for direct detection of the N. gonorrhoeae F89 strain in non-cultured clinical samples. It therefore provides an additional tool to aid investigations into the potential spread of F89 strain throughout Europe and elsewhere.

  2. Susceptibility to ceftriaxone and occurrence of penicillinase plasmids in Neisseria gonorrhoeae strains isolated in Poland in 2012-2013.

    Science.gov (United States)

    Mlynarczyk-Bonikowska, Beata; Kujawa, Marlena; Mlynarczyk, Grazyna; Malejczyk, Magdalena; Majewski, Slawomir

    2016-07-01

    Recent years have seen rising concerns over increasing antibiotic resistance of the gonorrhea-causing bacterium, Neisseria gonorrhoeae. This is especially true for third-generation cephalosporins, which are currently recommended for the treatment of such infections. Therefore, susceptibility to these antibiotics should be monitored internationally to the greatest extent possible. The susceptibility of N. gonorrhoeae strains to ceftriaxone and penicillin, as well as production of beta-lactamase by the Cefinase test was determined. Moreover, the presence and type of penicillinase plasmids were determined by PCR. All strains were susceptible to ceftriaxone, the minimal inhibitory concentration (MIC) values ranged from 0.002 to 0.125 mg/L; MIC50 was =0.016 mg/L and MIC90 was =0.064 mg/L. As much as 7.7 % of the strains demonstrated ceftriaxone MIC of 0.125 mg/L. For penicillin, the MICs ranged from 0.064 to 32 mg/L; MIC50 was =0.5 mg/L and MIC90 was =4 mg/L. It was shown that only 1.5 % of the strains were sensitive to penicillin according to The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Among the penicillin-resistant strains, six (30.0 %) produced penicillinase. The MICs of penicillin were substantially higher for penicillinase-producing than for penicillin-resistant, penicillinase-negative strains. MICs of ceftriaxone for penicillinase-producing strains were low (0.002-0.016 mg/L). Three of the penicillinase-producing strains possessed plasmids of African type (50 %) and three Toronto/Rio type (50 %). An increase of the proportion of beta-lactamase-positive strains in the last years as well as emergence of strains with elevated MIC of ceftriaxone indicate a need to constantly monitor N. gonorrhoeae strains for their susceptibility to beta-lactam antibiotics, as well as for their ability to produce beta-lactamases.

  3. Gatifloxacin versus ceftriaxone for uncomplicated enteric fever in Nepal: an open-label, two-centre, randomised controlled trial

    Science.gov (United States)

    Arjyal, Amit; Basnyat, Buddha; Nhan, Ho Thi; Koirala, Samir; Giri, Abhishek; Joshi, Niva; Shakya, Mila; Pathak, Kamal Raj; Mahat, Saruna Pathak; Prajapati, Shanti Pradhan; Adhikari, Nabin; Thapa, Rajkumar; Merson, Laura; Gajurel, Damodar; Lamsal, Kamal; Lamsal, Dinesh; Yadav, Bharat Kumar; Shah, Ganesh; Shrestha, Poojan; Dongol, Sabina; Karkey, Abhilasha; Thompson, Corinne N; Thieu, Nga Tran Vu; Thanh, Duy Pham; Baker, Stephen; Thwaites, Guy E; Wolbers, Marcel; Dolecek, Christiane

    2016-01-01

    Summary Background Because treatment with third-generation cephalosporins is associated with slow clinical improvement and high relapse burden for enteric fever, whereas the fluoroquinolone gatifloxacin is associated with rapid fever clearance and low relapse burden, we postulated that gatifloxacin would be superior to the cephalosporin ceftriaxone in treating enteric fever. Methods We did an open-label, randomised, controlled, superiority trial at two hospitals in the Kathmandu valley, Nepal. Eligible participants were children (aged 2–13 years) and adult (aged 14–45 years) with criteria for suspected enteric fever (body temperature ≥38·0°C for ≥4 days without a focus of infection). We randomly assigned eligible patients (1:1) without stratification to 7 days of either oral gatifloxacin (10 mg/kg per day) or intravenous ceftriaxone (60 mg/kg up to 2 g per day for patients aged 2–13 years, or 2 g per day for patients aged ≥14 years). The randomisation list was computer-generated using blocks of four and six. The primary outcome was a composite of treatment failure, defined as the occurrence of at least one of the following: fever clearance time of more than 7 days after treatment initiation; the need for rescue treatment on day 8; microbiological failure (ie, blood cultures positive for Salmonella enterica serotype Typhi, or Paratyphi A, B, or C) on day 8; or relapse or disease-related complications within 28 days of treatment initiation. We did the analyses in the modified intention-to-treat population, and subpopulations with either confirmed blood-culture positivity, or blood-culture negativity. The trial was powered to detect an increase of 20% in the risk of failure. This trial was registered at ClinicalTrials.gov, number NCT01421693, and is now closed. Findings Between Sept 18, 2011, and July 14, 2014, we screened 725 patients for eligibility. On July 14, 2014, the trial was stopped early by the data safety and monitoring board because S Typhi

  4. [Pharmacokinetic and clinical evaluations on ceftriaxone in neonates and premature infants].

    Science.gov (United States)

    Shiro, H; Kusumoto, Y; Satoh, Y; Oikawa, T; Osano, M

    1988-03-01

    Ceftriaxone (CTRX) was clinically evaluated and its pharmacokinetics studied in neonates and premature infants, and the results obtained are summarized as follows. 1. Average blood levels of CTRX after intravenous administration of 10 mg/kg in 3 neonates with birth weights of 2,500 g or more were 45.32 mcg/ml at 15 minutes, 28.91 mcg/ml at 1 hour, 15.76 mcg/ml at 6 hours, and 16.28 mcg/ml at 12 hours, and the half-life was 9.93 hours. The half-life in a newly born premature infant (less than 1 day) was 28.90 hours, and in a premature infant 6 days old it was 12.90 hours. 2. Average blood levels after intravenous administration of 20 mg/kg to 2 neonates aged 0 and 3 days with birth weights of 2,500 g or more, were 129.7 mcg/ml at 15 minutes, 60.94 mcg/ml at 1 hour, 32.04 mcg/ml at 6 hours, and 24.23 mcg/ml at 12 hours, and the half-life was 8.95 hours. The half-life in a newly born premature infant (less than 1 day) was 20.70 hours. 3. Urinary recovery rates of CTRX in 12 hours after intravenous administration of 10 or 20 mg/kg to 6 neonates aged 0 to 3 days (including premature infants) ranged from 13.8 to 50.6%. 4. Clinical efficacies of CTRX were excellent or good in 3 of 4 neonates including infants suspected of having infections (efficacy rate: 75%). 5. As a side effect, diarrhea was noted in 1 case. PMID:3404644

  5. Cefixime and ceftriaxone susceptibility of Neisseria gonorrhoeae in Italy from 2006 to 2010.

    Science.gov (United States)

    Carannante, A; Prignano, G; Cusini, M; Matteelli, A; Dal Conte, I; Ghisetti, V; D'Antuono, A; Cavrini, F; Antonetti, R; Stefanelli, P

    2012-06-01

    Neisseria gonorrhoeae resistance to cephalosporins, the currently recommended treatment, and treatment failures with cefixime have been reported worldwide. The purposes of the present study were (i) to examine the susceptibility of N. gonorrhoeae isolates isolated in Italy from 2006 through 2010 to cefixime (n = 293) taking into account both European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Clinical And Laboratory Standards Institute (CLSI) criteria for categorization; (ii) to determine the contribution to decreased/resistant susceptibility of mutations in the penA, mtrR, ponA and porB1b genes in a subsample of isolates; and (iii) to genotype the isolates showing decreased susceptibility or resistance to cefixime, by N. gonorrhoeae multi-antigen sequence typing (NG-MAST) and by pulsed-field gel electrophoresis (PFGE) to identify the predominant genotypes. Minimum inhibitory concentrations (MICs) were determined by the E-test and agar dilution method on 293 isolates and results were interpreted according to both EUCAST 2010 (MIC R >0.12 mg/L) and CLSI 2008 (MIC R >0.25 mg/L) criteria. All isolates showed full susceptibility to ceftriaxone, whereas those with a MIC for cefixime ≥0.125 mg/L were on the increase from 2008 through 2010. The same penA gene alterations were found among isolates with MICs close to the EUCAST breakpoint as the resistant ones, and they belong to ST1407. Seven isolates, belonging to various sequence types, showed a different por allele, though similar to the por 908 allele present in ST1407. PFGE divided strains ST1407 into two main groups confirming their genetic relationship.

  6. [The role of some individual amino acid substitutions in penicillin-binding protein (PBP2) of Neisseria gonorrhoeae in the emergence of resistance to ceftriaxone].

    Science.gov (United States)

    Kubanova, A A; Kubanov, A A; Kozhushnaia, O S; Vorob'ev, D V; Solomka, V S; Frigo, N V

    2014-01-01

    The goal of the study was to identify amino acid replacements in the structure of penicillin-binding protein PBP2, which may influence on the development of resistance N. gonorhoeae to the III cephalosporins generation. The gene penA of 50 strains of N. gonorrhoeae was sequenced: 20 strains with high sensitivity to ceftriaxone (MIC, Minimum Inhibitory Concentration, = 0.002 mg/L) and 30 strains with decreased sensitivity to ceftriaxone (MIC = 0.03-0.25 mg/L). The difference of MIC sensitivity between these strains was 30-250 times. Then nucleotide sequence was transformed into the amino acid sequence of PBP2 protein. Mutations in the gene penA and amino acid replacements in the protein PBP2 were found in 16 of 20 strains (80%) with high sensitivity to ceftriaxone and in all strains with decreased sensitivity to ceftriaxone. Amino acid replacements in the PBP2 protein were compared with amino acid replacements in groups, which characterize the PBP2 structure in accordance with the international classification Ito M. The amino acid replacement of PBP2 at positions 346, 505, 511, 517, 543, 567, 575, 576 are associated with V group by Ito M and have features of resistance of N. gonorrhoeae to ceftriaxone authentically (OR = 3.9 ± 2.5; χ2 = 4.9; p ceftriaxone. These data may be significant as showing strong influence of amino acid replacements at positions 346, 505, 511, 517, 567, 575 and, in particular, 543 for development of resistance N. gonorrhoeae strains to ceftriaxone.

  7. Combined action of MK-801 and ceftriaxone impairs the acquisition and reinstatement of morphine-induced conditioned place preference,and delays morphine extinction in rats

    Institute of Scientific and Technical Information of China (English)

    Yaodong Fan; Haichen Niu; Joshua D.Rizak; Ling Li; Guimei Wang; Liqi Xu; He Ren; Hao Lei; Hualin Yu

    2012-01-01

    Objective It is well established that glutamate and its receptors,particularly the N-methyl-D-aspartate receptor (NMDAR),play a significant role in addiction and that the inhibition of glutamatergic hyperfunction reduces addictive behaviors in experimental animals.Specifically,NMDAR antagonists such as MK-801,and an inducer of the expression of glutamate transporter subtype-1 (GLT-1) (cefiriaxone) are known to inhibit addictive behavior.The purpose of this study was to determine whether the combined action of a low dose of MK-801 and a low dose of ceftriaxone provides better inhibition of the acquisition,extinction,and reinstatement of morphine-induced conditioned place preference (CPP) than either compound alone.Methods A morphine-paired CPP experiment was used to study the effects of low doses of MK-801,ceftriaxone and a combination of both on reward-related memory (acquisition,extinction,and reinstatement of morphine preference) in rats.Results A low dose of neither MK-801 (0.05 mg/kg,i.p.) nor ceftriaxone (25 mg/kg,i.p.) alone effectively impaired CPP behaviors.However,when applied in combination,they reduced the acquisition of morphine-induced CPP and completely prevented morphine reinstatement.Their combination also notably impaired the extinction of morphine-induced CPP.Conclusion The combined action of a low dose of an NMDAR antagonist (MK-801)and GLT-1 activation by ceftriaxone effectively changed different phases of CPP behavior.

  8. [In vitro inhibition of granulopoiesis by beta-lactam antibiotics. Comparison of piperacillin, mezlocillin, ceftriaxone and ceftazidime].

    Science.gov (United States)

    Marie, J P; Thevenin, D; Zittoun, R

    1986-12-20

    The mechanism of neutropenia induced by beta-lactam antibiotics was explored by studying the action of these drugs on granulopoiesis in vitro. Normal bone marrows were cultivated in the presence of increasing concentrations of piperacillin (10 marrows), mezlocillin, ceftriaxone and ceftazidime (5 marrows each) in order to find out whether these antibiotics exhibited toxicity to granulocyte-monocyte precursors. A dose-dependent inhibition of granulopoiesis was found in all cases. When the doses used were equivalent to maximum plasma concentrations in vivo, inhibition was minimal with piperacillin and mezlocillin and much more pronounced with the cephalosporins. This dose-dependent inhibition suggests that toxicity is involved in the mechanism of neutropenia induced by beta-lactam antibiotics.

  9. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone.

    Science.gov (United States)

    Ohnishi, Makoto; Golparian, Daniel; Shimuta, Ken; Saika, Takeshi; Hoshina, Shinji; Iwasaku, Kazuhiro; Nakayama, Shu-ichi; Kitawaki, Jo; Unemo, Magnus

    2011-07-01

    Recently, the first Neisseria gonorrhoeae strain (H041) that is highly resistant to the extended-spectrum cephalosporin (ESC) ceftriaxone, the last remaining option for empirical first-line treatment, was isolated. We performed a detailed characterization of H041, phenotypically and genetically, to confirm the finding, examine its antimicrobial resistance (AMR), and elucidate the resistance mechanisms. H041 was examined using seven species-confirmatory tests, antibiograms (30 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of ESC resistance determinants (penA, mtrR, penB, ponA, and pilQ). Transformation, using appropriate recipient strains, was performed to confirm the ESC resistance determinants. H041 was assigned to serovar Bpyust, MLST sequence type (ST) ST7363, and the new NG-MAST ST4220. H041 proved highly resistant to ceftriaxone (2 to 4 μg/ml, which is 4- to 8-fold higher than any previously described isolate) and all other cephalosporins, as well as most other antimicrobials tested. A new penA mosaic allele caused the ceftriaxone resistance. In conclusion, N. gonorrhoeae has now shown its ability to also develop ceftriaxone resistance. Although the biological fitness of ceftriaxone resistance in N. gonorrhoeae remains unknown, N. gonorrhoeae may soon become a true superbug, causing untreatable gonorrhea. A reduction in the global gonorrhea burden by enhanced disease control activities, combined with wider strategies for general AMR control and enhanced understanding of the mechanisms of emergence and spread of AMR, which need to be monitored globally, and public health response plans for global (and national) perspectives are important. Ultimately, the development of new drugs for efficacious gonorrhea treatment is necessary.

  10. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone.

    Science.gov (United States)

    Ohnishi, Makoto; Golparian, Daniel; Shimuta, Ken; Saika, Takeshi; Hoshina, Shinji; Iwasaku, Kazuhiro; Nakayama, Shu-ichi; Kitawaki, Jo; Unemo, Magnus

    2011-07-01

    Recently, the first Neisseria gonorrhoeae strain (H041) that is highly resistant to the extended-spectrum cephalosporin (ESC) ceftriaxone, the last remaining option for empirical first-line treatment, was isolated. We performed a detailed characterization of H041, phenotypically and genetically, to confirm the finding, examine its antimicrobial resistance (AMR), and elucidate the resistance mechanisms. H041 was examined using seven species-confirmatory tests, antibiograms (30 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of ESC resistance determinants (penA, mtrR, penB, ponA, and pilQ). Transformation, using appropriate recipient strains, was performed to confirm the ESC resistance determinants. H041 was assigned to serovar Bpyust, MLST sequence type (ST) ST7363, and the new NG-MAST ST4220. H041 proved highly resistant to ceftriaxone (2 to 4 μg/ml, which is 4- to 8-fold higher than any previously described isolate) and all other cephalosporins, as well as most other antimicrobials tested. A new penA mosaic allele caused the ceftriaxone resistance. In conclusion, N. gonorrhoeae has now shown its ability to also develop ceftriaxone resistance. Although the biological fitness of ceftriaxone resistance in N. gonorrhoeae remains unknown, N. gonorrhoeae may soon become a true superbug, causing untreatable gonorrhea. A reduction in the global gonorrhea burden by enhanced disease control activities, combined with wider strategies for general AMR control and enhanced understanding of the mechanisms of emergence and spread of AMR, which need to be monitored globally, and public health response plans for global (and national) perspectives are important. Ultimately, the development of new drugs for efficacious gonorrhea treatment is necessary. PMID:21576437

  11. Antibiotic expected effectiveness and cost under real life microbiology: evaluation of ertapenem and ceftriaxone in the treatment of community-acquired pneumonia for elderly patients in Spain

    Directory of Open Access Journals (Sweden)

    Grau S

    2014-02-01

    Full Text Available Santiago Grau,1 Virginia Lozano,2 Amparo Valladares,3 Rafael Cavanillas,4 Yang Xie,5 Gonzalo Nocea3 1Hospital del Mar, Barcelona, Spain; 2Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain; 3Outcomes Research Merck Sharp and Dohme Ltd, Madrid, Spain; 4Medical Affairs, Merck Sharp and Dohme Ltd, Madrid, Spain; 5Global Health Outcomes, Merck Sharp and Dohme Ltd, Whitehouse Station, NJ, USA Background: Clinical efficacy of antibiotics may be affected by changes in the susceptibility of microorganisms to antimicrobial agents. The purpose of this study is to assess how these changes could affect the initial efficacy of ertapenem and ceftriaxone in the treatment of community-acquired pneumonia (CAP in elderly patients and the potential consequences this may have in health care costs. Methods: Initial efficacy in elderly was obtained from a combined analysis of two multicenter, randomized studies. An alternative scenario was carried out using initial efficacy data according to the pneumonia severity index (PSI. Country-specific pathogens distribution was obtained from a national epidemiological study, and microbiological susceptibilities to first- and second-line therapies were obtained from Spanish or European surveillance studies. A decision analytic model was used to compare ertapenem versus ceftriaxone for CAP inpatient treatment. Inputs of the model were the expected effectiveness previously estimated and resource use considering a Spanish national health system perspective. Outcomes include difference in proportion of successfully treated patients and difference in total costs between ertapenem and ceftriaxone. The model performed one-way and probabilistic sensitivity analyses. Results: First-line treatment of CAP with ertapenem led to a higher proportion of successfully treated patients compared with ceftriaxone in Spain. One-way sensitivity analysis showed that length of stay was the key parameter of the model. Probabilistic

  12. A Prospective Open-Label Multicentre Trial on the Use of 1 G, Once Daily Ceftriaxone in Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Donald E Low

    1994-01-01

    in the study. Clinical cure and clinical improvement were achieved in 64.6 and 28.3% of the evaluable patients. respectively. Relapse of infection occurred in two patients (1.8%. and treatment failure was recorded in six cases (5.3%. Twelve patients (8.8% died clue to reasons unrelated to the sludy treatment. Three adverse event (hives, diarrhea and phlebitis at the injection site were possibly related to the study drug. A cross-Canada in vitro susceptibility surveillance study of bacterial pathogens. frequently the cause of pneumonia. found ceftriaxone to have minimal inhibitory concentrations in 90% of isolates that would support such a dosing regimen. with the exception of Enterobacter species. These rcsults support the use of 1 g, once daily ceftriaxone for the empirical treatment of pneumonia in those patients requiring hospitalization.

  13. Septic arthritis of the hip in a Cambodian child caused by multidrug-resistant Salmonella enterica serovar Typhi with intermediate susceptibility to ciprofloxacin treated with ceftriaxone and azithromycin.

    Science.gov (United States)

    Pocock, J M; Khun, P A; Moore, C E; Vuthy, S; Stoesser, N; Parry, C M

    2014-08-01

    Septic arthritis is a rare complication of typhoid fever. A 12-year-old boy without pre-existing disease attended a paediatric hospital in Cambodia with fever and left hip pain. A hip synovial fluid aspirate grew multidrug-resistant Salmonella enterica ser. Typhi with intermediate susceptibility to ciprofloxacin. Arthrotomy, 2 weeks of intravenous ceftriaxone and 4 weeks of oral azithromycin led to resolution of symptoms. The optimum management of septic arthritis in drug-resistant typhoid is undefined.

  14. Is Neisseria gonorrhoeae Initiating a Future Era of Untreatable Gonorrhea?: Detailed Characterization of the First Strain with High-Level Resistance to Ceftriaxone ▿ †

    OpenAIRE

    Ohnishi, Makoto; Golparian, Daniel; Shimuta, Ken; Saika, Takeshi; Hoshina, Shinji; Iwasaku, Kazuhiro; Nakayama, Shu-ichi; Kitawaki,Jo; Unemo, Magnus

    2011-01-01

    Recently, the first Neisseria gonorrhoeae strain (H041) that is highly resistant to the extended-spectrum cephalosporin (ESC) ceftriaxone, the last remaining option for empirical first-line treatment, was isolated. We performed a detailed characterization of H041, phenotypically and genetically, to confirm the finding, examine its antimicrobial resistance (AMR), and elucidate the resistance mechanisms. H041 was examined using seven species-confirmatory tests, antibiograms (30 antimicrobials),...

  15. Antibiotics and production of granulocyte-macrophage colony-stimulating factor by human bronchial epithelial cells in vitro. A comparison of cefodizime and ceftriaxone.

    Science.gov (United States)

    Pacheco, Y; Hosni, R; Dagrosa, E E; Gormand, F; Guibert, B; Chabannes, B; Lagarde, M; Perrin-Fayolle, M

    1994-04-01

    Cultured human bronchial epithelial cells (HBEC) produce both granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin 8 (IL-8). The influence of cefodizime (CAS 69739-16-8), a new broad spectrum cephalosporin with immunostimulatory effects, and ceftriaxone on the production of GM-CSF and IL-8 in HBEC primary cultures was investigated. HBEC were isolated from biopsy specimens obtained during fibreoptic bronchoscopy in 12 patients (most frequent diagnosis: chronic bronchitis). Confluent monolayers of HBEC cultured on collagen were incubated for 24 h in a medium without study drugs (spontaneous production) or containing cefodizime or ceftriaxone at the clinically relevant concentrations of 1, 10 and 100 mg/l, with or without tumor necrosis factor alpha (TNF alpha, 100 U/ml). GM-CSF and IL-8 were measured in supernatant by ELISA technique. TNF alpha alone led to a significant (p ceftriaxone had no influence on cytokine production. This is the first report of a stimulatory effect of a beta-lactam antibiotic on cytokine production by epithelial cells. GM-CSF production by epithelial cells is an important immunological step for neutrophil and monocyte recruitment and cell priming during lung defence. Previous studies with cefodizime in immunodepressed subjects have shown activation of phagocytosis and phagocytosis-related functions in non-lung phagocytes. An indirect mechanism of action, similar to that indicated by our results, may have been responsible for these stimulatory effects.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. An ultrasensitive and selective method for the determination of Ceftriaxone using cysteine capped cadmium sulfide fluorescence quenched quantum dots as fluorescence probes

    Science.gov (United States)

    Samadi, Naser; Narimani, Saeedeh

    2016-06-01

    In this paper, L-cysteine (Cys) coated CdS quantum dots (QDs) have been prepared, which have excellent water-solubility and are highly stable in aqueous solution. These QDs is proposed as sensitizers for the determination of Ceftriaxone. The quantum dot nanoparticles were structurally and optically characterized by Ultra Violet-Visible absorption Spectroscopy (UV-vis absorption spectroscopy), Fourier transform infrared spectroscopy (FT-IR spectra) and photoluminescence (PL) emission spectroscopy. High resolution transmission electron microscopy (HRTEM) confirms that the Cys-CdS QDs have a spherical structure with good crystallinity. Therefore, a new simple and selective PL analysis system was developed for the determination of Ceftriaxone (CFX). Under the optimum conditions, The response of L-Cys capped CdS QDs as the probe was linearly proportional to the concentration of Ceftriaxone ions in the range of 1.6 × 10- 9-1.1 × 10- 3 M with a correlation coefficient (R2) of 0.9902. The limit of detection of this system was found to be 1.3 nM. This method is simple, sensitive and low cost.

  17. Antimicrobial resistance and molecular typing of Neisseria gonorrhoeae isolates in Kyoto and Osaka, Japan, 2010 to 2012: intensified surveillance after identification of the first strain (H041) with high-level ceftriaxone resistance.

    Science.gov (United States)

    Shimuta, Ken; Unemo, Magnus; Nakayama, Shu-Ichi; Morita-Ishihara, Tomoko; Dorin, Misato; Kawahata, Takuya; Ohnishi, Makoto

    2013-11-01

    In 2009, the first high-level ceftriaxone-resistant Neisseria gonorrhoeae strain (H041) was isolated in Kyoto, Japan. The present study describes an intensified surveillance (antimicrobial resistance and molecular typing) of Neisseria gonorrhoeae isolates in Kyoto and its neighboring prefecture Osaka, Japan, in 2010 to 2012, which was initiated after the identification of H041. From April 2010 to March 2012, 193 N. gonorrhoeae isolates were collected and the MICs (μg/ml) to six antimicrobials, including ceftriaxone, were determined. All isolates showed susceptibility to ceftriaxone and cefixime (MIC values, gonorrhoeae multiantigen sequence typing (NG-MAST) revealed that 12 (63%) of the 19 isolates with decreased susceptibility to ceftriaxone (MIC > 0.064 μg/ml) were of ST1407. NG-MAST ST1407 was also the most prevalent ST (16.1%; 31 of 193 isolates). In those NG-MAST ST1407 strains, several mosaic type penA alleles were found, including SF-A type (penicillin binding protein 2 allele XXXIV) and its derivatives. These were confirmed using transformation of the penA mosaic alleles as critical determinants for enhanced cefixime and ceftriaxone MICs. The intensified surveillance in Kyoto and Osaka, Japan, did not identify any dissemination of the high-level ceftriaxone-resistant N. gonorrhoeae strain H041, suggesting that H041 might have caused only a sporadic case and has not spread further.

  18. One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia.

    Science.gov (United States)

    Read, Phillip J; Limnios, E Athena; McNulty, Anna; Whiley, David; Lahra, Monica M

    2013-11-01

    Emerging antimicrobial resistance within Neisseria gonorrhoeae (NG) is a significant global public health threat. Detection and investigation of treatment failures is a crucial component of the World Health Organisation's response to this challenge. We report the cases of two homosexual men, both treated for pharyngeal NG with 500mg intramuscular ceftriaxone, in whom a test of cure 1 week after treatment showed persisting infection. Both men denied further sexual activity. In the first case, treatment failure was confirmed, since the isolates before and after treatment were identical by auxotype, antibiogram, multilocus sequence type (MLST) and multi-antigen sequence type (NG-MAST). In the second case, the MLSTs before and after treatment were identical, but NG-MAST results were similar but not indistinguishable. These cases underline the importance of test-of-cure and molecular investigations in identifying treatment failure, but also highlight the complexity of distinguishing treatment failure from reinfection when relying on highly variable molecular targets that may be subject to drug pressure.

  19. A sensitive "turn-on" fluorescent assay for quantification of ceftriaxone based on L-tryptophan-Pd(II) complex fluorophore

    Science.gov (United States)

    Qiao, Man; Jiang, Junze; Yang, Jidong; Liu, Shaopu; Liu, Zhongfang; Hu, Xiaoli

    2016-05-01

    Based on L-tryptophan-Pd(II) system, a sensitive and selective fluorimetric assay for the quantification of ceftriaxone (CTRX) had been developed. The experimental results showed that in pH 4.0 Britton-Robinson (BR) buffer medium, the fluorescence of L-tryptophan (L-Trp) (λex/λem = 276 nm/352 nm) could be efficiently quenched by Pd(II). When CTRX was added to the mixed solution of the L-tryptophan and Pd(II), the fluorescence of L-Trp recovered. The reaction mechanism and the reasons for the fluorescence recovery were also discussed. Pd(II) reacted with L-Trp to form a 1:1 chelate complex, and then, after CTRX was added in L-Try-Pd(II) system, the ligand exchange reaction occurred between L-Trp and CTRX, which resulted in the fluorescence recovery. Under the optimized experimental conditions, the recovered fluorescence intensities at 352 nm showed excellent linear relationship with the concentration of CTRX over the range of 6.0 × 10- 8-2.4 × 10-6 mol L- 1 (0.040-1.59 μg mL- 1). The correlation coefficient (R) was 0.9997 and the detection limit was 1.8 × 10-8 mol L- 1 (11.9 ng mL- 1). Furthermore, the assay had been applied to determine trace amount of CTRX human urine samples with satisfactory results.

  20. Adverse reactions of ceftriaxone sodium: Analysis of 6916 cases in Jiangsu Province%6916例头孢曲松钠不良反应报告分析

    Institute of Scientific and Technical Information of China (English)

    卞蓉蓉; 孙骏

    2012-01-01

    目的 头孢曲松钠临床应用广泛,其不良反应越来越引起重视.文中分析总结江苏省4年来抗感染药物头孢曲松钠的不良反应发生情况及其特点,为临床合理用药提供参考.方法 从江苏省药品不良反应监测中心数据库中提取2007年1月至2010年12月头孢曲松钠所致药物不良反应(adverse drug reaction,ADR)报告6916例,进行回顾性统计分析.结果 10岁以下儿童(18.65%)是高发组.头孢曲松钠所致ADR临床表现以皮肤及其附件损害最多(61.68%),其余依次是全身性损害、胃肠系统损害、药物热、神经系统损害等.结论 临床应重视头孢曲松钠引起ADR的各种因素,加强对其严重不良反应的预防和监测,确保临床安全、有效、合理用药.%Objective With the wide clinical application of ceftriaxone sodium, more and more attention has been drawn to its adverse reactions. This article analyzes the characteristics of the adverse drug reactions ( ADR ) of ceftriaxone sodium in Jiangsu Province to provide some reference for rational and safe medication in clinical practice. Methods We retrospectively analyzed 69f6 cases of adverse reactions of ceftriaxone sodium reported from Jan. 2007 to Dec. 20f0 from the database of our center. Results Children under the age of fO years was a high-risk cohort, with an ADR incidence of f8.65%. The clinical manifestations of the adverse reactions of ceftriaxone sodium were mostly skin lesions ( 61. 68% ), followed by systemic problems, gastrointestinal disorders, drug fever, and central and peripheral nervous system involvement. Conclusion Attention should be paid to the multiple factors causing serious ADRs of ceftriaxone sodium, and strengthened measures are necessitated for the prevention and control of ADRs.

  1. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure.

    Science.gov (United States)

    Unemo, Magnus; Golparian, Daniel; Nicholas, Robert; Ohnishi, Makoto; Gallay, Anne; Sednaoui, Patrice

    2012-03-01

    Recently, the first Neisseria gonorrhoeae strain (H041) highly resistant to the expanded-spectrum cephalosporins (ESCs) ceftriaxone and cefixime, which are the last remaining options for first-line gonorrhea treatment, was isolated in Japan. Here, we confirm and characterize a second strain (F89) with high-level cefixime and ceftriaxone resistance which was isolated in France and most likely caused a treatment failure with cefixime. F89 was examined using six species-confirmatory tests, antibiograms (33 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of known gonococcal resistance determinants (penA, mtrR, penB, ponA, and pilQ). F89 was assigned to MLST sequence type 1901 (ST1901) and NG-MAST ST1407, which is a successful gonococcal clone that has spread globally. F89 has high-level resistance to cefixime (MIC = 4 μg/ml) and ceftriaxone (MIC = 1 to 2 μg/ml) and resistance to most other antimicrobials examined. A novel penA mosaic allele (penA-CI), which was penA-XXXIV with an additional A501P alteration in penicillin-binding protein 2, was the primary determinant for high-level ESC resistance, as determined by transformation into a set of recipient strains. N. gonorrhoeae appears to be emerging as a superbug, and in certain circumstances and settings, gonorrhea may become untreatable. Investigations of the biological fitness and enhanced understanding and monitoring of the ESC-resistant clones and their international transmission are required. Enhanced disease control activities, antimicrobial resistance control and surveillance worldwide, and public health response plans for global (and national) perspectives are also crucial. Nevertheless, new treatment strategies and/or drugs and, ideally, a vaccine are essential to develop for efficacious gonorrhea management. PMID:22155830

  2. High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure.

    Science.gov (United States)

    Unemo, Magnus; Golparian, Daniel; Nicholas, Robert; Ohnishi, Makoto; Gallay, Anne; Sednaoui, Patrice

    2012-03-01

    Recently, the first Neisseria gonorrhoeae strain (H041) highly resistant to the expanded-spectrum cephalosporins (ESCs) ceftriaxone and cefixime, which are the last remaining options for first-line gonorrhea treatment, was isolated in Japan. Here, we confirm and characterize a second strain (F89) with high-level cefixime and ceftriaxone resistance which was isolated in France and most likely caused a treatment failure with cefixime. F89 was examined using six species-confirmatory tests, antibiograms (33 antimicrobials), porB sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST), multilocus sequence typing (MLST), and sequencing of known gonococcal resistance determinants (penA, mtrR, penB, ponA, and pilQ). F89 was assigned to MLST sequence type 1901 (ST1901) and NG-MAST ST1407, which is a successful gonococcal clone that has spread globally. F89 has high-level resistance to cefixime (MIC = 4 μg/ml) and ceftriaxone (MIC = 1 to 2 μg/ml) and resistance to most other antimicrobials examined. A novel penA mosaic allele (penA-CI), which was penA-XXXIV with an additional A501P alteration in penicillin-binding protein 2, was the primary determinant for high-level ESC resistance, as determined by transformation into a set of recipient strains. N. gonorrhoeae appears to be emerging as a superbug, and in certain circumstances and settings, gonorrhea may become untreatable. Investigations of the biological fitness and enhanced understanding and monitoring of the ESC-resistant clones and their international transmission are required. Enhanced disease control activities, antimicrobial resistance control and surveillance worldwide, and public health response plans for global (and national) perspectives are also crucial. Nevertheless, new treatment strategies and/or drugs and, ideally, a vaccine are essential to develop for efficacious gonorrhea management.

  3. Rising trend of antimicrobial resistance among Neisseria gonorrhoeae isolates and the emergence of N. gonorrhoeae isolate with decreased susceptibility to ceftriaxone

    Directory of Open Access Journals (Sweden)

    T Bharara

    2015-01-01

    Full Text Available Context: Gonorrhoea is one of the most common sexually transmitted infections (STI in developing countries and is a global health problem. Aims: To analyze the trend of antimicrobial susceptibility of Neisseria gonorrhoeae isolates over the years, in a tertiary care hospital of North India. Settings and Design: The study population comprised males with urethritis and females with endocervicitis attending STI clinic of our hospital. Materials and Methods: In our STI laboratory, all gonococcal isolates are subjected to antimicrobial susceptibility testing by disc diffusion method as per CLSI guidelines. β-lactamase production is determined by chromogenic cephalosporin test. Minimum Inhibitory Concentration (MIC for ceftriaxone is determined by E-test. Statistical Analysis Used: Data were expressed as percentages. The differences in percentages were tested for statistical significance by using χ2 test and P values were determined. Results: The percentage of penicillinase producing N. gonorrhoeae (PPNG increased from 8% in 1995-96 to 20% in 2004-05 and 88% in 2011-2013. Quinolone-resistant N. gonorrhoeae (QRNG showed a significant increase from 12% in 1995-96 to 98.3% in 2004-05, while 84% isolates were found to be QRNG by 2011-2013. In January 2013 we detected our first gonococcal isolate with decreased susceptibility to third-generation cephalosporins; Ceftriaxone, Cefixime and Cefpodoxime (MIC for ceftriaxone = 0.19 μg/ml. Conclusions: The results of our study highlighted an alarming increase in the percentage of PPNG and QRNG strains over the years. Emergence of N. gonorrhoeae isolates with decreased susceptibility to third-generation cephalosporins is a cause of concern and thus emphasises the importance of antimicrobial susceptibility testing.

  4. In vitro activity of fosfomycin alone and in combination with ceftriaxone or azithromycin against clinical Neisseria gonorrhoeae isolates.

    Science.gov (United States)

    Hauser, Christoph; Hirzberger, Lea; Unemo, Magnus; Furrer, Hansjakob; Endimiani, Andrea

    2015-03-01

    New therapeutic strategies are needed to combat the emergence of infections due to multidrug-resistant Neisseria gonorrhoeae. In this study, fosfomycin (FOS) was tested against 89 N. gonorrhoeae isolates using the Etest method, showing MIC50/MIC90s of only 8/16 μg/ml (range, ≤1 to 32 μg/ml). FOS in combination with ceftriaxone (CRO) or azithromycin (AZT) was then evaluated using the checkerboard method for eight strains, including N. gonorrhoeae F89 (CRO-resistant) and AZT-HLR (high-level AZT-resistant). All combinations that included FOS gave indifferent effects (fractional inhibitory concentration [FIC] index values, 1.2 to 2.3 for FOS plus CRO, 1.8 to 3.2 for FOS plus AZT). Time-kill experiments for FOS, CRO, AZT, and their combinations (at 0.5×, 1×, 2×, and 4× the MIC) were performed against N. gonorrhoeae strain ATCC 49226, one N. gonorrhoeae multiantigen sequence typing (NG-MAST) sequence type 1407 (ST1407) strain, F89, and AZT-HLR. For all strains, at 24 h, the results indicated that (i) FOS was bactericidal at 2× the MIC, but after >24 h, there was regrowth of bacteria; (ii) CRO was bactericidal at 0.5× the MIC; (iii) AZT was bactericidal at 4× the MIC; (iv) CRO plus AZT was less bactericidal than was CRO alone; (v) FOS plus AZT was bactericidal at 2× the MIC; and (vi) CRO plus AZT and FOS plus CRO were both bactericidal at 0.5× the MIC, but FOS plus CRO had more rapid effects. FOS is appealing for use in the management of N. gonorrhoeae infections because of its single and oral formulation. However, our results suggest it be used in combination with CRO. After the appropriate clinical trials are conducted, this strategy could be implemented for the treatment of infections due to isolates possessing resistance to CRO and/or AZT.

  5. 溶胶比浊法测定头孢曲松钠%Determination of ceftriaxone sodiumin by colloidal sol turbidimetry

    Institute of Scientific and Technical Information of China (English)

    孙双姣; 朱琪; 李明娟

    2015-01-01

    In alkaline conditions,ceftriaxone sodium could be degraded into two kinds of thiol compounds(R'SH,R″SH). In pH 4. 7,R'SH could reduce Cu(II)to Cu(I)and Cu(I)could generate white sol with R″SH,which lead to the change of absorbance in the system. The absorption intensity at 340nm is linear to ceftriaxone sodium concentration in the range of 0. 26~160μg·mL-1 ,The linear equation is△A=0. 019ρ+0. 0079,relation coefficient is 0. 9998 and detection limit is 0. 078μg·mL-1. The proposed method has been applied to determination of ceftriaxone sodium in injection with simplicity of instrument and reagents,good reproducibility and wide linear range.%在碱性条件下,头孢曲松钠加热会降解为两种巯基( R’ SH,R″SH)化合物。在pH为4.5时,R’ SH 可使Cu( II)还原为Cu( I),所生成的Cu( I)与R”SH中的巯基生成白色溶胶,导致体系吸光度发生变化。在0.26~160.00μg·mL-1范围内,△A340nm与头孢曲松钠浓度(ρ)之间存在良好的线性关系,回归方程为△A=0.019ρ+0.0079,相关系数为0.9998,检出限0.078μg·mL-1。将本方法直接用于针剂中头孢曲松钠的测定,具有仪器简单、线性范围宽,重现性好的特点。

  6. 52例头孢曲松钠不良反应分析%Analysis of 52 cases adverse reaction of ceftriaxone sodium

    Institute of Scientific and Technical Information of China (English)

    徐红冰; 石卫峰; 刘皋林

    2015-01-01

    Objective:To explore the characteristics and the correlation factors of adverse reaction resulting from ceftriaxone sodium so as to provide a reference for the clinically reasonable medication.Methods:Fifty two cases of adverse reaction of ceftriaxone sodium collected by our hospital from January, 2006 to December, 2012 were statistically analyzed through retrospective research.Results: The adverse reactions include mainly 33 cases (63.5%) skin and appendix harm, 5 cases (9.6%) anaphylactic shock.Conclusion: It was very necessary to strengthen the monitoring of the adverse reaction and pay attention to allergic shock to promote the reasonable application of this drug.%目的:探讨头孢曲松钠不良反应发生的特点及相关因素,为临床合理用药提供参考。方法:采用回顾性研究方法,对上海交通大学附属第一人民医院2006年1月-2012年12月上报的因使用头孢曲松钠出现的52例不良反应报告进行统计和分析。结果:头孢曲松钠所致不良反应主要为皮肤及附件损害(33例,63.5%)和过敏性休克(5例,9.6%)。结论:应加强对头孢曲松钠不良反应的监测,注意其过敏性休克等严重不良反应,保障用药安全。

  7. Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma

    Directory of Open Access Journals (Sweden)

    Petrilli Antonio Sérgio

    2003-01-01

    Full Text Available BACKGROUND: The empirical use of antibiotic treatments is widely accepted as a means to treat cancer patients in chemotherapy who have fever and neutropenia. Intravenous monotherapy, with broad spectrum antibiotics, of patients with a high risk of complications is a possible alternative. METHODS: We conducted a prospective open-label, randomized study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients received either monotherapy with ticarcillin/clavulanic acid (T or ceftriaxone plus amikacin (C+A. RESULTS: Seventy patients who presented 136 episodes were evaluated, 68 in each arm of the study. The mean neutrophil counts at admission were 217cells/mm³ (T and 201cells/mm³ (C+A. The mean duration of neutropenia was 8.7 days (T and 7.6 days (C+A. Treatment was successful without the need for modifications in 71% of the episodes in the T group and 81% in the C+A group (p=0.23. Treatment was considered to have failed because of death in two episodes (3% in the T group and three episodes (4% in the C+A group, and because of a change in the drug applied in one episode in the T group and two episodes in the C+A group. Overall success was 96% (T and 93% (C+A. Adverse events that occurred in group T were not related to the drugs used in this study. CONCLUSION: In pediatric and adolescent patients with leukemia or lymphoma, who presented with fever and neutropenia, during chemotherapy, ticarcillin/clavulanic acid was as successful as the combination of ceftriaxone plus amikacin. It should be considered an appropriate option for this group of patients at high risk for infections.

  8. Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone.

    Science.gov (United States)

    Pericas, J M; Cervera, C; del Rio, A; Moreno, A; Garcia de la Maria, C; Almela, M; Falces, C; Ninot, S; Castañeda, X; Armero, Y; Soy, D; Gatell, J M; Marco, F; Mestres, C A; Miro, J M

    2014-12-01

    The aim of this study was to assess changes in antibiotic resistance, epidemiology and outcome among patients with Enterococcus faecalis infective endocarditis (EFIE) and to compare the efficacy and safety of the combination of ampicillin and gentamicin (A+G) with that of ampicillin plus ceftriaxone (A+C). The study was a retrospective analysis of a prospective cohort of EFIE patients treated in our centre from 1997 to 2011. Thirty patients were initially treated with A+G (ampicillin 2 g/4 h and gentamicin 3 mg/kg/day) and 39 with A+C (ampicillin 2 g/4 h and ceftriaxone 2 g/12 h) for 4-6 weeks. Increased rates of high-level aminoglycoside resistance (HLAR; gentamicin MIC ≥512 mg/L, streptomycin MIC ≥1024 mg/L or both) were observed in recent years (24% in 1997-2006 and 49% in 2007-2011; p 0.03). The use of A+C increased over time: 1997-2001, 4/18 (22%); 2002-2006, 5/16 (31%); 2007-2011, 30/35 (86%) (p <0.001). Renal failure developed in 65% of the A+G group and in 34% of the A+C group (p 0.014). Thirteen patients (43%) in the A+G group had to discontinue treatment, whereas only one patient (3%) treated with A+C had to discontinue treatment (p <0.001). Only development of heart failure and previous chronic renal failure were independently associated with 1-year mortality, while the individual antibiotic regimen (A+C vs. A+G) did not affect outcome (OR, 0.7; 95% CI, 0.2-2.2; p 0.549). Our study shows that the prevalence of HLAR EFIE has increased significantly in recent years and that alternative treatment with A+C is safer than A+G, with similar clinical outcomes, although the sample size is too small to draw firm conclusions. Randomized controlled studies are needed to confirm these results.

  9. Behavioral and socioeconomic risk factors associated with probable resistance to ceftriaxone and resistance to penicillin and tetracycline in Neisseria gonorrhoeae in Shanghai.

    Directory of Open Access Journals (Sweden)

    Molly A Trecker

    Full Text Available Globally, incidence of Neisseria gonorrhoeae infection is once again the highest of the bacterial sexually transmitted infections. The bacterium can produce serious complications in those infected, and emerging resistance to third generation cephalosporins could usher in an era of potentially untreatable gonorrhea. This research aimed to identify risk factors for antibiotic resistant gonorrhea infection among clients at a Shanghai sexually transmitted infection clinic over two time periods, 2004-2005 and 2008-2011. Demographic and risk factor behavior data, and biological samples for antimicrobial resistance analysis, were collected. Statistical models were built to identify risk factors associated with probable resistance to ceftriaxone and resistance to penicillin and tetracycline. High levels of ciprofloxacin resistance (98% in our sample precluded examining its risk factors; all isolates were susceptible to spectinomycin. Overall (P<0.001, chromosomal (P<0.001, and plasmid-mediated (P = 0.01 penicillin resistance decreased from the first to second period of the study. For tetracycline, chromosomal resistance decreased (P = 0.01 and plasmid-mediated resistance increased (P<0.001 between the first and second periods of study. In multi-level multivariable regression models, male gender (P = 0.03 and older age (P = 0.01 were associated with increased minimum inhibitory concentrations to ceftriaxone. Male gender (P = 0.03 and alcohol use (P = 0.02 were associated with increased odds of overall tetracycline resistance. Male gender was associated with increased odds of chromosomally-mediated tetracycline resistance (P = 0.04, and alcohol use was associated with increased odds of plasmid-mediated tetracycline resistance (P = 0.02. Additionally, individuals in middle-salary categories were found to have lower odds of plasmid-mediated resistance to tetracycline compared with those in the lowest salary category (P≤0

  10. Cefepime Monotherapy is as Effective as Ceftriaxone Plus Amikacin in Pediatric Patients with Cancer and High-Risk Febrile Neutropenia: A Randomized Comparison

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Pires Pereira

    2008-01-01

    Full Text Available The empirical use of antibiotic therapies is widely accepted in patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients with high-risk of complications is an appropriate alternative. However, few data are available in pediatric patients. We conducted a prospective, randomized, open study in patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients were randomized to receive cefepime (CFP or ceftriaxone plus amikacin (CFT+AK. A total of 57 patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 and CFT + AK, 63 episodes. The mean neutrophil count at admission was 118.6 cells mm-3 (CFP and 107 cells mm-3 (CFT+AK. The mean duration of neutropenia was 9.0 days (CFP and 8.0 days (CFT+AK. Analyzing only the first episodes of each patient, CFP treatment was successful in 65.5% of the episodes and CFT+AK were successful in 64.3%. Overall rates of success with modification were 90% (CFP and 89% (CFT+AK. No major treatment-emergent toxicity was reported. Monotherapy with CFP seems to be as effective and safe as the combination of CFT+AK for initial empirical therapy in children and adolescents with NF.

  11. A randomised comparison of meropenem with cefotaxime or ceftriaxone for the treatment of bacterial meningitis in adults. Meropenem Meningitis Study Group.

    Science.gov (United States)

    Schmutzhard, E; Williams, K J; Vukmirovits, G; Chmelik, V; Pfausler, B; Featherstone, A

    1995-07-01

    Third-generation cephalosporins are presently the agents of choice for the empirical antimicrobial therapy of bacterial meningitis. However, a number of factors associated with these agents, namely the development of resistance by pneumococci, limited activity against some Enterobacteriaceae and Pseudomonas spp., and the possible adverse effects of their bacteriolytic mode of action, indicate that newer classes of antimicrobial agents be evaluated for the treatment of bacterial meningitis. Meropenem is a carbapenem antibiotic which is highly active against the major bacterial pathogens causing meningitis, and penetrates well into the cerebrospinal fluid. Two prospective randomised studies in 56 adult bacterial meningitis patients have compared meropenem 40 mg/kg 8-hourly, up to a maximum of 6 g/day (n = 28) with cephalosporin treatment, i.e. cefotaxime (n = 17) or ceftriaxone (n = 11). Patients were assessed by neurological examination, Glasgow Coma Score and Herson-Todd score. Clinical cure was observed in all 23 evaluable patients treated with meropenem (100%) and with 17 of the 22 evaluable cephalosporin-treated patients (77%). All pre-treatment isolates were eradicated except one isolate of Staphylococcus aureus in a cefotaxime-treated patient. Neurological sequelae were noted in three meropenem and four cephalosporin-treated patients. No patients in either treatment group experienced seizures after the start of therapy. This was despite the fact that a patient in each group had experienced seizures before therapy, several had underlying CNS disorders, and that doses of 6 g/day of meropenem were given. Hearing impairment was recorded in 11 meropenem and nine cephalosporin treated patients. Three patients in the meropenem group and one in the cephalosporin group died during treatment for reasons unrelated to study therapy. Overall, the results of this study indicate that meropenem is an effective and well-tolerated antibiotic for the treatment of bacterial

  12. Synergistic effects of ceftriaxone and erythropoietin on neuronal and behavioral deficits in an MPTP-induced animal model of Parkinson's disease dementia.

    Science.gov (United States)

    Huang, Chiu-Ku; Chang, Yen-Ting; Amstislavskaya, Tamara G; Tikhonova, Maria A; Lin, Chih-Li; Hung, Ching-Sui; Lai, Te-Jen; Ho, Ying-Jui

    2015-11-01

    Both ceftriaxone (CEF) and erythropoietin (EPO) show neuroprotection and cognitive improvement in neurodegenerative disease. The present study was aimed at clarifying whether combined treatment with CEF and EPO (CEF+EPO) had superior neuroprotective and behavioral effects than treatment with CEF or EPO alone in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease (PD) rat model. The rats were injected with CEF (5 mg/kg/day), EPO (100 IU/kg/day), or CEF+EPO after MPTP lesioning and underwent the bar-test, T-maze test, and object recognition test, then the brains were taken for histological evaluation. MPTP lesioning resulted in deficits in working memory and in object recognition, but the cognitive deficits were markedly reduced or eliminated in rats treated with CEF or CEF+EPO, with the combination having a greater effect. Lesioning also caused neurodegeneration in the nigrostriatal dopaminergic system and the hippocampal CA1 area and these changes were reduced or eliminated by treatment with CEF, EPO, or CEF+EPO, with the combination having a greater effect than single treatment in the densities of DAergic terminals in the striatum and neurons in the hippocampal CA1 area. Thus, compared to treatment with CEF or EPO alone, combined treatment with CEF+EPO had a greater inhibitory effect on the lesion-induced behavioral and neuronal deficits. To our knowledge, this is the first study showing a synergistic effect of CEF and EPO on neuroprotection and improvement in cognition in a PD rat model. Combined CEF and EPO treatment may have clinical potential for the treatment of the dementia associated with PD. PMID:26296668

  13. Behavioral and socioeconomic risk factors associated with probable resistance to ceftriaxone and resistance to penicillin and tetracycline in Neisseria gonorrhoeae in Shanghai.

    Science.gov (United States)

    Trecker, Molly A; Waldner, Cheryl; Jolly, Ann; Liao, Mingmin; Gu, Weiming; Dillon, Jo-Anne R

    2014-01-01

    Globally, incidence of Neisseria gonorrhoeae infection is once again the highest of the bacterial sexually transmitted infections. The bacterium can produce serious complications in those infected, and emerging resistance to third generation cephalosporins could usher in an era of potentially untreatable gonorrhea. This research aimed to identify risk factors for antibiotic resistant gonorrhea infection among clients at a Shanghai sexually transmitted infection clinic over two time periods, 2004-2005 and 2008-2011. Demographic and risk factor behavior data, and biological samples for antimicrobial resistance analysis, were collected. Statistical models were built to identify risk factors associated with probable resistance to ceftriaxone and resistance to penicillin and tetracycline. High levels of ciprofloxacin resistance (98%) in our sample precluded examining its risk factors; all isolates were susceptible to spectinomycin. Overall (Pceftriaxone. Male gender (P = 0.03) and alcohol use (P = 0.02) were associated with increased odds of overall tetracycline resistance. Male gender was associated with increased odds of chromosomally-mediated tetracycline resistance (P = 0.04), and alcohol use was associated with increased odds of plasmid-mediated tetracycline resistance (P = 0.02). Additionally, individuals in middle-salary categories were found to have lower odds of plasmid-mediated resistance to tetracycline compared with those in the lowest salary category (P≤0.02). This study is one of the first to use multilevel analysis to consider the association between risk factors for gonorrhea infections and mechanisms of resistance to individual antibiotics. Such information is urgently needed to combat the growing threat of untreatable gonorrhea.

  14. Calculi associated with intravenous infusion of ceftriaxone sodium in two infants%婴儿静脉输注头孢曲松钠相关结石2例

    Institute of Scientific and Technical Information of China (English)

    杨景秀; 戈升荣

    2014-01-01

    Two male infants (aged 5 months and 19 days,and 3 months and 19 days,respectively) were given an intravenous infusion of ceftriaxone sodium 0.7 g in 0.9% sodium chloride 100 ml once daily and an intravenous infusion of ceftriaxone sodium 0.6 g in 0.9% sodium chloride 50 ml once daily for bronchitis and infectious diarrhea,respectively.On day 10 and 4,white granules were found on skin surface of the two infants'oschea.There were no inflamed urinary meatus and abnormal results of routine urine tests.The white granules gradually decreased and disappeared after ceftriaxone sodium was withdrawn.%2例男婴(年龄分别为5个月19 d、3个月19 d)分别因支气管炎和感染性腹泻分别给予头孢曲松钠0.7g入0.9%氯化钠注射液100 ml静脉滴注,1次/d和头孢曲松钠0.6g入0.9%氯化钠注射液50 ml静脉滴注,1次/d.分别在用药第10、4天家长发现患儿阴囊处白色颗粒物,附于皮肤表面,尿道口无红肿,尿常规检查无异常.头孢曲松钠停用或减量后,白色颗粒物逐渐减少至消失.

  15. Spectroscopic Study on the Interaction Between Ceftriaxone Sodium and pepsin%头孢曲松钠与胃蛋白酶相互作用的光谱研究

    Institute of Scientific and Technical Information of China (English)

    肖敏; 邵从英; 葛宝宝; 訾言勤

    2014-01-01

    The interaction between ceftriaxone sodium and pepsin was investigated by spectrophotometric techniques such as fluorescence and UV-vis absorption at different temperatures.The binding constant K and the number of binding site n of the system were calculated.The results showed that ceftriaxone sodium has a strong quenching on the intrinsic fluorescence of pepsin through a dynamic quenching procedure.The nega⁃tive value of G0 reveals that the binding process is a spontaneous process and the positive value of ΔH/ΔS in⁃dicates that the binding power between them is mainly hydrophobic bond.It was determined that the distance between ceftriaxone sodium and tryptophan residues in pepsin is 0.92 nm by the mechanism of non-radiation energy transfer.%在不同温度下利用荧光光谱、紫外吸收光谱等方法研究胃蛋白酶与头孢曲松钠之间的相互作用.计算两者的结合常数K和结合位点数n,判断头孢曲松钠对胃蛋白酶荧光猝灭机制为动态猝灭.由热力学参数ΔG0且ΔS>0,表明结合过程是自发进行且两者之间的作用力主要是疏水作用力.通过Förster偶极-偶极非辐射能量转移机理确定头孢曲松钠在胃蛋白酶中与色氨酸残基之间距离R为0.92 nm.

  16. Mechanisms underlying the resistance and reduced susceptibility to ceftriaxone in Neisseria gonorrhoeae%淋病奈瑟菌对头孢曲松耐药性及敏感性降低机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    张丽君; 李国明

    2012-01-01

    头孢曲松为目前治疗淋病的首选药物之一,国内外淋球菌耐药监测均发现淋球菌对头孢曲松敏感性降低,并已发现少数散发的头孢曲松耐药株.淋球菌对头孢曲松敏感性降低主要由染色体介导,目前大多数研究主要关注三个方面:一是抗生素作用靶位点的改变,影响抗生素与淋球菌的结合产生耐药;二是细菌细胞膜孔蛋白的改变,导致膜通透性降低产生耐药;三是外排系统的改变,导致细菌外排作用增强产生耐药.涉及的基因有penA、ponA、porB和mtrR等.%Ceftriaxone is one of the first-line drugs for gonorrhea treatment.In vitro antimicrobial susceptibility studies have shown Neisseria gonorrhoeae strains with reduced susceptibility or resistance to ceftriaxone,which is mainly mediated by chromosomes.Current studies on ceftriaxone resistance are mainly focused on three aspects,i.e.,changes in antibiotic target sites affecting the combination of antibiotics and Neisseria gonorrhoeae,bacterial cell membrane porin changes resulting in decreased membrane permeability,and efflux system changes enhancing the bacterial efflux capacity,It has been demonstrated that penA,ponA,porB and mtrR genes are associated with Neisseria gonorrhoeae resistance.

  17. Clinical Study of Ceftriaxone Sodium in Treatment of Pregnancy Syphilis and Prevention of Congenital Syphilis%头孢曲松钠治疗妊娠梅毒预防先天性梅毒的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙静茹

    2015-01-01

    Objective To explore the effect of ceftriaxone sodium in in treatment of pregnancy syphilis and prevention of congenital syphilis. Methods 100 pregnant women with syphilis were selected into observation group(50 cases)and control group(50 cases). The patients in observation group were treated with ceftriaxone sodium,the control group patients were treated with benzathine penicillin. The incidences of congenital syphilis between two groups were compared. Results There were no significant difference between observation group and control group, the difference was not statistically significant(P>0.05). Conclusion Ceftriaxone sodium and benzathine penicillin have the same results in the prevention of congenital syphilis,for penicillin allergy persons,ceftriaxone sodium can be used as the medicine for preventing congenital syphilis. It can make more patients benefit.%目的:探讨头孢曲松钠治疗妊娠梅毒预防先天性梅毒的效果。方法选取我处接受治疗的梅毒孕妇100例,随机分为观察组和对照组,其中,观察组患者50例,以头孢曲松钠进行治疗。对照组患者50例,以苄星青霉素进行治疗。对比两组患者先天梅毒的发病率。结果观察组与对照组的组间无显著差异,结果不具有统计意义(P>0.05)。结论头孢曲松钠与苄星青霉素在预防先天性梅毒的效果中具有相同的结果,因此对于青霉素过敏者,可以使用头孢曲松钠作为预防先天性梅毒的药物,使得更多患者受益。

  18. Resistance trend of Neisseria gonorrhoeae to ceftriaxone and cefixime and its mechanism%淋球菌对头孢曲松和头孢克肟耐药现状及耐药机制研究进展

    Institute of Scientific and Technical Information of China (English)

    蒋法兴; 胡白; 王千秋

    2009-01-01

    The resistance of clinical isolates of Neisseria gonorrhoeae to ceftriaxone or cefixime has been increasingly reported all over the world. PenA, mtrR, porBlb and ponA gene are predominate genes associated with decreased susceptibility of Neisseria gonorrhoeae to cephalosporins. It has been revealed that mosaic-like structure of penicillin-binding protein 2 (PBP2) can confer decreased susceptibility to cefixime in Neisscria gonorrhoeae and may be related to decreased susceptibility to ceftriaxone. There is a confirmed correlation between mutions of mtrR, porBlb and ponA genes and decreased susceptibility of Neisseria gonorrhocae to cefixime and ceftriaxone. Also, mosaic alleles of PenA in conjunction with polymorphisms of mtrR, porB1b and ponA genes may contribute to the reduced susceptibility to cefixime and ceftriaxone in Neisseria gonorrhoeae.%世界各地不断分离出对头孢曲松和头孢克肟敏感性下降的淋球菌菌珠.penA、mtrR、DorB1b和ponA基因是与淋球菌对头孢菌素敏感性下降的主要相关基因.研究表明,镶嵌状penA基因导致淋球菌对头孢克肟敏感性降低,并可能导致淋球菌对头孢曲松敏感性下降.mtrR、porB1b和ponA基因突变与淋球菌对头孢克肟和头孢曲松敏感性下降有明确关系,镶嵌状penA、mtrR、porB1b和ponA基因多态性可能共同导致淋球菌对头孢曲松和头孢克肟的敏感性明显降低.

  19. Effects of ceftriaxone on ethanol, nicotine or sucrose intake by alcohol-preferring (P) rats and its association with GLT-1 expression.

    Science.gov (United States)

    Sari, Youssef; Toalston, Jamie E; Rao, P S S; Bell, Richard L

    2016-06-21

    Increased glutamatergic neurotransmission appears to mediate the reinforcing properties of drugs of abuse, including ethanol (EtOH). We have shown that administration of ceftriaxone (CEF), a β-lactam antibiotic, reduced EtOH intake and increased glutamate transporter 1 (GLT-1) expression in mesocorticolimbic regions of male and female alcohol-preferring (P) rats. In the present study, we tested whether CEF administration would reduce nicotine (NIC) and/or EtOH intake by adult female P rats. P rats were randomly assigned to 4 groups: (a) 5% sucrose (SUC) or 10% SUC [SUC], (b) 5% SUC+0.07mg/ml NIC and 10% SUC+0.14mg/ml NIC [NIC-SUC], 15% EtOH and 30% EtOH [EtOH] and (d) 15% EtOH+0.07mg/ml NIC and 30% EtOH+0.14mg/ml NIC [NIC-EtOH]. After achieving stable intakes (4weeks), the rats were administered 7 consecutive, daily i.p. injections of either saline or 200mg/kg CEF. The effects of CEF on intake were significant but differed across the reinforcers; such that ml/kg/day SUC was reduced by ∼30%, mg/kg/day NIC was reduced by ∼70% in the NIC-SUC group and ∼40% in the EtOH-NIC group, whereas g/kg/day EtOH was reduced by ∼40% in both the EtOH and EtOH-NIC group. The effects of CEF on GLT-1 expression were also studied. We found that CEF significantly increased GLT-1 expression in the prefrontal cortex and the nucleus accumbens of the NIC and NIC-EtOH rats as compared to NIC and NIC-EtOH saline-treated rats. These findings provide further support for GLT-1-associated mechanisms in EtOH and/or NIC abuse. The present results along with previous reports of CEF's efficacy in reducing cocaine self-administration in rats suggest that modulation of GLT-1 expression and/or activity is an important pharmacological target for treating polysubstance abuse and dependence.

  20. Meta-analysis of randomized clinical controlled trials on effect of ceftriaxone sodium for treatment of early syphilis%头孢曲松治疗早期梅毒患者临床疗效的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    秦家碧; 杨土保; 冯铁建; 杨帆; 洪福昌; 莫衍石; 蔡玉玲; 关阳; 刘晖

    2014-01-01

    OBJECTIVE To evaluate the efficacy and safety of ceftriaxone sodium for treatment of early syphilis ,so as to provide clinical evidences for valid therapeutic strategy of syphilis .METHODS 810 documents recorded from the establishment of the database to the beginning of Jul 2012 ,were evaluated for the randomized controlled trials of domestic ceftriaxone sodium for treating early syphilis via meta-analysis;the effect value of categorical data adopted relative risk (RR) rate and measurement data employed difference in means (x-);both of them were indicated by 95% confidential interval ;P less than 0 .05 indicated a difference with statistical significance . RESULTS A total of 15 documents involving 1371 patients were selected .Compared with penicillin(RR:1 .18 ,95%CI:0 .78 ~ 1 .80) ,the effect rate of ceftriaxone sodium for treating early syphilis increased 18 .0% within 6 months and increased 8 .0% after 12 months(RR:1 .08 ,95% CI:0 .89~1 .30) ,the difference between them had no statistical significance .In terms of skin lesion subsiding ,ceftriaxone sodium took shorter time than benzathine penicilli(x-:-2 .28 ,95% CI:-2 .90~ -1 .66) .Compared with procaine benzathine penicillin ,the effect rate of ceftriaxone sodium increased 14 .0% and 2 .0% after 6 months (RR:1 .14 ,95% CI:0 .98~1 .34) and 12 months (RR:1 .02 ,95% CI:0 .95~1 .10) respectively ,indicating no difference in statistical significance .The one-week subsiding degree of skin lesion with the combination treatment grew 1 .47 times (RR:1 .47 ,95% CI:1 .20~1 .81) . The adverse reaction were Jarisch-Herxheimer reaction , anaphylaxis , nausea , emesis , dizziness , muscular soreness ,increased local pyrexia in a short time ,while the adverse reaction rate had no difference between each study groups .CONCLUSION The efficacy of ceftriaxone sodium on early syphilis was equivalent to that of the combination of benzathine penicillin and procaine benzathine penicillin .However , the ccombination therapy of

  1. 深圳市头孢曲松低敏淋病奈瑟菌株耐药基因分析%Analysis of antibiotic resistance genes in Neisseria gonorrhoeae strains with decreased sensitivity to ceftriaxone from Shenzhen city

    Institute of Scientific and Technical Information of China (English)

    张丽君; 王峰; 莫俊銮; 彭毅

    2015-01-01

    目的 了解penA、ponA、porB和mtrR突变与深圳市淋球菌对头孢曲松敏感性降低的相关性.方法 收集2009-2011年深圳市淋球菌临床分离株296株,采用琼脂稀释法筛选出头孢曲松低敏株[MIC(0.06 ~ 0.50) μg/ml]53株.将头孢曲松低敏菌株以及按照1:1抽样原则随机抽取的53株高敏菌株,共计106株淋球菌作为试验菌株.对所有菌株penA、ponA、porB和mtrR基因进行PCR扩增以及DNA测序分析.结果 1株淋球菌的青霉素结合蛋白2(penicillin-binding protein 2,PBP2,由penA基因编码)具有镶嵌样结构(MIC0.125 0 μg/ml),对剩余105株淋球菌PBP2的氨基酸序列分析,共得到16个不同的氨基酸模式.模式Ⅻ、ⅩⅢ、ⅩⅩⅩⅧ对应的头孢曲松MIC值相对较高(MIC50均为0.062 5 μg/ml),而模式Ⅱ的头孢曲松MIC值相对较低(MIC50为0.008 0μg/ml).mtrR、porB以及ponA突变在头孢曲松低敏组和高敏组中的发生率,差异无统计学意义(均P> 0.05).结论 PBP2镶嵌样结构可能不是深圳市淋球菌对头孢曲松敏感性降低的主要原因,非镶嵌样PBP2 500 ~ 580位多个氨基酸突变产生的不同氨基酸模式联合mtrR、 porB以及ponA突变在诱导淋球菌对头孢曲松敏感性降低中可能有意义.%Objective To analyze the relationship of penA, ponA, porB and mtrR gene mutations with the reduced sensitivity to ceftriaxone in N.gonorrhoeae isolates from Shenzhen city.Methods A total of 296 clinical isolates of N.gonorrhoeae were collected in Shenzhen city from 2009 to 2011.The agar dilution method was used to estimate the sensitivity of these N.gonorrhoeae to ceftriaxone.Totally, 53 strains with reduced sensitivity to ceftriaxone (minimum inhibitory concentration (MIC): 0.06-0.50 μg/ml) were identified, and 53 strains with high sensitivity to ceftriaxone were randomly selected from the remaining strains and served as the control group.PCR was performed to amplify the penA, ponA,porB and mtrR genes from the 106

  2. 头孢曲松钠注射液致儿童假性结石2例%Two cases of pseudo-stone caused by ceftriaxone sodium injection in children

    Institute of Scientific and Technical Information of China (English)

    张威; 赵海涛; 张晓琳

    2011-01-01

    Example 1: One 11-year-old male patient was hospitalized for Ewing's sarcoma of the distal femur. Then the tumor was cut away and followed by artificial joint replacement surgery. Ceftriaxone sodium injection 2 g once daily was administered to prevent surgical infection. After 12 days, the patient complained about continuous pain at the top right abdominal. The result of B ultrasonic examination indicated cholecystolithiasis. Ceftriaxone was discontinued immediately and the patient received symptomatic treatment and supportive care. The pain disappeared after 3 days. Example 2: One 16-year-old male patient was hospitalized for the right distal fibula bone cysts. Curettage and bone graft surgery was conducted. The patient received ceftriaxone 2 g once daily to prevent infection. At the sixth day of medication, the patient had persistent colic at lower abdominal, the result of B ultrasonic indicated the right kidney stones. Ceftriaxone was discontinued immediately and the patient received symptomatic treatment and supportive care. The symptoms did not relieve until patient had received fiberoptic ERCP. Clinical tips: after medication with ceftriaxone, the ultrasound showed gall bladder or kidney stones might be pseudo-stone. Whether the need of surgical intervention should be taken into account according to clinical conditions before a further step.%例1:患者,男,11岁,因股骨下端尤文肉瘤入院,行瘤段截除人工关节置换术,手术预防用头孢曲松钠注射液(2 g,qd).用药第12天,患者诉右上腹疼痛,疼痛呈持续性,B超检查发现胆囊结石,停用头孢曲松钠,对症支持治疗,3 d后,疼痛症状消失.例2:患者,男,16岁,因右腓骨远端瘤样骨囊肿入院,行病灶刮除植骨术,手术预防用头孢曲松钠注射液(2 g,qd).用药第6天,患者出现下腹持续性绞痛,B超诊断为右肾结石,对症支持治疗,症状未缓解,行纤维镜下取石后疼痛症状消失.提示临床:使用头孢曲松钠后,超声

  3. 199株淋球菌对环丙沙星和头孢三嗪的敏感性测定%Sensitivity test of 199 Neisseria gonorrhoeae strains in Nanning to ciprofloxacin and ceftriaxone

    Institute of Scientific and Technical Information of China (English)

    李伟; 赵秀梅; 覃善列; 唐桂林

    2001-01-01

    Obiective To measure the susceptibility of Neisseria gonorrhoeae to ciprofloxacin and ceftriaxone in Nanning.Method 199 clinical isolates of Neisseria gonorrhoeae obtained from patients with gonorrhea in Nanning were tested for their susceptibilities to ciprofloxacin and ceftriaxone in vitro.The mininum inhibitory concentrations(MIC)of ciprofloxacin and ceftriaxone were determined by agar dilution method.Rusults The MIC ranges were from 0.002mg/L to 2mg/L for ciprofloxacin.MIC ranges were from 0.25 to≥ 16mg/L in 1999.14.5% of the isolates were susceptible to ciprofloxacin,41.71% were less sensitive;the prevalence of resistant gonococci were 43.72%.There are 4 strains out of the isolates in 1999,MIC of which were≥ 16mg/L.The MIC ranges were between 0.002mg/L and 1mg/L for ceftriaxione.The MICs at which 50% and 90% of isolates inhibited were 0.03mg/L and 0.5mg/L,respectively.55.28% of the isolates were susceptible to ceftriaxone,39.2% were less sensitive;A total of 5.53% strains were found to be ceftrixone resistant.None of the Isolates isolated were detected to be resistant of ceftriaxone in 1999.Conclusion The study shows that ciprofloxacin hasn′ t given priority to treating patients with gonorrhea in Nanning.Wheather ceftriaxione is still given priority to treating patients with gorrhea or not depends on continued surveillance of sensitivity of contemporary gonococci to ceftriaxione in vitro.%目的了解南宁地区淋球菌对环丙沙星,头孢三嗪的敏感性。方法采用琼脂稀释法分别测定环丙沙星、头孢三嗪对 199株淋球菌的最小抑菌浓度。结果环丙沙星 MIC范围为 0.002~ 2mg/L,其中 1999年 MIC范围为 0.25~≥ 16mg/L; 14.5%菌株对环丙沙星敏感, 41.71%为低度敏感, 43.72%为耐药,其中 1999年有 4株淋球菌 MIC≥ 16mg/L。头孢三嗪 MIC为 0.02~ 1mg/L, MIC50为 0.03mg/L, MIC90为 0.5mg/L; 55.28%菌株对头孢三嗪敏感, 39.20

  4. 头孢曲松试敏液浓度对皮试结果的影响%Effect of Ceftriaxone Sensitive Test Solution Concentration on the Skin Test Results

    Institute of Scientific and Technical Information of China (English)

    赵艳梅

    2014-01-01

    目的:通过不同浓度试敏液对患者的测试,观察能否降低皮试的假阴性。方法选取无青霉素严重过敏史及头孢曲松无过敏史的患者400例,分别用浓度为1250 ug/mL和500 ug/mL的头孢曲松钠原液做皮试。用药以任一浓度皮试液皮试结果阴性为准,观察统计假阴性结果例数。结果浓度为500 ug/mL试敏液做皮试发现假阴性14例,所致过敏反应发生率7%;浓度为1250 ug/mL皮试发生假阴性结果9例,所致过敏反应率4.5%。两者相比较2=1.15,>0.05。结论不能证明提高头孢曲松钠试敏液浓度可降低皮试假阴性结果引起的过敏反应发生率。%Objective Through the dif erent concentration of test sensitivity test for patients, observe whether it can reduce false positive skin test. Methods Select without severe al ergies and ceftriaxone penicil in al ergy history of 400 cases of patients, respectively, with concentration of 1250 ug/ml and 500 ug/ml of ceftriaxone sodium concentrate to do skin test. Drugs to any concentration of skin test skin test result is negative, observation statistics were false negative results. Results The concentration of 500 ug/ml try sensitive liquid found 14 of the false negatives do skin test, al ergic reaction caused by the incidence of 7%; Concentration to 1250 ug/ml skin test in 9 cases of false negative results, caused by an al ergic reaction rate was 4.5%. Comparing the two X squared =1.15, >0.05). Conclusion Try not prove that improve ceftriaxone sodium sensitive liquid concentration can reduce the incidence of skin test false negative results caused by an al ergic reaction.

