WorldWideScience

Sample records for ceftriaxone

  1. Ceftriaxone Injection

    Science.gov (United States)

    Ceftriaxone injection is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted ... skin, urinary tract, blood, bones, joints, and abdomen. Ceftriaxone injection is also sometimes given before certain types ...

  2. Ceftriaxone and acute renal failure in children.

    Science.gov (United States)

    Li, Ning; Zhou, Xuefeng; Yuan, Jiyan; Chen, Guiying; Jiang, Hongliang; Zhang, Wen

    2014-04-01

    Our aim was to evaluate the clinical profile, treatment, and outcome of ceftriaxone-associated postrenal acute renal failure (PARF) in children. We retrospectively studied 31 consecutive cases from 2003 to 2012 for PARF after ceftriaxone treatment. There was no past history of urolithiasis or nephropathy in these children. The average time of ceftriaxone administration before PARF was 5.2 days. The major symptoms apart from anuria included flank pain (>3 years old, 25/25), excessive crying (Ceftriaxone was verified to be the main component of the calculi in 4 children by tandem mass spectrometric analysis. The recovery was complete in all cases. Ceftriaxone therapy in children may cause PARF. Early diagnosis and prompt pharmacological therapy are important in relieving the condition. Retrograde ureteral catheterization is an effective treatment of those who fail to respond to pharmacotherapy.

  3. Ceftriaxone-induced immune hemolytic anemia.

    Science.gov (United States)

    Neuman, Gal; Boodhan, Sabrina; Wurman, Ilana; Koren, Gideon; Bitnun, Ari; Kirby-Allen, Melanie; Ito, Shinya

    2014-12-01

    To describe a case of ceftriaxone-induced immune hemolytic anemia (CIIHA) in a 6 year-old boy with sickle cell disease (SCD) and perform a systematic literature review to delineate the clinical and laboratory features of this condition. EMBASE (1947-January 2014), MEDLINE (1946-January 2014), and databases from the US Food and Drug Administration and Health Canada were searched, using anemia, hemolytic anemia, hemolysis, and ceftriaxone as search terms. Additional references were identified from a review of literature citations. All case reports and observational studies describing clinical and laboratory features of CIIHA were included. A total of 37 eligible reports of CIIHA were identified, including our index case, and 70% were children. Mortality was 30% in all age groups and 64% in children. The majority of patients had underlying conditions (70%), of which SCD was most commonly reported. Previous ceftriaxone exposure was reported in 65%. Common features included elevated lactate dehydrogenase (70%); early, new-onset hemoglobinuria (59%); acute renal failure (46%); positive direct antibody testing (70%); and anticeftriaxone antibodies (68%). Also, 32% had a preceding, unrecognized, hemolytic episode associated with ceftriaxone. Given the common use of ceftriaxone worldwide, knowledge of CIIHA, which often goes undiagnosed until late in the course, is essential for clinicians. Based on the findings of this review, we suggest obtaining past history of ceftriaxone exposures and screening for new-onset hemoglobinuria during ceftriaxone therapy in selected patients as potential methods for early diagnosis of this rare but potentially fatal condition. © The Author(s) 2014.

  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

    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.)

  6. Influence of ceftriaxone on emergence of Clostridium difficile.

    OpenAIRE

    Lejko-Zupanc, T; Zakelj, J; Strle, F; Janc, M; Pleterski-Rigler, D

    1992-01-01

    The influence of long-term ceftriaxone administration on the emergence of Clostridium difficile was studied with 80 patients receiving ceftriaxone for 14 days. In five patients (6.3%) C. difficile was cultured. The appearance of gastrointestinal disturbances during treatment with ceftriaxone was common, but the rate of emergence of C. difficile in immunocompetent patients was not high.

  7. Effects Of Ceftriaxone On Haematological And Biochemical ...

    African Journals Online (AJOL)

    Short-term effects of ceftriaxone on haematological and biochemical parameters of Nigerian local turkey poults were studied. The pre-treatment blood and serum samples were collected and the weight of animals taken before the administration of body weight for a period of 4 days. The animals were weighed daiy.

  8. Ceftriaxone-associated biliary pseuodolithiasis: sonographic and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Yoo Na; Lee, Seon Joo; Yoon, Jeong Hee [Inje University, Busan (Korea, Republic of)

    2005-11-15

    Ceftriaxone is known to induce a precipitation in the gallbladder that mimics gallstones on sonography in the children and adults. 'Biliary pseudolithiasis' is now used to describe this reversible, benign complication accompanying ceftriaxone therapy. It is important to be aware of this adverse effect because it does not need any specific treatment, To our knowledge, there have not been any reports of CT findings of ceftriaxone-associated biliary pseudolithiasis in literature. We herein report two cases of ceftriaxone-associated biliary pseudolithiasis with sonographic and CT findings, which were completely resolved after the cessation of ceftriaxone therapy.

  9. A comparison of the pharmacokinetics of Aspen Ceftriaxone and ...

    African Journals Online (AJOL)

    Intravenous ceftriaxone, of which Rocephin (ROC) is the originator brand, is recommended as first-line therapy in South Africa. Despite concerns regarding therapeutic equivalence with generic agents, this is the first study that has been conducted comparing clinical pharmacokinetics (PK) of a generic ceftriaxone ...

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

    NARCIS (Netherlands)

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

    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

  11. Effects of ceftriaxone on faecal flora : analysis by micromorphometry

    NARCIS (Netherlands)

    Geertsma, D.G.; Wilkinson, M.H.F.; Meijer, B.C

    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

  12. Validation and Application of a Dried Blood Spot Ceftriaxone Assay.

    Science.gov (United States)

    Page-Sharp, Madhu; Nunn, Troy; Salman, Sam; Moore, Brioni R; Batty, Kevin T; Davis, Timothy M E; Manning, Laurens

    2015-10-05

    Dried blood spot (DBS) antibiotic assays can facilitate pharmacokinetic/pharmacodynamic (PK/PD) studies in situations where venous blood sampling is logistically and/or ethically problematic. In this study, we aimed to develop, validate, and apply a DBS ceftriaxone assay. A liquid chromatography-tandem mass spectroscopy (LC-MS/MS) DBS ceftriaxone assay was assessed for matrix effects, process efficiency, recovery, variability, and limits of quantification (LOQ) and detection (LOD). The effects of hematocrit, protein binding, red cell partitioning, and chad positioning were evaluated, and thermal stability was assessed. Plasma, DBS, and cell pellet ceftriaxone concentrations in 10 healthy adults were compared, and plasma concentration-time profiles of DBS and plasma ceftriaxone were incorporated into population PK models. The LOQ and LOD for ceftriaxone in DBS were 0.14 mg/liter and 0.05 mg/liter, respectively. Adjusting for hematocrit, red cell partitioning, and relative recovery, DBS-predicted plasma concentrations were comparable to measured plasma concentrations (r > 0.95, P ceftriaxone retained >95% initial concentrations in DBS for 14 h, 35 h, 30 days, 21 weeks, and >11 months, respectively. The present DBS ceftriaxone assay is robust and can be used as a surrogate for plasma concentrations to provide valid PK and PK/PD data in a variety of clinical situations, including in studies of young children and of those in remote or resource-poor settings. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  13. 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. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  14. Ceftriaxone susceptibility of oxacillin-susceptible Staphylococcus aureus from patients with prosthetic joint infection.

    Science.gov (United States)

    Greenwood-Quaintance, Kerryl E; Kohner, Peggy; Osmon, Douglas R; Virk, Abinash; Patel, Robin

    2015-06-01

    Ceftriaxone is used to treat oxacillin-susceptible S. aureus (OSSA) prosthetic joint infection (PJI). Susceptibility of ceftriaxone against OSSA has been questioned. Ceftriaxone susceptibility was determined against 100 PJI OSSA isolates. Ceftriaxone MIC90/MIC50 were 8/4 and 4/3μg/mL by broth microdilution and Etest, respectively. Ceftriaxone susceptibility is inferable by oxacillin susceptibility. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Sonographic findings of ceftriaxone-associated gallbladder pseudolithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Hwa; Choi, Dae Seob; Lee, Hyeon Kyeong; Park, Sung Tae; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo; Cho, Sung Min; Jung, Jin Hwa [Dongkuk University College of Medicine, Kyongju (Korea, Republic of)

    2000-09-15

    The purpose of this study was to evaluate sonographic findings of ceftriaxone-associated pseudolithiasis in gallbladder (GB). Fifty-seven children who received ceftriaxone treatment were prospectively evaluated with ultrasound (US). Serial US examinations were performed at 1st-3rd day and at 5th-9th day after the initiation of ceftriaxone treatment in all patients. In eight of the patients with pseudolithiasis on 5th-9th day examinations, follow-up studies were also performed every 5-7 days until the pseudolithiasis had completely resolved. The incidence and type of pseudolithiasis and posterior acoustic shadowing associated with pseudolithiasis were analyzed. The types of pseudolithiasis were classified as floating dots, linear, globular, and combined. GB pseudolithiasis was found in 17 (30%) of 57 patients. According to the types of pseudolithiasis, there were four floating dots, four linear, one globular, and eight combined types. Posterior acoustic shadowing was present in 13 (76%) of 17 patients. All pseudolithiasis was demonstrated on 1st-3rd day examinations and completely resolved within 15 days after the stopping of ceftriaxone treatment in all of the patients in whom follow-up studies were available (mean=9, 2 days). GB pseudolithiasis can be associated with ceftriaxone treatment and it can mimic a stone. When a GB stone is demonstrated on US in a pediatric patients, the possibility of ceftriaxone-associated pseudolithiasis should be considered for accurate diagnosis and appropriate treatment.

  16. 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.

  17. In Vitro Susceptibility Test of Different Clinical Isolates against Ceftriaxone

    Directory of Open Access Journals (Sweden)

    Syed Hakim Masood

    2010-06-01

    Full Text Available Objectives: Because of the prevailing penicillin resistance in microorganisms, broad spectrum cephalosporins are used empirically specially in developing countries. The aim of this study is to determine the susceptibility pattern of different gram positive and gram negative pathogens against third generation cephalosporin-ceftriaxone to explore the existing effectiveness of this antibiotic.Methods: 180 clinical isolates of different gram positive and gram negative pathogens including P.mirabilis, S. typhi P.aeruginosa, E. coli, S. aureus and Klebsiella were collected from blood and urine samples of in-patients. 30 isolates of all species were tested against each of six brands of ceftriaxone using in vitro sensitivity tests by disc diffusion method (NCCLS criteria. The susceptibility limit was ≥21 mm zone of inhibition, while moderately susceptible was considered at 20-14 mm, and those isolates which showed >13 mm or no zone of inhibition were resistant to this antibacterial drug.Results: Ceftriaxone was found most effective against S. aureus. While 96.1% of the isolates showed susceptibility towards ceftriaxone, followed by E. coli (95%, P. aeruginosa (92.7%, K. pneumonia (89.4% and S. typhi (87.2%. P. mirabilis showed lowest susceptibility amongst all the test organisms (83.8%.Conclusion: Ceftriaxone can be used as a drug of choice in infections caused by S. aureus, E. coli, P. aurigenosa, K. pneumonia and S. typhi. However, it should be used with other antimicrobial agents in order to increase its effectiveness against P. mirabilis.

  18. Ceftriaxone-associated gallbladder sludge. Identification of calcium-ceftriaxone salt as a major component of gallbladder precipitate

    Energy Technology Data Exchange (ETDEWEB)

    Park, H.Z.; Lee, S.P.; Schy, A.L. (Univ. of Washington School of Medicine, Seattle (USA))

    1991-06-01

    Ceftriaxone, a third-generation cephalosporin, is partially excreted into bile. With its clinical use, the formation of gallbladder sludge detected by ultrasonography has been reported. Four surgical specimens were examined and no gallstones were found. Instead, fine precipitates of 20-250 microns were present. Microscopically, there was a small number of cholesterol monohydrate crystals and bilirubin granules among an abundant amount of granular-crystalline material that was not morphologically cholesterol monohydrate crystals. The chemical composition of the precipitates (n = 4) was determined. There was a small amount of cholesterol (1.7% +/- 0.8%) and bilirubin (13.9% +/- 0.74%). The major component of the precipitate was a residue. On further analysis using thin-layer chromatography, high-performance liquid chromatography, and electron microprobe analysis, the residue was identified as a calcium salt of ceftriaxone. The residue also had identical crystal morphology and chromatographic elution profile as authentic calcium-ceftriaxone standards. It is concluded that ceftriaxone, after excretion and being concentrated in the gallbladder bile, can form a precipitate. The major constituent has been identified as a ceftriaxone-calcium salt.

  19. Anuria and abdominal pain induced by ceftriaxone-associated ureterolithiasis in adults.

    Science.gov (United States)

    Li, Zhao-Lun; Li, Hong-Liang; Chen, Hai-Wen; Li, He-Cheng; Zhang, Peng; Wang, Zi-Ming; Chong, Tie

    2013-02-01

    Ceftriaxone is known to cause biliary pseudolithiasis and, rarely, nephrolithiasis mainly in children. However, we reported the development of bilateral distal ureteral ceftriaxone-associated lithiasis in 7 adults, which suggests that the risk of ureterolithiasis impaction should be considered when treating patients with ceftriaxone, even in adults. To avoid strengthening greater renal damage, ureteroscopic insertion of double J stents may be an alternative management for patients with ureteral ceftriaxone-associated lithiasis.

  20. 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?

    OpenAIRE

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

    2012-01-01

    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 strai...

  1. 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 (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.

  2. 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)

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

    2012-01-01

    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 (MIC50 = 0.032 μg/ml; MIC90 = 0.064 μg/ml) paralleled those of ceftriaxone (MIC50 = 0.032 μg/ml; MIC90 = 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 (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. PMID:22547617

  3. 76 FR 14023 - Determination that ROCEPHIN (Ceftriaxone Sodium) Injection, 250 Milligrams, 500 Milligrams, 1...

    Science.gov (United States)

    2011-03-15

    ... HUMAN SERVICES Food and Drug Administration Determination that ROCEPHIN (Ceftriaxone Sodium) Injection... (ceftriaxone sodium) Injection, 250 milligrams (mg), 500mg, 1 gram (g), 2g, and 10g base/vial, approved under... refer to a listed drug. ROCEPHIN (ceftriaxone sodium) Injection, 250mg, 500mg, 1g, 2g, and 10g base/vial...

  4. Determinants, outcomes and costs of ceftriaxone v. amoxicillin ...

    African Journals Online (AJOL)

    Background. Community-acquired pneumonia (CAP) is a major cause of death and morbidity worldwide. Treatment is centred on antibiotics with ceftriaxone and amoxicillin-clavulanate being some of the most commonly prescribed agents. Objective. To compare treatment outcomes and costs in patients receiving either of ...

  5. Efficacy of various single-dose regimens of ceftriaxone in ...

    African Journals Online (AJOL)

    1990-08-18

    Aug 18, 1990 ... The therapeutic efficacy of single intramuscular doses of ceftriaxone (Rocephin; Roche) (62,S, 125 and 250 mg), admini- stered without probenecid, was evaluated in 167 adult males with uncomplicated acute gonococcal urethritis. Cure rates of 100% were achieved at 62,5 mg and 250 mg. In the 125 mg.

  6. Efficacy of various single-dose regimens of ceftriaxone in ...

    African Journals Online (AJOL)

    The therapeutic efficacy of single intramuscular doses of ceftriaxone (Rocephin; Roche) (62,S, 125 and 250 mg), administered without probenecid, was evaluated in 167 adult males with uncomplicated acute gonococcal urethritis. Cure rates of 100% were achieved at 62,5 mg and 250 mg. In the 125 mg dose group, ...

  7. Assessment of ceftriaxone utilization in different wards of the Federal ...

    African Journals Online (AJOL)

    The unreasonable use of certain antimicrobials is one of the threatening issues worldwide leading to evolving antimicrobial resistant bacteria species. The problem becomes twofold when it occurs in low income countries like Ethiopia. The objective of this study was to assess the utilization of ceftriaxone in different wards of ...

  8. Effect of antibiotic ceftriaxone on elimination of ABI and GV3101 strains of Agrobacterium tumefaciens

    Directory of Open Access Journals (Sweden)

    Gorbatyuk I. R.

    2015-12-01

    Full Text Available Aim. To find out, at which concentration the antibiotic ceftriaxone of β-lactam group causes the elimination of ABI and GV3101 strains of Agrobacterium tumefaciens. Methods. The disc diffusion method. Results. Antibiotic ceftriaxone was used for the cell elimination of the Agrobacterium tumefaciens ABI strain for the first time. The same zones of inhibition were observed when using the 400 mg/l ceftriaxone and 500 mg/l cefotaxime solutions for both Agrobacterium strains (ABI and GV3101 studied. Conclusions. Ceftriaxone inhibits the Agrobacterium growth more effectively than cefotaxime. The ceftriaxone concentration for elimination of ABI and GV3101 Agrobacterium tumefaciens strains is 400 mg/l.

  9. Protective effects of ursodeoxycholic acid on ceftriaxone-induced hepatic injury in rats

    OpenAIRE

    Alhumaidha, Khaled A.; El-Awdan, Sally A.; El-Iraky, Wafaa I.; El-Denshary, Ezz-El-Din S.

    2014-01-01

    Ceftriaxone is a broad-spectrum semisynthetic cephalosporin antibiotic that causes partial damage in the liver manifested by transient elevation in some biochemical parameters. In this study, our aim was to investigate the use of ursodeoxycholic acid (UDCA) in prevention of the hepatotoxic effect and biochemical changes induced by ceftriaxone in rats. Rats were divided into six groups (control, UDCA 20 mg/kg, ceftriaxone 180 mg/kg, UDCA + ceftriaxone 180 mg/kg, ceftriaxone 360 mg/kg, and UDCA...

  10. Cost-effectiveness of ceftriaxone in the treatment of community ...

    African Journals Online (AJOL)

    1998-03-03

    Mar 3, 1998 ... 87.1%. 90.0%. 87.3%. 90.5%. 92.9%. Success rate. 49. 56. 19. 37. 21. 70. 256. 85.9%. 2 - 3 and 5.0. 256. 20. 276. :> x. :>. :> ca. 0 ca ct:I. ~. 5. ~. Y. ~ .... is observed between the two third-generation cephalosporins, ceftriaxone and cefotaxime. The difference between the other two treatment regimens does ...

  11. Ceftriaxone-Induced Hemolytic Anemia in a Jehovah's Witness.

    Science.gov (United States)

    Tasch, James; Gonzalez-Zayaz, Pedro

    2017-04-21

    BACKGROUND Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that may result from the administration of an antibiotic, most notably the cephalosporin class, commonly used in both the adult and pediatric populations. A delay in recognition by a provider may lead to continuation of the offending agent and possibly result in fatal outcomes. CASE REPORT We report the case of a 65-year-old woman on ceftriaxone infusions after being diagnosed with acute mitral valve endocarditis 3 weeks prior, which presented with severe anemia and bilateral transient vision loss. Being a Jehovah's Witness, the patient refused blood product transfusions and was managed with alternative therapies. The etiology of the symptoms was suspected to be a hemolytic anemia directly related to her ceftriaxone infusions. CONCLUSIONS This report demonstrates the importance of close vigilance while prescribing drugs known to cause hemolytic anemia. Although rare, drug-induced immune hemolytic anemia caused by ceftriaxone may be a potentially fatal condition, but with early recognition and withdrawal of the offending agent, successful treatment may ensue. Serological tests should be utilized to obtain a definitive diagnosis.

  12. Ciprofloxacin-Ceftriaxone Combination Prophylaxis for Prostate Biopsy; Infective Complications

    Directory of Open Access Journals (Sweden)

    Alper Ozorak

    2014-03-01

    Full Text Available Aim: To present our clinical experience about infective complications due to ultrasound guided transrectal prostate biopsy under ciprofloxacin plus third-generation cephalosporin (Ceftriaxone combination prophylaxis. Material and Method: The 1193 patients that used combination of ceftriaxone 1 g intramuscular 1 hour before biopsy and ciprofloxacin 500 mg twice a day for 5 days after biopsy were included to study. Before biopsy, urine analysis and urinary cultures were not performed routinely. Serious infective complications such as acute prostatitis and urosepsis, causing microorganisms were evaluated. Results: Serious infective complications occurred in (1.3% 16 patients. Fifteen of them had acute prostatitis and urine culture results were positive in 10/15 patients for Escherichia coli. The strains were uniformly resistant to ciprofloxacin. Only 1 patient had urosepsis and his blood and urine cultures demonstrated extended- spectrum %u03B2-lactamase-producing (ESBL Escherichia coli also resistant to ciprofloxacin. Antibiotic treatment-related side effects were not observed in any patient. Discussion: Although there is not a certain procedure, ciprofloxacin is the most common used antibiotic for transrectal prostate biopsy prophylaxis. On the other hand, the incidence of ciprofloxacin resistant Escherichia coli strain is increasing. Thus, new prophylaxis strategies have to be discussed. Ceftriaxone plus ciprofloxacin prophylaxis is safe and can be useable option for prophylaxis of prostate biopsy.

  13. Ceftriaxone Induced Hypersensitivity Reactions Following Intradermal Skin Test: Case Series

    Directory of Open Access Journals (Sweden)

    Sereen Rose Thomson

    2017-10-01

    Full Text Available The incidence of cephalosporin induced hypersensitivity reactions in non-penicillin allergic patients is about 1.7% and in penicillin allergic patients it is about 3-5%. Infact, cephalosporins are considered as the first choice in penicillin allergic patients who need antibiotic therapy intraoperatively. Prompt identification of patients with beta-lactam allergy would lead to an improved utilization of antibiotics and reduced occurrence of resistant strains. We hereby attempt to present a series of cases where ceftriaxone has been implicated in the manifestation of various hypersensitivity reactions. We have also tried to highlight some of the errors, risk factors and other drugs that precipitate a hypersensitivity reaction.

  14. 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.

  15. Research Progress of Mechanisms of Ceftriaxone Associated Nephrolithiasis.

    Science.gov (United States)

    Wang, Shu; Huang, Xiaobo; Xu, Qingquan; Xu, Tao

    2017-01-01

    Urinary calculi can be caused by a variety of reasons, such as metabolic abnormalities, urinary tract infection and obstruction. Certain medications can induce urinary stone disease. Ceftriaxone, a third generation cephalosporin with broad spectrum antibiotic activity, primarily eliminated by the kidneys, has now been widely used for treatment of infection. It has been long considered safe, especially in children. However, more and more cases about ceftriaxone induced nephrolithiasis as a rare side effect have been reported. This complication generally resolves spontaneously with cessation of the drug. Severe nephrolithiasis can cause post renal acute renal failure (PARF). There is limited information about how this complication develops, though high doses and extended treatment periods are generally considered to be responsible. Understanding the mechanisms would help the doctors to be aware of this rare complication and respond with proper treatment. The primary goal of this review is to discuss the possible mechanisms based on the most recent literatures. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. Synthesis and optimization of ceftriaxone-loaded solid lipid nanocarriers.

    Science.gov (United States)

    Kumar, Sandeep; Bhanjana, Gaurav; Kumar, Arvind; Taneja, Kapila; Dilbaghi, Neeraj; Kim, Ki-Hyun

    2016-10-01

    The use of nanocarriers to enhance drug delivery efficacy has been increasing in the healthcare field due to their tunable surface properties. In this study, ceftriaxone-loaded solid lipid nanoparticles (CL-SLNPs) were synthesized using a water-in-oil-in-water (w/o/w) type double emulsification method. The formulation was optimized using response surface methodology (RSM) and was characterized using transmission electron microscopy (TEM), photon correlation spectroscopy (PCS), and UV-vis and Fourier transform infrared (FTIR) spectroscopy. The CL-SLNPs were of spherical shape, 15-20nm in size, and retained the properties of the drug or other constituents/ingredients after loading. The prepared nanoformulation offered sustained drug release after 24h, while ceftriaxone sodium followed a burst release. Antibacterial activity of the nanoformulation was evaluated against different gram-positive and gram-negative bacterial strains. The minimum inhibitory concentration of CL-SLNPs against Pseudomonas aeruginosa was determined as 31μg/mL. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Pharmacokinetic and pharmacodynamic studies of diazepam, temazepam and ceftriaxone

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, N.A.M.

    1988-01-01

    Diazepam is a widely used drug in the management of anxiety and convulsion. Young, mature and senescent male Fischer 344 rats were injected with 180 {mu}g/kg body weight of {sup 14}C-diazepam and the brain levels of the drug and its active metabolites were determined by HPLC and reverse isotope dilution techniques. During the two hours after injection, the areas under the brain level-time curves (AUCs) of diazepam, N-desmethyldiazepam and temazepam were greater in senescent rats than in mature and young rats. Temazepam, an active metabolite of diazepam, is used as a hypnotic. Brain exposure to the behaviorally active dose of temazepam during the initial two hours after its iv administration was studied in young, mature and senescent rats. Similar brain levels in young and old rats indicated the possible existence of a level in brain above which temazepam impaired passive-avoidance acquisition. Ceftriaxone is a new cephalosporin antibiotic with a relatively long half-life. In male Sprague-Dawley rats, ethanol administration did not affect the pharmacokinetic parameters of ceftriaxone.

  18. In-vitro Activity of Three Brands of Ceftriaxone against different Clinical Isolates

    Directory of Open Access Journals (Sweden)

    B Thapa

    2010-09-01

    Full Text Available INTRODUCTION: Ceftriaxone is an extended spectrum cephalosporin that has been used for decades for combating infections caused by wide array of pathogens and prescription of antibiotic is in favor of specific brands without realizing the potency of the brand. The in-vitro activity of three brands of ceftriaxone and various antibiotics against clinical isolates is studied. METHODS: This comparative study was carried in Kathmandu Medical College Teaching Hospital (KMCTH, Basic Science Complex, Duwakot, Bhaktapur in 2009. Thirteen clinical isolates isolated from the specimens processed in the Microbiology Laboratory at KMCTH were used. Minimum inhibitory concentration (MIC of three brands of ceftriaxone (A, B, and C was determined by agar dilution and antibiotic resistance patterns were deduced by disc diffusion test. RESULTS: MIC for three brands of ceftriaxone ranged from 256 mg/L. The MIC for brands A and C of ceftriaxone were consistent for all isolates while for brand B, MIC was higher by at least two fold suggesting this brand had less in-vitro activity against isolates tested. All isolates were multi-drug resistant. Ceftriaxone resistant isolates (n = 6 were simultaneously resistant to various antibiotics tested. Imipenem and amino glycosides were sensitive to the isolates studied. CONCLUSIONS: Different brands of ceftriaxone are available in Nepal and imprudent use of less potent antibiotics should be controlled to stop the emergence and spread of multi-drug resistant pathogens and to prevent undue economic burden to the patient and the country. Keywords: agar dilution, ceftriaxone brands, multi-drug resistant.

  19. Pseudolithiasis after recent use of ceftriaxone : an unexpected diagnosis in a child with abdominal pain

    NARCIS (Netherlands)

    von Martels, Julius Z. H.; Van de Meeberg, Evelien K.; Holman, Mirjam; Ligtenberg, Jack J. M.; ter Maaten, Jan C.

    Ceftriaxone is a widely prescribed third-generation broad spectrum cephalosporin, often used for treatment of severe bacterial infections in children. It is known that ceftriaxone can cause sonographic biliary abnormalities in children. However, in only a minority of these cases, it will be

  20. Pharmacokinetics of ceftriaxone in plasma and bone of patients undergoing hip or knee surgery.

    Science.gov (United States)

    Gergs, Ulrich; Clauss, Tobias; Ihlefeld, Dorothea; Weiss, Michael; Pönicke, Klaus; Hofmann, Gunther O; Neumann, Joachim

    2014-11-01

    Patients undergoing hip or knee replacement therapy are routinely pretreated with antibiotics before surgery. It is controversial in which antibiotic is the treatment of choice for this purpose. One possibility is the cephalosporin ceftriaxone. Here, we wanted to know if effective tissue concentrations are reached. We studied plasma and bone kinetics of ceftriaxone in orthopaedic patients (n = 22) treated with ceftriaxone (2 g) immediately prior operation. Plasma samples were withdrawn before and at three time points after ceftriaxone infusion. After bone replacement, extracts from cancellous bone or cortical bone were obtained, and ceftriaxone was quantified using column chromatography. The plasma kinetics of ceftriaxone and distribution into bone were analysed using a population approach (ADAPT 5). The population mean of the area under the curve (AUC) was 140 mg h/l. A cancellous bone to plasma concentration ratio of 1.12 ± 1.29 was achieved 5 h after start of infusion. The half-life of uptake into the cortical bone was less (8.4 h) than into cancellous bone (12.1 h, P ceftriaxone in cancellous and cortical bone should be adequate to protect the patients against usual ceftriaxone-sensitive nosocomial infections and are substantially lower than the plasma concentrations. © 2014 Royal Pharmaceutical Society.

  1. Positive effects of ceftriaxone on pentylenetetrazol-induced convulsion model in rats.

    Science.gov (United States)

    Uyanikgil, Yigit; Özkeşkek, Kübra; Çavuşoğlu, Türker; Solmaz, Volkan; Tümer, Mehmet Kemal; Erbas, Oytun

    2016-01-01

    Many drugs have been associated with seizures as a side effect. Although they are defined as safe for nervous system. The effect on proconvulsant activity of beta lactam antibiotics have been also reported. We aimed to investigate whether ceftriaxone has an anticonvulsant effect on PTZ-induced seizures in rats. 36 male Sprague-Dawley rats, 18 of them for EEG recording and 18 of them are for behavioral studies, were randomly divided in two groups: group A for EEG recordings and group B for behavioral assesment. About 70 mg/kg PTZ was used for behavioral studies after Ceftriaxone administiration. About 35 mg/kg PTZ were used for EEG recording after ceftriaxone administiration. The electrodes were implanted on dura over the left frontal cortex and the reference electrode was implanted over the cerebellum for EEG recording. The Racine convulsion scale, first myoclonic jerk onset time, spike percentages, brain MDA and SOD levels were evaluated between the groups. First myoclonic jerk onset time was significantly shorter in saline group than both 200 and 400 mg/kg ceftriaxone groups (p ceftriaxone groups than saline group (p ceftriaxone groups have lower spike percentages than the saline group (p ceftriaxone group compared with the saline group (p ceftriaxone has protective effects on PTZ-induced convulsions and on oxidative damage associated with PTZ.

  2. EFFECT OF INTRAMUSCULAR CEFTRIAXONE ON AEROBIC ORAL AND FECAL FLORA OF 11 HEALTHY-VOLUNTEERS

    NARCIS (Netherlands)

    DEVRIESHOSPERS, HG; TONK, RHJ; VANDERWAAIJ, D

    1991-01-01

    11 volunteers received 1 g ceftriaxone i.m. every 24 h for 5 consecutive days. Volunteers were selected on the basis of the "ceftriaxone inactivating capacity" of their faeces, which should be 250 mg/kg faeces. The effect of treatment on the aerobic oral and faecal flora was studied. In the oral

  3. Combination of Ceftriaxone and Ampicillin for the Treatment of Enterococcal Endocarditis: A Qualitative Systematic Review.

    Science.gov (United States)

    Peterson, Shaylee C; Lau, Tim T Y; Ensom, Mary H H

    2017-06-01

    The aim of this systematic review is to review all human trials assessing the efficacy and safety of ampicillin and ceftriaxone for enterococcal endocarditis and to discuss the clinical implications of the findings. MEDLINE (1946-), EMBASE (1974-), CENTRAL, Google Scholar, and the World Health Organization Clinical Trials Registry Platform were searched through January 2017 using the search terms ampicillin, penicillin, ceftriaxone, cephalosporin, enterococ*, and endocarditis. Unpublished studies were eligible for inclusion. Additional references were identified from literature citations. Clinical trials in humans that reported on clinical efficacy or adverse outcomes with ceftriaxone and ampicillin therapy in patients with enterococcal endocarditis were included. Case reports, nonhuman, and non-English studies were excluded. Four observational clinical studies were identified. One examined the effects of ceftriaxone and ampicillin alone, and 3 compared the therapy to the current standard of care, ampicillin and gentamicin. The studies had small sample sizes and were not adequately designed or powered to establish noninferiority or equivalence to the current standard of care. Rates of clinical cure with ampicillin 2 g every 4 hours and ceftriaxone 2 g every 12 hours were similar to those of ampicillin and gentamicin. Ampicillin and ceftriaxone therapy was well tolerated with low rates of renal failure (0%-33%). The evidence to support the use of ampicillin and ceftriaxone for enterococcal endocarditis is not definitive. In the absence of compelling evidence, clinicians may consider ampicillin and ceftriaxone in patients with Enterococcus faecalis infection at high risk for nephrotoxicity or those with aminoglycoside-resistant pathogens.

  4. Ceftriaxone Etest non-susceptible methicillin susceptible Staphylococcus aureus time-kill responses.

    Science.gov (United States)

    Bremmer, Derek N; Balada-Llasat, Joan-Miquel; Goff, Debra A; Bauer, Karri A

    2017-06-01

    We determined the correlation between Etest and BMD MICs with bactericidal activity in MSSA blood isolates. Ceftriaxone was bactericidal in 36% and 9% of isolates exposed to the Etest and BMD MIC, respectively. With the sub-optimal activity of ceftriaxone, the Etest MIC may be a conservative method in identifying clinical utility. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Ceftriaxone-Associated Biliary and Cardiopulmonary Adverse Events in Neonates: A Systematic Review of the Literature.

    Science.gov (United States)

    Donnelly, Patrick C; Sutich, Rebecca M; Easton, Ryan; Adejumo, Oluwatunmise A; Lee, Todd A; Logan, Latania K

    2017-02-01

    Ceftriaxone is a third-generation cephalosporin with broad-spectrum activity against both Gram-positive and Gram-negative bacteria. Despite its effectiveness, its use for the treatment of infections in neonatal patients has been limited because of concern about its potential toxicity. Our aim was to review the literature for an association between ceftriaxone and cardiopulmonary events, hyperbilirubinemia, and pseudolithiasis among neonates. We searched PubMed and EMBASE and included studies that evaluated ceftriaxone safety in neonates. Study bias was evaluated in the following domains: exposure measurement, outcome measurement, attrition, generalizability, confounding, statistical analysis, and reporting. We included nine studies regarding ceftriaxone side effects, primarily spontaneous reports, published case reports, and small case series. Reports of bilirubin displacement attributed to ceftriaxone included increases in serum bilirubin necessitating antibiotic change in a subset of infants after administration of ceftriaxone. One study described self-resolving biliary sludge after ceftriaxone administration in six of 80 infants. Cardiopulmonary adverse events included a report of eight cardiopulmonary events related to concomitant ceftriaxone-calcium infusion, including seven infant deaths. Additional cardiopulmonary events reported included perinatal asphyxia, pulmonary hypertension, and thrombocytosis. However, the available literature had small sample sizes, poor external validity, and inconsistent outcome ascertainment methods, which made it impossible to estimate the magnitude of risk. Concomitant administration of intravenous ceftriaxone and calcium-containing solutions should be avoided in neonates. However, further controlled studies are needed to assess whether bilirubin displacement associated with the use of ceftriaxone is clinically relevant, particularly in healthy term and near-term neonates with mild hyperbilirubinemia.

  6. 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. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  7. In vitro activity of ceftriaxone alone and in combination with gentamicin, tobramycin, and amikacin against Pseudomonas aeruginosa.

    OpenAIRE

    Watanakunakorn, C

    1983-01-01

    The in vitro activity of ceftriaxone alone and in combination with gentamicin, tobramycin, and amikacin against 50 Pseudomonas aeruginosa strains was studied by the broth dilution method and the time-kill curve method. The majority of the P. aeruginosa strains tested were resistant to ceftriaxone. Combining ceftriaxone with the aminoglycosides resulted in synergism, antagonism, or indifference.

  8. Ceftriaxone Protects Astrocytes from MPP(+) via Suppression of NF-κB/JNK/c-Jun Signaling.

    Science.gov (United States)

    Zhang, Yunlong; Zhang, Xiuping; Qu, Shaogang

    2015-08-01

    Ceftriaxone has been shown to attenuate the dopaminergic neuron death and alleviate behavioral disorders in Parkinson's disease models via upregulation of glutamate transporter-1 (GLT-1) and decreases in extracellular glutamate. However, details of how this neuroprotection occurs are uncertain. We hypothesized that cytoprotection by ceftriaxone in astrocytes exposed to 1-methyl-4-phenylpyridinium (MPP(+)) involves suppression of the NF-κB/JNK/c-Jun signaling pathway. Here, we observed a protective effect of ceftriaxone in primary astrocytes exposed to MPP(+). Ceftriaxone enhanced glutamate uptake and promoted primary astrocyte viability after MPP(+) exposure. Ceftriaxone enhances glutamate uptake via upregulation of GLT-1 in the plasma membrane, and alleviates MPP(+)-induced neurotoxicity via suppression of NF-κB/JNK/c-Jun signaling. Collectively, our data offer evidence that increased expression and function of GLT-1 are involved in the protective mechanism of ceftriaxone in astrocytes exposed to MPP(+) in vitro, and we offer insight into the potential therapeutic role of ceftriaxone in treatment of Parkinson's disease.

  9. 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. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  10. Development of ceftriaxone resistance in Salmonella enterica serotype Oranienburg during therapy for bacteremia.

    Science.gov (United States)

    Yang, Wei-Chiun; Chan, Oi-Wa; Wu, Tsu-Lan; Chen, Chyi-Liang; Su, Lin-Hui; Chiu, Cheng-Hsun

    2016-02-01

    The majority of nontyphoid Salmonella infection is identified in children. When an invasive or severe Salmonella infection is encountered, ceftriaxone is recommended for such patients. A 2-year-old girl was hospitalized for the treatment of Salmonella bacteremia and discharged with standard ceftriaxone treatment. She was readmitted to the hospital after 2 days due to the recurrence of the Salmonella bacteremia. The study aimed to unveil the mechanism for the relapse. Six isolates (4 blood and 2 stool) were recovered from the patient, with the last two blood isolates being ceftriaxone-resistant. Pulsed-field gel electrophoresis was used for genotyping. Ceftriaxone resistance genes and transferability of the resistance plasmid were examined by molecular methods. All isolates were identified as Salmonella enterica serotype Oranienburg. Five isolates demonstrated almost identical electrophoresis patterns, except that in the two ceftriaxone-resistant isolates an extra band (>100 kb) was noted. A blaCMY-2 gene, carried by a 120-kb conjugative IncI1 plasmid of the sequence type 53, was identified in the two ceftriaxone-resistant isolates. Transfer of the resistance plasmid from one blood isolate to Escherichia coli J53 resulted in the increase of ceftriaxone minimum inhibitory concentration from 0.125 μg/mL to 32 μg/mL in the recipient. Ceftriaxone is the standard therapeutic choice for invasive or serious Salmonella infections in children. Pediatricians should be aware of the possibility of resistance development during therapy, especially in areas with a widespread of ceftriaxone resistance genes that are carried by a self-transferrable plasmid, such as the blaCMY-2-carrying IncI1 plasmid identified herein. Copyright © 2014. Published by Elsevier B.V.

  11. Identification of a new isomer from a reversible isomerization of ceftriaxone in aqueous solution.

    Science.gov (United States)

    Tian, Ye; Lu, Li; Chang, Yan; Zhang, Dou-sheng; Li, Jin; Feng, Yan-Chun; Hu, Chang-Qin

    2015-01-01

    A reversible isomerization of ceftriaxone in aqueous solution was observed, and the structure of the isomer was determined by mass spectrometry and various 1D and 2D NMR techniques. The mechanism of isomerization was also discussed. Finally, molecular docking simulations were performed and the antimicrobial activities of the isomers were measured. This showed that the biological activity of ceftriaxone was stronger than that of its isomer. The results reported in this article may be important to quality control requirements and to the stability of ceftriaxone products. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017

    DEFF Research Database (Denmark)

    Terkelsen, David; Tolstrup, Jacob; Johnsen, Camilla Hundahl

    2017-01-01

    We describe a multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Denmark, 2017. Whole genome sequencing of the strain GK124 identified MSLT ST1903, NG-MAST ST1614 and all relevant resistance determinants...... including similar penA resistance mutations previously described in ceftriaxone-resistant gonococcal strains. Although treatment with ceftriaxone 0.5 g plus azithromycin 2 g was successful, increased awareness of spread of gonococcal strains threatening the recommended dual therapy is crucial....

  13. 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.

  14. Drug-induced liver injury associated with high-dose ceftriaxone: a retrospective cohort study adjusted for the propensity score.

    Science.gov (United States)

    Nakaharai, Kazuhiko; Sakamoto, Yohei; Yaita, Kenichiro; Yoshimura, Yukihiro; Igarashi, Shun; Tachikawa, Natsuo

    2016-08-01

    Ceftriaxone has been recognized as a well-tolerated drug; however, in some instances, liver dysfunction occurs after using high-dose ceftriaxone. We aimed to assess the incidence of liver injury due to high-dose ceftriaxone and to determine whether there is a dose-dependent risk of liver injury with this drug. We conducted a retrospective cohort study of hospitalized adult patients treated with ceftriaxone at a tertiary care hospital from January 2012 to October 2013. We collected demographic and clinical data by reviewing their medical records. The incidence of liver injury based on biochemical criteria, defined as a primary outcome, was compared between patients treated with high-dose ceftriaxone (4 g/day) and those treated with a normal dose of ceftriaxone (2 g/day) for ≥5 consecutive days. A propensity score for the use of high-dose ceftriaxone was calculated from five factors. We identified 37 patients treated with high-dose ceftriaxone and 434 patients treated with a normal dose of ceftriaxone. Among these 471 patients, 15 patients (3.2 %) experienced liver injury, of whom six patients (6/37, 16.2 %) had received high-dose ceftriaxone and nine patients (9/434, 2.1 %) had received normal doses of ceftriaxone. In the multivariate analysis adjusted for the propensity score, high-dose ceftriaxone was independently associated with liver injury (odds ratio, 7.23; 95 % confidence interval, 2.01-26.0). The present study revealed that high-dose ceftriaxone was associated with a significantly higher incidence of liver injury compared with the normal-dose regimen. Therefore, clinicians should carefully observe for signs of liver injury after high-dose ceftriaxone use.

  15. First nationwide study regarding ceftriaxone resistance and molecular epidemiology of Neisseria gonorrhoeae in China.

    Science.gov (United States)

    Chen, Shao-Chun; Yin, Yue-Ping; Dai, Xiu-Qin; Unemo, Magnus; Chen, Xiang-Sheng

    2016-01-01

    Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health concern worldwide. This is the first nationwide study, performed within the China Gonococcal Antimicrobial Susceptibility Programme (China-GASP), regarding AMR, including ceftriaxone genetic resistance determinants, and molecular epidemiology of gonococci in China. Gonococcal isolates (n = 1257) from consecutive patients were collected at 11 sentinel sites distributed across China during 2012-13. Susceptibility to ceftriaxone, spectinomycin, ciprofloxacin and tetracycline was determined using the agar dilution method. Ceftriaxone resistance determinants penA and penB were examined using sequencing. N. gonorrhoeae multiantigen sequence typing (NG-MAST) was performed for molecular epidemiology. Among isolates, 0.2% were resistant to spectinomycin, 4.4% to ceftriaxone, 42.9% to tetracyclines (high-level resistance) and 99.8% to ciprofloxacin. Among 890 sequenced isolates, 16 (1.8%) possessed a penA mosaic allele; 4 of these isolates belonged to the MDR internationally spread NG-MAST genogroup G1407 (first description in China). Non-mosaic penA alleles with an A501T mutation and an A102D alteration in porB1b were statistically associated with decreased susceptibility/resistance to ceftriaxone. NG-MAST G10339, G1424 and G1053 were associated with decreased susceptibility/resistance to ceftriaxone. In China, ceftriaxone and spectinomycin can continue to be recommended for gonorrhoea treatment, with the possible exception of Hainan and Sichuan provinces where ceftriaxone resistance exceeded 5% and AMR surveillance needs to be strengthened. Molecular approaches including genotyping and AMR determinant analysis can be valuable to supplement and enhance conventional surveillance of gonococcal AMR in China. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Ceftriaxone attenuates acute cocaine-evoked dopaminergic neurotransmission in the nucleus accumbens of the rat.

    Science.gov (United States)

    Barr, J L; Rasmussen, B A; Tallarida, C S; Scholl, J L; Forster, G L; Unterwald, E M; Rawls, S M

    2015-11-01

    Ceftriaxone is a β-lactam antibiotic and glutamate transporter activator that reduces the reinforcing effects of psychostimulants. Ceftriaxone also reduces locomotor activation following acute psychostimulant exposure, suggesting that alterations in dopamine transmission in the nucleus accumbens contribute to its mechanism of action. In the present studies we tested the hypothesis that pretreatment with ceftriaxone disrupts acute cocaine-evoked dopaminergic neurotransmission in the nucleus accumbens. Adult male Sprague-Dawley rats were pretreated with saline or ceftriaxone (200 mg kg(-1) , i.p. × 10 days) and then challenged with cocaine (15 mg kg(-1) , i.p.). Motor activity, dopamine efflux (via in vivo microdialysis) and protein levels of tyrosine hydroxylase (TH), the dopamine transporter and organic cation transporter as well as α-synuclein, Akt and GSK3β were analysed in the nucleus accumbens. Ceftriaxone-pretreated rats challenged with cocaine displayed reduced locomotor activity and accumbal dopamine efflux compared with saline-pretreated controls challenged with cocaine. The reduction in cocaine-evoked dopamine levels was not counteracted by excitatory amino acid transporter 2 blockade in the nucleus accumbens. Pretreatment with ceftriaxone increased Akt/GSK3β signalling in the nucleus accumbens and reduced levels of dopamine transporter, TH and phosphorylated α-synuclein, indicating that ceftriaxone affects numerous proteins involved in dopaminergic transmission. These results are the first evidence that ceftriaxone affects cocaine-evoked dopaminergic transmission, in addition to its well-described effects on glutamate, and suggest that its ability to attenuate cocaine-induced behaviours, such as psychomotor activity, is due in part to reduced dopaminergic neurotransmission in the nucleus accumbens. © 2015 The British Pharmacological Society.

  17. 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)....

  18. 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.

  19. Potential deleterious effects of promoting the use of ceftriaxone in the treatment of Neisseria gonorrhoeae.

    Science.gov (United States)

    Golden, Matthew R; Barbee, Lindley A; Kerani, Roxanne; Dombrowski, Julia C

    2014-10-01

    US gonorrhea treatment guidelines recently changed to promote ceftriaxone as first-line therapy. Because ceftriaxone requires intramuscular administration, this could lead some patients to go untreated. We used an arithmetic model to compare the number of persons with gonorrhea who would be successfully treated with continued use of oral therapies versus exclusive use of ceftriaxone. Our base case scenario assumed the following: decreased cefixime susceptibility in 2% of heterosexuals and 5% of men who have sex with men, baseline oral therapy in 30% of heterosexuals and 15% of men who have sex with men, oral treatment failure in 10% of decreased susceptibility cases, and baseline patient-delivered partner therapy use in 30% of heterosexuals. Considering only effects on index cases, universal ceftriaxone use would result in fewer cures if at least 5% of oral therapy recipients go untreated with the change in treatment practice. Exclusive ceftriaxone use consistently led to fewer infected persons being cured when the model incorporated partner treatment effects and assumed that the change in treatment practices eliminated the use of patient delivered partner therapy. If oral treatment were 75% effective against decreased susceptibility gonorrhea, exclusive ceftriaxone use would likely increase cure rates in persons with decreased susceptibility gonorrhea, but could diminish them in persons with gonorrhea overall. At least in the short term, eliminating oral therapy for gonorrhea will likely have small effects on decreased susceptibility treatment failures and could increase gonorrhea rates overall.

  20. A pilot study evaluating the prescribing of ceftriaxone in hospitals in Ghana: findings and implications.

    Science.gov (United States)

    Afriyie, Daniel Kwame; Amponsah, Seth Kwabena; Dogbey, Justice; Agyekum, Kwabena; Kesse, Samuel; Truter, Ilse; Meyer, Johanna C; Godman, Brian

    2017-10-01

    Widespread empiric use of antibiotics exists especially in developing countries. This is a concern since inappropriate use of antibiotics, including their extended inappropriate use, will increase resistance rates. Consequently, there is a need to evaluate antibiotic utilisation across healthcare sectors to improve future use. This includes ceftriaxone, widely used among hospitals including those in Ghana. A cross-sectional study to evaluate the appropriateness of ceftriaxone prescribing in a leading hospital in Ghana. Ceftriaxone prescribing in patient-record cards was assessed using a modified WHO drug-utilization evaluation criteria as well as referencing the national standard treatment guidelines in Ghana and the ceftriaxone package insert. A total of 251 patients were assessed. Ceftriaxone was most commonly prescribed for comorbid malaria with bacterial infections, urinary tract infections, sepsis and gastroenteritis. The appropriateness of the indication was 86% (n = 218). The doses most prescribed were 1g (41%) and 2g (39%). Stat dose and once-daily dosage regimen constituted 51.4% and 84.5%, respectively. The most common duration of treatment was 1 (51.4%) and 2 days (35.1%). The overall appropriateness of prescribing was 93% against a pre-set threshold of 97%. The appropriateness of ceftriaxone prescribing was high in this leading hospital in Ghana; however, there is room for improvement with targeted education initiatives, with further research planned.

  1. Systemic pharmacokinetics and cerebrospinal fluid uptake of intravenous ceftriaxone in patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Zhao, Yanli; Cudkowicz, Merit E; Shefner, Jeremy M; Krivickas, Lisa; David, William S; Vriesendorp, Francine; Pestronk, Alan; Caress, James B; Katz, Jonathan; Simpson, Ericka; Rosenfeld, Jeffrey; Pascuzzi, Robert; Glass, Jonathan; Rezania, Kourosh; Harmatz, Jerold S; Schoenfeld, David; Greenblatt, David J

    2014-10-01

    The cephalosporin antibiotic ceftriaxone was evaluated as a potential therapeutic agent for the treatment of amyotrophic lateral sclerosis (ALS). The pharmacokinetics (PK) of ceftriaxone in plasma and cerebrospinal fluid (CSF) were investigated in 66 participants in a previously reported clinical trial. Their mean age was 51 years, and 65% were male. Participants were randomly assigned to 1 of 3 treatment groups receiving intravenous infusions (mean duration: 25 minutes) every 12 hours of either: placebo and placebo; 2 g ceftriaxone and placebo; or 2 g ceftriaxone twice. Mean steady-state plasma PK variables were: volume of distribution, 14 L (0.17 L/kg); elimination half-life, 8-9 h; total clearance, 17-21 mL/min (0.22-0.25 mL/min/kg). Values were not different between dosage groups. CSF PK analysis, determined through sparse CSF sampling, indicated apparent entry and elimination half-life values of 1.0 and 34 hours, respectively. With both dosage regimens, CSF concentrations were maintained above the target threshold of 1.0 µM (0.55 µg/mL) as determined from in vitro models. The plasma and CSF PK profiles of ceftriaxone were used as a basis for planning the Phase 3 clinical trial of ceftriaxone in ALS. © 2014, The American College of Clinical Pharmacology.

  2. Ceftriaxone pharmacokinetics by new simple and sensitive ultra-high-performance liquid chromatography method.

    Science.gov (United States)

    Campos, Michel Leandro; de Moura Alonso, Juliana; Dos Santos Martins, Evelin; Oliveira, Jonata Augusto; Hussni, Carlos Alberto; Peccinini, Rosângela Gonçalves

    2017-05-01

    Ceftriaxone is a cephalosporin antibiotic with a potent antimicrobial activity and excellent penetration in most body fluids such as pleural, peritoneal, spinal and brain. These facts contribute to the application of ceftriaxone in the treatment of bacterial peritonitis, an abdominal disorder in veterinary medicine, with potential risk of death. The determination of ceftriaxone levels in plasma and peritoneal fluid may be used to assess the pharmacokinetic profile at various instances of administration and allows observing if the concentrations needed are being achieved. Therefore a method was developed and validated for the determination of ceftriaxone in plasma and peritoneal fluid which after was applied in a pharmacokinetic profile study. The bioanalytical method validation was performed according to widely acceptable experiments. Two horses were used as a model of the method applicability; ceftriaxone was intraperitoneally administered to these animals as a single dose. The plasma and peritoneal fluid analysis were performed using an UHPLC system in reverse phase chromatography mode in fully validated conditions. The methods have shown linearity between 0.49 and 500μg/mL for plasma, and between 0.24 and 500μg/mL for peritoneal fluid. The quantitative analysis of ceftriaxone in these matrices allows monitoring of the therapy. This method showed improved sensitivity as well as the quantitation in peritoneal fluid. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Interactions of GFAP with ceftriaxone and phenytoin: SRCD and molecular docking and dynamic simulation.

    Science.gov (United States)

    Ruzza, Paolo; Vitale, Rosa Maria; Hussain, Rohanah; Biondi, Barbara; Amodeo, Pietro; Sechi, GianPietro; Siligardi, Giuliano

    2016-10-01

    GFAP is the major intermediate filament protein in mature astrocytes. Its increased expression and aggregation was firstly associated to Alexander's disease, and successively in different neurological diseases including scrapie, Alzheimer's and Creutzfeld-Jacob diseases. Recently, ceftriaxone a multi-potent β-lactam antibiotic able to overcome the blood-brain barrier, successfully eliminated the cellular toxic effects of misfolded mutated GFAP, similarly to phenytoin sodium, in a cellular model of Alexander's disease and inhibited α-synuclein aggregation protecting PC12 cells from the exposure to 6-hydroxydopamine. In this study, synchrotron radiation circular dichroism spectroscopy has been used to obtain structural information about the GFAP-ceftriaxone (phenytoin) interactions, while computational methods allowed the identification of the relevant putative binding site of either ceftriaxone or phenytoin on the dimer structure of GFAP, permitting to rationalize the spectroscopic experimental results. We found that GFAP exhibited enhanced stability upon the addition of two equivalents of each ligands with ceftriaxone imparting a more spontaneous interactions and a more ordered complex system than phenytoin. SRCD data and MD models indicate a stronger protective effect of ceftriaxone in neurological disorders characterized by an increased production and polymerization of GFAP. This result, in addition to our previous works in which we documented that ceftriaxone interacts with α-synuclein inhibiting its pathological aggregation and that a cyclical treatment with this molecule in a patient with adult-onset Alexander's disease halted, and partly reversed, the progression of neurodegeneration, suggests the possibility of a chaperone-like effect of ceftriaxone on protein involved in specific neurodegenerative diseases. Copyright © 2016 Diamond Light Source Ltd. Published by Elsevier B.V. All rights reserved.

  4. Ceftriaxone-Resistant Nontyphoidal Salmonella from Humans, Retail Meats, and Food Animals in the United States, 1996-2013.

    Science.gov (United States)

    Iwamoto, Martha; Reynolds, Jared; Karp, Beth E; Tate, Heather; Fedorka-Cray, Paula J; Plumblee, Jodie R; Hoekstra, Robert M; Whichard, Jean M; Mahon, Barbara E

    2017-02-01

    Ceftriaxone resistance in Salmonella is a serious public health threat. Ceftriaxone is commonly used to treat severe Salmonella infections, especially in children. Identifying the sources and drivers of ceftriaxone resistance among nontyphoidal Salmonella is crucial. The National Antimicrobial Resistance Monitoring System (NARMS) tracks antimicrobial resistance in foodborne and other enteric bacteria from humans, retail meats, and food animals. We examined NARMS data reported during 1996-2013 to characterize ceftriaxone-resistant Salmonella infections in humans. We used Spearman rank correlation to examine the relationships between the annual percentage of ceftriaxone resistance among Salmonella isolates from humans with isolates from retail meats and food animals. A total of 978 (2.9%) of 34,100 nontyphoidal Salmonella isolates from humans were resistant to ceftriaxone. Many (40%) ceftriaxone-resistant isolates were from children younger than 18 years. Most ceftriaxone-resistant isolates were one of three serotypes: Newport (40%), Typhimurium (26%), or Heidelberg (12%). All were resistant to other antimicrobials, and resistance varied by serotype. We found statistically significant correlations in ceftriaxone resistance between human and ground beef Newport isolates (r = 0.83), between human and cattle Typhimurium isolates (r = 0.57), between human and chicken Heidelberg isolates (r = 0.65), and between human and turkey Heidelberg isolates (r = 0.67). Ceftriaxone resistance among Salmonella Newport, Typhimurium, and Heidelberg isolates from humans strongly correlates with ceftriaxone resistance in isolates from ground beef, cattle, and poultry, respectively. These findings support other lines of evidence that food animals are important reservoirs of ceftriaxone-resistant Salmonella that cause human illness in the United States.

  5. Activity of ceftobiprole against Streptococcus pneumoniae isolates exhibiting high-level resistance to ceftriaxone.

    Science.gov (United States)

    Davies, Todd A; Flamm, Robert K; Lynch, A Simon

    2012-06-01

    Tracking Resistance in the US Today (TRUST) 2008 surveillance data showed that 6% of Streptococcus pneumoniae were non-susceptible to ceftriaxone [minimum inhibitory concentration (MIC) ≥ 2 μg/mL] and that 8% of the ceftriaxone-non-susceptible isolates exhibited high-level resistance (MIC ≥ 8 μg/mL). Here we describe the activity of ceftobiprole against ceftriaxone-resistant isolates and characterise the genotypic traits associated with resistance. Thirty isolates with ceftriaxone MICs ≥ 8 μg/mL were analysed by sequencing of penicillin-binding protein (PBP) and murM genes. Sequencing of pbp1a, pbp2b and pbp2x showed nine PBP patterns, with the most common (n=17) being: PBP1a T371S (STMK motif), P432T (SRNVP motif); PBP2b T446A (SSNT motif), A619G (KTGTA motif); and PBP2x T338A and M339F (STMK motif), L364F, I371T, R384G, M400T, L546V (LKSGT motif); six isolates had the same pattern without the PBP2b A619G change. For these 23 isolates, MICs were 8 μg/mL for ceftriaxone, 4-8 μg/mL for penicillin and 0.5-2 μg/mL for ceftobiprole. The remaining seven isolates with higher MICs (ceftriaxone 8-32 μg/mL, penicillin 4-32 μg/mL and ceftobiprole 2-4 μg/mL) had fewer PBP active-site motif substitutions. The majority of isolates (17/30) had murM alleles similar to the wild-type, whilst the rest had alleles reflecting a mosaic structure. No murM alleles were associated with higher MICs. Against these 30 isolates, ceftobiprole was 4-16-fold more active than ceftriaxone. Widely described PBP and MurM substitutions probably account for the high ceftriaxone MICs (8 μg/mL) in the majority of isolates. However, seven isolates with ceftriaxone MICs of 8-32 μg/mL had fewer PBP substitutions in active-site motifs, suggesting either that there is another resistance mechanism or that unique PBP mutations may contribute to high-level β-lactam resistance. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  6. Ceftriaxone-induced hemolytic anemia in a child successfully managed with intravenous immunoglobulin.

    Science.gov (United States)

    Vehapoğlu, Aysel; Göknar, Nilüfer; Tuna, Rümeysa; Çakır, Fatma Betül

    2016-01-01

    Drug-induced hemolytic anemia is an immune-mediated phenomenon that leads to the destruction of red blood cells. Here, we present a case of life-threatening ceftriaxone-induced hemolytic anemia (CIHA) in a previously healthy 3-year-old girl. We also reviewed the literature to summarize the clinical features and treatment of hemolytic anemia. Acute hemolysis is a rare side effect of ceftriaxone therapy associated with high mortality. Our patient had a sudden loss of consciousness with macroscopic hematuria and her hemoglobin dropped from 10.2 to 2.2 g/dl over 4 hours, indicating that the patient had life-threatening hemolysis after an intravascular dose of ceftriaxone who had previously been treated with ceftriaxone in intramuscular form for six days. CIHA is associated with a positive direct antiglobulin test, revealing the presence of IgG in all cases and C3d in most cases. Our patient's direct antiglobulin test was positive for IgG (3+) and for C3d (4+). The case was managed successfully with supportive measures and intravenous immunoglobulin therapy. Ceftriaxone is used very frequently in children; an early diagnosis and proper treatment of hemolytic anemia are essential to improve the patient outcome. The pathophysiological mechanism is the same as for non-drug autoimmune hemolytic anemia. However, there is still no consensus treatment for CIHA. Intravenous immunoglobulin can be used in clinical emergencies, such as our case, or in refractory cases.

  7. Fecal short-chain fatty acids at different time points after ceftriaxone administration in rats.

    Science.gov (United States)

    Holota, Yu V; Holubenko, O O; Ostapchuk, A M; Serhiychuk, T M; Zakordonets, L V; Tolstanova, G M

    2017-01-01

    Short-chain fatty acids (SCFAs) are major products of the microbial fermentation of dietary fiber in the colon. Recent studies suggest that these products of microbial metabolism in the gut act as signaling molecules, influence host energy homeostasis and play major immunological roles. In the present study, defined the long-term effects of ceftriaxone administration on the fecal SCFAs concentration in Wistar rats. Ceftriaxone (300 mg/kg, i.m.) was administered daily for 14 days. Rats were euthanized in 1, 15 and 56 days after ceftriaxone withdrawal. Caecal weight and fecal concentration of SCFAs by gas chromatography were measured. Ceftriaxone administration induced time-dependent rats’ caecal enlargement through accumulation of undigestable substances. In 1 day after ceftriaxone withdrawal, the concentrations of acetic, propionic, butyric acids and total SCFAs were decreased 2.9-, 13.8-, 8.5-, 4.8-fold (P < 0.05), respectively. Concentration of valeric, isovaleric and caproic acids was below the detectable level. That was accompanied by decreased 4.3-fold anaerobic index and increased the relative amount of acetic acid (P < 0.05). In 56 days, concentration of SCFAs was still below control value but higher than in 1 day (except propionic acid). Anaerobic index was lower 1.3-fold (P < 0.05) vs. control. Conclusion: antibiotic therapy induced long-term disturbance in colonic microbiota metabolic activity.

  8. 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.

  9. Evaluation of ceftriaxone utilization in medical and emergency wards of Tikur Anbessa specialized hospital: a prospective cross-sectional study.

    Science.gov (United States)

    Sileshi, Alemayehu; Tenna, Admasu; Feyissa, Mamo; Shibeshi, Workineh

    2016-02-18

    Ceftriaxone is one of the most commonly used antibiotics due to its high antibacterial potency, wide spectrum of activity and low potential for toxicity. However, the global trend shows misuse of this drug. The aim of this study was to evaluate prospectively the appropriateness of ceftriaxone use in medical and emergency wards of Tikur Anbessa Specialized Hospital. A prospective cross-sectional study was conducted by reviewing medication records of patients receiving ceftriaxone during hospitalization at Tikur Anbessa Specialized Hospital between February 1 and June 30, 2014. Drug use evaluation was conducted to determine whether ceftriaxone was being used appropriately based on six criteria namely indication for use, dose, frequency of administration, duration of treatment, drug-drug interaction, culture and sensitivity test. The evaluation was made as per the protocol developed from current treatment guidelines. The total of 314 records of patients receiving ceftriaxone was reviewed. The prescribing rate of ceftriaxone was found to be very high (58 % point prevalence). Ceftriaxone use was empiric in 274 (87.3 %) cases. The most common indication for ceftriaxone use was pneumonia; observed in 110 (35.0 %) cases. The most common daily dosage, frequency of administration and duration of treatment with ceftriaxone were 2 g (88.9 %), twice-daily (98.4 %) and 8-14 days (46.2 %), respectively. Inappropriate use of ceftriaxone was observed in most of cases (87.9 %), the greatest proportion of which was attributed to inappropriate frequency of administration (80.3 %), followed by absence of culture and sensitivity test (53.2 %). This study revealed that the inappropriate use of ceftriaxone was very high in the medical and emergency wards of Tikur Anbessa Specialized Hospital. This may lead to emergence of resistant pathogens which in turn lead to treatment failure and increased cost of therapy. Therefore, adherence to current evidence-based guidelines is

  10. 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...... for legal first trimester abortion, treated peroperatively with ceftriaxone. No significant difference was demonstrated between high risk patients treated with ceftriaxone or ampicillin/pivampicillin and metronidazole. Udgivelsesdato: 1994-Jul......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...

  11. Pharmaceutical quality of eight generics of ceftriaxone preparation for injection in Eastern Asia.

    Science.gov (United States)

    Arnet, Isabelle; Altermatt, Matthias; Roggo, Yves; Schnetzler, Gabriel

    2015-01-01

    To compare the pharmaceutical quality of original and generic ceftriaxone sodium preparations for injection produced in Eastern Asia. Standard physical and chemical laboratory tests were performed. Participants/material: Ceftriaxone (Rocephin®, Roche, Switzerland) was the reference material. Generics produced in China, India, and Indonesia were sampled in China and Myanmar within their expiration dates. Eight generics obtained from Eastern Asia markets in January 2013 were analysed. All eight generics failed the specifications in three or more tests. Residues of solvents and metals were detected in all generics, four were not particle free, and two were not sterile. All tested generic ceftriaxone products failed to meet the pharmaceutical quality standards of the branded original. The high levels of impurities and the identified contamination of particles and residues are of clinical concern, as they could impact tolerability and safety in patients in need of an effective parenteral antibiotic.

  12. Ceftriaxone reverses ketamine-induced lasting EEG and astrocyte alterations in juvenile mice.

    Science.gov (United States)

    Dodman, K; Featherstone, R E; Bang, J; Liang, Y; Siegel, S J

    2015-11-01

    Ketamine, an N-methyl-d-aspartate receptor antagonist, is used as a pediatric anesthetic because of its favorable safety profile. It is also being investigated as an antidepressant. Unfortunately, ketamine causes adverse reactions including hallucinations and is associated with a high prevalence of abuse among adolescents. Although chronic ketamine use has been shown to produce cognitive impairments even years following cessation, little is known about its long-term consequences on adolescents. The beta-lactam ceftriaxone has been shown to attenuate alcohol withdrawal, and alleviate early brain injury and memory impairments following subarachnoid hemorrhage. However, its ability to reverse the effects of adolescent ketamine exposure is not known. Previous data indicate that ketamine causes a reduction in the number of Excitatory Amino Acid Transporter Type 2 (EAAT2)-containing astrocytes. Additionally, the beta lactam antibiotic ceftriaxone increased expression of EAAT2. As EAAT2 is a principal mechanism of glutamate clearance from the synapse, the current study tests the hypothesis that ceftriaxone may reverse functional consequences of ketamine exposure. We examined the effects of chronic ketamine in juvenile mice as well as reversal by ceftriaxone using electroencephalography (EEG). Subsequently, we assessed the effects of these treatments on markers of astrocyte proliferation, using Glial Fibrillary Acidic Protein (GFAP), and function, as evidenced by EAAT2. Juvenile mice exposed to chronic ketamine showed lasting alterations in EEG measurements as well as markers of astrocyte number and function. These alterations were reversed by ceftriaxone. Data suggest that ceftriaxone may be able to ameliorate ketamine-induced long-term disturbances in adolescent brains. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Ceftriaxone susceptibility and molecular characteristics of Neisseria gonorrhoeae isolates in Changsha, China.

    Science.gov (United States)

    Peng, Ting; Lin, Hui; Liu, Qinglin; Cao, Wei; Ding, Hui; Chen, Jianlin; Tang, Lingli

    2017-06-01

    A total of 128 Neisseria gonorrhoeae isolates were consecutively obtained in Changsha, China, between April 2015 and June 2016. The minimum inhibitory concentrations (MICs) of ceftriaxone were measured by agar dilution method for each isolate. Ceftriaxone resistance determinants involving penA, mtrR, porB and ponA were amplified by PCR, and the PCR products were sequenced. N. gonorrhoeae multi-antigen sequence typing (NG-MAST) was conducted for genotyping. The results exhibited 11% (14/128) of isolates were reduced susceptibility or resistant to ceftriaxone. One isolate with a susceptibility MIC of 0.03 mg/L harbored a penA mosaic allele. PBP2 A501V/T or P551S and the PorB1b G120K/A121D mutations were predominant in the 14 decreased susceptible or resistant isolates. Among the 128 isolates, 31 sequence types (STs) were identified, and the most prevalent STs were STnew1 (n = 40), ST5061 (n = 25) and ST9176 (n = 18). The 14 decreased susceptible or resistant isolates were resolved into 9 STs, displaying considerable diversity. The results of ceftriaxone susceptibility testing indicated that ceftriaxone can continue to be recommended as the first-line drug for gonorrhea treatment in Changsha; however, it is important to maintain promptly surveillance for antimicrobial resistance (AMR). Non-mosaic penA alleles with A501V/T, P551S, and porB1b mutations may contribute to ceftriaxone resistance or decreased susceptibility among N. gonorrhoeae in this area, and heterogenous STs in these isolates excluded the clonal expansion for a particular subtype. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  14. Clinical predictors of ceftriaxone resistance in microorganisms causing febrile urinary tract infections in men.

    Science.gov (United States)

    Ramos Lázaro, Javier; Smithson, Alex; Jovè Vidal, Neus; Batida Vila, María Teresa

    2018-02-01

    Because of high rates of resistance to fluoroquinolones, ceftriaxone has become one of the main options for treating febrile urinary tract infection (FUTI). This study aimed to identify predictors of ceftriaxone resistance in community-acquired FUTIs in men. Cross-sectional ambispective study enrolling men with FUTIs treated in the emergency department of a local area hospital in Spain. A total of 552 FUTI episodes were studied; 103 (18.6%) were caused by a ceftriaxone-resistant microorganism. Variables associated with a ceftriaxone-resistant FUTI were older age, health care-associated FUTI, dementia, diabetes mellitus, neoplasms, a history of UTIs, urologic disease, and complicated FUTI. Patients with ceftriaxone-resistant FUTIs also had higher rates of recent antibiotic treatment. Independent variables associated with FUTI due to a ceftriaxoneresistant microorganism were cirrhosis of the liver (odds ratio [OR], 6,00 95% CI, 1.25-28; P = .025), health careassociated FUTI (OR, 2.3 95% CI, 1.23-4.27; P = .009), and prior treatment with antibiotics (OR, 2.15; 95% CI, 1.23-3.76 P = .007). Components of health care-associated FUTI were a history of admission to a long-term residence (OR, 2.90 95% CI, 1.21-7.16; P = .017) and use of penicillins with or without beta-lactamase inhibitors (OR, 2.16; 95% CI, 1.05-4.42; P = .035). Cirrhosis of the liver; history of health care-associated FUTI, especially in patients residing in a long-term care facility; and recent use of antibiotics, mainly penicillins with or without beta-lactamase inhibitors, are risk factors for ceftriaxone-resistant FUTI in men.

  15. Preformulation studies of ceftriaxone for pediatric non-parenteral administration as an alternative to existing injectable formulations.

    Science.gov (United States)

    Kauss, Tina; Marchivie, Mathieu; Phoeung, Thida; Gaubert, Alexandra; Désiré, Amélie; Tonelli, Giovanni; Boyer, Chantal; Langlois, Marie-Hélène; Cartwright, Anthony; Gomes, Melba; White, Nicholas; Gaudin, Karen

    2017-06-15

    Ceftriaxone, a third generation cephalosporin, has a wide antibacterial spectrum that has good CNS penetration, which makes it potentially suitable for initial treatment of severe neonatal pediatric infections providing suitable formulation. We evaluated its physicochemical and technical characteristics to assess its potential for development as a non-parenteral dosage form. As ceftriaxone is marked only for injectable use, these data are not available. Using HPLC and Karl Fischer titration, sensitivity of ceftriaxone to water, feasibility and impact of pharmaceutical processes and compatibility with common pharmaceutical excipients were assessed. X-ray diffraction studies gave deeper insight into the mechanisms involved in degradation. Chemometrical analysis of near infrared spectra enabled classification of ceftriaxone powder according to exposure conditions or processes applied. The results showed that ceftriaxone was not highly hygroscopic, could be processed in all climatic zones, but should be packaged protected against humidity. Controlling water presence in formulation was shown critical, as ceftriaxone degraded in the presence of water content above 2.4% w/w. To improve flowability, a critical parameter for dry dosage form development, granulation (wet and dry techniques, providing complete drying and moderate force compaction respectively) was shown feasible. Compression with moderate forces was possible, but grinding and high compression forces significantly affected long term ceftriaxone stability and should be avoided. Based on these results, development of ceftriaxone non-parenteral solid or liquid non-aqueous forms appears feasible. Copyright © 2017. Published by Elsevier B.V.

  16. Characterizing ceftriaxone-induced urolithiasis and its associated acute kidney injury: an animal study and Chinese clinical systematic review.

    Science.gov (United States)

    Zhang, Yifan; Ning, Benxiang; Zhu, Huaijun; Cong, Xiaoming; Zhou, Leqing; Wang, Qiang; Zhang, Liming; Sun, Xizhao

    2016-07-01

    To investigate the pathophysiological process of ceftriaxone-induced urolithiasis and its associated acute kidney injury (AKI) based on an animal study and summarize the main clinical characteristics based on a Chinese clinical systematic review. Male Sprague-Dawley rats were randomly divided into five groups of six each according to different treatments including control; ceftriaxone; ceftriaxone with calcium; calcium; and ceftriaxone, calcium with citrate, respectively. The 24-h urine volume, serum creatinine (Scr) and blood urea nitrogen (BUN) were measured; kidney histological examination and stone analysis were performed. Systematic searches of the Chinese Knowledge Database were conducted for reports on ceftriaxone-induced urolithiasis and AKI. The eligibility of each full-text publication was accessed, and qualified data were extracted and reviewed. Kidney stones and a significantly low 24-h urine volume with increased high Scr and BUN levels were found in the group that received ceftriaxone combined with calcium. Citrate was able to inhibit these biochemical changes and stone formations. A total of 161 qualified patients were included in the Chinese clinical systematic review: The proportion of ceftriaxone-induced urolithiasis was 21.1, 19.3, 19.3, 39.1 and 1.2 % for ages 60 years. 72.7 % developed acute kidney injury eventually. Ceftriaxone-induced urolithiasis was associated with a high risk of AKI. The pathophysiological process may be related to urinary obstruction and crystalline nephropathy. Citrate was able to inhibit stone formation and prevent further kidney injury.

  17. 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.

  18. Microbiological efficacy and tolerability of a single-dose regimen of 1 g of ceftriaxone in men with gonococcal urethritis.

    Science.gov (United States)

    Ito, Shin; Yasuda, Mitsuru; Hatazaki, Kyoko; Mizutani, Kosuke; Tsuchiya, Tomohiro; Yokoi, Shigeaki; Nakano, Masahiro; Deguchi, Takashi

    2016-09-01

    We treated men with gonococcal urethritis with a single-dose regimen of 1 g of ceftriaxone, which is recommended as the first-line treatment for gonorrhoea in Japan, to determine its microbiological outcomes and tolerability. We enrolled 255 men with gonococcal urethritis and treated them with a single-dose regimen of 1 g of ceftriaxone. We evaluated its microbiological outcomes and tolerability. We also determined ceftriaxone MICs for pretreatment isolates of Neisseria gonorrhoeae collected from the patients. The microbiological efficacy of the ceftriaxone regimen, which was determined between 5 and 9 days after treatment in 111 men based on the Japanese guideline for clinical research on antimicrobial agents in urogenital infections, was 100%. In the 194 men who returned to the clinic between 2 and 41 days after treatment, 191 (98.5%; 95% CI 96.8%-100%) were negative for N. gonorrhoeae after treatment. Ceftriaxone MICs determined for 136 pretreatment isolates obtained from these 194 men ranged from 0.001 to 0.25 mg/L. One isolate persisting after treatment exhibited a ceftriaxone MIC of 0.008 mg/L. For two isolates persisting after treatment, ceftriaxone MICs were not determined. Seven adverse events were observed in 7 (3.2%) of the 220 men treated with the ceftriaxone regimen. Four men had diarrhoea classified as grade 1. Three had urticaria during ceftriaxone administration, with one event classified as grade 1 and two events classified as grade 3. A single-dose regimen of 1 g of ceftriaxone was microbiologically effective against gonococcal urethritis and was safe and tolerable. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Azithromycin Resistance and Decreased Ceftriaxone Susceptibility in Neisseria gonorrhoeae, Hawaii, USA.

    Science.gov (United States)

    Papp, John R; Abrams, A Jeanine; Nash, Evelyn; Katz, Alan R; Kirkcaldy, Robert D; O'Connor, Norman P; O'Brien, Pamela S; Harauchi, Derek H; Maningas, Eloisa V; Soge, Olusegun O; Kersh, Ellen N; Komeya, Alan; Tomas, Juval E; Wasserman, Glenn M; Kunimoto, Gail Y; Trees, David L; Whelen, A Christian

    2017-05-01

    During 2016, eight Neisseria gonorrhoeae isolates from 7 patients in Hawaii were resistant to azithromycin; 5 had decreased in vitro susceptibility to ceftriaxone. Genomic analysis demonstrated a distinct phylogenetic clade when compared with local contemporary strains. Continued evolution and widespread transmission of these strains might challenge the effectiveness of current therapeutic options.

  20. Carbohydrate composition of rat intestine surface mucus layer after ceftriaxone treatment

    Directory of Open Access Journals (Sweden)

    Yu. V. Holota

    2016-12-01

    Full Text Available The epidemiological studies have shown that antibiotic treatment increases the susceptibility to inflammatory bowel disease development. The disturbance of mucus layer integrity might be one of the possible mechanisms. The aim of the present study was to investigate the effect of antibiotic ceftriaxone treatment on glycoproteins level and its carbohydrate composition in surface mucus layer of rat intestine. The study was done on male Wistar rats (140-160 g. Ceftriaxone (300 mg/kg, i.m. was administered once a day for 14 days. The surface mucus from terminal ileum and colon were collected on the 15th, 29th and 72nd days of the experiment. Total level of mucus glycoproteins, hexoses, hexosamines, fucose and sialic acids were measured. Ceftriaxone administration did not affect the levels of glycoproteins in rat ileum. In the colon, the levels of glycoprotein were 1.3-fold decreased (Р < 0.05 on the 72nd day of the experiment. These changes were accompanied by the 1.2-fold decrease of hexoses (Р < 0.05 and 3.1-fold (Р < 0.05 decrease of fucose level and 1.5-fold (Р < 0.05 increase of the levels of sialic acids in the surface mucus of the rat colon. Thus, ceftriaxone administration induces the long-term changes in the levels of glycoproteins and carbohydrates composition in the rat colon surface mucus. This could potentially explain the susceptibility to inflammatory bowel disea­ses development.

  1. Ceftriaxone Potentiates Warfarin Activity Greater Than Other Antibiotics in the Treatment of Urinary Tract Infections.

    Science.gov (United States)

    Saum, Lindsay M; Balmat, Ryan P

    2016-04-01

    The cephalosporin class has been associated with an increased risk of bleeding among elderly patients receiving warfarin. Urinary tract infections (UTI) are the most prevalent infection in elderly patients. To determine the extent of interaction between antibiotics used in the treatment of UTI, particularly specific cephalosporins and warfarin. A retrospective chart review was conducted on chronic warfarin patients with a diagnosis of UTI treated with ceftriaxone, a first-generation cephalosporin, penicillin, or ciprofloxacin. The primary outcome was the comparison of the extent of international normalized ratio (INR) change from baseline between each antibiotic group. The ceftriaxone group was found to have a statistically significant higher peak INR value compared to all other studied antibiotics (ceftriaxone: 3.56, first-generation cephalosporins: 2.66, penicillins: 2.98, ciprofloxacin: 2.3; P = .004), a statistically significant greater extent of change in INR value (+1.19, +0.66, +0.8, +0.275; P = .006), and a statistically significant greater percentage change in INR value when compared to ciprofloxacin (54.4% vs 12.7%; P = .037). Ceftriaxone interacts with warfarin to increase a patient's INR value more than other commonly administered antibiotics for UTI treatment. Other antibiotics should be preferred for UTI treatment in patients on warfarin. © The Author(s) 2014.

  2. The Effects of Ceftriaxone on Histology, Histomorphometry, and Histochemistry of Testis and Sperm Characteristics in Mice

    Directory of Open Access Journals (Sweden)

    Shapour Hasanzadeh

    2016-08-01

    Full Text Available Background and Objectives: Ceftriaxone is a third-generation cephalosporin antibiotic, which has a broad-spectrum activity against bacteria. Recently, its adverse effects on the reproductive system, was revealed. The aim of this study was to investigate the adverse effects of ceftriaxone on testicular tissue in adult male mice. Methods: A total of 40 adult male mice were randomly divided into 5 groups: Control group received normal saline; the first and second experimental groups, respectively, received ceftriaxone at doses of 20 and 50mg/kg bw for 7 days; and the third and fourth groups, respectively, received 20 and 50mg/kg bw of the drug for 45 days. After preparation of tissue sections, routine and specific staining was performed, and histological, histomorphometric, and histochemical studies were carried out. The data were analyzed by one-way ANOVA and Tukey’s test. Significance level was considered as p0.05 in the interstitial tissue thickness in all the experimental groups compared to the control group. In the experimental groups, Sudan Black and alkaline phosphatase reactions were intense, while PAS reaction was weak. Conclusion: Ceftriaxone damages testicular structure, which includes loss of balance of the spermatogenic cell population and decrease in the spermatogenesis and spermiogenesis processes.  

  3. A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

    Directory of Open Access Journals (Sweden)

    Shuichi Abe

    2017-01-01

    Full Text Available Prior literature suggests that ceftriaxone causes formation of gallbladder stones at a relatively high frequency, and when abdominal symptoms occur, prompt investigation of the gallbladder is required with institution of appropriate treatment. Aging, malnutrition, renal impairment, and sepsis are risk factors for pseudolithiasis, and prevention of these is important to suppress gallstone development.

  4. Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis.

    Science.gov (United States)

    Katanami, Yuichi; Hashimoto, Takehiro; Takaya, Saho; Yamamoto, Kei; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Ohmagari, Norio

    2017-05-01

    There is no proven alternative to penicillin for treatment of maternal syphilis. We report 2 case-patients with maternal syphilis who were successfully treated without penicillin. We used amoxicillin and probenecid for the first case-patient and amoxicillin, probenecid, and ceftriaxone for the second case-patient.

  5. Protein binding characteristics and pharmacokinetics of ceftriaxone in intensive care unit patients.

    Science.gov (United States)

    Schleibinger, Michael; Steinbach, Cathérine L; Töpper, Christoph; Kratzer, Alexander; Liebchen, Uwe; Kees, Frieder; Salzberger, Bernd; Kees, Martin G

    2015-09-01

    The aim of the present study was to assess the pharmacokinetics of total and unbound ceftriaxone in intensive care unit (ICU) patients and its protein binding characteristics. Twenty patients (m/f 15/5, age 25-86 years, body weight 60-121 kg, APACHE II 7-40, estimated glomerular filtration rate 19-157 ml min(-1) , albumin 11.7-30.1 g l(-1) , total bilirubin ICU patients (33.0%; 20.2-44.5%) than reported in healthy volunteers, particularly when renal impairment or severe hyperbilirubinaemia was present. In all patients, unbound concentrations during treatment with ceftriaxone 2 g once daily remained above the EUCAST susceptibility breakpoint (≤1 mg l(-1) ) throughout the whole dosing interval. Protein binding of ceftriaxone is reduced and variable in ICU patients due to hypoalbuminaemia, but also to altered binding characteristics. Despite these changes, the pharmacokinetics of unbound ceftriaxone is governed by renal function. For patients with normal or reduced renal function, standard doses are sufficient. © 2015 The British Pharmacological Society.

  6. Ceftriaxone, a GLT-1 transporter activator, disrupts hippocampal learning in rats.

    Science.gov (United States)

    Matos-Ocasio, Félix; Hernández-López, Anixa; Thompson, Kenira J

    2014-07-01

    Glutamate transporters (GluTs) are important for maintaining optimal glutamate concentrations at the synapse. This allows proper synaptic response, plasticity and prevents neurotoxicity. It has been shown that the β-lactam antibiotic ceftriaxone (Rocephin) induces an up-regulation of the glutamate transporter GLT-1. This GLT-1 up-regulation blocks the metabotropic glutamate receptor (mGluR) dependent long-term depression (LTD) at the mossy fiber (MF)-CA3 hippocampal synapse. It also has negative effects on long-term potentiation (LTP). However, the effects of GLT-1 up-regulation on hippocampal learning in rats are not known. In this study, we examine the role of chronic administration of ceftriaxone on novel object recognition, which is a hippocampal-dependent spatial learning task. Male Sprague Dawley rats (2-3 months old) were administered ceftriaxone (via i.p. injections, 200 mg/kg) for 8 consecutive days prior to training and testing on a standard novel object recognition task. We found that rats administered with ceftriaxone display memory impairments in novel object recognition, when compared to control rats (pceftriaxone administration has detrimental effects on spatial learning and memory in rats. Our results further support the notion that glutamate transporters provide an essential regulatory role in hippocampal learning and memory. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Carbohydrate composition of rat intestine surface mucus layer after ceftriaxone treatment.

    Science.gov (United States)

    Holota, Yu V; Olefir, Ya A; Dovbynchuk, T V; Tolstanova, G M

    2016-01-01

    The epidemiological studies have shown that antibiotic treatment increases the susceptibility to inflammatory bowel disease development. The disturbance of mucus layer integrity might be one of the possible mechanisms. The aim of the present study was to investigate the effect of antibiotic ceftriaxone treatment on glycoproteins level and its carbohydrate composition in surface mucus layer of rat intestine. The study was done on male Wistar rats (140-160 g). Ceftriaxone (300 mg/kg, i.m.) was administered once a day for 14 days. The surface mucus from terminal ileum and colon were collected on the 15th, 29th and 72nd days of the experiment. Total level of mucus glycoproteins, hexoses, hexosamines, fucose and sialic acids were measured. Ceftriaxone administration did not affect the levels of glycoproteins in rat ileum. In the colon, the levels of glycoprotein were 1.3-fold decreased (Р ceftriaxone administration induces the long-term changes in the levels of glycoproteins and carbohydrates composition in the rat colon surface mucus. This could potentially explain the susceptibility to inflammatory bowel disea­ses development.

  8. [In vitro activity of ampicillin-ceftriaxone against Enterococcus faecalis isolates recovered from invasive infections].

    Science.gov (United States)

    Burguer Moreira, Noelia; Nastro, Marcela; Vay, Carlos; Famiglietti, Ángela; Rodríguez, Carlos Hernán

    2016-01-01

    In vitro activity of the combination of ampicillin- ceftriaxone against 30 Enterococcus faecalis isolates recovered from invasive infections in patients admitted to Hospital de Clínicas José de San Martin in the city of Buenos Aires was assessed. Ampicillin- ceftriaxone synergies were determined by microdilution in Müeller-Hinton (MH) broth with and without subinhibitory concentrations of ceftriaxone. Synergy was detected in 22/30 isolates. A decrease in both minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was observed in 14/30 isolates, whereas in 6/30 isolates the decrease was observed in the MIC value and only in the MBC value in the 2 remaining isolates. The bactericidal activity of the combination showed to be higher at low concentrations of ampicillin (ceftriaxone combination and thus, its efficacy was confirmed in the treatment of severe infections by E. faecalis. Copyright © 2015 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Factors influencing ceftriaxone use in community-acquired pneumonia: Emergency doctors' perspectives.

    Science.gov (United States)

    Almatar, Maher Ali; Peterson, Gregory M; Thompson, Angus; Zaidi, Syed Tabish R

    2014-12-01

    To explore the perceptions of ED doctors regarding the use of ceftriaxone in patients with community-acquired pneumonia (CAP). Face-to-face interviews were conducted with ED doctors in an Australian tertiary public hospital. A semi-structured interview method was used for collecting data and a framework analysis approach utilised to identify emerging themes regarding the influences on ED prescribers when using ceftriaxone for CAP. Eight interviews were performed (two consultants, four registrars and two residents). Five main themes emerged as influencing decisions regarding the selection of ceftriaxone for patients with CAP: (i) clinical intuition versus structured evaluation of severity; (ii) clinical uncertainty; (iii) prior experience; (iv) source of guidance; and (v) prescribing etiquette. As most cases of CAP are initially diagnosed and treated empirically in the ED, any interventions that aim to decrease inappropriate use of ceftriaxone for CAP should address the factors identified here that influence ED doctors' prescribing decisions. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  10. An unusual case of delayed-type hypersensitivity to ceftriaxone and meropenem.

    Science.gov (United States)

    Dias de Castro, E; Leblanc, A; Sarmento, A; Cernadas, J R

    2015-11-01

    Recent studies have demonstrated a low cross-reactivity between β-lactam antibiotics and carbapenems in IgE-mediated reactions. There are no studies on cross-reactivity of meropenem in patients with non-immediate hypersensitivity to cephalosporins. We describe a case of a 13-year-old male, admitted in Neurosurgery with a severe extradural empyema complicating frontal sinusitis, submitted to an emergent bifrontal craniotomy. A generalized maculopapular exanthema, fever and malaise, appeared by the 7th day of meningeal doses of ceftriaxone, clindamycin and vancomycin. Those were replaced by meropenem, with posterior worsening of the reaction and mucosal involvement. A new scheme with amikacin, metronidazole and linezolid was done with improvement. Skin prick, intradermal and patch tests to penicillins, ceftriaxone and meropenem were negative. Lymphocyte transformation test was positive to ceftriaxone and negative to meropenem.Non-immediate T cell mechanism seems to be involved. Diagnosis work-up couldn't exclude cross-reactivity between ceftriaxone and meropenem.

  11. Synergistic protective effects of ceftriaxone and ascorbic acid against subacute deltamethrin-induced nephrotoxicity in rats.

    Science.gov (United States)

    Abdel-Daim, Mohamed M; El-Ghoneimy, Ashraf

    2015-03-01

    Deltamethrin (DLM) is a synthetic class II pyrethroid acaricide and insecticide widely used for veterinary and agricultural purposes. However, its animal and human exposure leads to nephrotoxicity. Our experimental objective was to evaluate protective effects of ceftriaxone and/or ascorbic acid against DLM-induced renal injury in male Wistar albino rats. DLM-treated animals revealed significant alterations in serum biochemical parameters related to renal injury; urea, uric acid and creatinine. There was a significant increase in renal lipid peroxidation and a significant inhibition in antioxidant biomarkers. Moreover, DLM significantly reduced serum acetylcholinesterase (AChE) activity. In addition, It induced serum and kidney tumor necrosis factor-α (TNF-α). Both ceftriaxone and ascorbic acid protect against DLM-induced biochemical alterations in serum and renal tissue when used alone or in combination along with DLM-intoxication. Furthermore, both ceftriaxone and ascorbic acid produced synergetic nephroprotective and antioxidant effects. Therefore, it could be concluded that ceftriaxone and/or ascorbic acid administration able to minimize the toxic effects of DLM through their free radical-scavenging and potent antioxidant activity.

  12. Chloramphenicol or ceftriaxone, or both, as treatment for meningitis in developing countries?

    Science.gov (United States)

    Duke, T; Michael, A; Mokela, D; Wal, T; Reeder, J

    2003-06-01

    To determine in children with meningitis whether there is any difference in mortality and neurological sequelae using chloramphenicol as first line treatment, with a change to ceftriaxone if chloramphenicol resistance is shown in vitro, compared to using ceftriaxone as first line treatment, with a change to chloramphenicol if there is no evidence of in vitro resistance. An observational study with a retrospective control group nested within a randomised trial of fluid management for bacterial meningitis where clinical care was standardised. Chloramphenicol is standard treatment for bacterial meningitis in Papua New Guinea. In the first 150 cases we used chloramphenicol and only changed treatment to ceftriaxone if chloramphenicol resistance for cerebrospinal fluid isolates was proved. After finding 20% of Haemophilus influenzae were resistant to chloramphenicol, and that most affected children had poor outcomes, we changed to an alternative strategy. In the next 196 cases first line treatment was ceftriaxone and treatment was changed to chloramphenicol if the isolated bacteria were found to be susceptible. When chloramphenicol was used as first line treatment for meningitis followed by ceftriaxone when in vitro resistance was shown, there was invariably a very poor outcome in chloramphenicol resistant disease (71% of children died or had severe neurological complications). Using ceftriaxone as first line treatment was effective in reducing mortality and neurological sequelae from chloramphenicol resistant Haemophilus influenzae type (71% v 9%, relative risk 0.13; 95% CI 0.02 to 0.87; p = 0.013). Changing to chloramphenicol if there was no evidence of in vitro resistance was less than half the cost of empirical use of ceftriaxone for a full course for all children with meningitis. Using a third generation cephalosporin as first line treatment is effective in dealing with the problem of poor outcomes from meningitis due to Haemophilus influenzae that is resistant to

  13. Attenuation of morphine-induced dependence and tolerance by ceftriaxone and amitriptyline in mice.

    Science.gov (United States)

    Habibi-Asl, Bohlul; Vaez, Haleh; Najafi, Moslem; Bidaghi, Ali; Ghanbarzadeh, Saeed

    2014-12-01

    Tolerance to and dependence on the analgesic effect of opioids is a pharmacological phenomenon that occurs after their prolonged administration. The aim of this study was to evaluate the protective effects of ceftriaxone and amitriptyline on the development of morphine-induced tolerance and dependence. In this study, 18 groups (9 groups each for tolerance and dependency tests) of mice (n = 8) received saline [10 mL/kg, intraperitoneally (i.p.)], morphine (50 mg/kg, i.p.), ceftriaxone (50 mg/kg, i.p., 100 mg/kg, i.p., and 200 mg/kg, i.p.), amitriptyline (5 mg/kg, i.p., 10 mg/kg, i.p., and 15 mg/kg, i.p.), or a combination of ceftriaxone (50 mg/kg, i.p.) and amitriptyline (5 mg/kg, i.p.) once per day for 4 days for investigation and comparison of the effects of ceftriaxone and amitriptyline on the prevention of dependency and tolerance to morphine. Tolerance was assessed with administration of morphine (9 mg/kg, i.p.) and using the hot plate test on the 5(th) day. In dependency tests, withdrawal symptoms were assessed on the 4(th) day for each animal 30 minutes after the administration of naloxone (4 mg/kg, i.p.; 2 hours after the last dose of morphine). It was found that treatment with ceftriaxone or amitriptyline attenuated the development of tolerance to the antinociceptive effect of morphine and also reduced naloxone-precipitated withdrawal jumping and standing on feet. Furthermore, coadministration of ceftriaxone and amitriptyline at low doses (50 mg/kg, i.p. and 5 mg/kg, i.p., respectively) prior to morphine injection also decreased both morphine-induced tolerance and dependence. Results indicate that the treatment with ceftriaxone and amitriptyline, alone or in combination, could attenuate the development of morphine-induced tolerance and dependence. Copyright © 2014. Published by Elsevier B.V.

  14. Total and unbound ceftriaxone pharmacokinetics in critically ill Australian Indigenous patients with severe sepsis.

    Science.gov (United States)

    Tsai, Danny; Stewart, Penelope; Goud, Rajendra; Gourley, Stephen; Hewagama, Saliya; Krishnaswamy, Sushena; Wallis, Steven C; Lipman, Jeffrey; Roberts, Jason A

    2016-12-01

    In the absence of specific data to guide optimal dosing, this study aimed to describe the pharmacokinetics of ceftriaxone in severely septic Australian Indigenous patients and to assess achievement of the pharmacodynamic target of the regimens prescribed. A pharmacokinetic study was conducted in a remote hospital intensive care unit in patients receiving ceftriaxone dosing of 1 g every 12 h (q12h). Serial blood and urine samples were collected over one dosing interval on two consecutive days. Samples were assayed using a validated chromatography method for total and unbound concentrations. Concentration-time data collected were analysed with a non-compartmental approach. A total of 100 plasma samples were collected from five subjects. Ceftriaxone clearance, volume of distribution at steady-state, elimination half-life and elimination rate constant estimates were 0.9 (0.6-1.5) L/h, 11.2 (7.6-13.4) L, 9.5 (3.2-10.2) h and 0.07 (0.07-0.21) h -1 , respectively. The unbound fraction of ceftriaxone ranged between 14% and 43%, with a higher unbound fraction present at higher total concentrations. The unbound concentrations at 720 min from the initiation of infusion for the first and second dosing intervals were 7.2 (4.8-10.7) mg/L and 7.8 (4.7-12.1) mg/L respectively, which exceeds the minimum inhibitory concentration of all typical target pathogens. In conclusion, the regimen of ceftriaxone 1 g q12h is adequate for critically ill Australian Indigenous patients with severe sepsis caused by non-resistant pathogens. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  15. 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. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  16. Antimicrobial Peptide Novicidin Synergizes with Rifampin, Ceftriaxone, and Ceftazidime against Antibiotic-Resistant Enterobacteriaceae In Vitro.

    Science.gov (United States)

    Soren, Odel; Brinch, Karoline Sidelmann; Patel, Dipesh; Liu, Yingjun; Liu, Alexander; Coates, Anthony; Hu, Yanmin

    2015-10-01

    The spread of antibiotic resistance among Gram-negative bacteria is a serious clinical threat, and infections with these organisms are a leading cause of mortality worldwide. Traditional novel drug development inevitably leads to the emergence of new resistant strains, rendering the new drugs ineffective. Therefore, reviving the therapeutic potentials of existing antibiotics represents an attractive novel strategy. Novicidin, a novel cationic antimicrobial peptide, is effective against Gram-negative bacteria. Here, we investigated novicidin as a possible antibiotic enhancer. The actions of novicidin in combination with rifampin, ceftriaxone, or ceftazidime were investigated against 94 antibiotic-resistant clinical Gram-negative isolates and 7 strains expressing New Delhi metallo-β-lactamase-1. Using the checkerboard method, novicidin combined with rifampin showed synergy with >70% of the strains, reducing the MICs significantly. The combination of novicidin with ceftriaxone or ceftazidime was synergistic against 89.7% of the ceftriaxone-resistant strains and 94.1% of the ceftazidime-resistant strains. Synergistic interactions were confirmed using time-kill studies with multiple strains. Furthermore, novicidin increased the postantibiotic effect when combined with rifampin or ceftriaxone. Membrane depolarization assays revealed that novicidin alters the cytoplasmic membrane potential of Gram-negative bacteria. In vitro toxicology tests showed novicidin to have low hemolytic activity and no detrimental effect on cell cultures. We demonstrated that novicidin strongly rejuvenates the therapeutic potencies of ceftriaxone or ceftazidime against resistant Gram-negative bacteria in vitro. In addition, novicidin boosted the activity of rifampin. This strategy can have major clinical implications in our fight against antibiotic-resistant bacterial infections. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  17. CEFTRIAXONE RELATED ADVERSE DRUG REACTIONS IN CHILDREN IN A TERTIARY CARE HOSPITAL, KOLKATA, WEST BENGAL, INDIA

    Directory of Open Access Journals (Sweden)

    Anjan Adhikari

    2014-06-01

    Full Text Available Ceftriaxone is a third-generation cephalosporin antibiotic, which has broad-spectrum activity against Gram-positive and Gram-negative bacteria. It is a frequently used antibiotic in children worldwide. Studies revealed a number of adverse reactions related to this third generation antibiotic. A survey was done where data related with adverse drug reactions (ADRs were collected for three months from the Department of Pediatrics of a tertiary care hospital, Kolkata, West Bengal, India and then evaluated. In the study, fifteen ADRs were detected. Ceftriaxone itself or its combinations correlated with more than thirty three percent (33.4% adverse reaction cases in this study. Most common adverse drug reactions in the present study population were different types of rashes like urticaria and maculopapular eruptions.

  18. 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

  19. Synthesis, spectral, thermal and antimicrobial studies of some new tri metallic biologically active ceftriaxone complexes

    Science.gov (United States)

    Ali, Alaa E.

    2011-01-01

    Iron, cobalt, nickel and copper complexes of ceftriaxone were prepared in 1:3 ligand:metal ratio to examine the ligating properties of the different moieties of the drug. The complexes were found to have high percentages of coordinated water molecules. The modes of bonding were discussed depending on the infrared spectral absorption peaks of the different allowed vibrations. The Nujol mull electronic absorption spectra and the magnetic moment values indicated the Oh geometry of the metal ions in the complexes. The ESR spectra of the iron, cobalt, and copper complexes were determined and discussed. The thermal behaviors of the complexes were studied by TG and DTA techniques. The antimicrobial activities of the complexes were examined and compared to that of the ceftriaxone itself.

  20. Ceftriaxone-resistant Salmonella Typhi carries an IncI1-ST31 plasmid encoding CTX-M-15.

    Science.gov (United States)

    Djeghout, Bilal; Saha, Senjuti; Sajib, Mohammad Saiful Islam; Tanmoy, Arif Mohammad; Islam, Maksuda; Kay, Gemma L; Langridge, Gemma C; Endtz, Hubert P; Wain, John; Saha, Samir K

    2018-04-04

    Ceftriaxone is the drug of choice for typhoid fever and the emergence of resistant Salmonella Typhi raises major concerns for treatment. There are an increasing number of sporadic reports of ceftriaxone-resistant S. Typhi and limiting the risk of treatment failure in the patient and outbreaks in the community must be prioritized. This study describes the use of whole genome sequencing to guide outbreak identification and case management. An isolate of ceftriaxone-resistant S. Typhi from the blood of a child taken in 2000 at the Popular Diagnostic Center, Dhaka, Bangladesh was subjected to whole genome sequencing, using an Illumina NextSeq 500 and analysis using Geneious software.Results/Key findings. Comparison with other ceftriaxone-resistant S. Typhi revealed an isolate from the Democratic Republic of the Congo in 2015 as the closest relative but no evidence of an outbreak. A plasmid belonging to incompatibility group I1 (IncI1-ST31) which included blaCTX-M-15 (ceftriaxone resistance) associated with ISEcp-1 was identified. High similarity (90 %) was seen with pS115, an IncI1 plasmid from S. Enteritidis, and with pESBL-EA11, an incI1 plasmid from E. coli (99 %) showing that S. Typhi has access to ceftriaxone resistance through the acquisition of common plasmids. The transmission of ceftriaxone resistance from E. coli to S. Typhi is of concern because of clinical resistance to ceftriaxone, the main stay of typhoid treatment. Whole genome sequencing, albeit several years after the isolation, demonstrated the success of containment but clinical trials with alternative agents are urgently required.

  1. 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

  2. Ceftriaxone mediated rescue of nigral oxidative damage and motor deficits in MPTP model of Parkinson's disease in rats.

    Science.gov (United States)

    Bisht, Rohit; Kaur, Baninder; Gupta, Hitu; Prakash, Atish

    2014-09-01

    Parkinson's disease is a neurodegenerative disorder characterized by the loss of dopamine neurons in the substantia nigra pars compacta along with decreased striatal dopamine levels, and consequent extra pyramidal motor dysfunctions occur. It has been reported that Ceftriaxone, a β-lactam antibiotic recently had shown to have neuroprotective effects in various neurodegenerative disorder. Therefore the present study was designed to investigate the effects of Ceftriaxone (CFX) in a MPTP model of Parkinson in rats. MPTP was administered intranigrally for the induction of PD in Male Wistar rats. Ceftriaxone (100 and 200mg/kg) and Ropinirole (1.5 and 3mg/kg) were given intraperitonially, after induction of Parkinson's disease for 14 days. Different behavioral performance was carried on 1st, 14th, 21st, 28th consecutive days and biochemical parameters were estimated on 28th day. Central administration of MPTP showed significant impairment of motor behavior and marked increase of oxidative damage and neuro-inflammmation in rats. However, post treatment with Ceftriaxone (100 and 200mg/kg) significantly improved the motor deficits and attenuated the oxidative damage indicating decreased rise of LPO and nitrite concentration and restored the decreased activities of endogenous antioxidant enzyme (Glutathione, Catalase, SOD). In addition Ceftriaxone also attenuates the pro-inflammatory cytokines like TNF-α and IL-β in striatum region of MPTP induced PD in rats. Ropinirole (1.5mg/kg) pretreatment with sub-effective dose of a Ceftriaxone (100mg/kg) had significantly enhanced the protective effect of Ceftriaxone as compare to its effect with per se group. These results suggested that Ceftriaxone exhibit Neuroprotective effect by mediating brain antioxidant defense mechanism and by up regulating of dopaminergic pathway and down regulation of glutamatergic pathway. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Ceftriaxone prevents and reverses behavioral and neuronal deficits in an MPTP-induced animal model of Parkinson's disease dementia.

    Science.gov (United States)

    Hsu, Chao-Yu; Hung, Ching-Sui; Chang, Hung-Ming; Liao, Wen-Chieh; Ho, Shih-Chun; Ho, Ying-Jui

    2015-04-01

    Glutamatergic hyperactivity plays an important role in the pathophysiology of Parkinson's disease (PD). Ceftriaxone increases expression of glutamate transporter 1 (GLT-1) and affords neuroprotection. This study was aimed at clarifying whether ceftriaxone prevented, or reversed, behavioral and neuronal deficits in an 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD rat model. Male Wistar rats were injected daily with either ceftriaxone starting 5 days before or 3 days after MPTP lesioning (day 0) or saline and underwent a bar-test on days 1-7, a T-maze test on days 9-11, and an object recognition test on days 12-14, then the brains were taken for histological evaluation on day 15. Dopaminergic degeneration in the substantia nigra pars compacta and striatum was observed on days 3 and 15. Motor dysfunction in the bar test was observed on day 1, but disappeared by day 7. In addition, lesioning resulted in deficits in working memory in the T-maze test and in object recognition in the object recognition task, but these were not observed in rats treated pre- or post-lesioning with ceftriaxone. Lesioning also caused neurodegeneration in the hippocampal CA1 area and induced glutamatergic hyperactivity in the subthalamic nucleus, and both changes were suppressed by ceftriaxone. Increased GLT-1 expression and its co-localization with astrocytes were observed in the striatum and hippocampus in the ceftriaxone-treated animals. To our knowledge, this is the first study showing a relationship between ceftriaxone-induced GLT-1 expression, neuroprotection, and improved cognition in a PD rat model. Ceftriaxone may have clinical potential for the prevention and treatment of dementia associated with PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Ceftriaxone rescues hippocampal neurons from excitotoxicity and enhances memory retrieval in chronic hypobaric hypoxia.

    Science.gov (United States)

    Hota, Sunil K; Barhwal, Kalpana; Ray, Koushik; Singh, Shashi B; Ilavazhagan, G

    2008-05-01

    Exposure to high altitude is known to cause impairment in cognitive functions in sojourners. The molecular events leading to this behavioral manifestation, however, still remain an enigma. The present study aims at exploring the nature of memory impairment occurring on chronic exposure to hypobaric hypoxia and the possible role of glutamate in mediating it. Increased ionotropic receptor stimulation by glutamate under hypobaric hypoxic conditions could lead to calcium mediated excitotoxic cell death resulting in impaired cognitive functions. Since glutamate is cleared from the synapse by the Glial Glutamate Transporter, upregulation of the transporter can be a good strategy in preventing excitotoxic cell death. Considering previous reports on upregulation of the expression of Glial Glutamate Transporter on ceftriaxone administration, the therapeutic potential of ceftriaxone in ameliorating hypobaric hypoxia induced memory impairment was investigated in male Sprague Dawley rats. Exposure to hypobaric hypoxia equivalent to an altitude of 7600 m for 14 days lead to oxidative stress, chromatin condensation and neuronal degeneration in the hippocampus. This was accompanied by delayed memory retrieval as evident from increased latency and pathlength in Morris Water Maze. Administration of ceftriaxone at a dose of 200 mg/kg for 7 days and 14 days during the exposure on the other hand improved the performance of rats in the water maze along with decreased oxidative stress and enhanced neuronal survival when compared to hypoxic group without drug administration. An increased expression of Glial Glutamate Transporter was also observed following drug administration indicating faster clearance of glutamate from the synapse. The present study not only brings to light the effect of longer duration of exposure to hypobaric hypoxia on the memory functions, but also indicates the pivotal role played by glutamate in mediating excitotoxic neuronal degeneration at high altitude. The

  5. Ceftriaxone treatment for two neurosyphilis cases presenting with cognitive and psychiatric symptoms

    Directory of Open Access Journals (Sweden)

    Melek Kandemir

    2011-06-01

    Full Text Available Syphilis is a disease caused by the spirochetal bacterium Treponema Pallidum subspecies pallidum. The route of transmission of syphilis is almost always through sexual contact. The incidence of syphilis decreased significantly with the introduction of penicilin in the 1940s but rose sharply again with the advent of HIV infection in the 1980s. Tertiary or late syphilis develops years after the initial infection and can involve any organ system. Neurologic involvement occurs in up to 10 percent of patients with untreated syphilis. General paresis, the clinical form of neurosyphilis most associated with psychiatric symptoms, occurs with parenchymatous disease and involves neuronal loss as opposed to the vascular lesions or inflammatory changes characteristic of most other forms of neurosyphilis. In the classic description, after early psychiatric manifestations such as mood changes, psychosis, or cognitive changes, demantia becomes prominent. Penicillin is the only drug that has proved effective in the treatment of neurosyphilis. Ceftriaxone is used as an alternative treatment in patients with penicilin allergy. This article reports two cases of neurosyphilis one of whom is presented with dementia and the other with psychiatric symptoms. Both of them are treated with ceftriaxone. Our purpose is to reveal the fact that ceftriaxone is a succesful alternative treatment for the cases with penicilin allergy and to emphasize the importance of neurosyphilis in the differential diagnosis for the psychiatric cases that are resistant to treatment

  6. Ceftriaxone pretreatment reduces the propensity of postpartum depression following stroke during pregnancy in rats.

    Science.gov (United States)

    Guan, Yonghong; Liu, Xianying; Su, Yuetian

    2016-10-06

    Ischemic stroke increases the propensity to develop depression in humans and laboratory animals, and we hypothesized that such an incidence during pregnancy may increase the risk for the development of postpartum depression (PPD). To test this hypothesis, we used bilateral common carotid arteries occlusion (BCCAO) to induce transient cerebral ischemia in pregnant rats, and evaluated its effects on subsequent development of PPD in dams. Additionally, we investigated whether ceftriaxone pretreatments before the induction of brain ischemia could alter the propensity of PPD. We found that 15min BCCAO during pregnancy enhanced immobility time and reduced the frequency of swimming or climbing behaviors in the forced swim test, and decreased the sucrose preference in dams at postpartum day 21. Such behavioral alterations were associated with lower level of GLT-1 expression in the medial prefrontal cortical regions (mPFC) of PPD dams. Specifically, mPFC GLT-1 expression levels in dams with ischemia history were correlated with sucrose preference levels at postpartum day 21. Finally, ceftriaxone pretreatment (200mg/kg/day, 5days) before the 15min BCCAO prevented the development of PPD, and prevented the reduction of GLT-1 expression in the mPFC. Taken together, our results suggested that ceftriaxone pretreatment before brain ischemia during pregnancy may reduce the propensity for the development of PPD by preventing the loss of GLT-1 expression in the mPFC. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Drug utilisation review (DUR) of the third generation cephalosporins. Focus on ceftriaxone, ceftazidime and cefotaxime.

    Science.gov (United States)

    Adu, A; Armour, C L

    1995-09-01

    Six parenteral third generation cephalosporins have been introduced into clinical use in the past 10 years. The 3 most frequently available agents are cefotaxime, ceftriaxone and ceftazidime. These 3 third generation cephalosporins are characterised by a broad spectrum of activity and increased stability to beta-lactamases compared with the first and second generation cephalosporins. However, there are growing numbers of reports of resistance to these agents with increasing use. The major differences in the properties of the 3 agents are the long half-life of ceftriaxone and its dual route of elimination. Ceftazidime is best restricted to Pseudomonas aeruginosa infections where other agents are contraindicated or ineffective. Cefotaxime and ceftriaxone can be used in nosocomial Gram-negative infections where P. aeruginosa can be ruled out. The types and incidences of adverse drug reactions are not different for the 3 agents. A number of drug utilisation review (DUR) studies of these agents in the hospital setting have reported a considerable incidence of inappropriate use and substantial avoidable costs. There are methodological problems with most of the DUR studies, especially the criteria and the methods of cost estimation. The use of pharmacoeconomic methodology could ensure more realistic cost estimation; however, outcome data are, in most cases, not available.

  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.

  9. Antimicrobial resistance, genetic resistance determinants for ceftriaxone and molecular epidemiology of Neisseria gonorrhoeae isolates in Nanjing, China.

    Science.gov (United States)

    Chen, Shao-Chun; Yin, Yue-Ping; Dai, Xiu-Qin; Unemo, Magnus; Chen, Xiang-Sheng

    2014-11-01

    Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major problem worldwide. This study investigated the AMR, genetic ceftriaxone resistance determinants and molecular epidemiology of N. gonorrhoeae in Nanjing, China. N. gonorrhoeae isolates were collected in 2007 (n = 198) and 2012 (n = 80). The susceptibility to ceftriaxone, spectinomycin, ciprofloxacin and tetracycline was determined using an agar-dilution method. The ceftriaxone resistance determinants penA, mtrR and penB were examined using sequencing. N. gonorrhoeae multi-antigen sequence typing (NG-MAST) was performed for molecular epidemiology. All isolates were resistant to ciprofloxacin, 42.4% produced β-lactamase and 34.9% showed high-level resistance to tetracycline (MIC ≥16 mg/L). In total, 5.4% of isolates were resistant to ceftriaxone; however, all of these isolates were obtained in 2007 and the susceptibility to ceftriaxone appeared to have increased. All isolates were susceptible to spectinomycin. No penA mosaic alleles were found. Non-mosaic penA alleles with A501T and G542S alterations, an H105Y alteration in mtrR and an A102D/N alteration in porB1b were statistically associated with decreased susceptibility or resistance to ceftriaxone. The most prevalent NG-MAST sequence types (STs) were ST568 (n = 13), ST270 (n = 9) and ST421 (n = 7). ST270 was the most common ST in isolates with decreased susceptibility or resistance to ceftriaxone. Ceftriaxone, ideally 500 mg and together with azithromycin (1-2 g), should be recommended for treatment of gonorrhoea in Nanjing, China. However, N. gonorrhoeae strains with resistance to ceftriaxone have been found in Nanjing. NG-MAST and ceftriaxone resistance determinant analysis can be valuable to supplement the antimicrobial resistance surveillance in China, which needs to be further strengthened. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights

  10. The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study

    Directory of Open Access Journals (Sweden)

    Srisuda Assawapalanggool

    2018-01-01

    Full Text Available Abstract Background Cesarean surgical site infections (SSIs can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to obstetricians’ preferences despite clear guidelines on preoperative antibiotic prophylaxis. This study aimed to compare the efficacy of ampicillin and ceftriaxone in preventing cesarean SSIs. Methods The observational prospective cohort study was conducted at a tertiary hospital in Thailand from 1 January 2007 to 31 December 2012. Propensity scores for ceftriaxone prophylaxis were calculated from potential influencing confounders. The cesarean SSI rates of the ceftriaxone group vs. those of the ampicillin prophylactic group were estimated by multilevel mixed-effects Poisson regression nested by propensity score. Results Data of 4149 cesarean patients were collected. Among these, 911 patients received ceftriaxone whereas 3238 patients received ampicillin as preoperative antibiotic prophylaxis. The incidence of incisional SSIs was (0.1% vs. 1.2%; p = 0.001 and organ space SSIs was (1.2% vs. 2.9%; p = 0.003 in the ceftriaxone group compared with the ampicillin group. After adjusting for confounders, the rate ratios of incisional and organ/space SSIs in the ceftriaxone compared with the ampicillin group did not differ (RR, 0.23; 95% CI 0.03–1.78, and (RR, 1.62; 95% CI 0.83–3.18, respectively. Conclusion These data indicate no difference exists between ampicillin and ceftriaxone to prevent SSIs after cesarean section. Ampicillin may be used as antibiotic prophylaxis in cesarean section.

  11. Trends in antimicrobial susceptibility for azithromycin and ceftriaxone in Neisseria gonorrhoeae isolates in Amsterdam, the Netherlands, between 2012 and 2015.

    Science.gov (United States)

    Wind, Carolien M; Schim van der Loeff, Maarten F; van Dam, Alje P; de Vries, Henry Jc; van der Helm, Jannie J

    2017-01-05

    Resistance of Neisseria gonorrhoeae to azithromycin and ceftriaxone has been increasing in the past years. This is of concern since the combination of these antimicrobials is recommended as the first-line treatment option in most guidelines. To analyse trends in antimicrobial resistance, we retrospectively selected all consultations with a positive N. gonorrhoeae culture at the sexually transmitted infection clinic, Amsterdam, the Netherlands, from January 2012 through September 2015. Minimum inhibitory concentrations (MICs) for azithromycin and ceftriaxone were analysed per year, and determinants associated with decreased susceptibility to azithromycin (MIC > 0.25 mg/L) or ceftriaxone (MIC > 0.032 mg/L) were assessed. Between 2012 and 2015 azithromycin resistance (MIC > 0.5 mg/L) was around 1.2%, the percentage of isolates with intermediate MICs (> 0.25 and ≤ 0.5 mg/L) increased from 3.7% in 2012, to 8.6% in 2015. Determinants associated with decreased azithromycin susceptibility were, for men who have sex with men (MSM), infections diagnosed in the year 2014, two infected sites, and HIV status (HIV; associated with less decreased susceptibility); for heterosexuals this was having ≥ 10 sex partners (in previous six months). Although no ceftriaxone resistance (MIC > 0.125 mg/L) was observed during the study period, the proportion of isolates with decreased ceftriaxone susceptibility increased from 3.6% in 2012, to 8.4% in 2015. Determinants associated with decreased ceftriaxone susceptibility were, for MSM, infections diagnosed in 2014, and pharyngeal infections; and for heterosexuals, infections diagnosed in 2014 or 2015, being of female sex, and having ≥ 10 sex partners. Continued decrease of azithromycin and ceftriaxone susceptibility will threaten future treatment of gonorrhoea. Therefore, new treatment strategies are warranted. This article is copyright of The Authors, 2017.

  12. Effects of ceftriaxone on GLT1 isoforms, xCT and associated signaling pathways in P rats exposed to ethanol.

    Science.gov (United States)

    Rao, P S S; Saternos, Hannah; Goodwani, Sunil; Sari, Youssef

    2015-07-01

    Several studies have demonstrated a correlation between extracellular glutamate concentration in the mesolimbic reward pathway and alcohol craving. Extracellular glutamate concentration is regulated by several glutamate transporters. Glial glutamate transporter 1 (GLT1) is one of them that regulates the majority of extracellular glutamate concentration. In addition, cystine/glutamate antiporter (xCT) is another transporter that regulates extracellular glutamate. We focus in this study to determine the effects of ceftriaxone, β-lactam antibiotic, on glial proteins such as GLT1 isoforms, xCT, glutamate aspartate transporter (GLAST), and several associated signaling pathways as well as ethanol intake in P rats. Additionally, to examine the onset of signaling pathways associated with GLT1 upregulation following ceftriaxone treatment, we tested 2- versus 5-day daily dosing of ceftriaxone. Ceftriaxone treatment (100 mg/kg), 2 and 5 days, resulted in about five fold reduction in ethanol intake by P rats. The reduction in ethanol intake was associated with significantly enhanced expression of GLT1, GLT1a, GLT1b, and xCT in the nucleus accumbens (NAc) and prefrontal cortex (PFC) of 5-day ceftriaxone-treated P rats. Two-day-treated P rats showed marked changes in expression of these glutamate transporters in the PFC but not in the NAc. Importantly, ceftriaxone-treated P rats (2 and 5 days) demonstrated enhanced phosphorylation of Akt and nuclear translocation of nuclear factor kappaB (NFκB) in the NAc and PFC compared to control animals. These findings demonstrate that ceftriaxone treatment induced upregulation of GLT1, GLT1 isoforms, and xCT in association with activation of the Akt-NFκB signaling pathway.

  13. Preventive Ceftriaxone in Patients with Stroke Treated with Intravenous Thrombolysis: Post Hoc Analysis of the Preventive Antibiotics in Stroke Study.

    Science.gov (United States)

    Vermeij, Jan-Dirk; Westendorp, Willeke F; Roos, Yvo B; Brouwer, Matthijs C; van de Beek, Diederik; Nederkoorn, Paul J

    2016-01-01

    The Preventive Antibiotics in Stroke Study (PASS), a randomized open-label masked endpoint trial, showed that preventive ceftriaxone did not improve functional outcome at 3 months in patients with acute stroke (adjusted common OR 0.95; 95% CI 0.82-1.09). Post-hoc analyses showed that among patients who received intravenous thrombolysis (IVT), patients who received ceftriaxone had a significantly better outcome as compared with the control group. This study aimed to gain more insight into the characteristics of these patients. In PASS, 2,550 patients were randomly assigned to preventive antibiotic treatment with ceftriaxone or standard care. In current post-hoc analysis, 836 patients who received IVT were included. Primary outcome included functional status on the modified Rankin Scale, analyzed with adjusted ordinal regression. Secondary outcomes included infection rate and symptomatic intracerebral hemorrhage (sICH) rate. For all patients in PASS, the p value for the interaction between IVT and preventive ceftriaxone regarding functional outcome was 0.03. Of the 836 IVT-treated patients, 437 were administered ceftriaxone and 399 were allocated to the control group. Baseline characteristics were similar. In the IVT subgroup, preventive ceftriaxone was associated with a significant reduction in unfavorable outcome (adjusted common OR 0.77; 95% CI 0.61-0.99; p = 0.04). Mortality at 3 months was similar (OR 0.75; 95% CI 0.48-1.18). Preventive ceftriaxone was associated with a reduction in infections (OR 0.43; 95% CI 0.28-0.66), and a trend towards an increased risk for sICH (OR 3.09; 95% CI 0.85-11.31). Timing of ceftriaxone administration did not influence the outcome (aOR 1.00; 95% CI 0.98-1.03; p = 0.85). According to the post-hoc analysis of PASS, preventive ceftriaxone may improve the functional outcome in IVT-treated patients with acute stroke, despite a trend towards an increased rate of post-IVT-sICH. © 2016 S. Karger AG, Basel.

  14. Population Pharmacokinetics of Fixed Dose Combination of Ceftriaxone and Sulbactam in Healthy and Infected Subjects.

    Science.gov (United States)

    Sharma, Vishnu Dutt; Singla, Aman; Chaudhary, Manu; Taneja, Manish

    2016-10-01

    Increased antibacterial resistance (ABR) and limited drug discovery warrant optimized use of available antibiotics. One option is to rationally combine two antibiotics (fixed dose combination (FDC)) that may delay or prevent emergence of ABR in notorious pathogen. Major concern with FDC is the mutual interaction of its components that might influence their pharmacokinetic (PK) profile, requiring reassessing of whole formulation (adding cost and time). The interaction can be identified by comparing PK profile of a drug present in FDC with its independent entity. An open-label, crossover, single-dose comparative PK study of FDC (ceftriaxone and sulbactam) with their individual reference formulations was performed in 24 healthy adult subjects. No mutual PK interactions between ceftriaxone and sulbactam were observed. Pharmacokinetic data was used to develop a population-PK model to understand between-subject variability (BSV). Pharmacokinetics of ceftriaxone/sulbactam was explained by one and two compartment models, respectively. The subject's "weight" was identified as a covariate explaining BSV. Both internal and external validations (healthy/infected subjects) were done. The model-derived population-PK parameters of FDC's active components in infected subjects were similar to literature reported values of individual components. Efficacies of various FDC dosage regimens over a range of minimum inhibitory concentrations (MICs) were assessed by Monte Carlo simulations using population-PK parameters of infected/healthy subjects. In infected subjects, 3 g FDC/24 h can treat bacteria with MIC ≤8 μg/mL, while for MIC 8-32 μg/mL, 3 g FDC/12 h is recommended. Lastly, the developed population-PK model was successfully used to predict drug exposure in pediatric population.

  15. Moxifloxacin versus Clindamycin/Ceftriaxone in the management of odontogenic maxillofacial infectious processes: A preliminary, intrahospital, controlled clinical trial

    Science.gov (United States)

    Gómez-Arámbula, Hansel; Hidalgo-Hurtado, Antonio; Rodríguez-Flores, Rosaura; González-Amaro, Ana-María; Garrocho-Rangel, Arturo

    2015-01-01

    Background The aim of this study was to compare the days of hospitalization length between patients treated with Moxifloxacin with that of patients treated with a Clindamycin/Ceftriaxone combination and additionally, to isolate and identify the oral pathogens involved in orofacial odontogenic infections. Material and Methods A pilot-controlled-clinical-trial was carried out on hospitalized patients with cervicofacial odontogenic abscesses or cellulitis, who were randomly asigned to two study groups: 1) patients who received Moxifloxacin, and 2) patients receiving Clindamycin/Ceftriaxone combination. Infiltrate samples were collected through transdermic or transmucosal punction and later cultured on a media specific for aerobic and anaerobic microorganisms. Mean hospitalization duration in days until hospital discharge and susceptibility assessment in rates were established. Results Mean hospitalization time in days of patients treated with Moxifloxacin was 7.0 ± 1.6 days, while in the Clindamycin/Ceftriaxone group, this was 8.4 ± 1.8 days, although significant difference could not be demonstrated (p=0.074). A total of 43 strains were isolated, all of these Gram-positive. These strains appeared to be highly sensitive to Moxifloxacin (97.5%) and Ceftriaxone (92.5%). Conclusions Moxifloxacin and Ceftriaxone appear to be potential convenient and rational alternatives to traditional antibiotics, for treating severe odontogenic infections, in conjunction with surgical extraoral incision, debridement, and drainage. Key words:Orofacial odontogenic infections, antimicrobial susceptibility, antimicrobial resistance. PMID:26644841

  16. Intratracheal co-administration of antioxidants and ceftriaxone reduces pulmonary injury and mortality rate in an experimental model of sepsis.

    Science.gov (United States)

    Galvão, Andre M; Wanderley, Marcela S O; Silva, Roberto A; Filho, Carlos A M; Melo-Junior, Mário R; Silva, Luciano A; Streck, Emílio L; Dornelas de Andrade, Armele F; Souza Maia, Maria B; Barbosa de Castro, Celia M M

    2014-10-01

    Recent studies showed that both sepsis and antibiotic therapy are associated with cell death and linked to reactive oxygen species generation. This study investigated the effects of intratracheal administration of combinations of antioxidants (n-acetyl cysteine (NAC), vitamins C and E) in the treatment of sepsis-induced lung injury. Ninety-six male Wistar rats subjected to sepsis were treated with ceftriaxone plus NAC with or without vitamins C and E and compared to appropriate controls. As an index of oxidative damage protein carbonyls, sulfhydryl groups, lipid peroxidation and superoxide anion were measured, as well as superoxide dismutase and catalase. Histopathological alterations and mortality rate were also analyzed. Twenty-four hours after sepsis induction, markers of oxidative stress increased in all lungs examined. Ceftriaxone plus intratracheal combination of NAC, vitamins C and E decreased lung injury in infected animals by reducing superoxide anion production (54%), lipid peroxidation (53%) and protein carbonyl (58%) and restored the redox status (7.5 times). This therapy also reduced the imbalance of antioxidant enzymes activities and attenuated the alveolar architectural disorganization, inflammatory cell infiltration and pulmonary oedema. Survival increased from 66.6% with ceftriaxone to 83.2% with ceftriaxone plus antioxidants. Ceftriaxone plus intratracheal co-administration of antioxidants provides better protection, by decreasing pulmonary oxidative stress, limiting histophatological alterations and improving survival. Antioxidants should be explored as a co-adjuvant in the treatment of severe lung injury. © 2014 Asian Pacific Society of Respirology.