  5. Effects of ceftriaxone on depressive-like behavior and changes of hippocampal glutamate transporter-1 in depression model C57 mice%头孢曲松对抑郁模型C57小鼠行为及海马谷氨酸转运体1蛋白表达的影响

    Institute of Scientific and Technical Information of China (English)

    陈建新; 姚丽华; 王惠玲; 刘忠纯; 王晓萍; 陈抗松; 王高华

    2015-01-01

    Objective To investigate the effects of ceftriaxone on depressive-like behavior and changes of hippocampal glutamate transporter-1 (GLT-1) in C57 mice depression model,and to further explore the molecular mechanism of ceftriaxone on antidepressant action.Methods Thirty male C57 mice were randomly divided into control group(group A,n=10),CUS group(group B,n=10) and CUS+ceftriaxone group(group C,n=10).The mice of the CUS group and the CUS+ceftriaxone group were subjected to chronic unpredictable stress (CUS) for 2 sessions per day for 21 days.Then,the mice of the CUS+ceftriaxone group were given ceftriaxone for 21 days.Behavioral changes were assessed by the sucrose preference test and open field test.The GLT-1 protein levels in the hippocampus were detected by Western blot analysis at the end of the ceftriaxone treatment.Results (1) Compared with the control group,the percentage of sucrose preference,the total traveled distance,the moved velocity,and the frequencies of rearing of the CUS group were significantly decreased(P<0.05) at the 21 days.However,the percentage of sucrose preference ((78.74 ± 3.54) %),the total traveled distance ((6818.35 ± 505.14) cm),the moved velocity((12.36±0.89) cm/s),and the frequencies of rearing(58.20±4.05) of the CUS+ceftriaxone group at the end of the ceftriaxone treatment were improved significantly compared with the CUS group ((59.46 ± 2.75) %,(2931.71±271.89) cm,(5.84±0.42) cm/s,(26.20±2.62),P<0.05).(2) Western blot analysis indicated significant reductions of the GLT-1 protein levels in the hippocampus of CUS group (versus the control mice:P <0.05),and chronic ceftriaxone treatment reversed the CUS-induced decrease in the GLT-1 levels(P<0.05).Conclusion Ceftriaxone might significantly improve depressive-like behavior in C57 mice depression model.Chronic unpredictable stress (CUS) could down-regulate the GLT-1 protein levels in the hippocampus,which are reversed by ceftriaxone.These results further support the

  6. The comparison of therapeutic effect on ceftriaxone and ciprofloxacin injection for children typhoid fever in Sierra Leone. LIU Huan1 ,%头孢曲松和环丙沙星静脉滴注治疗塞拉利昂儿童伤寒的对照研究

    Institute of Scientific and Technical Information of China (English)

    刘焕; Alex J.D. Kanu

    2011-01-01

    Objective To compare therapeutic effect on Ceftriaxone and Ciprofloxacin injection for children with typhoid fever. Methods Divide 216 cases to two groups, and give Ceftriaxone and Ciprofloxacin injection treatment respectively, record the therapeutic effect. Results There are no significant difference between the two groups in the narked effective rate, general effective rate and the time of temperature reduce(P > 0.05 ). Conclusion Ceftriaxone and Ciprofloxacin injection are sensitive to children typhoid fever,apart from ceftriaxone ciprofloxacin is another good medicine for children typhoid fever.%目的 比较头孢曲松和盐酸环丙沙星治疗儿童伤寒的疗效.方法 将216例无并发症的伤寒患儿随机分为两组,分别采用头孢曲松针剂(A组,n=118)和盐酸环丙沙星针剂(B组,n=98)治疗,比较两组疗效情况.结果 两组显效率、总有效率、体温下降起始时间、体温降至正常时间的差异均无统计学意义(P>0.05).结论 两种药物治疗儿童伤寒的疗效相当,除头孢曲松外环丙沙星也是非洲儿童治疗伤寒的良好选择.

  7. The need for antibiotic stewardship and treatment standardization in the care of cirrhotic patients with spontaneous bacterial peritonitis – a retrospective cohort study examining the effect of ceftriaxone dosing [v2; ref status: indexed, http://f1000r.es/3se

    Directory of Open Access Journals (Sweden)

    Laura Mazer

    2014-07-01

    Full Text Available Background: Spontaneous bacterial peritonitis (SBP is a common, often fatal affliction for cirrhotic patients. Despite all clinical trials of ceftriaxone for SBP using 2g daily, it is often given at 1g daily. Aim: We evaluated survival after SBP as a function of ceftriaxone dosage. Methods:  A retrospective cohort of all patients who received ceftriaxone for SBP (greater than 250 neutrophils in the ascites. Results: As opposed to 1 gram, median survival is longer for patients receiving 2 grams (228 days vs. 102 days (p = 0.26 and one year survival is significantly higher (p = 0.0034.  After adjusting for baseline Model for End Stage Liver Disease (MELD score, however, this difference was no longer significant.  Similarly, there was a significantly shorter length of intensive care for patients receiving 2 g (0.59 ± 1.78 days vs. 3.26 ± 6.9, p = 0.034, odds ratio 0.11 (95% CI 0.02 - 0.65. This difference, too, was no longer significant after controlling for the MELD score - odds ratio 0.21 (95% CI 0.04 - 1.07. Additionally, 70% of patients received at least one additional antibiotic; over 25 different medications were used in various combinations. Conclusions:  Patients receiving 2 g of ceftriaxone may require fewer intensive care days and may enjoy an improved survival compared to those receiving 1 g daily. The complexity of antibiotic regimens to which cirrhotic patients are exposed must be studied further and rationalized.  We recommend fastidious antibiotic stewardship for patients with cirrhosis. Efforts should be made to craft local standards for the treatment of SBP that include appropriate antibiotic selection and dose.

  8. Assessment of efficacy of benzathine penicillin, procaine penicillin and ceftriaxone in the treatment of early syphilis%苄星青霉素、普鲁卡因青霉素与头孢曲松治疗早期梅毒疗效评价

    Institute of Scientific and Technical Information of China (English)

    王松挺; 阮黎明; 刘国英; 朱伟芳; 蒋筱凌; 舒国斌

    2015-01-01

    Objective:To compare the efficacy of benzathine penicillin, procaine penicillin and ceftriaxone in the treatment of early syphilis. Methods: One hundred and two patients were divived into three groups:benzathine penicillin group (41 cases), procaine penicillin group (33 cases) and ceftriaxone group (28 ca-ses) . The clinical efficacy and antibody in serum were assessed. Results:The efficiency rate in the benzathine penicillin group, procaine penicillin group, and the ceftriaxone group was 92.68%, 93.93% and 92.85% re-spectively. The negative conversion rates benzathine penicillin group, procaine penicillin group and ceftriaxone group were 26.83%, 20.00% and 19.35% respectively. Conclusion:The total efficaly of the three regiments is smiilar in the treatment of early syphilis. However, the proportion of the patients ivith sero-resistence was lower in procaine penicillin group and ceftriaxone group.%目的::比较苄星青霉素、普鲁卡因青霉素及头孢曲松治疗早期梅毒的疗效。方法:102例首诊早期梅毒患者随机分为苄星青霉素组、普鲁卡因青霉素组及头孢曲松组,观察患者临床症状和血清RPR的变化。结果:苄星青霉素有效率92.68%、普鲁卡因青霉素93.93%、头孢曲松92.85%,三组之间比较无显著性差异(P>0.05),苄星青霉素组、普鲁卡因青霉素组和头孢曲松组血清固定分别占26.83%、20.00%和19.35%,三组比较差异有统计学意义( P<0.05)。结论:三种药物治疗早期梅毒疗效相当,但普鲁卡因青霉素组和头孢曲松组血清固定者明显低于苄星青霉素组。

  9. Amino acid substitution or insertion patterns in penicillin-binding protein 2 in Neisseria gonorrhoeae isolates with reduced susceptibility to ceftriaxone%头孢曲松低敏的淋球菌中青霉素结合蛋白2氨基酸替代或插入模式研究

    Institute of Scientific and Technical Information of China (English)

    蒋法兴; 其木格; 钱革; 郑波; 叶顺章; 苏晓红; 胡白; 王千秋

    2008-01-01

    Objective To investigate the amino acid patterns in penicillin-binding protein 2(PBP2)in Neisseria gonorrhoeae isolates with reduced susceptibility to ceftriaxonc.and the relationship between the amino acid patterns and reduced ceftriaxone susceptibility.Methods DNA was extracted from 13 clinical isolates of N.gonorrhoeae.including 11 strains with decreased susceptibility to ceftriaxone and 2 sensitive isolates.The full-length penA gene encoding the penicillin-binding protein 2 was amplified and sequenced.BLASTn and BLASTx programs were used to assess the insertion and substitution patterns of nucleotides in penA gene and of amino acids in PBP2,respectively.Results BLASTn analysis revealed insertion or substitution of 18-38 nucleotides in the penA gene of gonococcal isolates with reduced ceftriaxone susceptibility.As shown by BLASTX analysis.there were five patterns of amino acid substitution or insertion in PBP2 of the 11 isolates with reduced ceftriaxone susceptibility.However.mosaic structure of PBP2 was not found in any of these isolates.Conclusion Mosaic PBP2 seems not to be the major factor contributing to the decrease in susceptibility of N.gonorrhoeae to ceftriaxone.%目的 检测头孢曲松低敏的淋球菌中青霉素结合蛋白2(PBP2)模式,探讨其是否与淋球菌对头孢曲松敏感性降低有关.方法 将11株头孢曲松低敏和2株头孢曲松敏感的淋球菌penA基因全基因测序,通过BLASTn与BLASTx分析,研究penA基因的碱基插入和置换情况及PBP2中氨基酸插入和置换模式.结果 13株淋球菌的penA基因中有多个碱基置换或插入,PBP2中共发现5种模式的氨基酸插入或置换模式,没有发现PBP2镶嵌状结构模式.结论 PBP2的镶嵌状结构可能不是导致淋球菌对头孢曲松敏感性下降的主要因素.

  10. 2009-2011年深圳市头孢曲松低敏淋病奈瑟菌的流行特征%Molecular characteristics of Neisseria gonorrhoeae isolates with decreased susceptibilities to ceftriaxone in Shenzhen from 2009 to 2011

    Institute of Scientific and Technical Information of China (English)

    张丽君; 莫俊銮; 王峰; 彭毅; 赵广录; 吕德良

    2013-01-01

    Objective To investigate the genotype and characteristics of Neisseria gonorrhoeae (N.gonorrhoeae) isolates with reduced susceptibility to ceftriaxone in Shenzhen from 2009 to 2011.Methods A total of 296 N.gonorrhoeae isolates were collected in Shenzhen from 2009 to 2011.ceftriaxone strains (minimum inhibitory concentration between 0.06 and 0.50 μg/ml) were determined by agar dilution method.Logistic regression was used to analyze the associated factors of ceftriaxone N.gonorrhoeae infection.Neighbor-joining(NJ) phylogenetic tree analysis and N.gonorrhoeae multiantigen sequence typing (NG-MAST) were performed on all ceftriaxone isolates and susceptible control isolates randomly selected in accordance with the principle of 1 ∶ 1 sampling.Results No isolates displayed resistance to ceftriaxone,whereas 53 (17.9%) showed reduced susceptibility to ceftriaxone among 296 isolates.Only antibiotic use in recent two months was associated with ceftriaxone isolates infection(OR =3.080,95% CI:1.376-6.894).Among the ceftriaxone isolates,48 different ST were identified including 5 STs (ST1768,ST3927,ST641,ST7076 and ST7078) containing 2 isolates and 43 single STs.There were 26 STs previously reported from HongKong in China.Low sensitive strains clustering was not observed by NJ phylogenetic tree.Conclusion The proportion of ceftriaxone strains among the 296 N.gonorrhoeae isolates collected from 2009 to 2011 in Shenzhen is high.The STs of ceftriaxone strains may have unique epidemic features in Shenzhen.%目的 调查2009-2011年深圳市头孢曲松低敏淋病奈瑟菌(淋球菌)流行的基因型和特征.方法 收集2009至201 1年深圳市淋球菌296株,采用琼脂稀释法筛选出头孢曲松低敏株(最小抑菌浓度为0.06 ~0.50 μg/ml),用logistic回归分析方法,分析与头孢曲松低敏淋球菌感染相关的因素;根据1∶1抽样原则抽取出高敏菌株,与低敏菌株一起进行淋病奈瑟菌抗原序列分析(NG-MAST)基

  11. Clinical effect observation of ceftriaxone sodium in the treatment of HIV antibody positive mixed infection of syphilis%头孢曲松钠治疗HIV抗体阳性混合感染梅毒的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    邵群

    2015-01-01

    Objective To investigate the clinical effect of ceftriaxone sodium in the treatment of HIV antibody positive mixed infection of syphilis. Methods 109 patients with infection of syphilis in drug rehabilitation center were selected, 52 patients with HIV antibody positive mixed infection of syphilis as observation group,57 patients with HIV antibody negative mixed infection of syphilis as control group.Ceftriaxone sodium was applied in two groups.Treatment effect in two groups was compared and analyzed. Results Total effective rate in control group was 61.4%,higher than that in ob-servation group (40.4%),with statistical difference (P0.05). Conclusion Clinical effect of ceftriaxone sodium in the treatment of HIV antibody positive mixed infection of syphilis is poor.%目的:探讨头孢曲松钠治疗HIV抗体阳性混合感染梅毒的临床效果。方法从戒毒所中选取109例感染梅毒患者,其中52例HIV抗体阳性混合感染梅毒患者设为观察组,57例HIV抗体阴性混合感染梅毒患者设为对照组。两组均采用头孢曲松钠治疗,对比和分析两组的治疗效果。结果对照组的总有效为61.4%,高于观察组的40.4%,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P跃0.05)。结论头孢曲松钠治疗HIV抗体阳性混合感染梅毒的临床效果较差。

  12. 系统评价中国大陆地区有关淋球菌头孢曲松耐药监测的研究%Surveillance of ceftriaxone resistance in Neisseria gonorrhoeae in mainland China: a systematic review

    Institute of Scientific and Technical Information of China (English)

    陶小华; 许恩文; 胡辉; 刘彤云; 尚淑贤; 张津萍; 龚向东; 王千秋

    2009-01-01

    Objective To collect recent refefences with regard to surveillance of ceflriaxone resistance in Neisseria gonorrhoeae in mainland China,and to infer the tendency of ceftriaxone resistance.Methods References were searched in CNKI,PubMed and Cochrane databases,and eligible refefences were ineluded for systematic review.Results Forty-six refefences entered the systematic review in which 10 163 strains were reported.Of them,23 references were from South China (50%).The centrel Neisseria gonorrhoeae strains were from WHO in 26 (56.52%) references.Antimicrobial susceptibility testing was performed by agar dilution method using GC agar base recommended by WHO in 32(69.57%)refefences.The rate of ceflriaxone resistance in Neisseria gonorrhoeae in mainland China was low,but it showed an increasing tendency.Conclusion The quality of surveillance of antibiotic resistance in Neisseria gonorrhoeae should be improved in mainland China to better monitor the situation of ceflriaxone resistance.%目的 收集近期国内外发表的有关中国大陆淋球菌头孢曲松耐药监测文献,分析文献的质量及淋球菌的耐药趋势.方法 检索中国期刊全文数据库、PubMed、Cochrane数据库,筛选合格文献进行系统评价.结果 入选46篇文献,共报道10 163株淋球菌头孢曲松药敏情况.23篇文献主要来自华南(50%);26篇提供的标准菌株为WHO淋球菌分离株(56.52%);32篇文献药敏试验方法为WHO推荐的琼脂糖稀释法(69.57%);淋球菌的头孢曲松耐药率仍较低,但有增加趋势.结论 应该进一步提高淋球菌耐药监测研究的质量,使之能更好地反映淋球菌耐药状况.

  13. 头孢曲松钠致急性溶血性贫血伴多器官功能衰竭%Ceftriaxone sodium-induced acute hemolytic anemia with multiorgan failure

    Institute of Scientific and Technical Information of China (English)

    黄玉玲; 杨辉; 许沧海

    2012-01-01

    A 68-year-old woman with paronychia received an IV infusion of ceftriaxone sodium 4. 0 g in 0. 9% sodium chloride 250 ml once daily. She developed low back pain during drug therapy. On day 3, she was hospitalized with transient syncope and hematuria. On admission, she presented with severely jaundiced skin and sclera. Laboratory tests revealed the following results: white blood cell count 39.4 × 109/L, neutrophil 0. 97, red blood cell ( RBC ) count 1. 9 × 1012/L, hemoglobin ( Hb ) 42 g/L, reticulocytes 0.03, blood urea nitrogen 15.0 mmol/1, serum creatinine ( SCr ) 336 μmol/L, alanine aminotransferase ( ALT) 380 U/L, aspartate aminotransferase ( AST ) 930 U/L, gamma-glutamyltransferase ( γ-GT ) 60 U/L, total bilirubin ( TBil ) 235. 1 μmol/L, direct bilirubin ( DBil ) 130. 6 μmol/L, and indirect bilirubin ( IBil ) 104. 5 μmol/L, lactate dehydrogenase 2198 U/L, creatine kinase 211 U/L, α-hydroxybutyric dehydrogenase 1538 U/L, creatine kinase-MB 22 U/L, prothrombin time 21. 3 seconds, activated partial thromboplastin time 50. 5 seconds, thrombin time 29. 6 seconds, fibrinogen 1.03 g/L, D-dimer 10. 4 mg/L, and Coomb' s C3 ( + ). Routine urine tests showed the following results: urine bilirubin( + + ), occult blood ( + + + ), protein( + + ) and 3 RBC/high power field. Ceftriaxone sodium-induced acute hemolytic anemia with multiorgan failure was considered. An IV injection of human immunoglobulin and glucocorticoid was given. She received continuous renal replacement therapy, hemodialysis, plasma exchange, repeated transfusions of washed red blood cells, fresh frozen plasma and cryoprecipitate, urinary alkalinization, liver protection, and other symptomatic treatment. On day 57, laboratory testing showed the following levels: RBC count 4. 0 × 1012/L,Hb 112 g/L. SCr 110 μmol/L, ALT 13 U/L, AST 20 U/L, TBil 11.7 μmol/L, DBil 4. 5 μmol/L, IBil 7. 2 μmol/L. Her symptoms improved and she was discharged.%1例68岁女性患者因甲沟炎给予头孢曲松钠4 g

  14. 头孢曲松钠对大鼠热性惊厥的防治作用及机理研究%The Research of Mechanism and Effection in the Prevent and Therapeutic Course of Rats Febrile Convulsion with Ceftriaxone sodium

    Institute of Scientific and Technical Information of China (English)

    周蕊; 李俊利

    2013-01-01

      目的研究头孢曲松钠对大鼠热性惊厥时脑内谷氨酸和谷氨酸转运体表达的影响,探讨头孢曲松钠对抗高热惊厥脑损伤的机制。方法利用热水浴惊厥模型诱导出生15d后100只Wistar大鼠发生10次热性惊厥,将其分为治疗组和对照组。治疗组大鼠每次惊厥一出现立即腹腔注射头孢曲松钠(分为50mg/kg,100mg/kg,200mg/kg),对照组大鼠仅腹腔注射等量生理盐水,利用免疫组织化学方法检测正常对照组和高热惊厥组大鼠脑内谷氨酸及谷氨酸转运体的表达,并进行定性及定量分析。结果高热惊厥时脑细胞内谷氨酸表达上升,而脑细胞膜和细胞间质中的谷氨酸转运体GLT-1表达下降;接受头孢曲松钠治疗的大鼠脑细胞谷氨酸表达降低,而GLT-1表达上升并呈剂量依赖性。结论头孢曲松钠可以上调热性惊厥大鼠皮层和海马CA1区GLT-1蛋白的表达。%Objective To study the effection to the expression of aminoglutaminic acid and aminoglutaminic acid transporter in brain of febrile convulsion rat about ceftriaxone sodium, approach the mechanism about febrile convulsion brain injured with ceftriaxone sodium . Methods:Selected only 100 maleness Wistar rats , age of 15 days,weight 30~45g. Divided the rat into 2 groups:normal control group(20) and febrile convulsion group(80). Utilized hot bath convulsion model to induce febrile convulsion 10 times with birth 15d Wistar rats, divided it into therapy group and control group. The rat of therapy group was injected with ceftriaxone sodium immediately when the convulsion had happened,(divided into 50mg/kg, 100mg/kg, 200mg/kg three doses),the rat of control group only was injected with normal saline into partes aequales,use the method of immunohistochemistry to test and analysis the express condition of aminoglutaminic acid and aminoglutaminic acid transporter about in brain of normal control and febrile convulsion group rat

  15. 抑制性消减杂交结合基因芯片研究淋球菌耐头孢曲松的分子机制%Identification of genes related to induced resistance to ceftriaxone in Neisseria gonorrhoeae using suppression subtractive hybridization and DNA microarray

    Institute of Scientific and Technical Information of China (English)

    赖维; 龚子鉴; 黄朝伟; 黄宇青; 朱家馨; 张玉清; 陈荣章; 谢小元

    2008-01-01

    目的 探讨体外人工诱导的耐头孢曲松淋球菌的分子耐药机制.方法 在成功诱导淋球菌标准菌株ATCC49226和临床菌株ZSSY00205对头孢曲松耐药的基础上,分别对标准菌株和临床菌株进行诱导后耐药株对诱导前敏感株的抑制性消减杂交,构建差异基因文库.从文库中随机挑取192个差异基因作为探针点样于基因芯片,用分别标记Cy3、Cy5的敏感株、耐药株基因组DNA的RsaI酶切片段同时与芯片杂交,根据芯片扫描图选取差异荧光探针对应的基因进行测序和Blast分析.结果 分别构建淋球菌标准菌株ATCC49226和临床菌株ZSSY00205的诱导后耐药株DNA特异性的消减文库,并分别获得高分辨的基因芯片扫描图,发现两组菌株间有共同的耐药相关基因mtrR、mtrC、gyrB、rpsJ、PJD1.结论 淋球菌对头孢曲松耐药与mtrR、mtrC、gyrB、rpsJ等基因有关,很可能通过外排泵活性增强的途径介导耐药.伴随淋球菌对头孢曲松产生耐药的同时,可能引起对青霉素、四环素、红霉素、喹诺酮等多种抗菌药物产生耐药,即多重耐药现象.%Objective To elucidate the molecular basis for induced resistance of N. gonorrhoeae to ceftriaxone in vitro. Methods The reference strain ATCC49226 and clinical isolate ZSSY00205 of N. gon-orrhoeae were exposed to subinhibitory concentration of ceftriaxone for the induction of resistance. Then,suppression subtractive hybridization was performed with the pre-induction parent strains as drivers and post-induction mutant strains as testers to create a subtractive cDNA library. Following that, a total of 192 clones were randomly selected from the library, and arrayed by spotting onto nylon membranes. Finally, dif-ferentially expressed genes were screened by hybridization with labeled-RsaI restriction fragments from the sensitive and resistant N.gonorrhoeae strains respectively, and analyzed by sequencing and homology research using Blast

  16. Ceftriaxone susceptibility testing and multi-antigen sequence typing of Neisseria gonorrhoeae strains isolated in 2007 and 2012 from Nanjing, China%淋球菌对头孢曲松的敏感性及淋球菌多抗原测序分型研究

    Institute of Scientific and Technical Information of China (English)

    陈绍椿; 尹跃平; 戴秀芹; 孙厚华; 于瑞星; 韩燕; 陈祥生

    2014-01-01

    Objective To test the ceftriaxone susceptibility of Neisseria gonorrhoeae (NG) isolates from Nanjing city,and to assess their genotypes by using the NG multi-antigen sequence typing (NG-MAST) method.Methods A total of 204 NG strains isolated in 2007 and 81 in 2012 from Nanjing city were included in this study.The minimum inhibitory concentration (MIC) of ceftriaxone was determined for these strains using an agar dilution method.DNA was extracted by the Qiagen commercial kit from these strains followed by NG-MAST.Results All the isolates were susceptible to ceftriaxone (MIC,≤ 0.25 μg/ml).The MIC of ceftriaxone was ≥ 0.06 μg/ml for 63.2% of all the NG strains,70.6% of those isolated in 2007 and 44.4% of those in 2012,and ≥ 0.125 μg/ml for 31.6 % of all the NG strains,39.7% of those isolated in 2007,11.1% of those in 2012.Totally,166 genotypes were identified among the 285 isolates,of which,73 had been reported,and 93 were previously unreported.The most prevalent genotype was ST568 (n =13) in NG strains isolated in 2007,followed by ST270 (n =9),ST421 (n =7),ST2288 (n =5),ST1731 (n =4),ST1766 (n =4),ST1866 (n =4),ST1870 (n =4),while ST2318 (n =5),ST1053 (n =4),ST5990 (n =4),ST8726 (n =4) were the common genotypes in 2012.Those isolates with identical or similar genotypes tended to display similar MICs for ceftriaxone.Conclusions The prevalent genotypes of NG are markedly different between 2007 and 2012 in Nanjing region,and there is a strong association between the genotypes and ceftriaxone susceptibility of NG.NG-MAST results may serve as a genetic marker in the surveillance of antibiotic susceptibility in NG.%目的 探讨南京市淋球菌对头孢曲松的敏感性以及相应菌株的淋球菌多抗原测序分型(NG-MAST)基因型别.方法 2007年和2012年在中国疾病预防控制中心性病控制中心临床防治基地分别收集了204株和81株淋球菌,经过分离纯化及鉴定后,用琼脂稀释法测定其对头孢曲松的最

  17. Study on rapid plasma reagin serum outcome of ceftriaxone sodium combined with benzathine penicillin on latent syphilis%头孢曲松钠联合苄星青霉素治疗潜伏梅毒血清快速血浆反应素的转归

    Institute of Scientific and Technical Information of China (English)

    洪志林; 柯凤兰; 李晓华

    2016-01-01

    Objective To investigate the clinical effects of ceftriaxone sodium combined with benzathine penicillin on latent syphilis patients by monitor serum rapid plasma reaction element(RPR) change.Methods 100 cases of latent syphilis patients were randomly divided into the combined group and control group, each group of 50 cases. The combined group were treated by ceftriaxone sodium and benzylpenicillin, patients in the control group were treated by benzathine penicillin only. The cure rate of two group in 2, 6, 12 and 24 months after treatment were observed and compared.ResultsThe cure rate of the combined group was significantly higher than those of the control group at 3, 6, 12 and 24 months after treatment. The cure rate of the combined group was significantly higher than that of the control group (P<0.05).ConclusionCeftriaxone sodium and benzathine penicillin combined has a better clinical efficacy than benzathine penicillin treated only, which can effectively improve the cure rate of latent syphilis, is worth for popularization and application.%目的:探讨头孢曲松钠联合苄星青霉素治疗潜伏梅毒患者其血清快速血浆反应素(RPR)的转归变化。方法将100例潜伏梅毒患者随机分为联合组和对照组,每组各50例。联合组患者联合使用头孢曲松钠和苄星青霉素,对照组患者仅肌注苄星青霉素。观察和对比治疗后3、6、12、24个月两组患者的治愈率。结果治疗后3、6、12、24个月,联合组患者中早期潜伏期梅毒患者的治愈率均显著高于对照组早期潜伏期梅毒患者(P<0.05);联合组患者中晚期潜伏期梅毒患者的治愈率均显著高于对照组晚期潜伏期梅毒患者(P<0.05)。结论头孢曲松钠和苄星青霉素联合应用比单用苄星青霉素的疗效更显著,可有效提高潜伏梅毒的治愈率,值得推广应用。

  18. 苄星青霉素联合头孢曲松钠对早期梅毒患者皮损及血液免疫指标的影响观察%Influence of benzathine benzylpenicillin combined with ceftriaxone sodium for the skin lesion and blood im-mune indexes of patients with early syphilis

    Institute of Scientific and Technical Information of China (English)

    鞠小玲; 杜坤; 程丰; 苏江维

    2015-01-01

    Objectives:To observe the influence of benzathine benzylpenicillin combined with ceftriaxone sodium for the skin lesion and blood immune indexes of patients with early syphilis.Methods:60 patients with ear-ly syphilis in our hospital from March 2011 to August 2013 were selected and randomly divided into control group (benzathine benzylpenicillin group,30 cases)and observation group (benzathine benzylpenicillin combined with ceftriaxone sodium group,30 cases).The erythrocyte immune,skin lesion and peripheral blood T lymphocyte sub-sets of two groups before the treatment and at first and third month after the treatment were detected and compared. Results:The erythrocyte immune and peripheral blood CD3 +,CD4 +,CD4 /CD8 of observation group at first and third month after the treatment were all higher than those of control group,while CD8 + were lower than those of control group,and skin lesion CD3 +,CD4 +and CD4 /CD8 were lower than those of control group,CD8 +were higher than those of control group,with significant differences (all P <0.05 ).Conclusion:The influence of benzathine benzylpenicillin combined with ceftriaxone sodium for the skin lesion and blood immune indexes of pa-tients with early syphilis is great,and its treatment effect for the patients is better than that of only benzathine benzylpenicillin.%目的:观察苄星青霉素联合头孢曲松钠对早期梅毒患者皮损及血液免疫指标的影响程度。方法:选取2011年3月至2013年8月于本院进行诊治的60例早期梅毒患者为研究对象,将60例患者随机分为对照组(苄星青霉素组)30例和观察组(苄星青霉素联合头孢曲松钠组)30例,然后将两组患者治疗前和治疗后1 个月、3 个月时的红细胞免疫、皮损及外周血T 淋巴细胞亚群指标进行检测与比较。结果:观察组治疗后1 个月及3 个月时的红细胞免疫及外周血CD3 +、CD4 +、CD4 /CD8 均高于对照组,而CD8 +

  19. Ceftriaxone-resistant Salmonella enterica serotype Newport, France

    OpenAIRE

    Egorova, S.; Timinouni, M.; Demartin, M.; Granier, S.; Whichard, J.; Sangal, V; Fabre, L; Delaune, A.; Pardos, M.; Millemann, Y.; Espie, E; Achtman, M; Grimont, P; Weill, F.

    2008-01-01

    The multidrug-resistant (MDR) Salmonella enterica serotype Newport strain that produces CMY-2 β-lactamase(Newport MDR-AmpC) was the source of sporadic cases and outbreaks in humans in France during 2000–2005. Because this strain was not detected in food animals, it was most likely introduced into France through imported food products.

  20. Ceftriaxone-Resistant Salmonella enterica Serotype Newport, France

    OpenAIRE

    Egorova, Svetlana; Timinouni, Mohammed; Demartin, Marie; Granier, Sophie; Whichard, Jean; Sangal, Vartul; Fabre, Laëtitia; Delauné, Aurélia; Pardos, Maria; Millemann, Yves; Espié, Emmanuelle; Achtman, Mark; Grimont, Patrick; Weill, François-Xavier

    2008-01-01

    The multidrug-resistant (MDR) Salmonella enterica serotype Newport strain that produces CMY-2 beta-lactamase (Newport MDR-AmpC) was the source of sporadic cases and outbreaks in humans in France during 2000-2005. Because this strain was not detected in food animals, it was most likely introduced into France through imported food products.

  1. 76 FR 14023 - Determination that ROCEPHIN (Ceftriaxone Sodium) Injection, 250 Milligrams, 500 Milligrams, 1...

    Science.gov (United States)

    2011-03-15

    ...., Bldg. 51, rm. 6368, Silver Spring, MD 20993-0002, 301- 796-3522. SUPPLEMENTARY INFORMATION: In 1984... sodium) is a semisynthetic cephalosporin antibiotic for intravenous or intramuscular administration...

  2. Anaphylactoid reaction caused by sodium ceftriaxone in two horses experimentally infected by Borrelia burgdorferi

    OpenAIRE

    Basile, Roberta Carvalho; Rivera, Gabriela Gomes; Del Rio, Lara Antoniassi; de Bonis, Talissa Camargo Mantovani; do Amaral, Gabriel Paiva Domingues; Giangrecco, Edson; Ferraz, Guilherme; Yoshinari, Natalino Hajime; Canola, Paulo Aléscio; Queiroz Neto, Antonio

    2015-01-01

    Background Lyme borreliosis is a disease transmitted by ticks to mammals, especially in horses and humans. Caused by a spirochete Borrelia burgdorferi, it can result in lameness, arthritis, carditis, dermatitis and neurological signs. Anaphylactoid reactions are severe responses caused by direct action of substances (drugs, toxins), which can pose risks to life. Still poorly documented in horses, these reactions are caused by the effects of inflammatory mediators such as histamine, kinins and...

  3. Ceftriaxone, a Beta-Lactam Antibiotic, Reduces Ethanol Consumption in Alcohol-Preferring Rats

    OpenAIRE

    Sari, Youssef; Sakai, Makiko; Weedman, Jason M.; Rebec, George V.; Bell, Richard L.

    2011-01-01

    Aims: Changes in glutamatergic transmission affect many aspects of neuroplasticity associated with ethanol and drug addiction. For instance, ethanol- and drug-seeking behavior is promoted by increased glutamate transmission in key regions of the motive circuit. We hypothesized that because glutamate transporter 1 (GLT1) is responsible for the removal of most extracellular glutamate, up-regulation or activation of GLT1 would attenuate ethanol consumption. Methods: Alcohol-preferring (P) rats w...

  4. In Vitro Activities of Sparfloxacin, Ceftriaxone, Penicillin, Tetracycline and Doxycycline against Chlamydia trachomatis and Neisseria gonhorrhoeae

    Directory of Open Access Journals (Sweden)

    Hazel Talbot

    1992-01-01

    Full Text Available In vitro sparfloxacin was highly active against 223 penicillin-susceptible isolates of Neisseria gonorrhoeae with a 90% minimal inhibitory concentration (MIC90 of 0.004 μg/mL. Resistant strains of N gonorrhoeae totalled 55; 32 were penicillinase-producing and 23 chromosomally resistant. The MIC90 for these isolates was 0.004 μg/mL and 0.008 μg/mL, respectively. Chlamydia trachomatis was also very susceptible with an MIC50 of 0.063 μg/mL and a 50% minimal bactericidal concentration of 0.032 μg/mL for 11 isolates.

  5. Comparative therapeutic activities of Ciprofloxacin, Amoxicillin, Ceftriaxone and Cotrimoxazole in a new model of experimental infection with Escherichia coli

    OpenAIRE

    Hof, H.; Christen, A; Hacker, Jörg

    2009-01-01

    A new mouse model for systemic infection with Escherichia coli is presented. Whereas in other models 107_108 bacteria have to be injected into an animal to induce toxic effects resulting in death within 24 hours, now, only 103_104 bacteria of an appropriate strain are required to produce a genuine infection characterized by an increase in the bacterial load over several days. The quantitative determination of bacterial counts per liver allows a more sensitive measurement than recording death ...

  6. 头孢曲松钠精制方法的改进%Improvement of Recrystal Method of Ceftriaxone Sodium

    Institute of Scientific and Technical Information of China (English)

    汪东海; 王淑红; 马福顺; 轩书玉

    2007-01-01

    采用乙醇-水体系精制头孢曲松钠,收率可达94%,产品流动性与晶型得到大幅度改善,产品质量和稳定性也有较大提高.所得产品在温度40℃,相对湿度75%条件下做加速实验2个月,产品质量也表现出良好的稳定性,产品质量符合CP2005标准要求.

  7. PKQuest: capillary permeability limitation and plasma protein binding – application to human inulin, dicloxacillin and ceftriaxone pharmacokinetics

    OpenAIRE

    Levitt, David G.

    2002-01-01

    Background It is generally assumed that the tissue exchange of antibiotics is flow limited (complete equilibration between the capillary and the tissue water). This assumption may not be valid if there is a large amount of plasma protein binding because the effective capillary permeability depends on the product of the intrinsic capillary permeability (PS) and the fraction of solute that is free in the blood (fwB). PKQuest, a new generic physiologically based pharmacokinetic software routine ...

  8. Evaluation of ceftriaxone and other antibiotics against Escherichia coli, Pseudomonas aeruginosa, and Streptococcus pneumoniae under in vitro conditions simulating those of serious infections.

    OpenAIRE

    Satta, G; Cornaglia, G; Foddis, G; Pompei, R

    1988-01-01

    In pursuit of an in vitro system capable of reliably predicting the activities of antibiotics in serious infections and in infections occurring in immunocompromised hosts, we evaluated the abilities of four drugs to achieve virtually complete killing of bacterial cells growing in human body fluids in amounts which are very high and close to those likely to be present in serious infections; drug concentrations varied with time as they vary in human bronchial secretions or blood or urine (dynam...

  9. Study on the Resistance Trend of Neisseria Gonorrhoeae to Ceftriaxone%淋球菌对头孢曲松耐药现状研究进展

    Institute of Scientific and Technical Information of China (English)

    董磊; 其木格

    2012-01-01

    淋病奈瑟球菌简称淋球菌(Neisseria gonorrhoeae,NG)耐药一直是淋病防治面临的一个重要难题.头孢曲松是目前治疗淋病的主要一线药物.但是,淋球菌对头孢曲松敏感性下降趋势很明显,而且中国少数地区淋球菌头孢曲松耐药株检出率大于5%,故应密切监测淋球菌对头孢曲松的敏感性变化.目前,国外已有头孢曲松临床治疗失败的报道.

  10. Research Progress on Resistant Mechanism to Ceftriaxone in Neisseria Gonorrhoeae%淋球菌对头孢曲松耐药机制研究进展

    Institute of Scientific and Technical Information of China (English)

    其木格

    2012-01-01

    各地耐药监测发现头孢曲松低敏现象似乎逐渐普遍.目前研究表明penA、mtrR和pilQ基因可能是淋球菌对头孢曲松敏感性下降的相关基因.镶嵌状penA基因导致淋球菌对头孢曲松敏感性下降;mtrR、porBIb和ponA基因多态性改变可能导致淋球菌对头孢曲松的敏感性明显降低;pilQ基因突变可能与头孢曲松敏感性下降相关.因此penA、mtrR和pilQ基因等成为当前淋球菌耐药机制研究中的关注热点.

  11. 淋球菌对头孢曲松的耐药性监测%Surveillance of resistance of Neisseria gonorrhoeae to ceftriaxone

    Institute of Scientific and Technical Information of China (English)

    叶顺章; 苏晓红; 戴秀芹; 孙厚华

    2003-01-01

    目的监测淋球菌对头孢曲松的耐药性,为制订淋病防治策略和修改淋病的治疗方案提供参考依据.方法用琼脂稀释法测定菌株的最小抑菌浓度(MIC),计算耐药菌百分率,用概率法计算历年50%菌株抑菌浓度(MIC50)和90%菌株的抑菌浓度(MIC90).结果从1998年~2002年共检测4876株菌,耐药菌(MIC≥1.0μg/mL)11株,占0.23%;比较了1993~1995年及1999~2001年从南京地区分离的淋球菌菌株各300余株的MIC50及MIC90,表明这段时间内菌株对头孢曲松的敏感性无大的变化.结论头孢曲松依然是治疗淋病的极佳药物.但为防止菌株的耐药性增高,应对淋病进行规范治疗并继续开展淋球菌对头孢曲松的耐药性监测.

  12. Effect of ceftriaxone sodium on OmpA expression in E.coli K1%头孢曲松钠治疗大肠杆菌所致疾病机制的研究

    Institute of Scientific and Technical Information of China (English)

    方文刚; 兰宇

    2009-01-01

    目的 探讨头孢曲松钠对大肠杆菌(E.coli K1)的作用机制.方法 采用对照实验,培养E.coli K1至最佳状态,实验组细菌加入头孢曲松钠100 μg,对照组加入生理盐水,孵育1 h.通过western-blot方法检测E.coli K1外膜蛋白A的表达变化,软件分析蛋白表达灰度值.结果 实验组OmpA与对照组比较,表达量明显下降.结论 头孢曲松钠可以诱导E.coli K1的外膜蛋白A表达下降,从而影响E.coli K1外膜的完整性.

  13. Domestic Literatures about Drug Resistant Trend of Neisseria Gonorrhoeae to Ceftriaxone%淋病奈瑟菌对头孢曲松耐药趋势的国内文献综述

    Institute of Scientific and Technical Information of China (English)

    黄夏梦; 李苌清; 田驰; 王广基; 王霆

    2014-01-01

    为了解我国临床淋病奈瑟菌对头孢曲松的耐药趋势,本研究利用中国期刊全文数据库检索公开发表的关于淋病奈瑟菌耐药性监测文献,按一定标准进行筛选、归类,计算和分析不同年份和地区淋病奈瑟菌对头孢曲松的耐药率与敏感率.共筛选文献101篇,数据主要集中在2000~ 2010年,经分析,全国耐药率:平均为0.66%,2008年最高为1.45%;全国敏感率:平均为68.83%,2001年最低仅56.44%.期间淋病奈瑟菌对头孢曲松的耐药率与敏感率在不同年份、不同地区均呈波动变化.从文献分析结果可知,2000~2010年虽然各地区耐药率有差异,但总体上我国临床分离淋病奈瑟菌对头孢曲松耐药率呈上升趋势,敏感率下降.

  14. 耐头孢曲松淋球菌菌株的体外人工诱导及多重耐药现象%Multidrug Resistance in Two Ceftriaxone-Resistant Neisseria gonorrhoeae Induced in Vitro

    Institute of Scientific and Technical Information of China (English)

    龚子鉴; 赖维; 黄朝伟; 黄宇青; 谢小元

    2009-01-01

    目的 探讨体外人工诱导耐头孢曲松淋球菌的可行性,为研究淋球菌耐头孢曲松的机制提供实验菌株. 方法将对头孢曲松敏感的标准株ATCC49226(MIC 0.004ug/mL)和临床株ZSSY00205(MIC 0.25ug/mL)以头孢曲松次抑菌浓度法连续传代培养,定期监测生物学和分子生物学特性,诱导耐药成功后检测耐药菌株的稳定性,并分析诱导耐药前、后菌株RAPD图谱的改变及对其它抗菌药物耐药性的改变. 结果诱导后菌株ATCC49226和ZSSY00205对头孢曲松的MIC值是诱导前的125倍,诱导前、后菌株RAPD图谱未见明显改变,但头孢曲松诱导耐药后的淋球菌对青霉素、四环素、红霉素和环丙沙星的敏感性下降. 结论体外头孢曲松次抑菌浓度法可诱导产生头孢曲松耐药株,淋球菌对头孢曲松产生耐药的同时,可对包括青霉素、四环素、红霉素、喹诺酮在内的多种抗菌药物产生耐药或耐药性增加,即多重耐药现象.

  15. Establishment of ceftriaxone-resistant Neisseria gonorrhoeae strain in vitro and sensitivity test%淋病奈瑟菌药物敏感性测定及头孢曲松耐药株的建立

    Institute of Scientific and Technical Information of China (English)

    陶小华; 洪福昌; 冯铁建; 王千秋; 龚匡隆

    2010-01-01

    目的 应用琼脂糖稀释法测定奈瑟淋球菌(NG)药物敏感性,并建立体外NG头孢曲松耐药株.方法 配置含有不同浓度的四环素、环丙沙星、壮观霉素、头孢曲松培养基并接种一定量的NG菌悬液,培养24h后观察药敏试验结果.采用头孢曲松次抑菌浓度对NG敏感株体外反复诱导.结果 NG诱导前四环素、环丙沙星、壮观霉素、头孢曲松最小抑菌浓度(MIC)值分别为16μg/ml、16μg/ml、16μg/ml、0.016μg/ml.经过连续120次诱导传代,NG对四环素、环丙沙星、壮观霉素、头孢曲松MIC值分别为32μg/ml、16μg/ml、16μg/ml、1.00μg/ml,耐药子代经过30d的无药传代后,MIC值无明显变化.结论 琼脂糖稀释法是测定奈NG药物敏感性的有效、实用的方法;通过体外人工诱导可获得稳定性好的NG耐头孢曲松株.

  16. 南昌地区耐头孢三嗪淋病奈瑟菌的首次分离%First Isolation of Ceftriaxone-Resistant Neisseria Gonorrhoeae in Nanchang

    Institute of Scientific and Technical Information of China (English)

    黎帆; 傅颖媛

    2002-01-01

    目的:探讨南昌地区淋病奈瑟菌对头孢三嗪的敏感性.方法:采用琼脂稀释法测定头孢三嗪对淋病奈瑟菌的最小抑菌浓度(minimal inhibitory concentration,MIC).结果:首次在南昌地区分离到4株对头孢三嗪耐药的菌株;80%的淋病奈瑟菌对头孢三嗪敏感,3.33%耐药.结论:头孢三嗪在作为治疗淋病的首选药时,应高度重视耐头孢三嗪淋病奈瑟菌菌株的出现.

  17. Ceftriaxone resistance in Neisseria gonorrhoeae: research advances%淋病奈瑟球菌对头孢曲松耐药性及耐药机制研究进展

    Institute of Scientific and Technical Information of China (English)

    袁柳凤; 尹跃平

    2009-01-01

    头孢曲松作为淋病一线治疗药物之一,目前仍比较敏感,国内外尚未报道临床治疗失败病例,体外药敏试验也只发现少数散发头孢曲松耐药株.但是,淋病奈瑟球菌(淋球菌)对头孢曲松敏感性下降的趋势已很明显,而且中国少数地区淋球菌头孢曲松耐药株检出率>5%,故应密切监测淋球菌对头孢曲松的敏感性变化.目前淋球菌对头孢曲松的耐药机制尚不明确,penA和mtrR等基因突变在耐药中的作用成为关注热点.

  18. 头孢曲松低敏淋球菌中penA基因的初步研究%A Preliminary Study on the PenA Gene in Neisseria Gonorrhoeae Isolates with Reduced Susceptibility to Ceftriaxone

    Institute of Scientific and Technical Information of China (English)

    其木格; 张秀丽; 塔娜; 董磊

    2013-01-01

    目的:检测头孢曲松低敏淋球菌中penA基因的改变,探讨其是否与淋球菌对头孢曲松敏感性降低有关.方法:通过对5株头孢曲松低敏和1株头孢曲松敏感的淋球菌进行penA基因全基因测序,进一步了解penA基因的碱基置换或插入情况及青霉素结合蛋白2(PBP2)的结构模式.结果:5株头孢曲松低敏淋球菌的penA基因中有多个碱基置换或突变,没有发现含有镶嵌状penA基因结构模式.结论:penA基因的多个碱基置换或突变可能与淋球菌对头孢曲松敏感性降低相关.

  19. 头孢曲松与阿莫西林治疗儿童急性中耳炎的疗效比较研究%Efficacy and safety of one dose ceftriaxone vs. ten-day oral amoxicillin for treatment of acute otitis media in children

    Institute of Scientific and Technical Information of China (English)

    张亚梅; 董频; 陆培

    2003-01-01

    目的探索头孢曲松单剂注射与口服阿莫西林10 d治疗儿童急性中耳炎是否具有相同的疗效,并比较此两种方案的安全性.方法本研究为多中心、随机、对照、开放Ⅳ期临床实验.头孢曲松组: 头孢曲松50 mg/kg(总剂量不超过1 g)单次肌肉注射或静脉点滴.阿莫西林组:阿莫西林40 mg/(kg·d),每日3次,口服,连续10 d.年龄在1~12岁共212例儿童.用药后两次复诊,观察症状、体征,耳镜检查,白细胞计数和分类,听力检测等.结果给药后10~14 d,头孢曲松组106例中显效以上的为103例,占97.17%,有效率高于阿莫西林组106例中的96例,占90.57%,(P<0.05).不良反应为丘疹样皮疹、荨麻疹、口角皮肤色素沉着,两组中各2例, 差异无显著意义.结论对于急性中耳炎的儿童,单剂头孢曲松肌注或静脉滴注优于口服阿莫西林10 d,两者安全性相同.头孢曲松在治疗儿童急性中耳炎、特别是在婴幼儿用药顺应性差时是一个很好的选择.

  20. 2010年-2012年嘉兴港区头孢曲松非敏感淋病奈瑟菌流行现状及penA基因研究%Study of epidemic status and PenA gene of Neisseria gonorrhoeae isolates with nonsensitivity to ceftriaxone in Jiaxing port district from 2010 to 2012

    Institute of Scientific and Technical Information of China (English)

    丁琳; 凌丽燕; 陆卫良; 段达荣

    2015-01-01

    目的 调查2010年-2012年嘉兴港区头孢曲松非敏感淋病奈瑟菌的流行特征和基因型.方法 收集患者中分离的淋病奈瑟菌256株,采用K-B法筛选出头孢曲松非敏感株78株,分析与头孢曲松非敏感淋病奈瑟菌感染的相关因素;用PCR扩增所有非敏感菌株的penA基因片段,分析头孢曲松非敏感淋病奈瑟菌penA基因的流行状况.结果 在256株淋球菌中,检出头孢曲松非敏感菌株78株,占30.47%,并且每年呈上升趋势,未发现头孢曲松耐药菌株,年龄≥21岁和近2个月有服用抗生素与头孢曲松非敏感淋病奈瑟菌感染有相关.基因检测结果显示头孢曲松非敏感菌株penA基因检出率极高,为82.05%.结论 2010年-2012年分离到的淋病奈瑟菌中头孢曲松非敏感株的比例较高,流行具有一定的特征性;本地区头孢曲松非敏感淋病奈瑟菌菌株的基因型以penA为主.

  1. Separation of Differential Proteins from Ceftriaxone Sensitive Strain to Resistant Strain of Neisseria Gonorrhoeae by Two-dimensional Polyacrylamide Gel Electrophoresis%淋病奈瑟菌头孢曲松敏感株和耐药株双向凝胶电泳试验

    Institute of Scientific and Technical Information of China (English)

    陶小华; 王千秋; 张津萍; 洪福昌; 冯铁建

    2010-01-01

    目的 应用双向凝胶电泳试验初步分离淋病奈瑟菌头孢曲松临床敏感株和诱导耐药株的差异蛋白质.方法 分别提取两种细菌的总蛋白,进行等电点聚焦和SDS-聚丙烯胺凝胶电泳,对所得胶图利用ImageMaster 5.0软件进行分析.结果 得到了分辨率和重复性均好的双向凝胶电泳图谱,通过分析得到1.3倍差异点24个.结论 通过双向凝胶电泳试验,分离出淋病奈瑟菌头孢曲松临床敏感株和诱导耐药株之间的差异表达蛋白.

  2. Study on Cross-Resistance and Multi-Resistance of Neisseria Gonorrhoeae Induced with Ceftriaxone Subinhibitory Concentration%头孢曲松次抑菌浓度诱导淋球菌耐药及交叉/多重耐药现象的探讨

    Institute of Scientific and Technical Information of China (English)

    刘敏; 陈智睿; 赖维; 龚子鉴; 叶张章; 赵越; 朱珂; 刘晨; 陈荣章; 李美荣; 尹颂超

    2011-01-01

    目的:利用体外次抑菌浓度法诱导耐头孢曲松淋球菌,探讨其交叉耐药与多重耐药现象,为淋球菌耐头孢曲松机制的研究提供菌株和初步的理论基础.方法:将对头孢曲松敏感的标准株WHOA、WHOC、WHOD、WHOE及临床株ZSSY016以头孢曲松次抑菌浓度法连续传代培养,定期监测生物学特性,分析诱导前后菌株RAPD图谱的改变结果,并以琼脂稀释法检测诱导前后及诱导过程中菌株对其他抗生素耐药性的变化.结果:诱导后菌株对头孢曲松的MIC值提高了4~256倍,对青霉素、头孢呋辛的MIC值也发生了不同程度的耐药,对四环素、环丙沙星及大观霉素的耐药性变化未发生显著改变.结论:体外次抑菌浓度法可诱导耐头孢曲松淋球菌,诱导易感性存在菌株间的个体差异,耐头孢曲松机制与交叉耐药/多重耐药机制存在多样性.淋病治疗应合理足量应用抗生素,以防止体内诱导产生耐药菌株.

  3. Drug: D07659 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 9 D07659.gif Antibiotic, cephalosporin Same as: C06683 ATC code: J01DD04 Semisynthetic cephalosporin: broad spectrum cephalosporin...M ANTIBACTERIALS J01DD Third-generation cephalosporins J01DD04 Ceftriaxone D07659 Ceftriaxone (INN) USP drug

  4. Severe sepsis facilitates intestinal colonization by extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and transfer of the SHV-18 resistance gene to Escherichia coli during antimicrobial treatment.

    Science.gov (United States)

    Guan, Jun; Liu, Shaoze; Lin, Zhaofen; Li, Wenfang; Liu, Xuefeng; Chen, Dechang

    2014-01-01

    Infections caused by multidrug-resistant pathogens are frequent and life threatening in critically ill patients. To investigate whether severe sepsis affects gut colonization by resistant pathogens and genetic exchange between opportunistic pathogens, we tested the intestinal-colonization ability of an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strain carrying the SHV-18 resistance gene and the transfer ability of the resistance gene to endogenous Escherichia coli under ceftriaxone treatment in rats with burn injury only or severe sepsis induced by burns plus endotoxin exposure. Without ceftriaxone treatment, the K. pneumoniae strain colonized the intestine in both septic and burned rats for a short time, with clearance occurring earlier in burn-only rats but never in sham burn rats. In both burned and septic rats, the colonization level of the challenge strain dropped at the beginning and then later increased during ceftriaxone treatment, after which it declined gradually. This pattern coincided with the change in resistance of K. pneumoniae to ceftriaxone during and after ceftriaxone treatment. Compared with burn-only injury, severe sepsis had a more significant effect on the change in antimicrobial resistance to ceftriaxone. Only in septic rats was the resistance gene successfully transferred from the challenge strain to endogenous E. coli during ceftriaxone treatment; the gene persisted for at least 4 weeks after ceftriaxone treatment. We concluded that severe sepsis can facilitate intestinal colonization by an exogenous resistant pathogen and the transfer of the resistance gene to a potential endogenous pathogen during antimicrobial treatment. PMID:24277046

  5. Complete Genome Sequences of Neisseria gonorrhoeae with Coresistance to First-Line Antimicrobials

    Science.gov (United States)

    Bharat, Amrita; Martin, Irene; Demczuk, Walter; Allen, Vanessa; Haldane, David; Hoang, Linda

    2016-01-01

    Neisseria gonorrhoeae strains with coresistance to the first-line antimicrobial treatments azithromycin and ceftriaxone are an emerging public health threat. Here, we present the complete genome sequences of three strains of N. gonorrhoeae, including one susceptible strain and two strains with coresistance to ceftriaxone and azithromycin. PMID:27609929

  6. Fulminant hepatic failure caused by Salmonella paratyphi A infection

    Institute of Scientific and Technical Information of China (English)

    Fahmi Yousef Khan; Ahmed A Kamha; Ibrahim Y Alomary

    2006-01-01

    We report a case of fulminant hepatic failure associated with Salmonella paratyphi A infection, in a 29-yearold patient who was admitted to the intensive care unit (TCU) with fever of two days, headache and vomiting followed by behavioural changes and disorientation. On examination, the patient appeared acutely ill, agitated, confused, and deeply jaundiced. Temperature 38.5℃,pulse 92/min, blood pressure 130/89 mmHg. Both samples of blood grew S. paratyphi A, which was sensitive to ceftriaxone and ciprofioxacin. Ceftriaxon was administered with high-dose dexamethasone. Two weeks after treatment with ceftriaxon, the patient was discharged in satisfactory condition.

  7. Does Doxycycline Protect Against Development of Clostridium difficile Infection?

    OpenAIRE

    Doernberg, Sarah B.; Winston, Lisa G.; Deck, Daniel H.; Chambers, Henry F.

    2012-01-01

    To determine whether doxycycline protects against development of Clostridium difficile infection (CDI), we studied a cohort of adult inpatients who received at least one dose of ceftriaxone. Addition of doxycycline was associated with low risk of CDI.

  8. Cefadroxil

    Science.gov (United States)

    ... of the skin, throat, tonsils, and urinary tract. Cephalexin is in a class of medications called cephalosporin ... Avycaz), ceftibuten (Cedax), ceftriaxone (Rocephin), cefuroxime (Zinacef), or cephalexin (Keflex); penicillin antibiotics, or any other medications. Also ...

  9. Need for Treatment of Gonorrhea to be Effective against Chlamydia trachomatis

    Directory of Open Access Journals (Sweden)

    William R Bowie

    1993-01-01

    Full Text Available Men and women with gonorrhea or contact to gonorrhea are frequently co-infected with Chlamydia trachomatis. To assess the importance of using treatment regimens active against both Neisseria gonorrhoeae and C trachomatis, tetracycline 500 mg orally four times daily for five days, with activity against both organisms, was compared with ceftriaxone, 250 mg once intramuscularly, with activity against only N gonorrhoeae. N gonorrhoeae microbiological failure occurred in six of 148 patients (4% on tetracycline and zero of 85 on ceftriaxone. Microbiological failure for C trachomatis occurred in zero of 27 on tetracycline and 10 of 12 (83% on ceftriaxone (P<0.001. In addition, 14 others on ceftriaxone had C trachomatis first isolated after treatment. When all types of microbiologialc and clinical failures are included, outcome was significantly better on tetracycline (P<0.001. Optimal treatment of patients with gonorrhea must include regimens with activity against both C trachomatis and N gonorrhoeae.

  10. Multidrug-resistant Neisseria gonorrhoeae with reduced cefotaxime susceptibility is increasingly common in men who have sex with men, Amsterdam, the Netherlands

    NARCIS (Netherlands)

    H.J.C. de Vries; J.J. van der Helm; M.F. Schim van der Loeff; A.P. van Dam

    2009-01-01

    Antimicrobial resistance is an increasing problem in Neisseria gonorrhoeae (NG) treatment. Presently, third-generation parenteral cephalosporins, like ceftriaxone and cefotaxime, are the first option. Resistance to oral, but not to parenteral, third-generation cephalosporins has been reported previo

  11. Evaluation of Moxifloxacin, a New 8-Methoxyquinolone, for Treatment of Meningitis Caused by a PenicillinResistant Pneumococcus in Rabbits

    OpenAIRE

    Østergaard, Christian; Klitmøller Sørensen, Tina; Dahl Knudsen, Jenny; Frimodt-Møller, Niels

    1998-01-01

    Moxifloxacin is a new 8-methoxyquinolone with high activity against gram-positive bacteria, including penicillin-resistant pneumococci. In an experimental meningitis model, we studied the pharmacokinetics of moxifloxacin in infected and uninfected rabbits and evaluated the antibiotic efficacies of moxifloxacin, ceftriaxone, and vancomycin against a penicillin-resistant Streptococcus pneumoniae strain (penicillin, ceftriaxone, vancomycin, and moxifloxacin MICs were 1, 0.5, 0.5, and 0.125 μg/ml...

  12. Cephalosporin-induced hypoprothrombinemia: is the N-methylthiotetrazole side chain the culprit?

    OpenAIRE

    Agnelli, G.; Del Favero, A.; Parise, P; Guerciolini, R; Pasticci, B; Nenci, G G; Ofosu, F

    1986-01-01

    The reported high incidence of vitamin-K-reversible hypoprothrombinemia associated with the new beta-lactamase-stable cephalosporins prompted us to evaluate the effect on hemostasis of three cephalosporins (cefamandole, ceftriaxone, and ceftazidime) in 30 patients with serious infections. Cefamandole and ceftriaxone, both containing a sulfhydryl group, induced a significant and similar prolongation of prothrombin time and decrease in factor VII activity. Ceftazidime, in contrast, had no effec...

  13. A Case of Persistent and Possibly Treatment Resistant Pharyngeal Gonorrhea.

    Science.gov (United States)

    Levy, Vivian; Pandori, Mark; Berrada, Zenda L; Relucio, Karen I; Lopez, Teresa P; Samuel, Michael C; Park, Ina U

    2016-04-01

    An HIV-negative man with pharyngeal gonorrhea had a positive test-of-cure (nucleic acid amplification test) result 7 days after treatment with ceftriaxone/azithromycin. Neisseria gonorrhoeae Multi-Antigen Sequencing Type 1407 and mosaic pen A (XXXIV) gene were identified in the test-of-cure specimen, and culture was negative. Retreatment with ceftriaxone 500 mg intramuscularly plus azithromycin 2 g orally yielded a negative test-of-cure result. PMID:26967304

  14. Identification of amino acids conferring high-level resistance to expanded-spectrum cephalosporins in the penA gene from Neisseria gonorrhoeae strain H041.

    Science.gov (United States)

    Tomberg, Joshua; Unemo, Magnus; Ohnishi, Makoto; Davies, Christopher; Nicholas, Robert A

    2013-07-01

    The recent identification of a high-level-ceftriaxone-resistant (MIC = 2 to 4 μg/ml) isolate of Neisseria gonorrhoeae from Japan (H041) portends the loss of ceftriaxone as an effective treatment for gonococcal infections. This is of grave concern because ceftriaxone is the last remaining option for first-line empirical antimicrobial monotherapy. The penA gene from H041 (penA41) is a mosaic penA allele similar to mosaic alleles conferring intermediate-level cephalosporin resistance (Ceph(i)) worldwide but has 13 additional mutations compared to the mosaic penA gene from the previously studied Ceph(i) strain 35/02 (penA35). When transformed into the wild-type strain FA19, the penA41 allele confers 300- and 570-fold increases in the MICs for ceftriaxone and cefixime, respectively. In order to understand the mechanisms involved in high-level ceftriaxone resistance and to improve surveillance and epidemiology during the potential emergence of ceftriaxone resistance, we sought to identify the minimum number of amino acid alterations above those in penA35 that confer high-level resistance to ceftriaxone. Using restriction fragment exchange and site-directed mutagenesis, we identified three mutations, A311V, T316P, and T483S, that, when incorporated into the mosaic penA35 allele, confer essentially all of the increased resistance of penA41. A311V and T316P are close to the active-site nucleophile Ser310 that forms the acyl-enzyme complex, while Thr483 is predicted to interact with the carboxylate of the β-lactam antibiotic. These three mutations have thus far been described only for penA41, but dissemination of these mutations in other mosaic alleles would spell the end of ceftriaxone as an effective treatment for gonococcal infections.

  15. Influence of antimicrobial therapy on kinetics of tumor necrosis factor levels in experimental endocarditis caused by Klebsiella pneumoniae.

    Science.gov (United States)

    Mohler, J; Fantin, B; Mainardi, J L; Carbon, C

    1994-05-01

    The kinetics of tumor necrosis factor (TNF) levels in serum during therapy with cell wall-active agents (ceftriaxone, imipenem) and gentamicin were investigated in rabbits with experimental endocarditis caused by an isogenic pair of Klebsiella pneumoniae strains: a TEM-3 beta-lactamase-producing strain (KpR) or its susceptible variant (KpS). In vitro, KpR was resistant to ceftriaxone and was susceptible to gentamicin and imipenem, while KpS was susceptible to all three antibiotics. Serum TNF levels were determined in control rabbits hourly after bacterial inoculation and then daily; they were determined in treated animals hourly after the first antibiotic injection and then daily during a 4-day therapy with either imipenem (60 mg/kg of body weight four times daily), ceftriaxone (75 mg/kg once daily), or gentamicin (4 mg/kg once daily) alone or in combination with ceftriaxone. After a transient peak (10.2 +/- 3.1 ng/ml) at 90 min following bacterial challenge, serum TNF levels remained low and stable in control animals. The peak in the serum TNF levels occurred 4 h after the first antibiotic injection and with ceftriaxone was significantly higher (P ceftriaxone were significantly higher (P mechanism of action and the susceptibility of the strain at the early phase of therapy, without any effect of the rapidity of bacterial killing, and (ii) the final reduction of the bacterial count at a later stage of therapy.

  16. Determination of in vitro synergy for dual antimicrobial therapy against resistant Neisseria gonorrhoeae using Etest and agar dilution.

    Science.gov (United States)

    Wind, Carolien M; de Vries, Henry J C; van Dam, Alje P

    2015-03-01

    In response to antimicrobial resistance of Neisseria gonorrhoeae to last-resort extended-spectrum cephalosporins, combination therapy of azithromycin+ceftriaxone is now recommended. Dual therapy can be effective to treat monoresistant strains as well as multidrug-resistant strains, preferably employing the effect of in vitro synergy. As reports on in vitro synergy of azithromycin+ceftriaxone in N. gonorrhoeae are conflicting, in this study an evaluation of this combination was performed using a cross-wise Etest method and agar dilution. Synergy was defined as a fractional inhibitory concentration index (FICI) of ≤0.5. To identify other dual treatment options for gonorrhoea, in vitro synergy was evaluated for 65 dual antimicrobial combinations using Etest. Azithromycin, cefixime, ceftriaxone, colistin, ertapenem, fosfomycin, gentamicin, minocycline, moxifloxacin, rifampicin, spectinomycin and tigecycline were screened for synergy in all possible combinations. No synergy or antagonism was found for any of the 65 combinations. The geometric mean FICI ranged from 0.82 to 2.00. The mean FICI of azithromycin+ceftriaxone was 1.18 (Etest) and 0.55 (agar dilution). The difference between both methods did not result in a difference in interpretation of synergy. Ceftriaxone-resistant strain F89 was tested in all combinations and no synergy was found for any of them. Most importantly, the ceftriaxone minimum inhibitory concentration of F89 was not decreased below the breakpoint with any concentration of azithromycin.

  17. Phage-antibiotic synergism: a possible approach to combatting Pseudomonas aeruginosa.

    Science.gov (United States)

    Knezevic, Petar; Curcin, Sanja; Aleksic, Verica; Petrusic, Milivoje; Vlaski, Ljiljana

    2013-01-01

    Pseudomonas aeruginosa is a highly resistant opportunistic pathogen and an important etiological agent of various types of infections. During the last decade, P. aeruginosa phages have been extensively examined as alternative antimicrobial agents. The aim of the study was to determine antimicrobial effectiveness of combining subinhibitory concentrations of gentamicin, ceftriaxone, ciprofloxacin or polymyxin B with P. aeruginosa-specific bacteriophages belonging to families Podoviridae and Siphoviridae. The time-kill curve method showed that a combination of bacteriophages and subinhibitory concentrations of ceftriaxone generally reduced bacterial growth, and synergism was proven for a Siphoviridae phage σ-1 after 300 min of incubation. The detected alteration in morphology after ceftriaxone application, resulting in cell elongation, along with its specific mode of action, seemed to be a necessary but was not a sufficient reason for phage-antibiotic synergism. The phenomenon offers an opportunity for future development of treatment strategies for potentially lethal infections caused by P. aeruginosa.

  18. Resistance Pattern of Enterococci Isolated from Nosocomial Infections in the Hospitals Located in Gonbad and Gorgan Cities, Iran

    Directory of Open Access Journals (Sweden)

    Ebrahim Zade, A (MD

    2014-11-01

    Full Text Available Background and Objective: Streptococcus pneumoniae is the most common cause of acquired bacterial infections in the respiratory system. In recent years, a high incidence of pneumococcal resistance to different antibiotics has also been appeared. This study was conducted to evaluate the in vivo and in vitro resistance of pneumococcal pneumonia to ceftriaxone, azithromycin and co-amoxiclave in clinical setting and laboratory. Material and Methods: In this single-blind clinical trial study, the participants were the patients with the diagnosis of pneumonia referred to infectious diseases clinic in Vali-e-Asr hospital of Birjand university of Medical Sciences, October 2012 - April 2014. The patients were randomly allocated to one of the three therapeutic regimes including azithromycin, ceftriaxone, and co-amoxiclave. After 48-72 hours that the infection was confirmed by paraclinical findings, the patients with pneumococcal pneumonia remained in the study and their in vivo and in vitro resistance to the above mentioned antibiotics were compared. Results: The most in vitro drug resistance was to co-amoxiclave (41.5% and the least to ceftriaxone (20.8% (P>0.05. For In vivo, the most resistance was to azithromycin (47.4% and the least one to ceftriaxone (6.7% (p<0.05. The agreement coefficient between the laboratory antibiogram test and the clinical responses to therapeutic regimes of azithromycin, co-amoxiclave and ceftriaxone was 0.25 (p=0.26, 0.46 (p=0.02 and 0.44 (p=0.04, respectively. Conclusion: With regard to the demographic characteristics of the patients in this study, the resistance of Streptococcus pneumoniae to ceftriaxone is less than that of co-amoxiclave and azithromycin in both clinical setting and laboratory.

  19. Differential Release of Lipoteichoic and Teichoic Acids from Streptococcus pneumoniae as a Result of Exposure to β-Lactam Antibiotics, Rifamycins, Trovafloxacin, and Quinupristin-Dalfopristin

    OpenAIRE

    Stuertz, K; Schmidt, H.; Eiffert, H.; Schwartz, P.; Mäder, M.; Nau, R.

    1998-01-01

    The release of lipoteichoic acid (LTA) and teichoic acid (TA) from a Streptococcus pneumoniae type 3 strain during exposure to ceftriaxone, meropenem, rifampin, rifabutin, quinupristin-dalfopristin, and trovafloxacin in tryptic soy broth was monitored by a newly developed enzyme-linked immunosorbent assay. At a concentration of 10 μg/ml, a rapid and intense release of LTA and TA occurred during exposure to ceftriaxone (3,248 ± 1,688 ng/ml at 3 h and 3,827 ± 2,133 ng/ml at 12 h) and meropenem ...

  20. Beta-Lactam Antibiotics as A Possible Novel Therapy for Managing Epilepsy and Autism, A Case Report and Review of Literature

    Science.gov (United States)

    GHANIZADEH, Ahmad; BERK, Michael

    2015-01-01

    Autism is a disorder of unknown etiology. There are few FDA approved medications for treating autism. Co-occurring autism and epilepsy is common, and glutamate antagonists improve some symptoms of autism. Ceftriaxone, a beta-lactam antibiotic, increases the expression of the glutamate transporter 1 which decreases extracellular glutamate levels. It is hypothesized that modulating astrocyte glutamate transporter expression by ceftriaxone or cefixime might improve some symptoms of autism. This case report of a child with autism and epilepsy suggests a decrease in seizures after taking cefixime PMID:25767546

  1. Moxifloxacin in the Therapy of Experimental Pneumococcal Meningitis

    OpenAIRE

    Schmidt, H.; Dalhoff, A.; Stuertz, K; Trostdorf, F.; Chen, V.; Schneider, O.; Kohlsdorfer, C.; BRÜCK, W.; Nau, R.

    1998-01-01

    The activity of moxifloxacin (BAY 12-8039) against a Streptococcus pneumoniae type 3 strain (MIC and minimum bactericidal concentration [MBC] of moxifloxacin, 0.06 and 0.25 μg/ml, respectively; MIC and MBC of ceftriaxone, 0.03 and 0.06 μg/ml, respectively) was determined in vitro and in a rabbit model of meningitis. Despite comparable bactericidal activity, 10 μg of moxifloxacin per ml released lipoteichoic and teichoic acids less rapidly than 10 μg of ceftriaxone per ml in vitro. Against exp...

  2. Drug Utilization Study on Antimicrobial Use in Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    Sunil S Gidamudi

    2015-09-01

    Conclusion: The DDD/1000inhabitant/day of ceftriaxone was the highest (12.9. Third generation cephalosporins were used as first line drug in most cases. This group should be reserved for complicated UTIs. [Natl J Med Res 2015; 5(3.000: 216-221

  3. Nocardia Brain Abscess in a Liver Transplant Recipient

    OpenAIRE

    Moon, Jung Hyeon; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun

    2011-01-01

    Nocardia brain abscess is rare. We report on a unique case of N. farcinica brain abscess in a liver transplant recipient, following Aspergillus fumigatus pneumonia. A 43-year-old liver transplant recipient presented with altered mentality at 2 months after A. fumigates pneumonia. He was successfully treated with surgical removal and antibiotic therapy with trimethoprim-sulfamethoxazole and ceftriaxone.