  17. Ceftriaxone attenuates ethanol drinking and restores extracellular glutamate concentration through normalization of GLT-1 in nucleus accumbens of male alcohol-preferring rats.

    Science.gov (United States)

    Das, Sujan C; Yamamoto, Bryan K; Hristov, Alexandar M; Sari, Youssef

    2015-10-01

    Alteration of glutamatergic-neurotransmission is a hallmark of alcohol dependence. We have previously reported that chronic ethanol-drinking downregulated glutamate transporter 1 (GLT-1) in nucleus accumbens (NAc) in male P rats in a manner that was reversed by ceftriaxone treatment. However, the effect of ceftriaxone on extracellular glutamate concentrations in NAc after chronic ethanol-drinking has not yet been studied. In the present study, male P rats were treated with ceftriaxone (100 mg/kg/day, i.p.) for five consecutive days following five-weeks of free choice ethanol (15% and 30%) drinking. In vivo microdialysis was performed to measure the extracellular glutamate concentrations in NAc and the effect of blockade of GLT-1 with dihydrokainic acid (DHK) on extracellular glutamate in NAc of ceftriaxone-treated rats was determined. Ceftriaxone treatment attenuated ethanol intake as well as ethanol preference. Extracellular glutamate was significantly higher in NAc after five-weeks of ethanol drinking in saline-treated compared to water control rats. Ceftriaxone treatment blocked the increase extracellular glutamate produced by ethanol intake. Blockade of GLT-1 by DHK reversed the effects of ceftriaxone on glutamate and implicated the role of GLT-1 in the normalization of extracellular glutamate by ceftriaxone. In addition, GLT-1 protein was decreased in ethanol exposed animals and ceftriaxone treatment reversed this deficit. Ceftriaxone treatment also increased glutamine synthetase activity in NAc but not in PFC as compared to ethanol drinking saline-treated rats. Our present study demonstrates that ceftriaxone treatment prevents ethanol drinking in part through normalization of extracellular glutamate concentrations in NAc of male P rats via GLT-1. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Impact of the FDA warning of potential ceftriaxone and calcium interactions on drug use policy in clinical practice.

    Science.gov (United States)

    Esterly, John S; Steadman, Emily; Scheetz, Marc H

    2011-06-01

    In September 2007, the FDA issued an alert recommending that ceftriaxone and calcium-containing solutions should not be administered to any patient within 48 h of each other. Due to the widespread use of ceftriaxone, significant concern was expressed by the greater healthcare community about the warning, which the FDA eventually retracted in April of 2009. We sought to quantify the impact of the warning on healthcare institutions. A survey was administered to the membership of the Society of Infectious Diseases Pharmacists to quantify perceived changes in ceftriaxone use among healthcare institutions across the United States. A survey of Infectious Diseases experts was conducted. Participants were queried for hospital policies/drug use statistics during two times: immediately after the FDA warning and approximately 13 months post warning (preceding the FDA retraction). Related changes in formulary, drug-use policy, and the number of employee hours that were devoted to addressing the FDA warning were assessed. Ninety-four surveys representing 94 hospital systems were included in the analysis. Approximately half (n = 49, 52%) of respondent institutions enacted at least one drug-use policy change based on the warning; one institution removed ceftriaxone from a clinical protocol. Institutions' final interpretations of the warning differed slightly from initial understanding of the warning, and there was an overall minor decrease in the perceived use of ceftriaxone. The majority of those surveyed (n = 70, 74%) estimated that their respective institutions devoted between 1 and 49 employee hours to address the warning. Hospitals with ID pharmacists had minimal changes to ceftriaxone use after the 2007 FDA warning. Specialized pharmacists may be uniquely situated to help hospitals interpret global recommendations locally.

  19. Radiolabeling of Ceftriaxone with 99mTc as a Targeting Radiopharmaceutical for Staphylococcus Aureus Detection in Mouse Model

    Directory of Open Access Journals (Sweden)

    Akram Fazli

    2012-03-01

    Full Text Available Introduction Bacterial infection is one of the major causes of morbidity and mortality especially in developing countries. Nuclear medicine has an important role in helping the diagnosis of deep-seated infections by developing more specific radiopharmaceuticals. The aim of this study was to evaluate 99mTc-labeling ceftriaxone as a new radiopharmaceutical for Staphylococcus aureus infection imaging in nuclear medicine. Materials and Methods Radiolabeling of ceftriaxone was carried out by adding 370 MBq of 99mTc to 10 mg of ceftriaxone in the presence of 50 µg of SnCl2.2H2O at pH=5. The radiochemical purity and stability tests at room temperature and human blood serum were evaluated with ITLC. Intramuscular infection was induced by injection of Staphylococcus aureus into the left thigh muscle of the mice. The biodistribution of 99mTc-ceftriaxone was studied in normal and infected mice at various times post-injection. Results Radiochemical purity of the product was 94.5±5.4% with a good stability at room temperature and human serum, 80.6% and 71.2% after 24 h, respectively. The biodistribution studies showed the localization of 99mTc-ceftriaxone at the site of infection with high sensitivity without any significant accumulation in vital organs. Conclusion Due to the ease of 99mTc-ceftriaxone conjugation method, high labeling efficiency, and high uptake in the infected muscle, it may provide a promising candidate as a targeting radiopharmaceutical for imaging infectious foci due to Staphylococcus aureus in nuclear medicine.

  20. Comparative evaluation of ceftriaxone- and cefotaxime-induced biliary pseudolithiasis or nephrolithiasis: A prospective study in 154 children.

    Science.gov (United States)

    Ustyol, L; Bulut, M D; Agengin, K; Bala, K A; Yavuz, A; Bora, A; Demiroren, K; Dogan, M

    2017-06-01

    Biliary lithiasis, or sludge, and nephrolithiasis have been reported as a possible complication of ceftriaxone therapy. However, no study related to cefotaxime-induced biliary pseudolithiasis or nephrolithiasis was observed in the literature. Therefore, we investigated the comparative formation of biliary pseudolithiasis and nephrolithiasis after cefotaxime and ceftriaxone therapies. The patients treated with ceftriaxone or cefotaxime were enrolled during the study period. Ultrasound imaging of the biliary and urinary tract was performed in all patients before and after the treatment. The patients with a positive sonographic finding at the end of treatment were followed up with monthly ultrasonography for 3 months. The present study showed that abnormal biliary sonographic findings were demonstrated in 18 children (20.9%) treated with ceftriaxone, 13 (15.1%) had biliary lithiasis, 5 (5.8%) had biliary sludge and 1 (1.2%) had nephrolithiasis. Abnormal biliary sonographic findings were demonstrated in only four (5.9%) children treated with cefotaxime who had biliary sludge and only one (1.5%) had nephrolithiasis. It was observed that older age was at significantly higher risk of developing biliary sludge or stone formation. Receiver operating characteristic analysis was performed to determine the residual risk and analysis found that 4.5 years was the cut-off value for age. The present study is unique in the literature for reporting for the first time gall bladder sludge and nephrolithiasis associated with cefotaxime use. Therefore, patients treated with cefotaxime should be monitored for serious complications like patients treated with ceftriaxone. Nevertheless, if third-generation cephalosporin is used, cefotaxime is recommended to be used rather than ceftriaxone.

  1. Effects of ceftriaxone on the behavioral and neuronal changes in an MPTP-induced Parkinson's disease rat model.

    Science.gov (United States)

    Ho, Shih-Chun; Hsu, Chih-Chuan; Pawlak, Cornelius Rainer; Tikhonova, Maria A; Lai, Te-Jen; Amstislavskaya, Tamara G; Ho, Ying-Jui

    2014-07-15

    Hyperactivity of the glutamatergic system is involved in excitotoxicity and neurodegeneration in Parkinson's disease (PD) and treatment with drugs modulating glutamatergic activity may have beneficial effects. Ceftriaxone has been reported to increase glutamate uptake by increasing glutamate transporter expression. The aim of this study was to determine the effects of ceftriaxone on working memory, object recognition, and neurodegeneration in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD rat model. MPTP was stereotaxically injected into the substantia nigra pars compacta (SNc) of male Wistar rats. Then, starting the next day (day 1), the rats were injected daily with either ceftriaxone (200 mg/kg/day, i.p.) or saline for 14 days and underwent a T-maze test on days 8-10 and an object recognition test on days 12-14. MPTP-lesioned rats showed impairments of working memory in the T-maze test and of recognition function in the object recognition test. The treatment of ceftriaxone decreased the above MPTP-induced cognitive deficits. Furthermore, this study provides evidence that ceftriaxone inhibits MPTP lesion-induced dopaminergic degeneration in the nigrostriatal system, microglial activation in the SNc, and cell loss in the hippocampal CA1 area. In conclusion, these data support the idea that hyperactivity of the glutamatergic system is involved in the pathophysiology of PD and suggest that ceftriaxone may be a promising pharmacological tool for the development of new treatments for the dementia associated with PD. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Bi2WO6 nanoflowers: An efficient visible light photocatalytic activity for ceftriaxone sodium degradation

    Science.gov (United States)

    Zhao, Yanyan; Wang, Yongbo; Liu, Enzhou; Fan, Jun; Hu, Xiaoyun

    2018-04-01

    The morphology-controlled synthesis of nano-structure photocatalyst have leaded a new possibility to improve their physical and chemical properties. Herein, Bi2WO6 nanocrystals (BWO) with nano-flower, nano plates, knot shape, rod like and irregular morphologies have been successfully synthesized through a highly facile hydrothermal process by simply adjusting pH values, reactive solvents and temperature. Photocatalytic activity of the as-prepared samples were evaluated by degradation of Ceftriaxone sodium under visible light irradiation (λ > 420 nm), the results indicated that all the BWO samples exhibit morphology-associated photocatalytic activity, and the 3D flowerlike-structure of BWO composed of well-ordered nano plates (BWO-D-5) displayed the outstanding photocatalytic activity. Through getting insight into the mechanism, h+ and rad O2- play major roles compared with rad OH in photocatalytic degradation process. The possible pathway of Ceftriaxone sodium and the intermediates were proposed to better understand the reaction process. Moreover, this work not only provides an example of morphology-dependent photocatalytic activity of BWO but also provides an illustrative example for removing organic pollutant molecules according to practical requirements.

  3. Effect of ceftriaxone and cefepime on high-dose methotrexate clearance.

    Science.gov (United States)

    Tran, Hieu X; Herrington, Jon D

    2016-12-01

    Numerous drug interactions with methotrexate have been identified, which can lead to serious life-threatening effects. Up to 90% of methotrexate is excreted unchanged in the urine with primary excretion dependent on organic anion transport in the renal proximal tubule. The two pathways responsible for methotrexate secretion are organic anion transport 1 and primarily organic anion transport 3. Penicillins undergo tubular secretion via organic anion transport, and cephalosporins are believed to also possess a similar risk when administered with methotrexate; however, there are no human studies observing this interaction with cephalosporins and methotrexate. Ceftriaxone undergoes biliary clearance and has low affinity for the same organic anion transports as methotrexate; therefore, ceftriaxone has a low potential to interact with methotrexate. Cefepime is primarily secreted by organic cation transport N2, and also has a low potential to interact with methotrexate. This case report describes the pharmacokinetic effect of concomitant beta-lactam therapy in a patient receiving high-dose methotrexate. © The Author(s) 2015.

  4. Cellular Origin of [18F]FDG-PET Imaging Signals During Ceftriaxone-Stimulated Glutamate Uptake: Astrocytes and Neurons.

    Science.gov (United States)

    Dienel, Gerald A; Behar, Kevin L; Rothman, Douglas L

    2017-12-01

    Ceftriaxone stimulates astrocytic uptake of the excitatory neurotransmitter glutamate, and it is used to treat glutamatergic excitotoxicity that becomes manifest during many brain diseases. Ceftriaxone-stimulated glutamate transport was reported to drive signals underlying [ 18 F]fluorodeoxyglucose-positron emission tomographic ([ 18 F]FDG-PET) metabolic images of brain glucose utilization and interpreted as supportive of the notion of lactate shuttling from astrocytes to neurons. This study draws attention to critical roles of astrocytes in the energetics and imaging of brain activity, but the results are provocative because (1) the method does not have cellular resolution or provide information about downstream pathways of glucose metabolism, (2) neuronal and astrocytic [ 18 F]FDG uptake were not separately measured, and (3) strong evidence against lactate shuttling was not discussed. Evaluation of potential metabolic responses to ceftriaxone suggests lack of astrocytic specificity and significant contributions by pre- and postsynaptic neuronal compartments. Indeed, astrocytic glycolysis may not make a strong contribution to the [ 18 F]FDG-PET signal because partial or complete oxidation of one glutamate molecule on its uptake generates enough ATP to fuel uptake of 3 to 10 more glutamate molecules, diminishing reliance on glycolysis. The influence of ceftriaxone on energetics of glutamate-glutamine cycling must be determined in astrocytes and neurons to elucidate its roles in excitotoxicity treatment.

  5. 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.

  6. Trends in antimicrobial susceptibility for azithromycin and ceftriaxone in Neisseria gonorrhoeae isolates in Amsterdam, the Netherlands, between 2012 and 2015

    NARCIS (Netherlands)

    Wind, Carolien M.; Schim van der Loeff, Maarten F.; van Dam, Alje P.; de Vries, Henry Jc; van der Helm, Jannie J.

    2017-01-01

    Resistance of Neisseria gonorrhoeae to azithromycin and ceftriaxone has been increasing in the past years. This is of concern since the combination of these antimicrobials is recommended as the first-line treatment option in most guidelines. To analyse trends in antimicrobial resistance, we

  7. Pregnant women with erythema migrans and isolation of borreliae from blood: course and outcome after treatment with ceftriaxone.

    Science.gov (United States)

    Maraspin, Vera; Ružić-Sabljić, Eva; Pleterski-Rigler, Dušica; Strle, Franc

    2011-12-01

    The course and outcome in 7 pregnant European women with erythema migrans and borreliae isolated from blood, treated with intravenous ceftriaxone for 14 days, were uneventful, and the outcome of their pregnancies was good. Spirochetemia was not associated with constitutional symptoms. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Preventive Ceftriaxone in Patients with Stroke Treated with Intravenous Thrombolysis: Post Hoc Analysis of the Preventive Antibiotics in Stroke Study

    NARCIS (Netherlands)

    Vermeij, Jan-Dirk; Westendorp, Willeke F.; Roos, Yvo B.; Brouwer, Matthijs C.; van de Beek, Diederik; Nederkoorn, Paul J.

    2016-01-01

    The Preventive Antibiotics in Stroke Study (PASS), a randomized open-label masked endpoint trial, showed that preventive ceftriaxone did not improve functional outcome at 3 months in patients with acute stroke (adjusted common OR 0.95; 95% CI 0.82-1.09). Post-hoc analyses showed that among patients

  9. Upregulation of GLT-1 by treatment with ceftriaxone alleviates radicular pain by reducing spinal astrocyte activation and neuronal hyperexcitability.

    Science.gov (United States)

    Nicholson, K J; Gilliland, T M; Winkelstein, B A

    2014-01-01

    Cervical nerve root injury commonly leads to radicular pain. Normal sensation relies on regulation of extracellular glutamate in the spinal cord by glutamate transporters. The goal of this study was to define the temporal response of spinal glutamate transporters (glial glutamate transporter 1 [GLT-1], glutamate-aspartate transporter [GLAST], and excitatory amino acid carrier 1) following nerve root compressions that do or do not produce sensitivity in the rat and to evaluate the role of glutamate uptake in radicular pain by using ceftriaxone to upregulate GLT-1. Compression was applied to the C7 nerve root. Spinal glutamate transporter expression was evaluated at days 1 and 7. In a separate study, rats underwent a painful root compression and were treated with ceftriaxone or the vehicle saline. Glial glutamate transporter expression, astrocytic activation (glial fibrillary acidic protein [GFAP]), and neuronal excitability were assessed at day 7. Both studies measured behavioral sensitivity for 7 days after injury. Spinal GLT-1 significantly decreased (P ceftriaxone treatment (day 2), mechanical allodynia began to decrease; both mechanical allodynia and thermal hyperalgesia were attenuated (P Ceftriaxone also reduced (P < 0.024) spinal GFAP and GLAST expression, and neuronal hyperexcitability in the spinal dorsal horn, restoring the proportion of spinal neurons classified as wide dynamic range to that of normal. These findings suggest that nerve root-mediated pain is maintained jointly by spinal astrocytic reactivity and neuronal hyperexcitability and that these spinal modifications are associated with reduced glutamate uptake by GLT-1. Copyright © 2013 Wiley Periodicals, Inc.

  10. Antibiotic prophylaxis with intravenous ceftriaxone and fluoroquinolone reduces infectious complications after transrectal ultrasound-guided prostatic biopsy.

    Science.gov (United States)

    Lee, Chunwoo; You, Dalsan; Jeong, In Gab; Hong, Jun Hyuk; Choo, Myung-Soo; Ahn, Hanjong; Ahn, Tai Young; Kim, Choung-Soo

    2015-06-01

    To assess the rates of infectious complications before and after the change of prophylactic antibiotic regimens in prostate needle biopsy. The records of 5,577 patients who underwent prostate needle biopsy at Asan Medical Center between August 2005 and July 2012 were retrospectively reviewed. Group 1 (n=1,743) included patients treated between 2005 and 2009 with fluoroquinolone for 3 days, group 2 (n=2,723) included those treated between 2009 and 2012 with ceftriaxone once before the biopsy and fluoroquinolone before biopsy and continue therapy for 3 days, and group 3 (n=1,111) received the same treatment for more than 7 days after the biopsy. Univariable and multivariable logistic regression models addressed risk factors associated with infectious complication after prostate needle biopsy. Infectious complication after prostate needle biopsy developed in 18 (group 1), seven (group 2), and two patients (group 3) (p=0.001). In group 1, seven patients with infectious complication had positive blood cultures and harbored fluoroquinolone-resistant Escherichia coli, four had ceftriaxone susceptible isolates, and three had extended spectrum beta-lactamase-positive E. coli. Two patients in group 1 required intensive care because of septic shock. In multivariable analysis, the patients with combination of fluoroquinolone and ceftriaxone had significantly lower infectious complication rate than the fluoroquinolon alone (p=0.003). Antibiotic prophylaxis with ceftriaxone and fluoroquinolone before prostate needle biopsy decreased the risk of potentially serious infectious complications.

  11. Colelitíase associada ao uso de ceftriaxona Cholelithiasis associated with the use of ceftriaxone

    Directory of Open Access Journals (Sweden)

    Dorcas Lamounier Costa

    2005-12-01

    Full Text Available Criança de sete anos recebeu ceftriaxona para o tratamento de meningite, evoluindo com dor em hipocôndrio direito associada a cálculo na vesícula biliar. Após três meses, a ultrassonografia abdominal foi normal. O conhecimento de que a ceftriaxona pode levar ao surgimento de colelitíase pode evitar intervenções cirúrgicas desnecessárias.A seven-year-old boy treated with ceftriaxone for meningitis who presented a right upper quadrant abdominal pain associated with cholelithiasis. After three months he was symptom-free and abdominal ultrasonography was normal. Awareness of this phenomenon is highly important and can save many unnecessary cholecystectomies.

  12. Ceftriaxone modulates uptake activity of glial glutamate transporter-1 against global brain ischemia in rats.

    Science.gov (United States)

    Hu, Yu-Yan; Xu, Jing; Zhang, Min; Wang, Dan; Li, Li; Li, Wen-Bin

    2015-01-01

    Ceftriaxone(Cef) selectively increases the expression of glial glutamate transporter-1 (GLT-1), which was thought to be neuroprotective in some circumstances. However, the effect of Cef on glutamate uptake of GLT-1 was mostly assayed using in vitro studies such as primary neuron/astrocyte cultures or brain slices. In addition, the effect of Cef on neurons in different ischemic models was still discrepant. Therefore, this study was undertaken to observe the effect of Cef on neurons in global brain ischemia in rats, and especially to provide direct evidence of the up-regulation of GLT-1 uptake for glutamate contributing to the neuronal protection of Cef against brain ischemia. Neuropathological evaluation indicated that administration of Cef, especially pre-treatment protocols, significantly prevented delayed neuronal death in hippocampal CA1 subregion normally induced by global brain ischemia. Simultaneously, pre-administration of Cef significantly up-regulated the expression of GLT-1. Particularly, GLT-1 uptake assay with (3) H-glutamate in living cells from adult rats showed that up-regulation in glutamate uptake accompanied up-regulated GLT-1 expression. Inhibition of GLT-1 by antisense oligodeoxynucleotides or dihydrokainate significantly inhibited the Cef-induced up-regulation in GLT-1 uptake and the neuroprotective effect against global ischemia. Thus, we may conclude that Cef protects neurons against global brain ischemia via up-regulation of the expression and glutamate uptake of GLT-1. Glutamate uptake by glial glutamate transporter-1 (GLT-1) is the principal way to regulate extracellular glutamate homeostasis in central nervous system. Over-accumulation of glutamate results in excitotoxicity and injures neurons after cerebral ischemia. Ceftriaxone up-regulates GLT-1 expression and uptake of glutamate, diminishes the excitotoxicity of glutamate and then protects neurons against global brain ischemia. © 2014 International Society for Neurochemistry.

  13. 5 versus 10 days of treatment with ceftriaxone for bacterial meningitis in children: a double-blind randomised equivalence study.

    Science.gov (United States)

    Molyneux, Elizabeth; Nizami, Shaikh Qamaruddin; Saha, Samir; Huu, Khanh Truong; Azam, Matloob; Bhutta, Zulfiqar Ahmad; Zaki, Ramadan; Weber, Martin Willi; Qazi, Shamim Ahmad

    2011-05-28

    Bacterial meningitis is an important cause of morbidity and mortality in developing countries, but the duration of treatment is not well established. We aimed to compare the efficacy of 5 and 10 days of parenteral ceftriaxone for the treatment of bacterial meningitis in children. We did a multicountry, double-blind, placebo-controlled, randomised equivalence study of 5 versus 10 days of treatment with ceftriaxone in children aged 2 months to 12 years with purulent meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae type B, or Neisseria meningitidis. Our study was done in ten paediatric referral hospitals in Bangladesh, Egypt, Malawi, Pakistan, and Vietnam. We randomly assigned children who were stable after 5 days of treatment, through site-balanced computer-generated allocation lists, to receive a further 5 days of ceftriaxone or placebo. Patients, their guardians, and staff were masked to study-group allocation. Our primary outcomes were bacteriological failure or relapse. Our analysis was per protocol. This study is registered with the International Standard Randomised Controlled Trial Number Register, number ISRCTN38717320. We included 1004 of 1027 children randomly assigned to study groups in our analyses; 496 received treatment with ceftriaxone for 5 days, and 508 for 10 days. In the 5-day treatment group, two children (one infected with HIV) had a relapse; there were no relapses in the 10-day treatment group and there were no bacteriological failures in either study group. Side-effects of antibiotic treatment were minor and similar in both groups. In children beyond the neonatal age-group with purulent meningitis caused by S pneumoniae, H influenzae type b, or N meningitidis who are stable by day 5 of ceftriaxone treatment, the antibiotic can be safely discontinued. United States Agency for International Development. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Cluster of Neisseria gonorrhoeae Isolates With High-level Azithromycin Resistance and Decreased Ceftriaxone Susceptibility, Hawaii, 2016.

    Science.gov (United States)

    Katz, Alan R; Komeya, Alan Y; Kirkcaldy, Robert D; Whelen, A Christian; Soge, Olusegun O; Papp, John R; Kersh, Ellen N; Wasserman, Glenn M; O'Connor, Norman P; O'Brien, Pamela S; Sato, Douglas T; Maningas, Eloisa V; Kunimoto, Gail Y; Tomas, Juval E

    2017-09-15

    The Centers for Disease Control and Prevention (CDC) currently recommends dual therapy with ceftriaxone and azithromycin for gonorrhea to ensure effective treatment and slow emergence of antimicrobial resistance. Since 2013, the prevalence of reduced azithromycin susceptibility increased in the United States; however, these strains were highly susceptible to cephalosporins. We identified a cluster of Neisseria gonorrhoeae isolates with high-level azithromycin resistance, several of which also demonstrated decreased ceftriaxone susceptibility. Eight N. gonorrhoeae isolates collected from 7 patients on Oahu, Hawaii, seen 21 April 2016 through 10 May 2016 underwent routine Etest antimicrobial susceptibility testing by the Hawaii Department of Health. All demonstrated elevated azithromycin minimum inhibitory concentrations (MICs) >256 μg/mL and elevated ceftriaxone MICs (≥0.125 μg/mL). Isolates were sent to the University of Washington and CDC for confirmatory agar dilution testing; sequence data were sent to CDC for analysis. All patients were interviewed and treated, and when possible, partners were interviewed, tested, and treated. All isolates had azithromycin MICs >16 µg/mL and 5 had ceftriaxone MICs = 0.125 µg/mL by agar dilution. All isolates were β-lactamase positive and were resistant to penicillin, tetracycline, and ciprofloxacin. Genomic analysis revealed genetic relatedness. No patients reported recent travel or antibiotic use, and no male patients reported male sex partners. All patients were successfully treated. This cluster of genetically related gonococcal isolates with decreased ceftriaxone susceptibility and high-level azithromycin resistance may bring the threat of treatment failure in the United States with the current recommended dual therapy one step closer. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  15. Gentamicin versus ceftriaxone for the treatment of gonorrhoea (G-TOG trial): study protocol for a randomised trial.

    Science.gov (United States)

    Brittain, Clare; Childs, Margaret; Duley, Lelia; Harding, Jan; Hepburn, Trish; Meakin, Garry; Montgomery, Alan A; Tan, Wei; Ross, Jonathan D C

    2016-11-24

    Gonorrhoea is a common sexually transmitted infection which causes genital pain and discomfort; in women it can also lead to pelvic inflammatory disease and infertility, and in men to epididymo-orchitis. Current treatment is with ceftriaxone, but there is increasing evidence of antimicrobial resistance which is reducing its effectiveness against gonorrhoea. A small, but increasing, number of patients have already been found to have highly resistant strains of gonorrhoea which has been associated with clinical failure. This trial aims to determine whether gentamicin is not clinically worse than ceftriaxone in the treatment of gonorrhoea. This is a blinded, two-arm, multicentre, noninferiority randomised trial. Patients are eligible if they are aged 16-70 years with a diagnosis of genital, pharyngeal and/or rectal gonorrhoea. Exclusion criteria are: known concurrent sexually transmitted infection(s) (excluding chlamydia); bacterial vaginosis and/or Trichomonas vaginalis infection; contraindications or an allergy to gentamicin, ceftriaxone, azithromycin or lidocaine; pregnancy or breastfeeding; complicated gonorrhoeal infection; weight under 40 kg; use of ceftriaxone, gentamicin or azithromycin within the preceding 28 days. Randomisation is to receive a single intramuscular injection of either gentamicin or ceftriaxone, all participants receive 1 g oral azithromycin as standard treatment. The estimated sample size is 720 participants (noninferiority limit 5%). The primary outcome is clearance of Neisseria gonorrhoeae at all infected sites by a negative Nucleic Acid Amplification Test, 2 weeks post treatment. Secondary outcomes include clinical resolution of symptoms, frequency of adverse events, tolerability of therapy, relationship between clinical effectiveness and antibiotic minimum inhibitory concentration for N. gonorrhoeae, and cost-effectiveness. The options for future treatment of gonorrhoea are limited. Results from this randomised trial will demonstrate

  16. Fractional maximal effect method for in vitro synergy between amoxicillin and ceftriaxone and between vancomycin and ceftriaxone against Enterococcus faecalis and penicillin-resistant Streptococcus pneumoniae.

    Science.gov (United States)

    Desbiolles, N; Piroth, L; Lequeu, C; Neuwirth, C; Portier, H; Chavanet, P

    2001-12-01

    In the present study we assessed the use of a new in vitro testing method and graphical representation of the results to investigate the potential effectiveness of combinations of amoxicillin (AMZ) plus ceftriaxone (CRO) and of CRO plus vancomycin (VAN) against strains of Streptococcus pneumoniae highly resistant to penicillin and cephalosporins (PRP strains). We used the fractional maximal effect (FME) method of time-kill curves to calculate adequate concentrations of the drugs to be tested rather than relying on arbitrary choices. The concentrations obtained, each of which corresponded to a fraction of the maximal effect, were tested alone and in combination with the bacterial strains in a broth medium. Synergy was defined as a ratio of observed effect/theoretical effect, called FME, of greater than 1, additivity was defined as an FME equal to 1, and antagonism was defined as an observed effect lower than the best effect of one of the antibiotics used alone. The area between antagonism and additivity is the indifference zone. The well-known synergy between amoxicillin and gentamicin against a reference strain of Enterococcus faecalis was confirmed, with a best FME equal to 1.07. Two strains of PRP, strains PRP-1 and PRP-2, were studied. The MICs for PRP-1 and PRP-2 were as follows: penicillin, 4 and 16 microg/ml, respectively; AMZ, 2 and 8 microg/ml, respectively, CRO, 1 and 4 microg/ml, respectively; and VAN, 0.5 and 0.25 microg/ml, respectively. For PRP-1 the best FME for the combination AMZ-CRO was 1.22 with drug concentrations of 1.68 mg/liter for AMZ and 0.17 mg/liter for CRO; the best FME for the combination VAN-CRO was 1.75 with VAN at 0.57 mg/liter and CRO at 0.17 mg/liter. For PRP-2 the best FME obtained for the combination AMZ-CRO was 1.05 with drug concentrations of 11.28 mg/liter for AMZ and 0.64 mg/liter for CRO; the best FME obtained for the combination VAN-CRO was 1.35 with VAN at 0.25 mg/liter and CRO at 1.49 mg/liter. These results demonstrated

  17. THE EFFECT OF CEFTRIAXONE ON THE ANAEROBIC BACTERIAL-FLORA AND THE BACTERIAL ENZYMATIC-ACTIVITY IN THE INTESTINAL-TRACT

    NARCIS (Netherlands)

    WELLING, GW; MEIJERSEVERS, GJ; HELMUS, G; VANSANTEN, E; TONK, RHJ; DEVRIESHOSPERS, HG; VANDERWAAIJ, D

    1991-01-01

    The normal flora of the intestinal tract, mainly consisting of anaerobic bacteria, protects the host against colonization by pathogenic microorganisms. Antimicrobial treatment with ceftriaxone may influence the colonic microflora and as a consequence, the protective effect. Ten healthy volunteers

  18. Oral doxycycline versus intravenous ceftriaxone for treatment of multiple erythema migrans: an open-label alternate-treatment observational trial.

    Science.gov (United States)

    Stupica, Daša; Velušcek, Maša; Blagus, Rok; Bogovic, Petra; Rojko, Tereza; Cerar, Tjaša; Strle, Franc

    2018-01-29

    Several guidelines advocate the same treatment approaches for both early disseminated Lyme borreliosis, manifested as multiple erythema migrans (EM), and early localized Lyme borreliosis, manifested as solitary EM. Oral doxycycline (100 mg q12h) was compared on a non-inferiority premise with intravenous ceftriaxone (2 g q24h) for 14 days in 200 adult European patients with multiple EM in an open-label alternate-treatment observational trial performed in a single-centre university hospital. Treatment outcome was assessed at 14 days and at 2, 6 and 12 months post-enrolment. Non-specific symptoms in patients and 192 control subjects without a history of Lyme borreliosis were evaluated and compared. This trial was registered at http://clinicaltrials.gov (identifier NCT01163994). At the 12 month visit, 4/82 (4.9%) multiple EM patients prescribed doxycycline and 6/88 (6.8%) multiple EM patients prescribed ceftriaxone showed incomplete response manifested predominantly as post-Lyme symptoms (1.9% difference, upper limit of 95% CI 5.1%). The upper limit of 95% CI for the difference in proportion of patients with incomplete response between doxycycline and ceftriaxone groups did not exceed the predetermined non-inferiority margin of 10%. The frequency of non-specific symptoms in patients was similar to that in controls. The 14 day oral doxycycline was not inferior to the 14 day intravenous ceftriaxone in treatment of adult European patients with early disseminated Lyme borreliosis manifested as multiple EM. The frequency of non-specific symptoms in patients was similar to that in controls without a history of Lyme borreliosis. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. The Oral β-Lactamase SYN-004 (Ribaxamase) Degrades Ceftriaxone Excreted into the Intestine in Phase 2a Clinical Studies.

    Science.gov (United States)

    Kokai-Kun, John F; Roberts, Tracey; Coughlin, Olivia; Sicard, Eric; Rufiange, Marianne; Fedorak, Richard; Carter, Christian; Adams, Marijke H; Longstreth, James; Whalen, Heidi; Sliman, Joseph

    2017-03-01

    SYN-004 (ribaxamase) is a β-lactamase designed to be orally administered concurrently with intravenous β-lactam antibiotics, including most penicillins and cephalosporins. Ribaxamase's anticipated mechanism of action is to degrade excess β-lactam antibiotic that is excreted into the small intestine. This enzymatic inactivation of excreted antibiotic is expected to protect the gut microbiome from disruption and thus prevent undesirable side effects, including secondary infections such as Clostridium difficile infections, as well as other antibiotic-associated diarrheas. In phase 1 clinical studies, ribaxamase was well tolerated compared to a placebo group and displayed negligible systemic absorption. The two phase 2a clinical studies described here were performed to confirm the mechanism of action of ribaxamase, degradation of β-lactam antibiotics in the human intestine, and were therefore conducted in subjects with functioning ileostomies to allow serial sampling of their intestinal chyme. Ribaxamase fully degraded ceftriaxone to below the level of quantitation in the intestines of all subjects in both studies. Coadministration of oral ribaxamase with intravenous ceftriaxone was also well tolerated, and the plasma pharmacokinetics of ceftriaxone were unchanged by ribaxamase administration. Since ribaxamase is formulated as a pH-dependent, delayed-release formulation, the activity of ribaxamase in the presence of the proton pump inhibitor esomeprazole was examined in the second study; coadministration of these drugs did not adversely affect ribaxamase's ability to degrade ceftriaxone excreted into the intestine. These studies have confirmed the in vivo mechanism of action of ribaxamase, degradation of β-lactam antibiotics in the human intestine (registered at ClinicalTrials.gov under NCT02419001 and NCT02473640). Copyright © 2017 Kokai-Kun et al.

  20. Influence of the copper nanoparticle-ceftriaxone conjugate on hemodynamic indices in rabbits in an acute experiment

    Directory of Open Access Journals (Sweden)

    P. V. Simonov

    2015-08-01

    Full Text Available An implementation of series of preclinical studies of the copper nanoparticle-ceftriaxone conjugate as a new medication with a broad spectrum of antimicrobial action for treatment of infections, particularly caused by resistant strains, is of great importance nowadays. The aim of current research was to determinate effect of studied substance on cardiovascular function in animals when administered intravenously in an acute experiment. Methods and results. The study was carried out on 8 Chinchilla rabbits with monitoring of systemic and cardiac hemodynamic indices with ‘Hewlett Packard’ Hp Viridia Component Monitoring System. It was shown that the copper nanoparticle-ceftriaxone conjugate at doses of 10–200 mg/kg did not have a negative impact on the heart rate, maximum left ventricular pressure, systolic, diastolic blood pressure, the pulse pressure, and the mean arterial pressure. Conclusion. These findings attest to the fact that the copper nanoparticle-ceftriaxone conjugate may be considered a biosafe substance in the terms of an influence on systemic and cardiac hemodynamic indices when administered intravenously to rabbits in an acute experiment.

  1. Quality of Ceftriaxone Sodium in Lyophilized Powder for Injection Evaluated by Clean, Fast, and Efficient Spectrophotometric Method

    Directory of Open Access Journals (Sweden)

    Patrícia Vidal de Aléssio

    2017-01-01

    Full Text Available Ceftriaxone sodium, an antimicrobial agent that plays an important role in clinical practice, is successfully used to treat infections caused by most Gram-positive and Gram-negative organisms. Since there are few rapid analytical methods for ceftriaxone analysis to use in the pharmaceutical routine, the aim of this research was to develop a new method able to quantify this cephalosporin. Therefore, a sensitive, rapid, simple UV spectrophotometric method for the determination and quantification of ceftriaxone sodium was proposed. The UV detector was set at 241 nm. Beer’s law obeyed the concentration range of 10–20 µg mL−1. Statistical comparison of the results with a well-established reported method showed excellent agreement and proved that there is no significant difference in the accuracy and precision. Intra- and interday variability for the method were less than 2% relative standard deviation. The proposed method was applied to the determination of the examined drugs in pharmaceutical formulations and the results demonstrated that the method is equally accurate, precise, and reproducible as the official methods.

  2. A fully validated microbiological assay to evaluate the potency of ceftriaxone sodium

    Directory of Open Access Journals (Sweden)

    Maria Luisa Manfio

    2013-12-01

    Full Text Available Ceftriaxone (CFTX sodium is a third-generation, broad-spectrum cephalosporin that is resistant to beta-lactamases. An alternative bioassay for the assessment of the potency of this drug in pharmaceutical formulations has not been previously reported. Thus, this paper reports the development and full validation of a 3 x 3 agar diffusion bioassay using a cylinder-plate method to quantify CFTX sodium in pharmaceutical samples. The strain Staphylococcus aureus ATCC 6538P was used as the test microorganism, and the results of the proposed bioassay displayed high linearity, precision, accuracy, specificity and robustness. All potency results were statistically analyzed using an analysis of variance (ANOVA and were found to be linear (r=0.99999 in the range of 16-64 µg/mL, accurate (100.5%, and precise [repeatability: relative standard deviation (RSD=1.4%; intermediate precision: between-day RSD=2.1% and between-analyst RSD=2.5%]. The specificity of the bioassay was determined by evaluating a degraded sample (50 ºC at 0, 24 and 48 hours as compared against the results from the pharmacopeial liquid chromatography method for CFTX. The results validated the proposed microbiological assay, which allows reliable quantitation of CFTX in pharmaceutical samples. Moreover, it is a useful, simple and low-cost alternative method for monitoring the quality of this medicine.

  3. Reduction of EEG theta power and changes in motor activity in rats treated with ceftriaxone.

    Directory of Open Access Journals (Sweden)

    Michele Bellesi

    Full Text Available The glutamate transporter GLT-1 is responsible for the largest proportion of total glutamate transport. Recently, it has been demonstrated that ceftriaxone (CEF robustly increases GLT-1 expression. In addition, physiological studies have shown that GLT-1 up-regulation strongly affects synaptic plasticity, and leads to an impairment of the prepulse inhibition, a simple form of information processing, thus suggesting that GLT-1 over-expression may lead to dysfunctions of large populations of neurons. To test this possibility, we assessed whether CEF affects cortical electrical activity by using chronic electroencephalographic (EEG recordings in male WKY rats. Spectral analysis showed that 8 days of CEF treatment resulted in a delayed reduction in EEG theta power (7-9 Hz in both frontal and parietal derivations. This decrease peaked at day 10, i.e., 2 days after the end of treatment, and disappeared by day 16. In addition, we found that the same CEF treatment increased motor activity, especially when EEG changes are more prominent. Taken together, these data indicate that GLT-1 up-regulation, by modulating glutamatergic transmission, impairs the activity of widespread neural circuits. In addition, the increased motor activity and prepulse inhibition alterations previously described suggest that neural circuits involved in sensorimotor control are particularly sensitive to GLT-1 up-regulation.

  4. Assessment of the price-efficacy relationship for multiple brands of ceftriaxone sodium in Kabul: a cross-sectional study.

    Science.gov (United States)

    Naimi, H M; Rasekh, H; Haem Rahimi, M; Yousofi, H

    2016-02-12

    Most medicines are imported for health service practices in Afghanistan. A major concern for patients and practitioners in Kabul is the wide brand assortment and price range choices for the same drug. Ceftriaxone sodium is a broadly used antibiotic for infections caused by certain types of gram-positive and gram-negative bacteria. It is available in Kabul in a range of brands and prices. The objective of this study was to assess the relationship between cost/brand name and efficacy of this antibiotic. 40 brands of ceftriaxone, obtained from Kabul's main pharmacy, were derived from 12 countries including Pakistan, Turkey, India, and China. Ten samples/brand were tested for efficacy by the minimal bactericidal concentration assay against a sensitive strain of Staphylococcus aureus according to the Clinical Institute and Laboratory Standards Protocols. Efficacy data were obtained by inoculating suspensions of S. aureus grown in Mueller-Hinton medium with various concentrations (6.25-800 mcg/ml) of each brand followed by incubation at 37 °C for 18-24 h. Aliquots of inoculated cultures were transferred to agar plates, incubated at 37 °C for 18-24 h and visible colonies counted. Results were analyzed using ANOVA, Student's t test, and Pearson correlation by SPSS 19. A p value ≤ 0.05 was considered statistically significant. Ceftriaxone sodium price varied from 20-270 Afghanis/brand (average price = 69.80 Afghanis/brand). Of the 40 brands tested, 10 (25 %) were not registered with the General Directorate of Pharmaceutical Affairs of the Ministry of Public Health in Afghanistan. More importantly, we observed no statistically significant difference in efficacy against S. aureus among these brands (p = 0.59). Our study showed no significant correlation among price, brand, and efficacy of ceftriaxone sodium against S. aureus, an important consideration when treating S. aureus infection in Afghanistan and elsewhere. Differences in brand prices are likely due to

  5. 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.

  6. Characterization and biotransformation in the plasma and red blood cells of V(IV)O(2+) complexes formed by ceftriaxone.

    Science.gov (United States)

    Sanna, Daniele; Fabbri, Davide; Serra, Maria; Buglyó, Péter; Bíró, Linda; Ugone, Valeria; Micera, Giovanni; Garribba, Eugenio

    2015-06-01

    The coordination mode and geometry in aqueous solution of oxidovanadium(IV) complexes formed by a third-generation cephalosporin, ceftriaxone (H3cef), were studied by spectroscopic (EPR, electron paramagnetic resonance), pH-potentiometric and computational (DFT, density functional theory) methods. The behavior of the model systems containing 6-hydroxy-2-methyl-3-thioxo-3,4-dihydro-1,2,4-triazine-5(2H)-one (H2hmtdt) and 3-benzylthio-6-hydroxy-2-methyl-1,2,4-triazine-5(2H)-one (Hbhmt) was examined for comparison. The stability of the tautomers of ceftriaxone and 6-hydroxy-2-methyl-3-thioxo-3,4-dihydro-1,2,4-triazine-5(2H)-one in the neutral, mono- and bi-anionic form was calculated by DFT methods, both in the gas phase and in aqueous solution, and the electron density on the oxygen atoms of the hydroxytriazinone ring was related to the pKa of the ligands. The data demonstrate that ceftriaxone coordinates V(IV)O(2+) forming mono- and bis-chelated complexes with (Oket, O(-)) donor set and formation of five-membered chelate rings. The geometry of the bis-chelated complex, cis-[VO(Hcef)2(H2O)](2-), is cis-octahedral and this species can deprotonate, around physiological pH, to form the corresponding mono-hydroxido cis-[VO(Hcef)2(OH)](3-). The interaction of cis-[VO(Hcef)2(H2O)](2-) with apo-transferrin (apo-hTf) was studied and the results suggest that V(IV)O(2+) distributes between (VO)apo-hTf/(VO)2apo-hTf and cis-[VO(Hcef)2(H2O)](2-), whereas mixed complexes are not formed for charge and steric effects. The interaction of cis-[VO(Hcef)2(H2O)](2-) with red blood cells shows that ceftriaxone helps V(IV)O(2+) ion to cross the erythrocyte membrane. Inside the cell cis-[VO(Hcef)2(H2O)](2-) decomposes and the same species formed by inorganic V(IV)O(2+) are observed. The relationship between the biotransformation in the plasma and red blood cells and the potential pharmacological activity of V(IV)O(2+) species of ceftriaxone is finally discussed. Copyright © 2015 Elsevier

  7. 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

    2016-05-01

    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. 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. 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 strains with high-level resistance to

  8. Bactericidal activity of penicillin, ceftriaxone, gentamicin and daptomycin alone and in combination against Aerococcus urinae.

    Science.gov (United States)

    Hirzel, Cédric; Hirzberger, Lea; Furrer, Hansjakob; Endimiani, Andrea

    2016-09-01

    Aerococcus urinae can cause severe infections (bacteraemia and endocarditis) that are associated with high mortality. However, data on the bactericidal and synergistic activity for clinically implemented antibiotics are scarce. Time-kill analyses were performed on two clinical isolates (AU1 and AU2) and the reference strain ATCC 700306 for penicillin (PG), ceftriaxone (CRO), gentamicin (GEN), daptomycin (DAP) and their combinations. AU1 and AU2 were CRO-resistant (MICs, 2 µg/mL) and ATCC 700306 was high-level GEN-resistant (MIC, 512 µg/mL), whereas all strains were PG- and DAP-susceptible (MICs, ≤0.125 and ≤1 µg/mL, respectively). CFU counts were determined at various time points from 0 to 48 h. All experiments were performed at 0.5×, 1×, 2× and 4× MIC. PG and CRO were not bactericidal for all strains, whereas DAP exhibited bactericidal activity at all concentrations for AU2 and ATCC 700306. The combination of PG or CRO with GEN was bactericidal for AU1 and AU2 at antibiotic concentrations ≥1× MIC. Bactericidal synergism was detected for PG or CRO combined with GEN in the two clinical isolates. PG plus CRO showed non-bactericidal synergism for ATCC 700306. DAP with GEN was synergistic at 1× MIC for AU1, whereas the killing activity of DAP was too pronounced to detect potential synergism in AU2. The combination of PG or CRO with GEN is synergistic and bactericidal. Moreover, these in vitro data suggest that DAP may represent a potential bactericidal treatment alternative against A. urinae. This finding could be important for the treatment of patients with a β-lactam allergy or renal insufficiency. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  9. Ceftriaxone, a beta-lactam antibiotic, reduces ethanol consumption in alcohol-preferring rats.

    Science.gov (United States)

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

    2011-01-01

    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. Alcohol-preferring (P) rats were given 24 h/day concurrent access to 15 and 30% ethanol, water and food for 7 weeks. During Week 6, P rats received either 25, 50, 100 or 200 mg/kg ceftriaxone (CEF, i.p.), a β-lactam antibiotic known to elevate GLT1 expression, or a saline vehicle for five consecutive days. Water intake, ethanol consumption and body weight were measured daily for 15 days starting on Day 1 of injections. We also tested the effects of CEF (100 and 200 mg/kg, i.p.) on daily sucrose (10%) consumption as a control for motivated behavioral drinking. Statistical analyses revealed a significant reduction in daily ethanol, but not sucrose, consumption following CEF treatment. During the post treatment period, there was a recovery of ethanol intake across days. Dose-dependent increases in water intake were manifest concurrent with the CEF-induced decreases in ethanol intake. Nevertheless, CEF did not affect body weight. An examination of a subset of the CEF-treated ethanol-drinking rats, on the third day post CEF treatment, revealed increases in GTL1 expression levels within the prefrontal cortex and nucleus accumbens. These results indicate that CEF effectively reduces ethanol intake, possibly through activation of GLT1, and may be a potential therapeutic drug for alcohol addiction treatment.

  10. [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.

  11. Effects of ceftriaxone on ethanol intake: a possible role for xCT and GLT-1 isoforms modulation of glutamate levels in P rats.

    Science.gov (United States)

    Alhaddad, Hasan; Das, Sujan C; Sari, Youssef

    2014-10-01

    Evidence suggests that glutamate transporter 1 (GLT-1) and cystine/glutamate exchanger transporter (xCT) are critical in maintaining glutamate homeostasis. We have recently demonstrated that ceftriaxone treatment induced upregulation of GLT1 levels and attenuated ethanol intake; however, less is known about the involvement of xCT on ethanol intake. In this study, we investigated the effects of ceftriaxone on the levels of xCT in both continuous and relapse-like ethanol drinking, as well as GLT-1 isoforms, and glutamate aspartate transporter (GLAST) in relapse-like ethanol intake. P rats received free choice of 15 and 30 % ethanol and water for 5 weeks and then deprived of ethanol for 2 weeks. Rats were treated with ceftriaxone (100 mg/kg, i.p.) or saline during the last 5 days of the 2-week deprivation period. After deprivation period, P rats were re-exposed to free choice of 15 and 30 % ethanol and water for nine consecutive days. A second group of P rats was given continuous ethanol access for 5 weeks, then ceftriaxone (100 mg/kg, i.p.) or saline throughout the week 6. Ceftriaxone significantly attenuated relapse-like ethanol intake. Importantly, this effect of ceftriaxone was associated in part with upregulation of the levels of GLT-1a and GLT-1b isoforms and xCT in the prefrontal cortex (PFC) and the nucleus accumbens (NAc). There were no significant differences in GLAST expression among all groups. We also found that ceftriaxone treatment increased xCT levels in both PFC and NAc in continuous ethanol intake. These findings suggest that xCT and GLT-1 isoforms might be target proteins for the treatment of alcohol dependence.

  12. Effects of ceftriaxone on chronic ethanol consumption: a potential role for xCT and GLT1 modulation of glutamate levels in male P rats.

    Science.gov (United States)

    Rao, P S S; Sari, Youssef

    2014-09-01

    Alterations in glutamatergic neurotransmission have been suggested to affect many aspects of neuroplasticity associated with alcohol/drug addiction. We have previously shown that ceftriaxone, a β-lactam antibiotic known to upregulate glutamate transporter 1 (GLT1), reduced ethanol intake after 5 weeks of free choice ethanol drinking paradigm in male alcohol-preferring (P) rats. Evidence suggests that differential effects involving alterations of glutamatergic neurotransmission occur after long-term ethanol consumption. In this study, we tested whether the efficacy of administration of ceftriaxone persists after 14 weeks of free access to 15 and 30 % ethanol in male P rats. After 14 weeks of ethanol consumption, male P rats were administered ceftriaxone (100 mg/kg, intraperitoneal (i.p.)) or saline vehicle for 5 days. We found that ceftriaxone treatment resulted in a significant reduction in ethanol intake starting from day 2 (48 h after the first i.p. injections of ceftriaxone) through day 14, 10 days after final injection. Western blot analysis of brain samples from animals euthanized 24 h after treatment with the last dose of ceftriaxone revealed a significant upregulation of cystine/glutamate exchanger (xCT) and GLT1 levels in prefrontal cortex, nucleus accumbens, and amygdala as compared to saline vehicle-treated group. These findings demonstrated the effectiveness of ceftriaxone in attenuating ethanol intake in a chronic consumption paradigm. These might be due in part through the upregulation of both xCT and GLT1 levels in brain reward regions. Thus, the drug has a potential therapeutic action for the treatment of alcohol dependence.

  13. Safety and efficacy of ceftriaxone for amyotrophic lateral sclerosis: a multi-stage, randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Cudkowicz, Merit E; Titus, Sarah; Kearney, Marianne; Yu, Hong; Sherman, Alexander; Schoenfeld, David; Hayden, Douglas; Shui, Amy; Brooks, Benjamin; Conwit, Robin; Felsenstein, Donna; Greenblatt, David J; Keroack, Myles; Kissel, John T; Miller, Robert; Rosenfeld, Jeffrey; Rothstein, Jeffrey D; Simpson, Ericka; Tolkoff-Rubin, Nina; Zinman, Lorne; Shefner, Jeremy M

    2014-11-01

    Glutamate excitotoxicity might contribute to the pathophysiology of amyotrophic lateral sclerosis. In animal models, decreased excitatory aminoacid transporter 2 (EAAT2) overexpression delays disease onset and prolongs survival, and ceftriaxone increases EAAT2 activity. We aimed to assess the safety and efficacy of ceftriaxone for amyotrophic lateral sclerosis in a combined phase 1, 2, and 3 clinical trial. This three-stage randomised, double-blind, placebo-controlled study was done at 59 clinical sites in the USA and Canada between Sept 4, 2006, and July 30, 2012. Eligible adult patients had amyotrophic lateral sclerosis, a vital capacity of more than 60% of that predicted for age and height, and symptom duration of less than 3 years. In stages 1 (pharmacokinetics) and 2 (safety), participants were randomly allocated (2:1) to ceftriaxone (2 g or 4 g per day) or placebo. In stage 3 (efficacy), participants assigned to ceftriaxone in stage 2 received 4 g ceftriaxone, participants assigned to placebo in stage 2 received placebo, and new participants were randomly assigned (2:1) to 4 g ceftriaxone or placebo. Participants, family members, and site staff were masked to treatment assignment. Randomisation was done by a computerised randomisation sequence with permuted blocks of 3. Participants received 2 g ceftriaxone or placebo twice daily through a central venous catheter administered at home by a trained caregiver. To minimise biliary side-effects, participants assigned to ceftriaxone also received 300 mg ursodeoxycholic acid twice daily and those assigned to placebo received matched placebo capsules. The coprimary efficacy outcomes were survival and functional decline, measured as the slope of Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) scores. Analyses were by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00349622. Stage 3 included 66 participants from stages 1 and 2 and 448 new participants. In total

  14. A Randomized, Prospective Study of Pediatric Patients With Community-acquired Pneumonia Treated With Ceftaroline Versus Ceftriaxone.

    Science.gov (United States)

    Cannavino, Christopher R; Nemeth, Agnes; Korczowski, Bartosz; Bradley, John S; O'Neal, Tanya; Jandourek, Alena; Friedland, H David; Kaplan, Sheldon L

    2016-07-01

    Community-acquired bacterial pneumonia (CABP) remains a major infection among children, despite the use of pneumococcal vaccination. Ceftaroline fosamil is a broad-spectrum cephalosporin antibiotic with activity against many bacteria, including Streptococcus pneumoniae (both penicillin-nonsusceptible and multidrug-resistant strains) and Staphylococcus aureus (including methicillin-resistant S. aureus). This article describes the safety, tolerability, and effectiveness of ceftaroline fosamil in the treatment of pediatric patients hospitalized with CABP, from a randomized, active-controlled, observer-blinded clinical study (registration number NCT01530763). Pediatric patients were stratified into 4 age cohorts and randomized (3:1) to receive either intravenous ceftaroline fosamil or ceftriaxone, with optional oral switch for a total treatment duration of 5-14 days. Enrollment was planned for 160 patients. Data collected included demographics, infection characteristics and pathogens. Treatment-emergent adverse events, clinical outcomes, and microbiologic responses were assessed. Ceftaroline fosamil was well tolerated. Similar percentages of patients in the ceftaroline fosamil (55/121; 45%) and ceftriaxone (18/39; 46%) groups reported treatment-emergent adverse events. Coombs seroconversion was observed in 17% of patients in the ceftaroline fosamil group; however, no evidence of hemolytic anemia or hemolysis was found. No deaths were reported during the study. Ceftaroline fosamil had similar effectiveness to ceftriaxone, with high clinical cure rates at test-of-cure in the modified intent-to-treat population (94/107; 88% and 32/36; 89%, respectively). Three documented S. aureus infections were successfully treated in the ceftaroline group, including one caused by methicillin-resistant S. aureus. The results of this study suggest that ceftaroline fosamil may be an important treatment option for pediatric patients hospitalized with CABP.

  15. Ameliorative potential of pioglitazone and ceftriaxone alone and in combination in rat model of neuropathic pain: Targeting PPARγ and GLT-1 pathways.

    Science.gov (United States)

    Pottabathini, Raghavender; Kumar, Anil; Bhatnagar, Archana; Garg, Sukant; Ekavali, E

    2016-02-01

    The relation between glutamate homeostasis and PPAR gamma has got tremendous importance in nerve trauma and pain. Present study has been designed to elucidate the interaction between the GLT-1 activator (ceftriaxone) and PPAR gamma agonist (pioglitazone) in the spinal nerve ligation induced neuropathic pain. Male SD rats were subjected to spinal nerve ligation to induce neuropathic pain. Pioglitazone, ceftriaxone and their combination treatments were given for 28 days. Various behavioral, biochemical, neuroinflammatory and apoptotic mediators were assessed subsequently. In the present study, ligation of L5 and L6 spinal nerves resulted in marked hyperalgesia and allodynia to different mechanical and thermal stimuli. In addition there is marked increase in oxidative-nitrosative stress parameters, inflammatory and apoptotic markers in spinal cord of spinal nerve ligated rats. Treatment with pioglitazone and ceftriaxone significantly prevented these behavioral, biochemical, mitochondrial and cellular alterations in rats. Further, combination of pioglitazone (10mg/kg, ip) with ceftriaxone (100mg/kg, ip) significantly potentiated the protective effects as compared to their effects per se. Based on these results we propose that possible interplay between the neuroprotective effects of pioglitazone and ceftriaxone exists in suppressing the behavioral, biochemical, mitochondrial, neuroinflammatory and apoptotic cascades in spinal nerve ligation induced neuropathic pain in rats. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  16. Characterization of Resistance Genes and Plasmids from Outbreaks and Illness Clusters Caused by Salmonella Resistant to Ceftriaxone in the United States, 2011-2012.

    Science.gov (United States)

    Folster, Jason P; Grass, Julian E; Bicknese, Amelia; Taylor, Julia; Friedman, Cindy R; Whichard, Jean M

    2017-03-01

    Salmonella is an important cause of foodborne illness; however, quickly identifying the source of these infections can be difficult, and source identification is a crucial step in preventing additional illnesses. Although most infections are self-limited, invasive salmonellosis may require antimicrobial treatment. Ceftriaxone, an extended-spectrum cephalosporin, is commonly used for treatment of salmonellosis. Previous studies have identified a correlation between the food animal/retail meat source of ceftriaxone-resistant Salmonella and the type of resistance gene and plasmid it carries. In this study, we examined seven outbreaks of ceftriaxone-resistant Salmonella infections, caused by serotypes Typhimurium, Newport, Heidelberg, and Infantis. All isolates were positive for a plasmid-encoded bla CMY gene. Plasmid incompatibility typing identified five IncI1 and two IncA/C plasmids. Both outbreaks containing bla CMY -IncA/C plasmids were linked to consumption of cattle products. Three of five outbreaks with bla CMY -IncI1 (ST12) plasmids were linked to a poultry source. The remaining IncI1 outbreaks were associated with ground beef (ST20) and tomatoes (ST12). In addition, we examined isolates from five unsolved clusters of ceftriaxone-resistant Salmonella infections and used our plasmid-encoded gene findings to predict the source. Overall, we identified a likely association between the source of ceftriaxone-resistant Salmonella outbreaks and the type of resistance gene/plasmid it carries.

  17. The effect of N-formimidoyl thienamycin, ceftazidime, cefotiam, ceftriaxone and cefotaxime on non-fermentative Gram-negative rods, Aeromonas, Plesiomonas and Enterobacter agglomerans.

    Science.gov (United States)

    von Graevenitz, A; Bucher, C

    1982-01-01

    Thirty-one species (185 strains) of non-fermentative gram-negative rods (excluding Pseudomonas aeruginosa) as well as 45 strains of Aeromonas spp., 15 strains of Plesiomonas shigelloides and 68 strains of Enterobacter agglomerans were tested in microdilution procedures against N-formimidoyl thienamycin, ceftazidime, cefotiam, ceftriaxone and cefotaxime. N-formimidoyl thienamycin was the most effective drug as far as the spectrum of these bacterial groups and potency is concerned; ceftazidime was the second most effective agent. Ceftriaxone and cefotaxime were similar in their activity (against a smaller spectrum), while cefotiam showed little effect. There were occasional differences between MBC and MIC values which were most notable with ceftazidime, cefotiam, ceftriaxone and cefotaxime against E. agglomerans.

  18. Comparative in vitro activities of ceftaroline and ceftriaxone against bacterial pathogens associated with respiratory tract infections: results from the AWARE surveillance study.

    Science.gov (United States)

    Biedenbach, D J; Iaconis, J P; Sahm, D F

    2016-12-01

    Ceftaroline fosamil is indicated for the treatment of community-acquired bacterial pneumonia and ceftriaxone has an indication for lower respiratory tract infections. This study was conducted to compare the relative in vitro activities of these two agents against bacterial species associated with community-associated respiratory tract infections. In all, 13 005 isolates of Staphylococcus aureus, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae were collected in 2012-14 from 39 countries in the Asia-Pacific region, Europe, Latin America and Africa-Middle East from respiratory tract specimens. The identification was confirmed centrally by MALDI-TOF and broth microdilution susceptibility testing and interpretation was done according to CLSI guidelines. Ceftaroline was 16-fold more potent against MSSA (MIC 90 0.25 versus 4 mg/L) than ceftriaxone and ≥16-fold more potent against MRSA (MIC 90 2 versus >32 mg/L). Ceftaroline was 16-fold more potent against S. pneumoniae (MIC 90 0.12-0.25 mg/L) compared with ceftriaxone (MIC 90 1-2 mg/L), with higher MIC values observed among penicillin-non-susceptible isolates for both agents. Similar activity (MIC 90 ≤0.03 mg/L) was observed for ceftaroline and ceftriaxone against H. influenzae, with higher MIC values observed in the Asia-Pacific region for both agents compared with other regions. Ceftaroline was 4- to 8-fold more active against M. catarrhalis (MIC 90 0.12-0.25 mg/L) compared with ceftriaxone (MIC 90 1 mg/L). These global MIC data demonstrated that ceftaroline exhibited superior in vitro activity compared with ceftriaxone against bacterial species that commonly cause community-associated respiratory tract infections. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Outer membrane protein STM3031 (Ail/OmpX-like protein) plays a key role in the ceftriaxone resistance of Salmonella enterica serovar Typhimurium.

    Science.gov (United States)

    Hu, Wensi S; Lin, Jing-Fang; Lin, Ying-Hsiu; Chang, Hsin-Yu

    2009-08-01

    Previously, the putative outer membrane protein STM3031 has been correlated with ceftriaxone resistance in Salmonella enterica serovar Typhimurium. In this study, this protein was almost undetectable in the ceftriaxone-susceptible strain 01-4, but its levels were increased in 01-4 isogenic strains for which MICs were higher. The stm3031 gene deletion mutant, R200(Deltastm3031), was generated and showed >64-fold lower ceftriaxone resistance than R200, supporting a key role for STM3031 in ceftriaxone resistance. To investigate which outer membrane protein(s) was associated with resistance, the outer membrane protein profiles of 01-4, R200, and R200(Deltastm3031) were compared proteomically. Nine proteins were identified as altered. The expression levels of AcrA, TolC, STM3031, STM1530, VacJ, and Psd in R200 were increased; those of OmpC, OmpD, and OmpW were decreased. The expression levels of OmpD, OmpW, STM1530, VacJ, and Psd, but not those of OmpC, AcrA, and TolC, in R200(Deltastm3031) were returned to the levels in strain 01-4. Furthermore, the genes' mRNA levels correlated with their protein levels when the three strains were compared. The detection of higher AcrB levels, linked to higher acrB, acrD, and acrF mRNA levels, in strain R200 than in strains 01-4 and R200(Deltastm3031) suggests that AcrB, AcrD, and AcrF participate in ceftriaxone resistance. Taken together with the location of STM3031 in the outer membrane, these results suggest that STM3031 plays a key role in ceftriaxone resistance, probably by reducing permeability via a decreased porin OmpD level and enhancing export via increased AcrD efflux pump activity.

  20. The Treatment of Possible Severe Infection in Infants: An Open Randomized Safety Trial of Parenteral Benzylpenicillin and Gentamicin Versus Ceftriaxone in Infants <60 days of Age in Malawi.