  4. An evaluation of the bacteriolytic and biochemical properties of ceftiolene (42980RP).

    Science.gov (United States)

    Williamson, R; Gutmann, L; Kitzis, M D; Acar, J F

    1984-12-01

    Ceftiolene (42980RP) is a new cephalosporin with a broad antibacterial spectrum similar to cefotaxime or ceftriaxone. The characteristics of ceftiolene have been tested in a variety of assays involving various biochemical aspects of the mode of action of beta-lactam antibiotics. The affinities of ceftiolene for penicillin-binding proteins were very comparable with those of ceftriaxone and cefotaxime for Escherichia coli, and generally greater than those of latamoxef (moxalactam) for the higher molecular weight PBPs of E. coli. Enterobacter cloacae. Proteus mirabilis and Pseudomonas aeruginosa. The affinity of ceftiolene for PBP1 of Staphylococcus aureus was greater than those of cefotaxime or latamoxef, but comparable with these antibiotics for PBP3. The bacteriolytic activity of ceftiolene at defined concentrations against Gram-negative organisms was similar to that of ceftriaxone, and significantly better than that of the other third-generation cephalosporins tested. Introduction of plasmid-encoded beta-lactamases into E. coli reduced the wide variation in bacteriolytic effect of the different cephalosporins, and a significant inoculum effect was observed for the bacteriolysis. Chloramphenicol was less antagonistic against ceftiolene- or ceftriaxone-induced lysis than was observed for cefotaxime or latamoxef. Growth of Staph. aureus at low concentrations of ceftiolene caused the bacteria to become more sensitive to lysis by lysostaphin than organisms grown with cefotaxime or latamoxef under the same conditions. These observations confirm the necessity to use techniques other than routine MIC determinations to distinguish between antibiotics which would otherwise appear very similar.

  5. Pharmacological evaluation of glutamate transporter 1 (GLT-1) mediated neuroprotection following cerebral ischemia/reperfusion injury.

    Science.gov (United States)

    Verma, Rajkumar; Mishra, Vikas; Sasmal, Dinakar; Raghubir, Ram

    2010-07-25

    Recently glutamate transporters have emerged as a potential therapeutic target in a wide range of acute and chronic neurological disorders, owing to their novel mode of action. The modulation of GLT-1, a major glutamate transporter has been shown to exert neuroprotection in various models of ischemic injury and motoneuron degeneration. Therefore, an attempt was made to explore its neuroprotective potential in cerebral ischemia/reperfusion injury using ceftriaxone, a GLT-1 modulator. Pre-treatment with ceftriaxone (100mg/kg. i.v) for five days resulted in a significant reduction (Pceftriaxone-mediated increased glutamine synthetase activity by dihydrokainate (DHK), a GLT-1 specific inhibitor, confirms the specific effect of ceftriaxone on GLT-1 activity. In addition, ceftriaxone also induced a significant (P<0.01) increase in [(3)H]-glutamate uptake, mediated by GLT-1 in glial enriched preparation, as evidenced by use of DHK and DL-threo-beta-benzyloxyaspartate (DL-TBOA). Thus, the present study provides overwhelming evidence that modulation of GLT-1 protein expression and activity confers neuroprotection in cerebral ischemia/reperfusion injury.

  6. In Vitro Susceptibility Testing of Four Antibiotics against Borrelia burgdorferi: a Comparison of Results for the Three Genospecies Borrelia afzelii, Borrelia garinii, and Borrelia burgdorferi Sensu Stricto

    OpenAIRE

    Sicklinger, Martin; Wienecke, Ralf; Neubert, Uwe

    2003-01-01

    MICs and minimal bactericidal concentrations (MBCs) were evaluated for the four antibiotics azithromycin, amoxicillin, ceftriaxone, and doxycycline against the three main genospecies of Borrelia burgdorferi sensu lato. In MBC testing, statistically significant differences between the genospecies could be found in 7 out of 12 comparative evaluations (P < 0.05).

  7. In-vitro-Sensibilität von Borrelia burgdorferi sensu lato gegenüber vier Antibiotika: ein Vergleich der Genospezies Borrelia afzelii, Borrelia garinii und Borrelia burgdorferi sensu stricto

    OpenAIRE

    Sicklinger, Martin

    2006-01-01

    MICs and minimal bactericidal concentrations (MBCs) were evaluated for the four antibiotics azithromycin, amoxicillin, ceftriaxone, and doxycycline against the three main genospecies of Borrelia burgdorferi sensu lato. In MBC testing, statistically significant differences between the genospecies could be found in 7 out of 12 comparative evaluations (P < 0.05).

  8. In vitro synergistic activities of tobramycin and selected beta-lactams against 75 gram-negative clinical isolates.

    OpenAIRE

    Owens, R C; Banevicius, M A; Nicolau, D. P.; Nightingale, C H; Quintiliani, R

    1997-01-01

    The microdilution checkerboard technique was utilized to distinguish synergistic activity between tobramycin and four beta-lactams: piperacillin-tazobactam, ticarcillin-clavulanate, ceftazidime, and ceftriaxone. Beta-lactam-aminoglycoside combinations were tested against 75 clinical isolates of Pseudomonas aeruginosa, Acinetobacter baumanii, Citrobacterfreundii, Serratia marcescens, and Enterobacter cloacae. Despite in vitro susceptibilities, all isolates demonstrated either synergism or indi...

  9. Molecular characterization of extended-spectrum beta-lactamases and its correlation with clinical laboratory standards institute interpretive criteria for disk diffusion susceptibility testing in enterobacteriaceae isolates in Thaialnd.

    Science.gov (United States)

    Tangkoskul, Teerawit; Tiengrim, Surapee; Onsomang, Supiluck; Pati, Naratchaphan; Aswapokee, Nalinee; Thamlikitkul, Visanu; Chayakulkeeree, Methee

    2012-11-01

    We performed extended-spectrum beta-lactamase (ESBL) phenotypic testing and molecular characterization of three ESBL genes (TEM, SHV and CTX-M) and susceptibility testing by Clinical Laboratory Standards Institute (CLSI) disk diffusion method against three cephalosporins (ceftriaxone, ceftazidime, cefepime) and a cephamycin (cefoxitin) among 128 Thai Escherichia coli and 84 Thai Klebsiella pneumoniae clinical isolates. ESBL production was discovered in 62% of E. coli and 43% of K. pneumoniae isolates. All isolates susceptible to ceftriaxone were ESBL-negative. Nearly all isolates non-susceptible to ceftriaxone, ceftazidime and cefepime produced ESBL; the presence of CTX-M genes in the isolates correlated with a ceftriaxone non-susceptible phenotype. Thirty-nine of 83 isolates (47%) of ceftazidime-susceptible E. coli and 50 of 99 isolates (50.5%) of cefepime-susceptible E. coli were ESBL-producing. SHV-type beta-lactamase genes were more prevalent among K. pneumoniae than E. coli isolates. CTX-M was the major ESBL gene harbored by ESBL-producers in both E. coli and K. pneumoniae isolates. Non-CTX-M ESBL-producers were found only among K. pneumoniae isolates. This study reveals an increase in ESBL-producing Enterobacteriaceae among Thai isolates and demonstrates gaps in the current CLSI disk diffusion susceptibility guidelines; it indicates the results of ceftazidime and cefepime disk diffusion susceptibility testing using CLSI criteria should be interpreted with caution.

  10. Effects of low intensity electromagnetic irradiation of 70.6 and 73 GHz frequencies and antibiotics on energy-dependent proton and potassium ion transport by E. coli.

    Science.gov (United States)

    Torgomyan, H

    2012-12-01

    The effects of low intensity (flux capacity 0.06 mW/cm2) coherent electromagnetic irradiation (EMI) of 70.6 and 73 GHz frequencies and their combined effects with antibiotics--ceftriaxone or kanamycin (0.4 or 15 microM, correspondingly) on E. coli K12 growth and survival have been reported previously. To further study the effects of EMI and antibiotics and mechanisms, decrease in overall energy (glucose)-dependent H+ and K+ fluxes across the cell membrane was investigated in E. coli. The depression of H+ and K+ fluxes rate was maximally achieved with the 73 GHz frequency. The EMI strengthened the effect of N,N'-dicyclohexycarbodiimide (DCCD, an inhibitor of the F0F1-ATPase). The 73 GHz EMI had more influence on H+ efflux inhibition, whereas 70.6 GHz on K+ influx. Also, EMI strengthened the depressive effects of ceftriaxone and kanamycin on the overall and DCCD-inhibited H+ and K+ fluxes. The 73 GHz EMI strengthened the effect of ceftriaxone on both ions fluxes. Kanamycin depressed H+ efflux more as compared to ceftriaxone, which was also strengthened with EMI. The results of E. coli H+ and K+ transport systems activities depression by irradiation and the irradiation effect on DCCD and antibiotics action indicated the EMI and antibiotics causing primary changes in the bacterial membrane. PMID:23350277

  11. Characterization of extended-spectrum cephalosporin-resistant Salmonella enterica serovar Heidelberg isolated from food animals, retail meat, and humans in the United States 2009

    Science.gov (United States)

    Salmonella enterica is one of the most common causes of foodborne illness in the United States. Although salmonellosis is usually self-limiting, severe infections typically require antimicrobial treatment and ceftriaxone, an extended-spectrum cephalosporin, is commonly used in both adults and child...

  12. Acute meningoencephalitis as the sole manifestation of Q fever.

    Science.gov (United States)

    Guerrero, M; Gutierrez, J; Carnero, C; Gonzalez-Maldonado, R; Maroto, C

    1993-01-01

    The case of a 25-year old man who presented with meningoencephalitis as the sole clinical manifestation of Q fever is described. Serological studies revealed the presence of IgM and IgG antibodies to Coxiella burnetii. The patient responded favourably to a ten-day course of i.v. ceftriaxone and was discharged without any neurological sequelae.

  13. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

    OpenAIRE

    Omar, Mahmoud A.; Osama H. Abdelmageed; Tamer Z. Attia

    2009-01-01

    A simple, reliable, and sensitive kinetic spectrophotometric method was developed for determination of eight cephalosporin antibiotics, namely, Cefotaxime sodium, Cephapirin sodium, Cephradine dihydrate, Cephalexin monohydrate, Ceftazidime pentahydrate, Cefazoline sodium, Ceftriaxone sodium, and Cefuroxime sodium. The method depends on oxidation of each of studied drugs with alkaline potassium permanganate. The reaction is followed spectrophotometrically by measuring the rate of change of abs...

  14. Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management

    Directory of Open Access Journals (Sweden)

    Hamid Mohammad-Jafari

    2012-02-01

    Full Text Available Urinary tract infections (UTI are one of the most common infections with an increasing resistance to antimicrobial agents. PURPOSE: Empirical initial antibiotic treatment of UTI must rely on susceptible data from local studies. MATERIALS AND METHODS: Retrospective analysis of isolated bacteria from children with UTIs was performed at the university hospital during years 2006-2009. The findings were compared with data collected in a similar study carried out in 2002- 2003. RESULTS: A total of 1439 uropathogens were isolated. Escherichia coli (E.coli was the leading cause, followed by Enterobacter, and other gram negative bacilli. It was observed resistance of E.coli to ceftriaxone, cefexime, amikacin, gentamycin, and nalidixic acid; Enterobacter to cefexime; and the resistance of gram negative bacilli to gentamicin and cefexime increased significantly. The highest effective antibiotic was Imipenem, ciprofloxacin, and amikacin with 96.7%, 95% and 91% sensitivity rates , respectively, followed by ceftriaxone 77.2%, gentamicin 77%, nitrofurantoin 76.4%, nalidixic acid 74.3% and cefexime with 70%. CONCLUSION: The use of nitrofurantoin or nalidixic acid as initial empirical antibacterial therapy for cystitis seems appropriate. For cases of simple febrile UTI, the use of initial parenteral therapies with amikacin or ceftriaxone followed by an oral third generation cephalosporin also seemed appropriated, and in cases of severely ill patients or complicated UTI, imipenem as monotherapy or, a combination of Ceftriaxone with an aminoglycoside, are recommended.

  15. Gonococcal aneurysm of the ascending aorta: case report and review of Neisseria gonorrhoeae endovascular infections.

    Science.gov (United States)

    Markowicz, Samuel; Anstey, James Richards; Hites, Maya; Montesinos, Isabel; Roisin, Sandrine; Keyzer, Caroline; Jacobs, Frederique

    2014-02-01

    We present the case of a man with a bicuspid aortic valve who presented with persistent fever. Blood cultures yielded Neisseria gonorrhoeae, and the diagnosis of infected mycotic aneurysm was confirmed by detection of the bacterial genome in the aortic wall. The patient was cured with surgery and intravenous ceftriaxone.

  16. Pharmacodynamic profiling of commonly prescribed antimicrobial drugs against Escherichia coli isolates from urinary tract

    Directory of Open Access Journals (Sweden)

    Gabriel Trova Cuba

    2014-09-01

    Full Text Available Since antimicrobial resistance among uropathogens against current first line agents has affected the management of severe urinary tract infection, we determined the likelihood that antibiotic regimens achieve bactericidal pharmacodynamic exposures using Monte Carlo simulation for five antimicrobials (ciprofloxacin, ceftriaxone, piperacillin/tazobactam, ertapenem, and meropenem commonly prescribed as initial empirical treatment of inpatients with severe community acquired urinary tract infections. Minimum inhibitory concentration determination by Etest was performed for 205 Brazilian community urinary tract infection Escherichia coli strains from 2008 to 2012 and 74 E. coli bloodstream strains recovered from a surveillance study. Pharmacodynamic exposure was modeled via a 5000 subject Monte Carlo simulation. All isolates were susceptible to ertapenem and meropenem. Piperacillin/tazobactam, ceftriaxone and ciprofloxacin showed 100%, 97.5% and 83.3% susceptibility among outpatient isolates and 98.6%, 75.7% and 64.3% among inpatient isolates, respectively. Against outpatient isolates, all drugs except ciprofloxacin (82.7% in aggressive and 77.6% in conservative scenarios achieved high cumulative fraction of response: car-bapenems and piperacillin/tazobactam cumulative fraction of responses were close to 100%, and ceftriaxone cumulative fraction of response was 97.5%. Similar results were observed against inpatients isolates for carbapenems (100% and piperacillin/tazobactam (98.4%, whereas ceftriaxone achieved only 76.9% bactericidal cumulative fraction of response and ciprofloxacin 61.9% (aggressive scenario and 56.7% (conservative scenario respectively. Based on this model, standard doses of beta-lactams were predicted to deliver sufficient pharmacodynamic exposure for outpatients. However, ceftriaxone should be avoided for inpatients and ciprofloxacin empirical prescription should be avoided in both inpatients and outpatients with complicated

  17. Efficacy evaluation of Bauhinia variegata L. stem bark powder as adjunct therapy in chronic Staphylococcus aureus mastitis in goat

    Directory of Open Access Journals (Sweden)

    Jeevan Ranjan Dash

    2014-01-01

    Full Text Available Objective: The objective was to study the effect of Bauhinia variegata L. stem bark powder as adjunct therapy in chronic Staphylococcus aureus mastitis in goat. Materials and Methods: Mastitis was induced by intracisternal inoculation of coagulase positive S. aureus (J638 at the concentration of 2000 colony forming units. Group I animals were treated with repeated dose of ceftriaxone at 20 mg/kg intravenously, and Group II animals were treated with once daily oral administration of B. variegata L. stem bark powder at 6 g/kg for 7 days followed by maintenance dose at 3 g/kg for next 7 days along with repeated dose of the antibiotic at 20 mg/kg intravenously at 4 days interval. Results: No significant improvement in the clinical condition of the udder was noticed in the group treated with repeated dose of ceftriaxone alone. However, in the group treated with B. variegata L. stem bark powder along with repeated dose of ceftriaxone, no S. aureus colony was seen at 96 h and onwards in milk samples with a marked decrease in somatic cell count and milk alkaline phosphatase activity and increased lactoperoxidase activity. Further, plasma and milk concentration of ceftriaxone/ceftizoxime was increased, which indicated antibacterial, bioenhancing and antiinflammatory properties of the bark powder. The Group II animals also exhibited marked reduction in polymorphonuclear cells and fibrous tissue indicating antifibrotic property of B. variegata L. Conclusion: B. variegata L. stem bark powder can be considered as an effective adjunct therapy to intravenous ceftriaxone in S. aureus chronic mastitis in goat.

  18. Assessment of Etest as an alternative to agar dilution for antimicrobial susceptibility testing of Neisseria gonorrhoeae.

    Science.gov (United States)

    Liu, Hsi; Taylor, Thomas H; Pettus, Kevin; Trees, David

    2014-05-01

    We studied whether the Etest can be used as an alternative to agar dilution to determine antimicrobial susceptibilities of ceftriaxone, cefixime, and cefpodoxime in Neisseria gonorrhoeae surveillance. One hundred fifteen clinical and laboratory isolates of N. gonorrhoeae were tested following the Clinical Laboratory Improvement Amendments (CLIA)-approved CLSI standard agar dilution method and, separately, by the Etest according to the manufacturer's recommendations. The MICs were determined and compared. Ten laboratory-generated mutants were used to simulate substantially nonsusceptible specimens. The Etest and agar dilution methods were well correlated. Statistical tests produced regression R2 values of 88%, 82%, and 85% and Pearson correlation coefficients of 92%, 91%, and 92% for ceftriaxone, cefixime, and cefpodoxime, respectively. When paired comparisons were made, the two tests were 88.7%, 80%, and 87% within 1 log2 dilution from each other for ceftriaxone, cefixime, and cefpodoxime, respectively. The within-2-log2 agreements were 99.1%, 98.3%, and 94.8% for ceftriaxone, cefixime, and cefpodoxime, respectively. Notwithstanding the good correlations and the within-2-log2 general agreement, the Etest results produced slightly lower MICs than the agar dilution results. In conclusion, we found that the Etest can be effectively used as an alternative to agar dilution testing to determine the susceptibility of N. gonorrhoeae to ceftriaxone, cefixime, and cefpodoxime, although we recommend further research into extremely resistant isolates. For isolates within the typical range of clinical MICs, reexamination of the Etest interpretation of susceptible and nonsusceptible categories would likely allow for successful transition from agar dilution to the Etest.

  19. FASTCAP study on the management of hospitalized patients with community-acquired pneumonia: pharmacoeconomic analysis of the prospective phase

    Directory of Open Access Journals (Sweden)

    C. Lazzaro

    2013-05-01

    Full Text Available BACKGROUND The economic evaluation of guide-lines based hospital management of Community- Acquired Pneumonia (CAP with antibiotic therapy is rarely reported in literature. AIM OF THE STUDY To compare costs and effectiveness of 5 different antibiotic courses administered to Fine IV and V class patients with CAP, hospitalized in 31 Italian Internal Medicine (IM Departments and enrolled in the prospective phase of the multicentre FASTCAP study after the implementation of the Italian Federation of Internal Medicine (FADOI recommendations on the management of patients with CAP admitted to IM. METHODS 5 main antibiotic courses, administered to 786 patients, were considered (3 monotherapies: levofloxacin, 213 patients; amoxycillin/clavulanate, 134 patients; ceftriaxone, 166 patients; 2 combination therapies: amoxycillin/clavulanate + advanced macrolide, 137 patients; ceftriaxone + advanced macrolide, 136 patients. A cost analysis and two cost/effectiveness analyses (comparing, after the 1st cycle of therapy, cost to outcome for both Fine IV and V classes and cost to avoided mortality during hospitalization for Fine V class only were carried out adopting the hospital viewpoint. Health care cost, reported in euros 2007, included: drugs acquisition; nursing time; devices for ev administration; hospitalization in inpatient setting. RESULTS The least and the most costly therapies are levofloxacin (3,032.19 ± 2,045.34 euros and ceftriaxone (3,666.95 ± 2,389.46 euros in Fine IV class and amoxycillin/clavulanate (2,989.37 ± 2,242.15 euros and ceftriaxone + advanced macrolide (4,633.59 ± 2,491.57 euros in Fine V class. As far as the therapeutic outcome is concerned, levofloxacin dominates comparators in Fine IV class, whereas amoxycillin/clavulanate + advanced macrolide is both the most costly (3,433.16 ± 1,725.63 euros and the most effective option (69.6%; 95% CI: 54.3-82.3% in Fine V class. In Fine V class ceftriaxone + advanced macrolide reports both

  20. A cohort study of bacteremic pneumonia

    Science.gov (United States)

    Guillamet, Cristina Vazquez; Vazquez, Rodrigo; Noe, Jonas; Micek, Scott T.; Kollef, Marin H.

    2016-01-01

    Abstract Bacteremic pneumonia is usually associated with greater mortality. However, risk factors associated with hospital mortality in bacteremic pneumonia are inadequately described. The study was a retrospective cohort study, conducted in Barnes-Jewish Hospital (2008–2015). For purposes of this investigation, antibiotic susceptibility was determined according to ceftriaxone susceptibility, as ceftriaxone represents the antimicrobial agent most frequently recommended for hospitalized patients with community-acquired pneumonia as opposed to nosocomial pneumonia. Two multivariable analyses were planned: the first model included resistance to ceftriaxone as a variable, whereas the second model included the various antibiotic-resistant species (methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae). In all, 1031 consecutive patients with bacteremic pneumonia (mortality 37.1%) were included. The most common pathogens associated with infection were S aureus (34.1%; methicillin resistance 54.0%), Enterobacteriaceae (28.0%), P aeruginosa (10.6%), anaerobic bacteria (7.3%), and Streptococcus pneumoniae (5.6%). Compared with ceftriaxone-susceptible pathogens (46.8%), ceftriaxone-resistant pathogens (53.2%) were significantly more likely to receive inappropriate initial antibiotic treatment (IIAT) (27.9% vs 7.1%; P mechanical ventilation, immune suppression, prior hospitalization, prior antibiotic administration, septic shock, comorbid conditions, and severity of illness. In the second multivariable analysis that included the antibiotic-resistant species, IIAT was still associated with excess mortality, and P aeruginosa infection was identified as an independent predictor of mortality (OR 1.6, 95% CI 1.1–2.2, P = 0.047), whereas infection with ceftriaxone-resistant Enterobacteriaceae (OR 0.6, 95% CI 0.4–1.0, P = 0.050) was associated with lower mortality. More than one-third of our patients hospitalized with bacteremic

  1. A cohort study of bacteremic pneumonia: The importance of antibiotic resistance and appropriate initial therapy?

    Science.gov (United States)

    Guillamet, Cristina Vazquez; Vazquez, Rodrigo; Noe, Jonas; Micek, Scott T; Kollef, Marin H

    2016-08-01

    Bacteremic pneumonia is usually associated with greater mortality. However, risk factors associated with hospital mortality in bacteremic pneumonia are inadequately described.The study was a retrospective cohort study, conducted in Barnes-Jewish Hospital (2008-2015). For purposes of this investigation, antibiotic susceptibility was determined according to ceftriaxone susceptibility, as ceftriaxone represents the antimicrobial agent most frequently recommended for hospitalized patients with community-acquired pneumonia as opposed to nosocomial pneumonia. Two multivariable analyses were planned: the first model included resistance to ceftriaxone as a variable, whereas the second model included the various antibiotic-resistant species (methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae).In all, 1031 consecutive patients with bacteremic pneumonia (mortality 37.1%) were included. The most common pathogens associated with infection were S aureus (34.1%; methicillin resistance 54.0%), Enterobacteriaceae (28.0%), P aeruginosa (10.6%), anaerobic bacteria (7.3%), and Streptococcus pneumoniae (5.6%). Compared with ceftriaxone-susceptible pathogens (46.8%), ceftriaxone-resistant pathogens (53.2%) were significantly more likely to receive inappropriate initial antibiotic treatment (IIAT) (27.9% vs 7.1%; P mechanical ventilation, immune suppression, prior hospitalization, prior antibiotic administration, septic shock, comorbid conditions, and severity of illness. In the second multivariable analysis that included the antibiotic-resistant species, IIAT was still associated with excess mortality, and P aeruginosa infection was identified as an independent predictor of mortality (OR 1.6, 95% CI 1.1-2.2, P = 0.047), whereas infection with ceftriaxone-resistant Enterobacteriaceae (OR 0.6, 95% CI 0.4-1.0, P = 0.050) was associated with lower mortality.More than one-third of our patients hospitalized with bacteremic pneumonia died

  2. Optic neuropathy in children with Lyme disease.

    Science.gov (United States)

    Rothermel, H; Hedges, T R; Steere, A C

    2001-08-01

    Involvement of the optic nerve, either because of inflammation or increased intracranial pressure, is a rare manifestation of Lyme disease. Of the 4 children reported here with optic nerve abnormalities, 2 had decreased vision months after disease onset attributable to optic neuritis, and 1 had headache and diplopia early in the infection because of increased intracranial pressure associated with Lyme meningitis. In these 3 children, optic nerve involvement responded well to intravenous ceftriaxone therapy. The fourth child had headache and visual loss attributable to increased intracranial pressure and perhaps also to optic neuritis. Despite treatment with ceftriaxone and steroids, he had persistent increased intracranial pressure leading to permanent bilateral blindness. Clinicians should be aware that neuro-ophthalmologic involvement of Lyme disease may have significant consequences. If increased intracranial pressure persists despite antibiotic therapy, measures must be taken quickly to reduce the pressure.

  3. Streptococcus agalactiae Meningitis in Adult Patient: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fahmi Yousef Khan

    2016-01-01

    Full Text Available We report a case of group B streptococcus meningitis in a 72-year-old female patient who was admitted in our hospital with a 21-day history of bilateral lower thigh pain and swelling associated with fever, headache, and vomiting. Her past medical history was remarkable for DM type 2, hypertension, and hypothyroidism. Upon admission, examination showed bilateral warmth and tender soft tissue swelling around the knees and MRI showed cellulitis of distal thirds of both thighs. The next day, the patient became drowsy. Neurologic examination showed neck rigidity and right sided hemiparesis. Cerebrospinal fluid and blood cultures yielded group B streptococcus sensitive to ceftriaxone, penicillin G, and vancomycin. The patient received ceftriaxone for a total of 14 days after which she improved and was discharged from the hospital with right sided weakness.

  4. Streptococcus agalactiae Meningitis in Adult Patient: A Case Report and Literature Review.

    Science.gov (United States)

    Khan, Fahmi Yousef

    2016-01-01

    We report a case of group B streptococcus meningitis in a 72-year-old female patient who was admitted in our hospital with a 21-day history of bilateral lower thigh pain and swelling associated with fever, headache, and vomiting. Her past medical history was remarkable for DM type 2, hypertension, and hypothyroidism. Upon admission, examination showed bilateral warmth and tender soft tissue swelling around the knees and MRI showed cellulitis of distal thirds of both thighs. The next day, the patient became drowsy. Neurologic examination showed neck rigidity and right sided hemiparesis. Cerebrospinal fluid and blood cultures yielded group B streptococcus sensitive to ceftriaxone, penicillin G, and vancomycin. The patient received ceftriaxone for a total of 14 days after which she improved and was discharged from the hospital with right sided weakness. PMID:26904325

  5. Antimicrobial susceptibility pattern of Neisseria gonorrhoeae in western Austria.

    Science.gov (United States)

    Allerberger, F; Kofler, H; Brezinka, C; Guggenbichler, J P; Dierich, M P

    1993-01-01

    From January to October 1992 24 Neisseria gonorrhoeae isolates from clinical specimens were collected at the Federal Public Health Laboratory in Innsbruck (Austria) and screened for resistance to penicillin G, erythromycin, tetracycline, spectinomycin, ceftriaxone, cefuroxime, ciprofloxacine, and silver nitrate. Patients originated from the Austrian provinces Salzburg, Tirol, and Vorarlberg, and presented with manifest gonorrhoea. Two of 24 isolates were penicillinase-producing N. gonorrhoeae. Both strains were isolated from men who had just returned from Thailand or Kenya. The isolate from Africa was also resistant to tetracycline. Five of 24 infections were acquired abroad, sex tourism being involved in four cases. The antimicrobial resistance pattern found in gonococci in western Austria revealed that topical silver nitrate and erythromycin are equally acceptable for use in prophylaxis of neonatal ophthalmia. Penicillin is still the drug of choice in the treatment of endemic infections. If gonorrhoea has been acquired abroad, especially in Asia or Africa, ceftriaxone, spectinomycin or ciprofloxazine are recommended for therapy. PMID:8333204

  6. Increasing resistance to ciprofloxacin and other antibiotics in Neisseria gonorrhoeae from East Java and Papua, Indonesia, in 2004 - implications for treatment.

    Science.gov (United States)

    Sutrisna, A; Soebjakto, O; Wignall, F S; Kaul, S; Limnios, E A; Ray, S; Nguyen, N-L; Tapsall, J W

    2006-12-01

    We examined gonococci isolated in 2004, in East Java and Papua, Indonesia, to review the suitability of ciprofloxacin-based and other treatment regimens. Gonococci from the two provinces were tested in Sydney for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, gentamicin, azithromycin and rifampicin. Of 163 gonococcal isolates from East Java (91) and Papua (72), 120 (74%) of gonococci, 62 (68%) and 58 (80%) from East Java and Papua, respectively, were penicillinase-producing gonococci and 162 displayed high-level tetracycline resistance. Eighty-seven isolates (53%) were ciprofloxacin resistant, 44 (48%) from East Java and 43 (60%) from Papua. All isolates were sensitive to cefixime/ceftriaxone, spectinomycin and azithromycin. Minimum inhibitory concentrations of gentamicin were in the range 0.05-8 mg/L. Sixty-nine gonococci (42%) showed combined resistance, to penicillin, tetracycline and quinolones. Quinolone resistance has now reached unacceptable levels, and their use for the treatment of gonorrhoea in Indonesia should be reconsidered.

  7. Salmonella enterica Serotype Arizonae Meningitis in a Neonate

    Directory of Open Access Journals (Sweden)

    Wubishet Lakew

    2013-01-01

    Full Text Available Typhoidal and nontyphoidal salmonella infections are common causes of gastroenteritis in the community. However, salmonella only rarely causes invasive infections like meningitis. We report a 13-day-old female neonate with signs and symptoms of meningitis whose cerebrospinal fluid (CSF culture showed Salmonella enterica serotype Arizonae that was sensitive to ceftriaxone. She presented with fever and failure to feed for 2 days. Despite prompt treatment with ampicillin, gentamicin, and ceftriaxone, she developed communicating hydrocephalus, frequent seizures, and coma that progressed to death after 2 weeks of hospitalization. Salmonella enterica serotype Arizonae is a rare cause of human infection known to leading to meningitis symptoms similar to those caused by other salmonella species. This is the first report of it as a cause of meningitis in a child under one month of age. Therefore, it should be included in the differential diagnosis of Gram-negative bacillary meningitis in immunocompromised children, neonates, and those with contacts with reptiles.

  8. Antimicrobial susceptibility of enterococci from Italian patients with infective endocarditis

    Directory of Open Access Journals (Sweden)

    Claudio Farina

    2010-03-01

    Full Text Available The epidemiological and clinical study “Studio Endocarditi Italiane” (SEI evaluated 947 cases of infective endocarditis in 2004-2008. Enterococcal aethiology was described in 11% cases.The aim of our study was to evacuate the in vitro activity of twelve antibiotics alone and in association against 20 strains (15 E. faecalis, 5 E. faecium. Results show the in vitro activity of tigecyicline, daptomicine and linezolid. Synergism is appreciated for ceftriaxone-fosfomycin (FICindex50=0.34, FICindex90=0.56 against E. faecalis and for imipenem-fosfomycin against E. faecium.The majority of the tested strains show addition using ampicillin-ceftriaxone (FICindex50=0.85, FICindex90=1.01 and moxifloxacin- tigecycline (FICindex50=0.77, FICindex90=1.96.

  9. Listeria monocytogenes meningitis in an immunocompetent 18-year old patient as a possible diagnostic and therapeutical problem

    Directory of Open Access Journals (Sweden)

    Vrbić Miodrag

    2013-01-01

    Full Text Available Introduction. Listeria monocytogenes is the third most frequent cause of bacterial meningitis in adults. It commonly affects persons with defective cell-mediated immunity or advanced age, and only a few patients with no underlying predisposition have been reported. Case report. We presented an previously healthy, 18-year-old man with typical clinical features of meningitis. On the account of earlier treatment with ceftriaxone and cerebrospinal fluid finding, an assumption of partially treated bacterial meningitis was made. The initial treatment with vancomycin and ceftriaxone, substituted on day 4 with meropenem, did not produce any clinical effect. On day 6 Listeria monocytogenes was isolated and, even as late as that, the administration of ampicillin was followed by complete recovery of the patient. Conclusion. In younger, immunocompetent individuals, in spite of the existent diagnostic and therapeutic problems, the subacute course of Listeria monocytogenes meningitis provides enough time for appropriate treatment and favorable disease outcome.

  10. New treatment options for infections caused by increasingly antimicrobial-resistant Neisseria gonorrhoeae.

    Science.gov (United States)

    Lee, Hyukmin; Lee, Kyungwon; Chong, Yunsop

    2016-01-01

    The emergence of high-level resistance to ceftriaxone is giving rise to serious concern about absence of effective treatment options to cure gonococcal infections. Increasing the dosage regimen can be applied to ceftriaxone and azithromycin, but the emergence of high-level resistance has already been reported. Spectinomycin is another active drug but has low efficacy in the treatment of pharyngeal gonorrhoea. Conventional antibiotics could be introduced for gonococcal treatment, but they have some limitations, such as the absence of clinical trials and breakpoint. Combining antibiotics is another promising method to cure patients and to prevent the emergence of resistance. The most important strategy to maintain the efficacy of antibiotics is rapid detection and dissemination control of novel resistant isolate. PMID:26690658

  11. New treatment options for infections caused by increasingly antimicrobial-resistant Neisseria gonorrhoeae.

    Science.gov (United States)

    Lee, Hyukmin; Lee, Kyungwon; Chong, Yunsop

    2016-01-01

    The emergence of high-level resistance to ceftriaxone is giving rise to serious concern about absence of effective treatment options to cure gonococcal infections. Increasing the dosage regimen can be applied to ceftriaxone and azithromycin, but the emergence of high-level resistance has already been reported. Spectinomycin is another active drug but has low efficacy in the treatment of pharyngeal gonorrhoea. Conventional antibiotics could be introduced for gonococcal treatment, but they have some limitations, such as the absence of clinical trials and breakpoint. Combining antibiotics is another promising method to cure patients and to prevent the emergence of resistance. The most important strategy to maintain the efficacy of antibiotics is rapid detection and dissemination control of novel resistant isolate.

  12. In vitro potency and combination testing of antimicrobial agents against Neisseria gonorrhoeae.

    Science.gov (United States)

    Bharat, Amrita; Martin, Irene; Zhanel, George G; Mulvey, Michael R

    2016-03-01

    Antimicrobial resistant Neisseria gonorrhoeae is a major concern to public health due to decreased susceptibility to frontline antimicrobials. To find agents that are active against N. gonorrhoeae, we tested antimicrobials alone or in combination by Etest gradient strips. The potencies (as assessed by minimum inhibitory concentrations) of twenty-five antimicrobials were evaluated against nine reference strains of N. gonorrhoeae (WHO F, G, K, L, M, N, O, P and ATCC 49226). Potency was greatest for netilmicin, quinupristin-dalfopristin, ceftriaxone, ertapenem and piperacillin-tazobactam. Combinations of azithromycin, moxifloxacin, or gentamicin with ceftriaxone, doripenem, or aztreonam were tested against reference isolates and the fractional inhibitory concentration index (FICI) was calculated. All nine combinations resulted in indifference (>0.5 FICI ≤ 4). Combinations with FICI gonorrhoeae. These data on antimicrobials with higher potency and combinations that did not show antagonism can help to guide larger scale susceptibility studies for antimicrobial resistant N. gonorrhoeae.

  13. Survey of Neisseria gonorrhoeae Antimicrobial Susceptibility in Ontario

    Directory of Open Access Journals (Sweden)

    Vivian G Loo

    1990-01-01

    Full Text Available The minimal inhibitory concentrations (MICs of penicillin, tetracycline, erythromycin, cefoxitin, ceftriaxone and spectinomycin were determined for 300 consecutive strains of Neisseria gonorrhoeae collected from physicians’ offices in Ontario. Only four isolates were found to produce beta-lactamase. Of the remaining 296 isolates, five (1.7% had penicillin MICs greater than or equal to 1 mg/L, 78 (26.3% had tetracycline MICs greater than or equal to 1 mg/L, 13 (4.4% had cefoxitin MICs greater than or equal to 1 mg/L and 43 (14.5% had erythromycin MICs greater than or equal to 1 mg/L. Two isolates (0.7% had high level tetracycline resistance with MICs greater than or equal to 16 mg/L. All N gonorrhoeae isolates were susceptible to ceftriaxone and to spectinomycin.

  14. Screening of medicinal natural extracts for their antibacterial activity against salmonella species

    International Nuclear Information System (INIS)

    The present study was aimed to screen out natural crude extracts exhibiting antibacterial activity against Salmonella causing gastrointestinal problems in humans. Fifteen Salmonella species were isolated from uncooked chicken, polluted water, rotten potatoes, beef, rotten eggs etc. Aqueous plant extracts of Allium sativum (garlic), Nigella sativa (kalvanji), Azadirachta indica (neem), Ficus carica (anjeer), and Trigonella foenum-graecum (methi) were checked against Salmonella species by well plate method. In addition to plant extract, Honey was also used for antibacterial activity. Inhibition zones ranging from 2mm to 20mm were obtained with different concentration of plant extracts and honey. The antibacterial sensitivity pattern was in the order of kalvanji > garlic > honey > anjeer > methi > neem. The standard antibiotics such as Ceftriaxone and Ciprofloxacin were also used for comparison with natural extract for antibacterial activity. The extracts of Allium sativum, Nigella sativa and Honey were found to be more effective against Salmonella species for which even Ceftriaxone was found ineffective. (author)

  15. Pharmakawirkung auf in vitro kultivierte primäre humane Osteoblasten

    OpenAIRE

    Kalinowski, Ivonne

    2016-01-01

    In der Arbeit wurde der Einfluss dreier Antibiotika (Cefotiam, Ceftriaxon, Linezolid) sowie eines COX-2-Inhibitors (Parecoxib) und eines Bisphosphonats (Ibandronat) auf in vitro kultivierte primäre humane Osteoblasten untersucht. Anhand zahlreicher Testverfahren mit verschiedenen Pharmakakonzentrationen und Einwirkzeiten erfolgte die qualitative und quantitative Beurteilung von Proliferation, Zellaktivität, Apoptoseverhalten und osteogener Differenzierung. Dadurch können Rückschlüsse bezüglic...

  16. Prevalence of Multidrug-Resistant Bacteria on Fresh Vegetables Collected from Farmers' Markets in Connecticut.

    Science.gov (United States)

    Karumathil, Deepti Prasad; Yin, Hsin-Bai; Kollanoor-Johny, Anup; Venkitanarayanan, Kumar

    2016-08-01

    This study determined the prevalence of multidrug-resistant (MDR) Acinetobacter baumannii on fresh vegetables collected from farmers' markets in Connecticut. One hundred samples each of fresh carrots, potatoes, and lettuce were sampled and streaked on selective media, namely Leeds Acinetobacter and MDR Acinetobacter agars. All morphologically different colonies from MDR Acinetobacter agar were identified by using Gram staining, biochemical tests, and PCR. In addition, susceptibility of the isolates to 10 antibiotics commonly used in humans, namely imipenem, ceftriaxone, cefepime, minocycline, erythromycin, colistin-sulfate, streptomycin, neomycin, doxycycline, and rifampin was determined by using an antibiotic disk diffusion assay. The results revealed that only two samples of potato and one sample of lettuce yielded A. baumannii. In addition, all carrot samples were found to be negative for the organism. However, several other opportunistic, MDR human pathogens, such as Burkholderia cepacia (1% potatoes, 5% carrots, and none in lettuce), Stenotrophomonas maltophilia (6% potatoes, 2% lettuce, and none in carrots), and Pseudomonas luteola (9% potatoes, 3% carrots, and none in lettuce) were recovered from the vegetables. Antibiotic susceptibility screening of the isolates revealed high resistance rates for the following: ceftriaxone (6 of 6), colistin-sulfate (5 of 6), erythromycin (5 of 6), and streptomycin (4 of 6) in B. cepacia; colistin-sulfate (11 of 11) and imipenem (10 of 11) in P. luteola; colistin-sulfate (8 of 8), ceftriaxone (8 of 8), cefepime (7 of 8), erythromycin (5 of 8), and imipenem (4 of 8) in S. maltophilia; and imipenem (3 of 3), ceftriaxone (3 of 3), erythromycin (3 of 3), and streptomycin (3 of 3) in A. baumannii. The results revealed the presence of MDR bacteria, including human pathogens on fresh produce, thereby highlighting the potential health risk in consumers, especially those with a compromised immune system.

  17. Assessment of formulas for calculating critical concentration by the agar diffusion method.

    OpenAIRE

    Drugeon, H.B.; Juvin, M E; Caillon, J.; Courtieu, A L

    1987-01-01

    The critical concentration of antibiotic was calculated by using the agar diffusion method with disks containing different charges of antibiotic. It is currently possible to use different calculation formulas (based on Fick's law) devised by Cooper and Woodman (the best known) and by Vesterdal. The results obtained with the formulas were compared with the MIC results (obtained by the agar dilution method). A total of 91 strains and two cephalosporins (cefotaxime and ceftriaxone) were studied....

  18. [Multiple erythema migrans and facial nerve paralysis: clinical manifestations of early disseminated Lyme borreliosis].

    Science.gov (United States)

    Braun, S A; Baran, A M; Boettcher, C; Kieseier, B C; Reifenberger, J

    2014-04-01

    Lyme borreliosis is a common vector-borne disease in Europe. The infection follows different stages with a broad variability of clinical symptoms and manifestations in different organs. A 49-year-old man presented with flu-like symptoms, facial nerve paralysis and multiple erythematous macular on his trunk and extremities. We diagnosed Lyme disease (stage II) with facial nerve paralysis and multiple erythema migrans. Intravenous ceftriaxone led to complete healing of hissymptoms within 2 weeks.

  19. Effect of Cordyceps sinensis mycelium on serum vasoactive intestinal peptide and substance P in mice with intestinal dysbacteriosis

    OpenAIRE

    Kai-zhong DONG; Fu, Si-Wu; Sheng, Li; You-jun MI; Su, Lu

    2015-01-01

    Objective To observe the effect of Cordyceps sinensis mycelium on serum vasoactive intestinal peptide (VIP) and substance P (SP) in mice with dysbacteriosis induced by antibiotics. Methods Forty-eight healthy SPF BALB/c mice were randomly divided into the normal control group (normal drink), the dysbacteriosis model group (induced by oral administration of 0.5 g/L ceftriaxone sodium), the natural recovery group (oral sterile water to replace antibiotic after reproduction of dysbacteriosis), a...

  20. The polymicrobial Actinomyces naeslundii and Pseudomonas aeruginosa sepsis in a patient with ulcerative colitis 2 months after colonoscopy.

    Science.gov (United States)

    Topić, Mirjana Balen; Desnica, Boško; Vicković, Ninoslava; Skuhala, Tomislava; Bayer, Kristijan; Bukovski, Suzana

    2014-02-01

    We describe a case of an abrupt onset of polymicrobial Actinomyces naeslundii/Pseudomonas aeruginosa sepsis in a patient with a previously silent abdominal actinomycosis, developed 2 months after colonoscopy when the diagnosis of a left-sided ulcerative colitis was established. Prolonged high-dose ceftriaxone therapy was clinically effective, albeit accompanied by the development of a reversible pseudocholelithiasis that persisted for 5 months. PMID:24297267

  1. Susceptibility of Nocardia asteroides to 46 antibiotics, including 22 beta-lactams.

    OpenAIRE

    Gutmann, L; Goldstein, F W; Kitzis, M D; Hautefort, B; Darmon, C; Acar, J F

    1983-01-01

    Twelve Nocardia asteroides isolates were tested for their susceptibility to 46 antibiotics by the agar dilution method. N-Formimidoyl thienamycin was the most active of 22 beta-lactam antibiotics, inhibiting 11 of the 12 strains at 1 microgram/ml. Penicillins, including ureidopenicillins, showed poor activity. Cefotaxime, ceftriaxone, and especially cefuroxime had the best activities of the cephalosporins tested. Among the other antibiotics, amikacin and minocycline, respectively, inhibited a...

  2. Involvement of penicillin-binding protein 2 with other penicillin-binding proteins in lysis of Escherichia coli by some beta-lactam antibiotics alone and in synergistic lytic effect of amdinocillin (mecillinam).

    OpenAIRE

    Gutmann, L; Vincent, S; Billot-Klein, D; Acar, J F; Mrèna, E; Williamson, R.

    1986-01-01

    Compared with cefotaxime, ceftazidime, moxalactam, and aztreonam, ceftriaxone produced the best lytic and bactericidal effects when each was added at about 10 times the MIC to Escherichia coli W7. When each of these antibiotics was added at its MIC, only bacteriostasis occurred, but the simultaneous addition of amdinocillin (mecillinam) was synergistic in causing rapid lysis and bactericidal effects. Induction of lysis of two E. coli mutants containing either a thermosensitive penicillin-bind...

  3. Critical Analysis of Treatment Trials of Rhesus Macaques Infected with Borrelia burgdorferi Reveals Important Flaws in Experimental Design

    OpenAIRE

    Wormser, Gary P.; Baker, Phillip J.; O'Connell, Susan; Pachner, Andrew R.; Schwartz, Ira; Shapiro, Eugene D.

    2012-01-01

    A critical analysis of two treatment trials of Chinese rhesus macaques infected with Borrelia burgdorferi indicates that insufficient attention was placed on documenting the blood levels, pharmacokinetics, and pharmacodynamic parameters of the antibiotics used in this host. Consequently, it is impossible to conclude that the findings have validity in judging the efficacy of doxycycline or ceftriaxone for the treatment of Borrelia burgdorferi in this animal model.

  4. Kinetic features of L,D-transpeptidase inactivation critical for β-lactam antibacterial activity.

    Directory of Open Access Journals (Sweden)

    Sébastien Triboulet

    Full Text Available Active-site serine D,D-transpeptidases belonging to the penicillin-binding protein family (PBPs have been considered for a long time as essential for peptidoglycan cross-linking in all bacteria. However, bypass of the PBPs by an L,D-transpeptidase (Ldt(fm conveys high-level resistance to β-lactams of the penam class in Enterococcus faecium with a minimal inhibitory concentration (MIC of ampicillin >2,000 µg/ml. Unexpectedly, Ldt(fm does not confer resistance to β-lactams of the carbapenem class (imipenem MIC = 0.5 µg/ml whereas cephems display residual activity (ceftriaxone MIC = 128 µg/ml. Mass spectrometry, fluorescence kinetics, and NMR chemical shift perturbation experiments were performed to explore the basis for this specificity and identify β-lactam features that are critical for efficient L,D-transpeptidase inactivation. We show that imipenem, ceftriaxone, and ampicillin acylate Ldt(fm by formation of a thioester bond between the active-site cysteine and the β-lactam-ring carbonyl. However, slow acylation and slow acylenzyme hydrolysis resulted in partial Ldt(fm inactivation by ampicillin and ceftriaxone. For ampicillin, Ldt(fm acylation was followed by rupture of the C(5-C(6 bond of the β-lactam ring and formation of a secondary acylenzyme prone to hydrolysis. The saturable step of the catalytic cycle was the reversible formation of a tetrahedral intermediate (oxyanion without significant accumulation of a non-covalent complex. In agreement, a derivative of Ldt(fm blocked in acylation bound ertapenem (a carbapenem, ceftriaxone, and ampicillin with similar low affinities. Thus, oxyanion and acylenzyme stabilization are both critical for rapid L,D-transpeptidase inactivation and antibacterial activity. These results pave the way for optimization of the β-lactam scaffold for L,D-transpeptidase-inactivation.

  5. Improvement in the clinical cure rate of outpatient management of pelvic inflammatory disease following a change in therapy

    OpenAIRE

    Piyadigamage, A; Wilson, J.

    2005-01-01

    Objective: In the United Kingdom many genitourinary medicine clinics use oral doxycycline and metronidazole to treat pelvic inflammatory disease (PID). A retrospective case note review of PID treatment at our department in 2000 showed that the clinical cure rate (CCR) was only 55% with oral doxycycline and metronidazole for 2 weeks. We therefore added ceftriaxone 250 mg intramuscularly to the doxycycline and metronidazole for treating PID. We have repeated the review and compared the results ...

  6. Ceftriaxone–Associated Nephrolithiasis in Children

    OpenAIRE

    Fesharakinia, Azita; Ehsanbakhsh, Ali-Reza; Ghorashadizadeh, Nasrin

    2013-01-01

    Objective Ceftriaxone is a third-generation cephalosporin which is widely used for treatment of infection in children accompanied by complications like urinary tract lithiasis and gallbladder psudolithiasis or sludge. The aim of this study was to investigate the incidence and predisposing factors that contribute to these complications in children. Methods This quasi-experimental and before- and after-study was conducted in 96 children who were hospitalized for treatment of different bacterial...

  7. A Case of Ventilator-Associated Pneumonia Caused by Ewingella americana : First Report from Turkey

    Directory of Open Access Journals (Sweden)

    Kenan Ecemiş

    2014-09-01

    Full Text Available Ewingella americana is a very rare cause of serious infections, especially in immunocompromised patients. We report a case of ventilator-associated pneumonia (VAP in an intensive care unit patient, who was treated successfully with ceftriaxone. To the best of our knowledge, this is the first case of VAP due to Ewingella americana in the English literature.J Microbiol Infect Dis 2014; 4(3: 118-120

  8. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea

    OpenAIRE

    Unemo, Magnus; Nicholas, Robert A

    2012-01-01

    The new superbug Neisseria gonorrhoeae has retained resistance to antimicrobials previously recommended for first-line treatment and has now demonstrated its capacity to develop resistance to the extended-spectrum cephalosporin, ceftriaxone, the last remaining option for first-line empiric treatment of gonorrhea. An era of untreatable gonorrhea may be approaching, which represents an exceedingly serious public health problem. Herein, we review the evolution, origin and spread of antimicrobial...

  9. [Neuroborreliosis--a disease with many faces].

    Science.gov (United States)

    Czell, D; Rodic, B; Imoberdorf, R

    2011-05-11

    Borreliosis has been widely recognized in Switzerland and is often used in unclear cases with non-specific symptoms. Two illustrative cases should emphasize the current options for diagnosis and therapy of neuroborreliosis. The keystones of the diagnostic instruments are a history with typical symptoms and analysis of the cerebrospinal fluid with determination of appropriate antibodies. Therapy deals with ceftriaxon with intravenous and doxycyclin with oral application making ambulatory treatment possible. PMID:21563099

  10. Determination of Some Cephalosporins in Pharmaceutical Formulations by a Simple and Sensitive Spectrofluorimetric Method

    OpenAIRE

    Ali Abdollahi, Ahad Bavili-Tabrizi

    2016-01-01

    Background: Cephalosporins are among the safest and the most effective broad-spectrum bactericidal antimicrobial agents which have been prescribed by the clinician as antibiotics. Thus, the developing of simple, sensitive and rapid analytical methods for their determination can be attractive and desirable. Methods: A simple, rapid and sensitive spectrofluorimetric method was developed for the determination of cefixime, cefalexin and ceftriaxone in pharmaceutical formulations. Proposed method ...

  11. Development of a capillary electrophoresis method for the simultaneous determination of cephalosporins

    OpenAIRE

    Hancu Gabriel; Kelemen Hajnal; Rusu Aura; Gyéresi Árpád

    2013-01-01

    A rapid and simple capillary electrophoresis method has been developed for the simultaneous determination of six extensively used cephalosporin antibiotics (cefaclor, cefadroxil, cefalexin, cefuroxim, ceftazidim, ceftriaxon). The determination of cephalosporins was performed at a pH 6.8, using a 25 mM phospate - 25 mM borate mixed buffer, + 25 kV voltage at a temperature of 25 °C. We achieved a baseline separation in approximately 10 minutes. The separation resolution was increased by a...

  12. Prevalence of Multidrug-Resistant Bacteria on Fresh Vegetables Collected from Farmers' Markets in Connecticut.

    Science.gov (United States)

    Karumathil, Deepti Prasad; Yin, Hsin-Bai; Kollanoor-Johny, Anup; Venkitanarayanan, Kumar

    2016-08-01

    This study determined the prevalence of multidrug-resistant (MDR) Acinetobacter baumannii on fresh vegetables collected from farmers' markets in Connecticut. One hundred samples each of fresh carrots, potatoes, and lettuce were sampled and streaked on selective media, namely Leeds Acinetobacter and MDR Acinetobacter agars. All morphologically different colonies from MDR Acinetobacter agar were identified by using Gram staining, biochemical tests, and PCR. In addition, susceptibility of the isolates to 10 antibiotics commonly used in humans, namely imipenem, ceftriaxone, cefepime, minocycline, erythromycin, colistin-sulfate, streptomycin, neomycin, doxycycline, and rifampin was determined by using an antibiotic disk diffusion assay. The results revealed that only two samples of potato and one sample of lettuce yielded A. baumannii. In addition, all carrot samples were found to be negative for the organism. However, several other opportunistic, MDR human pathogens, such as Burkholderia cepacia (1% potatoes, 5% carrots, and none in lettuce), Stenotrophomonas maltophilia (6% potatoes, 2% lettuce, and none in carrots), and Pseudomonas luteola (9% potatoes, 3% carrots, and none in lettuce) were recovered from the vegetables. Antibiotic susceptibility screening of the isolates revealed high resistance rates for the following: ceftriaxone (6 of 6), colistin-sulfate (5 of 6), erythromycin (5 of 6), and streptomycin (4 of 6) in B. cepacia; colistin-sulfate (11 of 11) and imipenem (10 of 11) in P. luteola; colistin-sulfate (8 of 8), ceftriaxone (8 of 8), cefepime (7 of 8), erythromycin (5 of 8), and imipenem (4 of 8) in S. maltophilia; and imipenem (3 of 3), ceftriaxone (3 of 3), erythromycin (3 of 3), and streptomycin (3 of 3) in A. baumannii. The results revealed the presence of MDR bacteria, including human pathogens on fresh produce, thereby highlighting the potential health risk in consumers, especially those with a compromised immune system. PMID:27497135

  13. Leptospirosis in pregnancy with pathological fetal cardiotocography changes

    OpenAIRE

    Koe, Suan-Li Liana; Tan, Kim Teng; Tan, Thiam Chye

    2014-01-01

    We report the case of a 33-year-old primigravida who presented at 37 weeks of gestation with symptoms suggestive of acute fatty liver of pregnancy, but was later diagnosed with leptospirosis (i.e. Weil's disease or syndrome) on serological testing. Cardiotocography showed fetal distress, and an emergency Caesarean section was performed. A healthy neonate with no evidence of congenital leptospirosis was delivered. The patient was treated with intravenous ceftriaxone and discharged well 13 days...

  14. Effects of cefodizime on chemokines of liver tissues in mice with immunological hepatic injury

    Institute of Scientific and Technical Information of China (English)

    WANG Peng; KAN Quan-cheng; YU Zu-jiang; LI Ling; PAN Xue

    2011-01-01

    Background Chronic hepatic inflammation is characterized by the accumulation of lymphocytes as a consequence of increased recruitment from the blood and retention within the tissue at sites of infection. CXC chemokine ligand 16 (CXCL16) mRNA has been detected in both inflamed and normal liver tissues and is strongly upregulated in the injured liver tissues in a murine model. The aim of this study was to investigate the effect of cefodizime on CXCL16 mRNA of liver tissues in mice with immunological hepatic injury.Methods The murine model of immunological hepatic injury was induced by Bacillus Calmette Guerin and Lipoposaccharide. The mice with immunological hepatic injury were randomly assigned to the model group, the cefodizime group and the ceftriaxone group. The three groups were continuously given agents for seven days and CXCL16 mRNA of liver tissue was determined and contrasted with the control group treated by normal saline. Reverse transcription-polymerase chain reaction was used to assay CXCL16 mRNA levels in liver tissues.Results The expressions of CXCL16 mRNA were significantly higher in the model group and the ceftriaxone group than in the control group and the cefodizime group (P <0.05), indicating the mice in the model group and the ceftriaxone group were immunodeficient. There was no statistical difference in the expressions of CXCL16 mRNA between the control group and the cefodizime group. Similarly, no statistical difference in the expressions of CXCL16 mRNA between the model group and the ceftriaxone group was detected (P >0.05).Conclusion Cefodizime effectively reduces the infiltration of lymphocytes into liver tissues and alleviates the liver damage by decreasing CXCL16 mRNA in liver tissues in mice with immunological hepatic injury.

  15. Influence of human urine to antimicrobial susceptibility of clinical isolates of Klebsiella pneumoniae and Escherichia coli producing β-lactamase of different types

    Directory of Open Access Journals (Sweden)

    Ž. Žagar

    2007-02-01

    Full Text Available The purpose of the study was to determine the influence of human urine on the antibiotic susceptibilities of Klebsiella pneumoniae and Escherichia coli strains producing different types of extended-spectrum β-lactamases (ESBL. The study was performed on 26 ESBL negative strains of K. pneumoniae, 80 K. pneumoniae strains producing SHV-ESBLs (52-SHV-5, 31- SHV-2 and 7- SHV-12, 94 E. coli strains harbouring TEM- ESBLs and 14 E. coli strains possessing CTX-M group 1 β-lactamases. The minimum inhibitory concentrations of amoxycillin alone and combined with clavulanate (co-amoxilcav, cephalexin, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, cefepime, gentamicin and ciprofloxacin were performed in parallel in Mueller-Hinton broth and urine by broth microdilution method. With ESBL negative strains, urine increased MIC90 of amoxycillin alone and combined with clavulanate, cephalexin, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, cefepime, gentamicin and ciprofloxacin. Against SHV-5 producers, an increase in MIC90 was observed with cefotaxime, cefepime and ciprofloxacin when the test was performed in urine. SHV-2 producers showed elevated MIC90 of ceftazidime, cefotaxime, ceftriaxone and cefepime in the presence of urine, in contrast to SHV-12 producers which displayed elevated MIC90 only for cefotaxime. Urine increased MIC90 of amoxycillin/clavulanate, ceftazidime and cefepime against CTX-M producers, and of amoxycillin/clavulanate, cefotaxime, ceftriaxone, cefepime and ciprofloxacin for TEM producers. According to our results the activity of antibiotics used for the treatment of urinary tract infection could be overestimated by a standard in vitro testing. However, most of antibiotics used for the treatment of urinary tract infection achieve very high concentration in urine and that could abrogate the reduction of antimicrobial activity by biological fluid.

  16. Mutation in ribosomal protein S5 leads to spectinomycin resistance in Neisseria gonorrhoeae

    OpenAIRE

    Ilina, Elena N.; Malakhova, Maya V.; Bodoev, Ivan N.; Oparina, Nina Y.; Filimonova, Alla V.; Govorun, Vadim M.

    2013-01-01

    Spectinomycin remains a useful reserve option for therapy of gonorrhea. The emergence of multidrug-resistant Neisseria gonorrhoeae strains with decreased susceptibility to cefixime and to ceftriaxone makes it the only medicine still effective for treatment of gonorrhea infection in analogous cases. However, adoption of spectinomycin as a routinely used drug of choice was soon followed by reports of spectinomycin resistance. The main molecular mechanism of spectinomycin resistance in N. gonorr...

  17. In Vitro Selection of Neisseria gonorrhoeae Mutants with Elevated MIC Values and Increased Resistance to Cephalosporins

    OpenAIRE

    Johnson, S. R.; Grad, Yonatan Hagai; Ganakammal, S. R.; Burroughs, M; Frace, M.; Lipsitch, Marc; Weil, R.; Trees, D.

    2014-01-01

    Strains of Neisseria gonorrhoeae with mosaic penA genes bearing novel point mutations in penA have been isolated from ceftriaxone treatment failures. Such isolates exhibit significantly higher MIC values to third-generation cephalosporins. Here we report the in vitro isolation of two mutants with elevated MICs to cephalosporins. The first possesses a point mutation in the transpeptidase region of the mosaic penA gene, and the second contains an insertion mutation in pilQ.

  18. In Vitro selection of Neisseria gonorrhoeae mutants with elevated MIC values and increased resistance to cephalosporins.

    Science.gov (United States)

    Johnson, Steven R; Grad, Yonatan; Ganakammal, Satishkumar Ranganathan; Burroughs, Mark; Frace, Mike; Lipsitch, Marc; Weil, Ryan; Trees, David

    2014-11-01

    Strains of Neisseria gonorrhoeae with mosaic penA genes bearing novel point mutations in penA have been isolated from ceftriaxone treatment failures. Such isolates exhibit significantly higher MIC values to third-generation cephalosporins. Here we report the in vitro isolation of two mutants with elevated MICs to cephalosporins. The first possesses a point mutation in the transpeptidase region of the mosaic penA gene, and the second contains an insertion mutation in pilQ. PMID:25199775

  19. Trapping of nonhydrolyzable cephalosporins by cephalosporinases in Enterobacter cloacae and Pseudomonas aeruginosa as a possible resistance mechanism.

    OpenAIRE

    Then, R L; Angehrn, P

    1982-01-01

    Resistance to cefotaxime (CTA) and ceftriaxone (CTR) in Enterobacter cloacae and Pseudomonas aeruginosa was investigated in several strains which are susceptible or resistant to these agents. All strains produced a chromosomally mediated cephalosporinase of the Richmond type 1. beta-Lactamases in susceptible strains were inducible, whereas resistant strains produced the enzymes constitutively. CTA and CTR were very poor substrates but potent inhibitors of all enzymes. Binding to, rather than ...

  20. In Vitro selection of Neisseria gonorrhoeae mutants with elevated MIC values and increased resistance to cephalosporins.

    Science.gov (United States)

    Johnson, Steven R; Grad, Yonatan; Ganakammal, Satishkumar Ranganathan; Burroughs, Mark; Frace, Mike; Lipsitch, Marc; Weil, Ryan; Trees, David

    2014-11-01

    Strains of Neisseria gonorrhoeae with mosaic penA genes bearing novel point mutations in penA have been isolated from ceftriaxone treatment failures. Such isolates exhibit significantly higher MIC values to third-generation cephalosporins. Here we report the in vitro isolation of two mutants with elevated MICs to cephalosporins. The first possesses a point mutation in the transpeptidase region of the mosaic penA gene, and the second contains an insertion mutation in pilQ.

  1. Enterococcus faecalis infective endocarditis

    DEFF Research Database (Denmark)

    Dahl, Anders; Bruun, Niels Eske

    2013-01-01

    Enterococcus faecalis infective endocarditis (IE) is a disease of increasing importance, with more patients infected, increasing frequency of health-care associated infections and increasing incidence of antimicrobial resistances. The typical clinical presentation is a subacute course with fever...... or ceftriaxone. E. faecalis infective endocarditis continues to be a very serious disease with considerable percentages of high-level gentamicin resistant strains and in-hospital mortality around 20%. Strategies to prevent E. faecalis IE, improve diagnostics, optimize treatment and reduce morbidity...

  2. Short and Long Term Outcomes Associated with Fetal Cholelithiasis: A Report of Two Cases with Antenatal Diagnosis and Postnatal Follow-Up

    OpenAIRE

    Juan Troyano-Luque; Ana Padilla-Pérez; Ingrid Martínez-Wallin; Margarita Álvarez de la Rosa; Salvatore Andrea Mastrolia; José Luis Trujillo; Tirso Pérez-Medina

    2014-01-01

    The aims of this study were to present and discuss ultrasound findings of prenatal fetal cholelithiasis in two cases with different etiology and evolution. Case 1: a pregnant woman from sub-Saharan Africa, suffering from Lyme disease, was treated with ceftriaxone sodium. Six weeks later, biliary sludge associated with polyhydramnios was detected in the fetus and the fetal growth percentile was 14. Emergency caesarean was performed at 36 weeks of gestation due to fetal distress. Biliary sludge...

  3. Correlation between In vitro susceptibility and treatment outcome with azithromycin in gonorrhoea: A prospective study

    Directory of Open Access Journals (Sweden)

    Khaki P

    2007-01-01

    Full Text Available Purpose: This prospective study was carried out to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates by disc diffusion method and minimum inhibitory concentration (MIC by E -test with special reference to azithromycin. Also, the correlation between in vitro susceptibility and treatment outcome with single 2 g oral dose azithromycin was assessed. Methods: The study included 75 gonococcal isolates from males with urethritis, females with endocervicitis and their sexual contacts. All isolates were subjected to susceptibility testing for penicillin, ciprofloxacin, tetracycline, ceftriaxone, spectinomycin, cefixime and azithromycin. Males with gonococcal urethritis were randomised to receive a single dose of either azithromycin or ceftriaxone. Forty-two men with urethritis received 2 g single oral dose azithromycin, while all other patients were given 250 mg parentral ceftriaxone. All patients were called for follow-up to assess clinical and microbiological cure rates. Results: While all the isolates were susceptible to ceftriaxone, spectinomycin, cefixime and azithromycin; 74 (98.7%, 24 (32% and 23 (30.7% strains were resistant to ciprofloxacin, penicillin and tetracycline respectively, by both disc diffusion method and E -test. The MIC range, MIC 50 and MIC 90 of N. gonorrhoeae strains, to azithromycin were 0.016-0.25, 0.064 and 0.19 mg/mL, respectively. Follow-up attendance of the patients was 52.4 with 100% clinical and microbiological cure rates. Conclusions: Results of our study indicate that 2 g single oral dose azithromycin is safe and effective in the treatment of uncomplicated gonorrhoea.

  4. Trends in antimicrobial resistance in Neisseria gonorrhoeae isolated from Guangzhou, China, 2000 to 2005 and 2008 to 2013.

    Science.gov (United States)

    Cao, Wen-Ling; Liang, Jing-Yao; Li, Xiao-Dong; Bi, Chao; Yang, Ri-Dong; Liang, Yan-Hua; Li, Ping; Zhong, Dao-Qing; Ye, Xing-Dong; Zhang, Xi-Bao

    2015-01-01

    A total of 1224 Neisseria gonorrhoeae isolates from Guangzhou in 2 periods (2000-2005 and 2008-2013) were subjected to antimicrobial susceptibility testing. The percentage of penicillin- and ciprofloxacin-resistant isolates increased from 71.1% (473/665) to 90.9% (508/559) and 88.9% (591/665) to 98.0% (548/559), respectively. All isolates remain susceptible to spectinomycin and ceftriaxone, with increasing minimum inhibitory concentrations.

  5. Successful Treatment of Uncomplicated Gonococcal Urethritis in HIV-Infected Patients with Single-Dose Oral Cefpodoxime

    Directory of Open Access Journals (Sweden)

    George Psevdos

    2010-01-01

    Full Text Available Fluoroquinolones are no longer recommended for the treatment of gonococcal infections in the United States. Cephalosporins – ceftriaxone and cefixime – are the treatment of choice, as suggested by the Centers for Disease Control and Prevention (USA. There are limited data on the efficacy of cefpodoxime for the treatment of uncomplicated gonococcal infections. Two cases of HIV-infected homosexual men who were successfully treated with cefpodoxime for urethritis caused by Neisseria gonorrhoeae are described in the present study.

  6. Antibiotics Profile of Klebsiella pneumonia, Araad Hospital.Tehran.2008-2010

    Directory of Open Access Journals (Sweden)

    Hamed Molaabaszadeh

    2013-10-01

    Full Text Available ABSTRACT Background and objective: Today, the resistance to antibiotics among of pathogen bacteria is one of the main concerns of doctors all around the world, with consideration to different reports about Klebsiella pneumoniae bacteria’s sensitivity, this study was done to examine the pattern of sensitivity and antibiotic resistance of Klebsiella pneumoniae strains collected from clinical samples of patients hospitalized in Tehran’s Araad hospital. Materials and methods: In this descriptive examination, after extracting Klebsiella pneumoniae derivations from clinical samples (urine, catheter, phlegm, blood, wound and bronchial, their sensitivity was measured using standard Kirby-Bauer test, in contract with following antibiotics Amikacin, Ciprofloxacin, Gentamicin, Imipenem, Sulfametoxazole Trimetoprime, Ceftriaxone and Cefotaxime. Results: Most of Klebsiella pneumoniae strains isolated were from urine samples every three years and the lowest of Klebsiella pneumoniae strains from bronchial samples. The most amount of sensibility to Cefotaxime, Imipenem and Amikacin and the most amount of resistant were seen to Gentamicin, Ceftriaxone and Ciprofloxacin. Conclusion: The results of this study are indicating that Klebsiella pneumoniae strains resistance has increased against Gentamicin, Ceftriaxone and Ciprofloxacin; presumably it is due to excessive consumption of these antibiotics. It is obvious that, with regard to increasing consumption of antibiotics, and consequently, augmentation of antibacterial resistance, control of this resistance factor is necessary and inevitable, so it is recommended to avoid unnecessary usage of antibiotics.

  7. Impact of the factor V Leiden mutation on the outcome of pneumococcal pneumonia: a controlled laboratory study

    Science.gov (United States)

    2010-01-01

    Introduction Streptococcus (S.) pneumoniae is the most common cause of community-acquired pneumonia. The factor V Leiden (FVL) mutation results in resistance of activated FV to inactivation by activated protein C and thereby in a prothrombotic phenotype. Human heterozygous FVL carriers have been reported to be relatively protected against sepsis-related mortality. We here determined the effect of the FVL mutation on coagulation, inflammation, bacterial outgrowth and outcome in murine pneumococcal pneumonia. Methods Wild-type mice and mice heterozygous or homozygous for the FVL mutation were infected intranasally with 2*106 colony forming units of viable S. pneumoniae. Mice were euthanized after 24 or 48 hours or observed in a survival study. In separate experiments mice were treated with ceftriaxone intraperitoneally 24 hours after infection and euthanized after 48 hours or observed in a survival study. Results The FVL mutation had no consistent effect on activation of coagulation in either the presence or absence of ceftriaxone therapy, as reflected by comparable lung and plasma levels of thrombin-antithrombin complexes and fibrin degradation products. Moreover, the FVL mutation had no effect on lung histopathology, neutrophil influx, cytokine and chemokine levels or bacterial outgrowth. Remarkably, homozygous FVL mice were strongly protected against death due to pneumococcal pneumonia when treated with ceftriaxone, which was associated with more pronounced FXIII depletion; this protective effect was not observed in the absence of antibiotic therapy. Conclusions Homozygosity for the FVL mutation protects against lethality due to pneumococcal pneumonia in mice treated with antibiotics. PMID:20682036

  8. Daptomycin-β-Lactam Combinations in a Rabbit Model of Daptomycin-Nonsusceptible Methicillin-Resistant Staphylococcus aureus Endocarditis.

    Science.gov (United States)

    Chambers, Henry F; Basuino, Li; Hamilton, Stephanie M; Choo, Eun Ju; Moise, Pamela

    2016-07-01

    Beta-lactams enhance the in vitro activity of daptomycin against methicillin-resistant strains of Staphylococcus aureus Experiments were performed in a rabbit model of aortic valve endocarditis caused by methicillin-resistant daptomycin-nonsusceptible S. aureus strain CB5054 to determine if a cephalosporin, ceftriaxone, administered as a once-daily dose of 100 mg/kg of body weight, or a carbapenem, ertapenem, administered as a once-daily dose of 40 mg/kg, improved the efficacy of daptomycin, administered as a once-daily dose of 12 mg/kg. Daptomycin was ineffective alone in reducing organism densities compared to untreated controls in vegetations and spleen, but densities were 1.4 log10 CFU/g lower in kidney. The combination of daptomycin plus ceftriaxone or daptomycin plus ertapenem reduced bacterial densities in all tissues compared to single agents, with 0.6 to 1.0 log10 CFU/g fewer organisms in vegetations, 1.5 to 2.5 log10 CFU/g fewer organisms in spleen, and 1.8 to 2.5 log10 CFU/g fewer organisms in kidney, although differences were statistically significant only in spleen for daptomycin plus ceftriaxone and in kidney for daptomycin plus ertapenem. Drug exposures in rabbits were less than those achievable in humans, which may have limited the in vivo activity, particularly in vegetations. PMID:27090173

  9. [Case of Streptococcus salivarius bacteremia/meningoencephalitis leading to discovery of early gastric cancer].

    Science.gov (United States)

    Ijyuuin, Toshiro; Umehara, Fujio

    2012-01-01

    A 73-year old man was brought to our hospital because of acute onset of fever and consciousness disturbance. He had been hemodialyzed three times a week because of chronic renal failure since 13 years ago. Neurological examination revealed deteriorated consciousness and neck stiffness. A lumbar puncture yielded clouded fluid with a WBC 7,912/mm³ (polymorphonuclear cells 88%, mononuclear cells 12%), 786 mg/dl of protein and 4 mg/dl of glucose (blood glucose 118 mg/dl). Brain CT and MRI were unremarkable. He was treated with ceftriaxone and ampicillin. Streptococcus salivarius was isolated from the blood sample, but not from cerebrospinal fluid. The patient responded promptly to antibiotics therapy (ampicillin 3g/day, ceftriaxone 1g/day), and within several days he became lucid and afebrile. Isolated S. salivarius was sensitive for ampicillin and ceftriaxone. We diagnosed this case as S. salivarius bacteremia/meningoencephalitis. A gastrointestinal diagnostic workup revealed an asymptomatic gastric adenocarcinoma. S. salivarius is a common inhabitant of the oral mucosa that has been associated with infection in different sites. Meningeal infection by S. salivarius generally related to neoplasia of colon or iatrogenia, has been described on few occasions. This is the first report of S. salivarius bacteremia/meningoencephalitis associated with gastric neoplasm. Neurologist should be aware of the association of S. salivarius bacteremia/meningoencephalitis and gastrointestinal disease. PMID:22688117

  10. PHARMACOEPIDEMIOLOGICAL AND PHARMACOECONOMIC ANALYSIS OF TREATMENT OF ENDOMETRIT IN-HOSPITAL

    Directory of Open Access Journals (Sweden)

    L. Yu. Chernikova

    2016-02-01

    Full Text Available Pharmacoepidemiological and pharmacoeconomical analysis of endometrit drug therapy at special treatment-and-prophylactic institutions of the city of Tomsk. Estimate the intensity of the appointment of antibacterial drugs endometrit therapy using the methodology of the WHO ATC/DDD, calculated indicators of the intensity of the consumption of drugs in the course of treatment per patient. It was shown that 70% of the established daily dose had to beta-lactam antibiotics and macrolide. For the most common options for antibiotic therapy established nosology of the indicators of clinical efficacy. The calculation of the cost of the schemes of antibiotic therapy, which showed that the cost of treatment is maximal during therapy with ceftriaxone + clarithromycin (4902 RUR; further descending follow: amoxicillin / clavulanic acid + roxithromycin (4658 RUR; benzylpenicillin and gentamicin (4231 RUR. Economic efficiency of antibacterial treatments endometritis a “cost – effectiveness”. The cost of the patient, achieved remission, made during therapy with amoxicillin/clavulanic acid and roxithromycin (5416 RUR, During therapy with ceftriaxone and clarithromycin (6052 RUR, the treatment of benzylpenicillin and gentamicin (14420 RUR. Pharmacoeconomic evaluation results showed that the least acceptable scheme of antibacterial therapy of endometrit in the hospital is the combination of benzyl penicillin and gentamicin. Тhe antibiotic therapy for endometrit may be recommended by a combination of amoxicillin / clavulanic acid and roxithromycin and clarithromycin and ceftriaxone, for which there was no statistically significant differences in clinical efficacy and cost of antibiotic therapy.

  11. Antimicrobial resistance among invasive Haemophilus influenzae strains: results of a Brazilian study carried out from 1996 through 2000

    Directory of Open Access Journals (Sweden)

    Casagrande S.T.

    2002-01-01

    Full Text Available A total of 1712 strains of Haemophilus influenzae isolated from patients with invasive diseases were obtained from ten Brazilian states from 1996 to 2000. ß-Lactamase production was assessed and the minimum inhibitory concentrations (MIC of ampicillin, chloramphenicol, ceftriaxone and rifampin were determined using a method for broth microdilution of Haemophilus test medium. The prevalence of strains producing ß-lactamase ranged from 6.6 to 57.7%, with an overall prevalence of 18.4%. High frequency of ß-lactamase-mediated ampicillin resistance was observed in Distrito Federal (25%, São Paulo (21.7% and Paraná (18.5%. Of the 1712 strains analyzed, none was ß-lactamase negative, ampicillin resistant. A total of 16.8% of the strains were resistant to chloramphenicol, and 13.8% of these also presented resistance to ampicillin, and only 3.0% were resistant to chloramphenicol alone. All strains were susceptible to ceftriaxone and rifampin and the MIC90 were 0.015 µg/ml and 0.25 µg/ml, respectively. Ceftriaxone is the drug of choice for empirical treatment of bacterial meningitis in pediatric patients who have not been screened for drug susceptibility. The emergence of drug resistance is a serious challenge for the management of invasive H. influenzae disease, which emphasizes the fundamental role of laboratory-based surveillance for antimicrobial resistance.

  12. Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992–2009

    Directory of Open Access Journals (Sweden)

    Kauser Jabeen

    2011-01-01

    Full Text Available Emergence and spread of drug resistant Neisseria gonorrhoeae is global concern. We evaluated trends of antimicrobial resistance in Neisseria gonorrhoeae over years 1992–2009 in Pakistan. Resistance rates were compared between years (2007–2009 and (1992–2006. Antimicrobial susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute (CLSI criteria using the disk diffusion methodology against penicillin, ceftriaxone, tetracycline and ofloxacin. Additional antibiotics tested in 100 strains isolated during 2007–2009, included cefotaxime, cefoxitin, cefuroxime, cefipime, ceftazidime, ceftizoxime, cefixime, cefpodoxime, spectinomycin and azithromycin. Neisseria gonorrhoeae ATCC 49226 was used as control. Chi-square for trend analysis was conducted to assess resistance trend over the study period. During study period significant increase in combined resistance to penicillin, tetracycline and ofloxacin was observed (P value <0.01. Resistance rates during the two study period also increased significantly (P value <0.01. Ceftriaxone resistance was not observed. None of the isolates were found to be resistant or with intermediate sensitivity to additional antibiotics. Our findings suggest that penicillin, ciprofloxacin, tetracycline should not be used in the empirical treatment of gonorrhea in Pakistan. Ceftriaxone and cefixime should be the first line therapy; however periodic MICs should be determined to identify emergence of strains with reduced susceptibility.

  13. Up-regulation of GLT-1 severely impairs LTD at mossy fibre--CA3 synapses.

    Science.gov (United States)

    Omrani, Azar; Melone, Marcello; Bellesi, Michele; Safiulina, Victoria; Aida, Tomomi; Tanaka, Kohishi; Cherubini, Enrico; Conti, Fiorenzo

    2009-10-01

    Glutamate transporters are responsible for clearing synaptically released glutamate from the extracellular space. By this action, they maintain low levels of ambient glutamate, thus preventing excitotoxic damage, and contribute to shaping synaptic currents. We show that up-regulation of the glutamate transporter GLT-1 by ceftriaxone severely impaired mGluR-dependent long-term depression (LTD), induced at rat mossy fibre (MF)-CA3 synapses by repetitive stimulation of afferent fibres. This effect involved GLT-1, since LTD was rescued by the selective GLT-1 antagonist dihydrokainate (DHK). DHK per se produced a modest decrease in fEPSP amplitude that rapidly regained control levels after DHK wash out. Moreover, the degree of fEPSP inhibition induced by the low-affinity glutamate receptor antagonist gamma-DGG was similar during basal synaptic transmission but not during LTD, indicating that in ceftriaxone-treated rats LTD induction did not alter synaptic glutamate transient concentration. Furthermore, ceftriaxone-induced GLT-1 up-regulation significantly reduced the magnitude of LTP at MF-CA3 synapses but not at Schaffer collateral-CA1 synapses. Postembedding immunogold studies in rats showed an increased density of gold particles coding for GLT-1a in astrocytic processes and in mossy fibre terminals; in the latter, gold particles were located near and within the active zones. In both CEF-treated and untreated GLT-1 KO mice used for verifying the specificity of immunostaining, the density of gold particles in MF terminals was comparable to background levels. The enhanced expression of GLT-1 at release sites may prevent activation of presynaptic receptors, thus revealing a novel mechanism by which GLT-1 regulates synaptic plasticity in the hippocampus.

  14. Cephalosporin susceptibility among Neisseria gonorrhoeae isolates--United States, 2000-2010.

    Science.gov (United States)

    2011-07-01

    Neisseria gonorrhoeae is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility, and it can facilitate human immunodeficiency virus (HIV) transmission. Emergence of gonococcal resistance to penicillin and tetracycline occurred during the 1970s and became widespread during the early 1980s. More recently, resistance to fluoroquinolones developed. Resistance was documented first in Asia, then emerged in the United States in Hawaii followed by other western states. It then became prevalent in all other regions of the United States. In Hawaii, fluoroquinolone resistance was first noted among heterosexuals; however, resistance in the United States initially became prevalent among men who have sex with men (MSM) before generalizing to heterosexuals. This emergence of resistance led CDC, in 2007, to discontinue recommending any fluoroquinolone regimens for the treatment of gonorrhea. CDC now recommends dual therapy for gonorrhea with a cephalosporin (ceftriaxone 250 mg) plus either azithromycin or doxycycline. This report summarizes trends in cephalosporin susceptibility among N. gonorrhoeae isolates in the United States during 2000-2010 using data from the Gonococcal Isolate Surveillance Project (GISP). During that period, the percentage of isolates with elevated minimum inhibitory concentrations (MICs) to cephalosporins (≥0.25 µg/mL for cefixime and ≥0.125 µg/mL for ceftriaxone) increased from 0.2% in 2000 to 1.4% in 2010 for cefixime and from 0.1% in 2000 to 0.3% in 2010 for ceftriaxone. Although cephalosporins remain an effective treatment for gonococcal infections, health-care providers should be vigilant for treatment failure and are requested to report its occurrence to state and local health departments. State and local public health departments should promote maintenance of laboratory capability to culture N. gonorrhoeae to allow testing of isolates for cephalosporin resistance. They also should develop enhanced surveillance and

  15. Optimizing antibiotic therapy of group IV community-acquired pneumonia patients

    Directory of Open Access Journals (Sweden)

    Dziublyk Ya.O.

    2014-06-01

    Full Text Available The aim of the study was to evaluate the clinical and economical effectiveness of differentiated antibacterial therapy of group IV patients with community-acquired pneumonia (CAP. Materials and methods. 42 patients, admitted to the hospital with severe CAP without risk factors for P. aeruginosa infection were randomized in three groups in 1:1:1 ratio. All patients received sequential antibacterial therapy with i.v. amoxicillin/clavulanate or ceftriaxone, or ertapenem in combination with azithromycin switched to oral amoxicillin/clavulanate, cefuroxime axetil in combination with oral azithromycin or levofloxacin, respectively, after initial improvement in 3–4 days. A comparative effectiveness analysis was performed based on clinical, laboratory and economic data. Results. Treatment outcomes in all subgroups of patients were similar: in 1st subgroup the cure rate was (28,6  12,1 %, improvement – in (49,4  13,2 % of patients; in 2nd and 3rd subgroups the cure/improvement rates were (35,7  12,8 and (42,9 13,2 %, respectively (р  0,05. Conclusion. Antibacterial therapy, always empiric and differentiated depending on severity of disease, con¬comitant conditions and previous use of antibiotics within 3 months of the onset of the disease, is a milestone of treatmet of CAP patients. A sequential antibiotic therapy with either aminopenicillin (amoxicillin/clavulanate of 3rd generation cephalosporin (ceftriaxone/cefuroxime axetil in combination with macrolide (azithromycin or carbapenem (ertapenem, followed by levofloxacin is recommended in hospitalized clinical group IV CAP patients without risk factors for P. aeruginosa infection. In current group of patients pharmacoeconomic analysis confirmed the expediency of administration a sequential antibiotic therapy with parenteral amoxicillin/clavulanat or ceftriaxone in combination with azithromycin, followed by oral amoxicillin/clavulanat or cefuroxime axetil in combination with

  16. The survey of bacterial etiology and their resistance to antibiotics of urinary tract infections in children of Birjand city

    Directory of Open Access Journals (Sweden)

    Azita Fesharakinia

    2012-08-01

    Full Text Available Background and Aim: Urinary tract infection is one of the most prevalent bacterial infections in childhood, which due to an inapproto determine the common bacteria and their antibiotic susceptibility in children with urinary tract infection.   Materials and Methods: This descriptive-analytical and prospective study was done in 2009-2010 on urine samples of all children under 13 years who had been referred to Emmam-Reza hospital laboratory in Birjand and had positive urine culture. Sex and age of children, the kind of isolated bacteria in urine culture, susceptibility and resistance of these bacteria to current antibiotics were studied.The obtained data was analyzed by means of SPSS using Fisher exact- test.   Results: 100 children (84 girls and 16 boys with positive urine culture were studied. The most common age of urinary tract infection was under two years. In all ages the rate of urinary tract infection in females was more than males. E.coli was the most common cause in both sexes. There was a significant relationship between kind of microorganism and age of infection. The most prevalent cause of urinary tract infection in all ages was E.coli (75% ,infection by Proteus was 11%, and other microorganism caused 14% of the cases. E.coli had the most susceptibility to ceftriaxone and ceftazidime and the most resistance to cephalexin and co-trimoxazol. Not taking the type of microorganism into consideration, the most sensitive antibiotics were ceftazidime, ceftriaxone, cefexim and nalidixic acid and the most resistance was against co-trimoxasol and cefalexin.   Conclusion: Regarding the results, it is recommended to use cefexime and nalidixic acid for outpatient treatment of urinary infection , and ceftazidime and ceftriaxon for inpatient treatment.Selecting of antibiotics for urinary infection therapy should be based on the local prevalence of pathogenic bacteria and antibiotic sensitivities rather than on a universal guideline.

  17. Paratyphoid fever- Emerging problem in South India

    Institute of Scientific and Technical Information of China (English)

    Ragini Bekur; KEVandana; KN Shivashankara; Rohit Valsalan; Vishwanath Sathyanarayanan

    2010-01-01

    Objective:To review the clinical profile and drug susceptibilities ofSalmonella paratyphiA in a tertiary care hospital.Methods: Retrospective analyses of113patients with paratyphoid fever and101 culture provenSalmonella paratyphi A infection were included in the study. The study extended over a period of3 years(2006-2008). Diagnosis of patients were based on clinical features, serology and blood culture. The drug susceptibility testing of the isolates were performed by the disc diffusion method. Clinical presentation, laboratory parameters, susceptibility patterns of isolates, treatment and clinical response were studied.Results: Of the 113 cases, 77 (68.4 %) were males and36 were females(32.8%), which included2 pediatric patients. Fever was the most common symptom(100.0%) followed by loose stools(37.2%), headache(35.4%), myalgia(31.9%), pain abdomen (29.2%), dry cough (19.5%) and vomiting(13.3%). All patients were clinically cured. Majority of the isolates (46%)were resistant to cotrimoxazole in2006, however they became 100% sensitive in2007and2008. whereas the strains became100% sensitive to ampicillin and chloramphenicol only in 2008. In2006 the sensitivity of organisms to ciprofloxacin was89% but in2007and2008there has been an increasing resistance to ciprofloxacin (46% and86%) respectively . Surprisingly3isolates (8.1%) were resistant to ceftriaxone in2006, showed100% sensitivity in2008. Common drugs used were ceftriaxone in100 cases(88.4%) and ciprofloxacin in13cases(11.6%).One patient had relapse of paratyphoid fever after treatment with ciprofloxacin which responded to ceftriaxone.Conclusions:Paratyphoid fever A is one of the emerging infections and a significant problem in India. An increasing resistance to fluoroquinolones is noted. Continuous monitoring of drug susceptibilities is mandatory in instituting appropriate therapy.

  18. Choosing the correct empirical antibiotic for urinary tract infection in pediatric: Surveillance of antimicrobial susceptibility pattern of Escherichia coli by E-Test method.

    Directory of Open Access Journals (Sweden)

    Iraj Sedighi

    2014-12-01

    Full Text Available Urinary Tract Infections (UTIs are of the most common bacterial diseases worldwide. We investigate the antibiotic susceptibility patterns of Escherichia coli (E. coli strains isolated from pediatric patients with community acquired urinary tract infection (UTI to find a clinical guidance for choosing a right empirical antibiotic in these patients.In this cross sectional study, 100 urine specimens which were positive for E. coli had been investigated for antibiotics susceptibility pattern. The susceptibility to Co-trimoxazol (25μg, Amikacin (30μg, Ceftriaxone (30μg, Nalidixic Acid (30μg, Cefixime (5μg, and Nitrofurantoin (300μg tested with Disk diffusion agar and MIC determined with the E-test.Mean age of patients was 38 Months. Girls had greater proportion than boys (74 versus 26%. In Disk diffusion method, 26% of the isolates were susceptible to cotrimoxazole. Susceptibility to amikacin, ceftriaxone, nitrofurantoin, nalidixic acid and cefixime was 94%, 66%, 97%, 62% and 52%, respectively. By E-Test method and according to CLSI criteria susceptibility for co-trimoxazol, amikacin, ceftriaxone and nalidixic acid was 37%, 97%, 67% and 50%, respectively. The highest percentage of agreement between Disk diffusion and E-Test method was found for amikacin (96% and the lowest percentage for co-trimoxazole (89%.Treatment failure, prolonged or repeated hospitalization, increased costs of care, and increased mortality are some consequence of bacterial resistance in UTIs. Misuse of antibiotics in each geographic location directly affects antibiotic resistance pattern. In the treatment of UTI, proper selection of antimicrobial agents should be relevant to the bacterial susceptibility testing surveillance. According to our results, amikacin as an injectable drug and nitrofurantoin as an oral agent could be used as a drug of choice in our region for children with UTIs.

  19. Comparative antimicrobial susceptibility of Listeria monocytogenes, L. innocua, and L. welshimeri.

    Science.gov (United States)

    Davis, Johnnie A; Jackson, Charlene R

    2009-03-01

    The current study compared antimicrobial susceptibility of Listeria innocua, L. welshimeri, and L. monocytogenes isolated from various sources. Antimicrobial susceptibility testing was performed using a microbroth procedure with Sensititre minimum inhibitory concentration plates containing 18 antimicrobials. Resistant isolates were analyzed for the presence of antimicrobial resistance genes using PCR. The majority of L. monocytogenes isolates were resistant to oxacillin (99%, 89/90) and ceftriaxone (72%, 65/90), while few isolates were resistant to clindamycin (21%, 19/90) and ciprofloxacin (2%, 2/90). When selected sources of L. monocytogenes are compared, resistance to ceftriaxone, clindamycin, and oxacillin ranged from 27% to 86%, 7% to 43%, and 96% to 100%, respectively. Resistance to ciprofloxacin (6%, 2/34), quinupristin/dalfopristin (7%, 1/14), and tetracycline (7%, 1/15) was observed with L. monocytogenes isolated from food, animal, and environmental sources, respectively. All L. welshimeri isolates (6/6) were resistant to streptomycin, quinupristin/dalfopristin, ciprofloxacin, rifampin, oxacillin, penicillin, and clindamycin, while most isolates (67%, 4/6) were resistant to trimethoprim/sulfamethoxazole. All L. innocua isolates (4/4) were resistant to oxacillin and penicillin, whereas 75% (3/4) of isolates were resistant to tetracycline, ceftriaxone, and clindamycin. Resistant isolates were negative for aadA, strA-B, sul I-II, penA, vat(A-E), vga(A-B), and vgb(A-B). However, tetM was detected among tetracycline-resistant isolates. L. welshimeri was resistant to more of the tested antimicrobials than the other two Listeria species tested, but resistance was not attributed to selected resistance genes. These data demonstrate the variability in resistance among Listeria species. However, the human pathogen L. monocytogenes appears to be the least resistant among the tested species. PMID:19216646

  20. Gonorrhoea among Sex Workers in China: Prevalence,Risk Factors, and Resistance to Antibiotics

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To study gonorrhoea among sex workers in China as to prevalence, riskfactors, and resistance to antibioticsSubjects & Methods From March 1998 to October 1999, 966 sex workers fromGuangzhou were recruited into a sexually transmitted diseases (STD) care and pre-vention programme through various outreach activities. Data collection was standard-ized. Cervical samples were tested for the presence of Neisseria (N. ) gonorrhoea byculture. The agar dilution method was performed to determine susceptibilities of 85isolates to penicillin, ciprofloxacin , spectinomycin and ceftriaxone. The production ofB-lactamase was determined by paper acidometric testing.Results The prevalence of gonorrhoea was 9%. Independent predictors for thedisease were inconsistent condom use, lack of regular salary, absence of a previousSTD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamy-dial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent dis-charge at genital examination were also independently associated with gonorrhoea. Ofthe 85 N. gonorrhoea isolates, 3. 5% was penicillinase producing (PPNG) and 7%plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% wasinsensitive to penicillin, while 52% and 47% were resistant or less susceptible tociprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriax-one. All strains were susceptible to spectinomycin.Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, butstrains were sensitive to ceftriaxone and spectinomycin. Several personal or medicalcharacteristics were independently associated with the presence of gonorrhoea. Womendiagnosed with gonorrhoea should receive concurrent treatment for chlamydialinfection.

  1. In vitro activity of antibiotics alone and in combination against Actinobacillus actinomycetemcomitans.

    Science.gov (United States)

    Yogev, R; Shulman, D; Shulman, S T; Glogowski, W G

    1986-01-01

    The MICs for 90% of the organisms tested (MIC90S) of 11 antibiotics against 24 clinical isolates of Actinobacillus actinomycetemcomitans were determined by the MIC 2000 system. The lowest MIC90S (16 micrograms/ml) were observed with ceftriaxone and rifampin. The next lowest MIC90S were found with cephapirin, tetracycline, and chloramphenicol (3.12 micrograms/ml). The MIC90S of penicillin, ampicillin, ticarcillin, piperacillin, and amikacin were each greater than or equal to 12.5 micrograms/ml. Antibiotic synergy was studied by the killing curve method and was defined as a greater than or equal to 2 log10 reduction in CFU when two antibiotics were used in combination at one-fourth the MBC for each compared with the effect of each antibiotic alone at one-half the MBC. Synergism between rifampin and penicillin, cephapirin, or ceftriaxone was tested for with 12 A. actinomycetemcomitans strains. In 7 of 37 instances, synergism was demonstrated for the combinations rifampin plus ceftriaxone (n = 3) or rifampin plus penicillin (n = 4); in 9 instances, an additive effect was noted, and impaired killing with drug combinations compared with the effect of a single antibiotic was suggested in 4 strains. The majority of strains were indifferent to the combinations. Similarly, variable results were observed when the combination of trimethoprim and cephapirin was tested against eight A. actinomycetemcomitans strains. Our data suggest that rifampin and cephapirin are the most active of the 11 antibiotics studied against A. actinomycetemcomitans. In addition, in vitro synergism between rifampin and other antibiotics or between trimethoprim and cephapirin was not consistently demonstrable.

  2. Recurrent meningitis due to Salmonella enteritidis: A case report from Kashmir India

    Directory of Open Access Journals (Sweden)

    B A Fomda

    2012-01-01

    Full Text Available Recurrent bacterial meningitis in children is potentially life-threatening and induces psychological trauma to the patients through repeated hospitalization. Here we report a case of recurrent meningitis in a one month old baby. The CSF and blood culture grew Salmonella enteritidis. Injection ciprofloxacin and ceftriaxone were given for 3 weeks. Baby became symptomatically better and was afebrile at discharge. Twenty eight days after discharge baby got readmitted with complaints of fever and refusal of feeds. Blood and CSF culture again showed growth of Salmonella enteritidis. Physicians should be educated about the possibility of recurrence which may occur days or even weeks after apparent successful antibiotic treatment.

  3. Como Lo Hago Yo: Defectos Del Cierre Del Tubo Neural En Nicaragua

    Science.gov (United States)

    Gonzalez, Juan Bosco

    2014-01-01

    En Nicaragua no hay un plan de forltificación de alimentos con ácido fólico. Las madres son muy jóvenes. En La Mascota operamos mas de cuarenta niños por año. Derivación tardía es un problema. La infección preoperatoria tiene que ser descartada. Vancomicina y Ceftriaxone estan indicadas. Estricta regla de asepsia operatoria. Suturamos la plaqueta para asemejar su forma al cilindro normal de la médula. No ceramos la capa de músculo. PMID:24791221

  4. Pancreatic abscess following scrub typhus associated with multiorgan failure

    Institute of Scientific and Technical Information of China (English)

    Sun Young Yi; Jung Hyun Tae

    2007-01-01

    Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years old man with acute pancreatitis with abscess formation and multiorgan failure. Abdominal computed tomography showed multiple infected pancreatic pseudocysts with peri-pancreatic infiltration. Multiorgan failure was successfully treated with doxycycline, ceftriaxone, and supportive management. The pancreatic abscess was successfully drained percutaneously and the sizes of pseudocysts decreased remarkably.

  5. [Bilateral peripheral facial paralysis secondary to Lyme disease].

    Science.gov (United States)

    Zapater Latorre, E; Castillo Ruiz, A; Alba García, J R; Armengot Carceller, M; Sancho Rieger, J; Basterra Alegría, J

    2004-01-01

    Simultaneous bilateral facial paralisis (SBFP) occurs in 0.3-2% of all facial paralisis. We report a case of SBFP in association with Lyme disease. A review of literature about SBFP is made, studing specially the one caused by Borrelia burgdorferi. We present a diagnostic guideline of SBFP. Suspect diagnosis of Lyme disease is based on clinical and epidemiological criteria. Culture isolation of this bacteria is difficult, therefore serologic testing is required. Neuroborreliosis treatment is intravenous Ceftriaxone or Cefotaxime. Oral Doxycycline is useful in the treatment of neuritis without central nervous system involvement.

  6. Acute hepatitis with nontyphoidal salmonella and hepatitis E virus coinfection

    Directory of Open Access Journals (Sweden)

    Yu-Ting Kuo

    2014-09-01

    Full Text Available A 65-year-old Taiwanese man presented with dark urine for 5 days before admission to hospital and with fever on the 2nd day of admission to hospital. Laboratory studies showed acute hepatitis with hyperbilirubinemia. Acute hepatitis with nontyphoidal salmonella and hepatitis E virus coinfection was diagnosed. The fever subsided after treatment with ceftriaxone and cefepime. His serum bilirubin reached its peak value on the 3rd week after admission to hospital and then gradually returned to the normal range. To the best of our knowledge, acute hepatitis E coinfection with nontyphoidal salmonella has not been reported previously.

  7. Septic arthritis of the ankle due to Salmonella enteritidis.

    LENUS (Irish Health Repository)

    Dineen, Patrick F

    2011-06-01

    Salmonella septic arthritis in healthy, immunocompetent patients is extremely rare. We present the case of a 70-year-old man who presented with a one-day history of painful swelling of his ankle from which was aspirated pus which subsequently grew Salmonella enteritidis. There was no history of trauma or symptoms consistent with Salmonella enterocolitis. Our patient recovered fully after two weeks on intravenous ceftriaxone and six weeks on oral ciprofloxacin. Salmonella is a notifiable disease in the European Union and the United States of America, and is associated with outbreaks as a result of food contamination. The nature of Salmonella arthritis and its appropriate management are outlined.

  8. Third-generation cephalosporins: a critical evaluation.

    Science.gov (United States)

    Barriere, S L; Flaherty, J F

    1984-01-01

    Six third-generation cephalosporins--cefotaxime, moxalactam, cefoperazone, ceftizoxime, ceftriaxone, and cefmenoxime--are reviewed; covered are chemistry and structure-activity relationships, mechanism of action, spectra of activity, pharmacokinetics, clinical utility, adverse effects, and cost effectiveness. The third-generation cephalosporins have a similar mechanism of action to that of other beta-lactam antibiotics. None of the agents is particularly active against certain gram-positive bacteria, including methicillin-resistant Staphylococcus aureus; the drugs are effective against gonococci, Haemophilus influenzae, and Neisseria meningitidis. Several common gram-negative pathogens are susceptible to the third-generation cephalosporins, including Escherichia coli, Klebsiella, Citrobacter diversus, Proteus, and Morganella. About 50% of Pseudomonas aeruginosa isolates are susceptible. Only moxalactam has good activity against Bacteriodes fragilis. The pharmacokinetic profiles of the six agents reveal some important differences. The half-life of ceftriaxone allows once-daily dosing in many patients; the half-lives of ceftizoxime and cefoperazone permit dosing every 8-12 hours. Cefoperazone and ceftriaxone are highly protein bound, but the clinical relevance of this is unknown. Generally, the agents penetrate most body tissues and fluids well. Moxalactam and cefotaxime and possibly ceftriaxone effectively penetrate into the cerebrospinal fluid well. The third-generation cephalosporins have become the accepted drugs of choice for the treatment of adult gram-negative bacillary meningitis; as more experience is gained, they are likely to become the drugs of first choice for neonatal (with ampicillin) and childhood (except for moxalactam) meningitis. Serious infections of Enterobacteriaceae can be treated with these agents, thereby avoiding use of the aminoglycosides. Moxalactam is comparable with combination therapy in treating intra-abdominal infections. Adverse

  9. Preincubation of pneumococci with beta-lactams alone or combined with levofloxacin prevents quinolone-induced resistance without increasing intracellular levels of levofloxacin.

    Science.gov (United States)

    Cottagnoud, Philippe; Johnson, Maggie; Cottagnoud, Marianne; Piddock, Laura

    2005-08-01

    Preincubation of pneumococci with sub-MIC concentrations of ceftriaxone (1/16x MIC), cefotaxime (1/8x MIC), and meropenem (1/4x MIC) alone or combined with levofloxacin (1/8x MIC) over 6 h prevents the emergence of levofloxacin-resistant mutants after 96 h of incubation but does not affect the intracellular accumulation of levofloxacin in two penicillin-resistant pneumococcal strains, suggesting a link between the mechanism of action of beta-lactams and the emergence of quinolone-induced resistance in pneumococci.

  10. In Vitro Antimicrobial Resistance of Urinary Escherichia coli Isolates among U.S. Outpatients from 2000 to 2010

    OpenAIRE

    Sanchez, Guillermo V.; Master, Ronald N; Karlowsky, James A.; Bordon, Jose M.

    2012-01-01

    This study examines in vitro antimicrobial resistance data from Escherichia coli isolates obtained from urine samples of U.S. outpatients between 2000 and 2010 using The Surveillance Network (TSN). Antimicrobial susceptibility results (n = 12,253,679) showed the greatest increases in E. coli resistance from 2000 to 2010 for ciprofloxacin (3% to 17.1%) and trimethoprim-sulfamethoxazole (TMP-SMX) (17.9% to 24.2%), whereas nitrofurantoin (0.8% to 1.6%) and ceftriaxone (0.2% to 2.3%) showed minim...

  11. Haemophilus parainfluenzae urethritis among homosexual men.

    Science.gov (United States)

    Hsu, Meng-Shiuan; Wu, Mei-Yu; Lin, Tsui-Hsien; Liao, Chun-Hsing

    2015-08-01

    Haemophilus parainfluenzae is a common inhabitant of the human upper respiratory tract of the normal oral microflora. We report three men who had been having unprotected sex with men (MSM) and subsequently acquired H. parainfluenzae urethritis, which was confirmed by 16S rRNA gene sequencing analysis. Two men were treated with ceftriaxone and doxycycline, and the third man was treated with clarithromycin. All three patients responded to treatment. This case series highlights the potential role of H. parainfluenzae as a sexually transmitted genitourinary pathogen. PMID:23357607

  12. Catalase-negative Staphylococcus aureus isolated from a diabetic foot ulcer

    Directory of Open Access Journals (Sweden)

    MR Zali

    2010-12-01

    Full Text Available We report a catalase-negative Staphylococcus aureus isolated from a 56-year-old male diabetic patient with foot ulcer who attended our surgery ward. Species identification was confirmed by Gram staining, standard biochemical tests and PCR amplification of the nuc and fem genes. Antibiotic susceptibility showed that the strain was sensitive to imepenem, chloramphenicol, amoxicillin, vancomycin and resistant to oxacillin, penicillin, ceftriaxone, erythromycin, clindamycin, and amikacin. Clinicians and microbiologists must be encouraged to identify and report these atypical strains and the infections associated with them in order to establish their role in pathogenesis.

  13. Haemophilus parainfluenzae urethritis among homosexual men.

    Science.gov (United States)

    Hsu, Meng-Shiuan; Wu, Mei-Yu; Lin, Tsui-Hsien; Liao, Chun-Hsing

    2015-08-01

    Haemophilus parainfluenzae is a common inhabitant of the human upper respiratory tract of the normal oral microflora. We report three men who had been having unprotected sex with men (MSM) and subsequently acquired H. parainfluenzae urethritis, which was confirmed by 16S rRNA gene sequencing analysis. Two men were treated with ceftriaxone and doxycycline, and the third man was treated with clarithromycin. All three patients responded to treatment. This case series highlights the potential role of H. parainfluenzae as a sexually transmitted genitourinary pathogen.

  14. [Typhoid fever].

    Science.gov (United States)

    Marchou, B

    1996-01-15

    Endemic in regions with poor hygienic conditions, Enteric fevers are imported in France by returning travellers. They are caused by Salmonella strains, mainly S. Typhi, transmitted via fecal-oral route. Salmonella reach the blood stream after proliferating in mesenteric lymph nodes. At an initial stage blood and bone marrow cultures, later on Widal-Felix serology permit diagnosis. Antibiotics have rendered death exceptional. Quinolones and ceftriaxone allow treatments shorter than 10 days. Immunization (Typhim Vi) and improvement of hygienic standards are the cornerstone of prevention.

  15. Salmonella typhi--tid til aendring af den empiriske behandling

    DEFF Research Database (Denmark)

    Gade, Christina; Engberg, Jørgen; Weis, Nina

    2008-01-01

    out of seven cases. We recommend that empiric treatment of suspected cases of typhoid fever includes a third generation cephalosporin such as ceftriaxon. Furthermore, the present report stresses the importance of typhoid vaccination of travellers to areas where typhoid is endemic. Udgivelsesdato: 2008......In the present case series report we describe seven recent cases of typhoid fever. All the patients were travellers returning from Pakistan, where typhoid is endemic. Salmonella typhi isolated from the patients by blood culture were reported as intermediary susceptible to fluoroquinolones in six...

  16. A case of wound infection caused by Shewanella algae in the south of Iran

    Directory of Open Access Journals (Sweden)

    M. Taherzadeh

    2014-01-01

    Full Text Available Shewanella algae was isolated from the purulent discharge in the navel area of a young male with a history of swimming in the Persian Gulf. A routine laboratory diagnosis procedure, followed by 16S rRNA gene sequence analyses, was used to avoid misidentification with other species of Shewanella. The bacterium was suscetible to ceftazidime, ciprofloxacin, nalidixic acid, nitrophorantion, amikacin, ceftriaxone, cefotaxime, gentamicin and co-trimoxazole but was resistant to amoxicillin, vancomycin, doxycycline, cephalexin, ampicillin, tetracycline, cephalothin and ceftizoxime. The patient successfully recovered after treatment with antibiotics.

  17. Use of ampicillin-sulbactam for treatment of experimental meningitis caused by a beta-lactamase-producing strain of Escherichia coli K-1.

    OpenAIRE

    Guerra-Romero, L; Kennedy, S L; Fournier, M A; Tureen, J H; Täuber, M G

    1991-01-01

    We evaluated the pharmacokinetics and therapeutic efficacy of ampicillin combined with sulbactam in a rabbit model of meningitis due to a beta-lactamase-producing strain of Escherichia coli K-1. Ceftriaxone was used as a comparison drug. The MIC and MBC were 32 and greater than 64 micrograms/ml (ampicillin), greater than 256 and greater than 256 micrograms/ml (sulbactam), 2.0 and 4.0 micrograms/ml (ampicillin-sulbactam [2:1 ratio, ampicillin concentration]) and 0.125 and 0.25 micrograms/ml (c...

  18. Evaluation of piperacillin-tazobactam in experimental meningitis caused by a beta-lactamase-producing strain of K1-positive Escherichia coli.

    OpenAIRE

    Kern, W; Kennedy, S L; Sachdeva, M; E.R. Sande; Gunderson, D; Täuber, M G

    1990-01-01

    We evaluated the pharmacokinetics and therapeutic efficacy of piperacillin combined with tazobactam, a novel beta-lactamase inhibitor, in experimental meningitis due to a beta-lactamase-producing strain of K1-positive Escherichia coli. Different doses of piperacillin and tazobactam, as single agents and combined (8:1 ratio; dosage range, 40/5 to 200/25 mg/kg per h), and of ceftriaxone were given to experimentally infected rabbits by intravenous bolus injection followed by a 5-h constant infus...

  19. Neisseria gonorrhoeae strain with high-level resistance to spectinomycin due to a novel resistance mechanism (mutated ribosomal protein S5) verified in Norway.

    Science.gov (United States)

    Unemo, Magnus; Golparian, Daniel; Skogen, Vegard; Olsen, Anne Olaug; Moi, Harald; Syversen, Gaute; Hjelmevoll, Stig Ove

    2013-02-01

    Gonorrhea may become untreatable, and new treatment options are essential. Verified resistance to spectinomycin is exceedingly rare. However, we describe a high-level spectinomycin-resistant (MIC, >1,024 μg/ml) Neisseria gonorrhoeae strain from Norway with a novel resistance mechanism. The resistance determinant was a deletion of codon 27 (valine) and a K28E alteration in the ribosomal protein 5S. The traditional spectinomycin resistance gene (16S rRNA) was wild type. Despite this exceedingly rare finding, spectinomycin available for treatment of ceftriaxone-resistant urogenital gonorrhea would be very valuable. PMID:23183436

  20. Current and future antimicrobial treatment of gonorrhoea - the rapidly evolving Neisseria gonorrhoeae continues to challenge.

    Science.gov (United States)

    Unemo, Magnus

    2015-01-01

    Neisseria gonorrhoeae has developed antimicrobial resistance (AMR) to all drugs previously and currently recommended for empirical monotherapy of gonorrhoea. In vitro resistance, including high-level, to the last option ceftriaxone and sporadic failures to treat pharyngeal gonorrhoea with ceftriaxone have emerged. In response, empirical dual antimicrobial therapy (ceftriaxone 250-1000 mg plus azithromycin 1-2 g) has been introduced in several particularly high-income regions or countries. These treatment regimens appear currently effective and should be considered in all settings where local quality assured AMR data do not support other therapeutic options. However, the dual antimicrobial regimens, implemented in limited geographic regions, will not entirely prevent resistance emergence and, unfortunately, most likely it is only a matter of when, and not if, treatment failures with also these dual antimicrobial regimens will emerge. Accordingly, novel affordable antimicrobials for monotherapy or at least inclusion in new dual treatment regimens, which might need to be considered for all newly developed antimicrobials, are essential. Several of the recently developed antimicrobials deserve increased attention for potential future treatment of gonorrhoea. In vitro activity studies examining collections of geographically, temporally and genetically diverse gonococcal isolates, including multidrug-resistant strains particularly with resistance to ceftriaxone and azithromycin, are important. Furthermore, understanding of effects and biological fitness of current and emerging (in vitro induced/selected and in vivo emerged) genetic resistance mechanisms for these antimicrobials, prediction of resistance emergence, time-kill curve analysis to evaluate antibacterial activity, appropriate mice experiments, and correlates between genetic and phenotypic laboratory parameters, and clinical treatment outcomes, would also be valuable. Subsequently, appropriately designed

  1. INFEKSI LEPTOSPIROSIS DENGAN GEJALA JAUNDICE DAN ACUTE KIDNEY INJURY: SEBUAH LAPORAN KASUS

    Directory of Open Access Journals (Sweden)

    I Made Ade Sukma Gautama

    2015-01-01

    Full Text Available Infeksi leptospirosis adalah penyakit zoonosis yang disebabkan oleh mikro organisme dari genus Leptospira. Penularan penyakit ini melalui kontak langsung ataupun tidak langsung dari urin hewan yang terinfeksi. Angka perkiraan kejadian infeksi leptospirosis di dunia antara 100 per 100.000 populasi pada grup yang berisiko tinggi, dengan proporsi angka kematian mencapai 22%, tepatnya penanganan yang diberikan akan menurunkan angka kematian akibat infeksi ini dan komplikasi yang lebih berat yang dapat terjadi seperti Weil disease. Laporan kasus ini membahas tentang infeksi leptospirosis pada seorang laki-laki berusia 21 tahun disertai pemeriksaan serologi antibodi leptospira menunjukkan hasil positif. Pada pasien ini dilakukan penanganan berupa hemodialisa cito dan pemberian antibiotik ceftriaxone.

  2. Self Mutilating Behaviour in Severe Meningococcal Infection; An Interesting Association

    Science.gov (United States)

    Dinkar, Anju; Atam, Virendra; Sahani, Krishna Kumar; Patel, Munna Lal

    2016-01-01

    Neisseria meningitidis most commonly manifests as asymptomatic colonization in the nasopharynx of healthy adolescents and adults. It may rarely present as invasive disease which may be either bacterial meningitis or meningococcal septicaemia. Hereby we report a case presented with fever and rashes, irritability followed by self mutilating behaviour who was diagnosed as a case of invasive meningococcal infection. He responded well to treatment with intravenous ceftriaxone and self mutilating behaviour was subsided completely after treatment. Necrosed tissues of fingers were amputated. With best of our knowledge, no similar case of self-mutilation associated with meningococcal infection has been reported yet. PMID:27437275

  3. Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

    Science.gov (United States)

    Acevedo, Juan

    2015-01-01

    Recently, important changes have been reported regarding the epidemiology of bacterial infections in liver cirrhosis. There is an emergence of multiresistant bacteria in many European countries and also worldwide, including the United States and South Korea. The classic empirical antibiotic treatment (third-generation cephalosporins, e.g., ceftriaxone, cefotaxime or amoxicillin-clavulanic acid) is still effective in infections acquired in the community, but its failure rate in hospital acquired infections and in some health-care associated infections is high enough to ban its use in these settings. The current editorial focuses on the different epidemiology of bacterial infections in cirrhosis across countries and on its therapeutic implications. PMID:25954474

  4. Sulbactomax prevents antimicrobial resistance development by inhibition of conjugal transfer of F plasmids

    Directory of Open Access Journals (Sweden)

    Manu Chaudhary

    2012-03-01

    Full Text Available Aims: To evaluate the effect of EDTA on conjugation and plasmid transfer also to study the effect of different antibiotics on the conjugation. Methods and Results: The minimum inhibitory concentration (MIC of each antibacterial agent was determined using a broth dilution method. In-vitro conjugation study was performed in the presence of different concentration of EDTA. Following selection of appropriate concentration of EDTA which inhibits conjugation process and susceptibility profiles, the same concentration was corelated with Sulbactomax and a comparative study against ceftriaxone and ceftriaxone+sulbactam without EDTA was performed. Further to confirm the inhibition of conjugal transfer of plasmid, plasmid DNA was isolated from donor, recipient and transconjugates and processed for electrophoresis. Results of in vitro study shows that EDTA when used alone strongly inhibits conjugation process at 10 mM. Sulbactomax at half of MIC strongly inhibited the conjugation process as compared to ceftriaxone and ceftriaxone+sulbactam without EDTA. Further, it is clearly evident from agarose gel electrophoresis that conjugation process is inhibited by EDTA alone at 10 mM and higher as well as Sulbactomax. Conclusions: The results obtained in the present study, suggests that EDTA alone at 10 mM and at a very low concentration Sulbactomax inhibits the conjugation process and plasmid transfer. Thus, the inhibition of conjugation process is potentially a novel antimicrobial approach in the prevention of transfer of antibiotic resistance. Significance and Impact of Study: The increasing prevalence of microbial pathogens which are resistant to antibiotics has been encouraging investigation of new strategies for controlling bacterial infections. Conjugative plasmids are potential targets because of the high frequency of antibiotic resistance arising from conjugation and conjugative transfer of plasmid DNA by which antibiotic resistance genes spread between

  5. First antimicrobial resistance data and genetic characteristics of Neisseria gonorrhoeae isolates from Estonia, 2009–2013

    Directory of Open Access Journals (Sweden)

    D. Golparian

    2014-09-01

    Full Text Available Gonorrhoea is a sexually transmitted infection with major public health implications and Neisseria gonorrhoeae has developed resistance to all antimicrobials introduced for treatment. Enhanced surveillance of antimicrobial resistance in N. gonorrhoeae is crucial globally. This is the first internationally reported antimicrobial resistance data for N. gonorrhoeae from Estonia (44 isolates cultured in 2009–2013. A high prevalence of resistance was observed for azithromycin, ciprofloxacin and tetracycline. One and two isolates with resistance and decreased susceptibility to the last remaining first-line treatment option ceftriaxone, respectively, were identified. It is crucial to implement surveillance of gonococcal antimicrobial resistance (ideally also treatment failures in Estonia.

  6. Current and future antimicrobial treatment of gonorrhoea - the rapidly evolving Neisseria gonorrhoeae continues to challenge.

    Science.gov (United States)

    Unemo, Magnus

    2015-08-21

    Neisseria gonorrhoeae has developed antimicrobial resistance (AMR) to all drugs previously and currently recommended for empirical monotherapy of gonorrhoea. In vitro resistance, including high-level, to the last option ceftriaxone and sporadic failures to treat pharyngeal gonorrhoea with ceftriaxone have emerged. In response, empirical dual antimicrobial therapy (ceftriaxone 250-1000 mg plus azithromycin 1-2 g) has been introduced in several particularly high-income regions or countries. These treatment regimens appear currently effective and should be considered in all settings where local quality assured AMR data do not support other therapeutic options. However, the dual antimicrobial regimens, implemented in limited geographic regions, will not entirely prevent resistance emergence and, unfortunately, most likely it is only a matter of when, and not if, treatment failures with also these dual antimicrobial regimens will emerge. Accordingly, novel affordable antimicrobials for monotherapy or at least inclusion in new dual treatment regimens, which might need to be considered for all newly developed antimicrobials, are essential. Several of the recently developed antimicrobials deserve increased attention for potential future treatment of gonorrhoea. In vitro activity studies examining collections of geographically, temporally and genetically diverse gonococcal isolates, including multidrug-resistant strains particularly with resistance to ceftriaxone and azithromycin, are important. Furthermore, understanding of effects and biological fitness of current and emerging (in vitro induced/selected and in vivo emerged) genetic resistance mechanisms for these antimicrobials, prediction of resistance emergence, time-kill curve analysis to evaluate antibacterial activity, appropriate mice experiments, and correlates between genetic and phenotypic laboratory parameters, and clinical treatment outcomes, would also be valuable. Subsequently, appropriately designed

  7. Haemophilus influenzae type f meningitis in a previously healthy boy

    DEFF Research Database (Denmark)

    Ronit, Andreas; Berg, Ronan M G; Bruunsgaard, Helle;

    2013-01-01

    Non-serotype b strains of Haemophilus influenzae are extremely rare causes of acute bacterial meningitis in immunocompetent individuals. We report a case of acute bacterial meningitis in a 14-year-old boy, who was previously healthy and had been immunised against H influenzae serotype b (Hib). Th......). The causative pathogen was identified as H influenzae serotype f (Hif), and was successfully treated with ceftriaxone. An immunological evaluation revealed transient low levels of immunoglobulins but no apparent immunodeficiency was found 2 years after the clinical insult....

  8. Case report: Infective endocarditis caused by Brevundimonas vesicularis

    Directory of Open Access Journals (Sweden)

    Chen Tun-Chieh

    2006-12-01

    Full Text Available Abstract Background There are few reports in the literature of invasive infection caused by Brevundimonas vesicularis in patients without immunosuppression or other predisposing factors. The choice of antimicrobial therapy for bacteremia caused by the pathogen requires more case experience to be determined. Case presentation The case of a 40-year-old previously healthy man with subacute endocarditis proposed to be contributed from an occult dental abscess is described. The infection was found to be caused by B. vesicularis on blood culture results. The patient recovered without sequelae after treatment with ceftriaxone followed by subsequent ciprofloxacin therapy owing to an allergic reaction to ceftriaxone and treatment failure with ampicillin/sulbactam. Conclusion To our knowledge, this is the first report of B. vesicularis as a cause of infective endocarditis. According to an overview of the literature and our experience, we suggest that third-generation cephalosporins, piperacillin/tazobactam, and ciprofloxacin are effective in treating invasive B. vesicularis infections, while the efficacy of ampicillin-sulbactam needs further evaluation.

  9. Multidrug resistant Psudomonas aeruginosa infections complicating surgical wounds and the potential challenges in managing post-operative wound infections:University of Calabar Teaching Hospital experience

    Institute of Scientific and Technical Information of China (English)

    Jombo GT; Akpan S; Epoke J; Denen Akaa P; Odey F

    2010-01-01

    Objective:To ascertain the antimicrobial susceptibility profile of Pseudomonas aeruginosa (P. aeruginosa) recovered from surgical site infections (SSIs). Methods:The study was retrospective in nature and was compiled for a period of five years (1st February, 2004-31st January, 2009). Data were generated from the culture of post-operative wound swab specimens by the microbiology laboratory of University of Calabar Teaching Hospital. Relevant information from the patients’ records was compiled, such as age, gender, type of surgical procedure, microorganisms recovered and their antibiotic sensitivity patterns. Obtained data was analysed by using Epi Info 6 statistical software. Results:Of the 4 533 wound swab specimens processed, 673 were culture positive and P. aeruginosa was recovered from 13.1%of the culture positive specimens with its rate of recovery decreasing with age progression (P0.05). Most of the P. aeruginosa isolates were from general surgery wards and least from orthopaedic wards. Ofloxacin, ceftriaxone and augmentin were the most active antibiotics while ampicillin, tetracycline and co-trimoxazole were the least active antibiotics, with no antibiotic having a 100%activity against the organism. Conclusions:In view of the high resistance displayed by P. aeruginosa recovered from SSIs, adequate antiseptic procedures should be entrenched to avoid colonization of surgical wounds by this microorganism as well as others with similar sensitivity profile. Ofloxacin, ceftriaxone and augmentin may be considered for prevention of P.aeruginosa infection.

  10. Identification and antimicrobial susceptibility patterns of bacteria causing otitis externa in dogs.

    Science.gov (United States)

    Zamankhan Malayeri, Hamed; Jamshidi, Shahram; Zahraei Salehi, Taghi

    2010-06-01

    Bacterial agents are considered important pathogens causing external otitis in dogs. It is essential to carry out bacterial culture and antimicrobial susceptibility test in the case of otitis externa, particularly for chronic or recurring cases. Sterile swab samples were obtained from terminal part of vertical ear canals of 74 dogs with otitis externa for cytology, bacterial culture and antimicrobial susceptibility test. Cytologic smears were stained using Gram and Giemsa staining methods. Aerobic bacterial culture performed on blood agar and MacConkey agar. Among total number of 92 isolated bacteria, 68 were Staphylococcus intermedius. Other isolated bacteria included: Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Pasteurella canis, and six other species of coagulase-negative Staphylococcus. Antimicrobial susceptibility test were performed for all isolated bacteria using 14 antibiotics. Based on the results of this study, all isolated Staphylococcus spp. were sensitive to amikacin, enrofloxacin, and rifampin, and had low resistance to gentamicin, cephalothin and ceftriaxone. More than half of gram-positive isolates were resistant to penicillin and ampicillin. Generally, all isolated gram-negative bacteria, were sensitive to amikacin and enrofloxacin, and had low resistance to ceftriaxone and gentamicin. They were highly resistant to penicillin, eythromycin, and cephalothin. Regarding the results of this study, in cases of uncomplicated otitis externa, it is possible to select antimicrobial drugs merely based on cytology, but it is recommended to perform bacterial culture and antimicrobial susceptibility test. However, in complicated or refractory cases, antimicrobials should be selected based on bacterial culture and antimicrobial susceptibility test.

  11. Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital, Indonesia

    Institute of Scientific and Technical Information of China (English)

    Maksum Radji; Siti Fauziah; Nurgani Aribinuko

    2011-01-01

    Objective: To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit (ICU) of a tertiary care of Fatmawati Hospital Jakarta Indonesia. Methods: A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods, and their antibiotic susceptibility testing was performed using disk diffusion method. Results: Specimens were collected from 385 patients who were given antimicrobial treatment, of which 249 (64.68%) were cultured positive and 136 (35.32%) were negative. The most predominant isolate was Pseudomonas aeruginosa (P. aeruginosa) (26.5%) followed by Klebsiella pneumoniae (K. pneumoniae) (15.3%) and Staphylococcus epidermidis (14.9%). P. aeruginosa isolates showed high rate of resistance to cephalexin (95.3%), cefotaxime (64.1%), and ceftriaxone (60.9%). Amikacin was the most effective (84.4%) antibiotic against P. aeruginosa followed by imipenem (81.2%), and meropenem (75.0%). K. pneumoniae showed resistance to cephalexin (86.5%), ceftriaxone (75.7%), ceftazidime (73.0%), cefpirome (73.0%) and cefotaxime (67.9%), respectively. Conclusions: Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins, and quinolone antibiotics. Regular surveillance of antibiotic susceptibility patterns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

  12. Clinically significant anaerobic bacteria isolated from patients in a South African academic hospital: antimicrobial susceptibility testing.

    Science.gov (United States)

    Naidoo, S; Perovic, O; Richards, G A; Duse, A G

    2011-09-27

    BACKGROUND. Increasing resistance to some antimicrobial agents among anaerobic bacteria has made susceptibility patterns less predictable. METHOD. This was a prospective study of the susceptibility data of anaerobic organisms isolated from clinical specimens from patients with suspected anaerobic infections from June 2005 until February 2007. Specimens were submitted to the microbiology laboratory at Charlotte Maxeke Johannesburg Academic Hospital, where microscopy, culture and susceptibility testing were performed the using E test® strip minimum inhibitory concentration method. Results were interpreted with reference to Clinical and Laboratory Standards Institute guidelines for amoxicillin-clavulanate, clindamycin, metronidazole, penicillin, ertapenem, cefoxitin, ceftriaxone, chloramphenicol and piperacillin-tazobactam. RESULTS. One hundred and eighty anaerobic isolates were submitted from 165 patients. The most active antimicrobial agents were chloramphenicol (100% susceptible), ertapenem (97.2%), piperacillin-tazobactam (99.4%) and amoxicillin-clavulanic acid (96.7%). Less active were metronidazole (89.4%), cefoxitin (85%), clindamycin (81.7%), ceftriaxone (68.3%) and penicillin (33.3%). CONCLUSION. Susceptibility testing should be performed periodically to identify emerging trends in resistance and to modify empirical treatment of anaerobic infections.

  13. Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015

    Science.gov (United States)

    Grass, Julian; Bicknese, Amelia; Campbell, Davina; Hurd, Jacqueline; Kirkcaldy, Robert D.

    2016-01-01

    Shigella spp. cause ≈500,000 illnesses in the United States annually, and resistance to ciprofloxacin, ceftriaxone, and azithromycin is emerging. We investigated associations between transmission route and antimicrobial resistance among US shigellosis clusters reported during 2011–2015. Of 32 clusters, 9 were caused by shigellae resistant to ciprofloxacin (3 clusters), ceftriaxone (2 clusters), or azithromycin (7 clusters); 3 clusters were resistant to >1 of these drugs. We observed resistance to any of these drugs in all 7 clusters among men who have sex with men (MSM) but in only 2 of the other 25 clusters (p<0.001). Azithromycin resistance was more common among MSM-associated clusters than other clusters (86% vs. 4% of clusters; p<0.001). For adults with suspected shigellosis, clinicians should culture feces; obtain sex histories; discuss shigellosis prevention; and choose treatment, when needed, according to antimicrobial drug susceptibility. Public health interviews for enteric illnesses should encompass sex practices; health messaging for MSM must include shigellosis prevention. PMID:27533624

  14. Elevated Risk for Antimicrobial Drug-Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011-2015.

    Science.gov (United States)

    Bowen, Anna; Grass, Julian; Bicknese, Amelia; Campbell, Davina; Hurd, Jacqueline; Kirkcaldy, Robert D

    2016-09-01

    Shigella spp. cause ≈500,000 illnesses in the United States annually, and resistance to ciprofloxacin, ceftriaxone, and azithromycin is emerging. We investigated associations between transmission route and antimicrobial resistance among US shigellosis clusters reported during 2011-2015. Of 32 clusters, 9 were caused by shigellae resistant to ciprofloxacin (3 clusters), ceftriaxone (2 clusters), or azithromycin (7 clusters); 3 clusters were resistant to >1 of these drugs. We observed resistance to any of these drugs in all 7 clusters among men who have sex with men (MSM) but in only 2 of the other 25 clusters (p<0.001). Azithromycin resistance was more common among MSM-associated clusters than other clusters (86% vs. 4% of clusters; p<0.001). For adults with suspected shigellosis, clinicians should culture feces; obtain sex histories; discuss shigellosis prevention; and choose treatment, when needed, according to antimicrobial drug susceptibility. Public health interviews for enteric illnesses should encompass sex practices; health messaging for MSM must include shigellosis prevention. PMID:27533624

  15. Cephalosporin resistance in Pseudomonas aeruginosa, with special reference to the proposed trapping of antibiotics by beta-lactamase.

    Science.gov (United States)

    Livermore, D M; Williams, J D; Davy, K W

    1985-02-01

    Resistance of Pseudomonas aeruginosa strains to newer cephalosporins is often associated with stable derepression of synthesis of the chromosomal beta-lactamase. Similar resistance is developed by enzyme inducible (i.e. normal) strains in response to beta-lactamase inducers. By comparing the responses of otherwise isogenic P. aeruginosa beta-lactamase inducibility mutants to antipseudomonal cephalosporins alone or in combination with potent beta-lactamase inducers we confirmed that resistance to cefotaxime, ceftriaxone, cefoperazone, and ceftazidime and latamoxef was caused by beta-lactamase action. The low-level resistance to carbenicillin and cefsulodin which was exhibited by some fully beta-lactamase derepressed strains was not confirmed to be beta-lactamase determined and may have reflected concurrent target or permeability changes. The mechanism whereby the enzyme protected the cell against cefotaxime and ceftriaxone was also investigated. These agents are reportedly stable to the enzyme and some workers have suggested that resistance entails their being trapped rather than hydrolysed. However, the use of a novel model of cellular beta-lactamase function indicated that a hydrolytic resistance mechanism remained likely.

  16. Invasive meningococcal disease in the university of Malaya Medical Centre, Kuala Lumpur, Malaysia

    Directory of Open Access Journals (Sweden)

    Raja N

    2006-01-01

    Full Text Available Background: Neisseria meningitidis (N. meningitidis remains the leading worldwide cause of acute bacterial meningitis and fatal sepsis in healthy individuals. Materials and Methods: A total of 12 cases of N. meningitidis from patients with invasive meningococcal infections in University of Malaya Medical Centre, Kuala Lumpur during the years 1987-2004 were reviewed together with details of age, sex, disease, risk factors treatment and outcome of these patients. Results: Their ages ranged from 10 months to 64 years (median age 29.75 years. The male to female ratio was 1.42:1. Fever, neck stiffness, headache, vomiting and confusion were predominant symptoms. Upper respiratory tract viral infection and Hajj pilgrimage were directly associated with invasive meningococcal disease. Penicillin or ceftriaxone or both in some cases were administered as empirical therapy. All isolates were sensitive to penicillin, ceftriaxone, chloramphenicol and rifampicin. The case fatality ratio was 1:4. One Hajj pilgrim died despite having received polyvalent meningococcal vaccine. Amongst the survivors, two patients had neurological deficit, hearing loss and arthritis. Conclusion: Early antimicrobial therapy has been shown to reduce these adverse outcomes. Clinicians need to be alerted to the presence of the disease in the community and the disease should be made notifiable within 24 hours of detection both for early treatment of cases and to facilitate contact tracing, institution of prophylactic treatment and prevention of secondary cases.

  17. Antimicrobial susceptibility/resistance and molecular epidemiological characteristics of Neisseria gonorrhoeae in 2009 in Belarus.

    Science.gov (United States)

    Glazkova, Slavyana; Golparian, Daniel; Titov, Leonid; Pankratova, Nataliya; Suhabokava, Nataliya; Shimanskaya, Irina; Domeika, Marius; Unemo, Magnus

    2011-08-01

    Increased antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global concern, and ultimately gonorrhoea may become untreatable. Nonetheless, AMR data from East-Europe are scarce beyond Russia, and no AMR data or other characteristics of gonococci have been reported from Belarus for more than 20 years. The aim was to describe the prevalence of AMR, and report molecular epidemiological characteristics of gonococci circulating in 2009 in Belarus. In a sample of 80 isolates, resistance prevalences to antimicrobials used for gonorrhoea treatment in Belarus were: Ceftriaxone 0%, spectinomycin 0%, azithromycin 17.3%, tetracycline 25.9%, ciprofloxacin 34.6% and erythromycin 59.2%. The isolates displayed no penA mosaic alleles, 38 porB gene sequences and 35 N. gonorrhoeae multiantigen sequence types, of which 20 have not been described before worldwide. Due to the high levels of antimicrobial resistance, only ceftriaxone and spectinomycin can be recommended for empirical treatment of gonorrhoea in Belarus according to WHO recommendations. Continuous gonococcal AMR surveillance in Eastern Europe is crucial. This is now initiated in Belarus using WHO protocols.

  18. Valutazione farmacoeconomica di una casistica di pazienti con riacutizzazione di bronchite cronica

    Directory of Open Access Journals (Sweden)

    M. Liconti

    2001-09-01

    Full Text Available Aim of this study is to operate a pharmaeconomical evaluation on case histories of patients affected by chronic bronchitis relapse, comparing the effectiveness of different molecules with antibiotic activity and the total cost far each considered drogo. The observational retrospective study has been conducted at the Bronchopncumology Depaliment of the E. Morelli Hospital (Reggio Calabria on 344 patients aftècted by acute infective or chronic relapsed bronchopneumopaties between January, the 1st, 1997 and December, the 31th 1999. To avoid excessive data dispersal, the study considered only the active principles prescribed to at least 50 persons: ceftazidime, ceftriaxone, cefepime and piperacilline + tazobactam. AlI the patients have responded positively to the treatment, so the cost minimization analysis has been carried out far every dosage regimen, considering different parameters: nursing staff costs, consumable material and drug costs. The Prescribed Daily Dose (PDD has been taken as unit of measurement for drug costs. The single adminstration cost is based on nursing costs and consumable material costs. To get the total therapy cost, it’s necessary to add the single administration drug costo. In this study, the lowest total cost is guaranteed by treatment with ceftriaxone.

  19. Recent Sensitivity Pattern of Escherichia Coli in Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    R Nalini

    2014-06-01

    Full Text Available The objective of the study is to assess the recent sensitivity pattern of Escherichia coli in Urinary tract infection (UTI.Widespread use of antibiotics has led to the emergence of resistant microorganisms. As the antibiotic sensitivity patterns of the microorganisms are frequently changing, this retrospective analysis was designed to assess the recent antibiotic sensitivity pattern of Escherichia coli (E.coli in urinary tract infection among the human population. Details of 412 urine culture positive reports for E.coli and their antibiotic sensitivity pattern pertaining to the study period of 12months from June 2012 to May 2013 were collected from Central Microbiology Laboratory of Tirunelveli Medical College and the results were statistically analysed. The antibiotics tested for sensitivity were Amikacin, Gentamycin, Ciprofloxacin, Cotrimoxazole, Nitrofurantoin, Ceftazidime, Ceftriaxone and Cefotaxime. The sensitivity pattern of E.coli to antibiotics in UTI were Nitrofurantoin (85.19%, Amikacin (66.50%, Co-trimoxazole(31.31%, Gentamycin (26.90%, Ceftazidime (26.69% ,Ciprofloxacin (22.57%, Cefotaxime (22.30%, Ceftriaxone (17.47%. The study highlighted the re-emergence of E. coli sensitive to Nitrofurantoin and marked resistance of E.coli to Aminoglycoside and third generation Cephalosporins.

  20. Identification of Antibiotic Use Pattern as an Effort to Control Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Ivan S. Pradipta

    2012-03-01

    Full Text Available The objective of this study is to determine quantity and pattern of antibiotic use in hospitalized patients at one of Bandung’s private hospital that can give benefit in control of antibiotic resistance and procurement planning of antibiotic. Data of antibiotic consumption were obtained from hospital pharmacy department on February–September 2011. Data were processed using the ATC/DDD and DU90% method. There were 390,98 DDD/100 bed days and 381,34 DDD/100 bed days total of an-tbiotic use in 2009 and 2010. Thirty nine antibiotic were consumed in 2009 within 11 kind of antibiotics in DU90% segment (ceftriaxone, amoxicillin, cefotaxime, ciprofloxacin, levofloxacin, metronidazole, cefixime, doxycycline, thiamphenicol, cefodoxime, cefalexin and 44 antibiotic were consumed in 2010 within 18 kind of antibiotics in DU90% segment (ceftriaxone, ciprofloxacin, amoxicillin, cefixime, levofloxacin, cefadroxil, cefotaxime, metronidazole, thiamphenicol, doxycycline, clindamycin, chloramphenicol, amikacin, sulbactam, gentamycin, streptomycin, cefoperazone, canamycin. There were decline of antibiotic use that followed decline number of bed days/year in 2009–2010, but in both antibiotic kind and quantity of DU90% antibiotic group were increased.

  1. Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Angelina Maria Martins Lino

    2014-03-01

    Full Text Available Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF, intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks and doxycycline (200 mg/day/2 mo was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome.

  2. Assessment of Treatment of Community Acquired Severe Pneumonia by Two Different Antibiotics

    Science.gov (United States)

    Bilal, Jalal Ali; Eldouch, Widad; Abdin, Ali

    2016-01-01

    Introduction Pneumonia is common presentation in the emergency room and is still a cause of morbidity and mortality. The rationale of this study was to test the trend of paediatricians to achieve rapid response facing severe pneumonia, the lack of agreed on plan for the management of community acquired pneumonia (CAP) and the few experiences regarding injectable form of β-lactam antimicrobial. Materials and Methods This is a prospective case control study, purposive randomized sampling, three patients were excluded since their information was incomplete, 132 patients were randomly divided into groups, one group named control group (penicillin according to the guidelines of WHO 2013), 33 patients; second group treated by β-lactam inhibitors (Augmentin IV) 50 patients; and third group treated by 3rd generation cephalosporin (ceftriaxone) 49 patients. The study was conducted at the main tertiary care and paediatrics teaching hospital in Khartoum capital of Sudan. The study was completed within the duration from 2010 to 2011. Results Both group showed more or less similar results regarding response, as well as the failure rate however, the Augmentin and ceftriaxone groups showed a little bit better survival than the control group. Conclusion Antibiotics decrease the mortality rate among the pneumonia patients provided that it is given early in the disease. PMID:27437318

  3. ANTIBIOTIC RESISTANCE OF ESCHERICHIA COLI ISOLATED FROM UKRAINIAN BETULA VERRUCOSA EHRH. POLLEN AFTER MICROBIOLOGICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    Tetiana Shevtsova

    2013-08-01

    Full Text Available Seven samples of silver birch pollen from different habitat of Ukraine were investigated in order to estimate their contamination with the Enterobacteriaceae family, anaerobic bacteria and fungi. Also resistance of 108 strains of Escherichia coli isolated from seven samples of Ukrainian Betula verrucosa Ehrh. pollen against 5 antibiotics: ampicillin, chloramphenicol, meropenem, ceftriaxone and ofloxacin were determined. Disc diffusion method was used for antibiotic suceptibility testing according to EUCAST 2012. It is established the concentrations of enterobacteria ranged from 0.00 to 4.16 log cfu/g, of anaerobic bacteria – 2.48 to 4.90 log cfu/g and concentration of fungi ranged from 2.48 to 4.14 log cfu/g. Degree of pollen contamination is different depending on the habitats. The resistance of E. coli isolates was determined against ampicillin, chloramphenicol, meropenem and ofloxacin. But intermediate resistance in the 33.3% of E. coli isolates and susceptibility in the 8.3% to ceftriaxone was found out. Antibiotic resistance was evaluated for all samples of pollen in whole.

  4. Antibiotic resistance in Neisseria gonorrhoeae: origin, evolution, and lessons learned for the future.

    Science.gov (United States)

    Unemo, Magnus; Shafer, William M

    2011-08-01

    The strict human pathogen Neisseria gonorrhoeae has caused gonorrhea for thousands of years, and currently gonorrhea is the second most prevalent bacterial sexually transmitted infection worldwide. Given the ancient nature of N. gonorrhoeae and its unique obligate relationship with humankind over the millennia, its remarkable ability to adapt to the host immune system and cause repeated infections, and its propensity to develop resistance to all clinically useful antibiotics, the gonococcus is an ideal pathogen on which to study the evolution of bacterial pathogenesis, including antimicrobial resistance, over the long term and within the host during infection. Recently, the first gonococcus displaying high-level resistance to ceftriaxone, identified in Japan, was characterized in detail. Ceftriaxone is the last remaining option for empirical first-line treatment, and N. gonorrhoeae now seems to be evolving into a true "superbug." In the near future, gonorrhea may become untreatable in certain circumstances. Herein, the history of antibiotics used for treatment of gonorrhea, the evolution of resistance emergence in N. gonorrhoeae, the linkage between resistance and biological fitness of N. gonorrhoeae, lessons learned, and future perspectives are reviewed and discussed. PMID:22239555

  5. Committee Opinion No. 645 Summary: Dual Therapy for Gonococcal Infections.

    Science.gov (United States)

    2016-05-01

    Gonorrhea is the second most commonly reported bacterial sexually transmitted disease in the United States, with an estimated 820,000 new Neisseria gonorrhoeae infections occurring each year. Antimicrobial resistance limits treatment success, heightens the risk of complications, and may facilitate the transmission of sexually transmitted infections. Neisseria gonorrhoeae has developed resistance to the sulfonamides, the tetracyclines, and penicillin. Dual therapy with ceftriaxone and azithromycin remains the only recommended first-line regimen for the treatment of gonorrhea in the United States. Dual therapy with ceftriaxone and azithromycin should be administered together on the same day, preferably simultaneously, and under direct observation. Pregnant women who are infected with N gonorrhoeae should be treated with the recommended dual therapy. A test-of-cure is not needed for individuals diagnosed with uncomplicated urogenital or rectal gonorrhea who are treated with the recommended or alternative regimens. Repeat N gonorrhoeae infection is prevalent among patients who have been diagnosed with and treated for gonorrhea in the preceding several months. Most of these infections result from reinfection; therefore, clinicians should advise patients with gonorrhea to be retested 3 months after treatment. Pregnant women with antenatal gonococcal infection should be retested in the third trimester unless recently treated. PMID:27548417

  6. Committee Opinion No. 645: Dual Therapy for Gonococcal Infections.

    Science.gov (United States)

    2016-05-01

    Gonorrhea is the second most commonly reported bacterial sexually transmitted disease in the United States, with an estimated 820,000 new Neisseria gonorrhoeae infections occurring each year. Antimicrobial resistance limits treatment success, heightens the risk of complications, and may facilitate the transmission of sexually transmitted infections. Neisseria gonorrhoeae has developed resistance to the sulfonamides, the tetracyclines, and penicillin. Dual therapy with ceftriaxone and azithromycin remains the only recommended first-line regimen for the treatment of gonorrhea in the United States. Dual therapy with ceftriaxone and azithromycin should be administered together on the same day, preferably simultaneously, and under direct observation. Pregnant women who are infected with N gonorrhoeae should be treated with the recommended dual therapy. A test-of-cure is not needed for individuals diagnosed with uncomplicated urogenital or rectal gonorrhea who are treated with the recommended or alternative regimens. Repeat N gonorrhoeae infection is prevalent among patients who have been diagnosed with and treated for gonorrhea in the preceding several months. Most of these infections result from reinfection; therefore, clinicians should advise patients with gonorrhea to be retested 3 months after treatment. Pregnant women with antenatal gonococcal infection should be retested in the third trimester unless recently treated. PMID:27548425

  7. Prevalence and Antimicrobial Susceptibility of Coagulase-Negative Staphylococci isolated from Bovine Mastitis

    Directory of Open Access Journals (Sweden)

    Kaliwal B.B.