    Science.gov (United States)

    Molyneux, Elizabeth M; Dube, Queen; Banda, Francis M; Chiume, Msandeni; Singini, Isaac; Mallewa, Macpherson; Schwalbe, Edward C; Heyderman, Robert S

    2017-12-01

    The World Health Organization recommends benzylpenicillin and gentamicin as antimicrobial treatment for infants with sepsis in low-income settings, and ceftriaxone or cefotaxime as an alternative. In a meta-analysis from 13 low-income settings, Staphylococcus aureus, Klebsiella spp. and Escherichia coli accounted for 55% of infants with sepsis. In a review of bacterial meningitis, resistance to third generation cephalosporins was >50% of all isolates, and 44% of Gram-negative isolates were gentamicin resistant. However, ceftriaxone may cause neonatal jaundice, and gentamicin may cause deafness. Therefore, we compared parenteral benzylpenicillin plus gentamicin with ceftriaxone as first-line treatment, assessing outcome and adverse events. This was an open randomized trial carried out in the Queen Elizabeth Central Hospital, Blantyre, Malawi, from 2010 to 2013. Infants ceftriaxone. Adverse events and outcomes were recorded until 6 months post discharge. Three-hundred forty-eight infants were included in analyses. Outcome in the benzylpenicillin and gentamicin and ceftriaxone groups was similar; deaths were 13.7% and 16.5% and sequelae were 14.5% and 11.2%, respectively. More infants in the penicillin/gentamicin group required phototherapy: 15% versus 5%, P = 0.03. Thirteen (6%) survivors had bilateral hearing loss. There was no difference between the treatment groups. By 6 months post discharge, 11 more infants had died, and 17 more children were found to have sequelae. Ceftriaxone and gentamicin are safe for infants in our setting. Infants should receive long-term follow-up as many poor outcomes occurred after hospital discharge.

  1. Correlation between ceftriaxone resistance of Salmonella enterica serovar Typhimurium and expression of outer membrane proteins OmpW and Ail/OmpX-like protein, which are regulated by BaeR of a two-component system.

    Science.gov (United States)

    Hu, Wensi S; Li, Pei-Chuan; Cheng, Chao-Yin

    2005-09-01

    Mutant 7F2 of Salmonella enterica serovar Typhimurium has a transposon inserted in the regulator gene baeR of a two-component system and showed a more-than-fourfold reduction in resistance to ceftriaxone. Complementation analysis suggested an association among the outer membrane proteins OmpW and STM3031, ceftriaxone resistance, and baeR.

  2. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from symptomatic men attending the Nanjing sexually transmitted diseases clinic (2011-2012): genetic characteristics of isolates with reduced sensitivity to ceftriaxone.

    Science.gov (United States)

    Li, Sai; Su, Xiao-Hong; Le, Wen-Jing; Jiang, Fa-Xing; Wang, Bao-Xi; Rice, Peter A

    2014-11-27

    Evolving gonococcal antimicrobial resistance (AMR) poses a serious threat to public health. The aim of this study was to: update antimicrobial susceptibility data of Neisseria gonorrhoeae recently isolated in Nanjing, China and identify specific deteminants of antimicrobial resistance and gentoypes of isolates with decreased sensitivity to ceftriaxone. 334 N. gonorrhoeae isolates were collected consecutively from symptomatic men attending the Nanjing STD Clinic between April 2011 and December 2012. The minimum inhibitory concentrations (MICs) for penicillin, tetracycline, ciprofloxacin, spectinomycin and ceftriaxone were determined by agar plate dilution for each isolate. Penicillinase-producing N. gonorrhoeae (PPNG) and tetracycline-resistant N. gonorrhoeae (TRNG) were examined and typed for β-lactamase and tetM encoding plasmids respectively. Isolates that displayed elevated MICs to ceftriaxone (MIC ≥0.125 mg/L) were also tested for mutations in penA, mtrR, porB1b, ponA and pilQ genes and characterized by Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST). 98.8% (330/334) of N. gonorrhoeae isolates were resistant to ciprofloxacin; 97.9% (327/334) to tetracycline and 67.7% (226/334) to penicillin. All isolates were susceptible to ceftriaxone (MIC ≤0.25 mg/L) and spectinomycin (MIC ≤32 mg/L). Plasmid mediated resistance was exhibited by 175/334 (52%) of isolates: 120/334 (36%) of isolates were PPNG and 104/334 (31%) were TRNG. 90.0% (108/120) of PPNG isolates carried the Asia type β-lactamase encoding plasmid and 96% (100/104) of TRNG isolates carried the Dutch type tetM containing plasmid. Elevated MICs for ceftriaxone were present in 15 (4.5%) isolates; multiple mutations were found in penA, mtrR, porB1b and ponA genes. The 15 isolates were distributed into diverse NG-MAST sequence types; four different non-mosaic penA alleles were identified, including one new type. N. gonorrhoeae isolates in Nanjing generally retained similar antimicrobial

  3. Ceftriaxone-induced immune hemolytic anemia as a life-threatening complication of antibiotic treatment of 'chronic Lyme disease'.

    Science.gov (United States)

    De Wilde, Maarten; Speeckaert, Marijn; Callens, Rutger; Van Biesen, Wim

    2017-04-01

    'Chronic Lyme disease' is a controversial condition. As any hard evidence is lacking that unresolved systemic symptoms, following an appropriately diagnosed and treated Lyme disease, are related to a chronic infection with the tick-borne spirochaetes of the Borrelia genus, the term 'chronic Lyme disease' should be avoided and replaced by the term 'post-treatment Lyme disease syndrome.' The improper prescription of prolonged antibiotic treatments for these patients can have an impact on the community antimicrobial resistance and on the consumption of health care resources. Moreover, these treatments can be accompanied by severe complications. In this case report, we describe a life-threatening ceftriaxone-induced immune hemolytic anemia with an acute kidney injury (RIFLE-stadium F) due to a pigment-induced nephropathy in a 76-year-old woman, who was diagnosed with a so-called 'chronic Lyme disease.'

  4. Similar rebleeding rate in 3-day and 7-day intravenous ceftriaxone prophylaxis for patients with acute variceal bleeding.

    Science.gov (United States)

    Lee, Tzong-Hsi; Huang, Chung-Tsui; Lin, Chien-Chu; Chung, Chen-Shuan; Lin, Cheng-Kuan; Tsai, Kuang-Chau

    2016-07-01

    Although prophylactic antibiotics have been recommended for cirrhotic patients with upper gastrointestinal bleeding, the duration of its use remains an inconclusive issue. We designed this study to investigate the duration of antibiotic prophylaxis for cirrhotic patients with acute esophageal variceal bleeding. We enrolled those patients suffering from acute esophageal variceal bleeding and receiving band ligation. They were randomly allocated to two groups to receive prophylactic antibiotics; Group I: receiving intravenous ceftriaxone 500 mg every 12 hours for 3 days, and Group II: same regimen for 7 days. We used rebleeding rate within 14 days as the primary end point and also evaluated the survival rate within 28 days and the amount of transfusion during admission. There were 38 patients in Group I and 33 patients in Group II that completed the study course for analysis. Overall, there was no significant difference in the baseline characteristics between these two groups. There were three patients both in Group I and Group II who developed rebleeding within 14 days (8% vs. 9%, p > 0.99). There was also no difference between Group I and Group II in transfusion amount (2.71 ± 2.84 units vs. 3.18 ± 4.07, p = 0.839) and survival rate in 28 days (100 vs. 97%, p = 0.465). Our small scale study demonstrated that there was no difference in the rebleeding rate between 3-day and 7-day ceftriaxone prophylaxis for cirrhotic patients with acute esophageal variceal bleeding. There was also no difference in 28 day survival rate between these two groups. Copyright © 2016. Published by Elsevier B.V.

  5. Labelling of ceftriaxone with (99m) Tc and its bio-evaluation as an infection imaging agent.

    Science.gov (United States)

    Sohaib, Muhammad; Khurshid, Zain; Roohi, Samina

    2014-09-01

    Differentiation of bacterial and sterile inflammation will have a significant impact on the current clinical practice. Ceftriaxone (CTRX) was labelled with (99m) Tc and assessed for its ability to depict infection on scintigraphy. Stoichiometry was performed to optimize labelling parameters. Stability and bacterial binding was verified and biodistribution pattern was seen in normal, infected/inflamed animal models. (99m) Tc-CTRX prepared at pH 7 with stannous chloride of 50 µg, ligand of 30 mg, and boiling for 10 min gave labelling yield of 96.2 ± 0.2% with good stability. In vitro binding was higher for Escherichia coli than Staphylococcus aureus. Biodistribution in normal rats showed high uptake in hepatobiliary system, gut and urinary system. In animal models induced with infection or inflammation, lesion to normal ratios at 4 h were 2.36 ± 0.21, 12.66 ± 1.44 and 1.40 ± 0.01 with S. aureus infection, E. coli infection and turpentine oil inflammation, respectively. Infection specificity especially for E. coli was also confirmed on scintigraphic findings. Ceftriaxone can be labelled with (99m) Tc with high labelling yield at pH compatible with that of blood. Our preparation has shown stability in vitro and in human serum, and binds preferentially with bacteria. (99m) Tc-CTRX scintigraphy can be used to delineate sites of active infection and to differentiate infection and inflammation. Copyright © 2014 John Wiley & Sons, Ltd.

  6. A cost-minimisation analysis comparing moxifloxacin with levofloxacin plus ceftriaxone for the treatment of patients with community-acquired pneumonia in Germany: results from the MOTIV trial.

    Science.gov (United States)

    Lloyd, A; Holman, A; Evers, T

    2008-05-01

    This study presents a cost-minimisation analysis of moxifloxacin compared to combination treatment with levofloxacin and ceftriaxone in patients hospitalised with community-acquired pneumonia (CAP) in Germany. In the MOTIV study, 738 adult patients with CAP requiring hospitalisation and initial parenteral antibiotic therapy were randomised to sequential IV/oral therapy with either moxifloxacin (n = 368), or levofloxacin and ceftriaxone (n = 365). The primary effectiveness endpoint was the proportion of patients demonstrating clinical improvement 5-7 days after the completion of study treatment. Subgroup analysis considered patients with severe CAP according to pneumonia severity index (PSI) risk class IV and V, microbiologically proven infection, a history of chronic obstructive pulmonary disease, and a history of cardiovascular disease. The analysis included the cost of study medication, hospital stay, readmission and inpatient procedures and diagnostics. Event frequency in the study was multiplied by German unit costs to estimate per-patient expenditure. The analysis was conducted from a hospital perspective. Sensitivity analysis investigated the effect of costing from an insurer perspective. No significant difference was found in the percentage of successfully treated patients. Average per patient cost was euro 2190 for the moxifloxacin group, and euro 2619 for the levofloxacin + ceftriaxone group (difference -euro 430, 95% CI: -euro 138, -euro 740; p < 0.05). Variability in total costs was wide, with some patients accruing up to euro 18,000. Medication cost was significantly lower with moxifloxacin than levofloxacin + ceftriaxone (-euro 470, 95% CI: -euro 522, -euro 421), and accounted for between 15 and 30% of total costs. In this analysis of patients hospitalised with CAP in Germany, treatment with moxifloxacin was significantly less costly than treatment with levofloxacin and ceftriaxone.

  7. Ceftaroline fosamil versus ceftriaxone for the treatment of community-acquired pneumonia: individual patient data meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Taboada, Maria; Melnick, David; Iaconis, Joseph P; Sun, Fang; Zhong, Nan Shan; File, Thomas M; Llorens, Lily; Friedland, H David; Wilson, David

    2016-04-01

    We conducted a meta-analysis of clinical trials of adults hospitalized with pneumonia outcomes research team (PORT) risk class 3-4 community-acquired pneumonia (CAP) receiving ceftaroline fosamil versus ceftriaxone. Three Phase III trials (clinicaltrials.gov registration numbers NCT00621504, NCT00509106 and NCT01371838) including 1916 hospitalized patients with CAP randomized 1:1 to empirical ceftaroline fosamil (600 mg every 12 h) or ceftriaxone (1-2 g every 24 h) for 5-7 days were included in the meta-analysis. Primary outcome was clinical response at the test-of-cure visit (8-15 days after end of treatment) in the PORT risk class 3-4 modified ITT (MITT) and clinically evaluable (CE) populations. Data were tested for heterogeneity (χ(2) test) and, if not significant, results were pooled and OR and 95% CI constructed. A logistic regression analysis assessed factors impacting cure rate and treatment interactions. Clinical cure rates in each trial consistently favoured ceftaroline fosamil versus ceftriaxone, with no evidence of heterogeneity. In the meta-analysis, ceftaroline fosamil was superior to ceftriaxone in the MITT (OR: 1.66; 95% CI 1.34, 2.06; P Ceftaroline fosamil was superior to ceftriaxone for empirical treatment of adults hospitalized with CAP. Receipt of prior antimicrobial therapy appeared to diminish the observed treatment effect. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Ceftriaxone attenuates acquisition and facilitates extinction of cocaine-induced suppression of saccharin intake in C57BL/6J mice.

    Science.gov (United States)

    Freet, Christopher S; Lawrence, Antoneal L

    2015-10-01

    Growing evidence implicates glutamate homeostasis in a number of behaviors observed in addiction such as acquisition of drug taking, motivation, and reinstatement. To date, however, the role of glutamate homeostasis in the avoidance of natural rewards due to exposure to drugs of abuse has received little attention. The aim of the current study was to evaluate the beta-lactam antibiotic, ceftriaxone, which has been shown to normalize disrupted glutamate homeostasis associated with exposure to drugs of abuse, in cocaine-induced suppression of saccharin intake in C57BL/6J mice. Briefly, C57BL/6J mice received daily injections of either 200mg/kg ceftriaxone or saline. Mice were then given access to 0.15% saccharin for 1h and immediately injected intraperitoneally with either saline or 30 mg/kg cocaine; taste-drug pairings occurred every 24h for 5 trials followed by a final CS only trial. One week following taste-drug pairings, extinction was evaluated in a series of one- and two-bottle saccharin intake tests. Individual differences in cocaine-induced suppression were observed (i.e., low and high suppressors) with differential effects of ceftriaxone. Ceftriaxone delayed suppression of saccharin intake in high suppressors but prevented suppression in low suppressors. In addition, ceftriaxone history facilitated extinction in the high suppressors. These data suggest that changes in glutamate homeostasis may be involved in the formation and expression of cocaine-induced suppression of saccharin intake in mice. Copyright © 2015. Published by Elsevier Inc.

  9. Cefepime versus Ceftriaxone for perioperative systemic antibiotic prophylaxis in elective orthopedic surgery at Bugando Medical Centre Mwanza, Tanzania: a randomized clinical study.

    Science.gov (United States)

    Marwa, Joel M; Ngayomela, Isidor H; Seni, Jeremiah; Mshana, Stephen E

    2015-12-23

    Antimicrobial prophylaxis reduces the incidence of postoperative wound infections especially among patients undergoing orthopedics surgery. However, there is dearth of information on the clinical effectiveness, spectrum limitations and practical contextual information on third and fourth generation cephalosporins. The aim of this study was to evaluate the efficacy and safety of cefepime and ceftriaxone as peri-operative systemic antimicrobial prophylaxis in elective orthopedic surgery in our center. This study was a prospective, randomized, open label comparative clinical study of patients undergoing elective orthopedic procedures at the Bugando Medical Centre (BMC) between June 2014 and February 2015. Two hundred thirty participants were enrolled in the study and randomly assigned into Ceftriaxone regimen (group A) or Cefepime regimen (group B). Participants in ceftriaxone or cefepime group received 50 mg/kg up to 2 g single dose perioperative intravenous infusion at least 30 min before incision. Both groups were followed for 30 days using a Center for Disease Control superficial surgical site infection criterion for the outcome. A two-tailed margin of equivalence was set at 5% analyzed on the intent to treat. All 230 participants were subjected to final analysis with no patient being lost to follow-up. Superficial surgical site infection occurred in 5 out of 117 (4.3%, 0.6 to 7.9 at 95% CI) patients receiving cefepime compared to 3 out of 113 (2.7%, 0.3 to 5.6 at 95% CI) among patients receiving ceftriaxone regimen. The absolute difference of 1.6% (95% Confidence Interval: -6.3 to 3.1), equivocally lies outside the 5% statistically significant margin of presumed clinical equivalence. The difference between cefepime and ceftriaxone in preventing SSIs following elective clean orthopedic surgery was not statistically significant. Pan African Clinical Trial Registry: PACTR201406000803420.

  10. Ceftriaxone activity against Gram-positive and Gram-negative pathogens isolated in US clinical microbiology laboratories from 1996 to 2000: results from The Surveillance Network (TSN) Database-USA.

    Science.gov (United States)

    Karlowsky, J A; Jones, M E; Mayfield, D C; Thornsberry, C; Sahm, D F

    2002-05-01

    Ceftriaxone was introduced into clinical practice in the USA in 1985 and was the first extended-spectrum (third-generation) cephalosporin approved for once-daily treatment of patients with Gram-positive or Gram-negative infections. Review of ceftriaxone activity is important given its continued use since the mid-1980s and reports of emerging resistance among all antimicrobial agent classes. We reviewed the activity of ceftriaxone and relevant comparative agents against five Gram-positive and 11 Gram-negative species for a 5-year period, 1996-2000, using data from The Surveillance Network (TSN) Database-USA. All MIC results were interpreted using NCCLS breakpoint criteria. Ceftriaxone resistance among isolates of Streptococcus pneumoniae (n=17219) remained essentially unchanged over the 5 years studied and in fact was lower from 1998 to 2000 (5.0-5.1%) than in 1996 (6.3%) and 1997 (6.6%). Ceftriaxone resistance (range, 5.1-6.9%) among viridans group streptococci (n=6621) varied by <2% from 1997 to 2000. Beta-lactam-resistant Streptococcus pyogenes (n=935) and group B beta-haemolytic streptococci (n=2267) were not identified in any year. Among methicillin-susceptible Staphylococcus aureus (n=39 284) ceftriaxone resistance was 0.1-0.3% per year from 1996 to 2000. Ceftriaxone resistance among Escherichia coli (n=472407; range, 0.2-0.4%), Klebsiella oxytoca (n=16231; range, 3.5-4.8%), Klebsiella pneumoniae (n=117754; range, 1.9-2.6%), Proteus mirabilis (n=67692; range, 0.2-0.3%), Morganella morganii (n=11251; range, 0.3-2.1%) and Serratia marcescens (n=26519; range, 1.6-3.8%) was low and consistent from 1996 to 2000. Resistance to ceftriaxone among Enterobacter cloacae (n=48114; range, 21.7-23.9%) was relatively high, compared with other Enterobacteriaceae, but unchanged from 1996 to 2000. Rates of resistance to ceftriaxone among Acinetobacter spp. (n=20813) increased from 24.8% in 1996 to 45.1% in 2000. All Haemophilus influenzae (n=7911) and Neisseria gonorrhoeae (n

  11. Gatifloxacin in the treatment of community-acquired pneumonias: a comparative trial of ceftriaxone, with or without macrolides, in hospitalized adult patients with mild to moderately severe pneumonia

    Directory of Open Access Journals (Sweden)

    J.S. Mendonça

    Full Text Available Community-acquired pneumonia is very common, but some of the cases do require hospitalization for treatment, particularly when older patients and/or co-morbidities are involved; both "typical" and "atypical" respiratory pathogens take part etiologically, and there is increasing concern about the emergence of resistance. There is interest in therapeutic options that can: a comprehend such a spectrum of bacteria and resistance; b allow parenteral to oral sequential treatment. We made a multicenter, prospective and randomized trial to compare the "standard" treatment of ceftriaxone IV alone or in combination with erythromycin IV, followed by clarithromycin PO (ceftriaxone treatment arm, with gatifloxacin IV, followed by oral administration (gatifloxacin treatment arm. The need for hospitalization was based on clinical criteria as judged by the investigators. Standardized criteria for diagnosis and follow-up were employed. Fifty-six patients were enrolled, with 48% over 65 years old, and there were frequent co-morbidities. Of these, 51 were clinically evaluable, 26 in the gatifloxacin and 25 in the ceftriaxone arm, with comparable success rates, 92% and 88%, respectively, even when major prognostic factors were considered. There were no serious adverse events or significant laboratory value changes attributable to the study drugs. Gatifloxacin as monotherapy (initially IV then orally until completion of treatment was shown to be effective and safe, comparable to ceftriaxone IV alone or in combination with a macrolide (initially IV then orally until completion of treatment, in empirical therapy for community-acquired pneumonias, for patients that, at the physician s discretion, require initial treatment as inpatients.

  12. 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.

  13. 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.

  14. Poor outcomes of empiric ceftriaxone ± azithromycin for community-acquired pneumonia caused by methicillin-susceptible Staphylococcus aureus.

    Science.gov (United States)

    So, Wonhee; Crandon, Jared L; Nicolau, David P

    2016-06-01

    While ceftriaxone 1 g q24h is commonly used for hospitalized patients with community-acquired pneumonia (CAP), the prescribing information recommends 2-4 g a day to treat methicillin-susceptible Staphylococcus aureus (MSSA). Similarly, recent pharmacodynamic analyses suggest shortcomings of 1 g q24h against the bulk of the MSSA. We evaluated the outcomes of empiric ceftriaxone 1 g q24h ± azithromycin in patients with MSSA pneumonia, as compared with Streptococcus pneumoniae. Adult patients admitted to Hartford Hospital from 1/2005 to 12/2014 with respiratory culture for MSSA or S. pneumoniae were considered for inclusion. Non-ICU, CAP patients were included. Early clinical failure (ECF) was defined as persistent signs/symptoms or change of antibiotic due to poor response at 72-96 h. A multivariate analysis was performed to evaluate predictors of ECF. Over the study period, 403 MSSA and 227 S. pneumoniae positive respiratory cultures were identified. The majority of patients were excluded due to the following: no signs/symptoms of pneumonia, hospital-acquired pneumonia, alternative antibiotics, and polymicrobial infection. Thirty-nine patients met inclusion/exclusion criteria. All but three patients in the S. pneumoniae group received ceftriaxone + azithromycin. ECF was greater in the MSSA group (53 vs. 4 %, P = 0.003), as was length of stay (7.5 ± 5.4 vs. 4.6 ± 3.3 days, P = 0.006). When controlling for disease severity and macrolide non-susceptibility in a multivariate analysis, MSSA was significantly correlated with ECF (OR 12.3, 95 % CI 0.8-188.8). Poor clinical outcomes were observed in patients empirically treated with ceftriaxone ± azithromycin for MSSA CAP. Despite the popularity of ceftriaxone 1 g q24h, these data suggest this dose or compound may be inadequate for CAP caused by MSSA.

  15. Are first-generation cephalosporins obsolete? A retrospective, non-inferiority, cohort study comparing empirical therapy with cefazolin versus ceftriaxone for acute pyelonephritis in hospitalized patients.

    Science.gov (United States)

    Hobbs, Athena L V; Shea, Katherine M; Daley, Mitchell J; Huth, R Gordon; Jaso, Theresa C; Bissett, Jack; Hemmige, Vagish

    2016-06-01

    Literature is lacking regarding the utilization of first-generation cephalosporins for the treatment of acute pyelonephritis. The aim of this study was to determine whether cefazolin is non-inferior to ceftriaxone for the empirical treatment of acute pyelonephritis in hospitalized patients. The primary outcome included a composite of symptomatic resolution plus either defervescence at 72 h or normalization of serum white blood cell count at 72 h (non-inferiority margin 15%). Secondary outcomes included length of stay and 30 day readmission. A subgroup analysis of the composite outcome was also conducted for imaging-confirmed pyelonephritis. This was a retrospective, non-inferiority, multicentre, cohort study comparing cefazolin versus ceftriaxone for the empirical treatment of acute pyelonephritis in hospitalized patients. Overall, 184 patients received one of the two treatments between July 2009 and March 2015. The composite outcome was achieved in 80/92 (87.0%) in the cefazolin group versus 79/92 (85.9%) in the ceftriaxone group (absolute difference 1.1%, 95% CI -11.1% to 8.9%, P = 0.83), meeting the pre-defined criteria for non-inferiority. The composite outcome for patients with imaging-confirmed pyelonephritis was achieved in 46/56 (82.1%) versus 42/50 (84.0%) for the cefazolin group and the ceftriaxone group, respectively (absolute difference 1.9%, 95% CI -12.8% to 16.5%, P = 0.80). Additionally, there were no statistically significant differences in length of stay or 30 day readmission for cystitis or pyelonephritis. Cefazolin was non-inferior to ceftriaxone with regard to clinical response for the treatment of hospitalized patients with acute pyelonephritis in this study. No difference was observed for length of stay or 30 day readmission. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. ANALISIS FARMAKOEKONOMI PERESEPAN ANTIBIOTIKA CEFTRIAXONE DAN CEFTAZIDIME PADA PASIEN BEDAH SESAR DI RUMAH SAKIT PANTI RINI YOGYAKARTA

    Directory of Open Access Journals (Sweden)

    Maria Wisnu Donowati

    2016-04-01

    Full Text Available Abstract: The raising of cesarean section had leaded the abuse of antibiotic prescribing in order to minimize the wound or urethra infection that came in the caesarean surgery. Pharmaceutical care oriented had push pharmacist to care more about patients drug use to increase quality of live. The aim of this research is to identify the total hospital service cost and calculate total antibiotic cost, total drug and prescribtion. The data are collected through medical records and hospital service cost of 145 Panti Rini hospital cesarean section patients in 2003. Normality and homogenity test are using computer programme, α 95%. The most patient were 25-30 years old, first gestational fist partum and non aborts, cephalopelvic disproportion indication and having third class in hospital services. Ceftazidime in Pharodime® and Ceftriaxone in Tricefin® are the most cephalosphorin third generation that had been used among other antibiotics. Total hospital cost that must be paid by the third class cesarean section patients are same, Rp. 820,974 in a day. The average of total drug and medical equipment cost and total antibiotics cost are different. Total drug and medical equipment cost in a day by using Pharodime® is cheaper Rp. 33,903 than Tricefin®. Total antibiotics cost in a day by using Pharodime® is cheaper Rp. 34,663 than Tricefin®. Keywords: pharmacoeconomic, antibiotic, prescription.

  17. Ceftriaxone- and N-acetylcysteine-induced brain tolerance to ischemia: Influence on glutamate levels in focal cerebral ischemia.

    Directory of Open Access Journals (Sweden)

    Weronika Krzyżanowska

    Full Text Available One of the major players in the pathophysiology of cerebral ischemia is disrupted homeostasis of glutamatergic neurotransmission, resulting in elevated extracellular glutamate (Glu concentrations and excitotoxicity-related cell death. In the brain, Glu concentrations are regulated by Glu transporters, including Glu transporter-1 (GLT-1 and cystine/Glu antiporter (system xc-. Modulation of these transporters by administration of ceftriaxone (CEF, 200 mg/kg, i.p. or N-acetylcysteine (NAC, 150 mg/kg, i.p. for 5 days before focal cerebral ischemia may induce brain tolerance to ischemia by significantly limiting stroke-related damage and normalizing Glu concentrations. In the present study, focal cerebral ischemia was induced by 90-minute middle cerebral artery occlusion (MCAO. We compared the effects of CEF and NAC pretreatment on Glu concentrations in extracellular fluid and cellular-specific expression of GLT-1 and xCT with the effects of two reference preconditioning methods, namely, ischemic preconditioning and chemical preconditioning in rats. Both CEF and NAC significantly reduced Glu levels in the frontal cortex and hippocampus during focal cerebral ischemia, and this decrease was comparable with the Glu level achieved with the reference preconditioning strategies. The results of immunofluorescence staining of GLT-1 and xCT on astrocytes, neurons and microglia accounted for the observed changes in extracellular Glu levels to a certain extent. Briefly, after MCAO, the expression of GLT-1 on astrocytes decreased, but pretreatment with CEF seemed to prevent this downregulation. In addition, every intervention used in this study seemed to reduce xCT expression on astrocytes and neurons. The results of this study indicate that modulation of Glu transporter expression may restore Glu homeostasis. Moreover, our results suggest that CEF and NAC may induce brain tolerance to ischemia by influencing GLT-1 and system xc- expression levels. These

  18. Preparation of RuO2-TiO2/Nano-graphite composite anode for electrochemical degradation of ceftriaxone sodium.

    Science.gov (United States)

    Li, Dong; Guo, Xiaolei; Song, Haoran; Sun, Tianyi; Wan, Jiafeng

    2018-06-05

    Graphite-like material is widely used for preparing various electrodes for wastewater treatment. To enhance the electrochemical degradation efficiency of Nano-graphite (Nano-G) anode, RuO 2 -TiO 2 /Nano-G composite anode was prepared through the sol-gel method and hot-press technology. RuO 2 -TiO 2 /Nano-G composite was characterized by X-ray diffraction, X-ray photoelectron spectroscopy, transmission electron microscopy and N 2 adsorption-desorption. Results showed that RuO 2 , TiO 2 and Nano-G were composited successfully, and RuO 2 and TiO 2 nanoparticles were distributed uniformly on the surface of Nano-G sheet. Specific surface area of RuO 2 -TiO 2 /Nano-G composite was higher than that of TiO 2 /Nano-G composite and Nano-G. Electrochemical performances of RuO 2 -TiO 2 /Nano-G anode were investigated by cyclic voltammetry, electrochemical impedance spectroscopy. RuO 2 -TiO 2 /Nano-G anode was applied to electrochemical degradation of ceftriaxone. The generation of hydroxyl radical (OH) was measured. Results demonstrated that RuO 2 -TiO 2 /Nano-G anode displayed enhanced electrochemical degradation efficiency towards ceftriaxone and yield of OH, which is derived from the synergetic effect between RuO 2 , TiO 2 and Nano-G, which enhance the specific surface area, improve the electrochemical oxidation activity and lower the charge transfer resistance. Besides, the possible degradation intermediates and pathways of ceftriaxone sodium were identified. This study may provide a viable and promising prospect for RuO 2 -TiO 2 /Nano-G anode towards effective electrochemical degradation of antibiotics from wastewater. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. A comparison of agar dilution with the Calibrated Dichotomous Sensitivity (CDS) and Etest methods for determining the minimum inhibitory concentration of ceftriaxone against Neisseria gonorrhoeae.

    Science.gov (United States)

    Enriquez, Rodney P; Goire, Namraj; Kundu, Ratan; Gatus, Barrie J; Lahra, Monica M

    2016-09-01

    The objective of this study was to compare the Calibrated Dichotomous Sensitivity (CDS) based agar dilution (CDS AD) method with the Etest (bioMérieux SA) methods using 2 method protocols for determining the minimum inhibitory concentration (MIC) of ceftriaxone against Neisseria gonorrhoeae. The two method protocols were the manufacturer's protocol for which the Clinical and Laboratory Standards Institute (CLSI) interpretative criteria for Neisseria gonorrhoeae could be applied, and the CDS-adapted protocol. Comparability of MIC data is critical for situation analysis and monitoring trends in global antimicrobial analysis. Two hundred and forty eight clinical isolates of N. gonorrhoeae and the World Health Organisation (WHO) N. gonorrhoeae reference strains were tested using the three methods. When compared, CDS AD and CDS Etest gave a regression R(2) value of 94%, the Pearson's correlation coefficient was 97% and a paired comparison within one log2 dilution was 98%. The CDS AD and the Etest (CLSI) comparison gave a regression R(2) value of 90%, a Pearson's correlation coefficient of 95% and a paired comparison within one log2 dilution was 98%. The comparison of the CDS Etest and CLSI Etest gave a regression R(2) value of 91%, a Pearson's correlation coefficient of 95% and a paired comparison within one log2 dilution of 99%. Importantly, there was robust agreement between all three methods for the categorization of susceptibility of Neisseria gonorrhoeae isolates using the WHO nominated breakpoint for decreased susceptibility to ceftriaxone (≥0.125 μg/mL). The CDS Etest method is comparable to agar dilution and the Etest methods for determining the MIC of ceftriaxone against N. gonorrhoeae. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Susceptibility of Neisseria gonorrhoeae to azithromycin and ceftriaxone in China: A retrospective study of national surveillance data from 2013 to 2016.

    Directory of Open Access Journals (Sweden)

    Yue-Ping Yin

    2018-02-01

    Full Text Available Gonorrhea remains one of the most common sexually transmitted diseases worldwide. Successful treatment has been hampered by emerging resistance to each of the antibiotics recommended as first-line therapies. We retrospectively analyzed the susceptibility of gonorrhea to azithromycin and ceftriaxone using data from the China Gonococcal Resistance Surveillance Programme (China-GRSP in order to provide evidence for updating the treatment recommendations in China.In this study, we included 3,849 isolates collected from patients with a confirmed positive Neisseria gonorrhoeae (N. gonorrhoeae culture at clinic visits during the period of 1 January 2013 through 31 December 2016 in 7 provinces. Antimicrobial susceptibility testing of gonorrhea isolates using agar dilution was conducted to determine minimum inhibitory concentration (MIC. Resistance to azithromycin (RTA was defined as MIC ≥ 1.0 mg/l, and decreased susceptibility to ceftriaxone (DSC was defined as MIC ≥ 0.125 mg/l. The prevalence of isolates with RTA was 18.6% (710/3,827; 95% CI 17.4%-19.8%. The percentage of patients with DSC fluctuated between 9.7% and 12.2% over this period. The overall prevalence of isolates with both RTA and DSC was 2.3% (87/3,827; 95% CI 1.9%-2.8% and it increased from 1.9% in 2013 to 3.3% in 2016 (chi-squared test for trend, P = 0.03. Study limitations include the retrospective study design and potential biases in the sample, which may overrepresent men with symptomatic infection, coastal residents, and people reporting as heterosexual.To our knowledge, this is the first national study on susceptibility of N. gonorrhoeae to azithromycin and ceftriaxone in China. Our findings indicate high rates of RTA and DSC from 2013 to 2016. Although dual therapy with azithromycin and ceftriaxone has been recommended by WHO and many countries to treat gonorrhea, reevaluation of this therapy is needed prior to its introduction in China.

  1. Drifting towards ceftriaxone treatment failure in gonorrhoea: risk factor analysis of data from the Gonococcal Resistance to Antimicrobials Surveillance Programme in England and Wales.

    Science.gov (United States)

    Town, K; Obi, C; Quaye, N; Chisholm, S; Hughes, G

    2017-02-01

    Treatment of Neisseria gonorrhoeae is threatened by the emergence of antimicrobial resistance. We analysed data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England and Wales to identify groups most at risk of reduced susceptibility to the currently recommended first-line therapy, ceftriaxone. Data from GRASP between 2007 and 2013 on ceftriaxone susceptibility and strain types were analysed. Risk factors associated with isolates exhibiting a ceftriaxone minimum inhibitory concentration (MIC) of ≥0.015 mg/L (CTR ≥0.015 mg/L) were identified using logistic regression. One third of isolates from men who have sex with men (MSM) (1279/4203) and 9.9% from heterosexuals (458/4626) exhibited CTR ≥0.015 mg/L. Between 2007 and 2013, the modal MIC for isolates remained at 0.004 mg/L for MSM but increased from 0.002 to 0.004 mg/L for heterosexuals. Among MSM, CTR ≥0.015 mg/L was associated with Asian ethnicity (crude OR: 1.42; 95% CI 1.07 to 1.88) and previous gonorrhoea (1.34; 1.16 to 1.54). Among heterosexuals, CTR ≥0.015 mg/L was associated with older age (35+ years: 4.31; 3.34 to 5.55), ≥6 sexual partners (1.58; 1.01 to 2.44) and sex abroad (2.23; 1.71 to 2.91). CTR ≥0.015 mg/L was less likely in isolates from heterosexuals of black Caribbean or African ethnicity (0.29; 0.20 to 0.41, 0.66; 0.43 to 0.99), with a concurrent chlamydial infection (0.25; 0.19 to 0.34) or women (0.57; 0.46 to 0.71). Over 600 isolates (CTR ≥0.015 mg/L) were typed; the majority were in Genogroup 1407, containing sequence type 1407. The emergence and spread of gonorrhoea with reduced susceptibility to ceftriaxone seems a realistic prospect, most likely in those involved in 'rapid-transmission' or bridging sexual networks. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Changes in ceftriaxone pharmacokinetics/pharmacodynamics during the early phase of sepsis: a prospective, experimental study in the rat.

    Science.gov (United States)

    Selmi, Valentina; Loriga, Beatrice; Vitali, Luca; Carlucci, Martina; Di Filippo, Alessandro; Carta, Giulio; Sgambati, Eleonora; Tofani, Lorenzo; De Gaudio, Angelo Raffaele; Novelli, Andrea; Adembri, Chiara

    2016-11-15

    Sepsis is characterized by the loss of the perm-selectivity properties of the glomerular filtration barrier (GFB) with consequent albuminuria. We examined whether the pharmacokinetics-pharmacodynamics (PK/PD) of ceftriaxone (CTX), an extensively protein-bound 3rd generation cephalosporin, is altered during early sepsis and whether an increase in urinary loss of bound-CTX, due to GFB alteration, can occur in this condition. A prospective, experimental, randomized study was carried out in adult male Sprague-Dawley rats. Sepsis was induced by cecal ligation and puncture (CLP). Rats were divided into two groups: Sham-operated and CLP. CTX (100 mg i.p., equivalent to 1 g dose in humans) was administered in order to measure plasma and lung CTX concentrations at several time-points: baseline and 1, 2, 4 and 6 h after administration. CTX was measured by High Performance Liquid Chromatography (HPLC). The morphological status of the sialic components of the GFB barrier was assessed by lectin histo-chemistry. Monte Carlo simulation was performed to calculate the probability of target attainment (PTA >90%) for 80 and 100% of T free  > minimum inhibitory concentration (MIC) for 80 and 100% of dosing interval. After CLP, sepsis developed in rats as documented by the growth of polymicrobial flora in the peritoneal fluid (≤1 × 10 1 CFU in sham rats vs 5 × 10 4 -1 × 10 5  CFU in CLP rats). CTX plasma concentrations were higher in CLP than in sham rats at 2 and 4 h after administration (difference at 2 h was 47.3, p = 0.012; difference at 4 h was 24.94, p = 0.004), while lung penetration tended to be lower. An increased urinary elimination of protein-bound CTX occurred (553 ± 689 vs 149 ± 128 mg/L, p  90% for 100% of the dosing interval was reached neither for sham nor CLP rats using MIC = 1 mg/L, the clinical breakpoint for Enterobacteriacee. Sepsis causes changes in the PK of CTX and an alteration in the sialic components of the GFB, with

  3. Changes in ceftriaxone pharmacokinetics/pharmacodynamics during the early phase of sepsis: a prospective, experimental study in the rat

    Directory of Open Access Journals (Sweden)

    Valentina Selmi

    2016-11-01

    Full Text Available Abstract Background Sepsis is characterized by the loss of the perm-selectivity properties of the glomerular filtration barrier (GFB with consequent albuminuria. We examined whether the pharmacokinetics–pharmacodynamics (PK/PD of ceftriaxone (CTX, an extensively protein-bound 3rd generation cephalosporin, is altered during early sepsis and whether an increase in urinary loss of bound-CTX, due to GFB alteration, can occur in this condition. Methods A prospective, experimental, randomized study was carried out in adult male Sprague–Dawley rats. Sepsis was induced by cecal ligation and puncture (CLP. Rats were divided into two groups: Sham-operated and CLP. CTX (100 mg i.p., equivalent to 1 g dose in humans was administered in order to measure plasma and lung CTX concentrations at several time-points: baseline and 1, 2, 4 and 6 h after administration. CTX was measured by High Performance Liquid Chromatography (HPLC. The morphological status of the sialic components of the GFB barrier was assessed by lectin histo-chemistry. Monte Carlo simulation was performed to calculate the probability of target attainment (PTA >90% for 80 and 100% of Tfree > minimum inhibitory concentration (MIC for 80 and 100% of dosing interval. Measurements and main results After CLP, sepsis developed in rats as documented by the growth of polymicrobial flora in the peritoneal fluid (≤1 × 101 CFU in sham rats vs 5 × 104–1 × 105 CFU in CLP rats. CTX plasma concentrations were higher in CLP than in sham rats at 2 and 4 h after administration (difference at 2 h was 47.3, p = 0.012; difference at 4 h was 24.94, p = 0.004, while lung penetration tended to be lower. An increased urinary elimination of protein-bound CTX occurred (553 ± 689 vs 149 ± 128 mg/L, p  90% for 100% of the dosing interval was reached neither for sham nor CLP rats using MIC = 1 mg/L, the clinical breakpoint for Enterobacteriacee. Conclusions Sepsis causes changes in

  4. Labeling of ceftriaxone for infective inflammation imaging using {sup 99m}Tc eluted from {sup 99}Mo/{sup 99m}Tc generator based on zirconium molybdate

    Energy Technology Data Exchange (ETDEWEB)

    Mostafa, M., E-mail: mmostafa95@yahoo.co [Radioactive Isotopes and Generators Department, Hot Labs Center, Atomic Energy Authority, P.O. Box 13759, Cairo (Egypt); Motaleb, M.A. [Labeled Compounds Department, Hot Labs Center, Atomic Energy Authority, P.O. Box 13759, Cairo (Egypt); Sakr, T.M. [Radioactive Isotopes and Generators Department, Hot Labs Center, Atomic Energy Authority, P.O. Box 13759, Cairo (Egypt)

    2010-10-15

    Zirconium molybdate gel was prepared by mixing {sup 99}Mo, produced from {sup 98}Mo(n,{gamma}) reaction and Zr solutions in nitrate media with excess H{sub 2}O{sub 2}, and used as the base material for {sup 99}Mo/{sup 99m}Tc generator. The prepared generator showed a good performance. {sup 99m}Tc eluted from the prepared generator passed the quality control tests with specifications meeting the requirements of European and US Pharmacopeias. The {sup 99m}Tc eluate was used for labeling of cephalosporin analogue, ceftriaxone, which was then assessed for infection imaging in a mouse model. {sup 99m}Tc-ceftriaxone was prepared at pH 9 with a radiochemical yield of 95{+-}2% by adding {sup 99m}Tc to 30 mg ceftriaxone in the presence of 50 {mu}g SnCl{sub 2}.2H{sub 2}O. Biodistribution studies in mice were carried out using experimentally induced infection in the left thigh using E. coli. Both thighs of the mice were dissected and counted to evaluate the ratio of bacterial infected thigh/contralateral thigh. {sup 99m}Tc-ceftriaxone showed high uptake in the infectious lesion (T/NT =5.6{+-}0.6 at 4 h post injection). The abscess to normal muscle ratio indicated that {sup 99m}Tc-ceftriaxone could be used for infection imaging. Besides, in vitro studies showed that {sup 99m}Tc-ceftriaxone can differentiate between bacterial infection and sterile inflammation.

  5. Noncontrast multidetector-row computed tomography scanning for detection of radiolucent calculi in acute renal insufficiency caused by bilateral ureteral obstruction of ceftriaxone crystals.

    Science.gov (United States)

    Lu, Xiongbing; Wu, Rongpei; Huang, Xiaoning; Zhang, Yuanyuan

    2012-01-01

    Noncontrast computed tomography (CT) has great advantage with higher sensitivity and more clear modalities in detecting urinary tract radiolucent calculi in patients with acute renal insufficiency (ARI) compared to other image diagnosis approaches. We report two cases (female, 28 years old; male, 39 years old) with persistent flank pain and acute anuria after the administration of ceftriaxone (4.0 g daily) for 2 days intravenously. No abnormality was found in the kidney-ureter- bladder (KUB) areas with plain abdomen X-rays. A diagnosis of bilateral hydronephrosis was made by ultrasound examination in both cases. Serum creatinine levels reached up to 257 and 810 μ mol/L (normal serum creatinine level is 40-130 μ mol/L), respectively. Vague density spots were noticed in the pelvis with noncontrast multidetector-row CT (MDCT) scanning. However, distinguishable clusters of high-density shadows were seen in pelvic areas with maximum intensity projections (MIP, CT values in 30-128 HU). Ceftriaxone crystal calculi were found on both sides of distal ureters under endoscopy. Renal function recovered in both patients after double-J ureteral stents were installed. Out results demonstrated that noncontrast MDCT scanning and MIP reconstruction as an effective diagnostic tool could provide clear images in detection of radiolucent calculi in urinary tract when conventional X-rays image are not suitable in the patients with obstructive anuria and ARI of unknown origin.

  6. Solubility and density of the disodium salt hemiheptahydrate of ceftriaxone in (acetone + water) at T=(298.15,308.15, and 318.15) K[Salt; Solubility; Density; Mixed solvents

    Energy Technology Data Exchange (ETDEWEB)

    Dong Hong; Fu Ranran; Yan Weidong E-mail: yanwd@hzcnc.com; Zhu Ming

    2004-02-01

    The solubility of disodium salt hemiheptahydrate of ceftriaxone in different concentrations of acetone in water at T=(298.15,308.15, and 318.15) K was measured by using gravimetrical method. The density of the saturated solution was also determined with the help of a digital densimeter (Anton Paar, model DMA 45) at corresponding temperatures. The solubility of disodium salt hemiheptahydrate of ceftriaxone increases with increasing temperature, but decreases with increasing concentration of acetone in the solution. The experimental data were correlated with equation . The correlation is satisfactory with the average absolute deviation of 1.67 g {center_dot} kg{sup -1} mixed solvents.

  7. Contrasting the Role of xCT and GLT-1 Upregulation in the Ability of Ceftriaxone to Attenuate the Cue-Induced Reinstatement of Cocaine Seeking and Normalize AMPA Receptor Subunit Expression.

    Science.gov (United States)

    LaCrosse, Amber L; O'Donovan, Sinead M; Sepulveda-Orengo, Marian T; McCullumsmith, Robert E; Reissner, Kathryn J; Schwendt, Marek; Knackstedt, Lori A

    2017-06-14

    Long-term treatment with ceftriaxone attenuates the reinstatement of cocaine seeking while increasing the function of the glutamate transporter 1 (GLT-1) and system xC- (Sxc) in the nucleus accumbens core (NAc). Sxc contributes the majority of nonsynaptic extracellular glutamate in the NAc, while GLT-1 is responsible for the majority of glutamate uptake. Here we used antisense to decrease the expression of GLT-1 and xCT (a catalytic subunit of Sxc) to determine the relative importance of both proteins in mediating the ability of ceftriaxone to prevent cue-induced reinstatement of cocaine seeking and normalize glutamatergic proteins in the NAc of rats. Intra-NAc xCT knockdown prevented ceftriaxone from attenuating reinstatement and from upregulating GLT-1 and resulted in increased surface expression of AMPA receptor subunits GluA1 and GluA2. Intra-NAc GLT-1 knockdown also prevented ceftriaxone from attenuating reinstatement and from upregulating xCT expression, without affecting GluA1 and GluA2 expression. In the absence of cocaine or ceftriaxone treatment, xCT knockdown in the NAc increased the expression of both GluA1 and GluA2 without affecting GLT-1 expression while GLT-1 knockdown had no effect. PCR and immunoprecipitation of GLT-1 revealed that ceftriaxone does not upregulate GLT-1 and xCT through a transcriptional mechanism, and their coregulation by ceftriaxone is not mediated by physical interaction. These data support important and distinct roles for xCT and GLT-1 in the actions of ceftriaxone and add to a body of literature finding evidence for coregulation of these transporters. Our results also point to xCT expression and subsequent basal glutamate levels as being a key mediator of AMPA receptor expression in the NAc. SIGNIFICANCE STATEMENT Ceftriaxone attenuates the reinstatement of cocaine, alcohol, and heroin seeking. The mechanism of action of this behavioral effect has been attributed to glutamate transporter 1 (GLT-1) and xCT (a catalytic subunit

  8. 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.

  9. Co-administration of α-lipoic acid and glutathione is associated with no significant changes in serum bilirubin, alkaline phosphatase or γ-glutamyltranspeptidase levels during the treatment of neuroborreliosis with intravenous ceftriaxone.

    Science.gov (United States)

    Puri, Basant K; Hakkarainen-Smith, Jaana S; Derham, Anne; Monro, Jean A

    2015-09-01

    While pharmacotherapy with intravenous ceftriaxone, a third-generation cephalosporin, is a potential treatment of Lyme neuroborreliosis, there is concern that it can cause the formation of biliary sludge, leading to hepatobiliary complications such as biliary colic, jaundice and cholelithiasis, which are reflected in changes in serum levels of bilirubin and markers of cholestatic liver injury (alkaline phosphatase and γ-glutamyltranspeptidase). It has been suggested that the naturally occurring substances α-lipoic acid and glutathione may be helpful in preventing hepatic disease. α-Lipoic acid exhibits antioxidant, anti-inflammatory and anti-apoptotic activities in the liver, while glutathione serves as a sulfhydryl buffer. The aim of this study was to determine whether co-administration of α-lipoic acid and glutathione is associated with significant changes in serum levels of bilirubin, alkaline phosphatase and γ-glutamyltranspeptidase during the treatment of Lyme neuroborreliosis with long-term intravenous ceftriaxone. Serum levels of bilirubin, alkaline phosphatase and γ-glutamyltranspeptidase were measured in 42 serologically positive Lyme neuroborreliosis patients before and after long-term treatment with intravenous ceftriaxone (2-4 g daily) with co-administration of oral/intravenous α-lipoic acid (600 mg daily) and glutathione (100 mg orally or 0.6-2.4 g intravenously daily). None of the patients developed biliary colic and there were no significant changes in serum bilirubin, alkaline phosphatase or γ-glutamyltranspeptidase levels over the course of the intravenous ceftriaxone treatment (mean length 75.0 days). Co-administration of α-lipoic acid and glutathione is associated with no significant changes in serum bilirubin, alkaline phosphatase or γ-glutamyltranspeptidase levels during the treatment of neuroborreliosis with intravenous ceftriaxone.

  10. 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

  11. In vitro activity of ceftriaxone, cefetamet (Ro 15-8074), ceftetrame (Ro 19-5247; T-2588), and fleroxacin (Ro 23-6240; AM-833) versus Neisseria gonorrhoeae and Haemophilus ducreyi.

    OpenAIRE

    Le Saux, N M; Slaney, L A; Plummer, F A; Ronald, A R; Brunham, R C

    1987-01-01

    We examined 300 strains of Neisseria gonorrhoeae and 100 strains of Haemophilus ducreyi to determine their in vitro susceptibility to two new cephalosporins, cefetamet (Ro 15-8074) and ceftetrame (Ro 19-5247; T-2588), and a new fluroquinolone, fleroxacin (Ro 23-6240; AM-833). Their activity was compared with that of ceftriaxone, penicillin, spectinomycin, tetracycline, and erythromycin. Cefetamet, ceftetrame, and fleroxacin had excellent in vitro activity against both groups of microorganisms...

  12. Protein synthesis inhibiting clindamycin improves outcome in a mouse model of Staphylococcus aureus sepsis compared with the cell wall active ceftriaxone.

    Science.gov (United States)

    Azeh, Ivo; Gerber, Joachim; Wellmer, Andreas; Wellhausen, Malte; Koenig, Brigitte; Eiffert, Helmut; Nau, Roland

    2002-07-01

    The release of proinflammatory components from bacteria depends on the mode of action of the antibacterial therapy used. We studied whether this influences mortality in experimental sepsis. In a lethal murine model of Staphylococcus aureus sepsis, animals were randomly assigned to receive the protein synthesis inhibitor clindamycin (CLI) or the beta-lactam ceftriaxone (CRO). Therapy was introduced subcutaneously 5 hrs after intraperitoneal injection of 10 colony forming units of S. aureus American Type Culture Collection 29213 and was continued every 8 hrs for 3 days. Survival was higher in mice receiving CLI (29/50 animals [58%]) than in mice receiving CRO (16/50 animals [32%]; p =.015). Mice treated with CRO died earlier than mice receiving CLI (p =.002). Eight hours after the first antibiotic dose, the motor performance of mice receiving CRO had deteriorated more than it did for mice receiving CLI (p =.009). Higher levels of tumor necrosis factor-alpha were measured in serum (p =.027) and peritoneal fluid (p =.001) of CRO-treated mice. In vitro, CLI released smaller amounts of staphylococcal enterotoxin A than CRO. Antibiotic treatment of Gram-positive sepsis with a protein synthesis inhibitor decreases morbidity and mortality compared with a bacteriolytic compound. This may be caused by a reduction of the concentrations of proinflammatory/toxic bacterial components and cytokines.

  13. Antiallodynic Activity of Ceftriaxone and Clavulanic Acid in Acute Administration is Associated with Serum TNF-α Modulation and Activation of Dopaminergic and Opioidergic Systems.

    Science.gov (United States)

    Ochoa-Aguilar, A; Sotomayor-Sobrino, M A; Jaimez, R; Rodríguez, R; Plancarte-Sánchez, R; Ventura-Martinez, R

    2017-03-01

    Preclinical Research The aim of this study was to determine the antiallodynic effect of acute administration of the β-lactam antimicrobials, ceftriaxone (CFX) and clavulanic acid (CLAV), for the control of established pain on a model of neuropathic pain (NP). We also investigated the involvement of dopaminergic and opioidergic pathways as well as alterations in serum concentrations of TNF-α in the antiallodynic actions of these drugs. CFX, CLAV, or gabapentin (GAP), a reference drug, were administered i.p. twelve days after constriction of the sciatic nerve in rats. Mechanic and cold allodynia were evaluated for 3 h and alterations in serum concentration of TNF-α determined. Both CFX and CLAV had antiallodynic effects in response to mechanical and cold stimulation, similar to GAP. The antiallodynic effects of CFX and CLAV were blocked by haloperidol (HAL), a D2 receptor antagonist, and by naloxone (NLX), an opioid receptor antagonist. Additionally, serum TNF-α levels were attenuated following CFX and CLAV administration. These results suggest that acute administration of CFX and CLAV may represent a promising approach for treating the acute allodynia of NP, and that the mechanisms involved in these effects involve activation of dopaminergic and opioidergic pathways as well as modulation of TNF-α production. Drug Dev Res 78 : 105-115, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  14. Influence of ceftriaxone treatment on fdg uptake - an in vivo [{sup 18}f]-fluorodeoxyglucose imaging study in soft tissue infections in rats

    Energy Technology Data Exchange (ETDEWEB)

    Wyss, Matthias T. E-mail: matthias.wyss@usz.ch; Honer, Michael; Spaeth, Nicolas; Gottschalk, Jochen; Ametamey, Simon M.; Weber, Bruno; Schulthess, Gustav K. von; Buck, Alfred; Kaim, Achim H

    2004-10-01

    Our aim was to determine the influence of antibiotic treatment using ceftriaxone on [{sup 18}F]-fluorodeoxyglucose (FDG) uptake in experimental soft tissue infections. PET scans were performed in two groups (treated n=4; non-treated n=4) at days 3, 5, and 6 after inoculation of the infection. Additional autoradiography was performed in four animals at day 7 and in three animals at day 11. The difference of FDG uptake on day 5 (after three days of antibiotic treatment) between both groups proved to be significant (df=6; T=2.52; p=0.045). FDG uptake determined at the other days did not reveal significant difference between the two groups. It seems to be possible that the effect of antibiotic treatment on FDG uptake is less evident than reported for therapy monitoring of cancer treatment. The change of FDG uptake over time in treated and untreated infections is complex and further in vivo experiments have to be initiated to investigate the potential value of clinical FDG PET in therapy monitoring of infection.

  15. The Importance of Perioperative Prophylaxis with Cefuroxime or Ceftriaxone in the Surgical Site Infections Prevention after Cranial and Spinal Neurosurgical Procedures.

    Science.gov (United States)

    Dimovska-Gavrilovska, Aleksandra; Chaparoski, Aleksandar; Gavrilovski, Andreja; Milenkovikj, Zvonko

    2017-09-01

    Introduction Surgical site infections pose a significant problem in the treatment of neurosurgical procedures, regardless of the application of perioperative prophylaxis with systemic antibiotics. The infection rate in these procedures ranges from less than 1% to above 15%. Different antibiotics and administration regimes have been used in the perioperative prophylaxis so far, and there are numerous comparative studies regarding their efficiency, however, it is generally indicated that the choice thereof should be based on information and local specifics connected to the most probable bacterial causers, which would possibly contaminate the surgical site and cause infection, and moreover, the mandatory compliance with the principles of providing adequate concentration of the drug at the time of the anticipated contamination. Objective Comparing the protective effect of two perioperative prophylactic antibiotic regimes using cefuroxime (second generation cephalosporin) and ceftriaxone (third generation cephalosporin) in the prevention of postoperative surgical site infections after elective and urgent cranial and spinal neurosurgical procedures at the University Clinic for Neurosurgery in Skopje in the period of the first three months of 2016. Design of the study Prospective randomized comparative study. Outcome measures Establishing the clinical outcome represented as prevalence of superficial and deep incision and organ/space postoperative surgical site infections. Material and method We analyzed prospectively 40 patients who received parenteral antibiotic prophylaxis with two antibiotic regimes one hour before the routine neurosurgical cranial and spinal surgical procedures; the patients were randomized in two groups, according to the order of admission and participation in the study, alternately, non-selectively, those persons who fulfilled inclusion criteria were placed in one of the two programmed regimes with cefuroxime in the first, and cefotaxime in the

  16. Management of Pneumonia and Blood Stream Infections with New Antibiotic Adjuvant Entity (Ceftriaxone + Sulbactam + Disodium Edetate)- A Novel Way to Spare Carbapenems.

    Science.gov (United States)

    Shameem, Mohammad; Mir, Mohammad Amin

    2016-12-01

    Nosocomial infections have been considered as a major health problem causing incremental morbidity, mortality and costs of therapy. This retrospective study was initiated with aim to analyse the comparative efficacy of a novel Antibiotic Adjuvant Entity (AAE), a combination of ceftriaxone + sulbactam + disodium edetate and meropenem in combination with colistin, for the management of Multi Drug Resistant (MDR) nosocomial Gram-negative bacterial infections. Case history sheets of patients with documented MDR nosocomial Gram-negative infections who received either AAE or meropenem in combination with colistin for management of infections over a period of 3 years (November 2012 - October 2015) were included in the study. Data related to clinical management, demographics, vital signs and laboratory parameters along with prior antibiotic therapy, dose and clinical outcomes were evaluated thoroughly to analyse the clinical benefits of this new AAE+ colistin therapy for management of MDR nosocomial infections. Out of 115 patients short listed for the study, 52 patients had received AAE + colistin therapy and 63 patients have received meropenem + colistin. AAE + colistin therapy resulted in significantly higher efficacy (86.53%) as compared to meropenem + colistin (63.49%). A rising trend in clinical cure rates was observed in AAE based combination therapy in contrast to the decreasing trend in meropenem based combination therapy. A progressive decline in clinical cure rates was observed in meropenem treated group over a period of 3 years due to rising carbapenemases and multiple resistance by pathogens, where as AAE maintained the same efficacy. The AAE + colistin therapy has shown better bacteriological and clinical efficacy as compared to meropenem + colistin in the management of various nosocomial MDR Gram-negative infections. A significant number of meropenem failure patients responded to the AAE therapy highlighting the new hope to spare carbapenems.

  17. Ceftaroline fosamil versus ceftriaxone for the treatment of Asian patients with community-acquired pneumonia: a randomised, controlled, double-blind, phase 3, non-inferiority with nested superiority trial.

    Science.gov (United States)

    Zhong, Nan Shan; Sun, Tieying; Zhuo, Chao; D'Souza, George; Lee, Sang Haak; Lan, Nguyen Huu; Chiang, Chi-Huei; Wilson, David; Sun, Fang; Iaconis, Joseph; Melnick, David

    2015-02-01

    Ceftriaxone with or without a macrolide antibiotic is a recommended treatment for patients with community-acquired pneumonia requiring hospital admission and intravenous antibiotic treatment. We aimed to assess the efficacy and safety of ceftaroline fosamil compared with ceftriaxone in the treatment of Asian patients admitted to hospital with community-acquired pneumonia. In this international, randomised, controlled, double-blind, phase 3, non-inferiority with nested superiority trial, adult Asian patients with Pneumonia Outcomes Research Team (PORT) risk class III-IV acute community-acquired pneumonia were randomly assigned (1:1) to receive intravenous ceftaroline fosamil (600 mg every 12 h) or ceftriaxone (2 g every 24 h) for 5-7 days. Patients were randomly assigned via centralised telephone and web-based system; patients and treating clinicians were masked to treatment allocation. Investigators who did study assessments remained masked to treatment allocation until completion of the study. The primary endpoint was clinical cure at the test-of-cure visit (8-15 days after last dose of study drug) in the clinically evaluable population. Non-inferiority of ceftaroline fosamil was defined as a lower limit of the two-sided 95% CI for the difference in the proportion of patients clinically cured of -10% or higher; if non-inferiority was achieved, superiority was to be concluded if the lower limit of the 95% CI was greater than 0%. This trial is registered with ClinicalTrials.gov, number NCT01371838. Between Dec 13, 2011, and April 26, 2013, 847 patients were enrolled at 64 centres in China, India, South Korea, Taiwan, and Vietnam, of whom 771 were randomly assigned and 764 received study treatment. In the clinically evaluable population (n=498) 217 (84%) of 258 patients in the ceftaroline fosamil group and 178 (74%) of 240 patients in the ceftriaxone group were clinically cured at the test-of-cure visit (difference 9·9%, 95% CI 2·8-17·1). The superiority of

  18. A Multicenter, Randomized, Observer-blinded, Active-controlled Study Evaluating the Safety and Effectiveness of Ceftaroline Compared With Ceftriaxone Plus Vancomycin in Pediatric Patients With Complicated Community-acquired Bacterial Pneumonia.

    Science.gov (United States)

    Blumer, Jeffrey L; Ghonghadze, Tina; Cannavino, Christopher; O'Neal, Tanya; Jandourek, Alena; Friedland, Hillel David; Bradley, John S

    2016-07-01

    The broad-spectrum cephalosporin ceftaroline, a metabolite of the prodrug ceftaroline fosamil, has shown in vitro activity against clinical isolates from pediatric patients. This multicenter, randomized, observer-blinded, active-controlled study (NCT01669980) assessed the safety and effectiveness of ceftaroline fosamil compared with ceftriaxone plus vancomycin in patients between 2 months and 17 years of age with complicated community-acquired bacterial pneumonia. Patients were randomized 3:1 (stratified by age cohort) to receive either ceftaroline fosamil or ceftriaxone plus vancomycin (comparator) as intravenous therapy for ≥3 days. Patients who met specific study criteria on or after Study Day 4 were permitted to switch to an oral study drug. Safety assessments were treatment-emergent adverse events, and the effectiveness of treatment was assessed by clinical and microbiologic outcomes. The median duration of intravenous treatment was 9.0 (range, 3.0-19.0) days in the ceftaroline fosamil group (N=30) and 7.5 (5.0-13.0) days in the comparator group (N=10). At least one treatment-emergent adverse event was experienced by 12/30 patients (40%) in the ceftaroline fosamil group and 8/10 (80%) in the comparator group; most treatment-emergent adverse events in both groups were mild to moderate in intensity. Clinical response rates in the modified intent-to-treat population were 52% (15/29 patients) in the ceftaroline fosamil group and 67% in the comparator group (6/9); clinical stability at Study Day 4 was 21% (6/29) and 22% (2/9), respectively. Ceftaroline fosamil was well tolerated and showed similar clinical response rates to ceftriaxone plus vancomycin in pediatric patients with complicated community-acquired bacterial pneumonia.

  19. Assessment of time to clinical response, a proxy for discharge readiness, among hospitalized patients with community-acquired pneumonia who received either ceftaroline fosamil or ceftriaxone in two phase III FOCUS trials.