    2011-08-01

    Full Text Available The study was carried out to investigate the prevalence and antimicrobial susceptibility of Coagulase-Negative Staphylococci isolated from Bovine Mastitis in and around Dharwad region. A total of 310 samples were screened and 180 confirmed Coagulase-Negative Staphylococci were obtained. The antimicrobial susceptibility of Coagulase-Negative Staphylococci against 10 antimicrobial agents was tested using the disc diffusion method. The highest numbers of Coagulase-Negative Staphylococci were susceptible to ceftriaxone 83.88% followed by cefotaxime 79.41%, methicillin 76.47%, ciprofloxacin 73.52%, erythromycin 70.05%, amikacin 66.11%, gentamycin 42.94%, amoxicillin 36.76%, ampicillin 29.41%, and the lowest susceptibility was shown in penicillin 23.23% . The results indicated that the increase in prevalence and antibiotic resistance pattern of the Coagulase-Negative Staphylococci isolated from bovine mastitis exhibited the highest degree of susceptible to ceftriaxone of all the tested antimicrobial agents. [Vet. World 2011; 4(4.000: 158-161

  8. Inhibition of Phosphodiesterase-4 during Pneumococcal Pneumonia Reduces Inflammation and Lung Injury in Mice.

    Science.gov (United States)

    Tavares, Luciana P; Garcia, Cristiana C; Vago, Juliana P; Queiroz-Junior, Celso M; Galvão, Izabela; David, Bruna A; Rachid, Milene A; Silva, Patrícia M R; Russo, Remo C; Teixeira, Mauro M; Sousa, Lirlândia P

    2016-07-01

    Pneumococcal pneumonia is a leading cause of mortality worldwide. The inflammatory response to bacteria is necessary to control infection, but it may also contribute to tissue damage. Phosphodiesterase-4 inhibitors, such as rolipram (ROL), effectively reduce inflammation. Here, we examined the impact of ROL in a pneumococcal pneumonia murine model. Mice were infected intranasally with 10(5)-10(6) CFU of Streptococcus pneumoniae, treated with ROL in a prophylactic or therapeutic schedule in combination, or not, with the antibiotic ceftriaxone. Inflammation and bacteria counts were assessed, and ex vivo phagocytosis assays were performed. ROL treatment during S. pneumoniae infection decreased neutrophil recruitment into lungs and airways and reduced lung injury. Prophylactic ROL treatment also decreased cytokine levels in the airways. Although modulation of inflammation by ROL ameliorated pneumonia, bacteria burden was not reduced. On the other hand, antibiotic therapy reduced bacteria without reducing neutrophil infiltration, cytokine level, or lung injury. Combined ROL and ceftriaxone treatment decreased lethality rates and was more efficient in reducing inflammation, by increasing proresolving protein annexin A1 (AnxA1) expression, and bacterial burden by enhancing phagocytosis. Lack of AnxA1 increased inflammation and lethality induced by pneumococcal infection. These data show that immunomodulatory effects of phosphodiesterase-4 inhibitors are useful during severe pneumococcal pneumonia and suggest their potential benefit as adjunctive therapy during infectious diseases. PMID:26677751

  9. Clinical outcome of pneumococcal meningitis during the emergence of pencillin-resistant Streptococcus pneumoniae: an observational study

    Directory of Open Access Journals (Sweden)

    Gouveia Edilane L

    2011-11-01

    Full Text Available Abstract Background Prior to the availability of generic third-generation cephalosporins, penicillins were widely used for treatment of pneumococcal meningitis in developing countries despite concerns about rising levels of penicillin resistance among pneumococcal isolates. We examined the impact of penicillin resistance on outcomes of pneumococcal meningitis over a ten year period in an infectious diseases hospital in Brazil. Methods Clinical presentation, antimicrobial therapy and outcomes were reviewed for 548 patients with culture-confirmed pneumococcal meningitis from December, 1995, to November, 2005. Pneumococcal isolates from meningitis patients were defined as penicillin-resistant if Minimum Inhibitory Concentrations for penicillin were greater than 0.06 μg/ml. Proportional hazards regression was used to identify risk factors for fatal outcomes. Results During the ten-year period, ceftriaxone replaced ampicillin as first-line therapy for suspected bacterial meningitis. In hospital case-fatality for pneumococcal meningitis was 37%. Of 548 pneumococcal isolates from meningitis cases, 92 (17% were resistant to penicillin. After controlling for age and severity of disease at admission, penicillin resistance was associated with higher case-fatality (Hazard Ratio [HR], 1.62; 95% Confidence Interval [CI], 1.08-2.43. Penicillin-resistance remained associated with higher case-fatality when initial therapy included ceftriaxone (HR, 1.68; 95% CI 1.02-2.76. Conclusions Findings support the use of third generation cephalosporin antibiotics for treatment of suspected pneumococcal meningitis even at low prevalence of pneumococcal resistance to penicillins.

  10. Urinary Tract Infection: Analysis of Prescribing Pattern of Antibiotics

    Directory of Open Access Journals (Sweden)

    MAHADEVAMMA L

    2012-03-01

    Full Text Available Antibiotics are one of most common drugs prescribed in hospital today. It has been estimated that up to onethird of all patients receive at least one antibiotics during hospitalization`. The cost involved is therefore correspondingly high and up to 40% of a hospital’s drug expenditure may be devoted to the purchase of antibiotics1. The objective of this study was to analyze the prescribing pattern of antibiotics in Urinary Tract Infection (UTI. A prospective cross sectional and observational study was conducted on patients diagnosed with UTI. The study was carried out in the OBG and Urology departments of both in-patients and out-patients, for a period of 5 months (Aug 2011 to Dec 2011. Patients diagnosed with UTI and who were above age group of 15-years were included in the study. A suitable data collection form was prepared to collect the required data. Among 162 patents, 54 were in-patients and 108 were out-patients. Most of the in-patients were prescribed with Ciprofloxacin 13(22.8%, and Ceftriaxone 19(33.3%. In out-patients, Ciprofloxacin 25(23.8%, Norfloxacin 15(14.3% and Ceftriaxone 14(13.3% were prescribed frequently. The study found that gram negative organisms like E. coli and Klebsills was the most predominant organisms associated with infection. It was also found that Cephalosporin's were most commonly used and Quinolones were the second most commonly used drugs for the treatment of UTI.

  11. Proteochemometric model for predicting the inhibition of penicillin-binding proteins.

    Science.gov (United States)

    Nabu, Sunanta; Nantasenamat, Chanin; Owasirikul, Wiwat; Lawung, Ratana; Isarankura-Na-Ayudhya, Chartchalerm; Lapins, Maris; Wikberg, Jarl E S; Prachayasittikul, Virapong

    2015-02-01

    Neisseria gonorrhoeae infection threatens to become an untreatable sexually transmitted disease in the near future owing to the increasing emergence of N. gonorrhoeae strains with reduced susceptibility and resistance to the extended-spectrum cephalosporins (ESCs), i.e. ceftriaxone and cefixime, which are the last remaining option for first-line treatment of gonorrhea. Alteration of the penA gene, encoding penicillin-binding protein 2 (PBP2), is the main mechanism conferring penicillin resistance including reduced susceptibility and resistance to ESCs. To predict and investigate putative amino acid mutations causing β-lactam resistance particularly for ESCs, we applied proteochemometric modeling to generalize N. gonorrhoeae susceptibility data for predicting the interaction of PBP2 with therapeutic β-lactam antibiotics. This was afforded by correlating publicly available data on antimicrobial susceptibility of wild-type and mutant N. gonorrhoeae strains for penicillin-G, cefixime and ceftriaxone with 50 PBP2 protein sequence data using partial least-squares projections to latent structures. The generated model revealed excellent predictability (R2=0.91, Q2=0.77, QExt2=0.78). Moreover, our model identified amino acid mutations in PBP2 with the highest impact on antimicrobial susceptibility and provided information on physicochemical properties of amino acid mutations affecting antimicrobial susceptibility. Our model thus provided insight into the physicochemical basis for resistance development in PBP2 suggesting its use for predicting and monitoring novel PBP2 mutations that may emerge in the future. PMID:25344841

  12. Genetic Resistance Determinants, In Vitro Time-Kill Curve Analysis and Pharmacodynamic Functions for the Novel Topoisomerase II Inhibitor ETX0914 (AZD0914) in Neisseria gonorrhoeae.

    Science.gov (United States)

    Foerster, Sunniva; Golparian, Daniel; Jacobsson, Susanne; Hathaway, Lucy J; Low, Nicola; Shafer, William M; Althaus, Christian L; Unemo, Magnus

    2015-01-01

    Resistance in Neisseria gonorrhoeae to all available therapeutic antimicrobials has emerged and new efficacious drugs for treatment of gonorrhea are essential. The topoisomerase II inhibitor ETX0914 (also known as AZD0914) is a new spiropyrimidinetrione antimicrobial that has different mechanisms of action from all previous and current gonorrhea treatment options. In this study, the N. gonorrhoeae resistance determinants for ETX0914 were further described and the effects of ETX0914 on the growth of N. gonorrhoeae (ETX0914 wild type, single step selected resistant mutants, and efflux pump mutants) were examined in a novel in vitro time-kill curve analysis to estimate pharmacodynamic parameters of the new antimicrobial. For comparison, ciprofloxacin, azithromycin, ceftriaxone, and tetracycline were also examined (separately and in combination with ETX0914). ETX0914 was rapidly bactericidal for all wild type strains and had similar pharmacodynamic properties to ciprofloxacin. All selected resistant mutants contained mutations in amino acid codons D429 or K450 of GyrB and inactivation of the MtrCDE efflux pump fully restored the susceptibility to ETX0914. ETX0914 alone and in combination with azithromycin and ceftriaxone was highly effective against N. gonorrhoeae and synergistic interaction with ciprofloxacin, particularly for ETX0914-resistant mutants, was found. ETX0914, monotherapy or in combination with azithromycin (to cover additional sexually transmitted infections), should be considered for phase III clinical trials and future gonorrhea treatment. PMID:26696986

  13. A method for determining the free (unbound) concentration of ten beta-lactam antibiotics in human plasma using high performance liquid chromatography with ultraviolet detection.

    Science.gov (United States)

    Briscoe, Scott E; McWhinney, Brett C; Lipman, Jeffrey; Roberts, Jason A; Ungerer, Jacobus P J

    2012-10-15

    With the clinical imperative to further research in the area of optimising antibiotic dosing in the intensive care setting, a simple high performance liquid chromatography method was developed and validated for routinely determining the free (unbound) concentration of ten beta-lactam antibiotics in 200 μL of human plasma. Antibiotics determined include three cephalosporins (ceftriaxone, cephazolin and cephalotin); two carbapenems (meropenem and ertapenem); and five penicillins (ampicillin, piperacillin, benzylpenicillin, flucloxacillin and dicloxacillin). There was a single common sample preparation method involving ultracentrifugation and stabilisation. Chromatography was performed on a Waters XBridge C18 column with, depending on analytes, one of four acetonitrile-phosphate buffered mobile phases. Peaks of interest were detected via ultraviolet absorbance at 210, 260 and 304 nm. The method has been validated and used in a pathology laboratory for therapeutic drug monitoring in critically ill patients. The significant variability in the level of protein binding that is common with antibiotics traditionally considered to have high protein binding (e.g. ceftriaxone, cephazolin, ertapenem, flucloxacillin and dicloxacillin) suggests that this assay should be preferred for measuring the pharmacologically active concentration of beta-lactam antibiotics in a therapeutic drug monitoring programme. PMID:23026224

  14. Antibiogram pattern of bacteria causing endometritis in cows

    Directory of Open Access Journals (Sweden)

    S. Udhayavel

    2013-04-01

    Full Text Available Aim : To find out the organisms causing endometritis in cattle and to determine their in vitro sensitivity to various antibiotics Materials and methods: Thirty uterine secretion samples, 9 from Holstein Friesian and 21 from Jersey cows were collected in and around Namakkal district of Tamil Nadu from clinical cases of endometritis. The bacteria isolated both aerobically and anaerobically from endometritis showed the characteristic colony, were gram stained and confirmed by standard biochemical tests. The invitro antibiotic sensitivity test with different antibiotic discs were carried out. Results and Discussion: Out of 30 samples, 25 contained different strains of bacteria and 5 were found bacteriologically sterile. Different species of bacteria isolated from these samples were, Escherichia coli (36.66%, Klebsiella spp (30%, Proteus spp (13.33%, Pseudomonas aeruginosa (6.66%, Clostridium spp (3.33%. The in vitro antibiotic sensitivity test indicated that the highest number of isolates (64% were sensitive to Ceftriaxone, followed by Gentamicin, Enrofloxacin and Chlortetracycline (32%. Chloramphenicol showed sensitivity in minimum number (8% of isolates. Conclusion : This study revealed that the bacteria E.coli and Klebisella spp are more commonly isolated in endometritis in cows and the drug Ceftriaxone is highly effective. [Vet World 2013; 6(2.000: 100-102

  15. Molecular epidemiology of nontypeable Haemophilus influenzae causing community-acquired pneumonia in adults.

    Directory of Open Access Journals (Sweden)

    Carmen Puig

    Full Text Available Nontypeable Haemophilus influenzae (NTHi is an opportunistic pathogen which causes a variety of respiratory infections. The objectives of the study were to determine its antimicrobial susceptibility, to characterize the β-lactam resistance, and to establish a genetic characterization of NTHi isolates. Ninety-five NTHi isolates were analyzed by pulsed field gel electrophoresis (PFGE and multi locus sequence typing (MLST. Antimicrobial susceptibility was determined by microdilution, and the ftsI gene (encoding penicillin-binding protein 3, PBP3 was PCR amplified and sequenced. Thirty (31.6% isolates were non-susceptible to ampicillin (MIC ≥ 2 mg/L, with 10 of them producing β-lactamase type TEM-1 as a resistance mechanism. After ftsI sequencing, 39 (41.1% isolates showed amino acid substitutions in PBP3, with Asn526 → Lys being the most common (69.2%. Eighty-four patients were successfully treated with amoxicillin/clavulanic acid, ceftriaxone and levofloxacin. Eight patients died due either to aspiration or complication of their comorbidities. In conclusion, NTHi causing CAP in adults shows high genetic diversity and is associated with a high rate of reduced susceptibility to ampicillin due to alterations in PBP3. The analysis of treatment and outcomes demonstrated that NTHi strains with mutations in the ftsI gene could be successfully treated with ceftriaxone or fluoroquinolones.

  16. The relationship between antimicrobial consumption and the rates of resistance of Klebsiela pneumoniae in respiratory unit

    Institute of Scientific and Technical Information of China (English)

    YANG Xin-yun; ZHUO Chao; XIAO Xiang-lin; YUAN Jin-Ping; YANG Ling

    2008-01-01

    Objective To investigate the relationship between the consumption of antibacterial agents and resistance rate of Klebsiela pneumoniae(KP)in the hospital respiratory unit for 3 consecutive years in 2005-2007. Methods The total antibacterial consumption expressed as defined DDDs/100BD, as well as resistance rate of total KP and producing ESBLs KP were collected, and their correlation was analyzed. Results The rate of resistance of KP to cefoperazone/sulbactam, Cefepime, Imipenem, Moxifloxacin was significantly positively associated with the consumption of Cefotaxime, Ceftazidime, Moxifloxacin, Amikacin respectively;A significant positive association was observed between the rate of resistance of KP to Piperacillin/Tazobactam, Ceftriaxone and the consumption of Imipenem; The rate of resistance of KP to Piperacillin, Cefotaxime, Ciprofloxacin was significantly positively associated with the consumption of Levofloxacin. ESBLs producing bacilli of KP were detected in 44 of 75 isolates (58.7%), The rate of resistance of producing ES-BLs KP to Piperacillin/Tazobactarn, Ceftriaxone was significantly positively associated with the consumption of Imipenem, Ceftazidime; A significant positive association was observed between the rate of resistance of producing ESBLs KP to Piperacillin, Imipenem and the consumption of Moxifloxacin. There was no significant correlation in other drugs. Conclusions A relationship existed between antimicrobial consumption and rates of resistance of KP in the hospital respiratory unit. We must use antibiotics carefully and with reason to control and lessen the drug resistance of bacterial.

  17. Genetic resistance determinants, in vitro time-kill curve analysis and pharmacodynamic functions for the novel topoisomerase II inhibitor ETX0914 (AZD0914 in Neisseria gonorrhoeae

    Directory of Open Access Journals (Sweden)

    Sunniva eFoerster

    2015-12-01

    Full Text Available Resistance in Neisseria gonorrhoeae to all available therapeutic antimicrobials has emerged and new efficacious drugs for treatment of gonorrhea are essential. The topoisomerase II inhibitor ETX0914 (also known as AZD0914 is a new spiropyrimidinetrione antimicrobial that has different mechanisms of action from all previous and current gonorrhea treatment options. In this study, the N. gonorrhoeae resistance determinants for ETX0914 were further described and the effects of ETX0914 on the growth of N. gonorrhoeae (ETX0914 wild type, single step selected resistant mutants, and efflux pump mutants were examined in a novel in vitro time-kill curve analysis to estimate pharmacodynamic parameters of the new antimicrobial. For comparison, ciprofloxacin, azithromycin, ceftriaxone, and tetracycline were also examined (separately and in combination with ETX0914. ETX0914 was rapidly bactericidal for all wild type strains and had similar pharmacodynamic properties to ciprofloxacin. All selected resistant mutants contained mutations in amino acid codons D429 or K450 of GyrB and inactivation of the MtrCDE efflux pump fully restored the susceptibility to ETX0914. ETX0914 alone and in combination with azithromycin and ceftriaxone was highly effective against N. gonorrhoeae and synergistic interaction with ciprofloxacin, particularly for ETX0914-resistant mutants, was found. ETX0914, monotherapy or in combination with azithromycin (to cover additional sexually transmitted infections, should be considered for phase III clinical trials and future gonorrhea treatment.

  18. Antibiotic resistance of Neisseria gonorrhoeae isolated from gonorrhoeae patients

    Directory of Open Access Journals (Sweden)

    Mohammad Bokaeian

    2010-06-01

    Full Text Available Background: The objective of this study was to determine antibiotic susceptibility and penicillinase production by Neisseria gonorrhoeae strains isolated from gonorrhoeae patients in Zahedan.Materials and methods: In a descriptive study during 2005-2008 years, 400 suspected patients were studied by history review, medical examination, gram staining and culture in Thayer-Martin medium. Antibiotic susceptibility and penicillinase tests of isolated strains were done by disk diffusion method and aciodometric method, respectively.Results: Cultures were positive in 77(19.2% patients. The resistanat rate against antibiotics were as follow: penicillin (79.2%, ciprofloxacin (53.2%, ceftriaxone(3.8%, spectinomycin(2.5%, cefixime(12.9%, co-trimoxazole(93.5%, tetracycline(88.3% and gentamicin(29.8%. In the meanwhile, 83.1 percent of penicillin resistant isolates produced penicillinase enzyme. Discussion: Ceftriaxone, spectinomycin and cefixime are the sole antibiotics that could be considered as selective drugs. Quinolones which were regarded as an effective group of antibiotics recently have lost their importance. Resistance against other antibiotics is rapidly developing, thus, conducting experimental tests and determination of minimum inhibitory concentration and clinical trial studies at fixed intervals can contribute to diagnosis of resistance of gonococci and rapid and successful treatment of their infections in Zahedan region.

  19. [MOLECULAR MECHANISMS OF DRUG RESISTANCE NEISSERIA GONORRHOEAE HISTORY AND PROSPECTS].

    Science.gov (United States)

    Bodoev, I N; Il'ina, E N

    2015-01-01

    Neisseria gonorrhoeae (gonococcus) is a strict human pathogen, which causes gonorrhea--an infectious disease, whose origin dates back to more than two thousand years. Due to the unique plasticity of the genetic material, these bacteria have acquired the capacity to adapt to the host immune system, cause repeated infections, as well as withstand antimicrobials. Since the introduction of antibiotics in 1930s, gonococcus has displayed its propensity to develop resistance to all clinically useful antibiotics. It is important to note that the known resistance determinants of N. gonorrhoeae were acquired through horizontal gene transfer, recombination and spontaneous mutagenesis, and may be located both in the chromosome and on the plasmid. After introduction of a new antimicrobial drug, gonococcus becomes resistant within two decades and replaces sensitive bacterial population. Currently Ceftriaxone is the last remaining antibiotic for first-line treatment of gonorrhea. However, the first gonococcus displaying high-level resistance to Ceftriaxone was isolated in Japan a few years ago. Therefore, in the near future, gonorrhea may become untreatable. In the present review, we discuss the chronology of the anti-gonorrhea drugs (antibiotics) replacement, the evolution of resistance mechanisms emergence and future perspectives of N. gonorrhoeae treatment.

  20. The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013.

    Science.gov (United States)

    Hamasuna, Ryoichi; Yasuda, Mitsuru; Ishikawa, Kiyohito; Uehara, Shinya; Hayami, Hiroshi; Takahashi, Satoshi; Matsumoto, Tetsuro; Yamamoto, Shingo; Minamitani, Shinichi; Watanabe, Akira; Iwata, Satoshi; Kaku, Mitsuo; Kadota, Junichi; Sunakawa, Keisuke; Sato, Junko; Hanaki, Hideaki; Tsukamoto, Taiji; Kiyota, Hiroshi; Egawa, Shin; Tanaka, Kazushi; Arakawa, Soichi; Fujisawa, Masato; Kumon, Hiromi; Kobayashi, Kanao; Matsubara, Akio; Naito, Seiji; Kuroiwa, Kentaro; Hirayama, Hideo; Narita, Harunori; Hosobe, Takahide; Ito, Shin; Ito, Kenji; Kawai, Shuichi; Ito, Masayasu; Chokyu, Hirofumi; Matsumura, Masaru; Yoshioka, Masaru; Uno, Satoshi; Monden, Koichi; Takayama, Kazuo; Kaji, Shinichi; Kawahara, Motoshi; Sumii, Toru; Kadena, Hitoshi; Yamaguchi, Takamasa; Maeda, Shinichi; Nishi, Shohei; Nishimura, Hirofumi; Shirane, Takeshi; Yoh, Mutsumasa; Akiyama, Kikuo; Imai, Toshio; Kano, Motonori

    2015-05-01

    Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml.

  1. Genetic Resistance Determinants, In Vitro Time-Kill Curve Analysis and Pharmacodynamic Functions for the Novel Topoisomerase II Inhibitor ETX0914 (AZD0914) in Neisseria gonorrhoeae

    Science.gov (United States)

    Foerster, Sunniva; Golparian, Daniel; Jacobsson, Susanne; Hathaway, Lucy J.; Low, Nicola; Shafer, William M.; Althaus, Christian L.; Unemo, Magnus

    2015-01-01

    Resistance in Neisseria gonorrhoeae to all available therapeutic antimicrobials has emerged and new efficacious drugs for treatment of gonorrhea are essential. The topoisomerase II inhibitor ETX0914 (also known as AZD0914) is a new spiropyrimidinetrione antimicrobial that has different mechanisms of action from all previous and current gonorrhea treatment options. In this study, the N. gonorrhoeae resistance determinants for ETX0914 were further described and the effects of ETX0914 on the growth of N. gonorrhoeae (ETX0914 wild type, single step selected resistant mutants, and efflux pump mutants) were examined in a novel in vitro time-kill curve analysis to estimate pharmacodynamic parameters of the new antimicrobial. For comparison, ciprofloxacin, azithromycin, ceftriaxone, and tetracycline were also examined (separately and in combination with ETX0914). ETX0914 was rapidly bactericidal for all wild type strains and had similar pharmacodynamic properties to ciprofloxacin. All selected resistant mutants contained mutations in amino acid codons D429 or K450 of GyrB and inactivation of the MtrCDE efflux pump fully restored the susceptibility to ETX0914. ETX0914 alone and in combination with azithromycin and ceftriaxone was highly effective against N. gonorrhoeae and synergistic interaction with ciprofloxacin, particularly for ETX0914-resistant mutants, was found. ETX0914, monotherapy or in combination with azithromycin (to cover additional sexually transmitted infections), should be considered for phase III clinical trials and future gonorrhea treatment. PMID:26696986

  2. Antibiotic Susceptibilities and Serotyping of Clinical Streptococcus Agalactiae Isolates

    Directory of Open Access Journals (Sweden)

    Altay Atalay

    2011-11-01

    Full Text Available Objective: Streptococcus agalactiae (Group B streptococci, GBS are frequently responsible for sepsis and meningitis seen in the early weeks of life. GBS may cause perinatal infection and premature birth in pregnant women. The aim of this study was to serotype GBS strains isolated from clinical samples and evaluate their serotype distribution according to their susceptibilities to antibiotics and isolation sites. Material and Methods: One hundred thirty one S. agalactiae strains isolated from the clinical samples were included in the study. Of the strains, 99 were isolated from urine, 20 from soft tissue, 10 from blood and 2 from vaginal swab. Penicillin G and ceftriaxone susceptibilities of GBS were determined by the agar dilution method. Susceptibilities to erythromycin, clindamycin, vancomycin and tetracycline were determined by the Kirby-Bauer method according to CLSI criteria. Serotyping was performed using the latex aglutination method using specific antisera (Ia, Ib, II-VIII. Results: While in 131 GBS strains, serotypes VII and VIII were not detected, the most frequently isolated serotypes were types Ia (36%, III (30.5% and II (13% respectively. Serotype Ia was the most frequently seen serotype in all samples. All GBS isolates were susceptible to penicilin G, ceftriaxone and vancomycin. Among the strains, tetracycline, erythromycin and clindamycin resistance rates were determined as 90%, 14.5%, and 13% respectively. Conclusion: Penicillin is still the first choice of treatment for the infections with all serotypes of S. agalactiae in Turkey.

  3. Surveillance on antibiotic susceptibility of Neisseria gonorrhoeae in Shenzhen from 2008 to 2011%深圳地区2008~2011年淋球菌抗菌药物敏感性监测

    Institute of Scientific and Technical Information of China (English)

    张丽君; 王峰; 彭毅; 桂静; 莫俊銮

    2013-01-01

    OBJECTIVE To investigate the antibiotic susceptibility, resistance trends and popular features of clinical N. gonor-rhbeae isolates from 2008 to 2011 in Shenzhen area. METHODS 732 N.gonorrhoeae strains and informations of the patients were collected. The agar-dilution method was used to determine the minimum inhibitory concentration (MIC) of three antibiotics including Ciprofloxacin, Ceftriaxone and Spectinomycin. Penicillinase-producing N. gonorrhoeae was determined by cephalosporin paper. RESULTS Of the total 732 strains, 712 strains (97.3%) showed resistance to Ciprofloxacin. The resistant rate to Ciprofloxacin was more than 95% each year. All these isolates were susceptible to Ceftriaxone and Spectinomycin. But there were 163 strains (22.3%) with reduced susceptibility to Ceftriaxone. The proportion of the strains with reduced susceptibility to Ceftriaxone was the highest in 2008, then declined, remained at around 20%. 250 strains (35.71%) produced β-lactamase. MIC50 and MIC90 of three antimicrobial drugs were 1 -2 dilution increases over the four years. In addition to differences in antibiotic use, 732 cases didn't change significantly in demographic characteristics and the distributions. CONCLUSION From 2008 to 2011, the resistance trend of N. gonorrhoeae didn't increase obviously in Shenzhen. Spectiomycin and ceftriaxone should be used as the first line drugs in treating N. gonorrhoeae. Stability in demographic characteristics and distributions of patients are conducive to prevent and control Neisseria gonorrhoeae effectively.%目的 监测深圳地区2008~2011年淋球菌临床分离株对抗生素的敏感性,了解淋球菌的耐药趋势及流行特点.方法 收集淋球菌732株,同时整理相应患者信息资料,采用琼脂稀释法测定环丙沙星、头孢曲松、大观霉素对淋球菌的最低抑菌浓度(MIC),用头孢硝噻吩纸片测定β-内酰胺酶.结果 732株淋球菌菌株,对环丙沙星耐药的菌株有712株(97.3

  4. Comparative antimicrobial susceptibility of aerobic and facultative bacteria from community-acquired bacteremia to ertapenem in Taiwan

    Directory of Open Access Journals (Sweden)

    Fung Chang-Phone

    2007-07-01

    Full Text Available Abstract Background Ertapenem is a once-a-day carbapenem and has excellent activity against many gram-positive and gram-negative aerobic, facultative, and anaerobic bacteria. The susceptibility of isolates of community-acquired bacteremia to ertapenem has not been reported yet. The present study assesses the in vitro activity of ertapenem against aerobic and facultative bacterial pathogens isolated from patients with community-acquired bacteremia by determining and comparing the MICs of cefepime, cefoxitin, ceftazidime, ceftriaxone, ertapenem, piperacillin, piperacillin-tazobactam, ciprofloxacin, amikacin and gentamicin. The prevalence of extended broad spectrum β-lactamases (ESBL producing strains of community-acquired bacteremia and their susceptibility to these antibiotics are investigated. Methods Aerobic and facultative bacteria isolated from blood obtained from hospitalized patients with community-acquired bacteremia within 48 hours of admission between August 1, 2004 and September 30, 2004 in Chang Gung Memorial Hospital at Keelung, Taiwan, were identified using standard procedures. Antimicrobial susceptibility was evaluated by Etest according to the standard guidelines provided by the manufacturer and document M100-S16 Performance Standards of the Clinical Laboratory of Standard Institute. Antimicrobial agents including cefepime, cefoxitin, ceftazidime, ceftriaxone, ertapenem, piperacillin, piperacillin-tazobactam, ciprofloxacin, amikacin and gentamicin were used against the bacterial isolates to test their MICs as determined by Etest. For Staphylococcus aureus isolates, MICs of oxacillin were also tested by Etest to differentiate oxacillin-sensitive and oxacillin-resistant S. aureus. Results Ertapenem was highly active in vitro against many aerobic and facultative bacterial pathogens commonly recovered from patients with community-acquired bacteremia (128/159, 80.5 %. Ertapenem had more potent activity than ceftriaxone, piperacillin

  5. Approaching zero: temporal effects of a restrictive antibiotic policy on hospital-acquired Clostridium difficile, extended-spectrum β-lactamase-producing coliforms and meticillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Dancer, S J; Kirkpatrick, P; Corcoran, D S; Christison, F; Farmer, D; Robertson, C

    2013-02-01

    A restrictive antibiotic policy banning routine use of ceftriaxone and ciprofloxacin was implemented in a 450-bed district general hospital following an educational campaign. Monthly consumption of nine antibiotics was monitored in defined daily doses (DDDs) per 1000 patient-occupied bed-days (1000 pt-bds) 9 months before until 16 months after policy introduction. Hospital-acquired Clostridium difficile, meticillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL)-producing coliform cases per month/1000 pt-bds were identified and reviewed throughout the hospital. Between the first and final 6 months of the study, average monthly consumption of ceftriaxone reduced by 95% (from 46.213 to 2.129 DDDs/1000 pt-bds) and that for ciprofloxacin by 72.5% (109.804 to 30.205 DDDs/1000 pt-bds). Over the same periods, hospital-acquisition rates for C. difficile reduced by 77% (2.398 to 0.549 cases/1000 pt-bds), for MRSA by 25% (1.187 to 0.894 cases/1000 pt-bds) and for ESBL-producing coliforms by 17% (1.480 to 1.224 cases/1000 pt-bds). Time-lag modelling confirmed significant associations between ceftriaxone and C. difficile cases at 1 month (correlation 0.83; P<0.005), and between ciprofloxacin and ESBL-producing coliform cases at 2 months (correlation 0.649; P=0.002). An audit performed 3 years after the policy showed sustained reduction in C. difficile rates (0.259 cases/1000 pt-bds), with additional decreases for MRSA (0.409 cases/1000 pt-bds) and ESBL-producing coliforms (0.809 cases/1000 pt-bds). In conclusion, banning two antibiotics resulted in an immediate and profound reduction in hospital-acquired C. difficile, with possible longer-term effects on MRSA and ESBL-producing coliform rates. Antibiotic stewardship is fundamental in the control of major hospital pathogens. PMID:23276500

  6. Resistance to Third-Generation Cephalosporins and Other Antibiotics by Enterobacteriaceae in Western Nigeria

    Directory of Open Access Journals (Sweden)

    A. O. Okesola

    2009-01-01

    Full Text Available Problem statement: The emergence and spread of resistance to third-generation cephalosporins are threatening to create species resistant to all currently available agents. The most common cause of bacterial resistance to beta-lactam antibiotics is the production of beta-lactamases and many of the 2nd and 3rd-generation penicillins and cephalosporins were specifically designed to resist the hydrolytic action of major ß-lactamases. However new ß-lactamases emerged against each of the new classes of ß-lactams that were introduced and caused resistance. This study was designed to determine the rate of resistance to 3rd-generation cephalosporins and other classes of antibiotics by the Enterobacteriaceae in this environment. Approach: One hundred bacteria isolates belonging to the family Enterobacteriaceae identified from different clinical specimens between October and December 2007 using standard bacteriological methods. These were subjected to antibiotic susceptibility testing to third-generation cephalosporins and other classes of antibiotics which included quinolones and an aminoglycoside using the Kirby-Bauer method of disc diffusion test. Results: Out of the total number of Enterobacteriaceae isolated in the study period, only 54.8% of the klebsiella species isolated were sensitive to ceftazidime, 48.4% to ceftriaxone and 30.7% to cefotaxime. With Escherichia coli however, the susceptibility pattern to the 3rd-generation cephalosporins was better (65.6% were sensitive to ceftazidime, 62.5% to ceftriaxone and 71.9% to cefotaxime. In proteus species, the susceptibility pattern was generally poor to the three classes of antibiotics(50% were sensitive to ceftazidime and ceftriaxone, 0% to cefotaxime, 33.3% to ciprofloxacin, 50% to gentamycin and 0% to amoxycillin/clavulanate. Conclusion/Recommendations: The poor susceptibility to amoxicillin/clavulanate demonstrated by all the isolates in this

  7. Causes of catheter-related urinary tract infections and treatment strategies%导尿管相关性尿路感染的病因分析及治疗策略

    Institute of Scientific and Technical Information of China (English)

    刘晟; 张海涛; 蔡海荣; 燕东亮

    2013-01-01

    目的 总结由于留置导尿管而引起的尿路感染(UTI)病因分析以及治疗策略.方法 将80例UTI患者随机分为治疗组和对照组各40例,对照组采用静脉注射头孢曲松治疗,治疗组采用静脉注射头孢曲松联合口服氧氟沙星治疗.结果 UTI患者检出病原菌主要为革兰阴性杆菌,其中以大肠埃希菌、克雷伯菌属较为常见,分别占33.80%、14.08%;治疗组总有效率为l00.00%,对照组总有效率为75.00%,两组疗效比较,差异有统计学意义(P<0.05).结论 UTI的菌群主要为革兰阴性杆菌,静脉注射头孢曲松联合口服氧氟沙星胶囊的方法对于革兰阴性杆菌有抑制作用,所以对治疗UTI有一定疗效.%OBJECTIVE To summarize the causes of urinary tract infections (UTI) induced by the catheter indwelling and put forward the treatment strategies.METHODS A total of 80 cases of patients with UTI were randomly divided into the treatment group and the control group with 40 cases in each,then the control was treated with intravenous ceftriaxone,while the treatment group was treated with intravenous ceftriaxone combined with oral ofloxacin.RESULTS The gram-negative bacilli were the main pathogens isolated from the UTI patients,among which the Escherichia coli and the Klebsiella were the most common species,accounting for 33.80% and 14.08%,respectively.The overall effective rate of the treatment group was 100.00%,the control group 75.00%,as compared with the clinical efficacy between the two groups,the difference was significant (P<0.05).CONCLUSION The gram-negative bacilli are the predominant pathogens causing UTI,and the intravenous ceftriaxone combined with oral administration of ofloxacin capsules can inhibit the gram-negative bacilli,therefore,it can achieve certain curative effect on treatment of UTI.

  8. 早期神经梅毒治疗前后脑脊液检测临床分析%Clinical analysis of cerebrospinal fluid detection before and after treatments of early neurosyphilis

    Institute of Scientific and Technical Information of China (English)

    于增照; 史同新; 李永喜; 徐敬星; 李民; 曲才杰; 陈官芝

    2016-01-01

    间未发生吉海反应.结论 头孢曲松钠可作为治疗早期神经梅毒的有效替代药物,血清及脑脊液RPR滴度的变化可用于神经梅毒疗效的评估.%Objective To detect the changes of cerebrospinal fluid (CSF) before and after treatment with ceftriaxone sodium and penicillin in early neurosyphilis.Methods Totally 32 patients with neurosyphilis from January 2008 to December 2013 were randomly divided into ceftriaxone sodium group (17 cases) administrated with intravenous dripping of ceftriaxone sodium (2.0 g/d,14 days) and aqueous penicillin group (15 cases) administrated with intravenous dripping of penicillin (4 million unit,1 time/4 h,14 days) followed by intramuscular injection of benzylpenicillin G (2.4 million unit,1 time/week,3 times).The serum and CSF detections,including titer of rapid plasma regain card test (RPR),white blood cell count (WBC) in CSF,quantitative protein in CSF were compared between groups 6,12,and 18 months after treatment;the adverse reactions were observed.Results Six months after treatment,the serum RPR titer decreased in 16 cases (94.1%) in ceftriaxone sodium group and in 14 cases (93.3%) in penicillin group,among them,the serum RPR titer decreased by 4 times and more in 7 cases (41.2%) in ceftriaxone sodium group and 7 cases (46.7%) in penicillin group,without significant difference between groups (x2 =0.098,P =0.755);the CSF RPR titer decreased in 9 case (52.9%) in ceftriaxone sodium group and in 8 cases (53.3%) in penicillin group,without significant difference between groups (x2 =0.000,P =0.982);the WBC in CSF decreased to < 10 × 106/L in 11 cases (64.7%) in ceftriaxone sodium group and in 10 cases (66.7%) in penicillin group,without significant difference between groups (x2 =0.014,P =0.907).Twelve months after treatment,the serum and CSF RPR both turned negative in 14 cases (82.4%) in ceftriaxone sodium group and in 13 cases (86.7%) in penicillin group,without significant difference

  9. Neonatal sepsis at Muhimbili National Hospital, Dar es Salaam, Tanzania; aetiology, antimicrobial sensitivity pattern and clinical outcome

    Directory of Open Access Journals (Sweden)

    Mhada Tumaini V

    2012-10-01

    Full Text Available Abstract Background Neonatal sepsis contributes significantly to morbidity and mortality among young infants. The aetiological agents as well as their susceptibility to antimicrobial agents are dynamic. This study determined aetiology, antimicrobial susceptibility and clinical outcome of neonatal sepsis at Muhimbili National Hospital. Methods Three hundred and thirty neonates admitted at the Muhimbili National Hospital neonatal ward between October, 2009 and January, 2010 were recruited. Standardized questionnaires were used to obtain demographic and clinical information. Blood and pus samples were cultured on MacConkey, blood and chocolate agars and bacteria were identified based on characteristic morphology, gram stain appearance and standard commercially prepared biochemical tests. Antimicrobial sensitivity testing was performed for ampicillin, cloxacillin, gentamicin, amikacin, cefuroxime and ceftriaxone on Mueller Hinton agar using the Kirby Bauer diffusion method. Results Culture proven sepsis was noted in 24% (74/330 of the study participants. Isolated bacterial pathogens were predominantly Staphylococcus aureus, Klebsiella spp and Escherichia coli. Klebsiella spp 32.7% (17/52 was the predominant blood culture isolate in neonates aged below seven days while Staphylococcus aureus 54.5% (12/22 was commonest among those aged above seven days. Staphylococcus aureus was the predominant pus swabs isolate for both neonates aged 0–6 days 42.2% (98/232 and 7–28 days 52.3% (34/65. Resistance of blood culture isolates was high to ampicillin 81.1% (60/74 and cloxacillin 78.4% (58/74, moderate to ceftriaxone 14.9% (11/74 and cefuroxime 18.9% (14/74, and low to amikacin 1.3% (1/74. Isolates from swabs had high resistance to ampicillin 89.9% (267/297 and cloxacillin 85.2 (253/297, moderate resistance to ceftriaxone 38.0% (113/297 and cefuroxime 36.0% (107/297, and low resistance to amikacin 4.7% (14/297. Sepsis was higher in neonates with fever and

  10. Cost-Effectiveness Analysis of the Treatment of Pediatric Bronchial Pneumonia with Three Kinds of Cephalosporins%三种头孢类药物治疗小儿支气管肺炎的成本-效果分析

    Institute of Scientific and Technical Information of China (English)

    秦梦春

    2015-01-01

    Objective:To evaluate the cost-effectiveness of cefuroxime sodium,ceftizoxime sodium and, ceftriaxone sodium in respect to the treatment of pediatric bronchial pneumonia,so as to provide optimal clin-ical treatment protocol.Methods:Collect 152 discharged patients with pediatric bronchial pneumonia in de-partment of pediatrics in some hospital ,divide them into group A,B and C,Treat them with cefuroxime sodi-um ,ceftizoxime sodium ceftriaxone sodium respectively,make retrospective evaluation and analysis on the three treatment methods based on CEA.Results:There was no obvious difference between the three treatment protocols (P >0.05),the overall effective rate of the three groups was 94.44%,93.48%,96.15%respectively and cost-effectiveness was 34.40,35.35,32.72 respectively.Conclusion:it is the optimal protocol to treat ped-iatric bronchial pneumonia with ,ceftriaxone sodium.%目的::评价头孢呋辛钠、头孢唑肟钠、头孢曲松钠治疗小儿支气管肺炎的成本-效果,为临床提供最佳治疗方案。方法:收集某院儿科支气管肺炎患儿出院病历152份,分为 A、B、C3组,分别给予头孢呋辛钠(A)、头孢唑肟钠(B)、头孢曲松钠(C)治疗,运用药物经济学成本-效果分析方法对3种治疗方案的成本-效果进行回顾性评价分析。结果:3种治疗方案无显著性差异(P >0.05),总有效率分别为94.44%、93.48%、96.15%,成本-效果比分别为34.40、35.35、32.72。结论:头孢曲松钠(C 组)为治疗小儿支气管肺炎的较佳方案。

  11. Trend of antibiotic resistance in Neisseria gonorrhoeae in Chian:a systematic review%我国淋病奈瑟菌耐药趋势系统分析

    Institute of Scientific and Technical Information of China (English)

    陶小华; 关杨; 洪福昌; 冯铁建; 蓝丽娜

    2011-01-01

    目的 收集近期国内外发表的关于我国淋病奈瑟菌耐药监测文献,分析淋病奈瑟菌的耐药趋势.方法 检索中国期刊全文数据库、PubMed、Cochrane数据库,筛选合格文献进行系统评价.结果 在1996~2007年,最终有6篇文献入选.我国部分地区NG耐药率对青霉素(57.2%~96.3%)、环丙沙星(17.6%~99.5%)均较高;头孢曲松虽然未检测到耐药株,但中敏率高(10.8~61.0%);壮观霉素敏感率、中敏率和耐药率分别在97.8%~100%、O~2.2%、0~1.0%之间.结论 在我国,青霉素、环丙沙星已不适合用于治疗淋病.头孢曲松、壮观霉素是推荐治疗淋病的一线药物,但头孢曲松中敏率偏高,必须引起高度关注.%Objective To collect all recent references concerning surveillance of antibiotic resistance in Neisseria gonorrhoeae and analyze its tendency. Methods Database were searched by CNKI,PubMed and Cochrane. Eligible references were screened for systematic review. Resudts Six references were included. From 1996 to 2007,there was a high rate of resistance to penicillin and ciprofloxacin in Neisseria gonorrhoeae in certain regions of China. Although ceftriaxone resistant strain was not detected,the reduced susceptible rate was high. The rate of spectinomycin susceptible,reduced susceptible and resistant Neisseria gonorrhoeae were 97.8~100% ,0~2.2% ,0~1.0% respectively Conclusion In china,penicillin or ciprofloxacin should not be used in treatment of gonorrhoeae while ceftriaxone and spectinomycin can be recommended as first-line medicine. However,particular attention should be paid on account of the reduced susceptible rate of ceftriaxone to Neisseria gonorrhoeae. Moreover,the standard of surveillance of antibiotic resistance in Neisseria gonorrhoeae in China should be improved in order to guide its use in clinic more effectively.

  12. 佛山地区淋球菌流行株对抗生素敏感性测定%Detection of the Antibiotics Susceptibe Epidemic Strains of Neisseria gonorrhoeae in Foshan City

    Institute of Scientific and Technical Information of China (English)

    李燕娃; 潘洪亮; 吴兴中

    2009-01-01

    Objective To investigate the antibiotics susceptibility of Neisseria gonorrhoeae isolated in Foshan city in 2007. Methods Agar dilution method was used to determine the minimum inhibitory concentrations (MICs) of the isolates to penicillin G, tetracycline, ciprofloxacin, ceftriaxone and spectinomycin. Penicillinase produced by N. gonorrhoeae (PPNG) was analysed by the paper acidometric method. Results 98 N. gonorrhoeae isolates were identified, in which 34.7% were PPNG and 64.3% were TBNG. The percentage of drug resistance to penicillin, ciprofloxacin and tetracycline was 96.9%, 96.9% and 94.9%, respectively. Ceftriaxone and spectinomycin resistant strains were not found. The values of MIC50 and MIC90 of penicillin, tetracycline and ciprofloxacin for these isolates were significantly greater than the standards. Especially, the values of MIC50 and MIC90 of penicillin was 8 and 32 times respectively higher than the standard. Conclusion Ceftriaxone and spectiomycin should be used as the first-line agents in treating gonorrhoea.%目的 了解佛山地区2007年分离的淋球菌流行株对青霉素、四环素、大观霉素、头孢曲松和环丙沙星的耐药性及产β-内酰胺酶淋球菌(PPNG)和四环素高度耐药淋球菌(TRNG)的流行状况.方法 采用琼脂稀释法测定最小抑菌浓度(MIC),纸片酸度法检测β-内酰胺酶.结果 98株淋球菌检出PPNG 34株(34.7%),TRNG 63株(64.3%).青霉素、环丙沙星和四环素的耐药率分别为96.9%、96.9%和94.9%,未发现大观霉素及头孢曲松耐药株.青霉素、四环素和环丙沙星的MIC50及MIC90均已超过耐药标准,尤以青霉素为甚,其MIC50及MIC90均超过耐药标准的8倍和32倍.结论 大观霉素及头孢曲松是治疗淋病的首选药物.

  13. 某地区淋球菌对6种抗生素耐药性的结果分析%Analysis of the drug-resistance of Neisseria gonorrhoeae to 6 types of antibiotics in certain area

    Institute of Scientific and Technical Information of China (English)

    曹文苓; 黎小东; 毕超; 梁艳华; 宋卫忠; 林路洋; 吴德标; 张莉

    2011-01-01

    Objective To survey the antibiotic resistance and the prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) and tetracycline resistant Neisseria gonorrhoeae (TRNG) in certain area. Methods Minimum inhibitory concentrations (MIC) to penicillin G,tetracycline,ciprofloxacin,azithromyc, ceftriaxone and spectinomycin were determined by using the agar dilution method,and β-lactamase was determined by paper iodin quantitative method. Results 34 strains (38. 6%) of PPNG, 51 strains (60. 0%) of TRNG,87 strains (98. 9%) resistant to ciprofloxacin,24 strains (27. 2%) resistant to azithromyc were detected in 88 strains, while 16 strains (18.2%) were positive with penicillinase-producing, tetracycline resistant and highly resistant to cipro-floxacin(MIC≥161 mg/L). There was no ceftriaxone or spectinomycin resistant strain. Conclusion Ceftriaxone and spectinomycin could be choice drug to treat patients with Neisseria gonorrhoeae infection and it could be important to successively survey the antibiotic resistance of Neisseriae gonorrhoeae.%目的 了解广州地区淋球菌对6种抗生素的耐药性及产青霉素酶的淋球菌(PPNG)和质粒介导的耐四环素的淋球菌(TRNG)的流行状况.方法 用琼脂稀释法测定青霉素、四环素、环丙沙星、阿奇霉素、头孢曲松、大观霉素的最低抑菌浓度(MIC);用纸片碘量法检测β-内酰胺酶.结果 88株淋球菌检出PPNG 34株(38.6%)、TRNG 51株(60%)、环丙沙星耐药株87株(98.9%),同时检出PPNG、TRNG、环丙沙星高度耐药(MIC≥161 mg/L)菌株16株,占18.2%.阿奇霉素耐药株24株(27.2%),未发现头孢曲松、大观霉素的耐药菌株.结论 推荐大观霉素和头孢曲松作为广州地区治疗淋病的首选药物,加强淋球菌耐药性的连续性监测十分重要.

  14. Crazy-paving sign in high-resolution computed tomography in parainfluenza virus pneumonia

    International Nuclear Information System (INIS)

    The crazy-paving sign is the appearance of a smooth linear pattern superimposed on an area of ground-glass opacity on thin-section computed tomography (CT). A 69-year-old woman was admitted to our hospital for treatment of pneumonia. Thoracic CT showed a crazy-paving sign in the right lung field on admission. She received ceftriaxone and clarithromycin, and the symptoms and infiltration shadow promptly disappeared. Serologic testing revealed a greater than 4-fold increase in the IgG titer for parainfluenza virus I. To our knowledge, there is no previous report of the crazy-paving sign in associated with viral pneumonia in a non-immunocompromised host or with parainfluenza pneumonia.

  15. Raoultella Planticola Bacteremia Following Consumption of Seafood

    Directory of Open Access Journals (Sweden)

    Philip W Lam

    2014-01-01

    Full Text Available Raoultella planticola is a Gram-negative bacillus commonly found in water, soil and aquatic environments. There have only been 16 cases of R planticola infection documented in the literature to date. R planticola possesses the ability to convert histidine to histamine and can produce symptoms of scombroid poisoning when poorly prepared seafood is consumed in large amounts. The present report describes a case involving a 56-year-old woman who presented with R planticola bacteremia and symptoms consistent with cholangitis four days after consuming a seafood salad containing squid and octopus. She was successfully treated with intravenous ceftriaxone followed by oral ciprofloxacin. Recent chemotherapy, proton pump inhibitor use and altered biliary flow secondary to hepatic metastases may have been contributing factors to the pathogenesis of disease.

  16. [Antimicrobial susceptibility of Neisseria gonorrhoeae strains determined by disk diffusion].

    Science.gov (United States)

    Llanes Caballero, R; Acosta Giraldo, J C; Sosa Puente, J; Guzmán Hernández, D; Gutiérrez González, O; Llop Hernández, A

    1999-01-01

    The Gonoccocus Laboratory of "Pedro Kourí" Tropical Medicine Institute carried out a study of in vitro susceptibility of Neisseria gonorrhoeae to penicillin, tetracycline, cefuroxime ceftriaxone, cefotaxine and ciprofoxacin by means of a disk diffusion method with the culture medium agar base GC plus supplement. In the first phase, the method was standardized and the reference N. gonorrhoeae ATCC 49226 strain was used whereas in the second phase, 50 gonococcal strains isolated in 8 provinces during 1995 and 1996 were examined. The results of such standardization confirmed that the antimicrobial susceptibility values were within the allowable limits. 52 and 34% of strains were resistant to penicillin and tetracycline respectively and all of them showed susceptibility to the rest of evaluated antimicrobial drugs. We recommend the use of the disk diffusion method for surveillance of gonococci resistance to these drugs in our country. PMID:10887570

  17. [Complete atrioventricular block as the first clinical manifestation of a tick bite (Lyme disease)].

    Science.gov (United States)

    Bacino, Luca; Gazzarata, Massimo; Siri, Giambattista; Cordone, Stefano; Bellotti, Paolo

    2011-03-01

    A 52-year-old male patient presented to the emergency department because of malaise and frequent dizziness. The ECG revealed high-grade atrioventricular block that required placement of a temporary pacemaker. There were no other abnormalities in physical and echocardiographic examination, and coronary angiography excluded the presence of coronary artery disease. IgM and IgG antibodies against Borrelia were positive, and antibiotic therapy with ceftriaxone at the dose of 2 g/die for 15 days resulted in rapid regression of atrioventricular block. Seven-day ECG recording immediately after discharge and 24h ECG monitoring at 40 days confirmed the total disappearance of atrioventricular block. This represents a case of atrioventricular block as the first manifestation of Borrelia infection (Lyme disease). A prompt diagnosis and antibiotic therapy usually result in complete resolution of atrioventricular block without the need for a permanent pacemaker.

  18. Pulmonary melioidosis presenting with pleural effusion: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Chun Ian Soo

    2015-01-01

    Full Text Available Melioidosis is a serious infection, which can involve multiple systems. We report a case of pulmonary melioidosis with the initial presentation mimicking a partially treated pneumonia complicated by right-sided pleural effusion. The patient is a 49-year old man who did not respond to parenteral ceftriaxone and tazobactam/piperacillin therapy. However, upon culture and sensitivity results from blood and pleural samples isolated Burkholderia pseudomallei; antimicrobial therapy was de-escalated to parenteral ceftazidime. Within 72 h duration, his fever subsided and other respiratory symptoms improved tremendously. This case highlights the importance of early recognition of B. pseudomallei in pulmonary infection in order for prompt institution of appropriate antibiotics treatment; thus reducing morbidity and mortality.

  19. Eyes can See What Mind Can’t see

    International Nuclear Information System (INIS)

    A 55 year old Caucasian female with a history of Iron deficiency anemia with hemoglobin of 6.1 gm/dl was admitted from her hematologist office for a Venofer infusion. She had profound confusion on presentation. Physical examination was pertinent for fever of 101οF, and laboratory data pertinent for elevated blood sugars of 590 mg/dl, leukocytosis of 10.3 K/UL with bandemia of 13%, elevated AST 170 U/L, ALT 184 U/L, and normal alkaline phosphate and total bilirubin. She was subsequently found to have Strep. Viridian bacteremia and CT scan of Chestabdomen- pelvis revealed multiple hepatosplenic masses consistent with malignancy or abscesses. Liver biopsy showed benign liver cells with a background of acute and chronic inflammatory cells and abscess (*image shown). She was treated with long term course of Ceftriaxone via PICC line

  20. Management of Varicella Gangrenosa: A Life-Threatening Condition from Chickenpox

    Directory of Open Access Journals (Sweden)

    Judith P. M. Schots

    2014-01-01

    Full Text Available Varicella gangrenosa, in which gangrenous ulceration of the skin and/or deeper tissues is seen, is a rare but alarming complication of Varicella infection. An early surgical intervention is generally advised, especially in case of sepsis and/or the presence of large necrotic lesions. We describe a case of a previously healthy 12-month-old boy presenting with sepsis due to Varicella gangrenosa. He presented with moderate lesions of moist gangrene. We treated our patient initially with antibiotics (ceftriaxone and metronidazole and later on flucloxacillin and antiviral therapy (acyclovir whereupon his condition rapidly improved and all skin lesions healed entirely. This report highlights the possibility of conservative treatment and emphasizes the significance of acyclovir in the management of chickenpox complicated by moist gangrene due to bacterial superinfection.

  1. Multiple drug resistance of Aeromonas hydrophila isolates from Chicken samples collected from Mhow and Indore city of Madhyapradesh

    Directory of Open Access Journals (Sweden)

    Kaskhedikar

    2009-02-01

    Full Text Available Fourteen antibacterial agents belonging to 9 different groups of antibiotics viz. aminoglycosides, cephalosporins, nitrofurantoin, fluroquinolones, chloramphenicol, sulphonamides, tetracyclines, penicillin and polymixin were used for in vitro sensitivity testing of Aeromonas hydrophila isolated from fifteen samples of chicken collected from retail shops in Mhow city. The sensitivity (100% was attributed to ciprofloxacin, cefuroxime, ceftriaxone, cephotaxime, chloramphenicol, gentamycin, kanamycin, nitrofurantoin, nalidixic acid and ofloxacin followed by oxytetracycline (50%. All the isolates were resistant to ampicillin and colistin antibiotics. That means, none of the isolates were found to be sensitive for penicillin and polymixin group of antibiotics. Multiple drug resistance was also observed in all A. hydrophila isolates. Out of total isolates, 100% were resistant to two antimicrobial drugs and 50% to three drugs. [Vet. World 2009; 2(1.000: 31-32

  2. Citrobacter koseri folliculitis of the face.

    Science.gov (United States)

    Raia, D D; Barbareschi, M; Veraldi, S

    2015-10-01

    We report a case of severe Citrobacter koseri folliculitis of the face in a boy with acne. A 15-year-old boy affected by acne was admitted because of a rash located on the face. Dermatological examination revealed two large plaques, with numerous pustules, eschars and crusts, located bilaterally and symmetrically on the cheeks. Three bacteriological examinations were positive for C. koseri. The patient was successfully treated with i.m. ceftriaxone. C. koseri is a Gram-negative, aerobic, mobile, nonsporulating bacillus belonging to the Enterobacteriaceae family. It can cause meningitis, central nervous system abscess and sepsis, almost exclusively in infants and immunocompromised hosts. Respiratory tract and urinary infections have been reported in elderly people. Furthermore, rare cases of skin infections have been described.

  3. Voltammetric and theoretical studies of electrochemical behavior of cephalosporins at the mercury electrode

    Directory of Open Access Journals (Sweden)

    Nikolić Katarina

    2015-01-01

    Full Text Available Study of the adsorption and electroreduction behavior of cefpodoxime proxetil, cefotaxime, desacetylcefotaxime, cefetamet, ceftriaxone, ceftazidime, and cefuroxime axetile at the mercury electrode surface has been performed using Cyclic (CV, Differential Pulse (DPV, and Adsorptive Stripping Differential Pulse Voltammetry (AdSDPV. The Quantitative Structure Property Relationship (QSPR study of the seven cephalosporins adsorption at the mercury electrode has been based on the density functional theory DFT-B3LYP/6-31G (d,p calculations of molecular orbitals, partial charges and electron densities of analytes. The DFT-parameters and QSPR model explain well the process of adsorption of the examined cephalosporins. QSPR study defined that cefalosporins with lower charge of sulphur in the thiazine moiety, lower electron density on the nitrogen atom of the N-O bond, higher number of hydrogen bond accepting groups, and higher principal moment of inertia should express high adsorption on the mercury electrode. [Projekat Ministarstva nauke Republike Srbije, br. 172033

  4. Klebsiella pneumoniae liver abscess in an immunocompetent child.

    Science.gov (United States)

    Kwon, Jang-Mi; Jung, Hye Lim; Shim, Jae Won; Kim, Deok Soo; Shim, Jung Yeon; Park, Moon Soo

    2013-09-01

    Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.

  5. Klebsiella pneumoniae liver abscess in an immunocompetent child

    Directory of Open Access Journals (Sweden)

    Jang Mi Kwon

    2013-09-01

    Full Text Available Klebsiella pneumoniae has emerged as a leading pathogen for pyogenic liver abscess (PLA in Korea. K. pneumoniae liver abscess (KLA is a potentially life-threatening disease and the diagnosis is challenging. In developed countries, PLA in children is rare and frequently associated with disorders of granulocyte function and previous abdominal infection. We experienced a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter placed in intrahepatic abscess was left for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin were administered for 4 weeks, followed by oral antibiotics (cefixime for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications and the appropriate treatment of KLA.

  6. Multidrug-Resistant Salmonella Heidelberg Associated with Mechanically Separated Chicken at a Correctional Facility.

    Science.gov (United States)

    Taylor, Amanda L; Murphree, Rendi; Ingram, L Amanda; Garman, Katie; Solomon, Deborah; Coffey, Eric; Walker, Deborah; Rogers, Marsha; Marder, Ellyn; Bottomley, Marie; Woron, Amy; Thomas, Linda; Roberts, Sheri; Hardin, Henrietta; Arjmandi, Parvin; Green, Alice; Simmons, Latoya; Cornell, Allyson; Dunn, John

    2015-12-01

    We describe multidrug-resistant (MDR) Salmonella Heidelberg infections associated with mechanically separated chicken (MSC) served at a county correctional facility. Twenty-three inmates met the case definition. All reported diarrhea, 19 (83%) reported fever, 16 (70%) reported vomiting, 4 (17%) had fever ≥103°F, and 3 (13%) were hospitalized. A case-control study found no single food item significantly associated with illness. Salmonella Heidelberg with an indistinguishable pulsed-field gel electrophoresis pattern was isolated from nine stool specimens; two isolates displayed resistance to a total of five drug classes, including the third-generation cephalosporin, ceftriaxone. MDR Salmonella Heidelberg might have contributed to the severity of illness. Salmonella Heidelberg indistinguishable from the outbreak subtype was isolated from unopened MSC. The environmental health assessment identified cross-contamination through poor food-handling practices as a possible contributing factor. Proper hand-washing techniques and safe food-handling practices were reviewed with the kitchen supervisor.

  7. New criteria for selecting the proper antimicrobial chemotherapy for severe sepsis and septic shock.

    Science.gov (United States)

    Periti, P; Mazzei, T

    1999-07-01

    The mortality rate resulting from severe bacterial sepsis, particularly that associated with shock, still approaches 50% in spite of appropriate antimicrobial therapy and optimum supportive care. Bacterial endotoxins that are part of the cell wall are one of the cofactors in the pathogenesis of sepsis and septic shock and are often induced by antimicrobial chemotherapy even if it is administered rationally. Not all antimicrobial agents are equally capable of inducing septic shock; this is dependant on their mechanism of action rather than on the causative pathogen species. The quantity of endotoxin released depends on the drug dose and whether filaments or spheroplast formation predominates. Some antibiotics such as carbapenems, ceftriaxone, cefepime, glycopeptides, aminoglycosides and quinolones do not have the propensity to provoke septic shock because their rapid bactericidal activity induces mainly spheroplast or fragile spheroplast-like bacterial forms.

  8. [Cefditoren pivoxil: A new oral cephalosporin for skin, soft tissue and respiratory tract infections].

    Science.gov (United States)

    Hernández-Martin, J; Romá, E; Salavert, M; Doménech, L; Poveda, J L

    2006-09-01

    Cefditoren pivoxil, a new-third generation cephalosporin antibiotic that has recently been granted approval in Spain, shows important activity over a large part of the pathogens causing skin, soft tissue and respiratory tract infections, including Gram-negative and Gram-positive bacteria. Cefditoren has also been shown to be stable against hydrolysis by many common beta-lactamases. Data from in vitro studies and clinical trials show this antibiotic as an oral formulation with an intrinsic activity against Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae equivalent to that of other third-generation cephalosporins administered via parenteral, like cefotaxime or ceftriaxone, thereby placing its maximal benefits mainly in the treatment of ambulatory infections. This paper reviews the main characteristics of cefditoren pivoxil (spectrum of activity, chemical structure, mechanism of action, pharmacokinetics, adverse effects and clinical efficacy) and attempts to find its place in current antibiotic therapeutics.

  9. Design, synthesis, and evaluation of 2 beta-alkenyl penam sulfone acids as inhibitors of beta-lactamases.

    Science.gov (United States)

    Richter, H G; Angehrn, P; Hubschwerlen, C; Kania, M; Page, M G; Specklin, J L; Winkler, F K

    1996-09-13

    A general method for synthesis of 2 beta-alkenyl penam sulfones has been developed. The new compounds inhibited most of the common types of beta-lactamase. The level of activity depended very strongly on the nature of the substituent in the 2 beta-alkenyl group. The inhibited species formed with the beta-lactamase from Citrobacter freundii 1205 was sufficiently stable for X-ray crystallographic studies. These, together with UV absorption spectroscopy and studies of chemical degradation, suggested a novel reaction mechanism for the new inhibitors that might account for their broad spectrum of action. The (Z)-2 beta-acrylonitrile penam sulfone Ro 48-1220 was the most active inhibitor from this class of compound. The inhibitor enhanced the action of, for example, ceftriaxone against a broad selection of organisms producing beta-lactamases. The organisms included strains of Enterobacteriaceae that produce cephalosporinases, which is an exceptional activity for penam sulfones.

  10. Management of Gonorrhea in Adolescents and Adults in the United States.

    Science.gov (United States)

    Kidd, Sarah; Workowski, Kimberly A

    2015-12-15

    Gonorrhea is the second most commonly reported notifiable disease in the United States and is associated with serious health sequelae, including pelvic inflammatory disease, infertility, and ectopic pregnancy. Treatment for gonorrhea has been complicated by antimicrobial resistance. Neisseria gonorrhoeae has developed resistance to each of the antimicrobials that were previously recommended as first-line treatment regimens, and current treatment options are severely limited. This article summarizes the key questions and data that were discussed at the Sexually Transmitted Diseases (STD) Treatment Guidelines Expert Consultation meeting in April 2013, and the rationale for the 2015 Centers for Disease Control and Prevention STD treatment guidelines for gonococcal infections in adolescents and adults. Key issues addressed include whether to change the dosage of ceftriaxone and azithromycin used in the recommended dual treatment regimen, whether to continue to list dual treatment with cefixime and azithromycin as an alternative treatment regimen, and management of gonococcal infections in persons with severe cephalosporin allergy or suspected treatment failure.

  11. Neisseria elongata subsp elongata infective endocarditis following endurance exercise.

    Science.gov (United States)

    Jenkins, Joanne May; Fife, Amanda; Baghai, Max; Dworakowski, Rafal

    2015-12-11

    A 31-year-old Argentinian woman presented with a 3-week history of fever, night sweats, myalgia and lethargy following a work trip to Uganda where she ran a marathon. Malarial screens were negative but C reactive protein, erythrocyte sedimentation rate and neutrophil count were raised and she was anaemic. A new pansystolic murmur was heard over the mitral valve and the transthoracic echocardiogram showed a large vegetation (>1 cm) with at least moderate mitral regurgitation. Blood cultures grew Neisseria elongata, subsp elongata treated initially with ceftriaxone then oral ciprofloxacin to complete 4 weeks of treatment. CT scan revealed a wedge-shaped area of low attenuation in the spleen in keeping with a splenic infarct. Seven days postadmission, the patient underwent a successful mitral valve repair. Recovery was complicated by a likely embolic infarct in the right frontal lobe, but the patient was discharged 12 days postoperative with no neurological sequelae.

  12. Morganella morganii causing solitary liver abscess complicated by pyopericardium and left pleural effusion in a nondiabetic patient.

    Science.gov (United States)

    Tsai, Wen-Cheng; Chang, Liang-Kai

    2002-09-01

    Morganella morganii is a rare cause of solitary liver abscess in Taiwan. The complication of pyopericardium and pleural effusion in nondiabetic patient with solitary liver abscess are also rare. We present a case of a 48-year-old nondiabetic woman who experienced with epigastric discomfort 1 month prior to admission. Chills and fever developed 2 weeks before admission. Physical examination on admission revealed engorgement of the jugular vein over the right neck, precordial friction rubs, and tenderness over the right upper quadrant of abdomen. Chest film showed mild cardiomegaly and left pleural effusion. Computed tomography of the abdomen showed liver abscess, left hepatic lobe, pyopericardium, and left pleural effusion. M. morganii was isolated from 2 sets of blood cultures, one set of hepatic pus culture, and one set of pericardial pus culture. After pigtail drainage of liver abscess, pyopericardium for 12 days, and ceftriaxone intravenous administration for 19 days, the patient was discharged in stable condition.

  13. Piperacillin plus Tazobactam induced Drug Hypersensitivity Reaction: A Case Report

    Directory of Open Access Journals (Sweden)

    Modi RS

    2015-11-01

    Full Text Available Penicillin alone or with combination should be used in hospitalized patients to treat bacterial infections with great precautions since penicillin is known to produce hypersensitivity reactions very commonly. A 53 year old hospitalized male patient having tibia fracture was initially given ceftriaxone plus salbactum and amikacin as an antibacterial therapeutics. Subsequently patient was treated with Pipzo (Inj. Piperacillin plus Tezobactum; 4.5 gm. on the basis of anti- bacterial sensitivity test of pus culture. It was observed in patient having fever with chills and rigors immediately after injecting Pepzo. Though drug induced these hypersensitivity signs subsided gradually. Later on patient was switch over to inj. Imipenum to cover pseudomonal infection with resulting improvement.

  14. The value of blood culture audits at peripheral hospitals.

    Science.gov (United States)

    Kenyon, Chris R; Fatti, Geoff; Schrueder, Neshaad; Bonorchis, Kim; Meintjes, Graeme

    2012-03-07

    Knowledge of local antibiotic sensitivities is crucial to creating appropriate empiric antibiotic guidelines. The new National Health Laboratory Service (NHLS) Data Warehouse allows clinicians to access collated spreadsheets of culture isolates and antimicrobial susceptibility patterns for their facilities. We used this service to study the trends in blood culture (BC) results at GF Jooste Hospital from 2005 to 2010. We investigated the BC contamination rate and changes in the antibiotic sensitivity profiles of selected organisms, and estimated the proportion of infections that were hospital-acquired. Over 3000 BCs were performed per year in this period. A very high contamination rate was observed (7 - 9%) in 2005 - 2007, with a gratifying reduction by 2010. Ceftriaxone resistance increased from 16% to 62% in Klebsiella pneumoniae (p<0.0001), and from 33% to 100% in Enterobacter spp. (p=0.053).

  15. Persistent infection by Staphylococcus epidermidis in endodontic flare-up: a case report.

    Science.gov (United States)

    Gonçalves, Simone Helena Ferreira; de Vasconcelos, Rafaela Andrade; Cavalcanti, Bruno das Neves; Camargo, Carlos Henrique Ribeiro

    2016-01-01

    Endodontic flare-ups are challenging situations and may result from selective growth of specific bacterial species; microbial cultures and antibiograms should be used to allow faster, successful management of refractory lesions. A 47-year-old man reported pain on percussion after uncomplicated retreatment of the maxillary left canine for prosthetic purposes. In the following days, pain dramatically increased, leading to removal of the filling and use of intracanal medication. After many unsuccessful attempts to resolve the problem, a microbial culture of the root canal detected the presence of Staphylococcus epidermidis. An antibiogram determined the best drug combination to control this infection: tetracycline (oxytetracycline hydrochloride, 500 mg orally) plus third-generation cephalosporin (ceftriaxone, 1 g intramuscularly). Once the infection was controlled, the root canal was obturated. There was a reduction in the area of radiolucency, and the patient reported no pain at a 2-year follow-up. PMID:26943096

  16. Pharmacodynamic Profiling of Antimicrobials against Gram-negative Respiratory Isolates from Canadian Hospitals

    Directory of Open Access Journals (Sweden)

    Rebecca A. Keel

    2011-01-01

    Full Text Available The objective of this study was to assess the profile of a variety of dosing regimens for common intravenous antibiotics against contemporary Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa isolates collected in Canada during 2009, using pharmacodynamic modelling techniques. Monte Carlo simulation was conducted for standard and/or prolonged infusion regimens of cefepime, ceftazidime, ceftriaxone, ciprofloxacin, doripenem, ertapenem, meropenem and piperacillin/tazobactam. The cumulative fraction of response (CFR was calculated using bactericidal targets for each regimen against each species. All cefepime, doripenem, ertapenem and meropenem regimens achieved optimal exposures against Enterobacteriaceae, whereas target attainment was organism and dose dependent for the other agents. These results support that the currently recommended antimicrobial dosing regimens generally attain acceptable exposures to achieve the requisite pharmacodynamic targets against the Enterobacteriaceae species; however, they fall short of obtaining optimal bactericidal exposures against P aeruginosa.

  17. Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2010-03-01

    Full Text Available Abstract Background Bacterial meningitis in children causes high rates of mortality and morbidity. In a recent clinical trial, oral glycerol significantly reduced severe neurological sequelae in paediatric meningitis caused by Haemophilus influenzae type b, and a tendency towards a benefit of adjunctive glycerol was seen in pneumococcal meningitis. Methods Here we examined the effects of glycerol in pneumococcal meningitis of infant rats and adult mice. All animals received ceftriaxone, and glycerol or placebo. Brain damage, hearing loss, and inflammatory parameters were assessed. Results Clinically and by histopathology, animals treated with glycerol or placebo did not differ. While both groups showed equally high levels of matrix metalloproteinase-9 at 24 h after infection, a significant difference in favour of glycerol was observed at 40 h after infection. However, this difference in matrix metalloproteinase-9 in late disease did not result in an improvement of histopathologic parameters. Conclusion No benefit of adjunctive glycerol was found in these models of pneumococcal meningitis.

  18. [A case of disseminated gonococcal infection without typical skin rash].

    Science.gov (United States)

    Yokota, Kazuhisa; Gomi, Harumi; Morisawa, Yuji

    2011-07-01

    Few case reports have been published on disseminated gonococcal infection in Japan. We report such a non-HIV case without typical skin rash. A 49-year-old Japanese man living in Thailand on business was seen for fever and multiple arthralgia after returning to Japan. Given the travel history, differential diagnoses included endemic viral infection such as human immunodeficiency virus (HIV), dengue fever, and chikungunya. Diagnosis was based on right-knee arthrocentesis, and synovial fluid culture followed by Neisseria gonorrhoeae polymerase chain reaction (PCR). The isolated strain was sensitive to penicillin. The man was treated with intravenous ceftriaxone and oral levofloxacin. Disseminated gonococcal infection should thus be considered when examining those with classical polyarthralgia symptoms even without a typical skin rash.

  19. Development of a capillary electrophoresis method for the simultaneous determination of cephalosporins

    Directory of Open Access Journals (Sweden)

    Hancu Gabriel

    2013-01-01

    Full Text Available A rapid and simple capillary electrophoresis method has been developed for the simultaneous determination of six extensively used cephalosporin antibiotics (cefaclor, cefadroxil, cefalexin, cefuroxim, ceftazidim, ceftriaxon. The determination of cephalosporins was performed at a pH 6.8, using a 25 mM phospate - 25 mM borate mixed buffer, + 25 kV voltage at a temperature of 25 °C. We achieved a baseline separation in approximately 10 minutes. The separation resolution was increased by addition of an anionic surfactant, 50 mM sodium dodecyl sulfate, to the buffer solution. The proposed separation was evaluated on the basis of detection and quantification limits, effective electrophoretic mobility and relative standard deviation for migration times and peak areas.