    Science.gov (United States)

    Lodise, Thomas P; Anzueto, Antonio R; Weber, David J; Shorr, Andrew F; Yang, Min; Smith, Alexander; Zhao, Qi; Huang, Xingyue; File, Thomas M

    2015-02-01

    The primary driver of health care costs for patients with community-acquired pneumonia (CAP) is the hospital length of stay (LOS). Unfortunately, hospital LOS comparisons are difficult to make from phase III CAP trials because of their structured designs and prespecified treatment durations. However, an opportunity still exists to draw inferences about potential LOS differences between treatments through the use of surrogates for hospital discharge. The intent of this study was to quantify the time to a clinical response, a proxy for the time to discharge readiness, among hospitalized CAP patients who received either ceftaroline or ceftriaxone in two phase III CAP FOCUS clinical trials. On the basis of the Infectious Diseases Society of America and American Thoracic Society CAP management guidelines and recent FDA guidance documents for community-acquired bacterial pneumonia, a post hoc adjudication algorithm was constructed a priori to compare the time to a clinical response, a proxy for the time to discharge readiness, between patients who received ceftaroline or ceftriaxone. Overall, 1,116 patients (ceftaroline, n=562; ceftriaxone, n=554) from the pooled FOCUS trials met the selection criteria for this analysis. Kaplan-Meier analyses showed that ceftaroline was associated with a shorter time, measured in days, to meeting the clinical response criteria (P=0.03). Of the patients on ceftaroline, 61.0, 76.1, and 83.6% achieved a clinical response by days 3, 4, and 5, compared to 54.3, 69.8, and 79.3% of the ceftriaxone-treated patients. In the Cox regression, ceftaroline was associated with a shorter time to a clinical response (HR, 1.16, P=0.02). The methodology employed here provides a framework to draw comparative effectiveness inferences from phase III CAP efficacy trials. (The FOCUS trials whose data were analyzed in this study have been registered at ClinicalTrials.gov under registration no. NCT00621504 and NCT00509106.). Copyright © 2015, American Society

  20. High prevalence of ceftriaxone resistance among invasive Salmonella enterica serotype Choleraesuis isolates in Thailand: The emergence and increase of CTX-M-55 in ciprofloxacin-resistant S. Choleraesuis isolates.

    Science.gov (United States)

    Luk-In, Sirirat; Chatsuwan, Tanittha; Pulsrikarn, Chaiwat; Bangtrakulnonth, Aroon; Rirerm, Ubolrat; Kulwichit, Wanla

    2018-03-23

    S. Choleraesuis is a highly invasive zoonotic pathogen that causes a serious systemic infection in humans. The emergence and increase of resistance to ceftriaxone and ciprofloxacin among S. Choleraesuis has become a serious therapeutic problem. The present study demonstrated high frequency of antimicrobial resistance in Salmonella Choleraesuis among 414 nontyphoidal Salmonella isolates from bacteremic patients in Thailand. High rates of ceftriaxone (58.3%) and ciprofloxacin (19.6%) resistances were observed in S. Choleraesuis isolates. The dissemination of the self-transferable bla CTX-M-14 -carrying IncFII s , IncFII, and IncI1 plasmids and bla CMY-2 -carrying IncA/C plasmid along with the clonal spread of bla CMY-2 -harbouring S. Choleraesuis isolates contributed to the high frequency of resistance to extended-spectrum cephalosporins (ESCs; third- and fourth-generation cephalosporins) during 2005-2007. We reported the first occurrence of ceftazidime-hydrolysing CTX-M-55 in S. Choleraesuis isolates which dramatically increased and became the most abundant CTX-M variant among ESC-resistant S. Choleraesuis isolates during 2012-2016. The spread of clone pulsotype B3 was due to the dissemination of IncA/C plasmids carrying both bla CTX-M-55 and qnrS1 among ciprofloxacin-resistant S. Choleraesuis isolates harbouring D87G in GyrA. These isolates were apparently responsible for the high rates of co-resistance to ESCs and ciprofloxacin (51.3%) during 2012-2016. This study emphasizes the importance to have an action plan to control the dissemination of antimicrobial resistance in S. Choleraesuis since this poses a threat to global health due to travel and trade in animal food products. Copyright © 2018 Elsevier GmbH. All rights reserved.

  1. Safety and efficacy of a novel drug elores (ceftriaxone+sulbactam+disodium edetate) in the management of multi-drug resistant bacterial infections in tertiary care centers: a post-marketing surveillance study.

    Science.gov (United States)

    Chaudhary, Manu; Mir, Mohd Amin; Ayub, Shiekh Gazalla

    In India, Elores (CSE-1034: ceftriaxone+sulbactam+disodium edetate) was approved as a broad spectrum antibiotic in year 2011 and is used for management of Extended Spectrum Beta Lactamases/Metallo Beta lactamases infections in tertiary care centers. The objective of this study was to investigate the efficacy of this drug in patients with Extended Spectrum Beta Lactamases/Metallo Beta lactamases infections and identify the incidence of adverse events in real clinical settings. This Post Marketing Surveillance study was conducted at 17 centers across India and included 2500 patients of all age groups suffering from various bacterial infections and treated with Elores (CSE1034). Information regarding demographic, clinical and microbiological parameters, dosage and treatment duration, efficacy and adverse events (AEs) associated with the treatment were recorded. A total of 2500 patients were included in the study and efficacy was evaluated in 2487 patients. In total, 409 AEs were reported in 211 (8.4%) patients. The major AEs reported were vomiting (3.0%), pain at injection site (2.5%), nausea (2.3%), redness at site (1.96%), thrombophlebitis (1.4%). Of total reported AEs, 40 (5.3%) AEs were reported in pediatric, 310 (20.6%) in adult, and 59 (23.6%) in geriatric group. No AE belonging to grade IV or V was reported in any patient. In terms of efficacy, 1977 (79.4%) patients were cured, 501 (20.1%) patients showed clinical improvement and 5 (0.2%) patients were complete failure. The treatment duration varied from 5 to 7 days in different patients depending on the infection type. In this post-marketing surveillance study, CSE-1034 was found to be an effective and safe option against Pip tazo and meropenem in management of patients with multi-drug resistant (MDR) bacterial infections under routine ward settings. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  2. Ceftriaxone and ciprofloxacin restriction in an intensive care unit: less incidence of Acinetobacter spp. and improved susceptibility of Pseudomonas aeruginosa Restricción del uso de ceftriaxona y ciprofloxacino en una unidad de cuidados intensivos: menor incidencia de Acinetobacter spp. y mayor sensibilidad de Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Julio César Medina Presentado

    2011-12-01

    Full Text Available OBJETIVO: To determine whether restricting the use of ceftriaxone and ciprofloxacin couldsignificantly reduce colonization and infection with resistant Gram-negative bacilli (r-GNB. METHODS: A two-phase prospective study (before/after design was conducted in an intensive care unit in two time periods (2004-2006. During phase 1, there was no antibiotic restriction. During phase 2, use of ceftriaxone or ciprofloxacin was restricted. RESULTS: Atotal of 200 patients were prospectively evaluated. In phase 2, the use of ceftriaxone was reduced by 93.6% (P = 0.0001 and that of ciprofloxacin by 65.1% (P = 0.041, accompanied by a 113.8% increase in use of ampicillin-sulbactam (P = 0.002.During phase 1, 48 GNB were isolated [37 r-GNB (77.1% and 11 non-r-GNB (22.9%], compared with a total of 64 during phase 2 [27 r-GNB (42.2% and 37 non-r-GNB (57.8%](P = 0.0002. Acinetobacter spp. was isolated 13 times during phase 1 and 3 times in phase 2 (P = 0.0018. The susceptibility of Pseudomonas aeruginosa to ciprofloxacin increased from 40.0% in phase 1 to 100.0% in phase 2 (P = 0.0108. CONCLUSIONS: Restriction of ceftriaxone and ciprofloxacin reduced colonization by Acinetobacter spp. and improved the susceptibility profile of P. aeruginosa.OBJETIVO: Determinar si la restricción del uso de ceftriaxona y ciprofloxacino reduce significativamente la colonización y la infección por bacilos gramnegativos resistentes. MÉTODOS: Se efectuó un estudio prospectivo de dos fases (diseño antes/después de la intervención en una unidad de cuidados intensivos en dos períodos sucesivos entre los años 2004 y 2006. Durante la fase 1, no hubo ninguna restricción de antibióticos. Durante la fase 2, se restringió el uso de ceftriaxona y ciprofloxacino. RESULTADOS: Se evaluó prospectivamente a 200 pacientes en total. En la fase 2, el uso de ceftriaxona se redujo en 93,6% (P = 0,0001 y el de ciprofloxacino en 65,1% (P = 0,041, lo que se acompañó de un aumento de 113,8% en

  3. A rare case of ceftriaxone induced anaphylaxis in anaethesia practice

    Directory of Open Access Journals (Sweden)

    Anita Kumari

    2015-01-01

    Full Text Available Medications are among the second most common cause of anaphylaxis and the primary cause of anaphylaxis in adults. The most common classes of drugs causing anaphylaxis are antibiotics especially β-lactam antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs. Diagnosis of anaphylaxis is clinically based and usually straight forward. However data on epidemiology of anaphylaxis, particularly the most profound and life threatening form such as anaphylactic shock is limited and thought to be under-reported. In spite of negative skin testing, our patient had severe reaction resulting in anaphylactic shock after antibiotic administration but was managed successfully without any residual compromise. This case reflects the limitations of screening test done preoperatively for the diagnosis of sensitization to the drugs.

  4. Ceftriaxone or HIV associated angio-oedema? Case report ...

    African Journals Online (AJOL)

    Angio-oedema may be hereditary or acquired and is characterised by episodes of potentially life threatening localised tissue oedema and swelling resulting from deficiency of compliment pathway C1 esterase inhibitor. Acquired angio-oedema is about ten times less frequent than the hereditary type and has been ...

  5. Cost-effectiveness of ceftriaxone in the treatment of community ...

    African Journals Online (AJOL)

    effectiveness of four intravenous antibiotic treatment regimens in the treatment of severe community-acquired pneumonia (CAP) in adults in a private hospital setting. The study compared some third-generation cephalosporin regimens with a ...

  6. Antagonistic effects of ceftriaxone and sulphadimidine on ketamine ...

    African Journals Online (AJOL)

    Vital parameters such as determination of anesthesia; onset and duration, temperature, respiratory and heart rates were recorded. The results of onset of duration of anesthesia revealed significant difference (P< 0.05) among group E, F and A animals. Although the result of onset anesthesia revealed significant difference ...

  7. Anti-tumor necrosis factor antibody impairs the therapeutic effect of ceftriaxone in murine pneumococcal pneumonia

    NARCIS (Netherlands)

    Rijneveld, Anita W.; Florquin, Sandrine; Hartung, Thomas; Speelman, Peter; van der Poll, Tom

    2003-01-01

    Treatments aimed at inhibition of tumor necrosis factor (TNF) in patients with sepsis have been unsuccessful. Up to 50% of such patients suffer from pneumonia. To determine the effect that treatment with anti-TNF has on pneumococcal pneumonia, mice were intranasally inoculated with Streptococcus

  8. Steven Johnson syndrome due to I.V Ceftriaxone--a case report.

    OpenAIRE

    Narayanan Veena; Mamatha G; Ashok L; Rajashekar N

    2003-01-01

    Steven-Johnson syndrome (SJS) is a rare vesiculobullous disease characterized by an acute cutaneous eruption that ivolves the skin and mucous membranes including those of the oral cavity. A rare case of Steven-Johnson syndrome, an unexpected treatment response, in a 25-year-old female patient due to administration of intravenous Cefriaxone (1 gm), a third generation cephalosporin has been reported and literature reviewed.

  9. Amplification of Antimicrobial Resistance in Gut Flora of Patients Treated with Ceftriaxone

    NARCIS (Netherlands)

    Meletiadis, J.; Turlej-Rogacka, A.; Lerner, A.; Adler, A.; Taconelli, E.; Mouton, J.

    2017-01-01

    Although antibacterial therapy has an impact on human intestinal flora and the emergence of resistant bacteria, its role in the amplification of antimicrobial resistance and the quantitative exposure-effect relationship is not clear. An observational prospective study was conducted to determine

  10. Analisis Farmakoekonomi Peresepan Antibiotika Ceftriaxone Dan Ceftazidime Pada Pasien Bedah Sesar Di Rumah Sakit Panti Rini YOGYAKARTA

    OpenAIRE

    Donowati, Maria Wisnu

    2013-01-01

    The raising of cesarean section had leaded the abuse of antibiotic prescribing in order to minimize the wound or urethra infection that came in the caesarean surgery. Pharmaceutical care oriented had push pharmacist to care more about patients drug use to increase quality of live. The aim of this research is to identify the total hospital service cost and calculate total antibiotic cost, total drug and prescribtion. The data are collected through medical records and hospital service cost of 1...

  11. 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 ...

  12. Antibiotic Resistance In Neisseria Gonorrhoeae: Impact Of Ceftriaxone Resistance On Microbial Fitness And Potential Of Resistance Determinants To Spread During Mixed Infection

    Science.gov (United States)

    2016-03-07

    mega Dalton (MDa) conjugative plasmid. Evidence supported the theory that this resistance gene was introduced into the plasmid 48 through a one...six percent of clinical Gc isolates carry a 2.6 mega Dalton (MDa) cryptic plasmid, but this plasmid is not associated with any known virulence...so many strains. This theory is supported by the fact that portions of the plasmid, both large and small, are incorporated into the chromosome

  13. A Case of Bacteremia and Meningitis Associated with Piperacillin-Tazobactam Nonsusceptible, Ceftriaxone Susceptible Escherichia coli during Strongyloides Hyperinfection in an Immunocompromised Host

    Directory of Open Access Journals (Sweden)

    Santosh Dahal

    2017-01-01

    Full Text Available Strongyloidiasis is an emerging parasitic infection with intriguing epidemiology, presentation, and clinical management. We report a case of hyperinfection syndrome complicated by E. coli bacteremia and meningitis with one of the isolates showing a unique resistance pattern recently being recognized. This report describes the aspect of invasive bacterial infections in strongyloidiasis and highlights the unique susceptibility pattern of the E. coli isolate and the extreme caution required during the antibiotic therapy.

  14. Safety and efficacy of a novel drug elores (ceftriaxone + sulbactam + disodium edetate in the management of multi-drug resistant bacterial infections in tertiary care centers: a post-marketing surveillance study

    Directory of Open Access Journals (Sweden)

    Manu Chaudhary

    2017-07-01

    Conclusion: In this post-marketing surveillance study, CSE-1034 was found to be an effective and safe option against Pip tazo and meropenem in management of patients with multi-drug resistant (MDR bacterial infections under routine ward settings.

  15. Comparison of antibiotic use between an 'open' and a 'closed ...

    African Journals Online (AJOL)

    Results: Seven different antibiotics namely Erythromycin, Meropenem, Taxobactam/ Piperacillin, Metronidazole, Gentamycin, Ceftriaxone and Cefuroxime were used in sufficient numbers in both centres to allow for statistical analysis. Four of these seven namely metronidazole, gentamycin, ceftriaxone and cefuroxime ...

  16. Evaluation of gamma irradiation impact on antibacterial activity, chemical and physical characteristics of the sodium cifteraxon compound

    International Nuclear Information System (INIS)

    Al-Bachir, M.; Al-Adawi, M. A.; Hammouda, A.; Al-Baroudi, H.

    2008-04-01

    To investigate the effect of gamma irradiation on the solid state of ceftriaxon sodium salt (C18H16N8Na2O7S3) as a member of the third generation of cephalosporins. Solid Ceftriaxon as a pharmaceutical dosage was exposed to doses of 0, 5, 10, 15, 20, 25, and 50 kGy in 60 Co package irradiator. Physical and chemical characteristics of ceftriaxon have been investigated by using UV (Ultra Violet) and IR (Infra Red) spectroscopic, pH, solubility and DSC (Differential Scanning Calorimetric) methods. Antibacterial activity of ceftriaxon was investigated using Escherichia coli ATCC 25922 as a strain of bacteria. The obtained results indicated that gamma irradiation have no effect on physical and chemical characteristics of ceftriaxon, No significant differences were found between irradiated and non-irradiated samples in the Antibacterial activity of ceftriaxon on E. Coli.(author)

  17. Experimental study of cerebrospinal fluid tumor necrosis factor-alpha release in penicillin- and cephalosporin-resistant pneumococcal meningitis treated with different antibiotic schedules

    Directory of Open Access Journals (Sweden)

    M. Vivas

    2017-08-01

    Conclusion: CSF TNF-α levels were significantly lower in rabbits treated with daptomycin than in rabbits treated with ceftriaxone. Daptomycin avoided the inflammatory peak after administration observed in ceftriaxone-treated rabbits. The use of daptomycin plus dexamethasone achieved a significantly larger reduction in CSF TNF-α levels.

  18. Comparison of two disc diffusion methods with minimum inhibitory ...

    African Journals Online (AJOL)

    Susceptibility to penicillin, ciprofloxacin, tetracycline, ceftriaxone and spectinomycin and cefixime were determined by CSLI and AGSP method and Kappa statistics used to analyse the data with SPSS software. Results: All isolates were susceptible to ceftriaxone and spectinomycin by three methods. Ninety‑nine (99%) ...

  19. Aerobic bacteria in safe type chronic suppurative otitis media in ...

    African Journals Online (AJOL)

    ... cefuroxime, cefaclor and ceftriaxone. Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discouraged. Keywords: Aerobic bacteria, Chronic suppurative otitis media, Gezira ...

  20. An illustration of the potential health and economic benefits of combating antibiotic resistant gonorrhea.

    Science.gov (United States)

    Chesson, Harrell W; Kirkcaldy, Robert D; Gift, Thomas L; Owusu-Edusei, Kwame; Weinstock, Hillard S

    2017-09-22

    Preventing the emergence of ceftriaxone-resistant Neisseria gonorrhoeae can potentially avert hundreds of millions of dollars in direct medical costs of gonorrhea and gonorrhea-attributable HIV infections. In the illustrative scenario we examined, emerging ceftriaxone resistance could lead to 1.2 million additional N. gonorrhoeae infections over 10 years, costing $378.2 million.

  1. Effect of Salmonella thyphymurium Infection on the ...

    African Journals Online (AJOL)

    This study was designed to investigate the effect of Salmonella thyphimurium infection on the plasma kinetics of ceftriaxone in Sokoto red goats. In a randomised two-way study, 10 healthy male goats were divided into two groups of five each, and either received a single intramuscular (IM) injection of 1g ceftriaxone only or ...

  2. Hearing loss and cochlear damage in experimental pneumococcal meningitis, with special reference to the role of neutrophil granulytes

    DEFF Research Database (Denmark)

    Brandt, CT; Caye-Thomsen, P; Lund, SP

    2006-01-01

    treated with ceftriaxone 28 h after infection. Rats were treated with Granulocyte Colony Stimulating Factor (G-CSF) initiated prior to infection, 28 h after infection or with ceftriaxone only. Rats were followed for 7 days, and assessment of hearing was performed before infection and 24 h and day 8 after...

  3. Colorimetric Determination of Cefadroxil and Ceftriazone in ...

    African Journals Online (AJOL)

    Purpose: To develop a simple, rapid and selective method for the spectrophotometric determination of cefadroxil and ceftriaxone using 1, 2- napthaquinone-4- sulfonic acid sodium. Methods: The method was based on the derivatization of cefadroxil and ceftriaxone with 1, 2-naphthaquinone-4- sulfonic acid sodium in ...

  4. Bacterial blood stream infections and antibiogram among febrile ...

    African Journals Online (AJOL)

    , ceftriaxone and trimethoprim-sulfamethoxazole. The present study revealed that bacterial blood stream infections linked with high levels of drug resistance would pose a challenge in treatment of patients with BSIs. Hence, blood culture with ...

  5. Use of vaccines as a key antimicrobial stewardship strategy

    African Journals Online (AJOL)

    valent PCV (PCV7/PCV13) on the incidence of penicillin, ceftriaxone and multidrugresistant pneumococcal infections in South Africa in only 4 years. Equally impressive have been vaccines directed towards viruses such as influenza, which also ...

  6. MULTIDRUG-RESISTANT NEISSERIA GONORRHOEAE WITH REDUCED CEFOTAXIME SUSCEPTIBILITY IS INCREASINGLY COMMON IN MEN WHO HAVE SEX WITH MEN, AMSTERDAM, THE NETHERLANDS

    NARCIS (Netherlands)

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

    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

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

    NARCIS (Netherlands)

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

    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

  8. A Case-Control Study of Molecular Epidemiology in Relation to Azithromycin Resistance in Neisseria gonorrhoeae Isolates Collected in Amsterdam, the Netherlands, between 2008 and 2015

    NARCIS (Netherlands)

    Wind, Carolien M.; Bruisten, Sylvia M.; Schim van der Loeff, Maarten F.; Dierdorp, Mirjam; de Vries, Henry J. C.; van Dam, Alje P.

    2017-01-01

    Neisseria gonorrhoeae resistance to ceftriaxone and azithromycin is increasing, which threatens the recommended dual therapy. We used molecular epidemiology to identify N. gonorrhoeae clusters and associations with azithromycin resistance in Amsterdam, the Netherlands. N. gonorrhoeae isolates (n =

  9. Meropenem susceptibility of Neisseria meningitidis and Streptococcus pneumoniae from meningitis patients in The Netherlands

    NARCIS (Netherlands)

    van de Beek, D.; Hensen, E. F.; Spanjaard, L.; de Gans, J.; Enting, R. H.; Dankert, J.

    1997-01-01

    In-vitro susceptibility of 299 Neisseria meningitidis and 157 Streptococcus pneumoniae strains from meningitis patients in The Netherlands in 1993 and 1994 to meropenem was determined using the Etest. Susceptibility to penicillin, ceftriaxone, and chloramphenicol was also determined. Rifampicin

  10. Efficacy of rifampicin combination therapy on selected non ...

    African Journals Online (AJOL)

    Clinical isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa strains were exposed to antibacterial agents namely, Gentamicin, Cefuroxime, Ceftriaxone and Norfloxacin singly and also in combination with Rifampicin. Each minimum inhibitory concentration (MIC) as ...

  11. Bacterial agents and sensitivity pattern of neonatal conjuctivitis in ...

    African Journals Online (AJOL)

    44.6%) yielded no growth. Staphylococcus aureus was the most frequently isolated organism and was most sensitive to ceftriaxone, (73.1%). Escherichia coli was most sensitive to gentamicin (78.3%). Pseudomonas aeruginosa and Neisseria ...

  12. 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.

  13. 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. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  14. Emergence and Spread of Neisseria gonorrhoeae Isolates With Decreased Susceptibility to Extended-Spectrum Cephalosporins in Argentina, 2009 to 2013.

    Science.gov (United States)

    Gianecini, Ricardo; Romero, Maria de Las Mercedes; Oviedo, Claudia; Vacchino, Martin; Galarza, Patricia

    2017-06-01

    The emergence of Neisseria gonorrhoeae strains with decreased susceptibility to cephalosporins represents a major concern globally. The aim of this study was to examine the phenotypic and molecular characteristics of N. gonorrhoeae isolates with decreased susceptibility to ceftriaxone and cefixime in Argentina. A total of 1987 isolates were collected during 2009 and 2013. The susceptibility to penicillin G, tetracycline, ciprofloxacin, cefixime, ceftriaxone, and azithromycin was determined using the agar dilution method. The major extended-spectrum cephalosporin resistance determinants (penA, mtrR, and porB1b) were sequenced in 42 N. gonorrhoeae isolates that showed decreased susceptibility to ceftriaxone (minimum inhibitory concentration [MIC], 0.06-0.125 mg/L) and cefixime (MIC, 0.125-0.25 mg/L). Genotyping by N. gonorrhoeae multiantigen sequence typing (NG-MAST) was performed. Between 2009 and 2013, there was a shift in the modal MICs for ceftriaxone. Among the 42 isolates exhibiting decreased susceptibility to ceftriaxone and cefixime, 95.2% were resistant to penicillin G, 95.2% to tetracycline, 97.6% to ciprofloxacin, and 33.3% to azithromycin. Thirty-five (83.3%) of the 42 isolates had a mosaic penA allele XXXIV, which has been previously associated with resistance to ceftriaxone and cefixime as well as treatment failures. The isolates that contained the mosaic penicillin-binding protein 2 (PBP2) XXXIV were associated with NG-MAST ST1407 or closely related genotypes. In Argentina, N. gonorrhoeae isolates with decreased susceptibility to cefixime and ceftriaxone have now emerged, mostly due to the introduction of the internationally spread multidrug-resistant NG-MAST ST1407.

  15. Efficacy of ceftaroline fosamil for bacteremia associated with community-acquired bacterial pneumonia.

    Science.gov (United States)

    Jandourek, Alena; Smith, Alexander; Llorens, Lily; Thye, Dirk A; Eckburg, Paul B; Friedland, H David

    2014-02-01

    Few publications of prospective studies have described patient outcomes in community-acquired bacterial pneumonia (CABP)-associated bacteremia. Our objective, in performing this subgroup analysis, was to assess outcomes in subjects with CABP-associated bacteremia in 2 randomized, double-blind clinical studies comparing treatment with ceftaroline fosamil versus ceftriaxone. Our analysis summarizes baseline subject demographics, distribution of baseline pathogens isolated from blood cultures, clinical response rates at Day 4, and clinical cure rates at end of therapy and test of cure (8 to 15 days after end of therapy) in subjects with bacteremic CABP in the ceFtarOline Community-acquired pneUmonia trial vS ceftriaxone in hospitalized patients (FOCUS) studies. In the FOCUS studies, 23 of 614 patients in the ceftaroline fosamil-treated group and 22 of 614 patients in the ceftriaxone-treated group had CABP-associated bacteremia. Baseline demographics were similar between groups. Streptococcus pneumoniae was the most common baseline bloodstream isolate. For subjects with CABP-associated bacteremia, clinical response/cure rates were similar at Day 4 (60.9% vs 59.1%), end of therapy (69.6% vs 72.7%), and test of cure (69.6% vs 68.2%) for ceftaroline fosamil and ceftriaxone, respectively. In subjects with CABP-associated bacteremia, ceftaroline fosamil demonstrated similar clinical outcomes at Day 4, end of therapy, and test of cure compared with ceftriaxone.

  16. What is the best therapy for Whipple's disease? Our point of view.

    Science.gov (United States)

    Biagi, Federico; Biagi, Gian Luigi; Corazza, Gino Roberto

    2017-04-01

    Although Whipple's disease (WD) has been treated with antibiotics since the early 50s, the best antibiotics and the duration of the therapy have not yet been established. We consider here the pro and cons of the two most commonly used therapies, ceftriaxone followed by trimethoprim-sulfamethoxazole (TMP-SMZ) and hydroxychloroquine in combination with doxycycline. The therapy based on ceftriaxone and TMP-SMZ is efficient in the vast majority of patients for the first few years. However, since reinfections or reactivations can occur, a life-long prophylaxis is necessary and doxycycline is nowadays the best option. We thus propose a therapy based on merging these to therapies together, ceftriaxone, and TMP-SMZ for the first year(s) and then life-long prophylaxis with doxycycline.

  17. Beta-lactam antibiotic decreases acquisition of and motivation to respond for cocaine, but not sweet food, in C57Bl/6 mice.

    Science.gov (United States)

    Ward, Sara Jane; Rasmussen, Bruce A; Corley, Gladys; Henry, Craig; Kim, Jae K; Walker, Ellen A; Rawls, Scott M

    2011-08-01

    No medication is approved to treat cocaine addiction, but mounting evidence suggests that glutamate-directed approaches may reduce cocaine dependence and relapse. We tested the hypotheses that the glutamate transporter subtype 1 activator, ceftriaxone, disrupts acquisition of cocaine self-administration, motivation to self-administer cocaine, and conditioned place preference in mice. Repeated ceftriaxone (200 mg/kg) reduced the ability of mice to acquire cocaine and the motivation to self-administer cocaine after successful acquisition without affecting acquisition of or motivation for sweet food. Repeated ceftriaxone had no effect on cocaine-conditioned place preference. These results suggest that a β-lactam antibiotic reduces the direct reinforcing strength of cocaine without producing nonspecific deficits in conditioned learning processes.

  18. Gonorrhea treatment practices in the STD Surveillance Network, 2010-2012.

    Science.gov (United States)

    Kerani, Roxanne P; Stenger, Mark R; Weinstock, Hillard; Bernstein, Kyle T; Reed, Mary; Schumacher, Christina; Samuel, Michael C; Eaglin, Margaret; Golden, Matthew

    2015-01-01

    Replacing oral treatments with ceftriaxone is a central component of public health efforts to slow the emergence of cephalosporin-resistant Neisseria gonorrhoeae in the United States; US gonorrhea treatment guidelines were revised accordingly in 2010. However, current US gonorrhea treatment practices have not been well characterized. Six city and state health departments in Cycle II of the STD Surveillance Network (SSuN) contributed data on all gonorrhea cases reported in 101 counties and independent cities. Treatment data were obtained through local public health surveillance and interviews with a random sample of patients. Cases were weighted to adjust for site-specific sample fractions and for differential nonresponse by age, sex, and provider type. From 2010 to 2012, 135,984 gonorrhea cases were reported in participating areas, 15,246 (11.2%) of which were randomly sampled. Of these, 7,851 (51.5%) patients were interviewed. Among patients with complete treatment data, 76.8% received ceftriaxone, 16.4% received an oral cephalosporin, and 6.9% did not receive a cephalosporin; 51.9% of persons were treated with a regimen containing ceftriaxone and either doxycycline or azithromycin. Ceftriaxone treatment increased significantly by year (64.1% of patients in 2010, 79.3% in 2011, 85.4% in 2012; P = 0.0001). Ceftriaxone use varied widely by STD Surveillance Network site (from 44.6% to 95.1% in 2012). Most persons diagnosed as having gonorrhea between 2010 and 2012 in the United States received ceftriaxone, and its use has increased since the release of the 2010 Centers for Disease Control and Prevention STD Treatment Guidelines.

  19. Synthesis and antimicrobial activity of some new hydrazones of 4-fluorobenzoic acid hydrazide and 3-acetyl-2,5-disubstituted-1,3,4-oxadiazolines.

    Science.gov (United States)

    Rollas, Sevim; Gulerman, Nehir; Erdeniz, Habibe

    2002-02-01

    A series of hydrazide hydrazones and 1,3,4-oxadiazolines of 4-fluorobenzoic acid hydrazide were prepared and evaluated as potential antimicrobial agents and were tested for their antibacterial and antifungal activities against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. From these compounds, 4-fluorobenzoic acid[(5-nitro-2-furanyl)methylene]hydrazide (1a) showed equal activity with ceftriaxone against S. aureus. In addition, the MIC values of compounds 1c, 1d and 2a for the same strain were in the range of those reported for ceftriaxone according to NCCLS 1997.

  20. Efficacy of ceftaroline fosamil against penicillin-sensitive and -resistant streptococcus pneumoniae in an experimental rabbit meningitis model.

    Science.gov (United States)

    Cottagnoud, P; Cottagnoud, M; Acosta, F; Stucki, A

    2013-10-01

    Ceftaroline is a new cephalosporin with bactericidal activity against resistant Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae, as well as common Gram-negative organisms. This study tested the prodrug, ceftaroline fosamil, against a penicillin-sensitive and a penicillin-resistant strain of S. pneumoniae in an experimental rabbit meningitis model. The penetration of ceftaroline into inflamed meninges was approximately 14%. Ceftaroline fosamil was slightly superior to ceftriaxone against the penicillin-sensitive strain and significantly superior to the combination of ceftriaxone and vancomycin against the penicillin-resistant strain.

  1. Patterns of resistance to β-lactams and β-lactamase inhibitors in ...

    African Journals Online (AJOL)

    hope&shola

    2006-03-15

    Mar 15, 2006 ... FMV 1953 uropathogenic Escherichia coli isolate was extremely resistant to amoxicillin, co-amoxiclav, ticarcillin, mecillinam, cefoxitime, cefixime, cefuroxime, cefotaxime, ceftazidime, ceftriaxone and aztreoname. From the resistance patterns observed we deduce the phenotype as producing a TEM-1 β.

  2. Prophylactic antibiotic for pacemaker surgery: what is optimal ...

    African Journals Online (AJOL)

    One of them, a bed-ridden patient developed severe pocket infection necessitating explantation and replacement 3 weeks later. Conclusions: We noted with satisfaction that short regime of prophylactic parentral ceftriaxone is effective in preventing pacemaker infection and there is no need for the long regimen. Niger Med J.

  3. Antibiograms of Bacillus cereus isolates from some Nigerian Foods ...

    African Journals Online (AJOL)

    resistance to penicillin G (82%), cefotaxime (56.7%), ceftriaxone (53.3%) and ampicillin (44%) were most frequent, whereas isolates were least resistance to tetracycline (6.7%) nalidixic acid (3%) and gentamicin (1%). The predominant antimicrobial resistance patterns irrespective of food source were cefotaxime, penicillin, ...

  4. Resistance patterns of Streptococcus pneumoniae isolated from the ...

    African Journals Online (AJOL)

    Initial oxacillin screening for penicillin resistance revealed that 12 out of 36 isolates were clearly sensitive, but combined with the result of Etest, penicillin resistance was found to be 6.8%. Susceptibility testing by disc diffusion revealed that 80.5% of isolates were sensitive to ceftriaxone and 94.4% to chloramphenicol.

  5. Cost-Effectiveness of Dual Antimicrobial Therapy for Gonococcal Infections Among Men Who Have Sex With Men in the Netherlands

    NARCIS (Netherlands)

    Xiridou, Maria; Lugnér, Anna; De Vries, Henry J C; Van Bergen, Jan E A M; Götz, Hannelore M.; Van Benthem, Birgit H B; Wallinga, Jacco; Van Der Sande, Marianne A B

    2016-01-01

    BACKGROUND: In response to the rising threat of resistance to first-line antibiotics for gonorrhea, international guidelines recommend dual antimicrobial therapy. However, some countries continue to recommend monotherapy. We assess the cost-effectiveness of dual therapy with ceftriaxone and

  6. The Discharging Ears In Adults In Ibadan, Nigeria Causative Agents ...

    African Journals Online (AJOL)

    Others were Candida albicans and Aspergillus species. Susceptibility result showed that ceftazidime, azithromycin, ceftriaxone, ... In addition antifungal cream should be used as wick in dressing, as well as systemic metrondazole to take care of the anaerobes. (Af. J. of Clinical and Experimental Microbiology: 2002 3(1): 3-5) ...

  7. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

    OpenAIRE

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

    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...

  8. Concomitant gentamicin-induced nephrotoxicity and bilateral ...

    African Journals Online (AJOL)

    2015-11-20

    Nov 20, 2015 ... There was no associated earache, tinnitus, ear discharge, or vertigo. There was no significant change in her urine volume [Table 1]. At presentation, she was dehydrated and restless with blood pressure of 100/40 mHg. Urine culture yielded growth of. Escherichia coli sensitive to imipenem, ceftriaxone, and.

  9. Author Details

    African Journals Online (AJOL)

    Coetzee, K.D.. Vol 78, No 8 (1990) - Articles Efficacy of various single-dose regimens of ceftriaxone in uncomplicated acute gonococcal urethritis in adult males. Abstract PDF · Vol 78, No 8 (1990) - Articles A microbiological study therapy for gonococcal of failed urethritis penicillin in Durban Abstract PDF. ISSN: 0256-95749.

  10. South African Medical Journal - Vol 78, No 8 (1990)

    African Journals Online (AJOL)

    Efficacy of various single-dose regimens of ceftriaxone in uncomplicated acute gonococcal urethritis in adult males · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A.A. Hoosen, N O'Farrell, K.D. Coetzee, J van den Ende, 187-189 ...

  11. Download this PDF file

    African Journals Online (AJOL)

    chlamydial urethritis and cervicitis. The Azithromycin for. Chlamydial Infections Study Group. N Engl J Med. 1992;. 327(13): 921-925. 3. Handsfield HH, Dalu ZA, Martin DH, Douglas JM Jr,. McCarty JM, Schlossberg D. Multicenter trial of single- dose azithromycin vs. ceftriaxone in the treatment of uncomplicated gonorrhea.

  12. Opfølgning efter nontyfoid Salmonella-bakteriæmi er vigtig på grund af risiko for endovaskulær infection

    DEFF Research Database (Denmark)

    Sydenham, Thomas Vognbjerg; Andersen, Åse Bengård

    2015-01-01

    /computed tomography showed aortitis. Ceftriaxon and ciprofloxacin was administered. The patient was not a candidate for surgery and two weeks later he died from multiple organ failure. Follow-up visits with blood cultures after the first bacteraemia episode might have allowed for earlier diagnosis of the relapse....

  13. Download this PDF file

    African Journals Online (AJOL)

    Resistance to erythromycin was found in 5% of isolates from all population groups. Strains from all population groups were susceptible to ceftriaxone, cefuroxime, spectinomycin, norfloxacin and ciprofloxacin. The susceptibility of all isolates to spectinomycin observed supports the policy decision to change from ...

  14. Cost-Effectiveness of Dual Antimicrobial Therapy for Gonococcal Infections Among Men Who Have Sex With Men in the Netherlands

    NARCIS (Netherlands)

    Xiridou, Maria; Lugnér, Anna; de Vries, Henry J. C.; van Bergen, Jan E. A. M.; Götz, Hannelore M.; van Benthem, Birgit H. B.; Wallinga, Jacco; van der Sande, Marianne A. B.

    2016-01-01

    In response to the rising threat of resistance to first-line antibiotics for gonorrhea, international guidelines recommend dual antimicrobial therapy. However, some countries continue to recommend monotherapy. We assess the cost-effectiveness of dual therapy with ceftriaxone and azithromycin

  15. Microbial isolates in open fractures seen in the accident and ...

    African Journals Online (AJOL)

    Routine microscopy, culture and sensitivities for aerobic and anaerobic organisms were carried out on these specimens. ... pattern of all the isolates shows that pefloxacin, ciprofloxacin and ceftriaxone were more effective compared to cefuroxime and amoxycillin which had substantial resistance to most of the isolates.

  16. Gonokok wijzigt sneller dan voorschrijfgedrag: resistentie tegen veel voorgeschreven antibiotica

    NARCIS (Netherlands)

    Koedijk, Femke D. H.; van den Broek, Ingrid V. F.; Stirbu-Wagner, Irina; van Bergen, Jan E. A. M.

    2013-01-01

    Gonococcal resistance to antibiotics is increasing worldwide. In patients tested in Dutch STI clinics in 2009, gonococcal resistance to ciprofloxacin was over 50%. Ceftriaxone, a third-generation cephalosporin, has been the first-choice medication since 2004. General practitioners treated 25% of

  17. Gonorrhea Treatment Failures With Oral and Injectable Expanded Spectrum Cephalosporin Monotherapy vs Dual Therapy at 4 Canadian Sexually Transmitted Infection Clinics, 2010-2013.

    Science.gov (United States)

    Singh, Ameeta E; Gratrix, Jennifer; Martin, Irene; Friedman, Dara S; Hoang, Linda; Lester, Richard; Metz, Gila; Ogilvie, Gina; Read, Ron; Wong, Tom

    2015-06-01

    Antimicrobial resistance has developed to all antibiotics used to treat gonorrhea (GC), and trends in GC antimicrobial resistance have prompted changes in treatment guidelines. We examined treatment failures in sexually transmitted infection clinics. Four Canadian sexually transmitted infection clinics reviewed treatment regimens, minimum inhibitory concentrations for cephalosporins and azithromycin, anatomical infection sites, and treatment outcomes for GC infections between January 2010 and September 2013, in individuals who returned for test of cure within 30 days of treatment. Treatment failure was defined as the absence of reported sexual contact during the posttreatment period and (i) positive for Neisseria gonorrhoeae on culture of specimens taken at least 72 hours after treatment or (ii) positive nucleic acid amplification test specimens taken at least 2 to 3 weeks after treatment, and matching sequence type pretreatment and posttreatment. χ Test and Fisher exact test were used to assess association of categorical variables. Of 389 specimens reviewed, GC treatment failures occurred in 13 specimens treated with cefixime 400-mg single dose (17.8% treatment failure rate regardless of anatomical site) and in 1 oropharyngeal specimen treated with cefixime 800-mg single dose. No treatment failures occurred using either ceftriaxone monotherapy or cefixime/ceftriaxone combined with azithromycin or doxycycline. In contrast to oral cefixime monotherapy, no treatment failures were identified with injectable ceftriaxone monotherapy or combination GC treatment. Our data support the use of combination treatment of GC with an extended spectrum cephalosporin (including oral cefixime) with azithromycin or doxycycline as well as ceftriaxone monotherapy.

  18. 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

    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...

  19. 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

    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...

  20. Effect of Salmonella thyphymurium Infection on the ...

    African Journals Online (AJOL)

    Effect of Salmonella thyphymurium Infection on the Pharmacokinetics of Ceftriaxone in. Sokoto Red Goats. * O. J. Abdulgafar ... ABSTRACT: This study was designed to investigate the effect of Salmonella thyphimurium infection on the plasma kinetics of ..... oxytetracycline disposition in calves with experimental pneumonic ...

  1. Reuse of Expired Cefort Drug in Nickel Electrodeposition From Watts Bath

    Directory of Open Access Journals (Sweden)

    Delia-Andrada Duca

    2017-06-01

    Full Text Available This paper demonstrates the possibility to use ceftriaxone (CEFTR active compound from expired Cefort as additive in nickel electrodeposition from Watts baths. Electrochemical behaviour and the influence of CEFTR on nickel electroplating were studied by electrochemical methods. Experimental data recommends CEFTR as additive in nickel electroplating from Watts baths.

  2. aerobic bacteria in safe type chronic suppurative otitis media

    African Journals Online (AJOL)

    PUBLICATIONS1

    Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discour- aged. INTRODUCTION. Chronic suppurative otitis media (CSOM) is a persistent inflammatory disorder of the middle.

  3. Antimicrobial susceptibility pattern of bacterial isolates from surgical ...

    African Journals Online (AJOL)

    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 ...

  4. Lyme neuroborreliosis in a patient treated with TNF-alpha inhibitor.

    Science.gov (United States)

    Merkac, Maja Ivartnik; Tomazic, Janez; Strle, Franc

    2015-12-01

    A 57-year-old woman, receiving TNF-alpha inhibitor adalimumab for psoriasis, presented with early Lyme neuroborreliosis (Bannwarth's syndrome). Discontinuation of adalimumab and 14-day therapy with ceftriaxone resulted in a smooth course and favorable outcome of Lyme borreliosis. This is the first report on Lyme neuroborreliosis in a patient treated with TNF-alpha inhibitor.

  5. High prevalence of multi-drug resistant Klebsiella pneumoniae in a ...

    African Journals Online (AJOL)

    The lowest resistance rates were documented for Carbapenems (23.2%). For specific antibiotics, there was high resistance to commonly used antibiotics (over 80% for Ceftriaxone, Cefipime, Gentamycin and Ceftazidime). The antibiotics with least resistance were Amikacin and Meropenem (21% and 7 % respectively).

  6. Plasmid Conjugation in E. coli and Drug Resistance

    African Journals Online (AJOL)

    Prof. Ogunji

    more the copy number of resistance plasmid present in a bacterial cell, the higher the resistant ability of ... amoxicillin, as well as other semi synthetic penicillins, many cephalosporins, carbapenems, aztreonam, ... drugs resistant E. coli to amoxicillin-clavulanic acid and ceftriaxone were also carried out (Hadley, 2002;.

  7. Multiple Sclerosis in a Nigerian Alcoholic Male: A Case Report from ...

    African Journals Online (AJOL)

    Uche

    times a day, intravenous ceftriaxone 1gram 12- hourly, tablets. Vitamin E 1000IU once day, tablets. Vitamin C 400 milligram three times a day. Necessary dietary modifications were made and physical therapy commenced. Over the next few days the tremors subsided and the sensorium normalised. By the second week on.

  8. anti-retroviral therapy related liver injury (arli): a series of 11 cases

    African Journals Online (AJOL)

    2013-12-02

    Dec 2, 2013 ... care as in-patients; intravenous fluids, 5% dextrose, iv. Vitamin K 10 mg daily for seven to 14 days and was stopped when the INR was normalising, iv ceftriaxone. 1gm daily in patients who had neutrophilia or ascites (to prevent spontaneous bacterial peritonitis), hepermerz (a liver tonic containing ornithine ...

  9. Screening of natural extracts for their antibacterial activity against ...

    African Journals Online (AJOL)

    Screening of natural extracts for their antibacterial activity against different enteric pathogens isolated from soil, water and rotten fruit samples. ... The antibacterial activity of crude extract was comparable with ciprofloxacin and ceftriaxone, commonly used antibiotics for the treatment of infections in adults and children, ...

  10. Ward Round - Recurrent anemia and infection in an HIV-positive ...

    African Journals Online (AJOL)

    Past history. Two weeks previously, she was admitted to hospital for severe anaemia ([Hb] 3.2g/dl) and probable sepsis, for which she was transfused three units of blood and received ceftriaxone and ciprofloxacin therapy. Her HIV test was found to be positive on that occasion, and she was commenced on cotrimoxazole ...

  11. Download this PDF file

    African Journals Online (AJOL)

    FOBUR

    (Ceftriaxone 50mg/kg body weight daily and. Metronidazole 7.5mg/kg body weight 8hourly) for one week to prevent post operative meningitis. The content was sent for microscopy, ... lenticular hypodense collections with rim thick wall enhancement overlying the convexity of both frontal lobes. The brain parenchyma and the ...

  12. South African Medical Journal - Vol 103, No 12 (2013)

    African Journals Online (AJOL)

    A comparison of the pharmacokinetics of Aspen Ceftriaxone and Rocephin in community-acquired meningitis · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. GA Richards, E Elliott, EJ Shaddock, D Mushi, M Mzileni, R Ray, S Rulisa, F Seolwane, SL Stacey, A Stolz, ...

  13. JOURNAL V12 NO 1 2OO7 FINAL EDIT TO BIOLINE

    African Journals Online (AJOL)

    user

    100.0. Table 2. Outcome in Patients Who Had Ceftriaxone as Prophylactic Antimicrobial. Type of Operations. Patients with. Postoperative. Infections. Patients without. Postoperative. Infections. Total. VP Shunt. 2. 15. 17. Repair Of Encephalocele. 1. 1. Craniotomy & Excision Of Tumor. 2. 2. Wound Debridement And Elevation.

  14. Cephalosporin susceptibility of methicillin-resistant, coagulase-negative staphylococci.

    Science.gov (United States)

    Menzies, R E; Cornere, B M; MacCulloch, D

    1987-01-01

    Coagulase-negative staphylococci were tested for susceptibility to methicillin, cephradine, ceftriaxone, cephalothin, and cefamandole by standard broth microdilution. Most of the 26 methicillin-resistant isolates were susceptible to cephalothin and cefamandole, but very few were susceptible to ceftriaxone, and none was susceptible to cephradine. The proportion of bacterial cells that grew in the presence of 128 micrograms of methicillin per ml was calculated for each methicillin-resistant isolate. Those with every cell or 1 in 10 cells resistant to 128 micrograms of methicillin per ml included the isolates that were most resistant to the cephalosporins and highly resistant to methicillin. Those with 1 cell resistant in 10(5) or 10(6) cells were the isolates most susceptible to the cephalosporins, and their methicillin MICs were lower. When cells resistant to 128 micrograms of methicillin per ml were used as inocula for broth microdilution tests, resistance to cephradine remained the same, but resistance to ceftriaxone, cephalothin, and cefamandole increased significantly. Cefamandole was the only cephalosporin which retained antibacterial activity against some methicillin-resistant isolates (12 of 26). Cephradine, ceftriaxone, cephalothin, and cefamandole resistance appeared to be expressed by the same cells that expressed methicillin resistance. In this way, cross resistance was demonstrated between methicillin and the cephalosporins. PMID:3646002

  15. Fever, sore throat and myalgia | Ive | South African Medical Journal

    African Journals Online (AJOL)

    A 20-year-old man presented with a severely sore throat and myalgia, which were unresponsive to antibiotics. He was admitted to a regional hospital with an ongoing painful throat, generalised myalgia, fever and a transient, recurring, salmon-pink rash on his hands and trunk. He did not respond to ceftriaxone and had a ...

  16. Invasive Bacterial Pathogens and their Antibiotic Susceptibility ...

    African Journals Online (AJOL)

    The isolates showed high rates of resistance to most antibiotics tested. The range of resistance for gram positive bacteria were 0% to 85.7%, and for gram negative from 0% to 100%. None of the isolates were resistance to ciprofloxacin and ceftriaxone. CONCLUSION: Our study result showed the presence of invasive ...

  17. A novel STK1-targeted small-molecule as an "antibiotic resistance breaker" against multidrug-resistant Staphylococcus aureus.

    Science.gov (United States)

    Kant, Sashi; Asthana, Shailendra; Missiakas, Dominique; Pancholi, Vijay

    2017-07-11

    Ser/Thr protein kinase (STK1) plays a critical role in cell wall biosynthesis of and drug resistance in methicillin-resistant Staphylococcus aureus (MRSA). MRSA strains lacking STK1 become susceptible to failing cephalosporins, such as Ceftriaxone and Cefotaxime. STK1, despite being nonessential protein for MRSA survival, it can serve as an important therapeutic agent for combination therapy. Here, we report a novel small molecule quinazoline compound, Inh2-B1, which specifically inhibits STK1 activity by directly binding to its ATP-binding catalytic domain. Functional analyses encompassing in vitro growth inhibition of MRSA, and in vivo protection studies in mice against the lethal MRSA challenge indicated that at high concentration neither Inh2-B1 nor Ceftriaxone or Cefotaxime alone was able to inhibit the growth of bacteria or protect the challenged mice. However, the growth of MRSA was inhibited, and a significant protection in mice against the bacterial challenge was observed at a micromolar concentration of Ceftriaxone or Cefotaxime in the presence of Inh2-B1. Cell-dependent minimal to no toxicity of Inh2-B1, and its abilities to down-regulate cell wall hydrolase genes and disrupt the biofilm formation of MRSA clearly indicated that Inh2-B1 serves as a therapeutically important "antibiotic-resistance-breaker," which enhances the bactericidal activity of Ceftriaxone/Cefotaxime against highly pathogenic MRSA infection.

  18. Incidence and bacteriological pattern of puerperal infections within ...

    African Journals Online (AJOL)

    About three quarters of Staphylococcus aureus and Escherichia coli infections are resistant to ceftriaxone, while more than half these infections are resistant to gentamicin. Conclusion: The incidence of puerperal infection in Redemption Hospital, Liberia, within the first 120 hours after Caesarean section is 21%.

  19. Enterobacteriaceae members are primary inhabitants of the lower ...

    African Journals Online (AJOL)

    Dr. Karimi

    sensitivity rate of ceftriaxone, ceftazidime and ciprofloxacin was above 70% in all cases. Co-amoxiclav, gentamicin, cefuroxime, minocycline and piperacillin showed moderate to high activity. Klebsiella spp isolates portrayed high resistance against several drugs. The sensitivity patterns showed that empirical prescribing ...

  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

    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. 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...

  2. The Preventive Antibiotics in Stroke Study (PASS) : a pragmatic randomised open-label masked endpoint clinical trial

    NARCIS (Netherlands)

    Westendorp, Willeke F.; Vermeij, Jan-Dirk; Zock, Elles; Hooijenga, Imke J.; Kruyt, Nyika D.; Bosboom, Hans J. L. W.; Kwa, Vincent I. H.; Weisfelt, Martijn; Remmers, Michel J. M.; ten Houten, Robert; Schreuder, A. H. C. M. (Tobien); Vermeer, Sarah E.; van Dijk, Ewout J.; Dippel, Diederik W. J.; Dijkgraaf, Marcel G. W.; Spanjaard, Lodewijk; Vermeulen, Marinus; van der Poll, Tom; Prins, Jan M.; Vermeij, Frederique H.; Roos, Yvo B. W. E. M.; Kleyweg, Ruud P.; Kerkhoff, Henk; Brouwer, Matthijs C.; Zwinderman, Aeilko H.; van de Beek, Diederik; Nederkoorn, Paul J.; Algra, Ale|info:eu-repo/dai/nl/07483472X

    2015-01-01

    Background In adults with acute stroke, infections occur commonly and are associated with an unfavourable functional outcome. In the Preventive Antibiotics in Stroke Study (PASS) we aimed to establish whether or not preventive antimicrobial therapy with a third-generation cephalosporin, ceftriaxone,

  3. 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

    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...

  4. Salmonella typhi time to change empiric treatment

    DEFF Research Database (Denmark)

    Gade, C.; Engberg, J.; Weis, N.

    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: 2008/9/29...

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

    NARCIS (Netherlands)

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

    2015-01-01

    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

  6. Localized infusions of the partial alpha 7 nicotinic receptor agonist SSR180711 evoke rapid and transient increases in prefrontal glutamate release

    DEFF Research Database (Denmark)

    Bortz, D M; Mikkelsen, J D; Bruno, J P

    2013-01-01

    that inhibited (threo-beta-benzyl-oxy-aspartate (TβOA), 100.0μM) or facilitated (ceftriaxalone, 200mg/kg, i.p.) excitatory amino acid transporters. TβOA slowed both the clearance (s) and rate of clearance (μM/s) by 10-fold, particularly at the mid-late stages of the return to baseline. Ceftriaxone reduced...

  7. Prevalence of extended spectrum β-lactamases (esbls) among ...

    African Journals Online (AJOL)

    ). Standard discs of augmentin {AMC 30μg (Oxoid, England)}, ceftriaxone {AUF 30μg (Oxoid, England)} and ceftazidime {RP 30μg (Oxoid, England)} were used in the screening. Of the 143 isolates screened, 114 (79.72%) were Gram negative ...

  8. Treatment of shigella infections: why sulfamethoxazole-trimethoprim ...

    African Journals Online (AJOL)

    ... and one (1.3%) were Yersinia enterocolitica. Shigella isolates had high resistance to sulfamethoxazole-trimethoprim (97%), tetracycline (83.6%) ampicillin (58.2%) and chloramphenicol (20.9%). The isolates showed low resistance to nalidixic (4.5%) and ciprofloxacin (3.0%) while there was no resistance to ceftriaxone.

  9. Multiple drug resistance patterns in various phylogenetic groups of uropathogenic E.coli isolated from Faisalabad region of Pakistan

    Directory of Open Access Journals (Sweden)

    Saira Bashir

    2011-12-01

    Full Text Available The objective of this work was the phylogenetic characterization of local clinical isolates of uropathogenic E. coli with respect to drug resistance. A total of 59 uropathogenic E. coli responsible for community acquired urinary tract infections were included in this study. A triplex PCR was employed to segregate each isolate into four different phylogenetic groups (A, B1, B2 and D. Drug resistance was evaluated by disc diffusion method. The drugs used were ampicillin, aztreonam, cefixime, cefoperazone, ceftriaxone, cephradine among β-lactam group; amikacin, gentamicin, and streptomycin among aminoglycosides; nalidixic acid and ciprofloxacin from quinolones; trimethoprim-sulfomethoxazole, and tetracycline. Among 59 uropathogenic E. coli isolates majority belonged to phylogenetic group B2 (50% where as 19% each belonged to groups A and B1, and 12% to group D. All the isolates were multiple drug resistant (MDR. Most effective drugs against Group A, B1, and B2 were gentamicin, amikacin and cefixime; ceftriaxone and quinolones; and ceftriaxone and amikacin, respectively. Group D isolates were found to be highly resistant to all drugs. Our results have shown emergence of MDR isolates among uropathogenic E. coli with dominance of phylogenetic group B2. However, it was found that group D isolates were though less frequent, more drug resistant as compared with group B2. Groups A and B1 were relatively uncommon. Amikacin, ceftriaxone and gentamicin were the most effective drugs in general.

  10. Multiple drug resistance patterns in various phylogenetic groups of uropathogenic E.coli isolated from Faisalabad region of Pakistan.

    Science.gov (United States)

    Bashir, Saira; Sarwar, Yasra; Ali, Aamir; Mohsin, Mashkoor; Saeed, Muhammad Azeem; Tariq, Ayesha; Haque, Abdul

    2011-10-01

    The objective of this work was the phylogenetic characterization of local clinical isolates of uropathogenic E. coli with respect to drug resistance. A total of 59 uropathogenic E. coli responsible for community acquired urinary tract infections were included in this study. A triplex PCR was employed to segregate each isolate into four different phylogenetic groups (A, B1, B2 and D). Drug resistance was evaluated by disc diffusion method. The drugs used were ampicillin, aztreonam, cefixime, cefoperazone, ceftriaxone, cephradine among β-lactam group; amikacin, gentamicin, and streptomycin among aminoglycosides; nalidixic acid and ciprofloxacin from quinolones; trimethoprim-sulfomethoxazole, and tetracycline. Among 59 uropathogenic E. coli isolates majority belonged to phylogenetic group B2 (50%) where as 19% each belonged to groups A and B1, and 12% to group D. All the isolates were multiple drug resistant (MDR). Most effective drugs against Group A, B1, and B2 were gentamicin, amikacin and cefixime; ceftriaxone and quinolones; and ceftriaxone and amikacin, respectively. Group D isolates were found to be highly resistant to all drugs. Our results have shown emergence of MDR isolates among uropathogenic E. coli with dominance of phylogenetic group B2. However, it was found that group D isolates were though less frequent, more drug resistant as compared with group B2. Groups A and B1 were relatively uncommon. Amikacin, ceftriaxone and gentamicin were the most effective drugs in general.

  11. Pharmacodynamics of Ceftaroline plus Ampicillin against Enterococcus faecalis in an In Vitro Pharmacokinetic/Pharmacodynamic Model of Simulated Endocardial Vegetations.

    Science.gov (United States)

    Werth, Brian J; Shireman, Laura M

    2017-04-01

    The combination of ampicillin plus ceftaroline has been suggested to be more reliably synergistic against Enterococcus faecalis than ampicillin plus ceftriaxone using time-kill methods. The purpose of this study was to determine if this trend persists in a two-compartment model of simulated endocardial vegetations (SEV) using clinically relevant pharmacokinetic exposures of these antimicrobials. Three clinically derived E. faecalis strains were included in the study. The MICs of study antimicrobials were determined by broth microdilution. Simulations of ampicillin (2 g every 4 h [q4h]; maximum concentration of drug in serum [ C max ], 72.4 mg/liter; half-life [ t 1/2 ], 1.9 h), ceftaroline-fosamil (600 mg q8h; C max , 21.3 mg/liter; t 1/2 , 2.66 h), ceftriaxone ( C max , 257 mg/liter; t 1/2 , 8 h), and ampicillin plus ceftaroline and ampicillin plus ceftriaxone were evaluated against 3 strains of E. faecalis isolated from patients with endocarditis in an in vitro PK/PD SEV model over 72 h, with a starting inoculum of ∼9 log 10 CFU/g. All strains were susceptible to ampicillin (MIC, ≤2 mg/liter). Ceftaroline MICs varied from 2 to 16 mg/liter. All strains had ceftriaxone MICs of 256 mg/liter. W04 and W151 exhibited high-level aminoglycoside resistance but W07 did not. Ampicillin plus ceftaroline resulted in significantly greater reductions in CFU per gram by 72 h than ampicillin for all strains ( P ≤ 0.025) than ampicillin plus ceftriaxone for W04 ( P = 0.019) but not W07 or W151 ( P ≥ 0.15). A 4-fold increase in ampicillin MIC was observed for W07 at 72 h, but this was prevented by the addition of ceftaroline or ceftriaxone. The combination of ampicillin plus ceftaroline appears to be at least as efficacious as ampicillin plus ceftriaxone and may lead to improved activity against some strains of E. faecalis , but these differences may be small and the clinical significance should not be overestimated. Copyright © 2017 American Society for Microbiology.

  12. Role of Rifampin in Reducing Inflammation and Neuronal Damage in Childhood Bacterial Meningitis: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Uppal, Lipi; Singhi, Sunit; Singhi, Pratibha; Aggarwal, Ritu

    2017-06-01

    Treatment of acute bacterial meningitis in children with bactericidal antibiotics causes cell wall lysis and a surge in inflammatory cascade, which in turn contributes to neuronal damage and morbidity. Pretreatment with a nonbacteriolytic antibiotic, such as rifampin, has been shown to attenuate the inflammatory response in experimental models of bacterial meningitis. In a pilot study, in children with bacterial meningitis, we have studied markers of inflammatory response and neuronal damage in 2 groups of children with bacterial meningitis; one group received rifampin pretreatment with ceftriaxone and the other group received ceftriaxone alone. Forty children with bacterial meningitis, who were 3 months to 12 years of age, were randomly assigned to receive either a single dose rifampin (20 mg/kg) 30 minutes before ceftriaxone or ceftriaxone alone was given. The primary outcome variables were cerebrospinal fluid (CSF) concentrations of tumor necrosis factor alpha (TNFα), S100B and neuron-specific enolase on day 1 and day 5, and secondary outcome variables were the values of TNFα and interleukin 6 in serum on day 1 and day 5; hearing and neurologic sequelae at 3 months after recovery from the illness. Children in rifampin pretreatment group had significantly lower CSF TNFα concentrations [median (interquartile range [IQR]): 15.5 (7.2-22.0) vs. 53.0 (9.0-87.5) pg/mL, P = 0.019] and S100B [median (IQR): 145.0 (54.7-450.0) vs. 447.5 (221.0-804.6) pg/mL, P = 0.033] on day 1 and S100B [median (IQR): 109.7 (64.0-287.0) vs. 322 (106.7-578.0) pg/mL, P = 0.048] and neuron-specific enolase [median (IQR): 8.6 (5-14.75) vs. 18.2 (7.0-28.75) ng/mL, P = 0.035] on day 5 when compared with ceftriaxone alone group. The rifampin-treated group also had reduced morbidity and neurologic sequelae; however, these were not statistically significant. Pretreatment with single dose rifampin 30 minutes before ceftriaxone administration reduced the CSF concentrations of markers of

  13. Drug-interaction-induced hemodynamically mediated acute renal failure in postsurgical patient

    Directory of Open Access Journals (Sweden)

    Arup K Misra

    2014-01-01

    Full Text Available Acute renal failure is a life threatening condition. Nonsteroidal antiinflammatory drugs (NSAIDs and cephalosporins are widely used postoperative drugs. NSAID-induced acute renal failure has been reported in the past. In this case, drug interaction and decompensated state of the patient precipitate the condition. NSAIDs inhibit prostaglandins synthesis and thus aggravate ischemia to the kidney that is already facing volume crisis due to surgery. Due to renal dysfunction, plasma ceftriaxone level increases due to decrease clearance and it also acts as nephrotoxic by unknown mechanism. On the other hand, ceftriaxone on its interaction with diclofenac for renal tubular clearance also increases the level of diclofenac and thus further aggravate the ischemia. It is a reversible condition with excluding diclofenac from the treatment regimen and giving adequate hydration to the patient. This highlights the importance of hydration and knowledge of drugs interactions in a postsurgical patient.

  14. Moxifloxacin in experimental Streptococcus pneumoniae cerebritis and meningitis.

    Science.gov (United States)

    Djukic, Marija; Böttcher, Tobias; Wellmer, Andreas; Gerber, Joachim; Brocke, Viola V; Eiffert, Helmut; Nau, Roland

    2005-01-01

    Rifampin, a protein synthesis inhibitor, reduced mortality in a mouse model of meningitis compared to bacteriolytic cephalosporin standard therapy. To assess whether moxifloxacin (known to cause a less rapid bacteriolysis than cephalosporins) can similarly reduce mortality, mice infected with Streptococcus pneumoniae by deep intracerebral injection were treated subcutaneously with either 200 mg/kg of moxifloxacin or ceftriaxone every 8 hours for 5 days (n = 49 each). They were then observed for an additional 8 days. Overall mortalities were 35 and 29 in moxifloxacin- and ceftriaxone-treated mice, respectively (p = 0.29). Kaplan-Meier survival analysis also revealed no statistically significant differences (p = 0.32). Moxifloxacin failed to reduce mortality compared to cephalosporin standard therapy.

  15. The β-lactam clavulanic acid mediates glutamate transport-sensitive pain relief in a rat model of neuropathic pain

    DEFF Research Database (Denmark)

    Kristensen, P J; Gegelashvili, G; Munro, G

    2017-01-01

    , ceftriaxone, displays analgesic effects in rodent chronic pain models. METHODS: Here, the antinociceptive actions of another β-lactam clavulanic acid, which possesses negligible antibiotic activity, were compared with ceftriaxone in rats with chronic constriction injury (CCI)-induced neuropathic pain......-dependent manner. CONCLUSIONS: Thus, clavulanic acid up-regulates GluTs in cultured rodent- and human astroglia and alleviates CCI-induced hypersensitivity, most likely through up-regulation of GLT1b in spinal dorsal horn. SIGNIFICANCE: Chronic dosing of clavulanic acid alleviates neuropathic pain in rats and up......-regulates glutamate transporters both in vitro and in vivo. Crucially, a similar up-regulation of glutamate transporters in human spinal astrocytes by clavulanic acid supports the development of novel β-lactam-based analgesics, devoid of antibacterial activity, for the clinical treatment of chronic pain....

  16. A new antibacterial benzophenone glycoside from Psidium guajava (Linn.) leaves.

    Science.gov (United States)

    Ukwueze, Stanley E; Osadebe, Patience O; Okoye, Festus B C

    2015-01-01

    Bioactivity-guided fractionation of methanol extract from the leaves of Psidium guajava L. (Myrtaceae) yielded a new benzophenone glycoside, Guajaphenone A (2) together with two known compounds, Garcimangosone D (1) and Guaijaverin (3). Their structures were elucidated by analysis of spectroscopic data including 1D and 2D NMR and electrospray ionisation mass spectrometry (ESI-MS). The isolated compounds were screened against standard strains of Gram-positive and Gram-negative bacteria using broth dilution assay method, and the MIC values determined and compared with reference antibiotic ceftriaxone. They were found to have significant antibacterial activities against Escherichia coli and Staphylococcus aureus with all of them showing better activities against S. aureus, but displaying weaker activities, in comparison to ceftriaxone. However, despite reduced effect of these compounds against the organisms, this work opens the perspective to use these molecules as 'leads' for the design of novel and selective drug candidates for some tropical infectious diseases.

  17. Killing of Serratia marcescens biofilms with chloramphenicol.

    Science.gov (United States)

    Ray, Christopher; Shenoy, Anukul T; Orihuela, Carlos J; González-Juarbe, Norberto

    2017-03-29

    Serratia marcescens is a Gram-negative bacterium with proven resistance to multiple antibiotics and causative of catheter-associated infections. Bacterial colonization of catheters mainly involves the formation of biofilm. The objectives of this study were to explore the susceptibility of S. marcescens biofilms to high doses of common antibiotics and non-antimicrobial agents. Biofilms formed by a clinical isolate of S. marcescens were treated with ceftriaxone, kanamycin, gentamicin, and chloramphenicol at doses corresponding to 10, 100 and 1000 times their planktonic minimum inhibitory concentration. In addition, biofilms were also treated with chemical compounds such as polysorbate-80 and ursolic acid. S. marcescens demonstrated susceptibility to ceftriaxone, kanamycin, gentamicin, and chloramphenicol in its planktonic form, however, only chloramphenicol reduced both biofilm biomass and biofilm viability. Polysorbate-80 and ursolic acid had minimal to no effect on either planktonic and biofilm grown S. marcescens. Our results suggest that supratherapeutic doses of chloramphenicol can be used effectively against established S. marcescens biofilms.

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

    International Nuclear Information System (INIS)

    Yousaf, A.; Latif, Z.

    2014-01-01

    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)

  19. 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.

  20. 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.

  1. 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.

  2. Recurrent paratyphoid fever A co-infected with hepatitis A reactivated chronic hepatitis B.

    Science.gov (United States)

    Liu, Yanling; Xiong, Yujiao; Huang, Wenxiang; Jia, Bei

    2014-05-12

    We report here a case of recurrent paratyphoid fever A with hepatitis A co-infection in a patient with chronic hepatitis B. A 26-year-old male patient, who was a hepatitis B virus carrier, was co-infected with Salmonella enterica serovar Paratyphi A and hepatitis A virus. The recurrence of the paratyphoid fever may be ascribed to the coexistence of hepatitis B, a course of ceftriaxone plus levofloxacin that was too short and the insensitivity of paratyphoid fever A to levofloxacin. We find that an adequate course and dose of ceftriaxone is a better strategy for treating paratyphoid fever. Furthermore, the co-infection of paratyphoid fever with hepatitis A may stimulate cellular immunity and break immunotolerance. Thus, the administration of the anti-viral agent entecavir may greatly improve the prognosis of this patient with chronic hepatitis B, and the episodes of paratyphoid fever and hepatitis A infection prompt the use of timely antiviral therapy.

  3. 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.

  4. DoD Global Emerging Infections System Annual Report, Fiscal Year 2002

    Science.gov (United States)

    2002-01-01

    policy for that region in June 2002 to a combination of artesunate and mefloquine for first-line treatment of uncomplicated falciparium malaria...confirmed resistance to chloroquine with vivax malaria was noted in three subjects. In a study of 118 subjects in Central Java, combination chloroquine...jejuni has shown increased multiple resistance to ceftriaxon, norfloxacin , and ciprofloxacin. In a recent surveillance study involving 6,760 patients

  5. Clinical Investigation Program Annual Progress Report

    Science.gov (United States)

    1988-10-20

    and VP-16-213 in Children wiCh Resistant Malignant Tumors (0) ................................ 269 88/404 Ceftriaxone vs Amoxicillin /Clavulanate for...Immunodeficiency Virus. Presented: ACP, Colorado Associates Meeting, Denver, CO, May 1988. (C) Matthews JI, Rajput MA, and Neimus R: Drug Resistant Tuber- culosis...Presented: Interna- tional Symposium on Orthopedics, Mexico , September 1987. Publications: In preparation. 147 FAMC A.P.R. (RCS MED 300) Detail Summary

  6. Nonclinical Safety Assessment of SYN-004: An Oral β-lactamase for the Protection of the Gut Microbiome From Disruption by Biliary-Excreted, Intravenously Administered Antibiotics.

    Science.gov (United States)

    Kokai-Kun, John F; Bristol, J Andrew; Setser, John; Schlosser, Michael

    2016-05-01

    SYN-004 is a first in class, recombinant β-lactamase that degrades β-lactam antibiotics and has been formulated to be administered orally to patients receiving intravenous β-lactam antibiotics including cephalosporins. SYN-004 is intended to degrade unmetabolized antibiotics excreted into the intestines and thus has the potential to protect the gut microbiome from disruption by these antibiotics. Protection of the gut microbiome is expected to protect against opportunistic enteric infections such as Clostridium difficile infection as well as antibiotic-associated diarrhea. In order to demonstrate that oral SYN-004 is safe for human clinical trials, 2 Good Laboratory Practice-compliant toxicity studies were conducted in Beagle dogs. In both studies, SYN-004 was administered orally 3 times per day up to the maximum tolerated dose of the formulation. In the first study, doses of SYN-004 administered over 28 days were safe and well tolerated in dogs with the no-observed-adverse-effect level at the high dose of 57 mg/kg/day. Systemic absorption of SYN-004 was minimal and sporadic and showed no accumulation during the study. In the second study, doses up to 57 mg/kg/day were administered to dogs in combination with an intravenous dose of ceftriaxone (300 mg/kg) given once per day for 14 days. Coadministration of oral SYN-004 with intravenous ceftriaxone was safe and well tolerated, with SYN-004 having no noticeable effect on the plasma pharmacokinetics of ceftriaxone. These preclinical studies demonstrate that SYN-004 is well tolerated and, when coadministered with ceftriaxone, does not interfere with its systemic pharmacokinetics. These data supported advancing SYN-004 into human clinical trials. © The Author(s) 2015.

  7. Invasive Streptococcus pneumoniae in Children, Malawi, 2004–2006

    Science.gov (United States)

    Everett, Dean B.; Broughton, Caroline; Denis, Brigitte B.; Banda, Daniel L.; Carrol, Enitan D.; Parry, Christopher M.

    2011-01-01

    Of 176 invasive Streptococcus pneumoniae isolates from children in Malawi, common serotypes were 1 (23%), 6A/B (18%), 14 (6%), and 23F (6%). Coverage with the 7-valent pneumococcal conjugate vaccine (PCV) was 39%; PCV10 and PCV13 increased coverage to 66% and 88%, respectively. We found chloramphenicol resistance in 27% of isolates and penicillin nonsusceptibility in 10% (by using meningitis breakpoints); all were ceftriaxone susceptible. PMID:21749782

  8. 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...

  9. 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

  10. 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.

  11. Preoperative administration of cephalosporins for elective caesarean delivery

    Directory of Open Access Journals (Sweden)

    Bogavac Mirjana

    2010-01-01

    Full Text Available Introduction. Antibiotic prophylaxis means administration of antibiotics in prevention of infections. Objective. To investigate the efficacy of a single dose preoperative administration of ceftriaxone and cefazolin in the prevention of intra- and postoperative infections in the parturients without high risk of inflammation. Methods. The first group of 45 pregnant and 4 non-pregnant women were preoperatively administered ceftriaxone in a dose of 2 g, i.v., 10 minutes before the planned surgery. The second group of 45 pregnant and 4 non-pregnant women were preoperatively administered cefazolin in a dose of 2 g i.v., 10 minutes before the planned surgery. The concentrations of antibiotics were estimated immediately and 6 hours following the operation, as well as in the amniotic fluid and umbilical cord in the group of pregnant women. The estimation of antibiotic concentration was done by the method of liquid chromatography. Results. The mean concentrations of antibiotics in the patients following the elective caesarean section were as follows: ceftriaxone - 22.7 μg/l. vs cefazolin - 44.8 μg/l. Six hours later, the concentration of antibiotic decreased, but the concentration of cefazolin was still over the MIC for sensitive bacteria. The mean concentrations of antibiotics following gynaecological surgery in the non-pregnant patients were as follows: ceftriaxone - 12.0 μg/l vs cefazolin - 30.1 μg/l. Six hours later, the concentration of antibiotic decreased. Conclusion. It is most optimal to administer a single-dose of the first generation cephalosporins-cefazolin-immediately following the clamping of the umbilical cord as well as in preoperative prophylaxis in gynaecological operations.

  12. [Gonococci change more quickly than prescribing practices; resistance to frequently prescribed antibiotics].

    Science.gov (United States)

    Koedijk, Femke D H; van den Broek, Ingrid V F; Stirbu-Wagner, Irina; van Bergen, Jan E A M

    2013-01-01

    Gonococcal resistance to antibiotics is increasing worldwide. In patients tested in Dutch STI clinics in 2009, gonococcal resistance to ciprofloxacin was over 50%. Ceftriaxone, a third-generation cephalosporin, has been the first-choice medication since 2004. General practitioners treated 25% of their gonorrhoea patients with ciprofloxacin in 2010. There is a need for up-to-the-minute, dynamic guidelines for treating gonorrhoea as well as the more systematic use of an up-to-date digital prescription system.

  13. Implications of current recommendations for third-generation cephalosporin use in the WHO Western Pacific Region following the emergence of multiresistant gonococci.

    Science.gov (United States)

    Tapsall, J W

    2009-08-01

    To ascertain recommendations for the treatment of gonorrhoea in the WHO Western Pacific Region (WPR) following the emergence of "cephalosporin-resistant" Neisseria gonorrhoeae and to relate these to clinical and laboratory measures directed towards disease and antibiotic resistance control. WHO WPR Gonococcal Antimicrobial Resistance Programme members provided data on the type, dose and source of third-generation cephalosporins recommended for the treatment of gonorrhoea. Ceftriaxone was recommended more widely (11/15 respondents) than cefixime (five centres). No cephalosporins were recommended in three jurisdictions. One other oral (ceftibuten) and injectable (cefodizime) agent was recommended. Uniform (400 mg) doses of cefixime were recommended but ceftriaxone regimens ranged between 125 mg and 1 g, with nine of 11 respondents using a 250 mg dose. Both generic and proprietary preparations were widely used. Third-generation cephalosporins are widely recommended for the treatment of gonorrhoea in the WPR, with injectable ceftriaxone more extensively so than oral cefixime and in an expanded dose range. Few other cephalosporins were recommended. Current knowledge suggests that the trend towards ceftriaxone treatment in higher doses may decrease the impact of the circulation of "cephalosporin-resistant" gonococci in the WPR. These recommendations represent public sector practice only and of themselves are unlikely to contain the further spread of "cephalosporin-resistant" gonococci because of the general clinical use of cephalosporins. Optimisation of strategies for laboratory detection of third-generation cephalosporin resistance can be simplified in the WPR because of the restricted spectrum of cephalosporins recommended. Additional efforts are urgently required for both disease and antibiotic resistance control in gonorrhoea.

  14. Clinical Investigation Program, Fiscal Year 1991

    Science.gov (United States)

    1992-02-03

    chemically resistant human breast cancer cells. It has been hypothesized that suppressor T cells develop as one consequence of immunotherapy and that...Dose Intravenous Ceftriaxone and Oral Amoxicillin for the Prevention of Wound Infection in Cat Bites (Monitor: LTC Falbey) ........ 161 Dire, Daniel J...shoulders. The order of the tests will vary so that a similar number of subjects begin with either arm or leg exercise. Beginning with no added resistance

  15. Lack of Effectiveness of the 23-Valent Polysaccharide Pneumococcal Vaccine in Reducing All-Cause Pneumonias Among Healthy Young Military Recruits: A Randomized, Double-Blind, Placebo-Controlled Trial

    Science.gov (United States)

    2015-01-08

    antimicrobial resistance . Data collected from the nited States for the SENTRY Antimicrobial Surveillance Program eginning in 1998 showed an overall increasing...trend of S. pneu- oniae non-susceptibility to penicillin, amoxicillin , ceftriaxone, rythromycin, and clindamycin [26]. From 1998 to 2011, percent...penicillin resis- ance among non-sputum clinical isolates of S. pneumoniae was s high as 43% (18% intermediately resistant , 25% highly resistant ) 27

  16. Influence of growth medium on the in vitro activities of second- and third-generation cephalosporins against Streptococcus faecalis.

    OpenAIRE

    Sahm, D F; Baker, C N; Jones, R N; Thornsberry, C

    1984-01-01

    The influence of culture medium of the MICs of eight cephalosporins for 45 strains of Streptococcus faecalis was investigated. The MICs of cephalothin, cefamandole, and cefoperazone were not substantially influenced by the type of culture medium used. In contrast, MICs of cefuroxime, ceftizoxime, cefotaxime, cefmenoxime, and ceftriaxone varied markedly with both the commercial brand and the blood content of the broth used. The use of Mueller-Hinton broths (from Oxoid Ltd., GIBCO Diagnostics, ...

  17. Decorin binding proteins of Borrelia burgdorferi promote arthritis development and joint specific post-treatment DNA persistence in mice.

    Directory of Open Access Journals (Sweden)

    Jemiina Salo

    Full Text Available Decorin binding proteins A and B (DbpA and B of Borrelia burgdorferi are of critical importance for the virulence of the spirochete. The objective of the present study was to further clarify the contribution of DbpA and B to development of arthritis and persistence of B. burgdorferi after antibiotic treatment in a murine model of Lyme borreliosis. With that goal, mice were infected with B. burgdorferi strains expressing either DbpA or DbpB, or both DbpA and B, or with a strain lacking the adhesins. Arthritis development was monitored up to 15 weeks after infection, and bacterial persistence was studied after ceftriaxone and immunosuppressive treatments. Mice infected with the B. burgdorferi strain expressing both DbpA and B developed an early and prominent joint swelling. In contrast, while strains that expressed DbpA or B alone, or the strain that was DbpA and B deficient, were able to colonize mouse joints, they caused only negligible joint manifestations. Ceftriaxone treatment at two or six weeks of infection totally abolished joint swelling, and all ceftriaxone treated mice were B. burgdorferi culture negative. Antibiotic treated mice, which were immunosuppressed by anti-TNF-alpha, remained culture negative. Importantly, among ceftriaxone treated mice, B. burgdorferi DNA was detected by PCR uniformly in joint samples of mice infected with DbpA and B expressing bacteria, while this was not observed in mice infected with the DbpA and B deficient strain. In conclusion, these results show that both DbpA and B adhesins are crucial for early and prominent arthritis development in mice. Also, post-treatment borrelial DNA persistence appears to be dependent on the expression of DbpA and B on B. burgdorferi surface. Results of the immunosuppression studies suggest that the persisting material in the joints of antibiotic treated mice is DNA or DNA containing remnants rather than live bacteria.

  18. Klebsiella pneumonıae Ve Klebsiella oxytoca Bakterilerinde Kombine Disk Yöntemi İle Genişlemiş Spektrumlu Beta Laktamazın Belirlenmesi

    OpenAIRE

    Yılmaz, Ebru; Uraz, Güven

    2000-01-01

    Extended-spectrum beta lactamases (ESBLs) are responsible for resistance to cephalosporins (ceftazidime, ceftriaxone, and cefotaxime) and aztreonam in gram-negative bacilli. ESBL producing Klebsiella bacteria are a major problem for clinicians, ESBLs increase are cause of failure in treatment particularly paediatric patients and also in medical and surgical units. In this research ESBL was investigated by combined disc method. In this research, 128 clinical isolates of Klebsiella ssp. were co...

  19. [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.

  20. Lyme Carditis: An Interesting Trip to Third-Degree Heart Block and Back

    Directory of Open Access Journals (Sweden)

    Maxwell Eyram Afari

    2016-01-01

    Full Text Available Carditis is an uncommon presentation of the early disseminated phase of Lyme disease. We present the case of a young female who presented with erythema migrans and was found to have first-degree heart block which progressed to complete heart block within hours. After receiving ceftriaxone, there was complete resolution of the heart block in sequential fashion. Our case illustrates the importance of early recognition and anticipation of progressive cardiac conduction abnormalities in patients presenting with Lyme disease.

  1. Multidrug resistant shigella flexneri infection simulating intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Srirangaraj Sreenivasan

    2016-01-01

    Full Text Available Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, which was effectively treated by ceftriaxone.

  2. Antibiotic susceptibility of Salmonella spp.: a comparison of two surveys with a 5 years interval

    Directory of Open Access Journals (Sweden)

    Gordana Mijović

    2012-02-01

    Full Text Available Salmonella infections are one of the major global public health problems. During the last decade, antibiotic resistance and multiresistance of Salmonella spp. have increased a great deal, especially in developing countries with an increased and indiscriminate use of antibiotics in the treatment of humans and animals. This study aims to investigate and compare antimicrobial susceptibility patterns of Salmonella during 2005 and 2010.A total of 186 Salmonella strain during 2005 and 140 Salmonella strain during 2010 were isolated from stool specimens using standard methods. The isolates were confirmed as Salmonella by using a battery of biochemical reactions. Specific antisera were used for serologic characterization of Salmonella strain. Antimicrobial susceptibility testing was performed by standard disk diffusion method using ampicillin, trimethoprim-sulfamethoxasole, ceftriaxon, chloramphenicol, nalidixic acid and ciprofloxacin.One hundred eighty (96.8% of 186 isolated Salmonella strains in 2005, and 133 (95% of 140 isolated Salmonella strain in 2010 are recognized as Salmonella Enteritidis. Sensitivity of Salmonella isolates during 2005 and 2010 were 91.9% and 92.9% to ampicillin, 95.7% and 97.1% to trimethoprim-sulfamethoxasole, 99.5% and 100% to chloramphenicol, 99.5% and 100% to ciprofloxacin, 98.9% and 97.1% to ceftriaxon, 73.1% and 95.7% to nalidixic acid, respectively.Sensitivity of Salmonella isolates to all tested antimicrobial agents except to ceftriaxon was been slightly improved over testing period. Resistance rate to ceftriaxon was higher in 2010 than in 2005, and this fact deserves attention. Significantly increase susceptibility rate to nalidixic acid was observed between the two surveys

  3. Die Wirkung von Desacetylcefotaxin, einem Metaboliten von Cefotaxim, in vitro und auf die experimentelle Infektion mit Escherichia coli

    OpenAIRE

    Wirbelauer, J.; Hof, H.; Hacker, Jörg

    2009-01-01

    Die MHK-Werte von Desacetylcefotaxim gegen verschiedene, z. T. ampicillinresistente Stämme von Escherichia coH, die mit Hilfe einer Agardilutionsmethode erhoben wurden, waren höher als die von Cefotaxim und Ceftriaxon, jedoch niedriger als die von Cefoxitin. In einem Modell der systemischen Infektion der Maus mit einem plasmidtragenden, betalactamaseproduzierenden Stamm von E. coli führte die Therapie mit Desacetylcefotaxim zu einer starken Reduktion der Keime pro Leber. Im Vergleich zur Ther...

  4. Randomised controlled trial of three day versus 10 day intravenous antibiotics in acute pyelonephritis: effect on renal scarring

    OpenAIRE

    Benador, D; Neuhaus, T; Papazyan, J; Willi, U; Engel-Bicik, I; Nadal, D; Slosman, D; Mermillod, B; Girardin, E

    2001-01-01

    BACKGROUND—Acute pyelonephritis often leaves children with permanent renal scarring.
AIMS—To compare the prevalence of scarring following initial treatment with antibiotics administered intravenously for 10 or three days.
METHODS—In a prospective two centre trial, 220 patients aged 3 months to 16 years with positive urine culture and acute renal lesions on initial DMSA scintigraphy, were randomly assigned to receive intravenous ceftriaxone (50 mg/kg once daily) for 10 or ...

  5. Antimicrobial resistance of fecal Salmonella spp. isolated from all phases of pig production in 20 herds in Alberta and Saskatchewan

    OpenAIRE

    Rosengren, Leigh B.; Waldner, Cheryl L.; Reid‐Smith, Richard J.; Checkley, Sylvia L.; McFall, Margaret E.; Rajíc, Andrijana

    2008-01-01

    Salmonella spp. (n = 468), isolated from the feces of sows, nursery, and grow‐finish pigs in 20 farrow‐to‐finish herds in Alberta and Saskatchewan, were tested for susceptibility to 16 antimicrobials. No resistance was identified to amikacin, amoxicillin‐clavulanic acid, ceftiofur, ceftriaxone, ciprofloxacin or nalidixic acid, and less than 1% of the isolates were resistant to cefoxitin and gentamicin. Isolates were most commonly resistant to tetracycline (35%) and sulfamethoxazole (27%). Ove...

  6. Superior sensitivity and decreased time to detection with the Bactec Peds Plus/F system compared to the BacT/Alert Pediatric FAN blood culture system.

    Science.gov (United States)

    Sullivan, K V; Turner, N N; Lancaster, D P; Shah, A R; Chandler, L J; Friedman, D F; Blecker-Shelly, D L

    2013-12-01

    Here, we compare the sensitivities and times to detection (TTD) of BacT/Alert Pediatric FAN (PF) and Bactec Peds Plus blood culture bottles. Test bottles were inoculated with 2 ml of banked whole blood, 1-ml aliquots of antibiotic suspension, and organisms diluted to simulate a bacteremia level of 10 to 100 CFU/ml. The control bottles were inoculated with 3 ml of banked blood and organism suspensions only. The organism-drug combinations were Staphylococcus epidermidis and vancomycin, methicillin-resistant Staphylococcus aureus and vancomycin, Streptococcus pneumoniae, vancomycin, and ceftriaxone, Streptococcus agalactiae, ampicillin, and cefotaxime, Escherichia coli, cefotaxime, and cefepime, Pseudomonas aeruginosa, piperacillin-tazobactam, cefepime, and gentamicin, Neisseria meningitidis and ceftriaxone, and Haemophilus influenzae and ceftriaxone. The control and test bottle combinations were tested in duplicate. The bottles were incubated for 5 days; 32 control and 104 test bottles were incubated. Overall, the bacterial recovery rates for the PF and Peds Plus bottles were 37% and 62%, 94% and 100% in the controls, 19% and 50% in the test bottles, and 33% and 92% in the bottles with vancomycin, respectively. No bacteria were recovered from the bottles with S. pneumoniae, S. agalactiae, E. coli, N. meningitidis, or H. influenzae in combination with cefotaxime or ceftriaxone. The Peds Plus system detected P. aeruginosa in bottles with cefepime and piperacillin-tazobactam, but the PF system recovered bacteria only in bottles with trough levels of piperacillin-tazobactam. The mean TTD were shorter in the Peds Plus system controls (14.2 versus 18.0 h; P = 0.001) and the test bottles (14.3 versus 17.8 h; P = 0.008) than in the PF bottles. Overall, we demonstrated superior sensitivity, TTD, and antibiotic neutralization in the Bactec Peds Plus system compared to those in the Pediatric FAN system.

  7. Antibiotic Treatment of Hospitalized Patients with Pneumonia Complicated by Clostridium Difficile Infection.

    Science.gov (United States)

    Zycinska, K; Chmielewska, M; Lenartowicz, B; Hadzik-Blaszczyk, M; Cieplak, M; Kur, Z; Krupa, R; Wardyn, K A

    2016-01-01

    Clostridium difficile infection (CDI) is one of the most common gastrointestinal complication after antimicrobial treatment. It is estimated that CDI after pneumonia treatment is connected with a higher mortality than other causes of hospitalization. The aim of the study was to assess the relationship between the kind of antibiotic used for pneumonia treatment and mortality from post-pneumonia CDI. We addressed the issue by examining retrospectively the records of 217 patients who met the diagnostic criteria of CDI. Ninety four of those patients (43.3 %) came down with CDI infection after pneumonia treatment. Fifty of the 94 patients went through severe or severe and complicated CDI. The distribution of antecedent antibiotic treatment of pneumonia in these 50 patients was as follows: ceftriaxone in 14 (28 %) cases, amoxicillin with clavulanate in 9 (18 %), ciprofloxacin in 8 (16.0 %), clarithromycin in 7 (14 %), and cefuroxime and imipenem in 6 (12 %) each. The findings revealed a borderline enhancement in the proportion of deaths due to CDI in the ceftriaxone group compared with the ciprofloxacin, cefuroxime, and imipenem groups. The corollary is that ceftriaxone should be shunned in pneumonia treatment. The study demonstrates an association between the use of a specific antibiotic for pneumonia treatment and post-pneumonia mortality in patients who developed CDI.

  8. Evaluation of eight different cephalosporins for detection of cephalosporin resistance in Salmonella enterica and Escherichia coli.

    Science.gov (United States)

    Aarestrup, Frank M; Hasman, Henrik; Veldman, Kees; Mevius, Dik

    2010-12-01

    This study evaluates the efficacy of eight different cephalosporins for detection of cephalosporin resistance mediated by extended spectrum beta-lactamases (ESBL) and plasmidic AmpC beta-lactamases in Salmonella and Escherichia coli. A total of 138 E. coli and 86 Salmonella isolates with known beta-lactamase genes were tested for susceptibility toward cefoperazone, cefotaxime, cefpodoxime, cefquinome, ceftazidime, ceftiofur, ceftriaxone, and cefuroxime using minimum inhibitory concentration determinations and disc diffusion. The collection consisted of 84 ampicillin-susceptible, 57 ampicillin-resistant but cephalosporin-susceptible, 56 ESBL isolates and 19 isolates with plasmidic AmpC, as well as 10 ampC hyper-producing E. coli. The minimum inhibitory concentration distributions and zone inhibitions varied with the tested compound. Ampicillin-resistant isolates showed reduced susceptibility to the cephalosporins compared to ampicillin-susceptible isolates. Cefoperazone, cefquinome, and cefuroxime were not useful in detecting isolates with ESBL or plasmidic AmpC. The best substances for detection were cefotaxime, cefpodoxime, and ceftriaxone, whereas ceftazidime and ceftiofur were not as efficient. Ceftriaxone may be the recommended substance for monitoring because of some ability in separating ampC hyper-producing E. coli from ESBL and plasmidic AmpC isolates.

  9. Assessment of ceftaroline fosamil in the treatment of community-acquired bacterial pneumonia due to Streptococcus pneumoniae: insights from two randomized trials.

    Science.gov (United States)

    Shorr, Andrew F; Kollef, Marin; Eckburg, Paul B; Llorens, Lily; Friedland, H David

    2013-03-01

    Ceftaroline fosamil resulted in higher cure rates than ceftriaxone in patients with community-acquired bacterial pneumonia in 2 randomized trials (FOCUS 1 and FOCUS 2). The present analysis examines the subgroup of patients with Streptococcus pneumoniae infection to determine whether the apparent difference in cure rates persists after adjusting for potential covariates. We retrospectively pooled subjects with S. pneumoniae isolated at baseline in the original studies and employed logistic regression to evaluate the independent relationship between clinical cure and treatment with ceftaroline. Covariates evaluated included demographics, severity of illness, bacteremia, and pathogen characteristics. The final cohort included 139 subjects (69 ceftaroline, 70 ceftriaxone). Unadjusted cure rates were 85.5% and 68.6% (P = 0.009) in the ceftaroline and ceftriaxone groups, respectively. After logistic regression, ceftaroline remained associated with higher cure rates. Our findings indicate that ceftaroline may result in improved outcomes of S. pneumoniae pneumonia. Formal clinical trials are warranted to confirm this hypothesis. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Global resistance of Neisseria gonorrhoeae: when theory becomes reality.

    Science.gov (United States)

    Lewis, David A

    2014-02-01

    Neisseria gonorrhoeae has demonstrated a remarkable genetic capacity to acquire antimicrobial resistance (AMR) determinants. This review focuses on the recent developments in respect of third generation extended spectrum cephalosporin (ESC)-resistant gonorrhoea and the search for future treatment options. The estimated incidence of new gonorrhoea cases is increasing, and the antimicrobial resistance profile of N. gonorrhoeae is worsening. The most significant recent finding has been the emergence of extensively drug-resistant (XDR) N. gonorrhoeae characterized by very high ceftriaxone minimum inhibitory concentrations. A national switch from cefixime to high-dose ceftriaxone as first-line antigonococcal therapy in England and Wales, as well as parts of Japan, has been accompanied by a reduction in the prevalence of oral ESC-resistant gonococci. Azithromycin given in combination with either gentamicin or gemifloxacin has been shown to be an effective alternative antigonococcal therapy. Both ertapenem and solithromycin have good in-vitro activity against ESC-resistant N. gonorrhoeae strains. Current strategies to control gonococcal AMR should focus on the use of higher doses of ceftriaxone given as part of dual therapy and further evaluation of alternative drug combinations. The emergence of XDR gonorrhoea argues for enhanced efforts to develop novel antimicrobial agents and a gonococcal vaccine.

  11. Analysis and antibacterial activity of Nigella sativa essential oil formulated in microemulsion system.

    Science.gov (United States)

    Shaaban, Hamdy A; Sadek, Zainab; Edris, Amr E; Saad-Hussein, Amal

    2015-01-01

    The Essential oil (EO) of Nigella sativa (black cumin) was extracted from the crude oil and the volatile constituents were characterized using gas chromatographic analysis. The EO was formulated in water-based microemulsion system and its antibacterial activity against six pathogenic bacteria was evaluated using the agar well diffusion method. This activity was compared with two other well known biologically active natural and synthetic antimicrobials namely eugenol and Ceftriaxone(®). Results showed that N. sativa EO microemulsion was highly effective against S. aureus, B. cereus and S. typhimurium even at the lowest tested concentration of that EO in the microemulsion (100.0 μg/well). Interestingly, the EO microemulsion showed higher antibacterial activity than Ceftriaxone solution against S. typhimurium at 400.0 μg/well and almost comparable activity against E. coli at 500.0 μg/well. No activity was detected for the EO microemulsion against L. monocytogenes and P. aeruginosa. Eugenol which was also formulated in microemulsion was less effective than N. sativa EO microemulsion except against P. aeruginosa. The synthetic antibiotic (Ceftriaxone) was effective against most of the six tested bacterial strains. This work is the first report revealing the formulation of N. sativa EO in microemulsion system and investigating its antibacterial activity. The results may offer potential application of that water-based microemulsion in controlling the prevalence of some pathogenic bacteria.

  12. Antimicrobial resistance among lower respiratory tract isolates of Streptococcus pneumoniae: results of a 1992-93 western Europe and USA collaborative surveillance study. The Alexander Project Collaborative Group.

    Science.gov (United States)

    Goldstein, F W; Acar, J F

    1996-07-01

    One thousand, eight hundred and fifty-six Streptococcus pneumoniae strains, collected in 1992 and 1993 from 15 centres in Western Europe and USA were tested for susceptibility to 16 antibiotics. The overall resistance to penicillin was 23% (range 6-54%), with the highest prevalences in Madrid, Barcelona, Toulouse and Cleveland. Seven centres reported low-level penicillin resistance only. Amoxycillin was more active than ceftriaxone against strains with intermediate resistance to penicillin, and at least four-fold more active than cefuroxime; cefaclor and cefixime had poor activity. Against penicillin-resistant strains, ceftriaxone was slightly more active than amoxycillin, cefuroxime exhibited borderline activity and cefixime and cefaclor were inactive. Ten strains fully susceptible to penicillin had MICs of ceftriaxone > or = 0.1 mg/L; this may represent a first step towards the development of cephalosporin resistance. With the exception of fluoroquinolones, resistance to non-beta-lactam antibiotics (chloramphenicol, doxycycline, co-trimoxazole, erythromycin, clarithromycin and azithromycin) was considerably higher in penicillin-resistant strains compared with penicillin-susceptible isolates. Erythromycin-resistant isolates were also resistant to the other macrolides tested.

  13. 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.

  14. Usefulness of competitive inhibitors of protein binding for improving the pharmacokinetics of {sup 186}Re-MAG3-conjugated bisphosphonate ({sup 186}Re-MAG3-HBP), an agent for treatment of painful bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Kazuma [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto (Japan)]|[Kanazawa University, Advanced Science Research Center, Kanazawa (Japan); Mukai, Takahiro [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto (Japan)]|[Kyushu University, Graduate School of Pharmaceutical Sciences, Fukuoka (Japan); Kawai, Keiichi [Kanazawa University, Graduate School of Medical Sciences, Kanazawa (Japan)]|[University of Fukui, Biomedical Imaging Research Center, Yoshida, Fukui (Japan); Takamura, Norito [Kyushu University of Health and Welfare, School of Pharmaceutical Sciences, Nobeoka (Japan); Hanaoka, Hirofumi; Saji, Hideo [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto (Japan); Hashimoto, Kazuyuki [Japan Atomic Energy Agency, Tokai-mura, Ibaraki (Japan); Shiba, Kazuhiro; Mori, Hirofumi [Kanazawa University, Advanced Science Research Center, Kanazawa (Japan)

    2009-01-15

    We have developed a {sup 186}Re-mercaptoacetylglycylglycylglycine complex-conjugated bisphosphonate ({sup 186}Re-MAG3-HBP) for the treatment of painful bone metastases. We assumed competitive inhibitors of protein binding to be useful for procuring a favorable biodistribution of {sup 186}Re-MAG3-HBP for the palliation of bone pain because it has been reported that the concurrent administration of {sup 99m}Tc-MAG3 and drugs with high affinity for serum protein produced competitive displacement at specific binding sites and enhanced total clearance and tissue distribution. The displacement effects of several protein-binding inhibitors on the protein binding of {sup 186}Re-MAG3-HBP were investigated. Biodistribution experiments were performed by intravenously administering {sup 186}Re-MAG3-HBP into rats with ceftriaxone as a competitive protein-binding inhibitor or saline. The protein binding of {sup 186}Re-MAG3-HBP in rat serum, human serum, and a human serum albumin solution was significantly decreased by the addition of ceftriaxone, which has high affinity for binding site I on serum albumin. In the biodistribution experiments, pretreatment with ceftriaxone enhanced the clearance of the radioactivity of {sup 186}Re-MAG3-HBP in blood and nontarget tissues but had no effect on accumulation in bone. The findings suggested that the use of protein-binding competitive inhibitors would be effective in improving the pharmacokinetics of radiopharmaceuticals with high affinity for serum protein. (orig.)

  15. Increasing antimicrobial resistance of Vibrio cholerae OI biotype E1 tor strains isolated in a tertiary-care centre in India.

    Science.gov (United States)

    Mandal, Jharna; Dinoop, K P; Parija, Subhash Chandra

    2012-03-01

    The antimicrobial susceptibility patterns are on constant change with the recent emergence of multidrug-resistant strains of most bacteria. Results of recent studies in India showed that most isolates of Vibrio cholerae O1 were resistant to the commonly-used antibiotics. The study was conducted to determine the antibiotic susceptibility patterns of V. cholerae O1 isolated during 2008-2010 at the hospital of the Jawaharlal Nehru Institute of Post Graduate Medical Education and Research, Puducherry, India. In total, 154 strains of V. cholerae O1 from 2,658 stool specimens were reported during January 2008-December 2010--34 in 2008, 2 in 2009, and 118 in 2010. The isolates of V. cholerae O1 were subjected to antimicrobial susceptibility testing using the Kirby-Bauer method. The antibiotic disks tested were tetracycline (30 microg), furazolidone (100 microg), ampicillin (10 microg), ceftriaxone (30 microg), and ciprofloxacin (5 microg). Escherichia coli ATCC 25922 was used as the control organism. The minimum inhibitory concentrations (MICs) of ceftriaxone, ciprofloxacin, and tetracycline were determined using the agar dilution method for all the strains. The E-test method was used for the strains which had either intermediate resistance or were resistant to the antibiotics by the agar dilution method. The results of the agar dilution corroborated the results of the E-test. The MIC of ceftriaxone in 151 strains was resistant to ceftriaxone by the disc-diffusion test. The MIC of ciprofloxacin in 150 strains was 32 microg/mL, and the MIC of ciprofloxacin was >8 microg/mL. These four strains were resistant to both tetracycline and ciprofloxacin by the disc-diffusion test and were exclusive of the three ceftriaxone-resistant strains. The majority of the isolates were obtained from children aged 0-5 year(s)-70.3% (83 of 118) and 41.2% (14 of 34) were reported in 2010 and 2008 respectively. Since treating severe cases of cholera with antibiotics is important, the continuing

  16. Increasing Antimicrobial Resistance of Vibrio cholerae OI Biotype EI Tor Strains Isolated in a Tertiary-care Centre in India

    Science.gov (United States)

    Mandal, Jharna; Dinoop, K.P.

    2012-01-01

    The antimicrobial susceptibility patterns are on constant change with the recent emergence of multidrug-resistant strains of most bacteria. Results of recent studies in India showed that most isolates of Vibrio cholerae O1 were resistant to the commonly-used antibiotics. The study was conducted to determine the antibiotic susceptibility patterns of V. cholerae O1 isolated during 2008-2010 at the hospital of the Jawaharlal Nehru Institute of Post Graduate Medical Education and Research, Puducherry, India. In total, 154 strains of V. cholerae O1 from 2,658 stool specimens were reported during January 2008–December 2010—34 in 2008, 2 in 2009, and 118 in 2010. The isolates of V. cholerae O1 were subjected to antimicrobial susceptibili-ty testing using the Kirby-Bauer method. The antibiotic disks tested were tetracycline (30 μg), furazolidone (100 μg), ampicillin (10 μg), ceftriaxone (30 μg), and ciprofloxacin (5 μg). Escherichia coli ATCC 25922 was used as the control organism. The minimum inhibitory concentrations (MICs) of ceftriaxone, ciprofloxacin, and tetracycline were determined using the agar dilution method for all the strains. The E-test method was used for the strains which had either intermediate resistance or were resistant to the antibiotics by the agar dilution method. The results of the agar dilution corroborated the results of the E-test. The MIC of ceftriaxone in 151 strains was resistant to ceftriaxone by the disc-diffusion test. The MIC of ciprofloxacin in 150 strains was 32 μg/mL, and the MIC of ciprofloxacin was >8 μg/mL. These four strains were resistant to both tetracycline and ciprofloxacin by the disc-diffusion test and were exclusive of the three ceftriaxone-resistant strains. The majority of the isolates were obtained from children aged 0-5 year(s)—70.3% (83 of 118) and 41.2% (14 of 34) were reported in 2010 and 2008 respectively. Since treating severe cases of cholera with antibiotics is important, the continuing spread of

  17. Aminomethyl spectinomycins as therapeutics for drug-resistant gonorrhea and chlamydial co-infections.

    Science.gov (United States)

    Butler, Michelle M; Waidyarachchi, Samanthi L; Connolly, Kristie L; Jerse, Ann E; Chai, Weirui; Lee, Richard E; Kohlhoff, Stephan A; Shinabarger, Dean L; Bowlin, Terry L

    2018-02-26

    Bacterial sexually transmitted infections are widespread and common, with Neisseria gonorrhoeae (gonorrhea) and Chlamydia trachomatis (chlamydia) being the two most frequent causes. If left untreated, both infections can cause pelvic inflammatory disease, infertility, ectopic pregnancy and other sequelae. The recommended treatment for gonorrhea is ceftriaxone plus azithromycin (to empirically treat chlamydial co-infections). Antibiotic resistance to all existing therapies has developed in gonorrheal infections. The need for new antibiotics is great and the pipeline for new drugs is alarmingly small. The aminomethyl spectinomycins, a new class of semisynthetic analogs of the antibiotic, spectinomycin, were developed on the basis of a computational analysis of the spectinomycin binding site of the bacterial 30S ribosome and structure-guided synthesis. The compounds display particular potency against common respiratory tract pathogens as well as the sexually transmitted pathogens that cause gonorrhea and chlamydia. Here we demonstrate the in vitro potencies of several compounds of this class against both bacterial species; the compounds displayed increased potencies against N. gonorrhoeae compared to spectinomycin and, significantly, demonstrated activity against C. trachomatis that is not observed with spectinomycin. Efficacies of the compounds were compared to that of spectinomycin and gentamicin in a murine model of infection caused by ceftriaxone/azithromycin-resistant N. gonorrhoeae ; the aminomethyl spectinomycins significantly reduced the colonization load and were as potent as the comparator compounds. In summary, data produced by this study support aminomethyl spectinomycins as a promising replacement for spectinomycin and antibiotics such as ceftriaxone for treating drug-resistant gonorrhea, with the added benefit of treating chlamydial co-infections. Copyright © 2018 American Society for Microbiology.

  18. Macrolide therapy for community-acquired pneumonia due to atypical pathogens: outcome assessment at an early time point.

    Science.gov (United States)

    File, Thomas M; Eckburg, Paul B; Talbot, George H; Llorens, Lily; Friedland, H David

    2017-08-01

    Therapy directed against atypical pathogens in patients with community-acquired pneumonia (CAP) is often recommended. This post-hoc analysis evaluated the effect of addition of a macrolide to ceftaroline fosamil or ceftriaxone treatment in atypical CAP. Two phase 3, double-blind, comparative safety and efficacy studies of ceftaroline fosamil vs. ceftriaxone, FOCUS 1 and FOCUS 2, enrolled adults with CAP. Only FOCUS 1 included 24-h adjunctive clarithromycin therapy for all patients on day 1. Day 4 and test-of-cure (TOC) outcomes were compared for adjunctive vs. no adjunctive therapy. Of 1240 enrolled patients, 130 patients with CAP due to atypical pathogens alone were included (FOCUS 1, n = 64; FOCUS 2, n = 66). Among patients infected with Mycoplasma pneumoniae and/or Chlamydophila pneumoniae alone, a higher clinical response rate was observed with clarithromycin plus ceftaroline fosamil or ceftriaxone compared with treatment without additional clarithromycin at day 4 [38/49 (77.6%; FOCUS 1) vs. 24/43 (55.8%; FOCUS 2)], but not at the TOC assessment [42/49 (85.7%; FOCUS 1) vs. 41/43 (95.3%; FOCUS 2)]. In patients infected with Legionella pneumophila alone, a higher clinical response rate with adjunctive clarithromycin therapy was observed at the TOC assessment alone [12/12 (100%; FOCUS 1) vs. 14/19 (73.7%; FOCUS 2)]. The unadjusted odds ratio of a favourable clinical response at day 4 with adjunctive clarithromycin vs. no adjunctive clarithromycin was 2.4 (95% confidence interval 1.1-5.1; P = 0.0299) for all pathogens combined. These results suggest that empirical antibiotic therapy against atypical pathogens may improve early clinical response rate. This hypothesis is best evaluated in a prospective trial. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  19. Haemophilus influenzae Isolated From Men With Acute Urethritis: Its Pathogenic Roles, Responses to Antimicrobial Chemotherapies, and Antimicrobial Susceptibilities.

    Science.gov (United States)

    Ito, Shin; Hatazaki, Kyoko; Shimuta, Ken; Kondo, Hiromi; Mizutani, Kosuke; Yasuda, Mitsuru; Nakane, Keita; Tsuchiya, Tomohiro; Yokoi, Shigeaki; Nakano, Masahiro; Ohinishi, Makoto; Deguchi, Takashi

    2017-04-01

    There have been few comprehensive studies on Haemophilus influenza-positive urethritis. In this retrospective study, we enrolled 68 men with H. influenzae-positive urethritis, including coinfections with Neisseria gonorrhoeae, Chlamydia trachomatis, and/or genital mycoplasmas: 2, 3, 20, and 43 treated with ceftriaxone, levofloxacin, sitafloxacin, and extended-release azithromycin (azithromycin-SR), respectively. We assessed microbiological outcomes in 54 men and clinical outcomes in 46 with H. influenzae-positive monomicrobial nongonococcal urethritis. We determined minimum inhibitory concentrations (MICs) of 6 antimicrobial agents for 59 pretreatment isolates. H. influenzae was eradicated from the men treated with ceftriaxone, levofloxacin, or sitafloxacin. The eradication rate with azithromycin-SR was 85.3%. The disappearance or alleviation of urethritis symptoms and the decreases in leukocyte counts in first-voided urine were significantly associated with the eradication of H. influenzae after treatment. For the isolates, ceftriaxone, levofloxacin, sitafloxacin, azithromycin, tetracycline, and doxycycline MICs were ≤0.008-0.25, 0.008-0.5, 0.001-0.008, 0.12-1, 0.25-16, and 0.25-2 μg/mL, respectively. The azithromycin MICs for 3 of 4 strains persisting after azithromycin-SR administration were 1 μg/mL. H. influenzae with an azithromycin MIC of 1 μg/mL increased chronologically. H. influenzae showed good responses to the chemotherapies for urethritis. The significant associations of the clinical outcomes of the chemotherapies with their microbiological outcomes suggested that H. influenzae could play pathogenic roles in urethritis. All isolates, except for one with decreased susceptibility to tetracyclines, were susceptible to the examined agents. However, the increase in H. influenzae with an azithromycin MIC of 1 μg/mL might threaten efficacies of azithromycin regimens on H. influenzae-positive urethritis.

  20. In vitro susceptibility of European human Borrelia burgdorferi sensu stricto strains to antimicrobial agents.

    Science.gov (United States)

    Veinović, Gorana; Cerar, Tjaša; Strle, Franc; Lotrič-Furlan, Stanka; Maraspin, Vera; Cimperman, Jože; Ružić-Sabljić, Eva

    2013-03-01

    Broth microdilution and macrodilution assays were used to determine minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of six antimicrobial agents (ceftriaxone, cefuroxime sodium, azithromycin, amoxicillin, doxycycline and amikacin) for nine European human isolates of Borrelia burgdorferi sensu stricto (s.s.). Strains were obtained from patients diagnosed with Lyme borreliosis in Slovenia. Modified Kelly-Pettenkofer medium with a final inoculum of 10⁵ Borrelia cells/mL and incubation periods of 72 h and of 3 weeks and 6 weeks were used in the determination of MICs and MBCs, respectively. Observed MICs indicated that all isolates were susceptible to all the tested antimicrobial agents with the exception of amikacin. Cefuroxime sodium (MIC₉₀=0.063 mg/L), azithromycin (MIC₉₀=0.22 mg/L) and ceftriaxone (MIC₉₀=0.25 mg/L) displayed the lowest MICs, followed by amoxicillin (MIC₉₀=1 mg/L) and doxycycline (MIC₉₀=2 mg/L); no strain was susceptible to amikacin (MIC₉₀=256 mg/L). MBCs after incubation for 3 weeks and 6 weeks were determined for amoxicillin (MBC₉₀=32 mg/L), doxycycline (MBC₉₀)=32 mg/L) and amikacin (MBC₉₀=1024 mg/L) and were found to be high (but not defined) for azithromycin (MBC₉₀>0.88 mg/L), cefuroxime sodium (MBC₉₀>4 mg/L) and ceftriaxone (MBC₉₀>4 mg/L). In determination of borrelial susceptibility to antimicrobial agents, intrinsic low susceptibility or methodological factors could result in low in vitro susceptibility of individual strains. This study is the first report on the antibiotic susceptibility of a series of European human isolates of B. burgdorferi s.s. Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  1. Phenotypic and molecular characterization of Neisseria gonorrhoeae isolates from Slovenia, 2006-12: rise and fall of the multidrug-resistant NG-MAST genogroup 1407 clone?

    Science.gov (United States)

    Jeverica, Samo; Golparian, Daniel; Matičič, Mojca; Potočnik, Marko; Mlakar, Boštjan; Unemo, Magnus

    2014-06-01

    To determine the phenotypic and molecular characteristics of Neisseria gonorrhoeae isolates obtained between 2006 and 2012 in Slovenia. Gonococcal isolates obtained between 2006 and 2012 in Slovenia (n = 194) were investigated with Etest for susceptibility to cefixime, ceftriaxone, penicillin, ciprofloxacin, azithromycin, tetracycline, gentamicin and spectinomycin. All isolates were examined with N. gonorrhoeae multiantigen sequence typing for molecular epidemiology and sequencing of the major extended-spectrum cephalosporin (ESC) resistance determinants (penA, mtrR and penB) was performed. The overall prevalence of decreased susceptibility or resistance to cefixime and ceftriaxone (MIC ≥0.125 mg/L) was 11% and 5%, respectively. The decreased susceptibility or resistance showed an epidemic peak in 2011 (33% for cefixime and 11% for ceftriaxone), decreasing to 6% and 4%, respectively, in 2012. ST1407 (9% of isolates), ST21 (6%) and ST225 (6%) were the most common sequence types (STs) during 2006-12. Genogroup G1407 (ST1407 most prevalent ST), an internationally spread clone with decreased susceptibility or resistance to ESCs, was most prevalent (48%) in 2009. However, the G1407 prevalence then declined: in 2010, 30%; in 2011, 28%; and in 2012, 8%. Instead, in 2012 the ESC- and ciprofloxacin-susceptible G21 was the predominant genogroup (26%). The prevalence of gonococcal resistance to ESCs in Slovenia has been high, but fluctuating. Fortunately, in 2012 some ESC- and ciprofloxacin-susceptible clones, such as genogroups G21, G1195 and G2992, appeared to have mainly replaced the multidrug-resistant G1407 clone, a replacement also seen in several European countries. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Interim susceptibility testing for ceftaroline, a new MRSA-active cephalosporin: selecting potent surrogate β-lactam markers to predict ceftaroline activity against clinically indicated species.

    Science.gov (United States)

    Jones, Ronald N; Flamm, Robert K; Sader, Helio S; Stilwell, Matthew G

    2013-01-01

    Ceftaroline, the bio-active form of parenterally administered ceftaroline fosamil, is a unique broad-spectrum cephalosporin with in vitro and in vivo activity against methicillin-resistant Staphylococcus aureus and was approved for clinical use by the United States Food and Drug Administration in October 2010. In over a year since ceftaroline fosamil approval, no widely used commercial susceptibility test system has added this new compound to its product, therefore requiring use of alternative agar diffusion methods for clinical microbiology laboratories that want to test clinical isolates for ceftaroline susceptibility. An alternative strategy of applying a surrogate β-lactam class marker agent was assessed here, using results from 14,902 organisms (2008-2010) sampled in the USA. Very high and acceptable accuracy (≥ 99.75%) was observed for predicting ceftaroline susceptibility as follows: 1) use of imipenem or meropenem minimum inhibitory concentrations (MICs) at ≤ 8 μg/mL (susceptible and intermediate categories) when testing S. aureus; 2) use of ceftriaxone MIC at ≤ 2 μg/mL (susceptible and intermediate categories) when testing Streptococcus pneumoniae as well as other streptococci (S. pyogenes and S. agalactiae); and 3) use of ceftriaxone, or cefepime, or ceftazidime at ≤ 2 μg/mL (susceptible category) when testing Haemophilus influenzae. Only when testing indicated Enterobacteriaceae species using ceftriaxone susceptibility results did the ceftaroline-nonsusceptible errors increase (4.11%). These presented analyses offer a validated surrogate marker strategy for ceftaroline susceptibility testing, pending development and validation by the commonly used automated systems and agar diffusion commercial methods. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Culture and sensitivity pattern in patients with external ventricular drain infection

    International Nuclear Information System (INIS)

    Rafiq, M.F.A.; Ali, S.

    2011-01-01

    Background: External ventricular (EVD) is a life saving procedure and involves insertion of a catheter in ventricular space to drain cerebrospinal fluid (CSF). Our objective of this study was to determine the culture and sensitivity (C/S) pattern in patients with EVD infection. Methods: This cross sectional study was conducted in Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from December 1, 2008 to January 31, 2010. All admitted patients who had acute hydrocephalus, underwent EVD insertion after excluding meningitis and ventriculitis by physical examination and per operative CSF sampling. The EVD was done at right Kocher's point. Prophylactic third generation antibiotic (Ceftriaxone) was started and continued till EVD was in place. C/S was sent to PIMS laboratory on first documented fever and or change of CSF color or when plan was to replace EVD with Ventriculo-peritoneal shunt (VP). Once infection was there CSF was sent for C/S initially and routine examination (R/E) daily. Antibiotics were changed according to C/S report and continued till they were needed. Infection rate was also estimated. Results: Among 76 patients 41 (53.9%) were male and 35 (46.1%) were females. Most were adults and were between 31 to 40 years of age. Mean duration of EVD was 11.41 days. Overall infection rate was 11.8%. Among causative organisms Staphylococcus Aureus (44.4%) was most common followed by Acenitobacter and Enterobacter and commonly used prophylactic antibiotic (Ceftriaxone) had considerable resistance. Conclusion: EVD is a simple and life saving procedure. Most common organisms causing infection are Staphylococcus Aureus followed by Acenitobacter. Conventional used antibiotic Ceftriaxone has considerable resistance. (author)

  4. MDMA Decreases Gluatamic Acid Decarboxylase (GAD) 67-Immunoreactive Neurons in the Hippocampus and Increases Seizure Susceptibility: Role for Glutamate

    Science.gov (United States)

    Huff, Courtney L.; Morano, Rachel L.; Herman, James P.; Yamamoto, Bryan K.; Gudelsky, Gary A.

    2016-01-01

    3,4-Methylenedioxy-methamphetamine (MDMA) is a unique psychostimulant that continues to be a popular drug of abuse. It has been well documented that MDMA reduces markers of 5-HT axon terminals in rodents, as well as humans. A loss of parvalbumin-immunoreactive (IR) interneurons in the hippocampus following MDMA treatment has only been documented recently. In the present study, we tested the hypothesis that MDMA reduces glutamic acid decarboxylase (GAD) 67-IR, another biochemical marker of GABA neurons, in the hippocampus and that this reduction in GAD67-IR neurons and an accompanying increase in seizure susceptibility involve glutamate receptor activation. Repeated exposure to MDMA (3×10mg/kg, ip) resulted in a reduction of 37–58% of GAD67-IR cells in the dentate gyrus (DG), CA1, and CA3 regions, as well as an increased susceptibility to kainic acid-induced seizures, both of which persisted for at least 30 days following MDMA treatment. Administration of the NMDA antagonist MK-801 or the glutamate transporter type 1 (GLT-1) inducer ceftriaxone prevented both the MDMA-induced loss of GAD67-IR neurons and the increased vulnerability to kainic acid-induced seizures. The MDMA-induced increase in the extracellular concentration of glutamate in the hippocampus was significantly diminished in rats treated with ceftriaxone, thereby implicating a glutamatergic mechanism in the neuroprotective effects of ceftriaxone. In summary, the present findings support a role for increased extracellular glutamate and NMDA receptor activation in the MDMA-induced loss of hippocampal GAD67-IR neurons and the subsequent increased susceptibility to evoked seizures. PMID:27773601

  5. MDMA decreases glutamic acid decarboxylase (GAD) 67-immunoreactive neurons in the hippocampus and increases seizure susceptibility: Role for glutamate.

    Science.gov (United States)

    Huff, Courtney L; Morano, Rachel L; Herman, James P; Yamamoto, Bryan K; Gudelsky, Gary A

    2016-12-01

    3,4-Methylenedioxy-methamphetamine (MDMA) is a unique psychostimulant that continues to be a popular drug of abuse. It has been well documented that MDMA reduces markers of 5-HT axon terminals in rodents, as well as humans. A loss of parvalbumin-immunoreactive (IR) interneurons in the hippocampus following MDMA treatment has only been documented recently. In the present study, we tested the hypothesis that MDMA reduces glutamic acid decarboxylase (GAD) 67-IR, another biochemical marker of GABA neurons, in the hippocampus and that this reduction in GAD67-IR neurons and an accompanying increase in seizure susceptibility involve glutamate receptor activation. Repeated exposure to MDMA (3×10mg/kg, ip) resulted in a reduction of 37-58% of GAD67-IR cells in the dentate gyrus (DG), CA1, and CA3 regions, as well as an increased susceptibility to kainic acid-induced seizures, both of which persisted for at least 30days following MDMA treatment. Administration of the NMDA antagonist MK-801 or the glutamate transporter type 1 (GLT-1) inducer ceftriaxone prevented both the MDMA-induced loss of GAD67-IR neurons and the increased vulnerability to kainic acid-induced seizures. The MDMA-induced increase in the extracellular concentration of glutamate in the hippocampus was significantly diminished in rats treated with ceftriaxone, thereby implicating a glutamatergic mechanism in the neuroprotective effects of ceftriaxone. In summary, the present findings support a role for increased extracellular glutamate and NMDA receptor activation in the MDMA-induced loss of hippocampal GAD67-IR neurons and the subsequent increased susceptibility to evoked seizures. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Treatment Response in Enteric Fever in an Era of Increasing Antimicrobial Resistance: An Individual Patient Data Analysis of 2092 Participants Enrolled into 4 Randomized, Controlled Trials in Nepal.

    Science.gov (United States)

    Thompson, Corinne N; Karkey, Abhilasha; Dongol, Sabina; Arjyal, Amit; Wolbers, Marcel; Darton, Thomas; Farrar, Jeremy J; Thwaites, Guy E; Dolecek, Christiane; Basnyat, Buddha; Baker, Stephen

    2017-06-01

    Enteric fever, caused by Salmonella Typhi and Salmonella Paratyphi A, is the leading cause of bacterial febrile disease in South Asia. Individual data from 2092 patients with enteric fever randomized into 4 trials in Kathmandu, Nepal, were pooled. All trials compared gatifloxacin with 1 of the following comparator drugs: cefixime, chloramphenicol, ofloxacin, or ceftriaxone. Treatment outcomes were evaluated according to antimicrobial if S. Typhi/Paratyphi were isolated from blood. We additionally investigated the impact of changing bacterial antimicrobial susceptibility on outcome. Overall, 855 (41%) patients had either S. Typhi (n = 581, 28%) or S. Paratyphi A (n = 274, 13%) cultured from blood. There were 139 (6.6%) treatment failures with 1 death. Except for the last trial with ceftriaxone, the fluoroquinolone gatifloxacin was associated with equivalent or better fever clearance times and lower treatment failure rates in comparison to all other antimicrobials. However, we additionally found that the minimum inhibitory concentrations (MICs) against fluoroquinolones have risen significantly since 2005 and were associated with increasing fever clearance times. Notably, all organisms were susceptible to ceftriaxone throughout the study period (2005-2014), and the MICs against azithromycin declined, confirming the utility of these alternative drugs for enteric fever treatment. The World Health Organization and local government health ministries in South Asia still recommend fluoroquinolones for enteric fever. This policy should change based on the evidence provided here. Rapid diagnostics are urgently required given the large numbers of suspected enteric fever patients with a negative culture. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  7. SUSCEPTIBILITY OF RESPIRATORY ISOLATES OF STREPTOCOCCUS PNEUMONIAE ISOLATED FROM CHILDREN HOSPITALIZED IN THE CLINICAL CENTER NIS.

    Science.gov (United States)

    Dinić, Marina M; Mladenović Antić, Snezana; Kocić, Branislava; Stanković Dordević, Dobrila; Vrbić, Miodrag; Bogdanović, Milena

    2016-01-01

    Streptococcus pneumoniae is one of the most common causes of respiratory infections. The aim was to study the susceptibility to antimicrobial agents of respiratory isolates ofStreptococcus pneumoniae obtained from hospitalized children. A total of 190 respiratory pneumococcal isolates obtained from children aged from 0 to 14 years were isolated and identified by using standard microbiological methods. Susceptibility to oxacillin, erythromycin, clindamycin, tetracycline, cotrimoxazole, ofloxacin and rifampicin was tested by disc diffusion method. Minimal inhibitory concentrations for amoxicillin and ceftriaxone were determined by means of E test. The macrolide-resistant phenotype was detected by double disc diffusion test. All tested isolates were susceptible to amoxicillin and ceftriaxone. The minimal amoxicillin concentration inhibiting the growth of 50% of isolates and of 90% of isolates was 0.50 microg/ml and 1.0 microg/ml, respectively and the minimal ceftriaxone concentration inhibiting the growth of 50% of isolates and of 90% of isolates was 0.25 microg/ml and 0.50 microg/ml, respectively. Susceptibility to erythromycin and clindamycin was observed in 21.6% and 29.47% of isolates, respectively. The resistence to macrolides-M phenotype was detected in 10.07% of isolates and constitutive macrolide-lincosamide-streptogramin phenotype (constitutive MLS phenotype) was found in 89.93% of isolates. All tested isolates were susceptible to ofloxacin and rifampicin. Amoxicillin could be the therapy of choice in pediatric practice. The macrolides should not be recommended for the empirical therapy of pneumococcal respiratory tract infection in our local area.

  8. 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......). 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....

  9. Leptospirosis in pregnancy with pathological fetal cardiotocography changes.

    Science.gov (United States)

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

    2014-02-01

    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 after admission. Herein, we discuss the patient’s clinical presentation and the cardiotocography changes observed in leptospiral infection, and review the current literature.

  10. [Meningococcal disease: frequently asked questions].

    Science.gov (United States)

    Cofré, José

    2012-12-01

    On account of an increase of serogroup W135 meningococcal disease (M.D.) observed in Santiago, Chile, during last two years the medical community has experienced an avidity to update their knowledge about M.D. treatment and its prevention. In a queries and answers mode, the following topics on M.D. are presented: nasopharyngeal carriage and its importance, immunity and protection against the disease, reasons to choice ceftriaxone as the first line antibiotic in treatment, rationality and indications of chemoprophylaxis, fundamentals and advantages of conjugate vaccines, its indications, schedules, contraindications and decisions making in public health.

  11. [Profile of bacterial resistance in pediatric urinary tract infections in 2014].

    Science.gov (United States)

    Flammang, A; Morello, R; Vergnaud, M; Brouard, J; Eckart, P

    2017-03-01

    In pediatric units, bacteria-producing extended-spectrum-betalactamase (ESBL) have an increasing prevalence among bacteria causing febrile urinary tract infections (UTIs). The purpose of this study was to evaluate the epidemiology of bacteria resistance patterns observed in UTIs, in order to assess the current antibiotic treatment protocols. This study is based upon a single-center retrospective chart review of the cytobacteriological urine cultures performed in UTIs between 1 January and 31 December 2014, in the medical pediatric unit of the Caen University Hospital. Out of the total of 219 cases of UTI, 26.9% were recurrences of UTI, 18.3% were infections in infants less than 3 months old, 21% of the patients suffered from underlying uropathy, and 16.4% of the patients had recently been exposed to antibiotics. In 80.3% of the cases, Escherichia coli was found, while Enterococcus faecalis was found in 5.6%. The antibiograms proved that 33.5% of the bacteria were sensitive. Half of E. coli were resistant to ampicillin, 4.9% to cefixime, 4.9% to ceftriaxone, 1.1% to gentamicin, and 27.8% to trimethoprim-sulfamethoxazole. Nine E. coli and one Enterobacter cloacae produced ESBL, accounting for 4.6% of the UTIs. We did not find any bacteria-producing high-level cephalosporinase. Cefixime resistance was statistically linked to ongoing antibiotic treatment (OR=5.98; 95% CI [1.44; 24.91], P=0.014) and underlying uropathy (OR=6.24; 95% CI [1.47; 26.42], P=0.013). Ceftriaxone resistance was statistically related to ongoing antibiotic treatment (OR=6.93; 95% CI [1.45; 33.13], P=0.015). These results argue in favor of maintaining intravenous ceftriaxone for probabilistic ambulatory treatment. However, in case of hospitalization, cefotaxime can replace ceftriaxone, due to its lower ecological impact. Moreover, it is necessary to continue monitoring bacterial resistance and regularly review our treatment protocols. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Antibiotic additive and synergistic action of rutin, morin and quercetin against methicillin resistant Staphylococcus aureus.