  20. Clinical evaluation of the role of ceftaroline in the management of community acquired bacterial pneumonia

    Science.gov (United States)

    Maselli, Diego J; Fernandez, Juan F; Whong, Christine Y; Echevarria, Kelly; Nambiar, Anoop M; Anzueto, Antonio; Restrepo, Marcos I

    2012-01-01

    Ceftaroline fosamil (ceftaroline) was recently approved for the treatment of community- acquired pneumonia (CAP) and complicated skin infections. This newly developed cephalosporin possesses a broad spectrum of activity against gram-positive and gram-negative bacteria. Most importantly, ceftaroline demonstrates potent in vitro antimicrobial activity against multi-drug resistant Streptococcus pneumoniae and methicillin-resistant strains of Staphylococcus aureus. In two Phase III, double-blinded, randomized, prospective trials (FOCUS 1 and FOCUS 2), ceftaroline was shown to be non-inferior to ceftriaxone for the treatment of CAP in hospitalized patients. Ceftaroline exhibits low resistance rates and a safety profile similar to that of other cephalosporins. In this review, we will evaluate the pharmacological characteristics, safety, antimicrobial properties, and efficacy of ceftaroline and its applications in the treatment of CAP. PMID:22355258

  1. Analysis of Etiology and Drug Resistance of Biliary Infections

    Institute of Scientific and Technical Information of China (English)

    王欣; 李秋; 邹声泉; 孙自庸; 朱峰

    2004-01-01

    The bile was collected from fro patients with biliary infections, with the bacterium isolated to study the sensitivity of each kind of the bacterium to several antibiotics in common use. Except G- bacterium, we also found some kinds of G+ bacterium in infection bile. G- bacterium were not sensitive to Clindamycin, G+ bacterium were sensitive to Ciprofloxacin. Escherichia coli,Xanthomonas maltophilia, Enterobacter cloacae, Pseudomonas aeruginosa were sensitive to Ampicillin. G+ bacterium were not sensitive to Azactam. Enterococcus faecalis, Enterococcus faecium,Enterobacter cloacae were not sensitive to Ceftazidime. Enterococcus faecalis, Staphylococcus coagulase negative, Staphylococcus epidermidis, Pseudomonas aeruginosa were not sensitive to Ceftriaxone Sodium. We didn't found any bacterium resistance Imipenem. The possibility of the existence of G+ bacterium as well as drug resistance should be considered n patients with biliary infections.The value of susceptibility test should be respected to avoid drug abuse of antibiotics.

  2. ANTIMICROBIAL ACTIVITY OF MICROORGANISMS AND COLLOIDAL SILVER BASED ON COMPLEX MATERIALS

    Directory of Open Access Journals (Sweden)

    Voitenko O. Yu.

    2014-02-01

    Full Text Available The antimicrobial properties of complex materials containing ultradispersed silver particles directly formed in the Candida albіcans, Escherichia сolі, Pseudomonas fluorescens, and Bacillus cereus cell walls were investigated. Complex material based on pseudomonas was more active against gram-positive bacteria, the yeast like fungi based material was mainly active against colibacillus. After a cell-matrix treatment in a hypertonic solution or by acid hydrolysis, the antimicrobial properties of complex materials increased by 20—40%. In a liquid-phase medium, the complex materials with incorporated silver particles in composition with antibiotics strengthened anti-microbial properties of chloramphenicol, tetracycline and amoxiclav antibiotics with respect to E. faecalis, as well as penicillin antibiotics (ceftriaxone, cefotaxime, amoxicillin, amoxiclav against E. coli. The obtained data can serve as a basis for development of the new antibacterial and fungicide cells based materials impregnated with ultradispersed substances.

  3. Bacteremia and conventional diagnosis of Sphingobacterium spiritivorum. A case report

    Directory of Open Access Journals (Sweden)

    Elio Jesús Núñez Tamayo

    2003-12-01

    Full Text Available This is a case report of septicaemia due to Sphingobacterium Spiritovirum that caused acute symmetric acronecrosis in a previously healthy man who received medical assistance at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province in November 2002. The clinical symptoms were: fever, lumbar pain and chills which evolved to shock with general malaise, accompanied with paresthesia, symptoms of distal necrosis in the four members, nose and ear. Sphingobacterium Spiritovirum was diagnosed by the conventional diagnosis of growing in the marrow tests and serial blood cultures. Susceptibility antimicrobial tests were sensible to sulphametoxazole – trimetropin and resistant to tetracycline, aztreonam, ceftriaxone and imipenem. The bibliography consulted did not evidence any previous isolation in Cuba .

  4. Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes

    Directory of Open Access Journals (Sweden)

    Michael Vincent F. Tablang

    2008-11-01

    Full Text Available Spontaneous bacterial peritonitis is a severe and life-threatening complication in patients with ascites caused by advanced liver disease. The organisms most commonly involved are coliform bacteria and third-generation cephalosporins are the empiric antibiotics of choice. This is an uncommon case of spontaneous bacterial peritonitis caused by Listeria monocytogenes in a female patient with liver cirrhosis from autoimmune hepatitis. She did not improve with ceftriaxone and her course was complicated by hepatic encephalopathy, seizures and multi-organ failure. This case emphasizes that a high index of suspicion should be maintained for timely diagnosis and treatment. Listerial peritonitis should be suspected in patients with end-stage liver disease and inadequate response to conventional antibiotics within 48–72 h. Ampicillin/sulbactam should be initiated while awaiting results of ascitic fluid or blood culture.

  5. [Borreliosis--simultaneous Lyme carditis and psychiatric disorders--case report].

    Science.gov (United States)

    Legatowicz-Koprowska, Marta; Gziut, Aneta I; Walczak, Ewa; Gil, Robert J; Wagner, Teresa

    2008-05-01

    Borreliosis is a multisystemic disease transmitted by ticks. Its diagnosis still remains a challenge because of the varied clinical picture and of difficulties in detection of the etiological agent (Borrelia burgdorferi). We report a case of a 53-years-old woman admitted to the Clinic of Cardiology due to life-threatening arhythmias with simultaneous deficits in concentration and memory. A suspicion of borreliosis was driven from the presence of cardiac symptoms as well as of psychiatric and from the case histories of a tick bite. The diagnosis was confirmed both by specific serological test and endomyocardial biopsy which revealed spirochetes. The patient responded to treatment with doxycyclin and ceftriaxone. Cardiologic disorders retreated entirely, while cognitive deficits did only partly. PMID:18634389

  6. Prolonged dysphagia due to Listeria-rhombencephalitis with brainstem abscess and acute polyradiculoneuritis.

    Science.gov (United States)

    Smiatacz, Tomasz; Kowalik, Maciej Michal; Hlebowicz, Maria

    2006-06-01

    We report a case of previously healthy student with acute rhombencephalitis and brainstem abscess caused by Listeria monocytogenes. The disease begun with uncharacteristic prodromal symptoms of gastrointestinal infection followed by headache and vertigo. After hospital admission the patient rapidly deteriorated, presenting pronounced dysphagia and respiratory failure requiring mechanical ventilation. The diagnosis was established upon clinical symptoms of infection, brainstem involvement, typical MRI findings and positive for L. monocytogenes blood culture. Infection was complicated by acute, demyelinating neuropathy, diagnosed upon clinical symptoms of frail palsy confirmed by ENG. Initially introduced empirical doxycyclin/ceftriaxon treatment was subsequently changed to targeted ampicillin/gentamycin therapy, mechanical ventilation, intravenous human immunoglobulin treatment, tracheostomy and endoscopic gastrostomy. Prolonged dysphagia resolved after rehabilitation. After one year the patient remains well with only slight dysmetria. PMID:16260041

  7. Low back pain after a dental procedure: a case of Streptococcus viridans vertebral osteomyelitis.

    Science.gov (United States)

    Nazir, Salik; Lohani, Saroj; Tachamo, Niranjan; Rajagopalan, Priya

    2016-01-01

    Vertebral osteomyelitis due to Streptococcus viridans following a dental procedure is a rarely reported phenomenon. We discuss the case of a 67-year-old immunocompetent woman who presented with low back pain of 3 weeks duration associated with subjective fever and chills. On admission, the MRI of the lumbar spine showed L5-S1 vertebral osteomyelitis with associated paravertebral and epidural abscesses. Subsequently, detailed history was retaken and the patient reported having had a maxillary tooth extraction followed by a dental implant 2 months prior to the onset of her symptoms. Blood and abscess fluid cultures grew S. viridans Transthoracic echocardiogram showed no evidence of endocarditis. The patient was started on intravenous ceftriaxone but her treatment course was complicated by agranulocytosis requiring a switch to vancomycin. She required a total of 9 weeks of intravenous antibiotics for complete clinical cure. PMID:27268493

  8. Changing patient population in Dhaka Hospital and Matlab Hospital of icddr,b.

    Science.gov (United States)

    Das, S K; Rahman, A; Chisti, M J; Ahmed, S; Malek, M A; Salam, M A; Bardhan, P K; Faruque, A S G

    2014-02-01

    The Diarrhoeal Disease Surveillance System of icddr,b noted increasing number of patients ≥60 years at urban Dhaka and rural Matlab from 2001 to 2012. Shigella and Vibrio cholerae were more frequently isolated from elderly people than children under 5 years and adults aged 5-59 in both areas. The resistance observed to various drugs of Shigella in Dhaka and Matlab was trimethoprim-sulphamethoxazole (72-63%), ampicillin (43-55%), nalidixic acid (58-61%), mecillinam (12-9%), azithromycin (13-0%), ciprofloxacin (11-13%) and ceftriaxone (11-0%). Vibrio cholerae isolated in Dhaka and Matlab was resistant to trimethoprim-sulphamethoxazole (98-94%), furazolidone (100%), erythromycin (71-53%), tetracycline (46-44%), ciprofloxacin (3-10%) and azithromycin (3-0%).

  9. Eyes can See What Mind Can’t see

    Energy Technology Data Exchange (ETDEWEB)

    Irfan, Ahsan, E-mail: irfanahsanrajpoot@gmail.com; Zulfiqar, Arif; Ali, Ghani [Department of Internal Medicine, Abington Jefferson Health (United States)

    2016-03-03

    A 55 year old Caucasian female with a history of Iron deficiency anemia with hemoglobin of 6.1 gm/dl was admitted from her hematologist office for a Venofer infusion. She had profound confusion on presentation. Physical examination was pertinent for fever of 101οF, and laboratory data pertinent for elevated blood sugars of 590 mg/dl, leukocytosis of 10.3 K/UL with bandemia of 13%, elevated AST 170 U/L, ALT 184 U/L, and normal alkaline phosphate and total bilirubin. She was subsequently found to have Strep. Viridian bacteremia and CT scan of Chestabdomen- pelvis revealed multiple hepatosplenic masses consistent with malignancy or abscesses. Liver biopsy showed benign liver cells with a background of acute and chronic inflammatory cells and abscess (*image shown). She was treated with long term course of Ceftriaxone via PICC line.

  10. 头孢曲松治疗葡萄球菌烫伤样皮肤综合征的观察

    Institute of Scientific and Technical Information of China (English)

    钟永军

    2006-01-01

    葡萄球菌烫伤样皮肤综合征(Staphylococca Scalded Skin Syndronme,SSSS)由金葡球菌产生的表皮剥脱毒素(Exfoliative Toxin,ET)引起,是好发于新生儿、婴幼儿的疾病.笔者于2002年3月至2005年9月使用注射用头孢曲松钠(Ceftriaxone Sodium for Injection,规格1.0g,海南海口奇力制药有限公司生产)治疗小儿SSSS16例取得良好疗效,现将结果报告如下.

  11. Septic arthritis caused by Aspergillus fumigatus in an immunosuppressive patient: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Tuba Dal

    2012-03-01

    Full Text Available Septic arthritis is a serious medical problem that causes rapidly chronic and irreversible joint damage when diagnosisand treatment are delayed. Although, the bacteria are the most frequent cause of septic arthritis, rarely fungi may beresponsible for this disease. We presented here a case of septic arthritis caused by Aspergillus fumigatus, developed ina 65 years-old-male patient with diabetes mellitus. The patient admitted to our hospital with complaints of pain, swelling,redness in the right knee and high fever, which are not exceeding despite using vancomycin and ceftriaxone for 18days. Imipenem was started to the patient in our hospital. At the end of 7 days because of no regression of patient’scomplaints, arthroscopic synovectomy and lavage were performed for the patient’s right knee. Aspergillus fumigatuswas isolated from the aspiration biopsy specimen that received during the surgical operation and patient was treatedwith voriconazole, successfully. J Microbiol Infect Dis 2012; 2(1: 29-32

  12. Raoultella planticola bacteremia following consumption of seafood.

    Science.gov (United States)

    Lam, Philip W; Salit, Irving E

    2014-07-01

    Raoultella planticola is a Gram-negative bacillus commonly found in water, soil and aquatic environments. There have only been 16 cases of R planticola infection documented in the literature to date. R planticola possesses the ability to convert histidine to histamine and can produce symptoms of scombroid poisoning when poorly prepared seafood is consumed in large amounts. The present report describes a case involving a 56-year-old woman who presented with R planticola bacteremia and symptoms consistent with cholangitis four days after consuming a seafood salad containing squid and octopus. She was successfully treated with intravenous ceftriaxone followed by oral ciprofloxacin. Recent chemotherapy, proton pump inhibitor use and altered biliary flow secondary to hepatic metastases may have been contributing factors to the pathogenesis of disease.

  13. Carrying pharyngeal of Streptococcus pyogenes and sensitivity profiles in schoolchild from Cartagena

    Directory of Open Access Journals (Sweden)

    Lucy Margarita Villafañe-Ferrer

    2015-07-01

    Full Text Available To determine the frequency of carrying pharyngeal of Streptococcus pyogenes and their sensitivity profiles in schoolchildren from Cartagena. Analytical cross-sectional study, the sample was composed by 131 children. Strains of Streptococcus pyogenes were identified using conventional methods. Antibiotic sensitivity was determined the Kirby-Bauer methods. A questionnaire was applied in order to identify risk factors associated.19,8% of children were carriers of bacterium. 26 isolates of Streptococcus pyogenes were obtained. To evaluate the sensitivity were found strains sensible to ceftriaxone and erytrhomycin (84,6% each one. 23,1% (6/26 0f isolates were resistant to ampicillin. It not was found association between carrying pharyngeal of Streptococcus pyogenes and risk factors (p>0,05. It were found resistant strains to antibiotics considered of first election for therapy of infectious diseases produced by this bacterium.

  14. Study of Pseudomonas Aeroginosa resistance to Penicillines, Cephalosporins and Aminoglycosides

    Directory of Open Access Journals (Sweden)

    Maleknezhad P

    1998-07-01

    Full Text Available Drug therapy and prophylaxy in infectious diseases, from hygienic and economical point of view, are very important. Infections caused by pseudomonas aeroginosa were particularly severe, with high mortality rates. In the recent years pseudomonas aeroginosa continued to cause the most severe, life-thereating infections in burned patients, in spite of the introduction of a wide variety of antibiotics advised specifically for their anti pseudomonal activity. The aim of this study, in which many cases of ps.aeroginosa infections are assessed is to identify the drug resistance of this bacteria to penicillines, cephalosporins and aminoglycosides by antibiotic sensitivity test (disk ager diffusion. Results as percent of resistance to each antibiotic were 89% to carbenicillin, 55% to piperacillin, 89% to mezlocillin, 89.5% to ticarcillin+clavulonic acid, 85% to ceftriaxone, 95% to tobramycin, 5% of all isolates were not sensitive to any antibiotics.

  15. Pasteurella multocida bacterial meningitis caused by contact with pigs

    Directory of Open Access Journals (Sweden)

    C. López

    2013-01-01

    Full Text Available Pasteurella multocida belongs to the normal flora of the respiratory and digestive tract of many animals. Animal exposure is a considerable risk factor for Pasteurella infection. P. multocida is the most common cause of local infection after an animal bite but is an unusual cause of meningitis. We present a case of bacterial meningitis by P. multocida in a 37-year-old man who worked in a pig farm and was bitten by a pig. The patient had a defect located in the lamina cribosa and this lesion could be the gateway of the infection, although in this case the infection could also be acquired through the pig bite. The bacteria was identified as P. multocida with the biochemical test API 20E (bioMérieux. In agreement with findings in the literature, the strain was susceptible in vitro to penicillin, ampicillin, cefotaxime, ceftriaxone ciprofloxacin, levofloxacin, imipenem and tetracycline.

  16. Enteric fever in a British soldier from Sierra Leone.

    Science.gov (United States)

    Osborne, Lucy G; Brown, M; Bailey, M S

    2016-06-01

    Enteric fever (typhoid and paratyphoid) remains a threat to British troops overseas and causes significant morbidity and mortality. We report the case of a soldier who developed typhoid despite appropriate vaccination and field hygiene measures, which began 23 days after returning from a deployment in Sierra Leone. The incubation period was longer than average, symptoms started 2 days after stopping doxycycline for malaria chemoprophylaxis and initial blood cultures were negative. The Salmonella enterica serovar Typhi eventually isolated was resistant to amoxicillin, co-amoxiclav, co-trimoxazole and nalidixic acid and had reduced susceptibility to ciprofloxacin. He was successfully treated with ceftriaxone followed by azithromycin, but 1 month later he remained fatigued and unable to work. The clinical and laboratory features of enteric fever are non-specific and the diagnosis should be considered in troops returning from an endemic area with a febrile illness. Multiple blood cultures and referral to a specialist unit may be required.

  17. Comparative in vitro activity of oral antimicrobial agents against Enterobacteriaceae from patients with community-acquired urinary tract infections in three European countries.

    Science.gov (United States)

    Kresken, M; Körber-Irrgang, B; Biedenbach, D J; Batista, N; Besard, V; Cantón, R; García-Castillo, M; Kalka-Moll, W; Pascual, A; Schwarz, R; Van Meensel, B; Wisplinghoff, H; Seifert, H

    2016-01-01

    Enterobacteriaceae causing community-acquired urinary tract infections were examined in selected outpatient clinics and hospitals in Belgium, Germany and Spain using EUCAST breakpoints for susceptibility. A total of 1190 isolates were collected. Escherichia coli isolates were resistant to amoxicillin-clavulanic acid (28.1%), ciprofloxacin (23.4%) and trimethoprim-sulfamethoxazole (21.4%) compared with fosfomycin and nitrofurantoin (each, <1.5%). Ceftibuten (MIC50/90 0.25/0.5 mg/L) and ceftriaxone activity (MIC50/90 ≤0.25 mg/L) was comparable. Ceftibuten (MIC90 ≤0.25 mg/L) was also active against Proteus mirabilis and Klebsiella spp. Extended-spectrum β-lactamase phenotypes were 7.1% for E. coli, 5.6% for Klebsiella pneumoniae and 0.4% for P. mirabilis. Resistance was common among men and elderly women. PMID:26321667

  18. Considering Respiratory Tract Infections and Antimicrobial Sensitivity: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Amin, R.

    2009-01-01

    Full Text Available This study was conducted to observe the sensitivity and resistance of status of antibiotics for respiratory tract infection (RTI. Throat swab culture and sensitivity report of 383 patients revealed sensitivity profiles were observed with amoxycillin (7.9%, penicillin (33.7%, ampicillin (36.6%, co-trimoxazole (46.5%, azithromycin (53.5%, erythromycin (57.4%, cephalexin (69.3%, gentamycin (78.2%, ciprofloxacin (80.2%, cephradine (81.2%, ceftazidime (93.1%, ceftriaxone (93.1%. Sensitivity to cefuroxime was reported 93.1% cases. Resistance was found with amoxycillin (90.1%, ampicillin (64.1%, penicillin (61.4%, co-trimoxazole (43.6%, erythromycin (39.6%, and azithromycin (34.7%. Cefuroxime demonstrates high level of sensitivity than other antibiotics and supports its consideration with patients with upper RTI.

  19. Cavity Forming Pneumonia Due to Staphylococcus aureus Following Dengue Fever.

    Science.gov (United States)

    Miyata, Nobuyuki; Yoshimura, Yukihiro; Tachikawa, Natsuo; Amano, Yuichiro; Sakamoto, Yohei; Kosuge, Youko

    2015-11-01

    While visiting Malaysia, a 22-year-old previously healthy Japanese man developed myalgia, headache, and fever, leading to a diagnosis of classical dengue fever. After improvement and returning to Japan after a five day hospitalization, he developed productive cough several days after defervescing from dengue. Computed tomography (CT) thorax scan showed multiple lung cavities. A sputum smear revealed leukocytes with phagocytized gram-positive cocci in clusters, and grew an isolate Staphylococcus aureus sensitive to semi-synthetic penicillin; he was treated successfully with ceftriaxone and cephalexin. This second reported case of pneumonia due to S. aureus occurring after dengue fever, was associated both with nosocomial exposure and might have been associated with dengue-associated immunosuppression. Clinicians should pay systematic attention to bacterial pneumonia following dengue fever to establish whether such a connection is causally associated. PMID:26304914

  20. Blocking of leukocyte accumulation in the cerebrospinal fluid augments bacteremia and increases lethality in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian T; Lundgren, Jens D; Frimodt-Møller, Niels;

    2005-01-01

    The role of leukocyte accumulation in the cerebrospinal fluid (CSF) in the evolution of the pathophysiological changes that occur in bacterial meningitis is unclear. Here, we investigate how leukocyte recruitment to the CSF, modulated by the leukocyte blocker fucoidin, affects the extent of brain......, blocking leukocyte entry to the central nervous system in experimental pneumococcal meningitis compromises the survival prognosis but does not affect the risk of brain damage or level of infection in this compartment. Conversely, poorer prognosis was associated with an increase in bacterial load in blood...... damage and outcome in pneumococcal meningitis in rats treated with ceftriaxone from 28 h after infection. Rats treated with fucoidin from time of infection had an excess risk of a fatal outcome compared to rats not receiving fucoidin (25/63 versus 5/34, p=0.012), whereas the risk of cortical damage...

  1. Routes, dynamics, and correlates of cochlear inflammation in terminal and recovering experimental meningitis

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Worsøe, Lise; Brandt, Christian Thomas;

    2009-01-01

    OBJECTIVES/HYPOTHESIS: To examine the routes, dynamics and correlates of cochlear inflammation in meningitis to provide information on the pathogenesis of the associated hearing loss and indications for rational pharmacotherapeutical intervention. STUDY DESIGN: A well-established rat model...... of Streptococcus pneumoniae meningitis was employed. METHODS: Eight rats were inoculated intrathecally and not treated, whereas 26 were inoculated and treated with ceftriaxone. Six rats were sham-inoculated, making a total of 40 rats. The rats were sacrificed when reaching terminal illness or after 7 days......, followed by light microscopy. Routes of cochlear inflammatory infiltration were examined. The volume fraction of inflammatory infiltration was estimated and correlated to bacterial and leukocyte counts in cerebrospinal fluid (CSF) and blood. RESULTS: The perilymphatic space was infiltrated...

  2. Lichen sclerosus et atrophicans, scleroderma en coup de sabre and Lyme borreliosis

    Directory of Open Access Journals (Sweden)

    Serena Bonin

    2011-09-01

    Full Text Available Lichen sclerosus et atrophicans (LSA is a chronic, inflammatory skin disease of unknown etiology, characterized by atrophy. We report a case of LSA with frontoparietal distribution, mimicking scleroderma en coup de sabre, causing scarring alopecia. The case was associated with Borrelia infection. The lesion improved with 2 cycles of antibiotic therapy with ceftriaxone 2 gr /day i.v for 21 days associated with UVA-1 therapy and local and systemic vitamin E supply (400 mg 2x/day per os for 3 months. This case stresses the importance of identifying clinical manifestations associated with Lyme disease and the use of tissue PCR to detect borrelial DNA in patients with these lesions, but characterized by negative serology for Borrelia.

  3. Fabrication, characterization and in vitro profile based interaction with eukaryotic and prokaryotic cells of alginate-chitosan-silica biocomposite.

    Science.gov (United States)

    Balaure, Paul Catalin; Andronescu, Ecaterina; Grumezescu, Alexandru Mihai; Ficai, Anton; Huang, Keng-Shiang; Yang, Chih-Hui; Chifiriuc, Carmen Mariana; Lin, Yung-Sheng

    2013-01-30

    This work is focused on the fabrication of a new drug delivery system based on polyanionic matrix (e.g. sodium alginate), polycationic matrix (e.g. chitosan) and silica network. The FT-IR, SEM, DTA-TG, eukaryotic cell cycle and viability, and in vitro assay of the influence of the biocomposite on the efficacy of antibiotic drugs were investigated. The obtained results demonstrated the biocompatibility and the ability of the fabricated biocomposite to maintain or improve the efficacy of the following antibiotics: piperacillin-tazobactam, cefepime, piperacillin, imipenem, gentamicin, ceftazidime against Pseudomonas aeruginosa ATCC 27853 and cefazolin, cefaclor, cefuroxime, ceftriaxone, cefoxitin, trimethoprim/sulfamethoxazole against Escherichia coli ATCC 25922 reference strains.

  4. A case of meningococcal meningitis that was difficult to treat owing to concurrent ventriculitis.

    Science.gov (United States)

    Nakahara, Hiroaki; Oda, Toshimi; Fukao, Eri; Horiuchi, Izumi; Honma, Yutaka; Uchigata, Masanobu

    2016-05-31

    A 64-year-old male came to our hospital emergency department with fever and consciousness disturbance. Culture tests of blood and spinal fluid samples revealed meningococci (Neisseria meningitidis), and we made a diagnosis of meningococcal meningitis. Brain magnetic resonance imaging (MRI) findings revealed ventriculitis. Ceftriaxone was administered for 17 days, however, relapse was noted after that was discontinued, with neutropenia and renal impairment thought to be adverse reactions to the beta-lactam antibiotic. Hence, treatment was switched to oral administration of moxifloxacin for a total of 12 weeks, including in an outpatient setting. After moxifloxacin was discontinued, no side effects or relapse were seen, and treatment was ended. Although antibacterial agents generally show favorable effects for meningococcal meningitis, we consider that sufficient antimicrobial therapy is difficult in cases complicated with ventriculitis. PMID:27151225

  5. Chronic meningitis with intracranial hypertension and bilateral neuroretinitis following Mycoplasma pneumoniae infection.

    Science.gov (United States)

    Karampatsas, Konstantinos; Patel, Himanshu; Basheer, Sheikh N; Prendergast, Andrew J

    2014-12-23

    A previously well 12-year-old boy presented with a 2-week history of headache, nausea, vomiting and left-sided weakness. He subsequently developed meningism, right abducens nerve palsy, persistent papilloedema and reduced visual acuity in association with a bilateral macular star, consistent with neuroretinitis. Cerebrospinal fluid (CSF) examination indicated chronic meningitis and serological testing confirmed recent Mycoplasma pneumoniae infection, although PCR in CSF was negative. He was treated for aseptic meningitis with ceftriaxone, aciclovir, azithromycin and acetazolamide for intracranial hypertension, with gradual improvement in clinical condition and visual acuity over several weeks. This is the first report of M. pneumoniae chronic meningitis further complicated with bilateral neuroretinitis and intracranial hypertension. Evidence of central nervous system inflammation in the absence of direct infection suggests an immune-mediated pathophysiology. Although the use of macrolides with antibiotic and immunomodulatory activity might be beneficial, it was not possible to ascertain whether it influenced clinical recovery in this case.

  6. Neisseria gonorrhoeae and fosfomycin: Past, present and future.

    Science.gov (United States)

    Tesh, Lauren D; Shaeer, Kristy M; Cho, Jonathan C; Estrada, Sandy J; Huang, Vanthida; Bland, Christopher M; DiMondi, V Paul; Potter, Alicia N; Hussein, Gamal; Bookstaver, P Brandon

    2015-09-01

    Drug-resistant Neisseria gonorrhoeae has become a global health concern that requires immediate attention. Due to increasing resistance to cephalosporins, pursuing novel alternatives for treating N. gonorrhoeae infections is paramount. Whilst new drug development is often cumbersome, reviving antiquated antibiotic agents for treatment of modern infections has become prevalent in clinical practice. Fosfomycin exhibits bactericidal activity through a unique mechanism of action, and a variety of organisms including N. gonorrhoeae are susceptible. In vitro studies have demonstrated that fosfomycin can retain activity against ceftriaxone-resistant N. gonorrhoeae; however, it remains unclear whether there is synergy between fosfomycin and other antibiotics. Clinical investigations evaluating fosfomycin for the treatment of N. gonorrhoeae infections are confounded by methodological limitations, none the less they do provide some perspective on its potential role in therapy. Future studies are needed to establish a safe, convenient and effective fosfomycin regimen for treating N. gonorrhoeae infections. PMID:26145201

  7. Multidrug-Resistant Neisseria gonorrhoeae Isolates from Nanjing, China, Are Sensitive to Killing by a Novel DNA Gyrase Inhibitor, ETX0914 (AZD0914).

    Science.gov (United States)

    Su, Xiao-Hong; Wang, Bao-Xi; Le, Wen-Jing; Liu, Yu-Rong; Wan, Chuan; Li, Sai; Alm, Richard A; Mueller, John P; Rice, Peter A

    2016-01-01

    We tested the activity of ETX0914 against 187 Neisseria gonorrhoeae isolates from men with urethritis in Nanjing, China, in 2013. The MIC50, MIC90, and MIC range for ETX0914 were 0.03 μg/ml, 0.06 μg/ml, and ≤0.002 to 0.125 μg/ml, respectively. All isolates were resistant to ciprofloxacin, and 36.9% (69/187) were resistant to azithromycin. Of the isolates, 46.5% were penicillinase-producing N. gonorrhoeae (PPNG), 36% were tetracycline-resistant N. gonorrhoeae (TRNG), and 13% (24 isolates) had an MIC of 0.125 μg/ml for ceftriaxone. ETX0914 may be an effective treatment option for gonorrhea. PMID:26482313

  8. Drug Repurposing for the Development of Novel Analgesics.

    Science.gov (United States)

    Sisignano, Marco; Parnham, Michael J; Geisslinger, Gerd

    2016-03-01

    Drug development consumes huge amounts of time and money and the search for novel analgesics, which are urgently required, is particularly difficult, having resulted in many setbacks in the past. Drug repurposing - the identification of new uses for existing drugs - is an alternative approach, which bypasses most of the time- and cost-consuming components of drug development. Recent, unexpected findings suggest a role for several existing drugs, such as minocycline, ceftriaxone, sivelestat, and pioglitazone, as novel analgesics in chronic and neuropathic pain states. Here, we discuss these findings as well as their proposed antihyperalgesic mechanisms and outline the merits of pathway-based repurposing screens, in combination with bioinformatics and novel cellular reprogramming techniques, for the identification of novel analgesics. PMID:26706620

  9. Analysis of 12 beta-lactam antibiotics in human plasma by HPLC with ultraviolet detection.

    Science.gov (United States)

    McWhinney, Brett C; Wallis, Steven C; Hillister, Tara; Roberts, Jason A; Lipman, Jeffrey; Ungerer, Jacobus P J

    2010-07-15

    A simple and economical high performance liquid chromatography method was developed and validated for routine analysis of 12 Penicillin, Cephalosporin and Carbapenem antibiotics in 200 microL of human plasma. Antibiotics determined were Ceftazidime, Meropenem, Ceftriaxone, Ampicillin, Cefazolin, Ertapenem, Cephalothin, Benzylpenicillin, Flucloxacillin, Dicloxacillin, Piperacillin and Ticarcillin. There was a common sample preparation approach involving precipitation of proteins with acetonitrile and removal of lipid-soluble components by a chloroform wash. Separations were performed on a Waters X-bridge C18 column with, depending on analytes, one of three acetonitrile-phosphate buffer mobile phases. Detection was by UV at 210, 260 and 304 nm. Validation has demonstrated the method to be linear, accurate and precise. The method has been used in a pathology laboratory for therapeutic drug monitoring (TDM) of beta-lactams in critically ill patients. PMID:20561826

  10. A Case of Disseminated Infection Caused by Streptococcus equi Subspecies zooepidemicus

    Directory of Open Access Journals (Sweden)

    Marie-France Poulin

    2009-01-01

    Full Text Available Human infections with Streptococcus equi subspecies zooepidemicus, a group C streptococcus, are very rare and are generally associated with contact with horses, and consumption of unpasteurized milk products, goat cheese or pork. In most cases S zooepidemicus leads to fulminant infections. The case of a middle-aged woman who had sporadic contact with horses is described in the present report. She developed a bacteremia with severe and extensive complications that included meningitis, mitral endocarditis and blindness due to bilateral endophthalmitis. To the authors’ knowledge, this is the first reported case of an endophthalmitis due to S zooepidemicus. Because of a penicillin allergy, the patient was treated with ceftriaxone and rifampin over six weeks and survived. The present case report highlights the severe complications associated with S zooepidemicus infection.

  11. DETECTION & PREVALENCE OF EXTENDED SPECTRUM ΒETA - LACTAMASES AMONG ENTEROBACTERIACEAE SPECIES FROM VARIOUS CLINICAL SAMPLES AT KIMS, AMALAPURAM.

    Directory of Open Access Journals (Sweden)

    Padmaja

    2012-10-01

    Full Text Available ABSTRACT: The present study was conducted in the Department of Microbiology, KIMS, Amalapuram, East Godavari from January 2012 to July 2012. Out of 100 different clinical samples, 50 were culture positive. Of the 100 samples collected, more were from post operative wound sepsis - 44 (44%, followed by cellulites - 20 (20%, Ulcers - 17 (17%, Injuries 15 (15%. Least number of cases are from burns - 4 (4% . Among 50 culture positive cases, 38 (76% isolates belonged to Enterobacteriaceae famil y, followed by Pseudomonas aeruginosa - 8 (16%, followed by Staphylococcus aureus - 4 (8%. Among 38 of Enterobacteriaceae family isolates, 15 were ESBL producers. Among ESBL positiv e strains, more drug resistance was seen to Ceftazidime and Ampicillin (93.33%, followed by Ceftriaxone (86.66%, Aztreonam & Cefotaxime (80%.

  12. From past sailors' eras to the present day: scurvy as a surprising manifestation of an uncommon gastrointestinal disease.

    Science.gov (United States)

    Branquinho, Diogo Ferreira; Pinto-Gouveia, Miguel; Mendes, Sofia; Sofia, Carlos

    2015-01-01

    A 45-year-old man presented with follicular exanthema in his lower limbs, alternating bowel habits and significant weight loss. His medical history included seronegative arthritis, bipolar disease and an inconclusive diagnostic laparoscopy. Diagnostic work up revealed microcytic anaemia and multivitamin deficiency. Skin biopsy of the exanthema suggested scurvy. Owing to these signs of malabsorption, upper endoscopy with duodenal biopsies was performed, exhibiting villous atrophy and extensive periodic acid-Schiff-positive material in the lamina propria, therefore diagnosing Whipple's disease (WD). After starting treatment with ceftriaxone and co-trimoxazole, an impressive recovery was noted, as the wide spectrum of malabsorption signs quickly disappeared. After a year of antibiotics, articular and cutaneous manifestations improved, allowing the patient to stop taking corticosteroids and antidepressants. This truly unusual presentation reflects the multisystemic nature of WD, often leading to misdiagnosis of other entities. Scurvy is a rare finding in developed countries, but its presence should raise suspicion for small bowel disease. PMID:26376699

  13. Brain abscess caused by Haemophilus para phrophilus following a dental treatment in a girl. Report of a case

    Directory of Open Access Journals (Sweden)

    Vázquez Toledo María Eugenia

    2014-07-01

    Full Text Available We report the case of a six year old girl who developed three brain abscesses following a dental intervention (extraction of a tooth two weeks before. The etiologic agent was identified as Haemophilus paraprophilus, a gramnegative microorganism bacillus native mi- crobiota of the oropharynx nasopharynx and the gastrointestinal tract. 1 The patient was given ceftriaxone due to the sensitivity of the microorganism and metronidaole -because we couldn’t discard etiology by anaerobic- during six weeks. Surgical drainage of the abscesses was performed successfully. To date the patient has minimal neurologic sequelae. The importance of this case is that is the second report in the international literature of brain abscess secondary to Haemophilus paraprophilus in a pediatric patient and without associated heart disease.

  14. Risk assessment of antimicrobial usage in Danish pig production on the human exposure to antimicrobial resistant bacteria from pork

    DEFF Research Database (Denmark)

    Struve, Tina

    During the last decades, bacteria with resistance to all commonly used antimicrobial agents have been detected, thereby posing a major threat to public health. In worst case, infections with resistant bacteria can lead to treatment failure and death of humans. The evolution of bacteria resistant...... to antimicrobials are influenced by the use of antimicrobial agents, and the prudence of antimicrobial use have been emphasized since the Swann report in 1969 recommended that antibiotics used in human medicine should not be used as growth promoters in food-producing animals. In 2007, the World Health Organisation...... was investigated using selective agar plates supplemented with ceftriaxone. The occurrence of ESC producing E. coli was used as the outcome in the data analysis, where the effect of using cephalosporins, extended spectrum penicillins and tetracyclines was estimated using regression analysis. In Objective 2...

  15. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease

    Science.gov (United States)

    Lee, Kyung Jin; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-01-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved. PMID:26730366

  16. Neisseria gonorrhoeae and fosfomycin: Past, present and future.

    Science.gov (United States)

    Tesh, Lauren D; Shaeer, Kristy M; Cho, Jonathan C; Estrada, Sandy J; Huang, Vanthida; Bland, Christopher M; DiMondi, V Paul; Potter, Alicia N; Hussein, Gamal; Bookstaver, P Brandon

    2015-09-01

    Drug-resistant Neisseria gonorrhoeae has become a global health concern that requires immediate attention. Due to increasing resistance to cephalosporins, pursuing novel alternatives for treating N. gonorrhoeae infections is paramount. Whilst new drug development is often cumbersome, reviving antiquated antibiotic agents for treatment of modern infections has become prevalent in clinical practice. Fosfomycin exhibits bactericidal activity through a unique mechanism of action, and a variety of organisms including N. gonorrhoeae are susceptible. In vitro studies have demonstrated that fosfomycin can retain activity against ceftriaxone-resistant N. gonorrhoeae; however, it remains unclear whether there is synergy between fosfomycin and other antibiotics. Clinical investigations evaluating fosfomycin for the treatment of N. gonorrhoeae infections are confounded by methodological limitations, none the less they do provide some perspective on its potential role in therapy. Future studies are needed to establish a safe, convenient and effective fosfomycin regimen for treating N. gonorrhoeae infections.

  17. Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

    Science.gov (United States)

    Bunker, Daniel; Kerr, Leslie Dubin

    2015-01-01

    Disseminated gonococcal infection (DGI) is a rare complication of primary infection with Neisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions. PMID:26246922

  18. Genotyping of two Neisseria gonorrhoeae fluroquinolone-resistant strains in the Brazilian Amazon Region

    Directory of Open Access Journals (Sweden)

    William Antunes Ferreira

    2011-08-01

    Full Text Available We report two ciprofloxacin and ofloxacin-resistant Neisseria gonorrhoeae strains that were isolated from the urethral discharge of male patients at the sexually transmitted diseases outpatient clinic of the Alfredo da Matta Foundation (Manaus, state of Amazonas, Brazil. The gonococci displayed minimal inhibitory concentrations (> 32.00 µg/mL and three mutations in the quinolone resistance-determining region (S91F and D95G in GyrA and S87R in ParC. Both isolates were genotyped using N. gonorrhoeae multi-antigen sequence typing and the analysis showed that the ST225 which represented an emerging widespread multi-resistant clone that has also been associated with reduced susceptibility to ceftriaxone. We recommend continued surveillance of this pathogen to assess the efficacy of anti-gonococcal antibiotics in Brazil.

  19. Multidrug-Resistant Neisseria gonorrhoeae Isolates from Nanjing, China, Are Sensitive to Killing by a Novel DNA Gyrase Inhibitor, ETX0914 (AZD0914).

    Science.gov (United States)

    Su, Xiao-Hong; Wang, Bao-Xi; Le, Wen-Jing; Liu, Yu-Rong; Wan, Chuan; Li, Sai; Alm, Richard A; Mueller, John P; Rice, Peter A

    2015-10-19

    We tested the activity of ETX0914 against 187 Neisseria gonorrhoeae isolates from men with urethritis in Nanjing, China, in 2013. The MIC50, MIC90, and MIC range for ETX0914 were 0.03 μg/ml, 0.06 μg/ml, and ≤0.002 to 0.125 μg/ml, respectively. All isolates were resistant to ciprofloxacin, and 36.9% (69/187) were resistant to azithromycin. Of the isolates, 46.5% were penicillinase-producing N. gonorrhoeae (PPNG), 36% were tetracycline-resistant N. gonorrhoeae (TRNG), and 13% (24 isolates) had an MIC of 0.125 μg/ml for ceftriaxone. ETX0914 may be an effective treatment option for gonorrhea.

  20. Management of gonococcal infection among adults and youth

    Science.gov (United States)

    Pogany, Lisa; Romanowski, Barbara; Robinson, Joan; Gale-Rowe, Margaret; Latham-Carmanico, Cathy; Weir, Christine; Wong, Tom

    2015-01-01

    Abstract Objective To provide recommendations on the management of gonococcal infection among adults and youth. Quality of evidence Treatment recommendations in the Canadian guidelines on sexually transmitted infections are based on review of the literature, as well as the grades of recommendations and the levels of evidence quality determined by a minimum of 2 reviewers. The recommendations are peer-reviewed and require approval by the expert working group. Main message The new key recommendations for managing gonococcal infection among adults and youth include using culture as a diagnostic tool when practical, providing treatment with combination antibiotic therapy (ceftriaxone combined with azithromycin), and promptly reporting all cases with treatment failure to public health. Conclusion Following these new key recommendations might reduce treatment failure, contribute to better surveillance of antibiotic-resistance trends in Neisseria gonorrhoeae, and contribute to the prevention of transmission of multidrug-resistant gonorrhea. PMID:26472793

  1. 淋菌对β-内酰胺类抗菌药物的药敏试验结果回顾性分析%Drug susceptibility tests of neisseria gonorrhoeae to β-lactams antibiotics:a retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    刘明章; 沈翠芬; 吴原; 张晓祥; 王翔

    2011-01-01

    目的 了解淋菌对β-内酰胺类抗菌药物的敏感性,为淋病的防治提供科学依据.方法 回顾性分析纸片扩散法检测86株淋菌对6种β-内酞胺类抗菌药物的药敏试验结果,产色头孢硝噻吩法检测β-内酰胺酶.结果 质粒介导的产青霉素酶淋菌阳性菌株30株,占34.88%;淋菌对青霉素、头孢呋辛、头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率分别为8.14%,75.58%,90.70%,93.02%,86.05%,94.19%;青霉素的药物敏感性显著低于头孢呋辛,差异有统计学意义(X2=80.36,P<0.01);头孢呋辛的药物敏感性比头孢曲松的药物敏感性低,差异无统计学意义,但是头孢呋辛有5株耐药菌株;头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率,差异无统计学意义.结论 第三、四代头孢菌素可作为治疗淋菌感染的一线药物.%OBJECTIVE To investigate the β-lactams susceptibility of Neisseria gonorrhoeae and provide scientific basis for the treatment and prevention of gonorrhea. METHODS A retrospective survey was conducted. β-lactams susceptibility tests were tested by Disk diffusion, and βlactamase was determined by nitrocefin. RESULTS Plasmid mediated penicillinase producing Neisseria gonorrhoeae(PPNG) were 30 straines(34. 88 %). Susceptive rates of penicillin, cefuroxime, cefotaxime, ceftazidime, ceftriaxone and cefepime were 8. 14%, 75. 58%, 90.70%, 93. 02%, 86. 05% and 94. 19%, respectively. The sensitivity of penicillin was lower than that of cefuroxime with significant difference(x2 =80.36, P<0. 001). The sensitivity of cefuroxime was lower than that of ceftriaxone without significant difference (x2 =3.04, P = 0. 08), while there were 5 resistant strains for cefuroxine. There was no significant difference (x2=4.08,P= 2. 53) among the sensitivities of cefotaxime, ceftazidime, ceftriaxone and cefepime. CONCLUSION The third generation of cephalosporins such as cefotaxime, ceftazidime, ceftriaxone and the

  2. A misleading false-negative result using Neisseria gonorrhoeae opa MGB multiplex PCR assay in patient's rectal sample due to partial mutations of the opa gene.

    Science.gov (United States)

    Vahidnia, Ali; van Empel, Pieter Jan; Costa, Sandra; Oud, Rob T N; van der Straaten, Tahar; Bliekendaal, Harry; Spaargaren, Joke

    2015-07-01

    A 53-year-old homosexual man presented at his general practitioner (GP) practice with a suspicion of sexually transmitted infection. Initial NAAT screening was performed for Chlamydia trachomatis and Neisseria gonorrhoeae. The patient was positive for Neisseria gonorrhoeae both for his urine and rectal sample. The subsequent confirmation test for Neisseria gonorrhoeae by a second laboratory was only confirmed for the urine sample and the rectal sample was negative. We report a case of a potential false-negative diagnosis of Neisseria gonorrhoeae due to mutations of DNA sequence in the probe region of opa-MGB assay of the rectal sample. The patient did not suffer any discomfort as diagnosis of Neisseria gonorrhoeae in his urine sample had already led to treatment by prescribing the patient with Ceftriaxone 500 mg IV dissolved in 1 ml lidocaine 2% and 4 mL saline. The patient also received a prescription for Azithromycin (2x500 mg).

  3. Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

    Directory of Open Access Journals (Sweden)

    Daniel Bunker

    2015-01-01

    Full Text Available Disseminated gonococcal infection (DGI is a rare complication of primary infection with Neisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions.

  4. Analysis on sensitivity of Neisseria gonorrhoea to cephalosporin antibiotics and multi-antigen sequence typing%淋病奈瑟球菌对头孢菌素类药物的敏感性及多抗原序列分型研究

    Institute of Scientific and Technical Information of China (English)

    蓝银苑; 吴兴中; 覃晓琳; 黄进梅; 薛耀华; 曾维英; 欧江丽; 唐三梅; 方铭恒

    2015-01-01

    Objective To understand the molecular types of clinical isolated Neisseria gonorrhoeae (NG) in Guangzhou, and to analyze the sensitivity to the cephalosporin antibiotics. Methods A total of 121 NG strains isolated from Guangzhou Skin Disease Prevention and Control Center were included in this study. The agar dilution method was used to determine the minimum inhibitory concentrations (MIC) to ceftriaxone and cefixime. DNA was extracted for NG multi-antigen sequence typing (NG-MAST). Results The drug-resistance analysis showed that none of the strains appeared to be resistant to ceftriaxone and cefixime. However, the low sensitivity rates were 13.2%(16/121) and 2.5%(3/121), respectively. A total of 82 genotypes were identified among the 121 isolates. The most prevalent genotype was ST1768 (n=6) in NG strains isolated, followed by ST2083 (n=4), ST5062 (n=4), ST10229 (n=4), ST1766 (n=3), ST1866 (n=3), and ST10339 (n=3). There were 12 genotypes containing 2 NG strains, and 63 genotypes [76.8%(63/121) ] containing only one NG strain. Among the 13 NG strains with low sensitivity to ceftriaxone , there were 2 strains of ST10339 and 2 strains of ST10242 , and the rest were single genotype. Conclusions The 121 NG strains have relatively high sensitivity to ceftriaxone and cefixime. The genotypes of these NG-MAST strains are high diversity.%目的 了解广州市临床分离淋病奈瑟球菌 (NG) 的分子型别及其对头孢菌素类抗生素的敏感性. 方法 收集广东省皮肤性病防治中心临床分离的121株NG,用琼脂稀释法测定菌株对头孢曲松和头孢克肟的最小抑菌浓度(MIC),并进行NG多抗原测序分型(NG-MAST). 结果 未发现NG对头孢曲松和头孢克肟耐药的菌株,但它们的低敏率分别达到13.2%(16/121)和2.5%(3/121). 121株NG共有82个型别,其中ST1768共6株,ST2083、ST5062和ST10229各4株,ST1766、ST1866和ST10339各3株, 有12个ST族群包含2株菌株,其余63 个型别仅含1 株菌株,占76.8%(63/121).

  5. Leptospirosis: a globally increasing zoonotic disease.

    LENUS (Irish Health Repository)

    Rock, Clare

    2010-01-01

    A 27-year-old previously healthy man was admitted to the intensive care unit with severe jaundice, dyspnoea with haemoptysis, anaemia, thrombocytopenia and acute renal injury. He had no recent history of foreign travel but had been building a shed in his back garden in Cork, Ireland, for the preceding week. The patient\\'s history, clinical observations, haematological and radiological results were all consistent with icteric leptospirosis or Weil\\'s disease. This was confirmed on serological testing. He completed 7 days intravenous ceftriaxone and made a complete recovery. While endemic in tropical climates, leptospirosis incidence is increasing in temperate climates. Recent cases seen in temperate climates can be severe, particularly with pulmonary manifestations. The report of this case serves to increase awareness of this re-emerging potentially fatal infectious disease.

  6. Evaluation of anti-pneumococcal capsular antibodies as adjunctive therapy in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian; Frimodt-Moller, N; Lundgren, Jens Dilling;

    2006-01-01

    OBJECTIVE: Bacteraemia concomitant with meningitis has been shown to greatly affect outcome. Consequently, the efficacy of serotype-specific anti-pneumococcal antiserum (APAS) was investigated in a rat model of pneumococcal meningitis. METHODS: Rats were infected with Streptococcus pneumoniae...... serotype 3. All rats received ceftriaxone starting 26 h post-infection. APAS was administered either at the time of infection or 26 h post-infection and effects were compared with rats treated with antibiotics only. RESULTS AND CONCLUSION: A significant clinical benefit was found when APAS was given...... at the time of infection whereas no effect was found when administered 26 h after infection. This work indicates that the clinical value of using APAS in pneumococcal meningitis may be limited...

  7. RECURRENT SALMONELLA TYPHI CHEST WALL ABSCESSES IN A DIABETIC LADY

    Directory of Open Access Journals (Sweden)

    Jayasri Helen

    2014-09-01

    Full Text Available : Salmonella enterica serovar typhi causing typhoid fever is common in many parts of the world particularly in developing countries. Extra intestinal manifestations are uncommon and occur in immunocompromised individuals such as patients with diabetes, HIV infection, chronic steroid use, chemotherapy and malignancy. We report a case of Salmonella typhi causing recurrent chest wall abscesses in a lady with uncontrolled diabetes. She was admitted with high grade fever, left sided chest wall abscess and a previous history of two similar chest wall abscesses. After hospitalization prompt incision and drainage was done and aerobic culture of pus grew moderate growth of Salmonella typhi resistant to ciprofloxacin and sensitive to cephalosporins. Based on culture report our patient was treated with oral azithromycin for ten days and parenteral ceftriaxone for six weeks. There was rapid and full recovery and six months follow up revealed no recurrence.

  8. Spread of Extended Spectrum Cephalosporinase-Producing Escherichia coli Clones and Plasmids from Parent Animals to Broilers and to Broiler Meat in a Production Without Use of Cephalosporins

    DEFF Research Database (Denmark)

    Agersø, Yvonne; Jensen, Jacob Dyring; Hasman, Henrik;

    2014-01-01

    Objectives: This study investigated the occurrence of extended spectrum cephalosporinase (ESC)–producing Escherichia coli in a broiler production with no cephalosporin use and a low use of antimicrobials in general. Furthermore, it investigated whether the current consumption of aminopenicillins...... selects for ESC-producing E. coli and whether certain clones or plasmids spread from imported parent flocks to the meat. Materials and Methods: ESC-producing E. coli was isolated using MacConkey broth with 1 mg/L of ceftriaxone. ESC genes were identified using polymerase chain reaction and sequencing...... of ESC E. coli. Conclusions: ESC-producing E. coli from flocks of imported broiler parents spread clonally and horizontally to broiler meat (including potentially human pathogenic types) even in a country with no cephalosporin use. Use of aminopenicillins may influence the persistence of ESC-producing E...

  9. Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

    Directory of Open Access Journals (Sweden)

    Vacek TP

    2014-09-01

    Full Text Available Thomas P Vacek, Shahnaz Rehman, Shipeng Yu, Ankush Moza, Ragheb Assaly Department of Internal Medicine, The University of Toledo Medical Center, Toledo OH, USAAbstract: Chest pain requires a detailed differential diagnosis with good history-taking skills to differentiate between cardiogenic and noncardiogenic causes. Moreover, when other symptoms such as fever and elevated white blood cell count are involved, it may be necessary to consider causes that include infectious sources. A 53-year-old female with no significant past medical history returned to the hospital with recurrent complaints of chest pain that was constant, substernal, reproducible, and exacerbated with inspiration and expiration. The chest pain was thought to be noncardiogenic, as electrocardiography did not demonstrate changes, and cardiac enzymes were found to be negative for signs of ischemia. The patient's blood cultures were analyzed from a previous admission and were shown to be positive for Staphylococcus aureus. The patient was started empirically on vancomycin, which was later switched to ceftriaxone as the bacteria were more sensitive to this antibiotic. A transthoracic echocardiogram did not demonstrate any vegetation or signs of endocarditis. There was a small right pleural effusion discovered on X-ray. Therefore, computed tomography as well as magnetic resonance imaging of the chest were performed, and showed osteomyelitis of the chest. The patient was continued on intravenous ceftriaxone for a total of 6 weeks. Tests for HIV, hepatitis A, B, and C were all found to be negative. The patient had no history of childhood illness, recurrent infections, or previous trauma to the chest, and had had no recent respiratory infections, pneumonia, or any underlying lung condition. Hence, her condition was thought to be a case of primary sternal osteomyelitis without known cause.Keywords: substernal, pleuritic, myocardial infarction, differential

  10. Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital,Indonesia

    Institute of Scientific and Technical Information of China (English)

    Maksum; Radji; Siti; Fauziah; Nurgani; Aribinuko

    2011-01-01

    Objective:To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit(ICU) of a tertiary care of Falmawati Hospital Jakarta Indonesia.Methods:A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods,and(heir antibiotic susceptibility testing was performed using disk diffusion method.Results:Specimens were collected from 385 patients who were given antimicrobial treatment,of which 249(64.68%) were cultured positive and 136(35.32%) were negative.The most predominant isolate was Pseudomonas aeruginosa(P.aeruginosa)(26.5%) followed by Klebsiella pneumoniae(K.pneumoniae)(15.3%) and Staphylococcus epidermidis(14.9%).P.aeruginosa isolates showed high rate of resistance to cephalexin(95.3%),cefotaxime(64.1%),and ceftriaxone(60.9%).Amikacin was the most effective(84.4%) antibiotic against P.aeruginosa followed by imipenem(81.2%),and meropenem(75.0%).K.pneumoniae showed resistance to cephalexin(86.5%),ceftriaxone(75.7%),ceftazidime(73.0%),cefpirome(73.0%) and cefotaxime(67.9%),respectively.Conclusions:Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins,and quinolone antibiotics.Regular surveillance of antibiotic susceptibility pallerns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

  11. Prevalence and etiologic agents of female reproductive tract infection among in-patients and out-patients of a tertiary hospital in Benin city, Nigeria

    Directory of Open Access Journals (Sweden)

    Christopher Aye Egbe

    2010-10-01

    Full Text Available Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and Methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48% and out-patients (47.02%, although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01. Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out

  12. Prevalence and etiologic agents of female reproductive tract infection among in-patients and out-patients of a tertiary hospital in Benin city, Nigeria

    Directory of Open Access Journals (Sweden)

    Richard Omoregie

    2010-01-01

    Full Text Available Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48% and out-patients (47.02%, although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01. Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out

  13. Antimicrobial susceptibility pattern of bacterial isolates from surgical wound infections in Tertiary Care Hospital in Allahabad, India

    Directory of Open Access Journals (Sweden)

    A K Kapoor

    2012-01-01

    Full Text Available The aim of present study to analyze the occurrence and in-vitro antimicrobial susceptibility of bacterial pathogens isolated from surgical wound infections. Specimens from a total of 129 patients undergoing either emergency or elective surgery were collected from infected sites or stitch lines and inoculated onto appropriate media. The bacterial cultures were identified utilizing standard microbiological and biochemical methods. Isolates were tested for susceptibility to antimicrobials using the Kirby Bauer disk diffusion method. Statistical analysis was performed using the chi-square test. Of 129 patients investigated (62 emergency and 67 elective surgery cases, bacterial isolates were isolated with almost equal frequency both from emergency and elective surgery cases. Of 108 (83.72% culture positive samples, 62 (57.41% were Gram negative, 39 (36.11% Gram positive, and 7 (6.48% showed multiple organisms. Of total 115 bacteria isolated (101 single and 7 double organisms culture positive, 33 (28.69% were Escherichia coli and were also the commonest; followed by Staphylococcus aureus, 30 (26.09% cases. S. aureus and Streptococcus spp. showed maximum susceptibility (100% to linezolid and vancomycin. Maximum susceptibility of E. coli was observed to ciprofloxacin (75.7%, followed by gentamicin (54.5%; of Klebsiella spp. to ceftriaxone and gentamicin (66.6% each, of Proteus spp. to gentamicin (70% followed by ciprofloxacin (60%, and of Pseudomonas aeruginosa to piperacillin (100% and tobramycin (71.4%. E. coli and S. aureus were the most common and Salmonella spp. and Acinetobacter spp. were the least common organism causing surgical site infections. The definitive therapy included ciprofloxacin and gentamicin for E. coli; linezolid and vancomycin for S. aureus and Streptococcus spp; ceftriaxone and ciprofloxacin for Klebsiella spp., Citrobacter spp., acinetobacter spp and Salmonella spp.

  14. Antibiotic persistence: the role of spontaneous DNA repair response.

    Science.gov (United States)

    Debbia, E A; Roveta, S; Schito, A M; Gualco, L; Marchese, A

    2001-01-01

    Persisters are a small proportion of a bacterial population that exists in a physiological state permitting survival despite the lethal activity of antibiotics. To explain this phenomenon, it has been suggested that persisters are bacteria repairing spontaneous errors of DNA synthesis. To verify this assumption, Escherichia coli AB1157 and its lexA3 derivative were exposed to a dose 6x MIC of various antibiotics representative of different molecular mechanisms of action (ampicillin, ceftriaxone, meropenem, amikacin, ciprofloxacin). Bacterial cell counts, after 24 hr of exposure to the antimicrobials, revealed a reduction of about 90% of viable organisms in the lexA3 strains in comparison to the lexA+. In several cases, the number of colony-forming units decreased below the limit of assay. This behavior was noted with all antibiotics used, alone or in combination (amikacin plus ceftriaxone and amikacin plus ciprofloxacin). The same experiments were repeated using E. coli AB1157 cultured in the presence of mitomycin C (0.25x MIC), and the number of survivors exceeded by about 90% the values found in the nonexposed control. In contrast, in the sulA background, mitomycin C reacted synergically with all the antibiotics tested causing a strong reduction of the survivors in comparison with the control. The addition of chloramphenicol (0.125x MIC), on the contrary, caused a reduction of the number of survivors of about 90%. These findings indicate that, when DNA repair is active (a mechanism known to block cell division), the number of survivors is greater than that observed with lexA3. Thus, in addition to other possible explanations, persisters might be a fraction of bacteria that during antibiotic treatment are not growing because they are repairing spontaneous errors of DNA synthesis.

  15. In Vitro Antibiofilm Efficacies of Different Antibiotic Combinations with Zinc Sulfate against Pseudomonas aeruginosa Recovered from Hospitalized Patients with Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    Walid Elkhatib

    2014-02-01

    Full Text Available Urinary tract infections (UTIs are a serious healthcare dilemma influencing millions of patients every year and represent the second most frequent type of body infection. Pseudomonas aeruginosa is a multidrug-resistant pathogen causing numerous chronic biofilm-associated infections including urinary tract, nosocomial, and medical devices-related infections. In the present study, the biofilm of P. aeruginosa CCIN34519, recovered from inpatients with UTIs, was established on polystyrene substratum and scanning electron microscopy (SEM and was utilized for visualization of the biofilm. A previously described in vitro system for real-time monitoring of biofilm growth/inhibition was utilized to assess the antimicrobial effects of ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, ertapenem, ceftriaxone, gentamicin, and tobramycin as single antibiotics as well as in combinations with zinc sulfate (2.5 mM against P. aeruginosa CCIN34519 biofilm. Meanwhile, minimum inhibitory concentrations (MICs at 24 h and mutant prevention concentrations (MPCs at 96 h were determined for the aforementioned antibiotics. The real-time monitoring data revealed diverse responses of P. aeruginosa CCIN34519 biofilm to the tested antibiotic-zinc sulfate combinations with potential synergisms in cases of fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, and norfloxacin and carbapenem (ertapenem as demonstrated by reduced MIC and MPC values. Conversely, considerable antagonisms were observed with cephalosporin (ceftriaxone and aminoglycosides (gentamicin, and tobramycin as shown by substantially increased MICs and MPCs values. Further deliberate in vivo investigations for the promising synergisms are required to evaluate their therapeutic potentials for treatment of UTIs caused by P. aeruginosa biofilms as well as for developing preventive strategies.

  16. COMPARATIVE ACTIVITY OF DORIPENEM, IMIPENEM AND MEROPENEM AGAINST GRAM NEGATIVE PATHOGENS: A PRELIMINARY STUDY

    Directory of Open Access Journals (Sweden)

    Vipin Sam

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVE Doripenem is a new parenteral carbapenems, which has beta-lactamase stability and is not inactivated by renal dehydropeptidases. Doripenem has a spectrum of activity similar to imipenem and ertapenem against Gram-positive cocci and similar to meropenem against Gram-negative pathogens. In this study, we summarize the activity of doripenem against Gram negative bacilli in comparison with other carbapenems (Imipenem, meropenem and select group of antimicrobial drugs by disk diffusion. SETTINGS AND DESIGN A retrospective study was conducted over a period of 3 months (December 2013 to February 2014 in the Department of Microbiology of a tertiary care hospital in Northern India. METHODS AND MATERIAL Gram negative bacillary isolates were subjected to antimicrobial susceptibility with the following antibiotics: imipenem, meropenem, doripenem, ceftazidime, ceftriaxone, amikacin, ciprofloxacin, piperacillin/tazobactam, and trimethoprimsulphamethoxazole by employing the Kirby-Bauer disk diffusion method. The results were interpreted as per CLSI guidelines. RESULTS A total of 498 isolates obtained from urine, skin and soft tissue specimens and lower respiratory specimens were included in the study. The most frequent Gram-negative bacilli isolated were E. coli (31.5%, Acinetobacter spp. (20.1%, Klebsiella spp. (19.5%, P. aeruginosa (16.7%, Enterobacter spp. (8.2%, Proteus spp. (3% and Citrobacter spp. (1%. The isolates showed highest rates of susceptibility to meropenem (65.5% followed by imipenem (63.7%, doripenem (55.8%, amikacin (53.4%, piperacillin/tazobactam (48.7%, trimethoprim-sulphamethoxazole (38.3%, ceftazidime (26.9%, ceftriaxone (23.9% and ciprofloxacin (25.3%. CONCLUSIONS In this study, the activity of doripenem was found to be lower than meropenem and imipenem against all the isolates tested. Further detailed evaluation of doripenem is required with in-vitro MIC studies and their correlation with clinical outcomes.

  17. Community Acquired Spondylodiscitis caused by Escherichia Coli; Case Report and Literature Review.

    Science.gov (United States)

    Del Pozo, F Javier Fonseca; Alonso, Joaquín Valle; Ruiz, Miguel Ángel Caracuel; Vythilingam, Siyamini; Ruiz, Daniel Lopez

    2016-07-01

    Vertebral osteomyelitis, or spondylodiscitis, is a rare disease with increasing prevalence in recent years due to a greater number of spinal surgical procedures, nosocomial bacteraemia, an aging population and intravenous drug addiction. Haematogenous infection is the most common cause of spondylodiscitis. We report a 47-year-old man diagnosed with Escherichia coli spondylodiscitis. The patient initially presented with a 4-day history of inflammatory, mechanical pain in the lower back suggesting sciatica. Treatment included NSAIDs and opioids. Two days after discharge from hospital following an admission due to an upper GI bleeding, the back pain intensified, precipitating a new attendance to the emergency department; during which lumbosacral radiography showed marked reduction of L2/L3 intervertebral space. After a new admission to the rheumatology unit due to worsening of symptoms and raised inflammatory markers, an expedited MRI showed loss of intervertebral disc space at L2/L3, with an irregular high intensity area at L2; suggesting a fluid collection extending to adjacent soft tissues. Fluoroscopy-guided core needle bone biopsies were reported positive for Escherichia coli sensitive to ceftriaxone. The patient was treated (received treatment) with a three week course of ceftriaxone following a formal diagnosis of E. coli spondylodiscitis. Follow-up MRI demonstrated complete recovery with the patient able to return (has returned) to normal activity. In this case we highlight the importance of correct and timely diagnosis of spondylodiscitis. Diagnosis of spondylodiscitis is often difficult, delayed or even missed due to the rarity of the disease but can lead to devastating consequences. Therefore a high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes. PMID:27540554

  18. Community Acquired Spondylodiscitis caused by Escherichia Coli; Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    F Javier Fonseca del Pozo

    2016-07-01

    Full Text Available Vertebral osteomyelitis, or spondylodiscitis, is a rare disease with increasing prevalence in recent years due to a greater number of spinal surgical procedures, nosocomial bacteraemia, an aging population and intravenous drug addiction. Haematogenous infection is the most common cause of spondylodiscitis. We report a 47-year-old man diagnosed with Escherichia coli spondylodiscitis. The patient initially presented with a 4-day history of inflammatory, mechanical pain in the lower back suggesting sciatica. Treatment included NSAIDs and opioids. Two days after discharge from hospital following an admission due to an upper GI bleeding, the back pain intensified, precipitating a new attendance to the emergency department; during which lumbosacral radiography showed marked reduction of L2/L3 intervertebral space. After a new admission to the rheumatology unit due to worsening of symptoms and raised inflammatory markers, an expedited MRI showed loss of intervertebral disc space at L2/L3, with an irregular high intensity area at L2; suggesting a fluid collection extending to adjacent soft tissues. Fluoroscopy-guided core needle bone biopsies were reported positive for Escherichia coli sensitive to ceftriaxone. The patient was treated (received treatment with a three week course of ceftriaxone following a formal diagnosis of E. coli spondylodiscitis. Follow-up MRI demonstrated complete recovery with the patient able to return (has returned to normal activity. In this case we highlight the importance of correct and timely diagnosis of spondylodiscitis. Diagnosis of spondylodiscitis is often difficult, delayed or even missed due to the rarity of the disease but can lead to devastating consequences. Therefore a high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes.

  19. Antimicrobial agents' utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India

    Directory of Open Access Journals (Sweden)

    Nikhilesh Anand

    2016-01-01

    Full Text Available Background and Aims: High utilization and inappropriate usage of antimicrobial agents (AMAs in an Intensive Care Unit (ICU increases resistant organisms, morbidity, mortality, and treatment cost. Prescription audit and active feedback are a proven method to check the irrational prescription. Measuring drug utilization in DDD/100 bed-days is proposed by the WHO to analyze and compare the utilization of drugs. Data of AMAs utilization are required for planning an antibiotic policy and for follow-up of intervention strategies. Hence, in this study, we proposed to evaluate the utilization pattern and cost analysis of AMA used in the ICU. Methodology: A prospective observational study was conducted for 1 year from January 1, 2014, to December 31, 2014, and the data were obtained from the ICU of a tertiary care hospital. The demographic data, disease data, relevant investigation, the utilization of different classes of AMAs (WHO-ATC classification as well as individual drugs and their costs were recorded. Results: One thousand eight hundred and sixty-two prescriptions of AMAs were recorded during the study period with an average of 1.73 ± 0.04 prescriptions/patient. About 80.4% patients were prescribed AMAs during admission. Ceftriaxone (22.77% was the most commonly prescribed AMA followed by piperacillin/tazobactam (15.79%, metronidazole (12%, amoxicillin/clavulanic acid (6.44%, and azithromycin (4.34%. Ceftriaxone, piperacillin/tazobactam, metronidazole, and linezolid were the five maximally utilized AMAs with 38.52, 19.22, 14.34, 8.76, and 8.16 DDD/100 bed-days respectively. An average cost of AMAs used per patient was 2213 Indian rupees (INR. Conclusion: A high utilization of AMAs and a high cost of treatment were noticed which was comparable to other published data, though an increased use of newer AMAs such as linezolid, clindamycin, meropenem, colistin was noticed.

  20. [A meningitis case of Brucella and tuberculosis co-infection].

    Science.gov (United States)

    Karsen, Hasan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Demiröz, Ali Pekcan

    2008-10-01

    Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucella and tuberculosis co-infection has been presented. A 19-years-old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucella meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucella spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14th day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30th day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucella and tuberculosis co-infection, this report emphasizes that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis

  1. Clinical, Paraclinical, and Antimicrobial Resistance Features of Community-Acquired Acute Bacterial Meningitis at a Large Infectious Diseases Ward in Tehran, Iran.

    Science.gov (United States)

    Heydari, Behrooz; Khalili, Hossein; Karimzadeh, Iman; Emadi-Kochak, Hamid

    2016-01-01

    In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients' medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected. Kirby-Bauer disc diffusion method was used to determine their antimicrobial susceptibility profile. Details of medical management including antibiotic regimen, duration, patients' outcome, and possible sequelae of meningitis were recorded. The most commonly isolated microorganism from CSF or blood of patients was Streptococcus pneumonia (33.33%) followed by Neisseria meningitidis (27.78%) and Haemophilus influenza (16.67%). The most common antimicrobial regimen was ceftriaxone plus vancomycin (69.44%) followed by ceftriaxone plus vancomycin plus ampicillin (11.11%). Neurological sequelae of meningitis including cranial nerve palsy, deafness, and hemiparesis were identified in 4 (11.11%), 2 (5.56%), and 1 (2.78%) subjects, respectively. Regarding mortality, only 3 (8.33%) patients died from bacterial meningitis and the remaining 33 individuals discharged from the hospital. In conclusion, findings of the current study demonstrated that the mean incidence of acute bacterial meningitis in a referral infectious diseases ward in Iran was 9 episodes per year. The majority cases of community-acquired acute bacterial meningitis admitted to our center had negative CSF culture and classic triad of meningitis was absent in them. PMID:27610176

  2. Antimicrobial susceptibility patterns of Streptococcus pneumoniae over 6 years at Gondar University Hospital, Northwest Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Belay Anagaw; Chandrashekhar Unakal; Mucheye Gezachew; Fantahun Biadgelgene; Berhanu Anagaw; Tariku Geleshe; Birke Taddese; Birhanu Getie; Mengistu Endris; Andargachew Mulu

    2013-01-01

    Objective:To assess the magnitude and antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates from various clinical specimens. Methods:A record based on retrospective study was conducted at Gondar University Teaching Hospital from September 2007 to January 2012. All patients who visited Gondar University Hospital and provided clinical specimens (body fluids, discharge, swab and blood) for routine bacteriological culturing and antimicrobial susceptibility testing were taken for analysis. Clinical specimens were processed for bacterial culture according to the standard procedures. Antimicrobial susceptibility test for isolated organisms was done using agar disk diffusion method. The data were entered and analyzed using SPSS software version 16 package. Results: One hundred and fifty three Streptococcus pneumoniae were isolated from patients who visited Gondar University Teaching Hospital bacteriology laboratory for culture. Majority of the pneumococcal isolates were from inpatients [111(72.5%)], and 74(48.4%) were from body fluids. Out of the total isolates, 93(61%) were found to be resistant to at least one antibiotic used for susceptibility testing. Forty eight (43.2%) of the isolates were multi-drug resistant (resistant to two or more drugs). The resistance rate noted for both ciprofloxacin 17(11.1%) and ceftriaxone 15(9.8%) were alarming. Conclusions: High proportions of the isolates tend to be increasingly resistant to the commonly prescribed drugs. The recommended drug of choice like ciprofloxacin and ceftriaxone were found to be less susceptible in the study area. Based on the findings, we therefore recommend that antimicrobial agents should be inspected for acceptable activity before they are prescribed and administered empirically. Further study with a better design and survey of antimicrobial susceptibility at large scale shoule be performed to draw advanced information.

  3. Comparison of Two Different Disk Diffusion Agar Tests in Determination of Antibiotic Susceptibility for E-Coli Isolated from Urinary Tract Infection in Pediatrics

    Directory of Open Access Journals (Sweden)

    I. Sedighi

    2010-04-01

    Full Text Available Introduction & Objective: Urinary Tract Infection (UTI is one of the most common infections during childhood and E-Coli is the more predominant pathogen recovered in UTI. Disk Diffusion agar test is a method of choice because it is cost effective, simple, and now routinely used for detection of antibiotic susceptibility. A rapid increase in antibiotic resistance in our region made the authors to design a study to compare this traditional method with two different disk diffusion agar tests.Materials & Methods: Our study was conducted between 2009 and 2010 in Be’sat teaching hospital on 100 pediatric patients ranged 15 days to 13 years old with positive urine culture for E-coli. Antibiogram detection was performed by disk diffusion agar test with two different kits as Padtan-Teb (made in Iran and Mast (made in the U.K. for Co-trimoxazol, Amikacin, Ceftriaxone, Nalidixic Acid, Cefixime, and Nitrofurantoin. At last the data was analyzed by McNemar test.Results: Co-trimoxazol obtained the lowest (23% Padtan-Teb and 26% Mast and Nitrofurantoin had the highest (86% Padtan-Teb and 97% Mast sensitivity in the two methods which were used in our study. The results were statistically significant for Amikacin, Ceftriaxone, Cefixime, and Nitrofurantoin. The data was analyzed by Mc Memar test.Conclusion: According to our study the results of antibiotic susceptibility were more compatible with other non national Disk diffusion agar test and thus we recommend that our manufactures in Iran should increase the quality of their products.

  4. Prevalence of Aeromonas Hydrophila and Yersinia Enterocolitica in Children with Acute Diarrhea Attending Health Centers in Hamadan

    Directory of Open Access Journals (Sweden)

    S. Kazemi

    2016-01-01

    Full Text Available Introduction & Objective: Diarrhea is the most common cause of morbidity and mortality in all age groups, especially children, the elderly and immunocompromised patients. Various studies have been reported regarding the relationship between the children acute diarrhea and Aeromonashydrophila and Yersinia enterocolitica. This study aimed to investigate the prevalence of the bacteria and their sensitivity to common antibiotics and the prevalence of virulence genes in the bacteria in Hamadan, Iran. Materials & Methods: In this study, 120 stool samples collected from children less than 10 years of age with acute diarrhea were examined for Aeromonashydrophila and Yersinia enterocolitica. Identification of the bacteria was performed by biochemical reactions and PCR using 16S rRNA genes. Moreover, the prevalence of virulence genes earA and hyl of Aeromonashydrophila and ail and ystB genes of Yersinia enterocolitica were investigated using PCR. Antibiotic susceptibility of isolated bacteria was performed by disk diffusion method. Results: Out of 120 stool samples, 2 (1.7 % Aeromonashydrophila and 3 (2.5% Yersinia enterocolitica were isolated. All isolates of Aeromonashydrophila were sensitive to the chloramphenicol, co-trimoxazole, gentamicin, meropenem, amikacin and 50% of isolates were sensitive to the ceftriaxone and azithromycin. All Aeromonashydrophila isolates were resistant to erythromycin. All isolates of Yersinia enterocolitica were sensitive to the chloramphenicol, co-trimoxazole and meropenem. The 33.3% of the isolates were sensitive to gentamicin and amikacin and 66.6% of them were susceptible to ceftriaxone. However, all of Yersinia enterocolitica isolates were resistant to erythromycin and azithromycin. The prevalence aerA and hyl genes in Aeromonashydrophila were reported 100% and 50%, respectively. The prevalence of ail and ystB genes in Yersinia enterocolitica was reported as 66.6%. Conclusions: Identification and analysis of

  5. [Streptococcus pyogenes: penicillin and erythromycin susceptibility in the cities of Neuquen and Cipolletti].

    Science.gov (United States)

    Soriano, S V; Brasili, S; Saiz, M; Carranza, C; Vidal, P; Calderón, J; Lopardo, H A

    2000-01-01

    Penicillin resistance has not yet been detected in Streptococcus pyogenes. However macrolide-resistant streptococci have emerged in several countries. Only low rates of erythromycin-resistant S. pyogenes were reported in Argentina, with the exception of a 11.1% observed in Mendoza. The aim of the present study was to determine the susceptibility to penicillin and to erythromycin of 251 consecutive clinically-significant isolates of S. pyogenes obtained from four centers of Cipolletti and Neuquén during the period April-December 1998. The double disk test with erythromycin and clindamycin disks was employed as a screening method to detect ERY-resistant streptococci and to determine the phenotype of macrolide resistance. Disk diffusion was also employed for determining penicillin susceptibility. Macrolide-resistant isolates were also tested for penicillin, ceftriaxone, erythromycin, clindamycin and azithromycin susceptibility by the agar dilution method. Additionally they were also tested for erythromycin susceptibility by E-test (AB Biodisk, Solna, Sweden). All streptococci studied were susceptible to penicillin and thirty of them (12.0%) were resistant to erythromycin. All these resistant isolates were also resistant to azithromycin but susceptible to ceftriaxone and clindamycin. They showed the phenotype M (probably efflux-mediated mechanism) and the MICs of erythromycin ranged between 8 and 16 micrograms/ml. According to these results we conclude that in spite of universal susceptibility to penicillin in S. pyogenes, macrolide resistance is a matter of concern in Neuquén and Cipolletti. At least in those cities it appears to be necessary to routinely perform macrolide susceptibility tests in beta-hemolytic streptococci.

  6. Microbiology of discharging ears in Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Getachew Tesfaye; Daniel Asrat; Yimtubezinash Woldeamanuel; Messele Gizaw

    2009-01-01

    Objectives:To isolate and identify the bacterial etiologic agents,including their antibiotic susceptibility pat-tern isolated from patients with discharging ear infections.Methods:Between September 2006 and February 2007,178 patients with discharging ear visiting ENT clinics of St.Paul and Tikur Anbessa University Hospi-tals Addis Ababa,Ethiopia were investigated.Results:Of the patients investigated,52.8% were males and 47.2% were females resulting in an overall male to female ratio of 1.1:1.Ear discharge was the commonest clinical finding followed by hearing problem (91.2%),otalgia (ear pain)(74.7%),fever (17.9%)and itching of external ear (5.1%).S.aureus accounted for 30.2% of the total isolates followed by Proteus ssp. (P.mirabilis,P.vulgaris )(25.4%),and P.aeruginosa (13.4%).Both gram positive and negative bac-teria isolated from ear infections showed low resistance rates to most antimicrobial agents tested.Overall ceftri-axone and ciprofloxacin were the most effective drugs when compared to other drugs tested against the gram-positive and gram-negative bacteria.Conclusion:Otitis media was the most common clinical finding in pa-tients with ear infection.With discharging ear,the gram-negative bacteria were the predominant isolates.The susceptibility pattern of isolates from the study showed that ceftriaxone,ciprofloxacin and gentamicin were the most effective drugs.It is recommended that treatment of ear infections should be based on culture and sensi-tivity at the study sites.Therefore,efforts should be directed towards early diagnosis and treatment of acute ear infection and continued re-evaluation of the resistant patterns of organisms to optimize treatments and reduce complications.

  7. Spectrum and potency of ceftaroline against leading pathogens causing community-acquired respiratory tract and skin and soft tissue infections in Latin America, 2010

    Directory of Open Access Journals (Sweden)

    Robert K. Flamm

    2013-10-01

    Full Text Available Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil, is a cephalosporin with in vitro bactericidal activity against Gram-positive organisms, including methicillinsusceptible and -resistant Staphylococcus aureus, β-haemolytic and viridans group streptococci, and Streptococcus pneumoniae, as well as common Gram-negative organisms. In this study a total of 986 isolates collected in 2010 from patients in 15 medical centers in five Latin American countries from the Assessing Worldwide Antimicrobial Resistance Evaluation Program were identified as community-acquired respiratory tract or skin and soft tissue infection pathogens. Ceftaroline was the most potent agent tested against S. pneumoniae with a MIC90 value (0.12 µg/mL that was eight-fold lower than ceftriaxone, levofloxacin, and linezolid. Its spectrum of coverage (100.0% susceptible was similar to tigecycline, linezolid, levofloxacin and vancomycin. Against Haemophilus influenzae and Moraxella catarrhalis, ceftaroline was the most active agent tested. The activity of ceftaroline against S. aureus (including MRSA was similar to that of vancomycin and tetracycline (MIC90,1 µg/mL and linezolid (MIC90,2 Jg/mL. The 1-haemolytic streptococci exhibited 100.0% susceptibility to ceftaroline. Ceftaroline activity against Escherichia coli, Klebsiella spp., and Enterobacter spp. was similar to that of ceftriaxone and ceftazidime. These parenteral cephalosporin agents have potent activity against non-extended-spectrum These parenteral cephalosporin agents have potent activity against non-extended-spectrum-lactamase-phenotype strains, but are not active against extended-spectrum β-lactamase-phenotype strains. These results confirm the in vitro activity of ceftaroline against pathogens common in communityacquired respiratory tract and skin and soft tissue infection in Latin America, and suggest that ceftaroline fosamil could be an important therapeutic option for these infections.

  8. Epidemiology, Antimicrobial Resistance and β-lactamase Genotypic Features of Enteropathogenic Escherichia coli Isolated from Children with Diarrhea in Southern China.

    Science.gov (United States)

    Huang, Yong; Shan, Xue-feng; Deng, Haijun; Huang, Yu-jun; Mu, Xiao-ping; Huang, Ai-long; Long, Quan-xin

    2015-01-01

    The main objective of this study was to investigate the epidemiology, drug resistance and β-lactamase genotype distribution of enteropathogenic Escherichia coli (EPEC) isolated from pediatric patients with diarrhea in southern China. The prevalence of EPEC in children with diarrhea was 3.53%. The commonest serotypes were O55:K59 and O126:K71, and the typical EPEC were more prevalent than atypical EPEC (51 vs 7). Isolates from this region were most commonly found to be resistant to ampicillin and cotrimoxazole, followed by chloramphenicol, ceftriaxone, and ceftazidime. More than 96% of the strains were susceptible to cefoperazone/sulbactam and imipenem. The most common β-lactamase genotypes identified in 58 strains were blaCTX-M-1 (60.3%), blaTEM (56.9%), blaCTX-M-9 (27.6%), and blaSHV (15.5%). Among 58 isolates, 22 strains were found to harbor one β-lactamase gene, and the proportions of resistance to ampicillin, cotrimoxazole, chloramphenicol, ceftriaxone, and ceftazidime, were 81.8%, 63.6%, 40.9%, 18.2%, and 9.1%, respectively. A further 30 strains carrying multiple β-lactamase genes had increased resistance to the above antimicrobial agents (100%, 83.3%, 70.0%, 60.0%, and 30.0%, respectively). In contrast, antibiotic resistance in the last 6 strains without a detectable β-lactamase gene was substantially reduced. Drug resistance may be associated with the β-lactamase gene number, with a greater the number of β-lactamase genes resulting in higher antibiotic resistance.

  9. Antibiotic-resistant fecal bacteria, antibiotics, and mercury in surface waters of Oakland County, Michigan, 2005-2006

    Science.gov (United States)

    Fogarty, Lisa R.; Duris, Joseph W.; Crowley, Suzanne L.; Hardigan, Nicole

    2007-01-01

    Water samples collected from 20 stream sites in Oakland and Macomb Counties, Mich., were analyzed to learn more about the occurrence of cephalosporin-resistant Escherichia coli (E. coli) and vancomycin-resistant enterococci (VRE) and the co-occurrence of antibiotics and mercury in area streams. Fecal indicator bacteria concentrations exceeded the Michigan recreational water-quality standard of 300 E. coli colony forming units (CFU) per 100 milliliters of water in 19 of 35 stream-water samples collected in Oakland County. A gene commonly associated with enterococci from humans was detected in samples from Paint Creek at Rochester and Evans Ditch at Southfield, indicating that human fecal waste is a possible source of fecal contamination at these sites. E. coli resistant to the cephalosporin antibiotics (cefoxitin and/ or ceftriaxone) were found at all sites on at least one occasion. The highest percentages of E. coli isolates resistant to cefoxitin and ceftriaxone were 71 percent (Clinton River at Auburn Hills) and 19 percent (Sashabaw Creek near Drayton Plains), respectively. Cephalosporin-resistant E. coli was detected more frequently in samples from intensively urbanized or industrialized areas than in samples from less urbanized areas. VRE were not detected in any sample collected in this study. Multiple antibiotics (azithromycin, erythromycin, ofloxacin, sulfamethoxazole, and trimethoprim) were detected in water samples from the Clinton River at Auburn Hills, and tylosin (an antibiotic used in veterinary medicine and livestock production that belongs to the macrolide group, along with erythromycin) was detected in one water sample from Paint Creek at Rochester. Concentrations of total mercury were as high as 19.8 nanograms per liter (Evans Ditch at Southfield). There was no relation among percentage of antibiotic-resistant bacteria and measured concentrations of antibiotics or mercury in the water. Genetic elements capable of exchanging multiple antibiotic

  10. High in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical Neisseria gonorrhoeae isolates from 21 European countries from 2012 to 2014.

    Science.gov (United States)

    Unemo, Magnus; Ringlander, Johan; Wiggins, Catherine; Fredlund, Hans; Jacobsson, Susanne; Cole, Michelle

    2015-09-01

    Resistance in Neisseria gonorrhoeae against all antimicrobials available for the treatment of gonorrhea has emerged. The first gonococcal strains with high-level resistance to ceftriaxone, the last option for first-line empirical antimicrobial monotherapy, were recently described. Consequently, new treatment options are essential. In this study, the in vitro activity of the novel spiropyrimidinetrione ETX0914 (AZD0914), a DNA topoisomerase II inhibitor, was investigated among contemporary consecutive clinical N. gonorrhoeae isolates obtained in 21 European countries and compared to the activities of antimicrobials currently or previously recommended for treatment. Consecutive clinical N. gonorrhoeae isolates (n = 873) cultured in 21 European countries from 2012 to 2014 were examined for their susceptibility to ETX0914. The MICs of ETX0914 were determined using the agar dilution method. For comparison, the MICs of ceftriaxone, cefixime, azithromycin, and ciprofloxacin were determined using Etest or the agar dilution method. For ETX0914, the MIC range, modal MIC, MIC50, and MIC90 were ≤0.002 to 0.25 mg/liter, 0.125 mg/liter, 0.064 mg/liter, and 0.125 mg/liter, respectively. The MIC values were substantially lower than those of the fluoroquinolone ciprofloxacin and most other antimicrobials examined. No cross-resistance with any other examined antimicrobial was observed. In conclusion, the in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical isolates from 21 European countries was high, and no cross-resistance to antimicrobials currently or previously used for gonorrhea treatment was indicated. Additional studies investigating the in vitro and in vivo induction and mechanisms of ETX0914 resistance in gonococci, pharmacokinetics/pharmacodynamics in modeling/simulations and in humans, and performance in randomized controlled gonorrhea treatment trials are essential. PMID:26077246

  11. THE EFFECTS OF ANTIBIOTIC PROPHYLAXIS ON INFECTIOUS COMPLICATIONS AFTER CAESAREAN SECTION: A RANDOMISED CONTROLLED TRIAL IN A TERTIARY HOSPITAL OF EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Shelley

    2013-04-01

    Full Text Available ABSTRACT: CONTEXT: Infectious complications after caesarean deliveries are an important and substantial cause of maternal morbidity and inc rease in the hospital stay and cost of treatment. Routine prophylaxis with antibiotics may reduce this risk. AIMS: To determine whether prophylactic antibiotic administration using ceftriaxone at the time of caesarean section significantly reduces maternal and neonatal infectious complications . SETTINGS AND DESIGN: The study was conducted in a tertiary teaching hospi tal of eastern India during March 2011 to October 2011. It was a prospective, double-b lind randomised placebo-controlled trial. METHODS AND MATERIAL: After exclusion due to different reasons, 288 patien ts were enrolled in study group and received prophylactic inje ction ceftriaxone. 293 patients were enrolled in control group who received placebo. Patie nts were randomly selected according to computerized randomization protocol. Postpartum infect ious complications were recorded, as were the duration of hospital stay and neonatal compl ications. STATISTICAL ANALYSIS USED: Analysis of statistical data was done by using stat istical software Open Epi, 8version 2.3.1. RESULTS: Wound indurations, discharge, erythema were 2.43% a nd 5.80% in study and control group respectively and it was statistically significa nt with p value 0.043 (RR=0.419, 95% confidence interval [CI] 0.405. Endomyometritis was more in control group (1.04% vs. 3.75% with p value 0.036 and RR=0.279 and CMLE OR= 0.272. No significant relationship with neonatal morbidities was found. Maternal stay in ho spital was significantly more with p=0.01 in control group. CONCLUSIONS: Antibiotic prophylaxis prior to skin incision of caes arean sections resulted in better maternal outcome when i nfectious morbidity and postoperative hospital stay were concerned, without influencing th e neonatal outcome.

  12. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002

    Directory of Open Access Journals (Sweden)

    Thornsberry Clyde

    2004-05-01

    Full Text Available Abstract Background Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia. Methods From January to December of 2002, 82,569 bacterial blood culture isolates were reported to The Surveillance Network (TSN Database-USA by 268 laboratories. Susceptibility to relevant antibiotic compounds was analyzed using National Committee for Clinical Laboratory Standards guidelines. Results Coagulase-negative staphylococci (42.0%, Staphylococcus aureus (16.5%, Enterococcus faecalis (8.3%, Escherichia coli (7.2%, Klebsiella pneumoniae (3.6%, and Enterococcus faecium (3.5% were the most frequently isolated bacteria from blood cultures, collectively accounting for >80% of isolates. In vitro susceptibility to expanded-spectrum β-lactams such as ceftriaxone were high for oxacillin-susceptible coagulase-negative staphylococci (98.7%, oxacillin-susceptible S. aureus (99.8%, E. coli (97.3%, K. pneumoniae (93.3%, and Streptococcus pneumoniae (97.2%. Susceptibilities to fluoroquinolones were variable for K. pneumoniae (90.3–91.4%, E. coli (86.0–86.7%, oxacillin-susceptible S. aureus (84.0–89.4%, oxacillin-susceptible coagulase-negative staphylococci (72.7–82.7%, E. faecalis (52.1%, and E. faecium (11.3%. Combinations of antimicrobials are often prescribed as empiric therapy for bacteremia. Susceptibilities of all blood culture isolates to one or both agents in combinations of ceftriaxone, ceftazdime, cefepime, piperacillin-tazobactam or ciprofloxacin plus gentamicin were consistent (range, 74.8–76.3% but lower than similar β-lactam or ciprofloxacin combinations with vancomycin (range, 93.5–96.6%. Conclusion Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread.

  13. High in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical Neisseria gonorrhoeae isolates from 21 European countries from 2012 to 2014.

    Science.gov (United States)

    Unemo, Magnus; Ringlander, Johan; Wiggins, Catherine; Fredlund, Hans; Jacobsson, Susanne; Cole, Michelle

    2015-09-01

    Resistance in Neisseria gonorrhoeae against all antimicrobials available for the treatment of gonorrhea has emerged. The first gonococcal strains with high-level resistance to ceftriaxone, the last option for first-line empirical antimicrobial monotherapy, were recently described. Consequently, new treatment options are essential. In this study, the in vitro activity of the novel spiropyrimidinetrione ETX0914 (AZD0914), a DNA topoisomerase II inhibitor, was investigated among contemporary consecutive clinical N. gonorrhoeae isolates obtained in 21 European countries and compared to the activities of antimicrobials currently or previously recommended for treatment. Consecutive clinical N. gonorrhoeae isolates (n = 873) cultured in 21 European countries from 2012 to 2014 were examined for their susceptibility to ETX0914. The MICs of ETX0914 were determined using the agar dilution method. For comparison, the MICs of ceftriaxone, cefixime, azithromycin, and ciprofloxacin were determined using Etest or the agar dilution method. For ETX0914, the MIC range, modal MIC, MIC50, and MIC90 were ≤0.002 to 0.25 mg/liter, 0.125 mg/liter, 0.064 mg/liter, and 0.125 mg/liter, respectively. The MIC values were substantially lower than those of the fluoroquinolone ciprofloxacin and most other antimicrobials examined. No cross-resistance with any other examined antimicrobial was observed. In conclusion, the in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical isolates from 21 European countries was high, and no cross-resistance to antimicrobials currently or previously used for gonorrhea treatment was indicated. Additional studies investigating the in vitro and in vivo induction and mechanisms of ETX0914 resistance in gonococci, pharmacokinetics/pharmacodynamics in modeling/simulations and in humans, and performance in randomized controlled gonorrhea treatment trials are essential.

  14. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients attending a public referral center for sexually transmitted diseases in Belo Horizonte, State of Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Ligia Maria Bedeschi Costa

    2013-06-01

    Full Text Available Introduction The aim of this study was to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates obtained from patients attending a public referral center for sexually transmitted diseases and specialized care services (STD/SCS in Belo Horizonte, Brazil. Methods Between March 2011 and February 2012, 201 specimens of Neisseria gonorrhoeae were consecutively obtained from men with symptoms of urethritis and women with symptons of cervicitis or were obtained during their initial consultation. The strains were tested using the disk diffusion method, and the minimum inhibitory concentrations of azithromycin, cefixime, ceftriaxone, ciprofloxacin, chloramphenicol, penicillin, tetracycline and spectinomycin were determined using the E-test. Results The specimens were 100% sensitive to cefixime, ceftriaxone and spectinomycin and exhibited resistances of 4.5% (9/201, 21.4% (43/201, 11.9% (24/201, 22.4% (45/201 and 32.3% (65/201 to azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. Intermediate sensitivities of 17.9% (36/201, 4% (8/201, 16.9% (34/201, 71.1% (143/201 and 22.9% (46/201 were observed for azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. The specimens had plasmid-mediated resistance to penicillin PPNG 14.5% (29/201 and tetracycline TRNG 11.5% (23/201. Conclusions The high percentage of detected resistance to penicillin, tetracycline, chloramphenicol and ciprofloxacin indicates that these antibiotics are not appropriate for gonorrhea treatment at the Health Clinic and possibly in Belo Horizonte. The resistance and intermediate sensitivity of these isolates indicates that caution is recommended in the use of azithromycin and emphasizes the need to establish mechanisms for the surveillance of antimicrobial resistance for the effective control of gonorrhea.

  15. Antimicrobial susceptibility and molecular epidemiology of Neisseria gonorrhoeae in Germany.

    Science.gov (United States)

    Horn, Nicole Nari; Kresken, Michael; Körber-Irrgang, Barbara; Göttig, Stephan; Wichelhaus, Cornelia; Wichelhaus, Thomas A

    2014-07-01

    Antimicrobial drug resistance in Neisseria gonorrhoeae has become an increasing public health problem. Hence, surveillance of resistance development is of crucial importance to implement adequate treatment guidelines. Data on the spread of antibiotic resistance among gonococcal isolates in Germany, however, is scarce. In a resistance surveillance study conducted by the Paul Ehrlich Society for Chemotherapy between October 2010 and December 2011, 23 laboratories all over Germany were requested to send N. gonorrhoeae isolates to the study laboratory in Frankfurt am Main. Species verification was performed biochemically using ApiNH and with Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing was performed using the Etest method. For molecular epidemiological analysis, N. gonorrhoeae strains were genotyped by means of N. gonorrhoeae multi-antigen sequence typing. A total of 213 consecutive gonococcal isolates were analyzed in this nationwide study. Applying EUCAST breakpoints, high resistance rates were found for ciprofloxacin (74%) and tetracycline (41%). Penicillin non-susceptibility was detected in 80% of isolates. The rate of azithromycin resistance was 6%, while all strains were susceptible to spectinomycin, cefixime, and ceftriaxone. Molecular typing of gonococcal isolates revealed a great heterogeneity of 99 different sequence types (ST), but ST1407 predominated (n=39). This is the first comprehensive German multi-centre surveillance study on antibiotic susceptibility and molecular epidemiology of N. gonorrhoeae with implications for antibiotic choice for treatment of gonorrhoea. The World Health Organization supports the concept that an efficacious treatment of gonorrhoea results in at least 95% of infections being cured. Accordingly, as spectinomycin is not available on the German market, only the third generation cephalosporins cefixime and ceftriaxone are regarded as valuable drugs

  16. Rapid spread of Neisseria gonorrhoeae ciprofloxacin resistance due to a newly introduced resistant strain in Nuuk, Greenland, 2012–2015: a community-based prospective cohort study

    Science.gov (United States)

    Pedersen, Michael Lynge; Poulsen, Peter; Berthelsen, Lene; Nørgaard, Christina; Hoffmann, Steen; Jensen, Jørgen Skov

    2016-01-01

    Objectives To determine the antimicrobial susceptibility and genotype distribution of Neisseria gonorrhoeae strains isolated from a cohort of patients in Nuuk, Greenland in order to assess the risk of rapid spread in the event of introduction of new strains. Methods Gonococcal isolates (n=102) obtained from a prospective cohort study of ciprofloxacin resistance were collected between March 2012 and February 2013. Etest minimal inhibitory concentrations (MICs) were determined for ciprofloxacin, azithromycin, ceftriaxone, penicillin, tetracycline, spectinomycin and gentamicin. All isolates were subjected to molecular typing using N. gonorrhoeae multiantigen sequence typing (NG-MAST). After the introduction of a ciprofloxacin-resistant strain in early 2014, an additional 18 isolates were characterised. Results During the study period, all 102 isolates were fully susceptible to ciprofloxacin (≤0.03 mg/L), azithromycin, spectinomycin, gentamicin and ceftriaxone. 10 different NG-MAST types circulated in Nuuk but 7 were found as single isolates, and 3 of the 7 belonged to 1 of the 3 major genogroups (G210, G9816 and G9817) together comprising 96% of the 102 isolates. ST210 accounted for 55% of the 102 strains. The newly introduced ciprofloxacin resistant strain belonged to ST2400 and dominated the population with 59% resistant strains within 6 months after its introduction. All G2400 strains had MICs≥2 mg/L. Conclusions Introduction of a ciprofloxacin-resistant strain into a very homogeneous N. gonorrhoeae population led to an explosive spread of the resistant clone, probably as a result of large sexual networks suggested by the strain homogeneity. Careful surveillance of antimicrobial susceptibility is essential to avoid widespread treatment failure in closed populations. PMID:27577587

  17. Antimicrobial susceptibility and genetic characteristics of Neisseria gonorrhoeae isolates from India, Pakistan and Bhutan in 2007–2011

    Directory of Open Access Journals (Sweden)

    Sethi Sunil

    2013-01-01

    Full Text Available Abstract Background Knowledge on antimicrobial drug resistance and genetic characteristics of Neisseria gonorrhoeae isolates circulating in India, Pakistan, and Bhutan is sorely lacking. In this paper, we describe the prevalence of antimicrobial resistance and molecular characteristics of N. gonorrhoeae isolates from India, Pakistan, and Bhutan in 2007–2011. Methods Antimicrobial susceptibility and β-lactamase production were tested for 65 N. gonorrhoeae isolates from India (n=40, Pakistan (n=18 and Bhutan (n=7 using Etest methodology (eight antimicrobials and nitrocefin solution, respectively. Resistance determinants, i.e. penA, mtrR, porB1b, gyrA, and parC, were sequenced. N. gonorrhoeae multiantigen sequence typing (NG-MAST was performed for molecular epidemiology. Results The highest resistance level was observed for ciprofloxacin (94%, followed by penicillin G (68%, erythromycin (62%, tetracycline (55%, and azithromycin (7.7%. All the isolates were susceptible to ceftriaxone, cefixime, and spectinomycin. Thirty-four (52% of the isolates were producing β-lactamase. No penA mosaic alleles or A501-altered alleles of penicillin-binding protein 2 were identified. Forty-nine NG-MAST STs were identified, of which 42 STs have not been previously described worldwide. Conclusions Based on this study, ceftriaxone, cefixime, and spectinomycin can be used as an empirical first-line therapy for gonorrhoea in India, Pakistan, and Bhutan, whereas ciprofloxacin, penicillin G, tetracycline, erythromycin, and azithromycin should not be. It is imperative to strengthen the laboratory infrastructure in this region, as well as to expand the phenotypic and genetic surveillance of antimicrobial resistance, emergence of new resistance, particularly, to extended-spectrum cephalosporins, and molecular epidemiology.

  18. The Antibacterial Test in vitro of Andrographis paniculata Aqueous Extract Used Combination with 10 Kinds of Clinical Common Antimicrobial Agents%穿心莲水提物与10种临床常用抗菌药联用的体外抑菌试验

    Institute of Scientific and Technical Information of China (English)

    张国祖; 贾艳华; 刘梅; 张帅帅; 郭振环; 李荣誉; 陈献忠

    2012-01-01

    为研究穿心莲水提物与临床常用10种抗菌药联用对鸡致病性大肠杆菌的体外抑菌效果,本试验采用传统的水提法制备穿心莲中药液并浓缩至浓度为1 g/mL,用琼脂平板稀释法测定穿心莲水提物分别与阿莫西林、头孢曲松等10种常用抗菌药物联用对临床分离的10株鸡致病性大肠杆菌的体外抑菌作用.结果表明,穿心莲和头孢曲松、穿心莲和氟苯尼考联用100%呈现协同作用;穿心莲和头孢噻呋联用90%呈现协同作用,10%呈现无关作用;穿心莲和大观霉素联用80%呈现协同作用,20%呈现无关作用;穿心莲和林可霉素联用50%呈现协同作用,40%为无关或颉颃作用,10%为无关作用;穿心莲与阿莫西林、安普霉素、阿米卡星、多西环素、恩诺沙星联用以无关或颉颃作用为主.以上结果表明,在体外,穿心莲与头孢曲松、头孢噻呋、大观霉素、氟苯尼考联用对鸡致病性大肠杆菌呈现协同作用,与阿莫西林、安普霉素、阿米卡星、林可霉素、多西环素、恩诺沙星联用呈现无关或颉颃作用.%To study the antibacterial effect in vitro of Andrographis aqueous extract associated with clinical qommonly used 10 kinds of antimicrobial agents to the chicken pathogenic Escherichia colt. Andrographis prepared by the traditional water extraction liquid and concentrated to a concentration of 1 g/mL,determined the invitro inhibitory effect of Andrographis aqueous extract respectively, associated with amoxicilhn, ceftriaxone, and other 10 kinds of commonly used clinical antimicrobial drugs, using the agar dilution method, to the clinical 10 chicken pathogenic Escherichia coli. The results show that Andrographis paniculata and ceftriaxone, Andrographis paniculata and florfenicol associated with 100% showing a synergistic effect; Andrographis paniculata and ceftiofur associated with 90% showing a synergistic effect, 10% showing unrelated; Andrographis

  19. 西安地区2002-2009年淋球菌耐药性趋势分析%Trend analysis of antibiotic resistance in Neisseria gonorrhoeae in Xi'an region, 2002-2009

    Institute of Scientific and Technical Information of China (English)

    冯莲凤; 任昭; 孙明德; 郭旭昌

    2011-01-01

    declined from 2006 to 2009 (32.3%). The prevalence of resistance to spectinomycin maintained at a low level (0 to 2.8%) over these years, while that to ciprofloxacin remained higher than 80% from 2002 to 2009, and accounted for 100% in 2005, with the exception of 51% in 2006. Ceftriaxone resistance was observed in none of these strains except 4 isolates in 2003, but the susceptibility to ceftriaxone decreased yearly. Conclusions Neisseria gonorrhoeae is highly sensitive to spectinomycin, which should serve as the first treatment choice for gonorrhea.Full dose is necessary for the application of ceftriaxone in the treatment of gonorrhea. Ciprofloxacin should not be used to treat gonorrhea.

  20. Incidence, clinical presentation, and antimicrobial resistance trends in Salmonella and Shigella infections from children in Yucatan, Mexico

    Directory of Open Access Journals (Sweden)

    Mussaret Bano Zaidi

    2013-10-01

    Full Text Available Background: Salmonella and Shigella cause significant morbidity and mortality among children worldwide. Increased antimicrobial resistance results in greater burden of disease. Methods: From 2005 to 2011, Salmonella and Shigella isolates collected from ill children at a major hospital in Yucatan, Mexico, were subjected to serotyping and antimicrobial susceptibility testing by disk diffusion and agar dilution. The identification of blaCTX, blaCMY, blaSHV, blaTEM, and blaOXA and qnr resistance genes was conducted by PCR and sequencing. Results: Among 2344 children with acute gastroenteritis, salmonellosis decreased from 17.7% in 2005 to 11.2% in 2011 (p<0.001. In contrast, shigellosis increased from 8.3% in 2010 to 12.1% in 2011. Compared to children with Salmonella, those with Shigella had significantly more bloody stools (59% vs 36%, p<0.001, dehydration (27% vs 15%, p=0.031, and seizures (11% vs 3%, p=0.03. In Salmonella (n=365, there was a significant decrease in resistance to ampicillin (43% to 16%, p<0.001, trimethoprim-sulfamethoxazole (44% to 26%, p=0.014, and extended-spectrum cephalosporins (27% to 10%, p=0.009. Reduced susceptibility to ciprofloxacin in Salmonella rose from 30% to 41% (p<0.001. All ceftriaxone-resistant isolates harbored the blaCMY-2 gene. qnr genes were found in 42 (36% of the 117 Salmonella isolates with a ciprofloxacin MIC ≥ 0.125 µg/ml. Four were qnrA1 and 38 were qnrB19. Resistance to ampicillin (40% and trimethoprim-sulfamethoxazole (58% was common in Shigella (n=218, but isolates remained fully susceptible to ceftriaxone and ciprofloxacin. Conclusions:Illness from Salmonella has decreased while severe Shigella infections have increased among children with gastroenteritis in the Yucatan Peninsula. While Shigella resistance to clinically important antibiotics remained unchanged, resistance to most of these, except ciprofloxacin, declined in Salmonella. blaCMY-2 and qnr genes are common in Salmonella isolates.

  1. Antibiotic-Resistant Fecal Bacteria, Antibiotics, and Mercury in Surface Waters of Oakland County, Michigan, 2005-2006

    Science.gov (United States)

    Fogarty, Lisa R.; Duris, Joseph W.; Crowley, Suzanne L.; Hardigan, Nicole

    2007-01-01

    Water samples collected from 20 stream sites in Oakland and Macomb Counties, Mich., were analyzed to learn more about the occurrence of cephalosporin-resistant Escherichia coli (E. coli) and vancomycin-resistant enterococci (VRE) and the co-occurrence of antibiotics and mercury in area streams. Fecal indicator bacteria concentrations exceeded the Michigan recreational water-quality standard of 300 E. coli colony-forming units (CFU) per 100 milliliters of water in 19 of 35 stream-water samples collected in Oakland County. A gene commonly associated with enterococci from humans was detected in samples from Paint Creek at Rochester and Evans Ditch at Southfield, indicating that human fecal waste is a possible source of fecal contamination at these sites. E. coli resistant to the cephalosporin antibiotics (cefoxitin and/or ceftriaxone) were found at all sites on at least one occasion. The highest percentages of E. coli isolates resistant to cefoxitin and ceftriaxone were 71 percent (Clinton River at Auburn Hills) and 19 percent (Sashabaw Creek near Drayton Plains), respectively. Cephalosporin-resistant E. coli was detected more frequently in samples from intensively urbanized or industrialized areas than in samples from less urbanized areas. VRE were not detected in any sample collected in this study. Multiple antibiotics (azithromycin, erythromycin, ofloxacin, sulfamethoxazole, and trimethoprim) were detected in water samples from the Clinton River at Auburn Hills, and tylosin (an antibiotic used in veterinary medicine and livestock production that belongs to the macrolide group, along with erythromycin) was detected in one water sample from Paint Creek at Rochester. Concentrations of total mercury were as high as 19.8 nanograms per liter (Evans Ditch at Southfield). There was no relation among percentage of antibiotic-resistant bacteria and measured concentrations of antibiotics or mercury in the water. Genetic elements capable of exchanging multiple antibiotic

  2. Synthesis and characterization of amoxicillin derived silver nanoparticles: Its catalytic effect on degradation of some pharmaceutical antibiotics

    Energy Technology Data Exchange (ETDEWEB)

    Junejo, Y. [National Center of Excellence in Analytical Chemistry, University of Sindh Jamshoro, Jamshoro 76080 (Pakistan); Department of Chemistry, Fatih University, Buyukcekmece, 34500 Istanbul (Turkey); Güner, A., E-mail: aguner@fatih.edu.tr [Department of Biology, Fatih University, Buyukcekmece, 34500 Istanbul (Turkey); Baykal, A. [Department of Chemistry, Fatih University, Buyukcekmece, 34500 Istanbul (Turkey)

    2014-10-30

    Graphical abstract: - Highlights: • Amp-Ag (0) NPs were prepared by simple one-pot chemical reduction method. • Ampicillin as an antibiotic was used as both reducing and capping agents in this study. • Amp-Ag (0) NPs have proved as the remarkably efficient catalysts with enhanced rate of reduction for cefdinir, cefditoren, cefixime, ceftriaxone sodium and doxycycline. • Amp-Ag (0) NPs were showed excellent catalytic activity as catalyst for the 100% reduction of these antibiotics. - Abstract: We synthesized novel amoxicillin derived silver nanoparticles (Amp-Ag (0) NPs) in aqueous solution by one-pot simple synthetic method by reducing silver nitrate by the help of amoxicillin antibiotic as a reducing/capping agent and NaOH as the catalyst for reaction enhancement. The formation of the Amp-Ag (0) NPs was monitored using UV–Vis absorption spectroscopy which confirmed the formation of Amp-Ag (0) NPs by exciting the typical surface plasmon absorption maxima at 404 nm. Transmission electron microscopy (TEM) confirmed the spherical morphology and monodispersed Amp-Ag (0) NPs with particle size 6.87 ± 2.2 nm. The antibacterial activities of the antibiotics were evaluated against Gram-negative bacteria Escherichia coli, Salmonella enteritidis, Pseudomonas aeruginosa and Gram-positive bacteria Streptococcus pneumonia, Streptococcus pyogenes, Staphylococcus aureus by the disk diffusion method. Whereas standard antibiotics showed normal zone of inhibition, the reduced ones with Amp-Ag (0) NPs showed no inhibition zone. The antimicrobial results therefore reveal that newly synthesized Amp-Ag (0) NPs had an excellent catalytic activity as catalyst for the 100% reduction of antibiotics i.e. cefdinir, cefditoren, cefiximee, ceftriaxone sodium and doxycycline, which was carried out in just 2–5 min. They were recovered easily from reaction medium and reused with enhanced catalytic potential five times. Based upon these results it has been concluded that Amp-Ag (0) NPs

  3. Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

    Directory of Open Access Journals (Sweden)

    Owusu Michael

    2012-10-01

    Full Text Available Abstracts Background Meningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health. Methods We retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a Microsoft® excel spreadsheet. Results Records of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8% were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6% were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8% culture positive bacteria, 19 (11.7% culture positive Cryptococcus neoformans and 27(16.6% Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%, followed by E.coli 4 (3.4%, Salmonella species 4 (3.4%, Neisseria meningitidis 3 (2.5%, Pseudomonas species 3(2.5% and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%, 83.0% (95%CI: 73.4% to 90.1% and 100.0% (95%CI: 95.8% to 100.0% respectively. Conclusion Streptococcus pneumoniae is an important cause of meningitis among all age groups and its

  4. STUDY OF ANTIBIOTIC SUSCEPTIBILITY TEST OF MODERN GENERATION OF DRUGS AGAINST UPPER RESPIRATORY TRACT PATHOGENS

    Directory of Open Access Journals (Sweden)

    Vinod Singh et al

    2012-10-01

    Full Text Available Nasal infection or sinusitis is an inflammation of nasal passages caused by both viral and bacteriological pathogens. Antimicrobial resistance has universally recognized as growing problem concern about suitable therapy for nasal infection. The study was aimed at determining the prevalence and antimicrobial susceptibility against nasal infecting microorganisms. 50 clinical samples were taken from OPD of GMC Hospital, Bhopal (MP, India. Of the samples analyzed, 47 bacterial strains were isolated out of which 29 strains were of Gram positive bacteria (8 strains were of Staphylococcus aureus, 6 of Staphylococcus epidermidis, 7 of Streptococcus pneumoniae and 8 of Corynebacterium diptheriae and 18 strains were of Gram negative bacteria (8 of Escherichia coli, 6 of Pseudomonas aeruginosa and 4 of Neisseria meningitidis. Antimicrobial susceptibility assay was performed by disc diffusion method according to the reference criteria of clinical and laboratory standard institute guidelines. In the present study antibiotic susceptibility pattern results showed maximum level of resistance in gram positive strains S. aureus 8 (100%, S. epidermidis 6 (100% and C. diptheriae (8 (100% against penicillin, S. aureus 8 (100%, S. epidermidis 6 (100% and S. pneumoniae 7 (100% were resistant to Cefuroxime, S. aureus 7 (87.5%, S. epidermidis 6 (100%, S. pneumoniae 7 (100% and C. diptheriae (8 (100% were resistant to erythromycin and azithromycin whereas, rest of gram positive strains showed satisfactory antibiotic susceptibility against chloramphenical, cefazolin, cephalexin, ciprofloxacin, ofloxacin and tetracyclin. Similarly for gram negative strains multi-drug resistance was observed in 8 (100% isolates of E. coli against aztreonam, cefdinir, cefixime, cefotaxime, ceftriaxone, ceftazidime, cefuroxime, ciprofloxacin, nalidixic acid and ofloxacin, P. aeruginosa 6 (100% were resistant to aztreonam, cefdinir, cefixime, cefotaxime, ceftazidime, ceftriaxone, cefuroxime

  5. 大理地区志贺菌的血清型分布及耐药性分析%Study on Serotype Distribution and Drug Resistance of Shigellae in Dali

    Institute of Scientific and Technical Information of China (English)

    王国富; 薛士鹏; 白丽; 吴利先

    2012-01-01

    目的:了解大理地区志贺菌的血清型分布及对12种常用抗生素的耐药性。方法:通过分离培养和鉴定得到68株志贺菌,血清学鉴定其血清型,K-B法检测其对12种抗生素的敏感性。结果:血清学鉴定显示68株志贺菌中福氏志贺菌41株,宋内氏志贺菌25株,鲍氏志贺菌2株。志贺菌对萘啶酸耐药率最高,对复方磺胺甲噁唑和氨苄西林耐药率较高;对头孢曲松和头孢噻肟较敏感,对喹诺酮类显示出不同程度的耐药。结论:大理地区以福氏志贺菌感染为主。在志贺菌治疗中可首选头孢曲松和头孢噻肟。%Objective: To investigate the serotype distribution of Shigellae in Dali and evaluate the resistance of Shigellae to 12 common used drugs. Methods: Serotypes of 68 isolated and identified strains of Shigellae were measured. K-B test was applied to define the drug-resistance of Shigellae to 12 different drugs. Results: Among 68 strains examined, 41 were Shigella Flexner, 25 were Shigella sonnei and 2 were Shigella boydii identified by serotype. Shigellae showed the highest drug resistance to nalidixic acid, with followed sulfalene and nalidixic and varying extents of drug resistance to quinolones; Shigellae was sensitive to ceftriaxone and cefotaxime. Conclusion: These results suggest that Shigella Flexner is the main infection strains in Dali and ceftriaxone and cefotaxime should be preferred in the treatment with Shigellae.

  6. Emerging resistance among bacterial pathogens in the intensive care unit – a European and North American Surveillance study (2000–2002

    Directory of Open Access Journals (Sweden)

    Thornsberry Clyde

    2004-07-01

    Full Text Available Abstract Background Globally ICUs are encountering emergence and spread of antibiotic-resistant pathogens and for some pathogens there are few therapeutic options available. Methods Antibiotic in vitro susceptibility data of predominant ICU pathogens during 2000–2 were analyzed using data from The Surveillance Network (TSN Databases in Europe (France, Germany and Italy, Canada, and the United States (US. Results Oxacillin resistance rates among Staphylococcus aureus isolates ranged from 19.7% to 59.4%. Penicillin resistance rates among Streptococcus pneumoniae varied from 2.0% in Germany to as high as 20.2% in the US; however, ceftriaxone resistance rates were comparably lower, ranging from 0% in Germany to 3.4% in Italy. Vancomycin resistance rates among Enterococcus faecalis were ≤ 4.5%; however, among Enterococcus faecium vancomycin resistance rates were more frequent ranging from 0.8% in France to 76.3% in the United States. Putative rates of extended-spectrum β-lactamase (ESBL production among Enterobacteriaceae were low, Escherichia coli in the five countries studied. Ceftriaxone resistance rates were generally lower than or similar to piperacillin-tazobactam for most of the Enterobacteriaceae species examined. Fluoroquinolone resistance rates were generally higher for E. coli (6.5% – 13.9%, Proteus mirabilis (0–34.7%, and Morganella morganii (1.6–20.7% than other Enterobacteriaceae spp (1.5–21.3%. P. aeruginosa demonstrated marked variation in β-lactam resistance rates among countries. Imipenem was the most active compound tested against Acinetobacter spp., based on resistance rates. Conclusion There was a wide distribution in resistance patterns among the five countries. Compared with other countries, Italy showed the highest resistance rates to all the organisms with the exception of Enterococcus spp., which were highest in the US. This data highlights the differences in resistance encountered in intensive care units in

  7. Synthesis and characterization of amoxicillin derived silver nanoparticles: Its catalytic effect on degradation of some pharmaceutical antibiotics

    International Nuclear Information System (INIS)

    Graphical abstract: - Highlights: • Amp-Ag (0) NPs were prepared by simple one-pot chemical reduction method. • Ampicillin as an antibiotic was used as both reducing and capping agents in this study. • Amp-Ag (0) NPs have proved as the remarkably efficient catalysts with enhanced rate of reduction for cefdinir, cefditoren, cefixime, ceftriaxone sodium and doxycycline. • Amp-Ag (0) NPs were showed excellent catalytic activity as catalyst for the 100% reduction of these antibiotics. - Abstract: We synthesized novel amoxicillin derived silver nanoparticles (Amp-Ag (0) NPs) in aqueous solution by one-pot simple synthetic method by reducing silver nitrate by the help of amoxicillin antibiotic as a reducing/capping agent and NaOH as the catalyst for reaction enhancement. The formation of the Amp-Ag (0) NPs was monitored using UV–Vis absorption spectroscopy which confirmed the formation of Amp-Ag (0) NPs by exciting the typical surface plasmon absorption maxima at 404 nm. Transmission electron microscopy (TEM) confirmed the spherical morphology and monodispersed Amp-Ag (0) NPs with particle size 6.87 ± 2.2 nm. The antibacterial activities of the antibiotics were evaluated against Gram-negative bacteria Escherichia coli, Salmonella enteritidis, Pseudomonas aeruginosa and Gram-positive bacteria Streptococcus pneumonia, Streptococcus pyogenes, Staphylococcus aureus by the disk diffusion method. Whereas standard antibiotics showed normal zone of inhibition, the reduced ones with Amp-Ag (0) NPs showed no inhibition zone. The antimicrobial results therefore reveal that newly synthesized Amp-Ag (0) NPs had an excellent catalytic activity as catalyst for the 100% reduction of antibiotics i.e. cefdinir, cefditoren, cefiximee, ceftriaxone sodium and doxycycline, which was carried out in just 2–5 min. They were recovered easily from reaction medium and reused with enhanced catalytic potential five times. Based upon these results it has been concluded that Amp-Ag (0) NPs

  8. 超剂量拉莫三嗪与丙戊酸钠联用致全身皮疹%Generalized skin eruptions related to overdose of lamotrigine combined with valproate sodium

    Institute of Scientific and Technical Information of China (English)

    王丽君; 刘刚; 王宇; 战寒秋; 汤艳芬; 陈奇

    2015-01-01

    1例41岁男性患者胶质母细胞瘤切除术后出现癫痫,给予奥卡西平(初始剂量为0.3 g、2次/ d,后加至0.6 g、2次/ d)和丙戊酸钠(500 mg、1次/ d)口服,因癫痫控制不佳加用拉莫三嗪(25 mg 鼻饲、2次/ d)。加用拉莫三嗪第17天因出现肺感染给予头孢曲松(2 g 静脉滴注、1次/ d)。加用拉莫三嗪第19天,患者面颈部、胸背部、双上肢、腹部、双下肢依次出现鲜红色斑丘疹,部分融合成片,诊断为药疹。停用拉莫三嗪和头孢曲松,奥卡西平和丙戊酸钠继续应用,并给予地塞米松,葡萄糖酸钙、维生素 C 等治疗。5 d 后患者皮损好转,9 d 后皮疹消退。%A 41-year-old man with epilepsy after glioblastoma resection received oral oxcarbazepine (an initial dose of 0. 3 g twice daily,which was increased to 0. 6 g twice daily)and valproate sodium (500 mg,once daily). Nasal feeding lamotrigine 25 mg twice daily was added to her regimen due to poor control of epileptic condition. On day 17 of lamotrigine therapy,an IV infusion of ceftriaxone 2 g once daily was given for pulmonary infection. On day 19 of lamotrigine therapy, the patient developed red maculopapular eruptions successively on the face,neck,chest,back,arms,abdomen and legs,some rashes fused into lamella. He was diagnosed drug eruptions. Lamotrigine and ceftriaxone were discontinued immediately. Oxcarbazepine and valproate sodium were continued. He was given dexamethasone,calcium gluconate and vitamin C. Five days later,his skin lesions were improved. Nine days after lamotrigine withdrawal,the skin eruptions subsided.

  9. [A sepsis case caused by a rare opportunistic pathogen: Bacillus pumilus].

    Science.gov (United States)

    Borsa, Barış Ata; Aldağ, Mehmet Ersoy; Tunalı, Birsen; Dinç, Uğur; Güngördü Dalar, Zeynep; Özalp, Veli Cengiz

    2016-07-01

    trimethoprim-sulfamethoxazole. Initial treatment of patient was started with intravenous ceftriaxone and metronidazole empirically. Hypotension and fever returned to normal levels at the second and third days of the treatment, respectively. Metronidazole treatment was stopped at seventh day, and treatment was completed to 14 day with ceftriaxone alone. At the end of the treatment course, general condition of the patient was completely good, ESR and CRP were also decreased to normal levels. In conclusion, although most of the reported bloodstream infections that are caused by B.pumilus are intravascular catheter-related, artificial heart valves should also be considered as a risk factor even though vegetation was not detected in our patient. PMID:27525402

  10. Prevalence of antimicrobial resistance of Streptococcus pneumoniae in Chinese children: four hospitals surveillance

    Institute of Scientific and Technical Information of China (English)

    沈叙庄; 陆权; 叶启慈; 张国成; 俞桑洁; 张泓; 邓秋莲; 杨永弘

    2003-01-01

    Objective To investigate the nasal carriage of antibiotic-resistant pneumococci in children of <5 years old in the following four cities, Beijing, Shanghai, Guangzhou and Xi'an.Methods A total of 647 pneumococci strains were isolated and detected. Minimal inhibition concentrations (MICs) of antibiotics were determined by E-test. Disk diffusion test was used for the measurement of antimicrobial susceptibility.Results Prevalence of penicillin non-susceptible Streptococcus pneumoniae in the four cities was 41%, with Guangzhou (60.8%) ranking first, followed by Xi'an (45%), Shanghai (37%) and Beijing (25.9%). The majority of penicillin non-susceptibility isolates (23.9%-53.8%) had a low level of resistance (MIC 0.64-1.5 μg/ml). The most sensitive antimicrobials in terms of percentage of susceptible organisms were amoxicillin-clavulanic acid (99.4%), followed by ceftriaxone (92.1%); cefurxime and cefaclor were slightly more sensitive than penicillin with susceptibility of 74.8% and 77.9%. Erythromycin, tetracycline and TMP-SMZ were highly resistant (83.6%, 82.1% and 76.2% respectively). Among erythromycin resistant isolates, 100% were resistant to azithromycin, 98.6% to clarithromycin, 97.2% to roxithromycin and spiramycin, and 96.6% to clindamycin. 97.2% (141/145) were typical of the macrolides-lincosamides-streptogramons B (MLSB ) resistance phenotype, and 2.8% (4/145) were M phenotype. The group of PRSP was with significantly higher rates of non-susceptibility for ceftriaxone (18.4%), cefurxime (58.6%), cefaclor (53.4%), compared with the group of PEN-S (0.5%, 1.8% and 0.2%, respectively) and the rate of multi-drug resistance in the isolates of PRSP group (92.9%) was significantly higher than that of PEN-S group (59.2%).Conclusion The rates of penicillin and multi-drug resistance among isolates of pneumococci carried nasally in are high children and the high prevalence of multi-drug resistance in the Chinese population may be becoming one of the most serious

  11. The Clinical Observation of Severe Community Acquired Pneumonia Merger Atelectasis in Children%儿童重症社区获得性肺炎合并肺不张的临床观察

    Institute of Scientific and Technical Information of China (English)

    鲁金玲

    2013-01-01

    Objective:To explore the clinical treatment of severe community acquired pneumonia merger atelectasis in children. Methods:80 cases of children being diagnosed with severe community acquired pneumonia merger atelectasis were randomly divided into the observation group and the control group, 40 cases in each group. 2 groups were given conventional treatment, observation group was given Ceftriaxone sodium treatment on the basis of conventional therapy, each group's therapy was 4 weeks. Compared cough mitigation, pyretolysis and lung reexpansion situation of two groups. Results:The cough mitigation time, pyretolysis time and lung reexpansion situation time of observation group significantly lower than control group(P<0.01);the effective power of observation group higher than control group(P<0.05). Conclusions:Azithromycin combined with Ceftriaxone sodium in the treatment of severe community acquired pneumonia merger atelectasis in children had obviously effect.%目的:探讨儿童重症社区获得性肺炎合并肺不张的临床治疗。方法:儿童重症社区获得性肺炎合并肺不张的患儿80例,随机分为观察组和对照组,每组40例。2组均给予常规治疗,观察组在常规治疗基础上加用头孢曲松钠治疗,疗程4周,对比两组咳嗽缓解、退热、肺复张及疗效情况。结果:观察组的咳嗽缓解时间、退热时间及肺复张时间均明显低于对照组(P<0.01);观察组的有效率高于对照组(P<0.05)。结论:阿奇霉素联合头孢曲松钠治疗儿童重症社区获得性肺炎合并肺不张效果明显。

  12. An 0bservation on the curative effects of meropenem in the treatment of bacterial meningitis%美罗培南治疗细菌性脑膜炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘见民

    2014-01-01

    Objective To observe the clinical effects of meropenem in the treatment of bacterial meningitis. Methods 56 adult patients with bacterial meningitis who were admitted to our hospital from June 2010 to June 2013 were selected and randomLy assigned to two groups, with 28 patients in each group. The control group received intravenous drip of ceftriaxone sodium, while the observation group received intravenous drip of meropenem based on ceftriaxone sodium. The curative effects were compared between the two groups. Results Total effective rate for one week of treatment in the observation group was 67.9%, and 92.9%for two weeks, which were significantly higher than those of 21.4%and 53.6%respectively (P<0.01);bacteria eliminating rate in the observation group was 92.9%, significantly higher than that of 67.2%in the control group (P<0.01). Conclusion A proper use of meropenem treatment based on the results of drug sensitive test in early stages helps improve the curative effects of bacterial meningitis.%目的:观察美罗培南治疗细菌性脑膜炎的临床疗效。方法选取2010年6月~2013年6月我院确诊为细菌性脑膜炎的成人患者56例,随机分为两组,每组28例,对照组用头孢曲松钠静脉滴注;观察组在对照组的基础上加用美罗培南静脉滴注治疗,对比两组疗效。结果观察组治疗1周总有效率为67.9%、2周为92.9%,显著高于对照组的21.4%、53.6%(P<0.01);观察组细菌清除率(92.9%)显著高于对照组(67.2%)(P<0.01)。结论早期根据药敏试验结果合理使用美罗培南治疗方案能有助于提高细菌性脑膜炎的治疗效果。

  13. Antimicrobial Resistance Patterns of Aerobic Organisms in Patients With Chronic Rhinosinusitis in Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Farahani

    2014-08-01

    Full Text Available Background Although effective strategies have been presented for preventing the spread of antibiotic resistance in Iran, recent reports have revealed increasing antibiotic resistance among children and adults. Objectives In the present study, we tried to provide a clear view of the antibiotic resistance status of aerobic organism as the most prevalent organism in patients with rhinosinusitis in Hamadan, Iran. Patients and Methods A cross-sectional study was conducted on 216 consecutive patients referred to otolaryngology clinics of Imam Khomeini and Besat University hospitals in Hamadan with clinical and radiological manifestations of chronic rhinosinusitis. Two specimens were taken from each patient; one from the affected maxillary sinus by aspiration and another from the middle meatus and nasopharynx by swabbing. Antibiotic susceptibility was tested by Kirby Bauer’s method; distributions of the isolates from middle meatus, nasopharynx and sinus were determined and the results of susceptibility test were analyzed. Results Among the aerobic organism from meatus and oropharynx, the most frequent isolated strains were alpha-hemolytic Streptococcus (15.4%, followed by coagulase-negative Staphylococcus (14.6%, and Branhamella catarrhalis (13.2%, and the most prevalent isolated strains from sinus were S. aureus (19.1%, Klebsiella pneumonia (16.4%, and B. catarrhalis (15.6%, respectively. The highest antibiotic susceptibility was detected to ciprofloxacin and ceftriaxone in most of the strains; susceptibility to ciprofloxacin ranged from 76.7% (for Pseudomonas aeruginosa to 100% (for Escherichia coli and Haemophilus influenza; susceptibility to ceftriaxone ranged from 71.4% (for Acinetobacter baumannii to 100% (for S. pneumonia, Corynebacterium diphtheria, and H. influenza. Besides, regardless of strain, the highest resistance was mostly detected to penicillin (ranging from 33.3% to 91.7%, and to ampicillin (ranging from 38.4% to 83.7%. Conclusions

  14. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    The use of cochlear implants is increasingly common, particularly in children younger than 3 years. Bacterial meningitis, often with associated acute otitis media, is more common in children with cochlear implants than in groups of control children. Children with profound deafness who are candidates for cochlear implants should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza. In addition, starting at 24 months of age, a single dose of 23-valent pneumococcal polysaccharide vaccine should be administered. Before implant surgery, primary care providers and cochlear implant teams should ensure that immunizations are up-to-date, preferably with completion of indicated vaccines at least 2 weeks before implant surgery. Imaging of the temporal bone/inner ear should be performed before cochlear implantation in all children with congenital deafness and all patients with profound hearing impairment and a history of bacterial meningitis to identify those with inner-ear malformations/cerebrospinal fluid fistulas or ossification of the cochlea. During the initial months after cochlear implantation, the risk of complications of acute otitis media may be higher than during subsequent time periods. Therefore, it is recommended that acute otitis media diagnosed during the first 2 months after implantation be initially treated with a parenteral antibiotic (eg, ceftriaxone or cefotaxime). Episodes occurring 2 months or longer after implantation can be treated with a trial of an oral antimicrobial agent (eg, amoxicillin or amoxicillin/clavulanate at a dose of approximately 90 mg/kg per day of amoxicillin component), provided the child does not appear toxic and the implant does not have a spacer/positioner, a wedge that rests in the cochlea next to the electrodes present in certain implant models available between 1999 and 2002. "Watchful waiting" without antimicrobial

  15. Study on Drug Resistance of 103 Strains of Neisseria gonorrhoeae%103株淋球菌耐药性研究

    Institute of Scientific and Technical Information of China (English)

    蒋英; 刘键; 谢延; 林惠玲; 王怡心

    2013-01-01

    目的 了解深圳市福田区慢性病防治院2008-2012年103株淋球菌对五种抗菌药的耐药性及产青霉素酶淋球菌PPNG和高水平耐四环素淋球菌TRNG的流行趋势. 方法 用琼脂稀释法测定头孢曲松、大观霉素、环丙沙星、四环素及阿奇霉素的最低抑菌浓度(MIC),用头孢硝噻吩纸片检测β-内酰胺酶. 结果 103株淋球菌检出PPNG35株(34.0%),TRNG62株(60.2%),环丙沙星耐药率达96.1%,高度耐药株(MIC≥16mg/L)51株(49.5%),阿奇霉素耐药率为16.5%,头孢曲松、大观霉素未发现耐药菌株、抗菌活性均很强. 结论 持续性监测淋球菌的耐药性变迁是临床减少淋球菌耐药菌珠出现的有效办法.%Objective To investigate the drug resistance of 103 strains of Neisseria gonorrhoeae to 5 antibiotics and the prevalence of penicillinase - producing Neisseria gonorrhoeae (PPNG) and high-level tetracycline resistant Neisseria gonorrhoeae (TRNG) isolated from Futian District Institute for Prevention and Control of Chronic Diseases during the period of 2008 - 2011. Methods Agar dilution method was used to determine minimum inhibitory concentrations (MICs) to ceftriaxone, spectino-mycin, ciprofloxacin, tetracycline and azithromycin. (3- lactamase was tested using nitrocefin disk. Results Among 103 strains of Neisseria gonorrhoeae, 35 strains of PPNG (34.0%) and 62 strains of TRNG (60.2%) were detected. The resistance to ciprofloxacin accounted for 96.1% , including 51 (49.5%) highly resistant strains (MIC≥16 mg/L). The resistance to azithromycin accounted for 16.5%. No strain was found to be resistant to ceftriaxone and spectinomycin, which both had strong antibiotic activity. Conclusions It is the effective method to reduce drug resistant Neisseria gonorrhoeae by continuously monitoring the changes of antibiotic resistance of Neisseria gonorrhoeae in clinical practice.

  16. Antibiotic resistance of Neisseria gonorrhoeae in Guangzhou: an analysis result%2010年广州地区淋球菌耐药监测结果分析

    Institute of Scientific and Technical Information of China (English)

    黎小东; 曹文苓; 宋卫忠; 梁艳华; 毕超; 林路洋; 张莉; 张锡宝; 吴德标

    2012-01-01

    目的 了解广州地区淋球菌对抗生素耐药性的变化及PPNG和TRNG的流行趋势.方法 用琼脂稀释法测定头孢曲松、大观霉素、环丙沙星、阿奇霉素和四环素的最低抑菌浓度(MIC);用纸片碘量法检测β-内酰胺酶.结果 83株淋球菌检出PPNG 24株(28.9%)、TRNG 50株(60.2%)、环丙沙星耐药率高达98.8%,高度耐药株(MIC≥16mg/L)43株(51.8%),而76株淋球菌中阿奇霉素耐药株11株(14.5%),均未出现对头孢曲松、大观霉素耐药的菌株,抗菌活性强.结论 合理规范使用抗生素及动态监测淋球菌耐药性变迁是临床减少淋球菌耐药菌株出现的有效办法.%Objective To investigate the antibiotic resistance and the prevalence of PPNC and TRNG in Guangzhou. Method Minimum inhibitory concentrations (MICs) to ceftriaxone, spectiomycin, ciprofloxacin, azithromyc and tetracyciine were determined using the agar dilution method, and (J-lactama.se by paper iodine quantitative method. Result 24 strains of Neisseria gonorrhoeae producing β-lactamase were detected in 83 strains, while 50 strains showed plasmid-mediated, high-level resistance to tetracyciine (TRNG). Resistance rate to ciprofloxacin was 98. 8%. 43 strains were highly resistant (MIC≥16 mg/L) (51.8%). Resistance rate to azithromyc was 14. 5% (11/76). No strains were found to be resistant to ceftriaxone and specitinomycin. Conclusion Using antibiotics rationally and the changes of resistance being monitored dynamically can effectively reduce the occurance of more resistant strains of Neisseriae gonorrhoeae.

  17. Surveillance of Antibiotic Susceptibility of Neisseria gonorrhoeae Isolated from Ten Cities of China from 1993~ 1998%1993~ 1998年中国十城市分离的淋球菌对抗生素的敏感性监测

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    目的研究我国 1993~ 1998年分离的淋球菌对青霉素、四环素、环丙沙星、大观霉素和头孢曲松的敏感性,作为制定治疗方案和防治对策的参考依据。方法测定菌株对抗生素的敏感性用琼脂稀释法,测定产青霉素酶淋球菌菌株用纸片酸度法。结果 6年来,共检测了 3 186株淋球菌对抗生素的敏感性。发现青霉素的耐药菌百分率为 66.70%,产青霉素酶淋球菌菌株占 8.14%;对四环素的耐药菌株占 93.02% ,高度耐药的四环素耐药淋球菌菌株占 4.65%。结论我国近 6年分离的淋球菌对青霉素、四环素和环丙沙星耐药菌百分率较高,对大观霉素和头孢曲松仍较敏感。%Objective To investigate the antimicrobial susceptibility of Neisseria gonorrhoeae isolated from 10 cities of China, and to provide reference for the formulation of treatment guideline and making control strategy. Methods Agar dilution was used to detect antimicrobial susceptibility and acidometric method for PPNG testing. Results A total of 3186 gonococcal isolates were tested from 1993 to 1998. The resistant rate for penicillin was 66.70% . PPNG isolates accounted for 8.14% . Tetracycline- resistant isolates accounted for 93.02% , and high level tetracycline- resistant isolates (TRNG) accounted for 4.65% . The resistant rate for ciprofloxacin was also high (34.25% ). The resistant rates for spectinomycin and ceftriaxone were 0.44% and 0.57% respectively. Conclusions The gonococcal isolates are highly resistant to penicillin, tetracycline, and ciprofloxacin, while still sensitive to spectinomycin and ceftriaxone. These results suggest that the present treatment for gonorrhea can still be used.

  18. 1999年广州地区所见淋球菌对抗生素耐药性结果分析%Analysis of Antibiotic Resistance of Neisseria gonorrhoeae in Guangzhou, 1999

    Institute of Scientific and Technical Information of China (English)

    曹文苓; 费实; 李平; 颜景兰; 梁艳华; 宋卫忠

    2001-01-01

    Objective To survey the antibiotic resistance and the prevalence of penicillinase-producing Neisseria gonorrhoeae(PPNG) and high-level tetracycline resistant Neisseria gonorrhoeae(TRNG) in Guangzhou. Methods Minimum inhibitory concentrations(MIC) were determined using the agar dilution method and that of β-lactamase by paper iodin quantitative method.Results There were 9(5.4% ) strains PPNG and 16(9.6% ) strains TRNG in 167 strains Neisseriae gonorrhoeae. Resistant rates of ciprofloxacin was as much as 78.4 %. The high-level resistant stains(MIC≥ 16mg/L) were 37 (22.2 % ). No resistance strain to ceftriaxone and specitinomycin, ceftriaxone susceptibility was improving. Conclusion The study showed that it is important to successively survey the antibiotic resistance of Neisseriae gonorrhoeae.%目的了解广州地区所见淋球菌对抗生素的耐药性及产青霉素酶淋球菌(PPNG)和高水平耐四环素淋球茵(TRNG)的流行状况。方法用琼脂稀释法测定最低抑茵浓度(MIC)以及用纸片碘量法检测β-内酰胺酶。结果167株淋球菌检出PPNG 9株(5.4%)、TRNG 16株(9.6%)、环丙沙星耐药率达78.4%,高度耐药株(MIC≥16mg/L)37株(22.2%),头孢三嗪、壮观霉素未发现耐药菌株,且抗茵活性最强,头孢三嗪敏感性呈上升趋势。结论持续监测淋球菌的耐药性十分重要。

  19. Study of sensitivity test to neisseria gonorrhoeae antibiotic drug in NanTong district%南通地区2006~2008年淋球菌耐药性分析

    Institute of Scientific and Technical Information of China (English)

    孙亚军; 袁建芬; 喻海忠

    2009-01-01

    Objective To explore the sensitivity of Neisseria Gonorrhoea in Nantong to antibiotic remedy.Methods To select and identify 147 cases of Neisseria Gonorrhoeae specimens.Then drug sensitivity test was carried out through making five sorts of antibiotics.Results Of all the 3 antibiotic agents,the higher resistances to Neisseria Gonorrhoeae were penicillin,acheomycin, ciprofloxacin in turn,the percentages of resistance were 72.10%,68.08% and 8.85% respectively.On the other hand,the higher susceptibilities to Neisseria Gonorrhoeae were ceftriaxone and spectinomycin the percentages of susceptibility were 100% and 94.56% respectively.Conclusion Ceftriaxone and spectinomycin can still be used as primary agents to cure the disease like Neisseria Gonorrhoeae specimens in Nantong,but clinical doctors need to pay more attention to the fact that resistant strains to spectinomycin have come into existence.The result suggests that these antibiotics may be used under guidance of drug sensitivity test in clinic .%目的 探讨南通地区淋病奈瑟菌(NG) 对抗菌药物的敏感性.方法 选择147株NG标本进行菌株鉴定和5种抗菌药物的敏感试验.结果 NG对青霉素、四环素及环丙沙星的耐药率分别为72.10%、68.08%和8.85%,NG对菌必治(头孢三嗪)、壮观霉素的敏感率为100.00%、94.56%.结论 菌必治(头孢三嗪)和壮观霉素仍可作为南通地区淋病治疗的首选药物,但淋球菌对壮观霉素已出现耐药株,应引起临床医生的高度警惕;建议临床应在药敏试验的指导下用药.

  20. Vibrio vulnificus infection in Southern Brazil - Case report Infecção por Vibrio vulnificus no sul do Brasil - Relato de caso

    Directory of Open Access Journals (Sweden)

    João César Beenke França

    2013-06-01

    Full Text Available The genus Vibrio is a member of the family Vibrionaceae, and among their disease-causing species, Vibrio vulnificus, a lactose-positive gram-negative bacillus, is one of the most virulent pathogen of the noncholerae vibrios. We describe the case of a 39-year-old male patient, who was using immunosuppressive therapy, admitted to the hospital for liver transplantation. Twelve hours later, the patient presented high fever, myalgia, anuria and erythematous plaques on lower limbs, of rapid growth and proximal progression. The patient was treated with ceftriaxone, meropenem and oxacillin, however he expired within 30 hours. Blood cultures showed growth of a gram-negative bacillus, which was later identified as Vibrio vulnificus.O gênero Vibrio é membro da família Vibrionaceae, e entre as espécies patogênicas, Vibrio vulnificus, bacilo gram negativo lactose positivo, tem sido frequentemente citado. Descrevemos o caso de um paciente masculino de 39 anos, em uso de medicação imunossupressora, admitido no hospital para transplante hepático. Doze horas após a internação, o paciente evoluiu com febre, mialgias, anúria e placas eritematosas em membros inferiores, com rápido crescimento e evolução proximal. O paciente foi tratado com ceftriaxona, meropenem e oxacilina sem melhora, evoluindo para óbito em 30 horas. Hemocultura mostrou crescimento de bacilo gram negativo posteriormente identificado como Vibrio vulnificus.

  1. Salmonella gastroenteritis in children (clinical characteristics and antibiotic susceptibility): comparison of the years 1995-2001 and 2002-2008.

    Science.gov (United States)

    Ince, Osman Tolga; Yalçin, S Songül; Yurdakök, Kadriye; Ozmert, Elif Nursel; Aydin, Adem; Bariş, Zeren; Gür, Deniz

    2012-01-01

    We document herein the prevalence and serotype distribution among Salmonella enterica strains isolated from children treated for diarrhea over two seven-year periods spanning 14 years. Four hundred and eight (1.38%) S. enterica cases were isolated among 29,601 diarrheal admissions. Among the Salmonella isolates, 63.7% were serogroup D and 29.9% were serogroup B. Overall, 21.7% of cases were under one year of age, with 2.1% being younger than three months. Bloody diarrhea was found in 18.8% of the cases. The resistance rates were 25.8%, 18.2%, 7.0%, 4.7%, and 0.3%, to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ceftriaxone, and ciprofloxacin, respectively. In conclusion, our study has revealed that the predominance of Salmonella serogroup D continues. The clinical features of our patients were mostly mild, with no deaths or severe complications. While resistance to antimicrobial agents changes constantly, it is important to keep these strains under surveillance in order to formulate policies for the rational use of antimicrobial agents.

  2. Characteristics of Salmonella spp. Isolated from Wild Birds Confiscated in Illegal Trade Markets, Rio de Janeiro, Brazil.

    Science.gov (United States)

    Matias, Carlos Alexandre Rey; Pereira, Ingrid Annes; de Araújo, Maiara dos Santos; Santos, André Felipe Mercês; Lopes, Rudi Pereira; Christakis, Sandra; Rodrigues, Dália dos Prazeres; Siciliano, Salvatore

    2016-01-01

    The prevalence of Salmonella spp. was investigated in 109 wild birds poached in the illegal wildlife trade in Rio de Janeiro; most of them are passerines from Thraupidae family and three from Psittacidae. One strain of Salmonella ser. Typhimurium and two strains of Salmonella ser. Panama were isolated from passerine species and all of them showed resistance to multiple antimicrobial drugs, like ampicillin, ceftriaxone, ceftiofur, tetracycline, gentamicin, nalidixic acid, ciprofloxacin, and enrofloxacin. PFGE showed 100% similarity among the Salmonella ser. Typhimurium strain isolated from a Temminck's seedeater (Sporophila falcirostris) and the strains isolated from a human outbreak, in southern Brazil. The two Salmonella ser. Panama strains isolated from two chestnut-capped blackbirds (Chrysomus ruficapillus) present in the same catch showed the same clonal origin and have never been associated with epizooties and human outbreaks. Potential for dissemination of resistant Salmonella through situations offered by captive management and the isolation of the same strain from wild birds and human sources may become a problem for the conservation of natural populations and to public health.

  3. Nocardia abscessus-related intracranial aneurysm of the internal carotid artery with associated brain abscess: A case report and review of the literature.

    Science.gov (United States)

    Farran, Yvette; Antony, Suresh

    2016-01-01

    Nocardia infections primarily begin in the lungs and spread hematogenously to other sites in the body. Thus, a Nocardia brain abscess is not a completely uncommon occurrence. However, a Nocardia brain abscess complicated by a middle cerebral artery and infectious intracranial aneurysm is a very rare clinical entity. We present a case of an infectious intracranial aneurysm with an associated Nocardia brain abscess that required surgical intervention and resection. The patient was an immunocompetent 60-year-old male who presented with a chief complaint of headache and was found to have an infected intracranial aneurysm and cerebral abscess. He underwent drainage of the abscess with subsequent resection of the infected aneurysm. Cultures from both the blood vessel and brain tissue grew Nocardia abscessus. He was successfully treated with 6 weeks of ceftriaxone and high-dose trimethoprim-sulfamethoxazole. Infectious intracranial aneurysms of the brain caused by Nocardia are rare occurrences, and only a single previous case has been described in the literature. The outcomes of this condition can be catastrophic if it is not treated with a combination of surgery and intravenous antibiotics. The guidelines for the management of this infection are not well defined at this time. PMID:26724261

  4. [Lyme disease--clinical manifestations and treatment].

    Science.gov (United States)

    Stock, Ingo

    2016-05-01

    Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings.