    Science.gov (United States)

    Amin, Muhammad Usman; Khurram, Muhammad; Khattak, Baharullah; Khan, Jafar

    2015-03-12

    To determine the effect of flavonoids in conjunction with antibiotics in methicillin resistant Staphylococcus aureus (MRSA) a study was designed. The flavonoids included Rutin, Morin, Qurecetin while antibiotics included ampicillin, amoxicillin, cefixime, ceftriaxone, vancomycin, methicillin, cephradine, erythromycin, imipenem, sulphamethoxazole/trimethoprim, ciprofloxacin and levolfloxacin. Test antibiotics were mostly found resistant with only Imipenem and Erythromycin found to be sensitive against 100 MRSA clinical isolates and S. aureus (ATCC 43300). The flavonoids were tested alone and also in different combinations with selected antibiotics. Antibiotics and flavonoids sensitivity assays were carried using disk diffusion method. The combinations found to be effective were sifted through MIC assays by broth macro dilution method. Exact MICs were determined using an incremental increase approach. Fractional inhibitory concentration indices (FICI) were determined to evaluate relationship between antibiotics and flavonoids is synergistic or additive. Potassium release was measured to determine the effect of antibiotic-flavonoids combinations on the cytoplasmic membrane of test bacteria. Antibiotic and flavonoids screening assays indicated activity of flavanoids against test bacteria. The inhibitory zones increased when test flavonoids were combined with antibiotics facing resistance. MICs of test antibiotics and flavonoids reduced when they were combined. Quercetin was the most effective flavonoid (MIC 260 μg/ml) while morin + rutin + quercetin combination proved most efficient with MIC of 280 + 280 + 140 μg/ml. Quercetin + morin + rutin with amoxicillin, ampicillin, cephradine, ceftriaxone, imipenem, and methicillin showed synergism, while additive relationship was indicated between morin + rutin and amoxicillin, cephradine, ceftriaxone, imipenem, and methicillin. Quercetin alone had an additive effect with ampicillin, cephradine

  13. 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.

  14. [Analysis of the efficiency of antimicrobial treatment for community-acquired pneumonia in clinical practice].

    Science.gov (United States)

    Zhukova, O V; Ruina, O V; Kononova, S V; Konyshkina, T M

    To analyze actual drug consumption based on the defined daily dose (DDD analysis) and to analyze the utilization of drugs based on their proportion of the total defined daily doses (DU90% analysis) for the antimicrobial therapy of community-acquired pneumonia (CAP) in clinical practice at a hospital in Russia. The investigation materials were the data of 117 case histories of male (51.3%) and female (48.7%) patients hospitalized with CAP at Nizhny Novgorod City Clinical Hospital Five in 2015. The investigation enrolled all the patients admitted to the hospital over the analyzed period. DDD analysis and DU90% analysis were used as study methods. DDD analysis and DU90% analysis of antimicrobial therapy for CAP were carried out at the hospital in clinical practice during a year. The annual number of defined daily doses (NDDD) for antimicrobial drugs, the number of defined daily doses per 100 bed-days (NDDD/100 bed-days), and a drug load (g) per 1000 CAP patients per day and per CAP patient per year were determined. The largest NDDD/year for CAP treatment with ceftriaxone was 376 g, or 43.43 NDDD/100 bed-days, which is much higher than that with other antimicrobial agents. The daily drug load of ceftriaxone per 1,000 CAP patients was 8.8 g, which exceeds that of moxifloxacin by 18.7 times, azithromycin and levofloxacin by 5 times, and ampicillin/sulbactam by 2.3 times. The daily drug load of ceftriaxone per CAP patient was 3.2 g, which exceeds that of of ampicillin/sulbactam by 2.3 times, levofloxacin and azithromycin by 5 times, and moxifloxacin by 19 times. It may be recommended that the proportion of cephalosporins as drugs that promote the rise of resistance in microbes and their production of extended-spectrum β-lactamases should be further limited, the proportion of penicillins be extended, and the administered ampicillin/sulbactam be added, for example, by amoxicillin/clavulanate. Penicillins contribute to the rise of resistance to a lesser degree, and the use

  15. Nocardia abscessus brain abscess in an immunocompetent host.

    Science.gov (United States)

    Al Tawfiq, Jaffar A; Mayman, Talal; Memish, Ziad A

    2013-06-01

    Nocardia brain abscesses typically occur in immunocompromised patients. Most cases of nocardiosis are caused by the Nocardia asteroides complex and Nocardia brasiliensis. Here, we present a patient with a Nocardia abscessus brain abscess. The diagnosis was confirmed by DNA sequencing, and the organism was susceptible to linezolid, clarithromycin, ceftriaxone, imipenem, tobramycin, amikacin, minocycline and sulfamethoxazole. The patient was successfully treated medically in combination with surgical excision. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  16. THE CASE OF MIXED TICK-BORNE INFECTIONS – TICK-BORNE ENCEPHALITIS AND LYME DISEASE (B. GARINII, B. AFZELII IN THE KEMEROVO REGION

    Directory of Open Access Journals (Sweden)

    Анатолий Васильевич Субботин

    2017-10-01

    Conclusion. 1. The stable detection of TBE IgG antibodies at a high level indicates the absence of depression of humoral immunity in the application of the antibiotic Ceftriaxone. 2. A long term persistence of IgM antibodies in serum to Lyme disease, identification of the TBE antigen in serum and IgG antibodies in the cerebrospinal fluid of a patient, indicates incomplete elimination of the pathogen on the background of the therapy, causing the patient developed chronic mixed focal forms of TBE with latent form of ixodes tick-borne borreliosis. 3. Patient exhibits clinical symptoms of TBE (Epilepsy of Kozhevnikov.

  17. 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.

  18. 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.

  19. 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. Copyright © 2012. Published by Elsevier B.V.

  20. In vitro antianaerobic activity of ertapenem (MK-0826) compared to seven other compounds.

    Science.gov (United States)

    Hoellman, Dianne B; Kelly, Linda M; Credito, Kim; Anthony, Lauren; Ednie, Lois M; Jacobs, Michael R; Appelbaum, Peter C

    2002-01-01

    Ertapenem, imipenem, meropenem, ceftriaxone, piperacillin, piperacillin-tazobactam, clindamycin, and metronidazole were agar dilution MIC tested against 431 anaerobes. Imipenem, meropenem, and ertapenem were the most active beta-lactams (MICs at which 50% of the strains are inhibited [MIC(50)s], 0.125 to 0.25 microg/ml; MIC(90)s, 1.0 to 2.0 microg/ml). Time-kill studies revealed that ertapenem at two times the MIC was bactericidal for 9 of 10 strains after 48 h. The kinetics for other beta-lactams were similar to those of ertapenem.

  1. [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.

  2. Gangrènes du périnée et des organes génitaux externes en milieu ...

    African Journals Online (AJOL)

    Les signes cliniques ont été dominés par la douleur et la nécrose périnéale. Au plan bactériologique, le germe le plus fréquemment isolé était E. coli. Une résistance des germes isolés à la Ceftriaxone ®, à l'amoxicilline® et au métronidazole® a été notée dans tous les cas. La prise en charge chirurgicale comportait des ...

  3. Ceftaroline Fosamil for the Treatment of Community-Acquired Pneumonia: from FOCUS to CAPTURE.

    Science.gov (United States)

    Carreno, Joseph J; Lodise, Thomas P

    2014-12-01

    Ceftaroline fosamil (ceftaroline hereafter) is the latest addition to the armamentarium for the treatment of patients with community-acquired pneumonia (CAP). It is currently approved by the Food and Drug Administration (FDA) for community-acquired bacterial pneumonia (CABP), which is a recent FDA indication that centers on individuals with documented bacterial pneumonias that arise in the community setting. The purpose of this review is to summarize and discuss the major findings from the Phase III CAP clinical trials as well as the clinical experience with ceftaroline among patients with CAP in the "Ceftaroline Assessment Program and Teflaro(®) Utilization Registry" (CAPTURE). In its two Phase III CAP trials, ceftaroline was compared to ceftriaxone among adults with radiographically confirmed CAP requiring hospitalization who were classified as Pneumonia Outcomes Research Team (PORT) risk class III or IV. Among patients with CAP, clinical success at test of cure was 84.3% vs 77.7% (difference 6.6%, 95% confidence interval [CI]: 1.6-11.8%) in those treated with ceftaroline and ceftriaxone, respectively, across the two Phase III clinical trials. Among patients with a culture-confirmed CABP, day 4 response rates were numerically higher, albeit non-significant, among patients that received ceftaroline vs. ceftriaxone (69.5% for ceftaroline vs. 59.4% for ceftriaxone, difference 10.1%, 95% CI, -0.6% to 20.6%). The efficacy of ceftaroline is supported by real-world observational data from CAPTURE for patients with both CAP and CABP. In addition, the CAPTURE program afforded an opportunity to assess the outcomes of patients who were excluded or limited in the original Phase III trials in a non-comparative fashion. These underrepresented patient populations with CAP included: patients that received prior antibiotics, patients in the ICU, patients with severe renal dysfunction, and those with methicillin-resistant Staphylococcus aureus (MRSA) isolated from respiratory or

  4. Cutaneous fistula due to pulmonary actinomycosis in a Mapuche girl.

    Science.gov (United States)

    Briceño, Gaston; Guzman, Pablo; Schafer, Fabiola

    2013-01-01

    Actinomycosis is a chronic granulomatous disease caused by Gram-positive anaerobic bacteria of the genus Actinomyces. Pulmonary actinomycosis is a rare infection in children, and its extension into the chest wall is infrequently reported. We report a case of pulmonary actinomycosis in a 14-year-old girl of Mapuche descent who presented with chronic respiratory symptoms and multiple discharging skin sinuses on her right lower chest wall. The diagnosis was made by skin biopsy, which showed sulfur granules with actinomyces colonies. She was successfully treated with intravenous ceftriaxone and penicillin G for 6 weeks, followed by oral amoxicillin for 6 months. © 2013 Wiley Periodicals, Inc.

  5. 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.

  6. Medical Surveillance Monthly Report (MSMR). Volume 4, Number 1, January 1998

    Science.gov (United States)

    1998-01-01

    ceftriaxone therapy . Physical ex- amination revealed fever, hepatosplenomegaly, and ecchymoses. Laboratory tests documented WBCs 2,700 (31 segs/4...Inguinale 8 2 1 0 11 Rift Valley Fever 0 0 0 0 0 Guillain - Barre Syndrome 3 1 0 0 4 RMSF 0 0 0 0 0 H. influenzae, inv. 2 3 2 3 10 Rubella 1 1 0 0 2...thrombocytopenia. His physical ex- amination revealed a temperature of 103.7oF., a palpable spleen tip, and a liver edge that was palpable 5 cm. below

  7. Survey of Antibiotic Resistance and Frequency of blaOXA-23 and blaOXA-24 Oxacillinase in Acinetobacter baumannii Isolated from Tracheal Tube Specimens of Patients Hospitalized in Intensive Care Units in Isfahan city

    Directory of Open Access Journals (Sweden)

    M Ghalebi

    2017-04-01

    chi-square tests. Results: All isolates were found resistant to ceftazidime, ceftriaxone, meropenem and imipenem and the lowest resistance were seen against colistin (0% and tigecycline (10%, respectively. All isolates were resistant to imipenem using Etest method with MIC ≥ 32 μg / ml. blaOXA-23 and blaOXA-24 genes were detected in 87.5% and 25% of isolates, respectively. Conclusion: Due to the results, treatment of A. baumannii isolates by carbapenems is ineffective and tigecycline or colistin could be used for treatment. Other studies for detection of other mechanisms for carbapenem resistance are recommended.

  8. A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Odilia I. Woudstra

    2016-01-01

    Full Text Available We describe a case of primary meningococcal C pericarditis with myocardial involvement in a 71-year-old male that is thus far the oldest patient with isolated meningococcal pericardial disease and only the third patient with primary meningococcal myopericarditis described in English literature. Our patient was successfully treated by full sternotomy and surgical drainage combined with intravenous ceftriaxone. Mild symptoms unresponsive to anti-inflammatory treatment and leukocytosis may guide clinicians towards the correct diagnosis. It is important to recognize this cause of pericarditis as the relatively mild clinical presentation may rapidly progress into tamponade and right-sided heart failure.

  9. Early disseminated borreliosis with multiple erythema migrans and elevated liver enzymes: case report and literature review.

    Science.gov (United States)

    Benedix, Frauke; Weide, Benjamin; Broekaert, Sigrid; Metzler, Gisela; Frick, Julia-Stefanie; Burgdorf, Walter H C; Röcken, Martin; Schaller, Martin

    2007-01-01

    A 69-year-old man presented with multiple livid maculae and infiltrated urticarial plaques, as well as elevated liver enzymes. Based on typical clinical picture, histopathology and positive PCR from a skin biopsy, we diagnosed an early disseminated infection with Borrelia afzelii presenting with multiple erythema migrans (erythemata migrantia) and a subclinical hepatitis. During antibiotic treatment with intravenous ceftriaxone, the maculae and plaques vanished almost completely and the liver enzymes decreased within 14 days. Dermatologists should keep in mind that early disseminated borreliosis can present with multiple erythema migrans and hepatitis.

  10. A case of secondary syphilis with HIV, resembling borderline lepromatous leprosy

    Science.gov (United States)

    Mani, Mohan Zachariah; Kanish, Bimal; Kwatra, Kanwardeep; Chaudhary, Paulina R.; Bhatia, Anuradha

    2015-01-01

    We are reporting an unusual case of secondary syphilis, in a homosexual male patient, which resembled borderline lepromatous leprosy, and in whom the diagnosis was considered on clinical grounds. The patient also had concomitant HIV infection, with asymptomatic neurosyphilis. His rapid plasma reagin test was reactive in 1:128 dilution. He improved with three standard, weekly injections of benzathine penicillin, along with 2 g of intravenous ceftriaxone daily for 15 days. This case is being reported to highlight the need for a high index of suspicion in diagnosing unusual cases of secondary syphilis, especially in those with concomitant HIV infection. PMID:26692613

  11. Acute Meningitis on Account of Orbital Bone Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Zahra Arab-Mazar

    2016-04-01

    Full Text Available Background: Streptococcus pneumoniae (S. pneumoniae is a gram-positive pathogen bacteria which causes a variety of diseases, including otitis media, bacteremia, and meningitis.Cases Report: A 19-year-old man with paroxysm was admitted to emergency department of hospital. He was diagnosed with S. pneumoniae meningitis on the basis of an analysis of the cerebrospinal fluid and blood culture.Conclusion: We present a rare case of meningitis. The treatment was successful by just relying on the antibiogram test results. Vancomycin treatment was discontinued, and the patient fully recovered with Ceftriaxone

  12. Serotyping, PCR, phage-typing and antibiotic sensitivity testing of Salmonella serovars isolated from urban drinking water supply systems of Nepal

    DEFF Research Database (Denmark)

    Bhatta, D.R.; Bangtrakulnonth, A.; Tishyadhigama, P.

    2007-01-01

    . A total of 54 isolates identified to genus level by standard tests were subsequently confirmed by serotyping, phage typing and PCR detection of virulence genes (inv A and spv C). The predominant serotype was Salmonella Typhimurium, followed by Salm. Typhi, Salm. Paratyphi A and Salmonella Enteritidis....... Most of the Salm. Typhi isolates were E1 phage type followed by UVS4, A and UVS1. All isolates of Salm. Paratyphi A and Salm. Enteritidis were an untypable (UT) phage type. The majority of isolates were multi-drug resistant as revealed by Kirby-Bauer disc diffusion technique. Ceftriaxone resistant...

  13. 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.

  14. A Case of Pneumococcal Peritonitis after Caesarean Section in a Healthy Woman

    Directory of Open Access Journals (Sweden)

    Georgios Kourounis

    2015-01-01

    Full Text Available Pneumococcal peritonitis is prevalent in children and adults with comorbidities but extremely rare in healthy adults. Here we describe a case of pneumococcal peritonitis in a previously healthy woman with no known risk factors who presented with constipation, abdominal pain, and distention. Her only past medical history was an uncomplicated C-section two months prior to presentation. A laparotomy revealed a pneumococcal peritonitis without visible source of infection. The patient remained hospitalized until completion of antibiotic regimen with Ceftriaxone and resolution of symptoms. This report adds to the small body of evidence showing possible pneumococcal peritonitis in healthy young adults.

  15. A Case of Pneumococcal Peritonitis after Caesarean Section in a Healthy Woman.

    Science.gov (United States)

    Kourounis, Georgios; Panayiotou, Yiannis; Tabet, Patrick Paul; Richards, Brian David Wensley; Petrou, Athanasios; Loizou, Marios

    2015-01-01

    Pneumococcal peritonitis is prevalent in children and adults with comorbidities but extremely rare in healthy adults. Here we describe a case of pneumococcal peritonitis in a previously healthy woman with no known risk factors who presented with constipation, abdominal pain, and distention. Her only past medical history was an uncomplicated C-section two months prior to presentation. A laparotomy revealed a pneumococcal peritonitis without visible source of infection. The patient remained hospitalized until completion of antibiotic regimen with Ceftriaxone and resolution of symptoms. This report adds to the small body of evidence showing possible pneumococcal peritonitis in healthy young adults.

  16. 7-{[2-(4-Hydroxyphenylmethylidene]amino}-1,3-thiazol-4-yl-2-(methoxyiminoacetyl]amino}-3-{[(2-methyl-5,6-dioxo-1,2,5,6-tetrahydro-1,2,4-triazin-3-ylsulfanyl]methyl}-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic Acid

    Directory of Open Access Journals (Sweden)

    Ghulam Fareed

    2012-05-01

    Full Text Available Novel 7-{[2-(4-hydroxyphenylmethylidene]amino}-1,3-thiazol-4-yl-2-(methoxyiminoacetyl]amino}-3-{[(2-methyl-5,6-dioxo-1,2,5,6-tetrahydro-1,2,4-triazin-3-ylsulfanyl]methyl}-8-oxo-5-thia-1azabicyclo [4.2.0]oct-2-ene-2-carboxylic acid was prepared by condensation of ceftriaxone disodium (1 with 4-hydroxybenzaldehyde (2 in ethanol under reflux conditions for 3–4 h. The structure of synthesized compound was elucidated using LCMS, 1H-NMR, and CHN techniques.

  17. 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

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

    DEFF Research Database (Denmark)

    Gade, Christina; Engberg, Jørgen; Weis, Nina

    2008-01-01

    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...... 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...

  19. ANTIMICROBIAL TREATMENT OF OBSTETRIC AND GYNECOLOGIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    Srdjan Pesic

    2008-10-01

    Full Text Available Treatment regimens for pelvic inflammatory diseases (PID, as a common cause of morbidity in women under the age of 45, should provide broad-spectrum coverage of likely etiologic pathogens and take into account the polymicrobial nature of PID. Antibiotic regimens that do provide coverage of these pathogens showed unacceptably high failure rates. The most recent edition of the Center for Disease Control and Prevention of Sexually Transmitted Disease Treatment guidelines provides an evidence-based and reliable set of recommendations for treating patients with PID and other sexually transmitted diseases.Outpatient regimens for the treatment of mildly and moderately severe acute PID include ofloxacin or levofloxacin with or without metronidazole for anaerobic coverage for 14 days. Alternatively, a single dose ceftriaxone or cefoxitin plus probenecid, followed by doxycycline with or with metronidazole for 14 days. In more severe cases, inpatient antibiotic treatment should be based on intravenous therapy with cefotetan or cefoxitin plus doxycycline which should be continued until 24 hours after clinical improvement and followed by oral therapy with doxycycline and metronidazole. Clindamycin plus gentamicin can be used alternatively in penicillin-allergic and pregnant women.Many antimicrobial regimens effectively treat uncomplicated gonorrhea, like single-dose ceftriaxone or cefoxitin or other pareneral third-generation cephalosporin. Treatment options for uncomplicated genitourinary chlamydial infection include a single dose azithromycin orally or doxycycline for seven days. A first-line drug for chlamydial infection in pregnant women is erythromycin base or amoxicillin.

  20. Should urologists care for the pharyngeal infection of Neisseria gonorrhoeae or Chlamydia trachomatis when we treat male urethritis?

    Science.gov (United States)

    Hamasuna, Ryoichi; Takahashi, Satoshi; Uehara, Shinya; Matsumoto, Tetsuro

    2012-06-01

    Detection of Neisseria gonorrhoeae (NG) or Chlamydia trachomatis (CT) from the pharynx of women or men is not uncommon. However, there is no recommendation how urologists should care for the pharyngeal infection of men with urethritis in Japan. The aim of this study is to clarify the prevalence of NG or CT infection in the pharynx of men and to show a recommendation for urologists. The Japanese reports about the detection of NG or CT from the pharynx or the oral cavity of men in Japan are reviewed in the literature from 1990 to 2011. The prevalence of NG or CT in the pharynx was 4% or 6% in men who attended clinics, and 20% or 6% in men who were positive for NG or CT from genital specimens, respectively. Single 1-g dose ceftriaxone was recommended to treat pharyngeal NG, but no evidence was found for pharyngeal CT. There was not enough evidence for recommendation. However, when men with urethritis only caused by NG or CT are treated through the guideline of the Japanese Society of Sexually Transmitted Infection, we do not think additional tests or treatment for the pharynx are needed when a single 1-g dose ceftriaxone for gonococcal urethritis or a single 1- or 2- g dose azithromycin is prescribed for chlamydial urethritis in Japan.

  1. Nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan.

    Science.gov (United States)

    Hamasuna, Ryoichi; Yasuda, Mitsuru; Ishikawa, Kiyohito; Uehara, Shinya; Takahashi, Satoshi; Hayami, Hiroshi; Yamamoto, Shingo; Matsumoto, Tetsuro; Minamitani, Shinichi; Watanabe, Akira; Iwamoto, Aikichi; Totsuka, Kyoichi; 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; Tatsugami, Katsunori; Ito, Shin; Narita, Harunori; Kanokogi, Mototsugu; Sumii, Toru; Ito, Kenji; Hosobe, Takahide; Kawai, Shuichi; Kawano, Hiromi; Takayama, Kazuo; Yamaguchi, Takamasa; Endo, Katsuhisa; Yamauchi, Takamine; Maeda, Shinichi; Yoh, Mutsumasa; Horie, Masanobu; Ito, Masayasu; Chokyu, Hirofumi; Ihara, Hideari; Akiyama, Kikuo; Uno, Satoshi; Monden, Koichi; Kaji, Shinichi; Nishimura, Hirofumi; Kawahara, Motoshi; Sato, Takashi; Konishi, Takatoshi; Nishi, Shohei; Ishihara, Satoshi; Yoshioka, Masaru

    2013-08-01

    Neisseria gonorrhoeae is one of the most important pathogens causing sexually transmitted infection, and strains that are resistant to several antimicrobials are increasing. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the first nationwide surveillance. The urethral discharge was collected from male patients with urethritis at 51 medical facilities from April 2009 to October 2010. Of the 156 specimens, 83 N. gonorrhoeae strains were tested for susceptibility to 18 antimicrobial agents. The prevalence of β-lactamase-producing strains and chromosomally mediated resistant strains were 7.2 % and 16.5 %, respectively. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) of ceftriaxone for 7 strains (8.4 %) was 0.125 μg/ml. One strain was resistant to cefixime (MIC 0.5 μg/ml). The MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin, and tosufloxacin, showed a bimodal distribution. The MIC of sitafloxacin was lower than those of the three fluoroquinolones listed here, and it was found that the antimicrobial activity of sitafloxacin was stronger than that of the fluoroquinolones. The MIC of azithromycin in 2 strains was 2 μg/ml, but no high-level resistance to macrolides was detected.

  2. Comparison of resistance to third-generation cephalosporins in Shigella between Europe-America and Asia-Africa from 1998 to 2012.

    Science.gov (United States)

    Gu, B; Zhou, M; Ke, X; Pan, S; Cao, Y; Huang, Y; Zhuang, L; Liu, G; Tong, M

    2015-10-01

    We conducted a systematic review to compare resistance to third-generation cephalosporins (TGCs) in Shigella strains between Europe-America and Asia-Africa from 1998 to 2012 based on a literature search of computerized databases. In Asia-Africa, the prevalence of resistance of total and different subtypes to ceftriaxone, cefotaxime and ceftazidime increased markedly, with a total prevalence of resistance up to 14·2% [95% confidence interval (CI) 3·9-29·4], 22·6% (95% CI 4·8-48·6) and 6·2% (95% CI 3·8-9·1) during 2010-2012, respectively. By contrast, resistance rates to these TGCs in Europe-America remained relatively low--less than 1·0% during the 15 years. A noticeable finding was that certain countries both in Europe-America and Asia-Africa, had a rapid rising trend in the prevalence of resistance of S. sonnei, which even outnumbered S. flexneri in some periods. Moreover, comparison between countries showed that currently the most serious problem concerning resistance to these TGCs appeared in Vietnam, especially for ceftriaxone, China, especially for cefotaxime and Iran, especially for ceftazidime. These data suggest that monitoring of the drug resistance of Shigella strains should be strengthened and that rational use of antibiotics is required.

  3. 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.

  4. 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.

  5. Susceptibility profiles of Nocardia isolates based on current taxonomy.

    Science.gov (United States)

    Schlaberg, Robert; Fisher, Mark A; Hanson, Kimberley E

    2014-01-01

    The genus Nocardia has undergone rapid taxonomic expansion in recent years, and an increasing number of species are recognized as human pathogens. Many established species have predictable antimicrobial susceptibility profiles, but sufficient information is often not available for recently described organisms. Additionally, the effectiveness of sulfonamides as first-line drugs for Nocardia has recently been questioned. This led us to review antimicrobial susceptibility patterns for a large number of molecularly identified clinical isolates. Susceptibility results were available for 1,299 isolates representing 39 different species or complexes, including 11 that were newly described, during a 6-year study period. All tested isolates were susceptible to linezolid. Resistance to trimethoprim-sulfamethoxazole (TMP-SMX) was rare (2%) except among Nocardia pseudobrasiliensis (31%) strains and strains of the N. transvalensis complex (19%). Imipenem susceptibility varied for N. cyriacigeorgica and N. farcinica, as did ceftriaxone susceptibility of the N. nova complex. Resistance to more than one of the most commonly used drugs (amikacin, ceftriaxone, TMP-SMX, and imipenem) was highest for N. pseudobrasiliensis (100%), N. transvalensis complex (83%), N. farcinica (68%), N. puris (57%), N. brasiliensis (51%), N. aobensis (50%), and N. amikacinitolerans (43%). Thus, while antimicrobial resistance can often be predicted, susceptibility testing should still be considered when combination therapy is warranted, for less well characterized species or those with variable susceptibility profiles, and for patients with TMP-SMX intolerance.

  6. Epidemiological and antibiotic susceptibility profiles of infectious bacterial diarrhoea in Juba, South Sudan

    Directory of Open Access Journals (Sweden)

    Juma John Hassen Mogga

    2015-11-01

    Full Text Available Background: Diarrhoeal diseases have remained a major health problem in South Sudan where they accounted 45% prevalence in under five-year olds. Between 2006 and 2007, the country reported a morbidity of 8,337 cases and 176 deaths due to diarrhoeal outbreaks. Methodology: We investigated causative agents of diarrhoeal diseases and their antibiogram in persons presenting with diarrhoea to selected health facilities in Juba. Results: Bacterial agents were prevalent in 20(6.9% of the 286 patients with 5.7%(4/70 in under five-year olds alone. S. dysenteriae 50% (10/20 accounted for the majority of the identified pathogens followed S. flexneri 25% (5/20 and S. typh 25% (5/20. Antibiotic testing showed that S. flexneri (5/5 and S. typhi (5/5 were all 100% sensitive to ceftriaxone, and gentamicin while S. dysenteriae had varying sensitivity to ciprofloxacin (70%, nalidixic acid (90%, and ceftriaxone(100%. These pathogens had 100% resistance to amoxicillin, ampicillin, tetracycline and cotrimoxazole. No difference existed in isolation rates among different age groups, educational status, gender, water drank, use of chlorine, toilet use, exposure at home to diarrhoea patient, hand washing with soap and location of residence. However, diarrhoeagenic bacteria isolation was higher for participants with no source of income (OR=6.08, p<0.05. Conclusion: With emerging menace of resistance to commonly used antibiotics in South Sudan we recommend antibiotic resistance monitoring and regulation of antibiotic use.

  7. Gut microbiota composition modifies fecal metabolic profiles in mice.

    Science.gov (United States)

    Zhao, Ying; Wu, Junfang; Li, Jia V; Zhou, Ning-Yi; Tang, Huiru; Wang, Yulan

    2013-06-07

    The gut microbiome is known to be extensively involved in human health and disease. In order to reveal the metabolic relationship between host and microbiome, we monitored recovery of the gut microbiota composition and fecal profiles of mice after gentamicin and/or ceftriaxone treatments. This was performed by employing (1)H nuclear magnetic resonance (NMR)-based metabonomics and denaturing gradient gel electrophoresis (DGGE) fingerprint of gut microbiota. The common features of fecal metabolites postantibiotic treatment include decreased levels of short chain fatty acids (SCFAs), amino acids and primary bile acids and increased oligosaccharides, d-pinitol, choline and secondary bile acids (deoxycholic acid). This suggests suppressed bacterial fermentation, protein degradation and enhanced gut microbial modification of bile acids. Barnesiella, Prevotella, and Alistipes levels were shown to decrease as a result of the antibiotic treatment, whereas levels of Bacteroides, Enterococcus and Erysipelotrichaceae incertae sedis, and Mycoplasma increased after gentamicin and ceftriaxone treatment. In addition, there was a strong correlation between fecal profiles and levels of Bacteroides, Barnesiella, Alistipes and Prevotella. The integration of metabonomics and gut microbiota profiling provides important information on the changes of gut microbiota and their impact on fecal profiles during the recovery after antibiotic treatment. The correlation between gut microbiota and fecal metabolites provides important information on the function of bacteria, which in turn could be important in optimizing therapeutic strategies, and developing potential microbiota-based disease preventions and therapeutic interventions.

  8. Activity of LY333328 in Experimental Meningitis Caused by a Streptococcus pneumoniae Strain Susceptible to Penicillin

    Science.gov (United States)

    Gerber, Joachim; Smirnov, Alexander; Wellmer, Andreas; Ragheb, Jasmin; Prange, Juliane; Schütz, Eckhardt; Wettich, Klaus; Kalich, Siegfried; Nau, Roland

    2001-01-01

    In a rabbit model of Streptococcus pneumoniae meningitis single doses of 10 and 2.5 mg of the glycopeptide LY333328 per kg of body weight reduced bacterial titers in cerebrospinal fluid (CSF) almost as rapidly as ceftriaxone at 10 mg/kg/h (changes in log CFU, −0.29 ± 0.21 and −0.26 ± 0.22 versus −0.34 ± 0.15/ml/h). A dose of 1 mg/kg was bacteriostatic (change in log CFU, 0.01 ± 0.11/ml/h). In two animals receiving LY333328 at a dose of 40 mg/kg the bacterial titers were reduced by 0.54 and 0.51 log CFU/ml/h. The penetration of CSF by LY333328 was 1 to 5%. The concentrations of lipoteichoic and teichoic acids in CSF and neuronal damage were similar in ceftriaxone- and LY333328-treated animals. PMID:11408247

  9. 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. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. 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.

  11. Uncomplicated Urinary Tract Infections in Women in a Sao Paulo Quaternary Care Hospital: Bacterial Spectrum and Susceptibility Patterns

    Directory of Open Access Journals (Sweden)

    Marcelo Hisano

    2014-03-01

    Full Text Available Uncomplicated urinary tract infections (UTI in women are very common. Regular analysis of bacterial flora is important to formulate updated guidelines. The objective of this study is to determine and compare the microbiology of UTIs and their susceptibility patterns in a quaternary care hospital. In a seven-year review, the urine culture results of 480 female patients with uncomplicated UTIs were analyzed. Patients were divided into three groups according to their diagnosis and treatment characteristics: Group 1, cystitis at outpatient basis; group 2, cystitis at the Emergency Unit; and group 3, pyelonephritis. Group 1 included older patients, with a higher incidence of concomitant diabetes mellitus and recurrent UTIs. E. coli was the most common pathogen, responsible for 75.1% of cases, mainly for pyelonephritis (87.3%. Of the oral antimicrobials tested for cystitis, amoxicillin/clavulanate and nitrofurantoin had the highest susceptibility profiles (84.4% and 87.3%, respectively. For E. coli only, their susceptibility profiles were as high as 90.8% and 97.4%, respectively. For pyelonephritis treatment, fluoroquinoles had a susceptibility profile <90%, while ceftriaxone and gentamicin had susceptibility >90%. Uncomplicated UTI treatment is becoming more challenging because the susceptibility profiles of oral antimicrobials are increasingly resistant. In our environment, cystitis can still be managed with nitrofurantoin. Uncomplicated pyelonephritis should be managed with ceftriaxone or gentamicin.

  12. Adjuvant granulocyte colony-stimulating factor therapy results in improved spatial learning and stimulates hippocampal neurogenesis in a mouse model of pneumococcal meningitis.

    Science.gov (United States)

    Schmidt, Anna Kathrin; Reich, Arno; Falkenburger, Björn; Schulz, Jörg B; Brandenburg, Lars Ove; Ribes, Sandra; Tauber, Simone C

    2015-01-01

    Despite the development of new antibiotic agents, mortality of pneumococcal meningitis remains high. In addition, meningitis results in severe long-term morbidity, most prominently cognitive deficits. Granulocyte colony-stimulating factor (G-CSF) stimulates proliferation and differentiation of hematopoietic progenitor cells and increases the number of circulating neutrophil granulocytes. This study investigated the effect of adjuvant G-CSF treatment on cognitive function after pneumococcal meningitis. C57BL/6 mice were infected by subarachnoid injection of Streptococcus pneumoniae serotype 3 and treated with ceftriaxone and G-CSF subcutaneously or ceftriaxone alone for 5 days. Clinical scores, motor performance, and mortality during bacterial meningitis were unaffected by adjuvant G-CSF treatment. No effect of G-CSF treatment on production of proinflammatory cytokines or activation of microglia or astrocytes was observed. The G-CSF treatment did, however, result in hippocampal neurogenesis and improved spatial learning performance 6 weeks after meningitis. These results suggest that G-CSF might offer a new adjuvant therapeutic approach in bacterial meningitis to reduce long-term cognitive deficits.

  13. Genomic Epidemiology of Gonococcal Resistance to Extended-Spectrum Cephalosporins, Macrolides, and Fluoroquinolones in the United States, 2000–2013

    Science.gov (United States)

    Grad, Yonatan H.; Harris, Simon R.; Kirkcaldy, Robert D.; Green, Anna G.; Marks, Debora S.; Bentley, Stephen D.; Trees, David; Lipsitch, Marc

    2016-01-01

    Background. Treatment of Neisseria gonorrhoeae infection is empirical and based on population-wide susceptibilities. Increasing antimicrobial resistance underscores the potential importance of rapid diagnostic tests, including sequence-based tests, to guide therapy. However, the usefulness of sequence-based diagnostic tests depends on the prevalence and dynamics of the resistance mechanisms. Methods. We define the prevalence and dynamics of resistance markers to extended-spectrum cephalosporins, macrolides, and fluoroquinolones in 1102 resistant and susceptible clinical N. gonorrhoeae isolates collected from 2000 to 2013 via the Centers for Disease Control and Prevention's Gonococcal Isolate Surveillance Project. Results. Reduced extended-spectrum cephalosporin susceptibility is predominantly clonal and associated with the mosaic penA XXXIV allele and derivatives (sensitivity 98% for cefixime and 91% for ceftriaxone), but alternative resistance mechanisms have sporadically emerged. Reduced azithromycin susceptibility has arisen through multiple mechanisms and shows limited clonal spread; the basis for resistance in 36% of isolates with reduced azithromycin susceptibility is unclear. Quinolone-resistant N. gonorrhoeae has arisen multiple times, with extensive clonal spread. Conclusions. Quinolone-resistant N. gonorrhoeae and reduced cefixime susceptibility appear amenable to development of sequence-based diagnostic tests, whereas the undefined mechanisms of resistance to ceftriaxone and azithromycin underscore the importance of phenotypic surveillance. The identification of multidrug-resistant isolates highlights the need for additional measures to respond to the threat of untreatable gonorrhea. PMID:27638945

  14. Genomic Epidemiology of Gonococcal Resistance to Extended-Spectrum Cephalosporins, Macrolides, and Fluoroquinolones in the United States, 2000-2013.

    Science.gov (United States)

    Grad, Yonatan H; Harris, Simon R; Kirkcaldy, Robert D; Green, Anna G; Marks, Debora S; Bentley, Stephen D; Trees, David; Lipsitch, Marc

    2016-11-15

     Treatment of Neisseria gonorrhoeae infection is empirical and based on population-wide susceptibilities. Increasing antimicrobial resistance underscores the potential importance of rapid diagnostic tests, including sequence-based tests, to guide therapy. However, the usefulness of sequence-based diagnostic tests depends on the prevalence and dynamics of the resistance mechanisms.  We define the prevalence and dynamics of resistance markers to extended-spectrum cephalosporins, macrolides, and fluoroquinolones in 1102 resistant and susceptible clinical N. gonorrhoeae isolates collected from 2000 to 2013 via the Centers for Disease Control and Prevention's Gonococcal Isolate Surveillance Project.  Reduced extended-spectrum cephalosporin susceptibility is predominantly clonal and associated with the mosaic penA XXXIV allele and derivatives (sensitivity 98% for cefixime and 91% for ceftriaxone), but alternative resistance mechanisms have sporadically emerged. Reduced azithromycin susceptibility has arisen through multiple mechanisms and shows limited clonal spread; the basis for resistance in 36% of isolates with reduced azithromycin susceptibility is unclear. Quinolone-resistant N. gonorrhoeae has arisen multiple times, with extensive clonal spread.  Quinolone-resistant N. gonorrhoeae and reduced cefixime susceptibility appear amenable to development of sequence-based diagnostic tests, whereas the undefined mechanisms of resistance to ceftriaxone and azithromycin underscore the importance of phenotypic surveillance. The identification of multidrug-resistant isolates highlights the need for additional measures to respond to the threat of untreatable gonorrhea. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  15. A NOSOCOMIAL INFECTION MANIFESTED AS ERYSIPELAS IN PEMPHIGUS FOLIACEUS PATIENT UNDER INTRAVENOUS DEXAMETHASONE TREATMENT

    Directory of Open Access Journals (Sweden)

    Achmad Yudha Pranata

    2016-05-01

    Full Text Available Introduction: Puncture wound in diagnostic interventions permits the entry of bacteria into the skin or soft tissue, thus precipitating nosocomial infection, such as erysipelas. There are other risk factors of nosocomial infections including old age, immunosuppressive drugs, and underlying diseases. Pemphigus foliaceus (PF is an autoimmune disease with corticosteroid treatment as the mainstay therapy, which could cause immunosuppression and predispose patients to infection. The objective of this paper was to report erysipelas as one of the manifestations of nosocomial infection in patients under immunosuppressive therapy. Case: A case of erysipelas acquired on the 9th day of hospitalization in a PF patient underwent intravenous dexamethasone injection, with history of puncture wounds on the previous day on the site of erysipelas was reported. The clinical findings of erysipelas were well defined, painful erythema and edema that felt firm and warm on palpation, with blisters and pustules on top. Gram staining from the pustules and blisters fluid revealed Gram (+ cocci. Patient was given 2 grams intravenous ceftriaxone for 7 days and saline wet compress. Improvement on the erysipelas was seen the day after ceftriaxone injection. The patient was discharged after 12 days of hospitalization with improvement both on the PF and the erysipelas. On the next visit 7 days later, the erysipelas lesion disappeared. Conclusion: Puncture wound and immunosuppresive treatment are the factors that could cause erysipelas as a nosocomial infection, and an appropriate treatment of the infection would decrease the functional disability of the patient.

  16. [Role of parenteral cephalosporins for outpatients treatment of infections].

    Science.gov (United States)

    Esposito, S; Mazzei, T; Novelli, A

    2001-12-01

    OPAT (Outpatient Parenteral Antibiotic Therapy) arose in the early 1980s in the USA and later in many other countries from the primary consideration that outpatient treatment is more cost-effective than hospitalisation. Currently, several thousand patients undergo OPAT programmes all over the world and several different bacterial infections are included in the list of treatable diseases, especially those requiring long-term parenteral treatment such as osteomyelitis and soft tissue infections. All injectable antibiotics are suitable for OPAT according to their microbiological spectrum, although clearly some pharmacological properties make one antibiotic more preferable than another. Beta-lactams represent more than half of the antibiotic world market and two-thirds of them are cephalosporins. Such a widespread use of cephalosporins is certainly due to their wide antibacterial spectrum and good tolerability. Among third-generation cephalosporins, covering the majority of micro-organisms responsible for community-acquired infections, ceftriaxone is the only one with an 8-hour half-life, thereby permitting a single daily dose, which represents a great advantage when undertaking an OPAT programme. Analysis of antibiotic consumption used for OPAT therapies, based on data collected from the International OPAT Registry project, with the participation of many countries (USA, Canada, Britain, Argentina, etc.) including Italy, shows that ceftriaxone is the most widely used antibiotic for home therapy, clearly due to the above-mentioned properties.

  17. 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

  18. Chronic Lyme borreliosis associated with minimal change glomerular disease: a case report.

    Science.gov (United States)

    Florens, N; Lemoine, S; Guebre-Egziabher, F; Valour, F; Kanitakis, J; Rabeyrin, M; Juillard, L

    2017-02-06

    There are only few cases of renal pathology induced by Lyme borreliosis in the literature, as this damage is rare and uncommon in humans. This patient is the first case of minimal change glomerular disease associated with chronic Lyme borreliosis. A 65-year-old Caucasian woman was admitted for an acute edematous syndrome related to a nephrotic syndrome. Clinical examination revealed violaceous skin lesions of the right calf and the gluteal region that occurred 2 years ago. Serological tests were positive for Lyme borreliosis and skin biopsy revealed lesions of chronic atrophic acrodermatitis. Renal biopsy showed minimal change glomerular disease. The skin lesions and the nephrotic syndrome resolved with a sequential treatment with first ceftriaxone and then corticosteroids. We report here the first case of minimal change disease associated with Lyme borreliosis. The pathogenesis of minimal change disease in the setting of Lyme disease is discussed but the association of Lyme and minimal change disease may imply a synergistic effect of phenotypic and bacterial factors. Regression of proteinuria after a sequential treatment with ceftriaxone and corticosteroids seems to strengthen this conceivable association.

  19. Dysuria, Urinary Retention, and Inguinal Pain as Manifestation of Sacral Bannwarth Syndrome

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-01-01

    Full Text Available Only few cases with sacral radiculitis due to infection with Borrelia burgdorferi leading to neurogenic urinary dysfunction have been reported. A 57-year-old male developed urethral pain and urinary retention, requiring permanent catheterization. Extensive urological investigations did not reveal a specific cause, which was why neurogenic bladder dysfunction was suspected. Neurologic exam revealed only mildly reduced tendon reflexes. Cerebral and spinal MRI were noninformative. CSF investigations, however, revealed pleocytosis, elevated protein, and antibodies against Borrelia burgdorferi. Intravenous ceftriaxone for three weeks resulted in immediate improvement of bladder dysfunction, with continuous decline of residual urine volume and continuous increase of spontaneous urine volume even after removal of the catheter and initiation of self-catheterization. Sacral radiculitis due to infection with Borrelia burgdorferi is a potential cause of detrusor areflexia and urethral, perineal, inguinal, and scrotal pain and may be misinterpreted as cystitis or urethritis. Ceftriaxone may result in progressive recovery of bladder dysfunction and pain. Neuroborreliosis may manifest exclusively as neurourological problem.

  20. Evaluation of antibiotic susceptibility in wound infections: A pilot study from Bangladesh [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sushmita Roy

    2017-12-01

    Full Text Available Introduction: Infections due to antibiotic resistant bacteria have increased alarmingly in both developed and developing countries. Unrestrained and rapidly spreading bacterial growth has turned the management of wound infections into a serious challenge. This study aimed to determine the prevalence of different bacterial pathogens and their antibiotic susceptibility in various types of wound infections. Methods:  A cross-sectional study was conducted to collect 105 wound swabs. All isolated bacteria were identified based on colony characteristics, gram stain and standard biochemical tests, and antibiotic susceptibility testing (AST with the disc diffusion method. Descriptive statistics were used to present the study findings, and all analyses were performed using Stata Version 13. Results:  The rate of isolation of bacteria was 92.3%. Staphylococcus aureus was found to be the most frequent isolate (55.7%, followed by Escherichia coli (23.7%, Pseudomonas spp. (8.2%, and Streptococcus pyogenes (7.2%. Gram-positive bacteria were mostly (60% found sensitive to vancomycin, azithromycin, gentamicin, imipenem, cefixime, and ceftriaxone in this study. Among the Gram-negative bacteria, Escherichia coli (>60% showed sensitivity to cefixime, azithromycin, cefuroxime, ceftriaxone, cefotaxime, gentamycin, and ceftazidime. Conclusions: The diversity of isolated bacteria and their susceptibility patterns signify a need to implement a proper infection control strategy, which can be achieved by carrying out antibiotic sensitivity tests of the isolates.

  1. Evaluation of antibiotic susceptibility in wound infections: A pilot study from Bangladesh

    Science.gov (United States)

    Roy, Sushmita; Ahmed, Mejbah Uddin; Uddin, Bhuiyan Mohammad Mahtab; Ratan, Zubair Ahmed; Rajawat, Monali; Mehta, Varshil; Zaman, Sojib Bin

    2017-01-01

    Introduction: Infections due to antibiotic resistant bacteria have increased alarmingly in both developed and developing countries. Unrestrained and rapidly spreading bacterial growth has turned the management of wound infections into a serious challenge. This study aimed to determine the prevalence of different bacterial pathogens and their antibiotic susceptibility in various types of wound infections. Methods:  A cross-sectional study was conducted to collect 105 wound swabs. All isolated bacteria were identified based on colony characteristics, gram stain and standard biochemical tests, and antibiotic susceptibility testing (AST) with the disc diffusion method. Descriptive statistics were used to present the study findings, and all analyses were performed using Stata Version 13. Results:  The rate of isolation of bacteria was 92.3%. Staphylococcus aureus was found to be the most frequent isolate (55.7%), followed by Escherichia coli (23.7%), Pseudomonas spp. (8.2%), and Streptococcus pyogenes (7.2%). Gram-positive bacteria were mostly (60%) found sensitive to vancomycin, azithromycin, gentamicin, imipenem, cefixime, and ceftriaxone in this study. Among the Gram-negative bacteria, Escherichia coli (>60%) showed sensitivity to cefixime, azithromycin, cefuroxime, ceftriaxone, cefotaxime, gentamycin, and ceftazidime. Conclusions: The diversity of isolated bacteria and their susceptibility patterns signify a need to implement a proper infection control strategy, which can be achieved by carrying out antibiotic sensitivity tests of the isolates. PMID:29527295

  2. High levels of multiple antibiotic resistance among 938 Haemophilus influenzae type b meningitis isolates from Cuba (1990-2002).

    Science.gov (United States)

    Tamargo, Isis; Fuentes, Kiomy; Llop, Alina; Oteo, Jesús; Campos, José

    2003-10-01

    A national surveillance study to determine antimicrobial susceptibility in Haemophilus influenzae type b isolated from cerebrospinal fluid was carried out in Cuba from 1990 to 2002. Susceptibility to ampicillin, co-amoxiclav, cefotaxime, ceftriaxone, co-trimoxazole, tetracycline, chloramphenicol and rifampicin was tested by the microdilution method according to the NCCLS guidelines. The 34 participating laboratories recovered 938 consecutive, non-identical isolates. All the isolates were retrieved from children aged pre-vaccination era (1990-1998) was 93; after vaccination, 57 isolates were reported in 1999, 31 in 2000, four in 2001 and five in 2002. Resistance to ampicillin, co-trimoxazole, tetracycline and chloramphenicol was 46.3% (all beta-lactamase-positive), 51.3%, 33.2% and 44.0%, respectively. Ampicillin-resistant beta-lactamase-negative strains were not detected. All strains were susceptible to co-amoxiclav, cefotaxime, ceftriaxone and rifampicin. Ampicillin resistance was strongly associated with resistance to tetracycline, co-trimoxazole and chloramphenicol (Pantibiotics was observed from 1990 to 2000 in the range 40.7%-54.8% for ampicillin, 40.1%-51.6% for chloramphenicol, 45.4%-58.1% for co-trimoxazole and 23%-45.2% for tetracycline. In Cuba, the widespread vaccination against Haemophilus influenzae type b prevented a large number of meningitis cases in children caused by strains resistant to multiple antibiotics.

  3. Tracking the implementation of NCCLS M100-S12 expanded-spectrum cephalosporin MIC breakpoints for nonmeningeal isolates of Streptococcus pneumoniae by clinical laboratories in the United States during 2002 and 2003

    Directory of Open Access Journals (Sweden)

    Thornsberry Clyde

    2004-01-01

    Full Text Available Abstract Background The Performance Standards for Antimicrobial Susceptibility Testing, Twelfth Informational Supplement, M100-S12, published by the National Committee for Clinical Laboratory Standards (NCCLS in January 2002 introduced distinct minimum inhibitory concentration (MIC interpretative breakpoints for ceftriaxone, cefotaxime, and cefepime for nonmeningeal isolates of Streptococcus pneumoniae. Previously, a single set of interpretative breakpoints was used for both meningeal and nonmeningeal isolates. Methods To estimate the rate of adoption of the M100-S12 interpretive breakpoints by clinical laboratories, antimicrobial susceptibility test results for ceftriaxone and cefotaxime from nonmeningeal S. pneumoniae isolates were studied using data collected from January 2002 to June 2003 by The Surveillance Network® Database – USA (TSN®, an electronic surveillance database. Results Of the 262 laboratories that provided data that could be evaluated, 67.6% had adopted the M100-S12 breakpoints one and one-half years after they were published. Conclusions The NCCLS M100-S12 recommendation to interpret MICs to expanded-spectrum cephalosporins using two distinct sets of breakpoints for meningeal and nonmeningeal isolates of S. pneumoniae was steadily implemented by clinical microbiology laboratories in the United States following their initial publication in January 2002. The use of these new breakpoints more accurately reflects the clinical activities of expanded-spectrum cephalosporins than did the single set of interpretative breakpoints previously used for both meningeal and nonmeningeal isolates.

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

    Science.gov (United States)

    Lino, Angelina Maria Martins; Spera, Raphael Ribeiro; de Campos, Fernando Peixoto Ferraz; Freitas, Christian Henrique de Andrade; Garcia, Márcio Ricardo Taveira; Lopes, Leonardo da Costa; Prokopowitsch, Aleksander Snioka

    2014-01-01

    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/3 wks) 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).

  5. New Diagnosis of AIDS Based on Salmonella enterica subsp. I (enterica Enteritidis (A Meningitis in a Previously Immunocompetent Adult in the United States

    Directory of Open Access Journals (Sweden)

    Andrew C. Elton

    2017-01-01

    Full Text Available Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation. A lumbar puncture showed cloudy CSF with Gram negative rods. He was admitted to the ICU. CSF culture confirmed Salmonella enterica subsp. I (enterica Enteritidis (A. Based on this finding, a 4th-generation HIV antibody/p24 antigen test was sent. When this returned positive, a CD4 count was obtained and showed 3 cells/mm3, confirming AIDS. The patient ultimately received 38 days of ceftriaxone, was placed on elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (Genvoya for HIV/AIDS, and was discharged neurologically intact after a 44-day admission.

  6. Pantoea agglomerans Infections in Children: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Shraddha Siwakoti

    2018-01-01

    Full Text Available Introduction. Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. Case Presentations. A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding. Postoperative meningitis was confirmed as cerebrospinal fluid culture revealed P. agglomerans. She responded well with a 14-day intravenous (IV course of ceftriaxone. Also, we report a case of a 3-year-old male child referred to our center with a provisional diagnosis of UTI with chickenpox for further evaluation. During his 24-hour stay at the local hospital, he had received oral antibiotics and urinary catherization. Urine culture of catheter clamp urine was sterile. P. agglomerans was grown in blood culture. He was treated successfully with IV ceftriaxone and amikacin. Conclusion. P. agglomerans can cause postsurgical meningitis and bloodstream infection in children. The clinical course of infection was mild and timely administration of proper antibiotic resulted in a favorable outcome.

  7. Pantoea agglomerans Infections in Children: Report of Two Cases.

    Science.gov (United States)

    Siwakoti, Shraddha; Sah, Rinku; Rajbhandari, Rupa Singh; Khanal, Basudha

    2018-01-01

    Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding. Postoperative meningitis was confirmed as cerebrospinal fluid culture revealed P. agglomerans . She responded well with a 14-day intravenous (IV) course of ceftriaxone. Also, we report a case of a 3-year-old male child referred to our center with a provisional diagnosis of UTI with chickenpox for further evaluation. During his 24-hour stay at the local hospital, he had received oral antibiotics and urinary catherization. Urine culture of catheter clamp urine was sterile. P. agglomerans was grown in blood culture. He was treated successfully with IV ceftriaxone and amikacin. P. agglomerans can cause postsurgical meningitis and bloodstream infection in children. The clinical course of infection was mild and timely administration of proper antibiotic resulted in a favorable outcome.

  8. Leptospirosis in Franche-Comté (FRANCE): clinical, biological, and therapeutic data.

    Science.gov (United States)

    Estavoyer, J M; Chirouze, C; Faucher, J F; Floret, N; Couetdic, G; Leroy, J; Hoen, B

    2013-09-01

    We report the patient data in 77 cases of leptospirosis confirmed by PCR and/or serology (micro-agglutination), observed between 1994 and 2008 at the Besançon teaching hospital. Our aim was to compare the epidemiological, clinical, biological, and therapeutic characteristics of leptospirosis in the Franche-Comté region, to those reported in other regions. The median age was 42years and 95% were male patients. Leptospirosis acquisition was likely related to aquatic leisure activities (50.6%), professional exposure (28.6%), building maintenance works (11.7%), or unknown (9.1%). Forty-eight cases were uncomplicated and 29 were severe presentations of leptospirosis. Among severe cases, eight patients had to be managed in an intensive care unit, and one patient died. L. grippotyphosa and L. icterohaemorrhagiae were the main serogroups involved. Age above 50years and serogroup L. icterohaemorrhagiae were positively associated with clinical severity. The outcome was favorable for 15 patients treated with ceftriaxone for less than 7days. We recommended conducting clinical trials aiming at validating short courses of ceftriaxone to treat leptospirosis. Copyright © 2013. Published by Elsevier SAS.

  9. Travel-related leptospirosis: a series of 15 imported cases.

    Science.gov (United States)

    van de Werve, Charlotte; Perignon, Alice; Jauréguiberry, Stéphane; Bricaire, François; Bourhy, Pascal; Caumes, Eric

    2013-01-01

    Leptospirosis belongs to the spectrum of travel-related infections. We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100. Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered. Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis. © 2013 International Society of Travel Medicine.

  10. Gonococcal infections in Austria: a long-term observation of prevalence and resistance profiles from 1999 to 2014.

    Science.gov (United States)

    Stary, Angelika; Heller-Vitouch, Claudia; Binder, Michael; Geusau, Alexandra; Stary, Georg; Rappersberger, Klemens; Komericki, Peter; Hoepfl, Reinhard; Haller, Maria

    2015-11-01

    The increase in minimum inhibitory concentrations (MICs) of cephalosporins for Neisseria gonorrhoeae has given rise to concerns regarding potentially untreatable gonococcal infections. The goal was to ascertain the prevalence of gonorrhea in a Viennese patient group and determine resistance patterns. Another objective was to evaluate resistance profiles and MIC values of gonococcal isolates in an Austria-wide surveillance project. From 1999 to 2014, 350,000 individuals were tested for gonococci at the Viennese Outpatient Clinic. In addition, from 2010 to 2014, the MICs of recommended antibiotics was determined in 3,584 gonococcal isolates, initially by agar dilution and breakpoint determination, and, from 2012 onwards, by Etest®. During the observation period, the prevalence of gonorrhea increased eightfold, with a significantly greater number of quinolone, penicillin, and tetracycline- resistant strains. In gonococcal strains isolated from across Austria, there was an increase in cefixime and ceftriaxone MICs toward breakpoints. Twenty-one isolates showed cefixime resistance, and while there was an increase in azithromycin resistance from 0.9 % (2013) to 3.2 % (2014), no resistance to ceftriaxone was observed. Currently, there is no imminent risk of untreatable gonorrhea in Austria. However, continuing the use of gonococcal cultures as a diagnostic tool for establishing resistance profiles is essential in order to monitor trends in the development of Neisseria (N.) gonorrhoeae resistance. © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  11. 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.

  12. 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.

  13. 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.

  14. The use of antibiotics in hospitalized adult typhoid patients in an Indonesian hospital

    Directory of Open Access Journals (Sweden)

    Anggita Bunga Anggraini

    2014-08-01

    in the Indonesian Red Cross Hospital in Bogor (West Java during the period of July to December 2012. The analysis for typhoid was qualitatively (DU90% and quantitatively (DDD /hbd using ATC/DDD method.Results: From 459 typhoid patients, the total use of antibiotics in hospitalized adult typhoid patients during the period of July to December 2012 was6.35 DDD/hbd. The use of ceftriaxone had the highest DDD/hbd which was equal to 4.10 DDD/hbd. This meant out of 100 typhoid patients, 4 patients received 2 g ceftriaxone per day. Ceftriaxone was given in injection form. Furthermore, there were more drugs in segment 10% than 90% segment. From 26 types of antibiotics, 7 were included in the DU 90% segment which were ceftriaxone (64.54%; levofloxacin (13.90%; ciprofloxacin (3.57%; meropenem (2.80%; metronidazole (2.52%; ampicillin-sulbactam (1.65%; cefditoren pivoxil (1.60%.Conclusion: Ceftriaxone was the most widely used antibiotics in the treatment of hospitalized adult typhoid patients in a hospital in Indonesia. (Health Science Indones 2014;1:40-3Key words: antibiotics, typhoid, ATC/DDD, DU 90%

  15. Overall Low Extended-Spectrum Cephalosporin Resistance but high Azithromycin Resistance in Neisseria gonorrhoeae in 24 European Countries, 2015.

    Science.gov (United States)

    Cole, Michelle J; Spiteri, Gianfranco; Jacobsson, Susanne; Woodford, Neil; Tripodo, Francesco; Amato-Gauci, Andrew J; Unemo, Magnus

    2017-09-11

    Surveillance of Neisseria gonorrhoeae antimicrobial susceptibility in Europe is performed through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP), which additionally provides data to inform the European gonorrhoea treatment guideline; currently recommending ceftriaxone 500 mg plus azithromycin 2 g as first-line therapy. We present antimicrobial susceptibility data from 24 European countries in 2015, linked to epidemiological data of patients, and compare the results to Euro-GASP data from previous years. Antimicrobial susceptibility testing by MIC gradient strips or agar dilution methodology was performed on 2134 N. gonorrhoeae isolates and interpreted using EUCAST breakpoints. Patient variables associated with resistance were established using logistic regression to estimate odds ratios (ORs). In 2015, 1.7% of isolates were cefixime resistant compared to 2.0% in 2014. Ceftriaxone resistance was detected in only one (0.05%) isolate in 2015, compared with five (0.2%) in 2014. Azithromycin resistance was detected in 7.1% of isolates in 2015 (7.9% in 2014), and five (0.2%) isolates displayed high-level azithromycin resistance (MIC ≥ 256 mg/L) compared with one (0.05%) in 2014. Ciprofloxacin resistance remained high (49.4%, vs. 50.7% in 2014). Cefixime resistance significantly increased among heterosexual males (4.1% vs. 1.7% in 2014), which was mainly attributable to data from two countries with high cefixime resistance (~11%), however rates among men-who-have-sex-with-men (MSM) and females continued to decline to 0.5% and 1%, respectively. Azithromycin resistance in MSM and heterosexual males was higher (both 8.1%) than in females (4.9% vs. 2.2% in 2014). The association between azithromycin resistance and previous gonorrhoea infection, observed in 2014, continued in 2015 (OR 2.1, CI 1.2-3.5, p resistance and low overall resistance to ceftriaxone and cefixime. The low cephalosporin resistance may be attributable to the effectiveness

  16. Antimicrobial susceptibility profile, treatment outcome and serotype distribution of clinical isolates of Salmonella enterica subspecies enterica: a 2-year study from Kerala, South India

    Directory of Open Access Journals (Sweden)

    Harichandran D

    2017-03-01

    Full Text Available Deepa Harichandran, Kavitha Radhakrishnan Dinesh Department of Microbiology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala, India Background/purpose: Typhoid and paratyphoid fever continue to be important causes of illness and death in parts of Asia, being associated with poor sanitation and consumption of unsafe food and water. Antimicrobial resistance has emerged to traditional first-line drugs, namely, the fluoroquinolones, as well as to third-generation cephalosporins, posing challenges to treatment. Azithromycin has proven to be an effective alternative for treatment of uncomplicated typhoid fever. The purpose of this study was to determine the antimicrobial susceptibility, clinical outcome and serotype distribution pattern of clinical isolates belonging to Salmonella enterica subspecies enterica. Methodology: All clinical isolates of S. enterica obtained from blood, sterile body fluids, as well as stool and urine samples at Amrita Institute of Medical Sciences and Research Centre, Kerala, India, between August 2011 and July 2013 were included in the study and processed based on standard microbiology protocols. Results: A total of 118 isolates of Salmonella were obtained during the study period. Out of these, 79 were of S. Typhi (66.95%, followed by isolates of S. Paratyphi A (22; 18.64% and S. Typhimurium 12 (10.17%. Five isolates could not be identified further. There was 100% susceptibility to ceftriaxone in all S. enterica subspecies. Ciprofloxacin susceptibility was 32.91% for S. Typhi and 40.90% for S. Paratyphi A as determined by the disk diffusion method. The susceptibility profile of S. Typhi isolates to different antimicrobials was as follows: chloramphenicol (94.93%, ampicillin (77.21%, cotrimoxazole (75.94% and azithromycin (78.48%. For S. Typhi, the minimum inhibitory concentration (MIC of ciprofloxacin required to inhibit the growth

  17. Ceftaroline activity tested against contemporary Latin American bacterial pathogens (2011

    Directory of Open Access Journals (Sweden)

    Robert K. Flamm

    2014-03-01

    Full Text Available A total of 2484 target bacterial pathogens were collected (one per patient episode from patients in 16 Latin American medical centers located in seven nations during 2011. Isolate identity was confirmed at a coordinating laboratory and susceptibility testing was performed for ceftaroline and comparator agents according to reference broth microdilution methods. A total of 30.0% of isolates were from respiratory tract, 29.4% from skin and skin structure, 21.4% from blood stream, 7.9% from urinary tract and 11.3% from other sites. Ceftaroline was active against Staphylococcus aureus (42.8% MRSA with 83.6% of the isolates at ≤1 mg/L and all isolates at ≤2 mg/L (MIC5090, 0.25/2 mg/L. National MRSA rates ranged from a low of 28.8% in Colombia to a high of 68.1% in Chile. All Streptococcus pyogenes and Streptococcus agalactiae were susceptible to ceftaroline (MIC50/90 values were at ≤0.015/≤0.015 mg/L for both. All Streptococcus pneumoniae were susceptible to ceftaroline, linezolid, tigecycline and vancomycin. Susceptibility to ceftriaxone was at 88.4% (CLSI non-meningitis interpretive criteria and 73.9% (CLSI meningitis interpretive criteria for all S. pneumoniae. Ceftriaxone susceptibility was only at 33.3% (CLSI non-meningitis interpretive criteria and 0.0% (CLSI meningitis interpretive criteria for penicillin-intermediate (penicillin MIC, 4 mg/L strains. All Haemophilus influenzae (29.4% β-lactamase-positive isolates were susceptible to ceftaroline, amoxicillin–clavulanate, ceftriaxone, and levofloxacin. For the Latin American region, the ESBL-phenotype rate was 37.6% for Escherichia coli and 53.3% for Klebsiella pneumoniae. Ceftaroline was not active against ESBL-phenotype strains but was active against >90.0% of the non-ESBL-phenotype. The spectrum of activity of ceftaroline against pathogens from Latin America indicates that it merits further study for its potential use in the Latin American region.