  5. Multidrug Resistance of Acinetobacter Baumannii in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria

    Science.gov (United States)

    Odewale, G.; Adefioye, O. J.; Ojo, J.; Adewumi, F. A.; Olowe, O. A.

    2016-01-01

    Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections at Ladoke Akintola University Teaching Hospital. Isolates were assayed according to standard protocol. The isolates were subjected to molecular techniques to detect blaOXA, blaTEM, blaCTX-M, and blaSHV genes in strains of the A. baumannii isolates. The prevalence of A. baumannii was 8.5% and was most prevalent among patients in the age group 51–60 (36%); the male patients (63.6%) were more infected than their female counterparts. Patients (72.7%) in the intensive care unit (ICU) were most infected with this organism. The isolates showed 100% resistance to both amikacin and ciprofloxacin and 90.9% to both ceftriaxone and ceftazidime, while resistance to the other antibiotics used in this study were: piperacillin (81.8%), imipenem (72.7%), gentamycin (72.2%), and meropenem (63.6%). None of the isolates was, however, resistant to colistin. PCR results showed that blaOXA, blaTEM, and blaCTX-M genes were positive in some isolates, while blaSHV was not detected in any of the isolates. This study has revealed that the strains of A. baumannii isolated are multiple drug resistant. Regular monitoring, judicious prescription, and early detection of resistance to these antibiotics are, therefore, necessary to check further dissemination of the organism. PMID:27766173

  6. Neurobrucellosis: three case reports and literature review

    Directory of Open Access Journals (Sweden)

    WANG Jia-wei

    2013-01-01

    Full Text Available Background Brucellosis is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of this infection. This article aims to present clinical manifestations and to discuss the clinical features and management of 3 neurobrucellosis cases. Methods The diagnosis, treatment, laboratory results and accessory examination findings of 3 patients with neurobrucellosis between August 2010 and March 2012 were retrospectively analyzed, and relevant literature was reviewed. Results All the 3 cases had definite history of exposure to epidemic areas or infectious diseases, and history of being infected with Brucella by drinking raw milk. During the screening because of fever for reasons unknown, they were proved to be infected with Brucella by etiological or serological tests. Initial clinical manifestations consisted of fever and headache, with meningitis symptoms and signs, spondylitis, uroschesis and constipation (which might be caused by lumbosacral nerve root lesion, or neurological manifestations in auditory nerve and abducent nerve, such as hearing loss and diplopia. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Conclusion Neurobrucellosis presents with various clinical signs and symptoms, and is often accompanied by systemic infection. Brucellosis should be kept in mind during the screening of fever for reasons unknown, and be differentiated from Mycobacterium tuberculosis infection. The combined treatment by antibotics of different pharmacological mechanisms with full dose and long range is effective, and the prognosis is favorable.

  7. Phenotypic and genotypic detection of extended-spectrum β-lactamase (ESBL) producing Escherichia coli isolated from urinary tract infections in Zabol, Iran

    Institute of Scientific and Technical Information of China (English)

    Saeide Saeidi; Mehdi Ghamgosha; Ramezan Ali Taheri; Yasub Shiri; Mahmood Solouki; Kazem Hassanpour; Gholamreza Farnoosh

    2014-01-01

    Objective: To investigate the role of a rapid polymerase chain reaction (PCR) assay in comparison with traditional empiric therapy in detection of extended spectrum β-lactamase (ESBL) producer Escherichia coli (E. coli). Methods: Ninety isolates of E. coli from urinary tract infection were collected and screening of ESBL resistance using disc diffusion method, minimum inhibitory concentration (MIC) for ceftazidime and detection of TEM resistant gene by PCR were done. Results: The results of disc diffusion method showed that forty out of ninety E. coli isolates were ESBLs producing organisms. Antibiotic susceptibility of E. coli isolates to 9 antibacterial agents were evaluated. However, all isolated E. coli were resistant to all 9 antibacterial agents by these percentage: ceftriaxon (100%), ceftazidime (100%), amoxicillin (100%), erythromycin (100%), azithromycin (95%), cefixime (87.5%), tetracyclin (87.5%), nalidixic acid (85%) and difloxcain (75%). The abundance of antibiotic-resistant TEM gene according to PCR was 30%. Totally 82.5% of strains tested by MIC were observed as ceftazidime-resistant.Conclusions:We conclude that the TEM gene PCR assay is a rapid, sensitive and clinically useful test, particularly for the early detection of ESBLs-producing E. coli.

  8. Multidrug resistant Escherichia coli strains isolated from urine sample, University of Gondar Hospital, Northwest Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Setegn Eshetie; Fentahun Tarekegn; Gemechu Kumera; Feleke Mekonnen

    2016-01-01

    Objective: To assess multidrug resistant (MDR) Escherichia coli (E. coli) isolates from patients with urinary tract infection. Methods: From February to June 2014, a cross sectional study was conducted among urinary tract infection patients at the University of Gondar Hospital. Culture and disk diffusion method were used for E. coli isolation and to determine the antibiotic susceptibility patterns. Data were entered and analyzed using SPSS version 20. P Results: A total of 112 E. coli isolates were identified and the rate of isolation was higher among female participants (28.7%; P = 0.03). Of the isolates, 104 (92.9%) were MDR E. coli; and the isolates showed high resistance rates towards ampicillin (99%), cotrimoxazole (69%), chloramphenicol (58.7%), gentamycin (56.7%) and ceftazidime (55.8%). However, comparative isolates showed low resistance rates to ciprofloxacin (1%), cefepime (8.7%), and ceftriaxone (11.5%). Moreover, resistance rates of MDR E. coli isolates were significantly higher than non-MDR strains for ceftazidime (55.8% versus 12.5%; P = 0.015), and ampicillin (99% versus 87.5%; P = 0.018). Conclusions: High prevalence of MDR E. coli isolates was observed in this study. Regular monitoring of antibiotic resistance rates is necessarily required to improve and revise empirical antibiotic therapy protocols.

  9. Propionibacterium acnes: An Underestimated Pathogen in Implant-Associated Infections

    Directory of Open Access Journals (Sweden)

    María Eugenia Portillo

    2013-01-01

    Full Text Available The role of Propionibacterium acnes in acne and in a wide range of inflammatory diseases is well established. However, P. acnes is also responsible for infections involving implants. Prolonged aerobic and anaerobic agar cultures for 14 days and broth cultures increase the detection rate. In this paper, we review the pathogenic role of P. acnes in implant-associated infections such as prosthetic joints, cardiac devices, breast implants, intraocular lenses, neurosurgical devices, and spine implants. The management of severe infections caused by P. acnes involves a combination of antimicrobial and surgical treatment (often removal of the device. Intravenous penicillin G and ceftriaxone are the first choice for serious infections, with vancomycin and daptomycin as alternatives, and amoxicillin, rifampicin, clindamycin, tetracycline, and levofloxacin for oral treatment. Sonication of explanted prosthetic material improves the diagnosis of implant-associated infections. Molecular methods may further increase the sensitivity of P. acnes detection. Coating of implants with antimicrobial substances could avoid or limit colonization of the surface and thereby reduce the risk of biofilm formation during severe infections. Our understanding of the role of P. acnes in human diseases will likely continue to increase as new associations and pathogenic mechanisms are discovered.

  10. Musculoskeletal manifestations of Lyme disease.

    Science.gov (United States)

    Steere, A C

    1995-04-24

    Musculoskeletal involvement, particularly arthritis, is a common feature of Lyme disease. Early in the illness, patients may experience migratory musculoskeletal pain in joints, bursae, tendons, muscle, or bone in one or a few locations at a time, frequently lasting only hours or days in a given location. Weeks to months later, after the development of a marked cellular and humoral immune response to the spirochete, untreated patients often have intermittent or chronic monoarticular or oligoarticular arthritis-primarily in large joints, especially the knee-during a period of several years. The diagnosis of Lyme arthritis is usually based on the presence of this characteristic clinical picture, exposure in an endemic area, and an elevated immunoglobulin G antibody response to Borrelia burgdorferi. In addition, spirochetal DNA can often be detected in joint fluid by polymerase chain reaction. Lyme arthritis can usually be treated successfully with 1-month courses of oral doxycycline or amoxicillin or with 2- to 4-week courses of intravenous ceftriaxone. However, patients with certain genetic and immune markers may have persistent arthritis, despite treatment with oral or intravenous antibiotics. B. burgdorferi may occasionally trigger fibromyalgia, a chronic pain syndrome with diffuse joint and muscle symptoms. This syndrome does not appear to respond to antibiotic therapy.

  11. Serotypes, antibiotic susceptibilities, and multi-locus sequence type profiles of Streptococcus agalactiae isolates circulating in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Ping Wang

    Full Text Available To investigate the serotypes, antibiotic susceptibilities, and multi-locus sequence type (MLST profiles of Streptococcus agalactiae (S. agalactiae in Beijing to provide references for the prevention and treatment of S. agalactiae infections.All isolates were identified using the CAMP test and the latex-agglutination assay and serotyped using a Strep-B-Latex kit, after which they were assessed for antibiotic susceptibility, macrolide-resistance genes, and MLST profiles.In total, 56 S. agalactiae isolates were identified in 863 pregnant women (6.5%. Serotypes Ia, Ib, II, III, and V were identified, among which types III (32.1%, Ia (17.9%, Ib (16.1%, and V (14.3% were the predominant serotypes. All isolates were susceptible to penicillin and ceftriaxone. The nonsusceptiblity rates measured for erythromycin, clarithromycin, azithromycin, telithromycin, clindamycin, tetracycline, and levofloxacin were 85.7%, 92.9%, 98.2%, 30.4%, 73.2%, 91%, and 39.3%, respectively. We identified 14 sequence types (STs for the 56 isolates, among which ST19 (30.4% was predominant. The rate of fluoroquinolone resistance was higher in serotype III than in the other serotypes. Among the 44 erythromycin-resistant isolates, 32 (72.7% carried ermB.S. agalactiae isolates of the serotypes Ia, Ib, III, and V are common in Beijing. Among the S. agalactiae isolates, the macrolide and clindamycin resistance rates are extremely high. Most of the erythromycin-resistant isolates carry ermB.

  12. Procalcitonin implication in renal cell apoptosis induced by acute pyelonephritis in children

    Science.gov (United States)

    Belhadj-Tahar, Hafid; Coulais, Yvon; Tafani, Mathieu; Bouissou, François

    2008-01-01

    The aim of this biomedical trial was to clarify the physiological role of procalcitonin (PCT) in renal parenchyma apoptosis and fibrosis caused by acute childhood pyelonephritis. This prospective study enrolled 183 children. All children were treated with bi-therapy according to the French consensus on acute pyelonephritis treatment dated November 16, 1990: intra-vascular administration of ceftriaxone 50 mg/kg/day and netromicine 7 mg/kg/day during the first 48 hours, followed by specific antibiotherapy suited to antibiogram. On admission, PCT, C-reactive protein, and phospholipase A2 were quantified in serum. Scintigraphy monitoring with 99mTc-DMSA was performed on day 4 and 9 months later, in the presence of persistent abnormalities. On day 4, 78% presented renal parenchyma alterations and 30% renal fibrosis 9 months after admission. Paradoxically, PCT level was significantly lower in the presence of renal fibrosis due to cell apoptosis (4.19 vs 7.59 μgL−1). A significant increase in PCT indicated favorable progress (recovery 7.55 vs aggravation 3.34) and no difference between recovery and improvement. This result suggests the protective effect of PCT against apoptosis by nitric oxide down-regulation. PMID:21694876

  13. Systemic lupus erythematosus and splenic abscess

    International Nuclear Information System (INIS)

    Systemic lupus erythematosus is an autoimmune disease in which there is an increase risk of infections by common germ as by opportunistic germs. This fact is explained by the alterations in the humoral and cellular immunity, and phagocytic mononuclear system due to the disease and the immunosuppressive therapy use for its treatment. Multiple infectious processes have been describes in patients with SLE and within them, the splenic abscess, although in few cases. Usually its presence is associated with an underlying disease such as sepsis or peritonitis, with multiple outcomes. Due to its low frequency as well as the unusual presentation, we reported a case of a solitary splenic abscess documented by ultrasound in a teenager with SLE and immunosuppressive treatment, without any underlying infection, who presents with fever, abdominal pain, leucocytosis and elevation of acute phase reactants. He received antibiotic therapy with clindamycin and ceftriaxone and percutaneous drainage of the abscess guided by ultrasound and sent to culture in which grew non-typificable anaerobe germs, with a favorable evolution after 5 year of follow up

  14. Antibiotic Resistance in Children with Bloody Diarrhea

    Directory of Open Access Journals (Sweden)

    Hamedi Abdolkarim

    2009-05-01

    Full Text Available Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(TMP-SMX; however multidrug-resistance has occurred and careful antibiotic selection must be considered in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroquinolones may be used in adults and oral third-generation cephalosporins and nalidixic acid in children. All children (n=2400 with acute diarrhea who were admitted to the Pediatric department of Dr.sheykh Hospital Mashhad, Iran from March 2004 to March 2005 were selected and their stool culture were obtained, then positive cultures (312 cases,13% were evaluated by antibiogram. This study showed that in heavily populated areas of IRAN like Mashhad, 97% shigella strain isolated from children with bloody diarrhea were sensitive to nalidixic acid, ciprofloxacin and cefixime and rarely susceptible to ampicillin and cotrimoxazole. There is increasing resistance of Shigella to most of the antibiotics in use, and for this reason, careful selection of antibiotics must use considered in each area. Development and use of new drugs are expensive and have severe limitations in the third world. Simple prophylactic alternatives are therefore, required, such as awareness of hygienic child care practices and early promotion of breast feeding. For treatment of shigellosis in infants Ceftriaxon, and in children Nalidixic Acid is recommended.

  15. Voluntary ban on cephalosporin use in Danish pig production has effectively reduced extended-spectrum cephalosporinase-producing Escherichia coli in slaughter pigs

    DEFF Research Database (Denmark)

    Agersø, Yvonne; Aarestrup, Frank Møller

    2013-01-01

    . For detection of ESC-producing E. coli, three sampling types were included: at slaughter, caecal samples were collected from pigs in 2009 and 2010 (June) before and in two periods (2010 and 2011) after a voluntary ban on cephalosporins was effected (July 2010); at farm level, pools of five stool samples from...... different pigsties were collected in 2010 and in 2011; and samples from pork were collected randomly at retail stores and outlets from 2009 to 2011. ESC-producing E. coli was isolated after selective enrichment in MacConkey broth with 1 mg/L ceftriaxone. ESC genes were detected using PCR, microtube array...... and sequencing.Results From July 2010 the consumption of cephalosporins approximated zero. The occurrence of ESC-producing E. coli in pigs at slaughter was not significantly different (P = 0.7) between 2009 [10.8% (85/786)] and 2010 [11.8% (48/407)], but in 2011 the occurrence [3.6% (28/777)] decreased...

  16. Outbreak of Salmonella Typhi enteric fever in sub-urban area of North India:A public health perspective

    Institute of Scientific and Technical Information of China (English)

    Nidhi Singla; Neha Bansal; Varsha Gupta; Jagdish Chander

    2013-01-01

    Outbreaks of enteric fever are a major health concern not only due to significant human morbidity and mortality but also fear of spread of multidrug resistant strains.We report an outbreak of enteric fever caused bySalmonella enterica serotypeTyphi in a suburban area, in cityChandigarh ofNorthIndia.Twenty-seven strains ofS. typhi were isolated from blood cultures over a period of two weeks with18 of these27 patients residing in the same area.Maximum cases were in the age group5-14 years(10 patients,55.5%) while4(22.2%) cases were children under5 years.All the strains showed similar resistogram being resistant to ampicillin and nalidixic acid, intermediate to ciprofloxacin and sensitive to chloramphenicol, ceftriaxone, cefotaxime, cotrimoxazole and azithromycin on disc diffusion testing.Minimum inhibitory concentration of ciprofloxacin was determined by agar dilution method and was found to be raised(≥2 μg/mL).This nalidixic acid resistant S. typhioutbreak report warrants the necessity of implementing stringent sanitation practices in public health interest.

  17. [Primary meningococcal infection of the knee. A rare cause of septic arthritis].

    Science.gov (United States)

    Klatte, T O; Lehmann, W; Rueger, J M

    2015-10-01

    This article presents a case of primary septic arthritis of the knee due to serogroup C Neisseria meningitidis. A 19-year-old female presented to the emergency department with a painless but swollen knee joint which had started 2 days previously and fever (38 °C). The patient reported that she suddenly felt unwell 3 days ago and developed a rush at the same time which had almost disappeared when arrived at the emergency department. The patient was admitted to hospital and an antibiotic therapy was started with sulbactam and ampicillin. Initially, incubation of synovial fluid over the next 3 days did not result in detection of any pathogens; therefore, a reactive arthritis was assumed until Neisseria meningitidis was detected in cultures of the synovial fluid. Therapy was then switched to antibiotic therapy with ceftriaxon and arthroscopic irrigation was performed. The patient quickly recovered and was discharged from hospital after 14 days. This case example shows the difficulties of the clinical and microbiological diagnostics of a primary septic meningococcal arthritis; however, the treatment is relatively easy and mostly successful compared to other forms of bacterial joint infection.

  18. Impaired consciousness revealing a cerebral amebiasis in an immunocompetent adult

    Directory of Open Access Journals (Sweden)

    Hanane Ezzouine

    2012-01-01

    Full Text Available Amebiasis is a parasitic infection with manifestations, mainly digestives. It is rarely described extra-gastrointestinal locations including the brain. We report the case of a patient aged 42, made five months earlier for an appendectomy, and was admitted to the ICU after a convalescent stable uncomplicated. At admission, he was 12/15 in Glasgow and had a right hemiplegia. Brain CT revealed a discrete diffuse hypodensities perilesional edema. An abdominal ultrasound found an aspect for multiple hepatic abscesses. Abscess puncture was performed, which was not conclusive, and no seed could be identified. On Ultrasound, no cardiac abnormalities were found, and no endocarditis was present. And since the appearance macroscopic (chocolate-brown, amebic serology is performed and has been highly positive. The therapeutic management included an intubation and ventilation as well as a tri-antibiotic-based ceftriaxon, metronidazol and gentamycin. Confirmation of amebiasis required high doses of metronidazol for an extended period. The replay of the play was an appendectomy for an amebome. Evolution was favorable. Amebiasis can have extraintestinal locations, issues to think about including the cerebral forms.

  19. Alternative Pathway Inhibition by Exogenous Factor H Fails to Attenuate Inflammation and Vascular Leakage in Experimental Pneumococcal Sepsis in Mice.

    Science.gov (United States)

    van der Maten, Erika; van Selm, Saskia; Langereis, Jeroen D; Bootsma, Hester J; van Opzeeland, Fred J H; de Groot, Ronald; de Jonge, Marien I; van der Flier, Michiel

    2016-01-01

    Streptococcus pneumoniae is a common cause of sepsis. Effective complement activation is an important component of host defence against invading pathogens, whilst excessive complement activation has been associated with endothelial dysfunction and organ damage. The alternative pathway amplification loop is important for the enhancement of complement activation. Factor H is a key negative regulator of the alternative pathway amplification loop and contributes to tight control of complement activation. We assessed the effect of inhibition of the alternative pathway on sepsis associated inflammation and disease severity using human factor H treatment in a clinically relevant mice model of pneumococcal sepsis. Mice were infected intravenously with live Streptococcus pneumoniae. At the first clinical signs of infection, 17 hours post-infection, mice were treated with ceftriaxone antibiotic. At the same time purified human factor H or in controls PBS was administered. Treatment with human factor H did not attenuate disease scores, serum pro-inflammatory cytokines, or vascular permeability and did not significantly affect C3 and C3a production at 26 h post-infection. Therefore, we conclude that inhibition of the alternative complement pathway by exogenous human factor H fails to attenuate inflammation and vascular leakage at a clinically relevant intervention time point in pneumococcal sepsis in mice. PMID:26872035

  20. Resistance to Cefepime and Cefpirome Due to a 4-Amino-Acid Deletion in the Chromosome-Encoded AmpC β-Lactamase of a Serratia marcescens Clinical Isolate

    Science.gov (United States)

    Mammeri, Hedi; Poirel, Laurent; Bemer, Pascal; Drugeon, Henri; Nordmann, Patrice

    2004-01-01

    A multiresistant Serratia marcescens strain, HD, isolated from a patient with a urinary tract infection, was resistant to amino-, carboxy-, and ureidopenicillins, ceftazidime, and cefepime and was susceptible to cefotaxime and ceftriaxone, according to the guidelines of the NCCLS. No synergy was found between expanded-spectrum cephalosporins and clavulanic acid, according to the double-disk synergy test. The blaAmpC gene of the strain was amplified by PCR and cloned into Escherichia coli DH10B, giving rise to high-level resistance to ceftazidime, cefepime, and cefpirome. Sequencing analysis revealed that the blaAmpC gene from S. marcescens HD had a 12-nucleotide deletion compared to the blaAmpC gene from reference strain S. marcescens S3, leading to a 4-amino-acid deletion located in the H-10 helix of the β-lactamase. Kinetic analysis showed that this enzyme significantly hydrolyzed ceftazidime, cefepime, and cefpirome. This work underlined that resistance to the latest expanded-spectrum cephalosporins may be mediated by structurally modified AmpC-type β-lactamases. PMID:14982755

  1. Resistance to cefepime and cefpirome due to a 4-amino-acid deletion in the chromosome-encoded AmpC beta-lactamase of a Serratia marcescens clinical isolate.

    Science.gov (United States)

    Mammeri, Hedi; Poirel, Laurent; Bemer, Pascal; Drugeon, Henri; Nordmann, Patrice

    2004-03-01

    A multiresistant Serratia marcescens strain, HD, isolated from a patient with a urinary tract infection, was resistant to amino-, carboxy-, and ureidopenicillins, ceftazidime, and cefepime and was susceptible to cefotaxime and ceftriaxone, according to the guidelines of the NCCLS. No synergy was found between expanded-spectrum cephalosporins and clavulanic acid, according to the double-disk synergy test. The bla(AmpC) gene of the strain was amplified by PCR and cloned into Escherichia coli DH10B, giving rise to high-level resistance to ceftazidime, cefepime, and cefpirome. Sequencing analysis revealed that the bla(AmpC) gene from S. marcescens HD had a 12-nucleotide deletion compared to the bla(AmpC) gene from reference strain S. marcescens S3, leading to a 4-amino-acid deletion located in the H-10 helix of the beta-lactamase. Kinetic analysis showed that this enzyme significantly hydrolyzed ceftazidime, cefepime, and cefpirome. This work underlined that resistance to the latest expanded-spectrum cephalosporins may be mediated by structurally modified AmpC-type beta-lactamases.

  2. Antimicrobial drug susceptibility of Neisseria meningitidis strains isolated from carriers

    Directory of Open Access Journals (Sweden)

    Dayamí García

    2000-06-01

    Full Text Available When it is necessary to determine the susceptibility of Neisseria meningitidis (Nm strains to antimicrobial drugs, it is important to consider that it should be analyzed in a double context. One of them related to the use of drugs in a specific medical treatment; and the other; to chemoprophylatic drugs, both with the same purpose: the accurate selection of the “in vivo” antimicrobial agent. This requires the study of the sensitivity and resistance of strains isolated in both carriers and patients. With the aim of further studying the behavior of the strains that currently circulate in Cuba, an antimicrobial drug susceptibility study was conducted in 90 strains isolated from carriers during the first half of 1998. The agar dilution method was used to determine the minimum inhibitory concentrations (MICs to: penicillin, ampicillin, rifampin, sulfadiazine, chloramphenicol, ciprofloxacin, ceftriaxone, cefotaxime. The study of the three latter drugs was done for the first time in our country. The search for β- lactamase-producer strains was also performed. There was a predominance of penicillin sensitive strains (82,2% with an intermediate sensitivity to ampicillin (57,8%, while 70% of the strains were sensitive to sulfadiazine. Regarding the rest of the antimicrobial drugs, 100% of the strains were sensitive. The paper shows the MICs for each drug as well as the phenotypic characteristics of the strains with the penicillin and sulfadiazine sensitivity and resistance patterns. No β-lactamase-producer strains were found.

  3. A Case of Neonatal Neutropenia Due to Anti-Fc Gamma Receptor IIIb Isoantibodies Treated with Recombinant Human Granulocyte Colony Stimulating Factor

    Directory of Open Access Journals (Sweden)

    Maja Tomicic

    2009-01-01

    Full Text Available Alloimmunization to granulocyte-specific antigens can occur during pregnancy. Maternal antibodies of IgG class can cross the placenta to result in alloimmune neonatal neutropenia. Antibodies to human neutrophil antigens anti-HNA-1a, HNA-1b, and HNA-2a have been most commonly reported to cause alloimmune neonatal neutropenia. Isoantibodies to Fc gamma RIIIb (CD16 if mother is a HNA-null phenotype are rarely involved in neonatal neutropenia. We report on a case of severe neutropenia (440 neutrophils/μL due to anti-Fc gamma RIIIb (CD16 isoimmunization. On day 14 severe omphalitis developed, which was treated for 7 days by an antibiotic (ceftriaxone in a dose of 80 mg/kg/d according to umbilical swab finding. Omphalitis persisted for 10 days in spite of antibiotic therapy and only resolved upon the introduction of rhG-CSF therapy. Therapy with rh-GCSF proved efficient and led to neutrophil count increase to 1970/μL and cure of omphalitis. However, therapeutic effect on granulocyte count was of transient nature, as granulocyte count fell to 760 n/μL on day 4 of therapy discontinuation. Neutropenia persisted for 2 months. The newborn was discharged from the hospital on day 26 with normal clinical status with clinical and laboratory control examinations at 2-week intervals. No additional infections were observed during the course of neutropenia.

  4. MICROBIOLOGICAL PROFILE OF BILE IN CHOLELITHIASIS AND THEIR IMPLICATION IN CAUSING POST OPERATIVE WOUND INFECTIONS

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-12-01

    Full Text Available BACKGROUND: Cholecystitis is a common indication for major abdominal surgeries. It may occur with or without obstruction of common bile duct. Obstruction leads to secondary bacterial infection of bile. Bactibilia is an important predisposing factor for post-operative complications. Hence, this study was designed to determine the prevalence of bacteria in bile samples of cholecystitis patients and to correlate bactibilia and post-operative wound infection. MATERIALS AND METHODS: Bile samples collected intra-operatively were subjected to gram stain, culture, and antibiotic sensitivity testing. The patients were followed-up for post-operative complications. If post-operative wound infection was found, cultures were done and correlated with bacteria isolated from bile samples. RESULTS: Bactibilia was found in 43/100 (43% of patients. Polymicrobial flora was found in 7% of bile samples. Escherichia coli, citrobacter, Klebsiella pneumoniae and pseudomonas were the predominant organisms isolated. Post-operative wound infection was found in ten (10% patients who had bactibilia. Amikacin, gentamicin, ceftriaxone sulbatum, pipracillin tazobactum, imipenem were among most effective in prophylactic regimen. CONCLUSION: The organisms responsible for bactibilia were found to cause post-operative infections in the same patient warranting the use of prophylactic antibiotics in every patient undergoing cholecystectomy. All patients undergoing cholecystectomy should receive prophylactic antibiotic to prevent post-operative wound infections.

  5. Characteristics of Salmonella spp. Isolated from Wild Birds Confiscated in Illegal Trade Markets, Rio de Janeiro, Brazil

    Science.gov (United States)

    Matias, Carlos Alexandre Rey; Pereira, Ingrid Annes; de Araújo, Maiara dos Santos; Santos, André Felipe Mercês; Lopes, Rudi Pereira; Christakis, Sandra; Rodrigues, Dália dos Prazeres; Siciliano, Salvatore

    2016-01-01

    The prevalence of Salmonella spp. was investigated in 109 wild birds poached in the illegal wildlife trade in Rio de Janeiro; most of them are passerines from Thraupidae family and three from Psittacidae. One strain of Salmonella ser. Typhimurium and two strains of Salmonella ser. Panama were isolated from passerine species and all of them showed resistance to multiple antimicrobial drugs, like ampicillin, ceftriaxone, ceftiofur, tetracycline, gentamicin, nalidixic acid, ciprofloxacin, and enrofloxacin. PFGE showed 100% similarity among the Salmonella ser. Typhimurium strain isolated from a Temminck's seedeater (Sporophila falcirostris) and the strains isolated from a human outbreak, in southern Brazil. The two Salmonella ser. Panama strains isolated from two chestnut-capped blackbirds (Chrysomus ruficapillus) present in the same catch showed the same clonal origin and have never been associated with epizooties and human outbreaks. Potential for dissemination of resistant Salmonella through situations offered by captive management and the isolation of the same strain from wild birds and human sources may become a problem for the conservation of natural populations and to public health. PMID:26881216

  6. Pathogen distribution and drug resistance of nephrology patients with urinary tract infections

    Directory of Open Access Journals (Sweden)

    Yunqian Wang

    2016-05-01

    Full Text Available Objective: Pathogen distribution characteristics of nephrology patients with urinary tract infections are studied, and drug resistance of nephrology and urinary tract infection disease are analyzed, so as to provide sufficient evidence for treatment of patients. Methods: Conduct randomized control study of 3500 cases of nephrology patients with urinary tract infections treated in different hospitals from December 2013 to December 2015, isolate pathogens in patients’ urine samples, perform identification and drug sensitive test and then conduct detailed analysis of drug resistance of pathogens. Results: Through isolation of pathogens, it can be found that all pathogens include Escherichia coli, Gram-positive cocci, gram-negative bacteria, fungi, Acinetobacter baumannii, Enterococcus faecalis, and urinary Enterococcus. Among them, proportion of E. coli is the largest. Patients have relatively high drug resistance to ceftriaxone, gentamicin, ciprofloxacin and cotrimoxazole. Conclusion: For nephrology patients with urinary tract infection, the main pathogen is E. coli, which has had some drug resistance. Drug resistance detection of pathogen should be strengthened in clinics, so as to provide strong guidance for clinical treatment and promote effective treatment of patients.

  7. Effect of Cordyceps sinensis mycelium on serum vasoactive intestinal peptide and substance P in mice with intestinal dysbacteriosis

    Directory of Open Access Journals (Sweden)

    Kai-zhong DONG

    2015-01-01

    Full Text Available Objective To observe the effect of Cordyceps sinensis mycelium on serum vasoactive intestinal peptide (VIP and substance P (SP in mice with dysbacteriosis induced by antibiotics. Methods Forty-eight healthy SPF BALB/c mice were randomly divided into the normal control group (normal drink, the dysbacteriosis model group (induced by oral administration of 0.5 g/L ceftriaxone sodium, the natural recovery group (oral sterile water to replace antibiotic after reproduction of dysbacteriosis, and Cordyceps sinensis mycelium treatment group (treated by intragastric administration of Cordyceps sinensis mycelium. The feces were collected without contamination, and the change in intestinal bacterial number was observed with the plate dilution method. The volatile fatty acid was detected by chromatography. The serum VIP and SP contents were assayed with enzyme linked immunosorbent assay (ELISA. Results Compared with the normal control group, the numbers of probiotics, volatile fatty acids and serum VIP significantly decreased in the model group, while the serum SP markedly increased (P<0.01. Compared with the natural recovery group, the bacteria number, the quantities of volatile fatty acids and serum VIP significantly increased after the Cordyceps sinensis mycelium treatment, while the serum SP significantly decreased (P<0.01, P<0.05. Conclusion Cordyceps sinensis mycelium may effectively adjust the proportion of the probiotics in the mice with dysbacteriosis, and the mechanism is apparently related to alteration in the VIP and SP. DOI: 10.11855/j.issn.0577-7402.2014.11.06

  8. Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria

    Directory of Open Access Journals (Sweden)

    Ikefuna Anthony N

    2011-09-01

    Full Text Available Abstract Background Urinary tract infection (UTI is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Methods One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml on two consecutive cultures were regarded as having asymptomatic bacteriuria. Results Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1 when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%. All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones. Conclusion The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.

  9. The Role of the β5-α11 Loop in the Active-Site Dynamics of Acylated Penicillin-Binding Protein A from Mycobacterium tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Fedarovich, Alena; Nicholas, Robert A.; Davies, Christopher [MUSC; (UNC)

    2013-04-22

    Penicillin-binding protein A (PBPA) is a class B penicillin-binding protein that is important for cell division in Mycobacterium tuberculosis. We have determined a second crystal structure of PBPA in apo form and compared it with an earlier structure of apoenzyme. Significant structural differences in the active site region are apparent, including increased ordering of a β-hairpin loop and a shift of the SxN active site motif such that it now occupies a position that appears catalytically competent. Using two assays, including one that uses the intrinsic fluorescence of a tryptophan residue, we have also measured the second-order acylation rate constants for the antibiotics imipenem, penicillin G, and ceftriaxone. Of these, imipenem, which has demonstrable anti-tubercular activity, shows the highest acylation efficiency. Crystal structures of PBPA in complex with the same antibiotics were also determined, and all show conformational differences in the β5–α11 loop near the active site, but these differ for each β-lactam and also for each of the two molecules in the crystallographic asymmetric unit. Overall, these data reveal the β5–α11 loop of PBPA as a flexible region that appears important for acylation and provide further evidence that penicillin-binding proteins in apo form can occupy different conformational states.

  10. Invasive meningococcal disease

    Directory of Open Access Journals (Sweden)

    Vanessa L. Strelow

    2013-09-01

    Full Text Available Invasive meningococcal disease (IMD is a major public health and continues to cause substantial mortality and morbidity. Serotype C is the most frequent in Brazil. The clinical spectrum of IMD is broad (meningitis, meningococcemia or both and the clinical evolution may be unpredictable. Main features associated with mortality are: age higher than 50 years old, seizures, shock, and meningococcemia without meningitis. Blood cultures should be obtained immediately. Lumbar puncture can be performed without previous computed tomography scan (CT in most cases. Clinical features can be useful to predic patients where an abnormal CT scan is likely. Cerebrospinal fluid (CSF culture and Gram stain should always be required. Latex agglutination sensitivity is highly variable. Polymerase chain reaction is specially useful when other methods are negative or delayed. Usually ceftriaxone should not be delayed while awaiting CSF study or CT. Dexamethasone can be used in meningococcal meningitis. Early suspicion of IMD and antibiotic in primary care before hospitalization, rapid transportation to a hospital, and stabilization in an intensive-care unit has substantially reduced the case-fatality rate. Vaccines against serotypes A, C, W-135, and Y are available while vaccines against serotype B are expected.

  11. Management of Gonorrhea in Adolescents and Adults in the United States.

    Science.gov (United States)

    Kidd, Sarah; Workowski, Kimberly A

    2015-12-15

    Gonorrhea is the second most commonly reported notifiable disease in the United States and is associated with serious health sequelae, including pelvic inflammatory disease, infertility, and ectopic pregnancy. Treatment for gonorrhea has been complicated by antimicrobial resistance. Neisseria gonorrhoeae has developed resistance to each of the antimicrobials that were previously recommended as first-line treatment regimens, and current treatment options are severely limited. This article summarizes the key questions and data that were discussed at the Sexually Transmitted Diseases (STD) Treatment Guidelines Expert Consultation meeting in April 2013, and the rationale for the 2015 Centers for Disease Control and Prevention STD treatment guidelines for gonococcal infections in adolescents and adults. Key issues addressed include whether to change the dosage of ceftriaxone and azithromycin used in the recommended dual treatment regimen, whether to continue to list dual treatment with cefixime and azithromycin as an alternative treatment regimen, and management of gonococcal infections in persons with severe cephalosporin allergy or suspected treatment failure. PMID:26602618

  12. Immediate reaction to clarithromycin.

    Science.gov (United States)

    Gangemi, S; Ricciardi, L; Fedele, R; Isola, S; Purello-D'Ambrosio, F

    2001-01-01

    We present the case of bronchospastic reaction to clarithromycin had during a drug challenge test. Personal allergic history was negative for respiratory allergies and positive for adverse drug reactions to general and regional anesthesia and to ceftriaxone. After the administration of 1/4 of therapeutic dose of clarithromycin the patient showed dyspnea, cough and bronchospasm in all the lung fields. The positivity of the test was confirmed by the negativity to the administration of placebo. The quickness and the clinical characteristic of the adverse reaction suggest a pathogenic mechanism of immediate-type hypersensitivity. On reviewing the literature we have found no reports of bronchospastic reaction to clarithromycin. Macrolides are a class of antibiotics mainly used in the last years in place of beta-lactams because of a broad spectrum of action and a low allergic power. In fact, there are few reports on allergic reactions to these molecules. Clarithromycin is one of the latest macrolides, characterised by the presence of a 14-carbon-atom lactone ring as erythromycin, active on a wide spectrum of pathogens.

  13. Current treatment of sepsis and endotoxaemia.

    Science.gov (United States)

    Periti, P

    2000-09-01

    This article reviews the new criteria for selecting the proper antimicrobial agent and dosage regimen for standard treatment of severe sepsis, with the intention of preventing septic shock. After introducing new concepts on the pathogenesis of sepsis and septic shock, the authors analyse the parameters of beta-lactam antibacterial activity, the antibiotic-induced release of bacterial endotoxin and the interrelationships between pharmacokinetics and pharmacodynamics of antibiotics in the search for an optimum dosage regimen of antimicrobial mono- or polytherapy for severely ill septic patients admitted to the intensive care unit. The mortality rate resulting from severe bacterial sepsis, particularly that associated with shock, still approaches 50% in spite of appropriate antimicrobial therapy and optimum supportive care. Bacterial endotoxins that are part of the cell wall are one of the cofactors in the pathogenesis of sepsis and septic shock and are often induced by antimicrobial chemotherapy, even if administered rationally. Not all antimicrobial agents are equally capable of inducing septic shock; this is dependent on their mechanism of action rather than on the causative pathogen species. The quantity of endotoxin released depends on the drug dose and whether filaments or spheroplast formation predominate. Some antibiotics, such as carbapenems, ceftriaxone, cefepime, glycopeptides, aminoglycosides and quinolones, do not have the propensity to provoke septic shock because their rapid bacterial activity induces mainly spheroplast or fragile spheroplast-like bacterial forms.

  14. Mode of action of the dual-action cephalosporin Ro 23-9424.

    Science.gov (United States)

    Georgopapadakou, N H; Bertasso, A; Chan, K K; Chapman, J S; Cleeland, R; Cummings, L M; Dix, B A; Keith, D D

    1989-07-01

    Ro 23-9424 is a broad-spectrum antibacterial agent composed of a cephalosporin and a quinolone moiety. Its biological properties were compared with those of its two components and structurally related cephalosporins and quinolones. Like ceftriaxone and cefotaxime but unlike its decomposition product, desacetyl cefotaxime, Ro 23-9424 bound at less than or equal to 2 micrograms/ml to the essential penicillin-binding proteins 1b and 3 of Escherichia coli and 1, 2, and 3 of Staphylococcus aureus. In E. coli, Ro 23-9424 produced filaments exclusively and decreased cell growth; cefotaxime produced both filaments and lysis. Like its decomposition product fleroxacin but unlike quinolone esters, Ro 23-9424 also inhibited replicative DNA biosynthesis in E. coli. In an E. coli strain lacking OmpF, growth continued after addition of Ro 23-9424, decreased after addition of cefotaxime, and stopped immediately after addition of fleroxacin. The results, together with the chemical stability of Ro 23-9424 (half-life, approximately 3 h at pH 7.4 and 37 degrees C), suggest that in E. coli the compound acts initially as a cephalosporin with intrinsic activity comparable to that of cefotaxime but with poorer penetration. Subsequent to the decomposition of Ro 23-9424 to fleroxacin and desacetyl cefotaxime, quinolone activity appears. The in vitro antibacterial activity reflects both mechanisms of action.

  15. Meningococcal disease: History, epidemiology, pathogenesis, clinical manifestations, diagnosis, antimicrobial susceptibility and prevention

    Directory of Open Access Journals (Sweden)

    Manchanda V

    2006-01-01

    Full Text Available Meningoccocal disease has repeatedly caused outbreaks worldwide. There has been sudden surge of cases of meningococcemia and meningococcal meningitis in early 2005 in Delhi, India and neighboring states of Uttar Pradesh and Haryana. As of June 17, 2005, 429 probable cases of meningococcal disease have been reported in Delhi out of which 128 cases have revealed microbiological evidence of Neisseria meningitidis . It is possible that the number of cases was in excess of the numbers notified. During this episode drug susceptibility testing by MIC method (E-test using break points recently recommended by NCCLS/CLSI, revealed that all isolates were sensitive to penicillin, ampicillin, rifampicin and ceftriaxone. As regards to ciprofloxacin, about two third of the isolates tested were found to be ′non-susceptible′ (MIC =0.03µg/mL- 0.190µg/mL. All the isolates were found resistant to cotrimoxazole (MIC> 16µg/mL. Repeated outbreaks, decreased susceptibility to ciprofloxacin, which is commonly used for chemoprophylaxis of meningococcal disease, highlights the need for a constant surveillance system. Present review deals with various aspects of Neisseria meningitidis and meningococcal disease in view of recent episode.

  16. Waterhouse-Friderichsen syndrome in an adult patient with meningococcal meningitis

    Directory of Open Access Journals (Sweden)

    Alka Sonavane

    2011-01-01

    Full Text Available Waterhouse-Friderichsen syndrome is one of the fatal complications of meningococcal infection. Here we report a fatal case of this syndrome due to Neisseria meningitidis in a 29-year-old male patient who was admitted with high-grade fever and chills and vomiting since 7 days, a skin rash over the abdomen and trunk, and altered sensorium since 2 days. On examination, the signs of meningitis were present along with the hemorrhagic rash. The diagnosis of adrenal hemorrhage was confirmed by computerized tomographic scan findings. The patient was started on intravenous ceftriaxone, and the cerebrospinal fluid was processed for bacterial culture, which yielded growth of N meningitidis. The patient′s condition deteriorated; he developed purpura along with a fall in platelet count, and died due to shock. This case is being reported as such a complication is comparatively rare in this antibiotic era, especially in adults, and starting steroids like dexamethasone prior to antibacterial therapy may be useful to diminish the inflammation brought about by bacterial cell death and thus help in reducing the otherwise high mortality in these cases.

  17. Rapid recovery following fulminant meningococcemia complicated by myocarditis in a 15-year-old Nepalese girl: a case report

    Directory of Open Access Journals (Sweden)

    Shrestha P

    2013-08-01

    Full Text Available Pratyush Shrestha,1 Nabin K Shrestha,2 Smith Giri31Department of Surgery, College of Medical Sciences, Bharatpur, Nepal; 2Department of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal; 3Department of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, NepalIntroduction: Fulminant meningococcemia is a relatively rare life-threatening disease caused by Neisseria meningitidis. The clinical presentation is varied, but, when associated with myocarditis, it carries a particularly poor prognosis. We report a case of a patient with fulminant meningococcemia who subsequently developed severe myocardial dysfunction and successfully recovered within a period of 14 days of hospitalization.Case presentation: A 15-year-old girl presented with headache, fever, body ache, and diarrhea for 1 day, and ecchymotic rash over her body for 4 hours. Blood cultures confirmed infection with N. meningitidis. After 6 days in the hospital, the patient developed anasarca, elevated jugular venous pressure, and shock. The patient was managed with intravenous ceftriaxone and captopril. Over the next 3 days the patient rapidly improved and started walking.Conclusion: Meningococcemia complicated by myocarditis has an extremely poor prognosis with high mortality. Our case suggests that recovery from a severe myocardial dysfunction can occur rapidly within a few days. Prompt recognition and management in this case might have contributed to the patient's rapid recovery from myocarditis.Keywords: Neisseria meningitidis, Nepal, recovery, shock

  18. Marcadores epidemiológicos de cepas de Neisseria meningitidis aisladas en Cuba durante el período 1985 a 1992.

    Directory of Open Access Journals (Sweden)

    Isabel Martínez

    2000-03-01

    Full Text Available Genotypic markers, that give a more complete information on the epidemiology of meningococcal disease (MD and complement the characterization obtained with the other traditional markers, are used to study the genetic variability and population structure of Neissseria meningitidis strains isolated in outbursts and epidemics. The epidemiological follow-up of the disease is an important task carried out by Finlay Institute. For this purpose 91 epidemic strains isolated from 1985 to 1992 were studied. The identification by genus, species and serogroups was carried out by conventional techniques and, for the classification in sero/subtypes, a whole-cell ELISA with monoclonal antibodies (AcMs was used. Sensitivity and resistance against penicillin, chloramphenicol, sodium sulphadiazine, ciproflaxin, rifampin and ceftriaxone and the study of 14 enzymes obtained from strain lysates was carried out for the first time in our country. Among the Cuban strains 26 electrophoretic types (ETs were found with complexes ET-5 (67,0% and A4 (3,3% prevailing. Only serogroup B was detected with predominance of serotypes 4 (67,0% and 15 (27,5%, together with subtypes P1.15, P1.10 and P1.16. Moderate. susceptibility (MS to penicillin and resistance (R to sodium sulphadiazine were respectively of 80,0 and 42,8%. All strains were sensitive to the rest of the drugs.

  19. Chronic meningococcemia: a rare presentation of meningococcal disease: case report

    Directory of Open Access Journals (Sweden)

    Antonio Adolfo Guerra Soares Brandão

    2012-03-01

    Full Text Available Chronic meningococcemia is a rare clinical presentation within the spectrumof infections due to Neisseria meningitidis, which was first described in 1902.It is defined as a chronic and benign meningococcal bacteremia withoutmeningeal signs or symptoms with at least one week’s duration, characterizedby intermittent or continuous fever, polymorphic cutaneous rash, and migratoryarthropathy. The incidence is believed to be around 1:200,000 inhabitants. Itaffects predominantly young people and adults, and it is equally distributedbetween genders. Diagnosis may be challenging in the early stages of thedisease because of the difficulty in isolating Neisseria meningitidis (it reaches74% of positivity in advanced stages. Recently, the use of PCR for detectingNeisseria sp antigen in skin biopsies specimens has been considered for thoseculture-negative cases. The authors report a case of a 54-year-old femalepatient who sought medical attention for a five-day fever followed by arthralgiaand skin lesions predominantly in the lower limbs. The patient progressed toa toxemic clinical status that improved after the administration of antibiotictherapy, which consisted of oxacillin and ceftriaxone. The diagnosis of chronicmeningococcemia was performed after the isolation of Neisseria meningitidisin two different blood sample cultures. This is, to our knowledge, the firstcase of chronic meningococcemia described in Brazil (up to the writing of thisreport.

  20. PREVALENCE AND ANTIMICROBIAL RESISTANCE ASSESSMENT OF SUBCLINICAL MASTITIS IN MILK SAMPLES FROM SELECTED DAIRY FARMS

    Directory of Open Access Journals (Sweden)

    Murugaiyah Marimuthu

    2014-01-01

    Full Text Available This study was conducted in order to determine the prevalence and bacteriological assessment of subclinical mastitis and antimicrobial resistance of bacterial isolates from dairy cows in different farms around Selangor, Malaysia. A total of 120 milk samples from 3 different farms were randomly collected and tested for subclinical mastitis using California Mastitis Test (CMT, as well as for bacterial culture for isolation, identification and antimicrobial resistance. The most prevalent bacteria was Staphylococcus sp. (55%, followed by Bacillus sp., (21% and Corynebacterium sp., (7%, Yersinia sp. and Neisseria sp. both showed 5% prevalence, other species with prevalence below 5% are Acinetobacter sp., Actinobacillus sp., Vibrio sp., Pseudomonas sp., E.coli, Klebsiella sp. and Chromobacter sp. Selected Staphylococcus sp. showed a mean antimicrobial resistance of 73.3% to Ampicillin, 26.7% to Penicillin, Methicillin and Compound Sulphonamide each, 20% to Oxacillin, Amoxycillin and Cefuroxime, 13.3% to Polymyxin B, Erythromycin, Ceftriaxone and Azithromycin and 6.7% to Streptomycin, Clindamycin, Lincomycin and Tetracycline each. This study indicates the need for urgent and effective control measures to tackle the increase in prevalence of subclinical mastitis and their antimicrobial resistance in the study area.

  1. An unusual case of chronic meningitis

    Directory of Open Access Journals (Sweden)

    Hinton Anna

    2004-10-01

    Full Text Available Abstract Background Chronic meningitis is defined as symptoms and signs of meningeal inflammation and persisting cerebrospinal fluid abnormalities such as elevated protein level and pleocytosis for at least one month. Case presentation A 62-year-old woman, of unremarkable past medical history, was admitted to hospital for investigation of a four-week history of vomiting, malaise an associated hyponatraemia. She had a low-grade pyrexia with normal inflammatory markers. A CT brain was unremarkable and a contrast MRI brain revealed sub-acute infarction of the right frontal cortex but with no evidence of meningeal enhancement. Due to increasing confusion and patient clinical deterioration a lumbar puncture was performed at 17 days post admission. This revealed gram-negative coccobacilli in the CSF, which was identified as Neisseria meningitidis group B. The patient made a dramatic recovery with high-dose intravenous ceftriaxone antibiotic therapy for meningococcal meningitis. Conclusions 1 Chronic bacterial meningitis may present highly atypically, particularly in the older adult. 2 There may be an absent or reduced febrile response, without a rise in inflammatory markers, despite a very unwell patient. 3 Early lumbar puncture is to be encouraged as it is essential to confirm the diagnosis.4 Despite a delayed diagnosis appropriate antibiotic therapy can still lead to a good outcome.

  2. Audit of antibiotic therapy in surgical neonates in a tertiary hospital in Benin City, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2011-01-01

    Full Text Available Objective: To report the outcome of commonly used antibiotic combinations in surgical neonates in sub-Saharan African settings. Methods: A retrospective analysis that determines the outcome of commonly combined antibiotics in surgical neonates between January 2006 and December 2008 at two referral paediatric surgical centres in Benin city was carried out. Results: Ampicillin ampiclox, metronidazole, gentamicin, cefuroxime and ceftriaxone were variously combined in the management of 161 neonates with a mean age at presentation of 9.2 ± 2.6 days, mean weight 3.1 ± 1.4 kg and a male:female ratio 1.6:1. Polymicrobial postoperative wound infections and sepsis caused by Staphylococcus aureus, Escherichia coli, Neisseria meningitidis, Klebsiella pneumonia, Pseudomonas aeroginosa and anaerobes, were mainly encountered. The most common aerobes isolated from wound cultures were S. aureus and P. aeroginosa while the ones from that of blood cultures were E. coli and K. pneumonia. Overall postoperative infections recorded were: wound infection 19 (11.8%, sepsis 16 (9.9% and sepsis-related deaths 6 (3.7%. Conclusion: Combinations of gentamicin/metronidazole/cefuroxime and gentamicin/cefuroxime were adequate for gastrointestinal and extra-gastrointestinal neonatal operations, respectively, in these sub-Saharan African settings, which may be useful in similar regions.

  3. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea.

    Science.gov (United States)

    Unemo, Magnus; Nicholas, Robert A

    2012-12-01

    The new superbug Neisseria gonorrhoeae has retained resistance to antimicrobials previously recommended for first-line treatment and has now demonstrated its capacity to develop resistance to the extended-spectrum cephalosporin, ceftriaxone, the last remaining option for first-line empiric treatment of gonorrhea. An era of untreatable gonorrhea may be approaching, which represents an exceedingly serious public health problem. Herein, we review the evolution, origin and spread of antimicrobial resistance and resistance determinants (with a focus on extended-spectrum cephalosporins) in N. gonorrhoeae, detail the current situation regarding verified treatment failures with extended-spectrum cephalosporins and future treatment options, and highlight essential actions to meet the large public health challenge that arises with the possible emergence of untreatable gonorrhea. Essential actions include: implementing action/response plans globally and nationally; enhancing surveillance of gonococcal antimicrobial resistance, treatment failures and antimicrobial use/misuse; and improving prevention, early diagnosis and treatment of gonorrhea. Novel treatment strategies, antimicrobials (or other compounds) and, ideally, a vaccine must be developed.

  4. Órfãos de terapia medicamentosa: a administração de medicamentos por via intravenosa em crianças hospitalizadas

    Directory of Open Access Journals (Sweden)

    Peterlini Maria Angélica Sorgini

    2003-01-01

    Full Text Available Estudo descritivo, realizado em um hospital universitário, que verificou quantidade e tipo de medicamentos administrados por via intravenosa em crianças, além da adequação da apresentação farmacológica para uso em pediatria e custo estimado de administração de algumas drogas. Em trinta dias, foram administradas 8.245 doses de medicamentos, com média diária de 274,83 doses, e projeção anual de 98.940. Os principais medicamentos utilizados foram metilpredinosolona, vancomicina, furosemida, ranitidina, penicilina, amicacina, midazolan, fentanil, ceftriaxone e cefalotina. Nenhum dos 41 medicamentos identificados possuía apresentação pediátrica, acarretando, em alguns casos, maior manipulação durante o preparo, risco de contaminação e perda da estabilidade. Observou-se que a falta de apresentação pediátrica gerou aumento dos custos de atendimento; na prescrição de uma criança em pós-operatório, com tempo de internação estimado de cinco dias, a terapia administrada diária foi de US$ 6.71, e US$ 39.52 de medicamentos tiveram que ser desprezados, por excederem as necessidades terapêuticas da criança.

  5. Integron presence in a multiresistant Morganella morganii isolate.

    Science.gov (United States)

    Rojas, Laura; Vinuesa, Teresa; Tubau, Fe; Truchero, Consol; Benz, Roland; Viñas, Miguel

    2006-06-01

    A multiresistant strain of Morganella morganii was isolated from a patient affected by several severe pathologies. The isolate was found to be resistant to the following antimicrobials: ampicillin, nalidixic acid, cefalothin, cefoxitin, ceftriaxone, ciprofloxacin, chloramphenicol, streptomycin, erythromycin, gentamicin, novobiocin, penicillin, rifampicin, tetracycline and violet crystal. Mechanisms leading to this multiresistance were studied. Porins of M. morganii multiresistant and wild-type strains were analysed by sodium dodecylsulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and were characterised by their ability to form channels in planar black lipid bilayers. The channels formed by porins from multiresistant and susceptible strains suggested that the porins of the multiresistant strain were not responsible for resistance. A 6.6 kb plasmid (pML2003) was detected, isolated and studied. pML2003 included two integrons. Direct sequencing revealed that one of the integrons contained two cassettes, aminoglycoside adenyltransferase (aadB) and chloramphenicol acetyltransferase (catB3) conferring resistance to aminoglycosides and chloramphenicol, respectively. The second integron contained carbenicillinase (blaP1b) and adenyltransferase (aadA2), which confer resistance to beta-lactamases and streptomycin, respectively.

  6. A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review

    Directory of Open Access Journals (Sweden)

    Ismail Necati Hakyemez

    2012-01-01

    Full Text Available Hydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.

  7. A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review.

    Science.gov (United States)

    Hakyemez, Ismail Necati; Sit, Mustafa; Aktas, Gulali; Tas, Tekin; Mengeloglu, Fırat Zafer; Kucukbayrak, Abdulkadir

    2012-01-01

    Hydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.

  8. Emphysematous cystitis: A rare disease of Genito-urinary system

    Directory of Open Access Journals (Sweden)

    Shilpi Singh

    2015-01-01

    Full Text Available Context: Emphysematous cystitis (EC is a rare infection of the urinary tract that results in gas production in the bladder. It is more common in diabetic and female patients, and can be associated with more serious complications, including pyelonephritis. Case Report: We describe a case of recurrent bacterial cystitis caused by Escherichia coli (E. coli. An incidental finding in our patient of pneumaturia on computed tomography (CT scan prompted further work-up. Differential diagnoses for pneumaturia include infection, trauma, and fistula, most commonly colovesicular. The patient history ruled out trauma and CT scanning ruled out a fistula; culture of the urine then showed a bacterial load greater than 100,000 E. coli/mL. The patient was then diagnosed with EC. She was treated with ceftriaxone and released in stable condition. Conclusion: The literature was scarce when it came to diagnoses of EC based on bacterial load. We present this case to increase health care providers′ awareness of recurrent EC with a urine culture bacterial load greater than 100,000 E. coli/mL.

  9. Distribution, detection of enterotoxigenic strains and antimicrobial drug susceptibility patterns of Bacteroides fragilis group in diarrheic and non-diarrheic feces from Brazilian infants

    Directory of Open Access Journals (Sweden)

    Débora Paula Ferreira

    2010-10-01

    Full Text Available Despite the importance of gastrointestinal diseases and their global distribution, affecting millions of individuals around the world, the role and antimicrobial susceptibility patterns of anaerobic bacteria such as those in the Bacteroides fragilis group (BFG are still unclear in young children. This study investigated the occurrence and distribution of species in the BFG and enterotoxigenic strains in the fecal microbiota of children and their antimicrobial susceptibility patterns. Diarrheic (n=110 and non-diarrheic (n=65 fecal samples from children aged 0-5 years old were evaluated. BFG strains were isolated and identified by conventional biochemical, physiological and molecular approaches. Alternatively, bacteria and enterotoxigenic strains were detected directly from feces by molecular biology. Antimicrobial drug susceptibility patterns were determined by the agar dilution method according to the guidelines for isolated bacteria. BFG was detected in 64.3% of the fecal samples (55% diarrheic and 80.4% non-diarrheic, and 4.6% were enterotoxigenic. Antimicrobial resistance was observed against ampicillin, ampicillin/sulbactam, piperacillin/tazobactam, meropenem, ceftriaxone, clindamycin and chloramphenicol. The data show that these bacteria are prevalent in fecal microbiota at higher levels in healthy children. The molecular methodology was more effective in identifying the B. fragilis group when compared to the biochemical and physiological techniques. The observation of high resistance levels stimulates thoughts about the indiscriminate use of antimicrobial drugs in early infancy. Further quantitative studies are needed to gain a better understanding of the role of these bacteria in acute diarrhea in children.

  10. Distribution, detection of enterotoxigenic strains and antimicrobial drug susceptibility patterns of bacteroides fragilis group in diarrheic and non-diarrheic feces from brazilian infants.

    Science.gov (United States)

    Ferreira, Débora Paula; Silva, Vânia Lúcia; Guimarães, Danielle Aparecida; Coelho, Cíntia Marques; Zauli, Danielle Alves Gomes; Farias, Luiz Macêdo; Carvalho, Maria Auxiliadora Roque; Diniz, Claudio Galuppo

    2010-07-01

    Despite the importance of gastrointestinal diseases and their global distribution, affecting millions of individuals around the world, the role and antimicrobial susceptibility patterns of anaerobic bacteria such as those in the Bacteroides fragilis group (BFG) are still unclear in young children. This study investigated the occurrence and distribution of species in the BFG and enterotoxigenic strains in the fecal microbiota of children and their antimicrobial susceptibility patterns. Diarrheic (n=110) and non-diarrheic (n=65) fecal samples from children aged 0-5 years old were evaluated. BFG strains were isolated and identified by conventional biochemical, physiological and molecular approaches. Alternatively, bacteria and enterotoxigenic strains were detected directly from feces by molecular biology. Antimicrobial drug susceptibility patterns were determined by the agar dilution method according to the guidelines for isolated bacteria. BFG was detected in 64.3% of the fecal samples (55% diarrheic and 80.4% non-diarrheic), and 4.6% were enterotoxigenic. Antimicrobial resistance was observed against ampicillin, ampicillin/sulbactam, piperacillin/tazobactam, meropenem, ceftriaxone, clindamycin and chloramphenicol. The data show that these bacteria are prevalent in fecal microbiota at higher levels in healthy children. The molecular methodology was more effective in identifying the B. fragilis group when compared to the biochemical and physiological techniques. The observation of high resistance levels stimulates thoughts about the indiscriminate use of antimicrobial drugs in early infancy. Further quantitative studies are needed to gain a better understanding of the role of these bacteria in acute diarrhea in children.

  11. Antimicrobial resistance of Escherichia coli isolated in newly-hatched chickens and effect of amoxicillin treatment during their growth.

    Science.gov (United States)

    Jiménez-Belenguer, Ana; Doménech, Eva; Villagrá, Arantxa; Fenollar, Alejandro; Ferrús, Maria Antonia

    2016-08-01

    The use of antimicrobials in food animals is the major determinant for the propagation of resistant bacteria in the animal reservoir. However, other factors may also play a part, and in particular vertical spread between the generations has been suggested to be an important transmission pathway. The objective of this paper was to determine the resistance patterns of Escherichia coli isolated from newly-hatched chickens as well as to study the antibiotic pressure effect when amoxicillin was administered during their growing period. With this aim, meconium from 22 one-day-old Ross chickens was analysed. In addition, during their growth period, amoxicillin treatments at days 7, 21 and 35 were carried out. Results showed a high number of E. coli-resistant strains were isolated from the treated one-day-old chickens, and were the highest for β-lactams group, followed by quinolone and tetracyclines. After treatment with amoxicillin, the highest percentage of resistances were detected for this antibiotic compared to the others analysed, with significant differences in resistance percentages between control and treated broilers detected in relation to ampicillin, cephalothin, streptomycin, kanamycin, gentamicin, chloramphenicol and tetracycline. Differences in resistances to ciprofloxacin and nalidixic acid between control and treated animals were not observed and there was lack of resistance for amikacin and ceftriaxone. These results suggest the possibility of vertical transmission of resistant strains to newly-hatched chicks from parent flocks, and seem to indicate that the treatment with amoxicillin increased the resistance of E. coli to other antibiotics. PMID:27035748

  12. Reversal of morphine-induced cell-type-specific synaptic plasticity in the nucleus accumbens shell blocks reinstatement.

    Science.gov (United States)

    Hearing, Matthew C; Jedynak, Jakub; Ebner, Stephanie R; Ingebretson, Anna; Asp, Anders J; Fischer, Rachel A; Schmidt, Clare; Larson, Erin B; Thomas, Mark John

    2016-01-19

    Drug-evoked plasticity at excitatory synapses on medium spiny neurons (MSNs) of the nucleus accumbens (NAc) drives behavioral adaptations in addiction. MSNs expressing dopamine D1 (D1R-MSN) vs. D2 receptors (D2R-MSN) can exert antagonistic effects in drug-related behaviors, and display distinct alterations in glutamate signaling following repeated exposure to psychostimulants; however, little is known of cell-type-specific plasticity induced by opiates. Here, we find that repeated morphine potentiates excitatory transmission and increases GluA2-lacking AMPA receptor expression in D1R-MSNs, while reducing signaling in D2-MSNs following 10-14 d of forced abstinence. In vivo reversal of this pathophysiology with optogenetic stimulation of infralimbic cortex-accumbens shell (ILC-NAc shell) inputs or treatment with the antibiotic, ceftriaxone, blocked reinstatement of morphine-evoked conditioned place preference. These findings confirm the presence of overlapping and distinct plasticity produced by classes of abused drugs within subpopulations of MSNs that may provide targetable molecular mechanisms for future pharmacotherapies. PMID:26739562

  13. Acute Bacterial Prostatitis: Diagnosis and Management.

    Science.gov (United States)

    Coker, Timothy J; Dierfeldt, Daniel M

    2016-01-15

    Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy. PMID:26926407

  14. Streptococcus agalactiae mural infective endocarditis in a structurally normal heart.

    Science.gov (United States)

    Ariyoshi, Nobuhiro; Miyamoto, Keisuke; Bolger, Dennis T

    2016-01-01

    A 38-year-old Caucasian man with uncontrolled diabetes mellitus type 2 was admitted with a 1-week duration of fevers, chills, and a non-productive cough. He had a left ischiorectal abscess 1 month prior to admission. Physical examination revealed caries on a left upper molar and a well-healed scar on the left buttock, but no heart murmur or evidence of micro-emboli. Blood cultures grew Streptococcus agalactiae. A transesophageal echocardiogram revealed a mobile mass in the right ventricle that attached to chordae tendineae without valvular disease or dysfunction. A computed tomography (CT) with contrast revealed the mass within the right ventricle, a left lung cavitary lesion, and a splenic infarction. He was initially treated with penicillin G for a week. Subsequently, ceftriaxone was continued for a total of 8 weeks. A follow-up CT showed no evidence of right ventricular mass 8 weeks after discharge. This is the first reported case of S. agalactiae mural infective endocarditis in a structurally normal heart. PMID:27124171

  15. Urinary Tract Infections due to Multidrug-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Chicago Emergency Department

    Directory of Open Access Journals (Sweden)

    Thana Khawcharoenporn

    2013-01-01

    Full Text Available Background. Selection of empiric antibiotics for urinary tract infections (UTIs has become more challenging because of the increasing rates of multidrug-resistant Enterobacteriaceae (MDRE infections. Methods. This retrospective study was conducted to determine antibiotic resistance patterns, risk factors, and appropriate empiric antibiotic selection for MDRE UTIs. Adult patients seen in the Emergency Department (ED with Enterobacteriaceae UTIs during 2008-2009 were identified from review of microbiology records. MDRE were defined as organisms resistant to at least 3 categories of antibiotics. Results. There were 431 eligible patients; 83 (19% had MDRE UTIs. Resistance rates for individual antibiotics among MDRE UTIs were significantly greater than non-MDRE UTIs: levofloxacin, 72% versus 14%; TMP-SMX, 77% versus 12%; amoxicillin-clavulanate, 35% versus 4%; nitrofurantoin, 21% versus 12%, and ceftriaxone, 20% versus 0%. All Enterobacteriaceae isolates were susceptible to ertapenem (MIC ≤ 2 mg/L. Independent risk factors for MDRE UTI were prior fluoroquinolone use within 3 months (adjusted odds ratio (aOR 3.64; , healthcare-associated risks (aOR 2.32; , and obstructive uropathy (aOR 2.22; . Conclusion. Our study suggests that once-daily intravenous or intramuscular ertapenem may be appropriate for outpatient treatment of ED patients with MDRE UTI.

  16. Characterization of Salmonella Isangi possessing a CTX-M15 ESBL associated with an outbreak in a US Hospital.

    Science.gov (United States)

    Suleyman, Geehan; Perri, Mary; Vager, Dora; Samuel, Linoj; Zervos, Marcos J; Alangaden, George; Tibbetts, Robert J

    2016-07-01

    Over an approximately 50-day period in 2015, an outbreak of CTX-M-15 extended spectrum β-lactamase-(ESBL)-possessing Salmonella Isangi occurred among 19 adult surgical patients and one healthcare worker (HCW) at a large urban tertiary care hospital in the United States. A total of 45 S. Isangi isolates were isolated from stool (35), blood (4), urine (3), respiratory (2), and wound (1) cultures. Phenotypically, all but three isolates demonstrated resistance to ampicillin, ampicillin/sulbactam, ceftriaxone, and cefepime, and one isolate was resistant to ertapenem. Genotypically, a single CTX-M-15 ESBL was identified in all but three isolates by real-time PCR. Interestingly, two of the CTX-M-15 negative, susceptible isolates were isolated from a single patient who initially had a CTX-M positive, resistant strain. Isolates were clonally related, including both resistant and susceptible strains, as confirmed by pulse field gel electrophoresis (PFGE). This is the first case of a novel Salmonella outbreak at this hospital, and we believe it to be the first case of an S. Isangi serotype outbreak in the United States. PMID:27130476

  17. Current status in outpatient parenteral antimicrobial therapy: a practical view.

    Science.gov (United States)

    Candel, Francisco Javier; Julián-Jiménez, Agustin; González-Del Castillo, Juan

    2016-04-01

    Outpatient parenteral antimicrobial therapy (OPAT) programs are a current and widely spread trend in clinical practice because of it's a cost-effective option, it's associated with a greater comfort for the patient, a lower risk of nosocomial complications and an important cost saving for the health care system. OPAT is used for treating a wide range of infections, including skin and soft tissue infections, osteoarticular infections, bacteraemia, endocarditis and complex intra-abdominal and urinary tract infections, even in presence of multiresistant microorganisms. Correct choice of antimicrobial agent and adequate patient selection are crucial for reaching therapeutic success and avoiding readmissions, treatment prolongation or treatment-related toxicity. The optimal antimicrobial for OPAT must be highly effective, have a long half-life and an adequate spectrum of action. Ceftriaxone and teicoplanin are currently the most prescribed antibiotics for OPAT, though daptomycin and ertapenem are also on the rise, due to their high efficiency, safety and wide spectrum of action. Antibiotics that are stable at room temperature can be administered through a continuous perfusion, though self-administration is preferable although it requires training of the patient or the caregiver. Factors that are most frequently associated with OPAT failure include advanced age, recent hospitalization and isolation of multiresistant microorganisms. PMID:27014770

  18. Correlation of TEM, SHV and CTX-M extended-spectrum beta lactamases among Enterobacteriaceae with their in vitro antimicrobial susceptibility

    Directory of Open Access Journals (Sweden)

    A Manoharan

    2011-01-01

    Full Text Available Purpose: The present study was carried out to characterize the ESBL types and evaluated their in vitro activity against a collection of Gram negative bacteria (GNB from a multicentric Indian surveillance study. Material and Methods: During January 2005 to June 2006, six tertiary care centres in India forwarded 778 non-duplicate GNB to our reference laboratory. Three hundred GNB from this collection were selected based on clinical significance and were used in the present study. Tested isolates included Escherichia coli (167, Klebsiella spp. (122 and Enterobacter spp. (11. ESBL screening and confirmation was performed for all the isolates. Minimum inhibitory concentration of imipenem, meropenem, ertapenem, levofloxacin, amikacin, piperacillin/tazobactam and ceftriaxone was determined by the E-test method. Molecular typing of the ESBLs was performed by polymerase chain reaction among the 121 selected isolates. Results: The study showed excellent susceptibility among the strains to imipenem (100%, meropenem (100% and ertapenem (98.7%; good susceptibility to amikacin (89.7% and piperacillin/tazobactam (85.3% was observed. TEM and CTX-M were predominantly found in E. coli (39.2% while, among the Klebsiella spp., TEM, SHV and CTX-M occurred together in 42.6% of the isolates. Conclusion: More than one ESBL was produced by many strains, and this was correlated with increased resistance levels. Carbapenems continue to show good in vitro activity and ertapenem is a potential alternative to imipenem and meropenem. Continued antimicrobial resistance surveillance is warranted in light of these findings.

  19. Effects of ampicillin, cefazolin and cefoperazone treatments on GLT-1 expressions in the mesocorticolimbic system and ethanol intake in alcohol-preferring rats.

    Science.gov (United States)

    Rao, P S S; Goodwani, S; Bell, R L; Wei, Y; Boddu, S H S; Sari, Y

    2015-06-01

    Chronic ethanol consumption is known to downregulate expression of the major glutamate transporter 1 (GLT-1), which increases extracellular glutamate concentrations in subregions of the mesocorticolimbic reward pathway. While β-lactam antibiotics were initially identified as potent upregulators of GLT-1 expression, only ceftriaxone has been extensively studied in various drug addiction models. Therefore, in this study, adult male alcohol-preferring (P) rats exposed chronically to ethanol were treated with other β-lactam antibiotics, ampicillin, cefazolin or cefoperazone (100mg/kg) once daily for five consecutive days to assess their effects on ethanol consumption. The results demonstrated that each compound significantly reduced ethanol intake compared to the saline-treated control group. Importantly, each compound significantly upregulated both GLT-1 and pAKT expressions in the nucleus accumbens and prefrontal cortex compared to saline-treated control group. In addition, only cefoperazone significantly inhibited hepatic aldehyde dehydrogenase-2 enzyme activity. Moreover, these β-lactams exerted only a transient effect on sucrose drinking, suggesting specificity for chronically inhibiting ethanol reward in adult male P rats. Cerebrospinal fluid concentrations of ampicillin, cefazolin or cefoperazone have been confirmed using high-performance liquid chromatography. These findings demonstrate that multiple β-lactam antibiotics demonstrate efficacy in reducing alcohol consumption and appear to be potential therapeutic compounds for treating alcohol abuse and/or dependence. In addition, these results suggest that pAKT may be an important player in this effect, possibly through increased transcription of GLT-1.

  20. AEROBIC BACTERIOLOGY OF CHRONIC SUPPURATIVE OTITIS MEDIA: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Mahesh V .

    2015-08-01

    Full Text Available Chronic Suppurative Otitis Media (CSOM is a condition of the middle ear that is characterized by persistent or recurrent discharge through a chronic perforation of the tympanic membrane from the middle ear cleft. Untreated cases of Chronic Suppurative Oti tis Media can result in a broad range of complications like mastoiditis, labyrinthitis, facial nerve paralysis and serious intracranial complications. In this study an attempt is made to know the aerobic bacteriology of Chronic Suppurative Otitis Media, wi th antimicrobial susceptibility testing of the bacterial isolates. The present prospective study was carried out on 50 patients presenting with Chronic Suppurative Otitis Media between January 2014 to December 2014 in the department of E.N.T, Basaveshwara Medical College Hospital and Research Centre, Chitradurga. The most common bacteria in Chronic Suppurative Otitis Media in this study was Pseudomonas aeruginosa (62% followed by Staphylococcus aureus (22%. Gentamicin was the most sensitive (100% antibio tic against Pseudomonas aeruginosa followed by Amikacin (96.77%. Ceftriaxone and Gentamicin were the most sensitive (100% antibiotic against Staphylococcus aureus followed by Amikacin (90.9%