  18. Antimicrobial multiple resistance index, minimum inhibitory concentrations, and extended-spectrum beta-lactamase producers of Proteus mirabilis and Proteus vulgaris strains isolated from domestic animals with various clinical manifestations of infection

    Directory of Open Access Journals (Sweden)

    Vanessa Zappa

    2017-05-01

    Full Text Available Proteus spp. are opportunistic multidrug resistant enterobacteria associated with diverse clinical diseases in domestic animals. However, Proteus infections in domestic animals are often misdiagnosed or considered contaminants in microbiological cultures rather than a primary agent of disease. Descriptions of Proteus infections in domestic animals are typically restricted to case reports, retrospective studies, or surveillance of other microorganisms. The present study investigated multiple antibiotic resistance indices, minimum inhibitory concentrations (MICs, and ESBL production in 73 strains of Proteus mirabilis (n = 69 and Proteus vulgaris (n = 4 isolated from domestic animals with various clinical manifestations. In dogs, the pathogen was most commonly associated with cystitis (48.21, enteritis (21.42%, otitis (14.29%, and conjunctivitis (3.57%. In bovines, the microorganism was predominant in cases of enteritis (22.22%, abscess (11.11%, otitis (11.11%, omphalitis (11.11%, and peritonitis (11.11%, and in organ fragments (11.11%. In equines (50.0% and cats (100.0%, diarrhea was the main clinical sign. In vitro standard disk diffusion assay showed that the most effective antimicrobials against the isolates were imipenem (98.63, norfloxacin (95.89, amikacin (95.89, levofloxacin (90.41, ceftriaxone (87.64, and florfenicol (87.67. In contrast, the isolates commonly showed resistance to novobiocin (95.89, azithromycin (57.53, and trimethropim/sulfamethoxazole (39.73. Among the 73 isolates, the efficacy of amoxicillin/clavulanic acid, gentamicin, ceftriaxone, and ciprofloxacin according to MICs was 87.67%, 86.30%, 84.93%, and 82.19%, respectively. The MIC50 values of amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, and gentamicin were, respectively, 1.0, 0.004, 0.03, and 1.0 µg/mL. Thirty-three strains (45.21% showed a antimicrobial multiple resistance index of ? 0.3. Multidrug resistance profiles of isolates were observed most frequently

  19. Role of outpatient parenteral antibiotic therapy in the treatment of community acquired skin and soft tissue infections in Singapore.

    Science.gov (United States)

    Chan, Monica; Ooi, Chee Kheong; Wong, Joshua; Zhong, Lihua; Lye, David

    2017-07-06

    Treatment of community acquired skin and soft tissue infections (SSTIs) is a common indication for outpatient parenteral antibiotic therapy (OPAT) in USA, UK and Australasia, however data from Asia are lacking. OPAT is well established within the Singapore healthcare since 2002, however, systematic use of OPAT for the treatment of SSTIs remains infrequent. In this report, we describe the treatment and outcome of patients with SSTIs referred directly from Emergency Department (ED) to OPAT for continuation of intravenous (IV) antibiotics in Singapore, thus avoiding potential hospital admission. This is a single center university hospital retrospective study of patients with SSTIs presenting to ED who were assessed to require IV antibiotics and accepted to the OPAT clinic for continuation of IV treatment. Exclusion criteria were: haemodynamic instability, uncontrolled or serious underlying co-morbidities, necessity for inpatient surgical drainage, facial cellulitis and cephalosporin allergy. Patients returned daily to the hospital’s OPAT clinic for administration of IV antibiotics and review, then switched to oral antibiotics on improvement. From 7 February 2012 to 31 July 2015, 120 patients with SSTIs were treated in OPAT. Median age was 56 years and 63% were male. Lower limbs were affected in 91%. Diabetes was present in 20%. Sixty-seven (56%) had been treated with oral antibiotics for a median duration of 3 days prior to OPAT treatment. Common symptoms were erythema (100%), swelling (96%), pain (88%) and fever (55%). Antibiotics administered were IV cefazolin with oral probenecid (71%) or IV ceftriaxone (29%) for median 3 days then oral cloxacillin (85%) for median 7 days. Clinical improvement occurred in 90%. Twelve patients (10%) were hospitalized for worsening cellulitis, with 4 patients requiring surgical drainage of abscess. Microbiological cultures from 2 patients with drained abscess grew methicillin sensitive Staphylococcus aureus (MSSA) and Klebsiella

  20. Actividad “in vitro” de 10 antimicrobianos frente a bacterias anaerobias: Estudio multicéntrico, 1999-2002 “In vitro” activity of ten antimicrobial agents against anaerobic bacteria. A collaborative study, 1999-2002

    Directory of Open Access Journals (Sweden)

    M. Litterio

    2004-09-01

    Full Text Available Se evaluó la actividad de ampicilina, ampicilina-sulbactama, cefoxitina, ceftriaxona, imipenem, piperacilina, piperacilina-tazobactama, clindamicina, metronidazol y azitromicina frente a 166 cepas de bacterias anaerobias aisladas en 8 hospitales de Buenos Aires. Se estudiaron: Bacteroides grupo fragilis (65, Fusobacterium spp. (26, Prevotella spp. (21, Porphyromonas spp. (10, Clostridium difficile (10, otros clostridios (12 y cocos gram-positivos (22. Las CIMs se determinaron usando el método patrón de dilución en agar recomendado por el NCCLS, documento M11-A5. Los antibióticos más activos fueron metronidazol y piperacilina-tazobactama que exhibieron valores de CIM90£ 2 µg/ml y £ 4 µg/ml frente a los microorganismos gram-negativos y £ 2 µg/ml y £ 8 µg/ml frente a los microorganismos gram-positivos, respectivamente. Entre los b-lactámicos el orden de actividad frente a bacilos gram-negativos fue: imipenem > piperacilina > cefoxitina > ceftriaxona > ampicilina. En gram-positivos la actividad decreciente fue: piperacilina> imipenem > cefoxitina > ceftriaxona > ampicilina. La mayoría de las especies estudiadas mostraron distintos niveles de resistencia con clindamicina y azitromicina. Sin embargo, el 90% de las cepas de Fusobacterium nucleatum y Por-phyromonas spp. fue inhibido por una concentración de 0,125 µg/ml de clindamicina y azitromicina, respectivamente.The antimicrobial activity of ampicillin, ampicillin-sulbactam, cefoxitin, ceftriaxone, imipenem, piperacillin, piperacillin-tazobactam, clindamycin, metronidazole, and azitromycin was assesed against 166 strains of anaerobic bacteria recovered from eight hospitals in Buenos Aires. The strains studied were Bacteroidesfragilis group (65, Fusobacterium spp. (26, Prevotella spp. (21, Porphyromonas spp. (10, Clostridium difficile (10, other clostridia (12, and gram-positive cocci (22. The MICs were determined by the agar dilution method according to NCCLS document M11-A5

  1. 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

  2. To evaluate the clinical efficacy of a 99mTc-Scintibact for the diagnosis of orthopedic infections: first results

    International Nuclear Information System (INIS)

    Kaur, Parvinder; Babbar, A.K.; Sharma, A.K.; Kaul, Ankur; Mishra, A.K.; Singh, B.; Sarika; Mittal, Bhagwant R.

    2010-01-01

    Full text: A novel approach to infection imaging is the use of radiolabeled antibiotics. With the advent of time, the micro-organisms develop resistance to the extensively used antibiotics and there is a need to radiolabel newer generation antibiotics to increase the sensitivity and specificity of this imaging modality. In this study, we evaluated the clinical utility of 99m Tc labeled ceftriaxone for the detection of orthopedic infections. Materials and Methods: Ceftriaxone- a third-generation cephalosporin antibiotic was successfully labeled with 99m Tc with radiolabeling efficiency (≤99%) and formulated into a ready to use single vial kit preparation (Brand Name: Scintibact). Fourteen patients (10M; 4F, mean age 37.7 yrs, range 22-65 yrs) with clinical and radiological suspicion of orthopedic infection were recruited. All the patients underwent a 3-phase bone scan (740 MBq, 99m Tc-MDP, i.v. injection) followed by (4 days later) 99m Tc- ceftriaxone scanning (static/isotime images at 1h, 4h, 24h after i.v. administration of 555.0 MBq activity of the radiotracer). Whole body Scintibact scanning was also done to study the biodistribution of the radiotracer. The sample aspirates from site involved were taken and analyzed for the microbial growth. Results: Scintibact scan findings were positive in 11/14 and culture positive in 11/14 patients. The diagnostic accuracy of the technique was found to be 71.0%, sensitivity and specificity were 80% and 75% respectively. The bio-distribution studies indicated that 2/3rd and 1/3rd of the radiotracer excretes through the renal and hepato-biliary routes which corroborated with our animal experimentation performed using this preparation. Conclusions: Single vial kit preparation of Scintibact has reasonably good accuracy in the diagnosis of orthopedic infections. The use of this formulation needs to be validated in a large cohort of patients also in few treated and symptomatic cases of bone infection

  3. Ceftaroline activity against bacterial organisms isolated from acute bacterial skin and skin structure infections in United States medical centers (2009-2011).

    Science.gov (United States)

    Pfaller, Michael A; Flamm, Robert K; Sader, Helio S; Jones, Ronald N

    2014-04-01

    Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil, is a new cephalosporin with bactericidal activity against resistant Gram-positive organisms including methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant strains of Streptococcus pneumoniae, and commonly isolated Gram-negative organisms, including ceftriaxone-susceptible Enterobacteriaceae. We evaluated the in vitro activity of ceftaroline and selected comparator agents against bacterial isolates collected from patients with acute bacterial skin and skin structure infections (ABSSSIs) in the USA. A total of 6222 isolates were collected from 67 medical centers distributed across all nine USA census regions between 2009 and 2011 and tested for susceptibility by reference broth microdilution methods. Ceftaroline was very active against S. aureus (MIC50/90, 0.5/1 μg/mL; 99.6% susceptible), including MRSA (MIC50/90, 0.5/1 μg/mL; 99.1% susceptible). Against β-hemolytic streptococci, the activity of ceftaroline (MIC50/90, ≤0.015/0.03 μg/mL; 100.0% susceptible) was comparable to that of both penicillin (MIC50/90, ≤0.06/≤0.06 μg/mL; 100.0% susceptible) and ceftriaxone (MIC50/90, ≤0.25/≤0.25 μg/mL; 100.0% susceptible). Ceftaroline was also highly active against viridans group streptococci (MIC50/90, 0.03/0.06 μg/mL). Similar to ceftriaxone and ceftazidime, ceftaroline was active against wild-type strains of Escherichia coli (MIC50/90, 0.12/0.25 μg/mL; 94.0% susceptible) and Klebsiella pneumoniae (MIC50/90, 0.12/0.25 μg/mL; 96.8% susceptible); however, the ceftaroline activity was compromised among strains with an extended-spectrum β-lactamase-phenotype (MIC50/90, >32/>32 μg/mL for both E. coli and K. pneumoniae). In summary, ceftaroline showed potent activity against a large contemporary collection (6222) of bacterial isolates associated with ABSSSI in the USA. © 2014.

  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. Results from the Survey of Antibiotic Resistance (SOAR) 2011-13 in Ukraine.

    Science.gov (United States)

    Feshchenko, Y; Dzyublik, A; Pertseva, T; Bratus, E; Dzyublik, Y; Gladka, G; Morrissey, I; Torumkuney, D

    2016-05-01

    To determine the antibiotic susceptibility of respiratory isolates of Streptococcus pneumoniae and Haemophilus influenzae collected in 2011-13 from Ukraine. MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. A total of 134 isolates of S. pneumoniae and 67 of H. influenzae were collected from eight sites in Ukraine. Overall, 87.3% of S. pneumoniae were penicillin susceptible by CLSI oral breakpoints and 99.3% by CLSI iv breakpoints. Susceptibility to amoxicillin/clavulanic acid (amoxicillin), ceftriaxone and levofloxacin was 100% by CLSI and PK/PD breakpoints. Cephalosporin and macrolide susceptibility was ≥95.5% and 88.1%, respectively using CLSI breakpoints. Trimethoprim/sulfamethoxazole was essentially inactive against pneumococci. Of the 67 H. influenzae tested, 4.5% were β-lactamase positive and all H. influenzae were fully susceptible to amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, cefixime and levofloxacin (all breakpoints). Cefuroxime susceptibility was 100% by CLSI but 73.1% by EUCAST and PK/PD breakpoints. A discrepancy was found in macrolide susceptibility between CLSI (∼100% susceptible), EUCAST (22%-43% susceptible) and PK/PD (0%-22% susceptible) breakpoints. Trimethoprim/sulfamethoxazole was poorly active (59.7% susceptible). Generally, antibiotic resistance was low in respiratory pathogens from Ukraine. However, only amoxicillin/clavulanic acid (amoxicillin), ceftriaxone and levofloxacin were fully active against both species. Trimethoprim/sulfamethoxazole was the least active, particularly against S. pneumoniae. Some susceptibility differences were apparent between CLSI, EUCAST and PK/PD breakpoints, especially with macrolides against H. influenzae. These data suggest that further efforts are required to harmonize these international breakpoints. Future studies are warranted to monitor continued low resistance levels in Ukraine

  6. Multi-antibiotic resistant extended-spectrum beta-lactamase producing bacteria pose a challenge to the effective treatment of wound and skin infections.

    Science.gov (United States)

    Oli, Angus Nnamdi; Eze, Dennis Emeka; Gugu, Thaddeus Harrison; Ezeobi, Ifeanyi; Maduagwu, Ukamaka Nwakaku; Ihekwereme, Chibueze Peter

    2017-01-01

    The increasing incidence of antibiotic resistant bacteria is a concern both to the clinicians and the patients due to obvious consequences such as treatment failures, prolonged patients' stay in hospital and nosocomial infections. The choice of the first antibiotic therapy in emergency wards in hospitals is usually not based on patient-specific microbial culture and susceptibility test result.This study is aimed at profiling extended-spectrum beta-lactamase (ESBL) producing bacteria associated with wound injuries and highlighting their multi-antibiotic resistance character. Sixty-three wound swab samples were collected and cultured on nutrient agar and on selective media. Evaluation for ESBL production was by phenotypic method while the antibiogram screening was by disc-diffusion. The wounds evaluated were diabetic sore (14), cancer wounds (12), surgical wounds (17), wounds due to road traffic accidents (10) and wounds from fire burn (10). The result showed that 61 wounds were infected and the prevalence of the infecting pathogens was Escherichia coli 17.46%, Klebsiella Pneumonia 14.28%, Salmonella typhi 12.79%, Pseudomonas Aeruginosa 34.92% and Staphylococcus aureus 17.46%. Thirty four (55.74 %) isolates were ESBL producers, greater than 50% of which being Pseudomonas Aeruginosa . The antibiogram study of the ESBL producers showed multi-drug resistance with resistance highest against ampicillin (100%), followed by cephalosporins: cefuroxime (94.12%) and ceftriaxone (61.76%). No resistance was recorded against the β-lactamase inhibitors: amoxicillin/clavulanate and ceftriaxone/sulbactam. There was a high incidence (55.74 %) of ESBL-producing microbes in the wounds. The isolates were mostly multi-antibiotic resistant. Multi-drug resistant ESBL-producing bacteria are common in wound infections in the community. However, amoxicillin/clavulanate or ceftriaxone/sulbactam may be used to treat most patients with such infections in the hospital. This may guide antibiotic

  7. 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; Pcoliform 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. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  8. Prevalence of multiple drug resistant Streptococcus suis in and around Guwahati, India

    Directory of Open Access Journals (Sweden)

    Mrinalee Devi

    2017-05-01

    Full Text Available Aim: This study was conducted to determine the prevalence and antimicrobial susceptibility of Streptococcus suis and their resistance patterns isolated from both clinically healthy carriers and diseased pigs in and around Guwahati, Assam, India. Materials and Methods: A total of 497 samples were collected during October, 2012, to April, 2014, from clinically healthy (n=67 and diseased (n=230 pigs of varying age and either sex maintained under organized and unorganized farming systems. Samples were processed for isolation and identification of S. suis by biochemical characterization and polymerase chain reaction targeting the housekeeping gene glutamate dehydrogenase. In vitro antimicrobial susceptibility of the recovered isolates against nine antibiotic groups comprising 17 antimicrobial agents was studied by standard method. Results: Of the 497 samples examined, 7 (1.41% isolates were confirmed to be S. suis of which 5 (1.87% and 2 (0.87% were derived from clinically healthy and diseased pigs, respectively. All the isolates were susceptible to gentamicin, amikacin, and erythromycin (100% followed by the penicillin group and enrofloxacin (85.71%, ceftriaxone, doxycycline HCL, ofloxacin and chloramphenicol (71.43%, to kanamycin, clindamycin and co-trimoxazole (42.85%. The isolates showed least susceptibility to cefalexin, tetracycline and streptomycin (28.57%. All the five S. suis isolates from clinically healthy pigs were susceptible to penicillin G, amoxyclav, doxycycline HCl, gentamicin, amikacin and erythromycin, 80.00% isolates susceptible to ampicillin, enrofloxacin and ofloxacin, 60.00% to ceftriaxone, kanamycin and chloramphenicol, 40% to cefalexin, tetracycline, clindamycin and co-trimoxazole, respectively. Only 20.00% isolates were susceptible to streptomycin. Both the isolates recovered from diseased pigs were susceptible to ampicillin, ceftriaxone, gentamicin, amikacin, enrofloxacin, erythromycin, and clindamycin. On the other hand

  9. [Meningococcemia and meningitis due to Neisseria meningitidis W135 developed in two cases vaccinated with bivalent (A/C) meningococcal vaccine].

    Science.gov (United States)

    Turhan, Vedat; Acar, Ali; Kılıç, Abdullah; Budak, Sinem; Oncül, Oral; Haznedaroğlu, Tunçer; Görenek, Levent

    2010-07-01

    Meningococcal infections may develop as episodic or endemic cases particularly among children attending day-care centers, boarding schools or among military personnel. Bivalent (A/C) meningococcal vaccine is applied to all new military stuff since 1993 in Turkey. In this report two cases of meningococcemia and meningitis, developed in two soldiers vaccinated with meningococcal vaccine, were presented. The first case was a 21 years old male patient who was admitted to the emergency service with the complaints of high fever, headache, fatigue and vomiting. He was conscious, cooperative and oriented with normal neurological findings. Maculopapular exanthems were detected at the lower extremities. The patient was hospitalized with the initial diagnosis of sepsis or meningococcemia and empirical treatment was initiated with ceftriaxone and dexamethasone. Cerebrospinal fluid (CSF) examination yielded 10 cells/mm3 (lymphocytes) with normal CSF biochemical parameters. A few hours later skin rashes spread over the body rapidly, the symptoms got worse, confusion, disorientation and disorientation developed, and the patient died due to cardiac and respiratory arrest at the seventh hour of his admission. The second case was also a 21 years old male patient who was admitted to the hospital with the complaints of fever, headache, painful urination, confusion and agitation. He was initially diagnosed as acute bacterial meningitis due to clinical (stiff neck, positive Kernig and Brudzinsky signs) and CSF (8000 cells/mm3; 80% polymorphonuclear leukocytes, increased protein and decreased glucose levels) findings. Empirical antibiotic therapy with ceftriaxone was initiated and continued for 14 days. The patient was discharged with complete cure and no complication was detected in his follow-up visit after two months. The first case had an history of vaccination with bivalent (A/C) meningococcal vaccine three months ago and the second case had been vaccinated one month ago. The

  10. An atypical limping teenager.

    Science.gov (United States)

    Liegeois, Claire; Stewart, Charles

    2015-08-14

    A 13-year-old boy presented with a 5-day history of left-sided limp of gradual onset. There was no history of trauma. He developed a fever and rigours a few days before presenting to the paediatric emergency department. On examination, he was tender on palpating the left gluteal area on active mobilisation of the left hip and could not weight bear on the left leg. Pelvic X-rays and ultrasound of the left hip were normal. The blood results showed raised inflammatory markers and normal white cell count. The blood cultures were positive for Staphylococcus aureus. On day 2, a left hip MRI was performed as well as CT-guided drainage. Diagnosis of left sacroiliac septic arthritis was made. After an initial lack of improvement under intravenous ceftriaxone, a drain was inserted and left in situ for 8 days with double intravenous antibiotic therapy instituted. The patient made a full recovery. 2015 BMJ Publishing Group Ltd.

  11. Bacterial adhesion to urethral catheters: role of coating materials and immersion in antibiotic solution.

    Science.gov (United States)

    Cormio, L; La Forgia, P; La Forgia, D; Siitonen, A; Ruutu, M

    2001-09-01

    To determine whether new coating materials (silver and hydrogel) or immersion in antibiotic solution may reduce or prevent bacterial adhesion to urethral catheters. Precut segment of Teflon-, silver- and hydrogel-coated urethral catheters were incubated with two uropathogenic bacterial strains with and without previous immersion in antibiotic solution. Tobramycin, ceftriaxone and ciprofloxacin solutions were used as these antibiotics are commonly administered for the prophylaxis and treatment of urinary tract infection (UTI), especially in hospitals. Microbiological analysis showed that the new coating materials (silver and hydrogel) did not reduce bacterial adhesion to urethral catheters, whereas immersion in antibiotic solution yielded a statistically significant (ptobramycin. Immersion in a suitable antibiotic solution may significantly reduce bacterial adhesion to urethral catheters and consequently reduce the risk of UTI in connection with these devices. Although experimental, these findings may be of clinical relevance and provide grounds for further studies in vivo.

  12. 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

  13. Clinical association: Lyme disease and Guillain-Barre syndrome.

    Science.gov (United States)

    Patel, Kinner; Shah, Siddharth; Subedi, Dinesh

    2017-10-01

    Guillain-Barre Syndrome (GBS) is a life-threatening condition in which patients may present to the Emergency Department in respiratory distress leading to death. The early identification and treatment of such a condition is paramount in preventing mortality. While there are many infections associated with GBS, the association with Lyme disease is uncommon. Through our case we aim to highlight Borrelia burgdorferi as an important antecedent infection associated with the development of GBS. In this case we report a 31-year-old male who was diagnosed with Lyme disease and GBS with relevant clinical presentation including progressive numbness and weakness in bilateral hands and feet for the past 1week along with areflexia. Initiation of medical therapy with intravenous immunoglobulin and parenteral ceftriaxone resulted in resolution of his symptoms. The treatment of both diseases early can help prevent further central nervous complications leading to high morbidity and mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. 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.

  15. 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.

  16. Calcinosis Cutis and Calciphylaxis.

    Science.gov (United States)

    Jiménez-Gallo, D; Ossorio-García, L; Linares-Barrios, M

    2015-12-01

    Calcinosis cutis (CC) is defined as the deposition of calcium salts in the skin. The condition is divided into 5 types: calciphylaxis and dystrophic, metastatic, idiopathic, and iatrogenic CC. Dystrophic CC is the most common form and usually occurs in association with autoimmune diseases. CC can be treated surgically or with the use of drugs such as diltiazem, bisphosphonates, warfarin, ceftriaxone, probenecid, minocycline, or aluminum hydroxide. Calciphylaxis is defined as calcification of the media of small- and medium-sized blood vessels in the dermis and subcutaneous tissue. Clinically, calciphylaxis causes livedo racemosa, which progresses to retiform purpura and skin necrosis. First-line treatment is with sodium thiosulfate. We present a review of the calcifying disorders of the skin, focusing on their diagnosis and treatment. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

  17. Characterization of antimicrobial resistance patterns and class 1 integrons in Escherichia coli O26 isolated from humans and animals.

    Science.gov (United States)

    Srinivasan, Velusamy; Gillespie, Barbara E; Nguyen, Lien T; Headrick, Susan I; Murinda, Shelton E; Oliver, Stephen P

    2007-03-01

    Antimicrobial resistance patterns and the prevalence of antimicrobial resistance genes and class 1 integrons in 35 Escherichia coli O26 isolated from humans and food-producing animals were evaluated. All isolates were resistant to cefaclor, cefalothin and sulfonamide and were susceptible to amikacin, gentamicin, cefmetazole, cefotaxime, ceftriaxone, ciprofloxacin, norfloxacin and trimethoprim. Most isolates were resistant to aztreonam, ampicillin, tetracycline, streptomycin and kanamycin. All ampicillin- and streptomycin-resistant E. coli O26 carried ampC and strA-strB gene sequences, respectively. Florfenicol- and chloramphenicol-resistant isolates carried floR but not cmlA. Class1 integrons were identified in 14% of E. coli O26 isolates. To our knowledge, this is the first report describing the presence of multiple antimicrobial resistance genes in E. coli O26 isolated from human and animal origins.

  18. 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...

  19. 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.

  20. Synthesis and biological evaluation of the progenitor of a new class of cephalosporin analogues, with a particular focus on structure-based computational analysis.

    Directory of Open Access Journals (Sweden)

    Anna Verdino

    Full Text Available We present the synthesis and biological evaluation of the prototype of a new class of cephalosporins, containing an additional isolated beta lactam ring with two phenyl substituents. This new compound is effective against Gram positive microorganisms, with a potency similar to that of ceftriaxone, a cephalosporin widely used in clinics and taken as a reference, and with no cytotoxicity against two different human cell lines, even at a concentration much higher than the minimal inhibitory concentration tested. Additionally, a deep computational analysis has been conducted with the aim of understanding the contribution of its moieties to the binding energy towards several penicillin-binding proteins from both Gram positive and Gram negative bacteria. All these results will help us developing derivatives of this compound with improved chemical and biological properties, such as a broader spectrum of action and/or an increased affinity towards their molecular targets.

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

    Energy Technology Data Exchange (ETDEWEB)

    Matsuno, Osamu [Department of Respiratory Disease, NHO National Osaka Minami Medical Center, Kido higashi machi 2-1, Kawachinagano City, Osaka 586-8521 (Japan)], E-mail: matsuno@ommc-hp.jp; Hayama, Yoshitomo; Honda, Hidehiro; Yamane, Hiroyuki; Yamamoto, Suguru; Ueno, Kiyonobu [Department of Respiratory Disease, NHO National Osaka Minami Medical Center, Kido higashi machi 2-1, Kawachinagano City, Osaka 586-8521 (Japan); Saeki, Yukihiko [Department of Clinical Research, NHO National Osaka Minami Medical Center, Kido higashi machi 2-1, Kawachinagano city, Osaka 586-8521 (Japan)

    2010-05-15

    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.

  2. 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

  3. Synergistic antibiotic combinations for colistin-resistant Klebsiella pneumoniae.

    Science.gov (United States)

    Kádár, Béla; Kocsis, Béla; Tóth, Ákos; Damjanova, Ivelina; Szász, Máté; Kristóf, Katalin; Nagy, Károly; Szabó, Dóra

    2013-06-01

    In this study antibiotic combinations for multidrug-resistant Klebsiella pneumoniae strains were investigated. The study included a colistin-susceptible and a colistin-resistant KPC-2 producing K. pneumoniae ST258 strains isolated in 2008 and 2009 during an outbreak in Hungary. Antibiotic combinations were analyzed by checkerboard technique and fractional inhibitory concentration indices were calculated. The following antibiotics were tested: ceftazidime, cefotaxime, ceftriaxone, ampicillin, imipenem, ertapenem, amikacin, tobramycin, ciprofloxacin, levofloxacin, moxifloxacin, rifampicin, polymyxin B and colistin. Combinations including 0.25 μg/ml colistin plus 1 μg/ml rifampicin, 0.25 μg/ml polymyxin B plus 1 μg/ml rifampicin, 1 μg/ml imipenem plus 2 μg/ml tobramycin, were found synergistic.These in vitro synergistic combinations suggest potential therapeutical options against infections caused by KPC-2 producing, multidrug-resistant K. pneumoniae ST258.

  4. [Acute bacterial meningitis as an occupational disease].

    Science.gov (United States)

    Seixas, Diana; Lebre, Ana; Crespo, Pedro; Ferreira, Eugénia; Serra, José Eduardo; Saraiva da Cunha, José Gabriel

    2014-01-01

    Streptococcus suis is a zoonotic pathogen with worldwide distribution, responsible for more than 700 human cases globally reported. This infection affects mostly men, exposed to pig or pork, which leads to its usual classification as an occupational disease. We report a case of acute bacterial meningitis in a 44 years old male. According to his past medical history, the patient had chronic alcoholism and worked in a restaurant as a piglet roaster. Microbiological examination of blood and CSF revealed S. suis. After 14 days of ceftriaxone the patient fully recovered. The authors review the clinical reports previously described in Portugal. In all of them was possible to identify risk exposition to pork. We alert to this microorganism's importance in Portugal where it is probably underdiagnosed.

  5. Diabetic foot gangrene patient with multi-drug resistant Pseudomonas putida infection in Karawaci District, Indonesia

    Directory of Open Access Journals (Sweden)

    Nata Pratama Hardjo Lugito

    2015-01-01

    Full Text Available Pseudomonas putida is a rod-shaped, non fermenting Gram-negative organism frequently found in the environment that utilizes aerobic metabolism, previously thought to be of low pathogenicity. It had been reported as cause of skin and soft tissue infection, especially in immunocompromised patients. A female green grocer, 51 year-old came to internal medicine out-patient clinic with gangrene and osteomyelitis on her 1 st , 2 nd and 3 rd digit and wound on the sole of the right foot since 1 month prior. The patient had history of uncontrolled diabetes since a year ago. She was given ceftriaxone 2 grams b.i.d, metronidazole 500 mg t.i.d empirically and then amikacin 250 mg b.i.d, followed by amputation of the digits and wound debridement. The microorganism′s culture from pus revealed multi drug resistant Pseudomonas putida. She recovered well after antibiotics and surgery.

  6. Salmonella Typhi Vertebral Osteomyelitis and Epidural Abscess

    Directory of Open Access Journals (Sweden)

    Hau Wei Khoo

    2016-01-01

    Full Text Available Salmonella vertebral osteomyelitis is an uncommon complication of Salmonella infection. We report a case of a 57-year-old transgender male who presented with lower back pain for a period of one month following a fall. Physical examination only revealed tenderness over the lower back with no neurological deficits. MRI of the thoracic and lumbar spine revealed a spondylodiscitis at T10-T11 and T12-L1 and right posterior epidural collection at the T9-T10 level. He underwent decompression laminectomy with segmental instrumentation and fusion of T8 to L3 vertebrae. Intraoperatively, he was found to have acute-on-chronic osteomyelitis in T10 and T11, epidural abscess, and discitis in T12-L1. Tissue and wound culture grew Salmonella Typhi and with antibiotics susceptibility guidance he was treated with intravenous ceftriaxone for a period of six weeks. He recovered well with no neurological deficits.

  7. Administration of Drug Induce Liver Injury to the Inpatients with Liver Disease

    Directory of Open Access Journals (Sweden)

    Sindy E. Cinthya

    2012-06-01

    Full Text Available Drug induced liver injury is a serious human health problems. Pre-existing liver diseases are risk factor of liver injury by the drugs. The study was conducted to evaluate the use of drug induced liver injury in patients hospitalized with liver disease at one hospital in Kota Tasikmalaya. Informations were collected retrospectively in the period 2010-2011 from the patient’s medical record. A total of 52 patients research subjects were discovered 50 patients (96% using drug induced liver injury and 2 patients (4% did not use it. Drug induced liver injury most widely used were ranitidine (31.3%, ceftriaxone (23.1%, and paracetamol (16.4%. Level of the DILI usage in patient with liver disease was relative high (96%. Further research is needed to determine the effect of the drug induced liver injury to liver injury.

  8. 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.

  9. Pasteurella multocida bacterial meningitis caused by contact with pigs.

    Science.gov (United States)

    López, C; Sanchez-Rubio, P; Betrán, A; Terré, R

    2013-01-01

    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.

  10. Spatial memory and learning deficits after experimental pneumococcal meningitis in mice.

    Science.gov (United States)

    Wellmer, A; Noeske, C; Gerber, J; Munzel, U; Nau, R

    2000-12-22

    Survivors of bacterial meningitis frequently suffer from long-term sequelae, particularly from learning and memory deficits. For this reason, spatial memory and learning was studied in a mouse model of ceftriaxone-treated Streptococcus pneumoniae meningitis. Persistent deficits of spatial learning despite normal motor function were observed in mice infected with 10(4) colony-forming units (CFU) in 25 microl of saline into the right forebrain in comparison to mice treated with an equal amount of saline. Survivors of meningitis performed significantly worse in memorizing a hidden platform in a Morris water maze. After 2 weeks, the difference between post-meningitis and control mice diminished. Yet, when the platform was moved after 180 days, learning of the new location was still strongly impaired in mice surviving meningitis.

  11. Gemifloxacin Is Effective in Experimental Pneumococcal Meningitis

    Science.gov (United States)

    Smirnov, A.; Wellmer, A.; Gerber, J.; Maier, K.; Henne, S.; Nau, R.

    2000-01-01

    In a rabbit model of Streptococcus pneumoniae meningitis, 5 mg of gemifloxacin mesylate (SB-265805) per kg/h reduced the bacterial titers in cerebrospinal fluid (CSF) almost as rapidly as 10 mg of ceftriaxone per kg/h (Δlog CFU/ml/h ± standard deviation [SD], −0.25 ± 0.09 versus −0.38 ± 0.11; serum and CSF concentrations of gemifloxacin were 2.1 ± 1.4 mg/liter and 0.59 ± 0.38 mg/liter, respectively, at 24 h). Coadministration of 1 mg of dexamethasone per kg did not affect gemifloxacin serum and CSF levels (2.7 ± 1.4 mg/liter and 0.75 ± 0.34 mg/liter, respectively, at 24 h) or activity (Δlog CFU/ml/h ± SD, −0.26 ± 0.11). PMID:10681354

  12. 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.

  13. Outpatient parenteral antibiotic therapy: Evaluation of practices and limits of use in rural areas in France.

    Science.gov (United States)

    Triffault-Fillit, C; Ferry, T; Perpoint, T; Adélaïde, L; Le Ngoc Tho, S; Ader, F; Chidiac, C; Valour, F

    2018-03-01

    To evaluate outpatient parenteral antibiotic therapy (OPAT) practices in a French rural area. Descriptive study assessing knowledge, practices, and limitations of OPAT use among hospital practitioners (HP), family physicians (FP), and private nurses (PN). OPAT (mainly ceftriaxone and penicillins) was used by 69.6%, 73.3%, and 97.7% of the 23 HPs, 45 FPs, and 46 PNs mostly for respiratory or urinary tract infections, bacteremia, and/or multidrug-resistant bacterial infections. Overall, 65.2% of HPs and 37.8% of FPs were in contact with an infectious disease specialist. Knowledge of OPAT benefits and risks was lower for FPs than HPs. The main obstacles were the patient's geographic isolation (HPs), the availability of a venous catheter, the lack of training (FPs), and the expected OPAT-associated overwork (PNs). OPAT practice is weak in rural areas. Declared obstacles constitute fields of improvement for its essential expansion. Copyright © 2017. Published by Elsevier SAS.

  14. Young-infant Sepsis Combined with Urinary Tract Infection Due to Hafnia alvei

    Directory of Open Access Journals (Sweden)

    Chia-Hung Liu

    2007-01-01

    Full Text Available Hafnia alvei infections are uncommon and occur mainly in adult patients featuring underlying illnesses. Its isolation in pediatric cases is even more unusual. We report a rare case of sepsis combined with urinary tract infection caused by H. alvei in a 39-day-old infant who did not appear to feature any underlying disease. The infant was successfully treated with ceftriaxone over a 14-day period. In this case, we want to remind clinicians that the possibility of an extraintestinal invasive infection such as bacteremia or urinary tract infection caused by H. alvei should be taken into account in young infants who feature no apparent underlying disease. [J Formos Med Assoc 2007;106(3 Suppl:S39-S43

  15. Antibacterial activity of various antibiotics against oral streptococci isolated in the oral cavity.

    Science.gov (United States)

    Pasquantonio, G; Condò, S; Cerroni, L; Bikiqu, L; Nicoletti, M; Prenna, M; Ripa, S

    2012-01-01

    A total of 550 oral streptococci: 270 Streptococcus mitis, 110 Streptococcus sanguis, 90 Streptococcus anginosus, 50 Streptococcus mutans, 30 Streptococcus salivarius, were isolated from dental plaque and gengival crevices of patients and tested for their susceptibility to 12 β-lactam antibiotics and to 5 non-β-lactam antibiotics, using the microdiluition method. Overall, a reduced susceptibility to penicillin was recorded in 13.4% of cases. The percentage of strains resistant to penicillin appeared significantly higher in S. mitis (24%) than in S. sanguis (19%), in S. mutans (14%) and in S. salivarius (10%). No levels of penicillin resistance were shown by 90 strains of S. anginosus. In susceptibility test to antibiotics, imipenem was the most active molecule tested, confirming its general good activity against oral streptococci. Also third generation cephalosporins such as ceftriaxone and fourth generation cephalosporins such as cefepime, showed good activity. Chinolones, glycopeptides and rifampicin confirmed a good activity against oral streptococci.

  16. Bacteremic meningitis caused by Parvimonas micra in an immunocompetent host.

    Science.gov (United States)

    Ko, Jae-Hoon; Baek, Jin Yang; Kang, Cheol-In; Lee, Woo Joo; Lee, Ji Yong; Cho, Sun Young; Ha, Young Eun; Kim, So Hyun; Chung, Doo Ryeon; Peck, Kyong Ran; Lee, Nam Yong; Song, Jae-Hoon

    2015-08-01

    A 61-year-old man with chronic hepatitis B and dyslipidemia visited the emergency department with a fever and severe headache. He was diagnosed with bacterial meningitis after a lumbar puncture, and blood culture revealed Parvimonas micra bacteremia. Although he had a history of extraction of a molar two weeks before symptom onset, there was no evidence of abscess formation on physical examination or imaging studies. He was successfully treated with oral metronidazole for 12 days after 9 days of treatment with IV ceftriaxone and vancomcycin. This is the first report of primary bacterial meningitis caused by this organism, which indicates that this organism is capable of being a bacterial meningitis pathogen. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. 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. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Skin ulcers caused by Serratia marcescens: three cases and a review of the literature.

    Science.gov (United States)

    Veraldi, Stefano; Nazzaro, Gianluca

    2016-08-01

    Serratia marcescens is a Gram-negative, encapsulated, motile, anaerobic, non-sporulating bacillus that belongs to the Enterobacteriaceae family. It is found in water, soil, plants, food, and garbage. S. marcescens is an opportunistic pathogen. It usually causes nosocomial infections, such as lung and genitourinary infections, sinusitis, otitis, endocarditis, and sepsis. Skin infections caused by S. marcescens are rare. To describe three new cases of skin ulcers of the leg caused by S. marcescens and review the relevant literature. We investigated three patients admitted for ulcers on the leg. In two patients, post-traumatic aetiology was concluded. The modality of infection was not identified for the other patient. One patient was diabetic. All patients recovered with specific antibiotic therapy (ciprofloxacin, ceftriaxone and levofloxacin, respectively). Skin ulcers due to S. marcescens are very rare. The three cases presented here add to the limited literature of skin infections caused by S. marcescens.

  19. [Acute appendicitis during pregnancy: report of 4 cases].

    Science.gov (United States)

    Bolívar-Rodríguez, Martín Adrián; Cazarez-Aguilar, Marcel Antonio; Fierro-López, Rodolfo; Romero-Aguilar, Rosa Estela; Lizárraga-González, Hernán; Morgan-Ortiz, Fred

    2014-05-01

    Acute appendicitis is the more frequent no obstetric surgical emergency during pregnancy with an incidence of 1 in 1500 pregnancies. The clinical diagnosis is difficult because of the physiological changes of pregnancy itself. If not treated early increases the risk of maternal and fetal morbidity. To describe the diagnosis and treatment of four cases of acute appendicitis during pregnancy. Four cases of acute appendicitis during pregnancy diagnosed in the period of a month. Gestational age at diagnosis of appendicitis was between 8 and 13 week. All patients underwent laparotomy; three cases were appendicitis phase II and one phase III. The preoperative was managed with indomethacin and ceftriaxone. There were no maternal or obstetric complications. An early diagnosis and treatment of acute appendicitis during pregnancy, and a multidisciplinary approach between surgeon, obstetrician and anesthesiologist is the basis for success in the management of these patients.

  20. [Study of phenotypical and antimicrobial susceptibility markers in enteric Escherichia coli strains].

    Science.gov (United States)

    Aguila, Adalberto; Bernedo, Robert; Llop, Alina; Ramírez, Margarita; Bravo, Laura; Fernández, Anabel; Ledo, Yudith

    2007-01-01

    Forty strains of Escherichia coli isolated from children under 5 years of age with acute diarreas, coming from different provinces of the country , were analyzed. Four important phenotypical determinants were tested: sorbosa, sorbitol, enterohemolysin and 0157:H7 serology, in order to select those strains from enterohemorrhagic or Shiga toxin-producing category. Likewise, they were characterized by biotyping and antimicrobial susceptibility methods. The use of phenotypical tests showed six strains with presumptive characteristics, four of which were most likely to be Shiga toxin-producing strains. In antimicrobial susceptibility test, the strains showed high resistance mainly to ampicillin and trimethrophin-sulfamethoxasole. Another interesting finding were intermediate resistance and susceptibility values to augmentin, aztreonan and ceftriaxone. There were 12 antimicrobial resistance patterns of which 10 were multi-resistant.

  1. [Facial diplegia as the presenting feature of Lyme disease].

    Science.gov (United States)

    Lesourd, A; Ngo, S; Sauvêtre, G; Héron, F; Levesque, H; Marie, I

    2015-05-01

    Diagnosis of neuroborreliosis may be difficult. Neuroborreliosis mainly results in lymphocytic meningitis and in meningoradiculitis (67-83% of cases). We report the case of a patient who developed a sudden facial diplegia, revealing neuroborreliosis proved by positive blood and cerebrospinal fluid serology. The patient had no previous history of tick bite and migrans erythema. The patient was given ceftriaxone therapy (2 g/day for 21 days), leading to resolution of all clinical symptoms. Our report underscores that neuroborreliosis should be considered in patients exhibiting facial diplegia. Thus, Lyme serology should be performed systematically in these patients. Altogether, early management is crucial, before the onset of neurological manifestations at late stage, leading to disabling sequelae despite antibiotic therapy. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. The use of cephalosporins for gonorrhea: an update on the rising problem of resistance

    Science.gov (United States)

    Stoltey, Juliet E; Barry, Pennan M

    2014-01-01

    Introduction Over the last several years, Neisseria gonorrhoeae has developed decreased susceptibility to extended-spectrum cephalosporins worldwide. Areas covered Gonococcal antimicrobial surveillance programs in multiple regions have documented the rise in N. gonorrhoeae isolates’ minimum inhibitory concentrations to cephalosporins, and the first cases of ceftriaxone treatment failures have been reported. These developments have prompted the use of the term “superbug,” and concerns about the emergence of untreatable gonococcal infections. In response to this threat, a variety of treatment strategies have been proposed, including increasing the dose or providing multiple doses of cephalosporins, multidrug therapy, rotating therapeutic regimens, and individualized treatment based on susceptibility testing. Expert opinion A robust public health response is needed, and includes better diagnosis and treatment of pharyngeal gonorrhea, improved surveillance of antimicrobial resistance, informed treatment approaches, and reduction of the global burden of gonococcal infections. PMID:22646654

  3. Synthesis and biological evaluation of the progenitor of a new class of cephalosporin analogues, with a particular focus on structure-based computational analysis.

    Science.gov (United States)

    Verdino, Anna; Vigliotta, Giovanni; Giordano, Deborah; Caputo, Ivana; Soriente, Annunziata; De Rosa, Margherita; Marabotti, Anna

    2017-01-01

    We present the synthesis and biological evaluation of the prototype of a new class of cephalosporins, containing an additional isolated beta lactam ring with two phenyl substituents. This new compound is effective against Gram positive microorganisms, with a potency similar to that of ceftriaxone, a cephalosporin widely used in clinics and taken as a reference, and with no cytotoxicity against two different human cell lines, even at a concentration much higher than the minimal inhibitory concentration tested. Additionally, a deep computational analysis has been conducted with the aim of understanding the contribution of its moieties to the binding energy towards several penicillin-binding proteins from both Gram positive and Gram negative bacteria. All these results will help us developing derivatives of this compound with improved chemical and biological properties, such as a broader spectrum of action and/or an increased affinity towards their molecular targets.

  4. Substitutions in PBP3 confer resistance to both ampicillin and extended-spectrum cephalosporins in Haemophilus parainfluenzae as revealed by site-directed mutagenesis and gene recombinants

    DEFF Research Database (Denmark)

    Wienholtz, Nanna H; Ciechanowski, Aynur Barut; Nørskov-Lauritsen, Niels

    2017-01-01

    I from clinical strains encoding four substitutions in the transpeptidase region of PBP3 conferred resistance to ampicillin, but not to cephalosporins. Introduction of ftsI from a clinical strain encoding eight substitutions conferred resistance to ampicillin, cefotaxime and ceftriaxone. MICs....../H/S in combination with V511A were resistant to ampicillin. Substitution S385T increased the MICs of third-generation cephalosporins if V511A was also present. Conclusions: Substitutions in PBP3 are sufficient to confer resistance to both ampicillin and third-generation cephalosporins in H. parainfluenzae...... . A combination of substitutions at positions Val-511 and Asn-526 confers resistance to ampicillin. Resistance to third-generation cephalosporins probably requires more than four substitutions in PBP3....

  5. Atrio-ventricular block as the first presentation of disseminated Lyme disease.

    Science.gov (United States)

    Panic, Gordana; Stanulovic, Vid; Popov, Tanja

    2011-08-04

    A 36 year old male patient presented to emergency cardiology department because of fatigability. ECG revealed high grade II atrio-ventricular block and bradycardia of 31 beats/min. An erythema increasing in size to up to 7-8 cm in diameter appeared a month earlier and spontaneously resolved within 10 days. ELISA testing for antibodies against Borrelia burgdorferi IgM was positive and IgG titer was 1:40. Intravenous ceftriaxone 2g qod, and 0.5 g metronidazole tid lead to regression of grade II block to grade I block within 2 days. Grade I block persisted for an additional 10 days. This is a relatively rare case of early occurrence of Lyme carditis within one month of exposure as the first sign of Lyme disease dissemination. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Nephritis and cerebellar ataxia: rare presenting features of enteric fever.

    Directory of Open Access Journals (Sweden)

    Parmar R

    2000-07-01

    Full Text Available Enteric fever is a common infectious disease of the tropical world, about 80% of these cases occur in Asian countries. Enteric fever presenting with isolated cerebellar ataxia or nephritis is rare. We report three cases of enteric fever that presented with these complications. Isolated cerebellar ataxia usually occurs in the second week, whereas in our cases it presented within first four days of fever. The common complications of enteric fever related to the urinary tract are cystitis, pyelitis, and pyelonephritis. Glomerulonephritis is uncommon. Most patients with enteric glomerulonephritis present with acute renal failure, hypertensive encephalopathy, or nephritic syndrome. In comparison, our case had milder manifestations. All three patients were treated with parenteral ceftriaxone and showed a prompt recovery.

  7. 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.

  8. Mixed-Ligand Nickel(II Complexes Containing Sulfathiazole and Cephalosporin Antibiotics: Synthesis, Characterization, and Antibacterial Activity

    Directory of Open Access Journals (Sweden)

    J. R. Anacona

    2012-01-01

    (L1,4, x=1; L2,3, x=0; L = monoanion of cefazolin HL1, cephalothin HL2, cefotaxime HL3, ceftriaxone HL4 and [Ni(L5(stz]Cl (cefepime L5, which were characterized by physicochemical and spectroscopic methods. Their spectra indicated that cephalosporins are acting as multidentate chelating agents, via the lactam carbonyl and carboxylate and N-azomoieties. The complexes are insoluble in water and common organic solvents but soluble in DMSO, where the [Ni(L5(stz]Cl complex is 1 : 1 electrolyte. They probably have polymeric structures. They have been screened for antibacterial activity, and the results are compared with the activity of commercial cephalosporins.

  9. Novel fluorene-based supramolecular sensor for selective detection of amoxicillin in water and blood.

    Science.gov (United States)

    Shah, Kiramat; Hassan, Erum; Ahmed, Farid; Anis, Itrat; Rabnawaz, Muhammad; Shah, Muhammad Raza

    2017-07-01

    Synthesis, characterization and molecular recognition properties of fluorene based supramolecular cleft 1 is reported. The cleft molecule 1 was prepared in a single-step with good yield (85% yield), by linking Fluorene with 1-ethyl piperazine. The cleft molecule 1 was carefully characterized using various spectroscopic techniques such as NMR and mass spectrometry. The supramolecular interaction of cleft 1 with amoxicillin, 6APA, aspirin, captopril, cefotaxime, ceftriaxone, cefuroxime, diclofenac, penicillin, and cephradine was evaluated by fluorescent spectroscopy. The molecular recognition studies showed that amoxicillin selectively binds with cleft 1 in the presence of other drugs. The analytical method developed for the supramolecular interaction of molecular cleft 1 and amoxicillin was validated at varying pH, concentration and temperature during recognition process. Job's plots indicated that the stochiometry of the interactions between the cleft 1 and the amoxicillin was 1:1. Copyright © 2017. Published by Elsevier Inc.

  10. [Streptococcal Toxic Shock-like Syndrome due to Streptococcus suis Serotype 2 in a Japanese Pig Farmer].

    Science.gov (United States)

    Yamanaka, Atsushi; Shirahama, Tomohiro; Nishimura, Naoya; Ueda, Naoyasu; Himeji, Daisuke; Kawaguchi, Takeshi; Ueda, Akira

    2015-11-01

    Streptococcus suis is a major swine pathogen. It has recently been recognized as an emerging zoonosis that causes mainly meningitis and sepsis in human. In particular, toxic shock-like syndrome (TSLS) caused by this pathogen has a high mortality rate. However, misidentification of S. suis by conventional biochemical and commercial identification tests is not rare. The patient was a 71-year-old man who worked as a pig farmer who was admitted for fever, oliguria and subcutaneous hemorrhage. He was diagnosed as having septic shock and blood culture was positive for Gram-positive cocci, mainly diplococcus. This pathogen was identified with S. suis with using MALDI-TOF MS analysis, though a commercial Gram-Positive bacteria identification kit revealed viridans streptococci. His clinical features met the diagnostic criteria of TSLS, and ceftriaxone and clindamycin were administered. On admission day 28, he was discharged in good condition.

  11. Antibacterial activity of some medicinal plants against selected human pathogenic bacteria.

    Science.gov (United States)

    Khan, Usman Ali; Rahman, Hazir; Niaz, Zeeshan; Qasim, Muhammad; Khan, Jafar; Tayyaba; Rehman, Bushra

    2013-12-01

    Medicinal plants are traditionally used for the treatment of human infections. The present study was undertaken to investigate Bergenia ciliata, Jasminum officinale, and Santalum album for their potential activity against human bacterial pathogens. B. ciliata, J. officinale, and S. album extracts were prepared in cold and hot water. The activity of plant extracts and selected antibiotics was evaluated against five bacterial pathogens including Staphylococcus aureus, Bacillus subtilis, Proteus vulgaris, Pseudomonas aeruginosa, and Escherichia coli using agar well diffusion method. Among the three medicinal plants, B. ciliata extracts displayed potential activity against bacterial pathogens. Cold water extract of Bergenia ciliate showed the highest activity against B. subtilis, which is comparable with a zone of inhibition exhibited by ceftriaxone and erythromycin. J. officinale and S. album extracts demonstrated variable antibacterial activity. Further studies are needed to explore the novel antibacterial bioactive molecules.

  12. 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).

  13. Antimicrobial Disk Susceptibility Testing of Leptospira spp. Using Leptospira Vanaporn Wuthiekanun (LVW) Agar.

    Science.gov (United States)

    Wuthiekanun, Vanaporn; Amornchai, Premjit; Langla, Sayan; White, Nicholas J; Day, Nicholas P J; Limmathurotsakul, Direk; Peacock, Sharon J

    2015-08-01

    Leptospira Vanaporn Wuthiekanun (LVW) agar was used to develop a disk diffusion assay for Leptospira spp. Ten pathogenic Leptospira isolates were tested, all of which were susceptible to 17 antimicrobial agents (amoxicillin/clavulanic acid, amoxicillin, azithromycin, cefoxitin, ceftazidime, ceftriaxone, chloramphenicol, ciprofloxacin, clindamycin, doripenem, doxycycline, gentamicin, linezolid, nitrofurantoin, penicillin, piperacillin/tazobactam, and tetracycline). All 10 isolates had no zone of growth inhibition for four antimicrobials (fosfomycin, nalidixic acid, rifampicin, and trimethoprim/sulfamethoxazole). Of the ten Leptospira, seven had a growth inhibition zone of ≤ 21 mm for aztreonam, the zone diameter susceptibility break point for Enterobacteriaceae. This assay could find utility as a simple screening method during the epidemiological surveillance of antimicrobial resistance in Leptospira spp. © The American Society of Tropical Medicine and Hygiene.

  14. 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.

  15. Helicobacter bilis-Associated Suppurative Cholangitis in a Patient with X-Linked Agammaglobulinemia.

    Science.gov (United States)

    Degand, Nicolas; Dautremer, Justine; Pilmis, Benoît; Ferroni, Agnès; Lanternier, Fanny; Bruneau, Julie; Hermine, Olivier; Blanche, Stéphane; Nassif, Xavier; Lortholary, Olivier; Lecuit, Marc

    2017-10-01

    ᅟ: Helicobacter bilis is a commensal bacterium causing chronic hepatitis and colitis in mice. In humans, enterohepatic Helicobacter spp. are associated with chronic hepatobiliary diseases. We aimed at understanding the microbial etiology in a patient with X-linked agammaglobulinemia presenting with suppurative cholangitis. 16S rDNA PCR directly performed on a liver biopsy retrieved DNA of H. bilis. Clinical outcome resulted in the normalization of clinical and biological parameters under antibiotic treatment by a combination of ceftriaxone, metronidazole, and doxycyclin followed by a 2-week treatment with moxifloxacin and a 2-month treatment with azithromycin. In conclusion, these data suggest a specific clinical and microbiological approach in patients with humoral deficiency in order to detect H. bilis hepatobiliary diseases.

  16. Neurosyphilis manifesting with unilateral visual loss and hyponatremia: a case report

    Directory of Open Access Journals (Sweden)

    Discher Thomas

    2011-01-01

    Full Text Available Abstract Background Syphilis is called the chameleon of the diseases due to its variety of its clinical presentations, potentially affecting every organ of the body. Incidence of this ancient disease is once again on the increase worldwide. Case presentation We here report an unusual case of neurosyphilis manifesting with unilateral visual loss and hyponatremia. The patient also had primary syphilitic lesions and was concomitantly diagnosed with Human Immunodeficiency Virus (HIV, Hepatitis B Virus (HBV and Hepatitis C Virus (HCV infection. Treatment with ceftriaxone and prednisolone, completely resolved the hyponatremia and visual acuity was partially restored. Conclusion Awareness of syphilis as a differential diagnosis is important as previously unreported presentations of neurosyphilis can arise, especially in HIV infected patients.

  17. 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.

  18. Acute Appendicitis Complicating into Portal and Superior Mesenteric Vein Thrombosis.

    Science.gov (United States)

    Yousaf, Adnan; Ahmed, Mushtaq; Aurangzeb, Mahmud

    2016-06-01

    This case report describes a young man who presented with 9-day history of sudden-onset epigastric and right-sided lower abdominal pain. He was tachycardiac with temperature of 102°F. Tenderness was present in the peri-umbilical area and right iliac fossa. Investigations revealed a raised total leucocyte count (predominantly neutrophilic). Triphasic CTscan abdomen found thrombosis of right portal vein and its hepatic tributaries alongwith superior mesenteric vein (SMV) and its tributaries. Co-existent fluid in right hemipelvis abutting the cecum and appendiceal tip was suggestive of acute appendicitis. He was resuscitated with fluids and analgesics and started on intravenous metronidazole and ceftriaxone. Anticoagulation with subcutaneous heparin was commenced and eventually switched over to warfarin. Appendicectomy was not performed as the patient responded to conservative treatment. Appendicitis is associated with multiple complications but secondary venous thrombosis has rarely been reported with it.

  19. Treatment of a subdural empyema complicated by intracerebral abscess due to Brucella infection

    Directory of Open Access Journals (Sweden)

    J. Zhang

    Full Text Available A 55-year-old male presented with fever, stupor, aphasia, and left hemiparesis. A history of head trauma 3 months before was also reported. Cranial magnetic resonance imaging revealed slight contrast enhancement of lesions under the right frontal skull plate and right frontal lobe. Because of deterioration in nutritional status and intracranial hypertension, the patient was prepared for burr hole surgery. A subdural empyema (SDE recurred after simple drainage. After detection of Brucella species in SDE, craniotomy combined with antibiotic treatment was undertaken. The patient received antibiotic therapy for 6 months (two doses of 2 g ceftriaxone, two doses of 100 mg doxycycline, and 700 mg rifapentine for 6 months that resulted in complete cure of the infection. Thus, it was speculated that the preexisting subdural hematoma was formed after head trauma, which was followed by a hematogenous infection caused by Brucella species.

  20. 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. © The American Society of Tropical Medicine and Hygiene.

  1. 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.

  2. 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

    2016-06-07

    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. 2016 BMJ Publishing Group Ltd.

  3. Nosocomial diarrhea in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Paula Marcon

    Full Text Available We made an epidemiological case-control study to examine risk factors for the development of diarrhea in the intensive care unit (ICU of a public hospital in Santo André, SP, from January to October 2002. Forty-nine patients with diarrhea (cases and 49 patients without diarrhea (controls, matched for age and gender, were included in the study. A stool culture and enzyme immunoassays for Clostridium difficile toxins A and B were performed on fecal specimens from diarrhea patients. Fourteen of them presented positive cultures for Pseudomonas aeruginosa and 22 patients presented positive ELISA for Clostridium diffícile. Nosocomial diarrhea was associated with several factors, including use of antibiotics (P=0.001, use of ceftriaxone (P=0.001, presence of infection (P=0.010 and length of hospital stay (P=0.0001.

  4. Current trend of drug sensitivity in bovine mastitis

    Directory of Open Access Journals (Sweden)

    Rajeev Ranjan

    2010-02-01

    Full Text Available The study was conducted on 190 milk samples of bovine mastitis and 138 samples were confirmed positives for microorganisms. All the 138 samples were subjected to drug sensitivity test. The most effective antibiotic was enrofloxacin (91.67% followed by ciprofloxacin (90.15%, amikacin (87.12%, ceftriaxone (84.10%, chloramphenicol (80.31%, cefotaxime (79.55% and gentamicin (77.27%. Microorganisms were mostly resistant to drugs like streptomycin, penicillinG, ampicillin, cloxacillin, amoxycillin and neomycin in increasing order of resistance. Hence, it is suggested that the line of treatment should be based on antibiogram study of various isolates from bovine mastitis. Further, the selection of drugs after culture and sensitivity test should be based on their ability to cross blood tissue barrier or mammary parenchyma, lipophilicity and ability to work in alkaline pH. [Vet. World 2010; 3(1.000: 17-20

  5. 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.

  6. 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.

  7. Molecular and Clinical Epidemiology of Salmonella Paratyphi A Isolated from Patients with Bacteremia in Nepal.

    Science.gov (United States)

    Sherchan, Jatan Bahadur; Morita, Masatomo; Matono, Takashi; Izumiya, Hidemasa; Ohnishi, Makoto; Sherchand, Jeevan B; Tandukar, Sarmila; Laghu, Ujjwal; Nagamatsu, Maki; Kato, Yasuyuki; Ohmagari, Norio; Hayakawa, Kayoko

    2017-12-01

    Little is known about the epidemiology of typhoid and paratyphoid fever in Nepal. We aimed to elucidate the molecular and clinical epidemiology of Salmonella Paratyphi A in Nepal. Isolates were collected from 23 cases of bacteremia due to S. Paratyphi A between December 2014 and October 2015. Thirteen patients (57%) were male, and the median age was 21 years. None of the patients had an underlying chronic disease. All S. Paratyphi A isolates were sensitive to ampicillin, trimethoprim/sulfamethoxazole, ceftriaxone, and chloramphenicol. All isolates were resistant to nalidixic acid and were categorized as intermediately susceptible to levofloxacin. Phylogenetic analysis revealed close relatedness among the isolates, including several clonal groups, suggesting local spread. Patients with bacteremia due to S. Paratyphi A in Kathmandu, Nepal, were relatively young and nondebilitated. Improving control of S . Paratyphi infections should focus on effective infection control measures and selection of empirical therapy based on current resistance patterns.

  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%). © 2013 John Wiley & Sons Ltd.

  9. 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...

  10. Culture Negative Listeria monocytogenes Meningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy

    DEFF Research Database (Denmark)

    Gaini, Shahin; Karlsen, Gunn Hege; Nandy, Anirban

    2015-01-01

    A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy...... the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically for Listeria monocytogenes in all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection...... for bacteria, no bacterial growth, and negative polymerase chain reaction for bacterial DNA. The patient developed hydrocephalus on a second CT scan of the brain on the 5th day of admission. An external ventricular catheter was inserted and Listeria monocytogenes grew in the cerebrospinal fluid from...

  11. 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...

  12. Nocardia abscessus-Associated Subcutaneous Infection in a Patient with Non-Hodgkin’s Lymphoma

    Directory of Open Access Journals (Sweden)

    Ahmet Karakas

    2016-09-01

    Full Text Available This paper describes primary subcutaneous infection caused by N. abscessus in a 60-year-old male patient with the history of non-Hodgkin’s lymphoma and chronic lymphocytic leukemia. The patient was presented with pain and swelling in his left thigh for 45 days. Soft tissue ultrasonography showed a heterogeneous and hypoechoic mass consistent with an abscess. Gram-positive and branched filamentous bacilli, along with neutrophils, were identified in gram-stained smears of the pus. Pus culture was positive for Gram-positive bacilli, which identified as N. abscessus. Initially, the patient was treated with trimethoprim-sulfamethoxazole. Due to insufficient clinical response, ceftriaxone was added for two weeks. Then, the patient was prescribed a 3-month course of trimethoprim-sulfamethoxazole. It is important to start appropriate and effective treatment as soon as possible in patients with immunosuppression. [Dis Mol Med 2016; 4(3.000: 31-33

  13. 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.

  14. 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.

  15. Eyes can See What Mind Can’t see

    International Nuclear Information System (INIS)

    Irfan, Ahsan; Zulfiqar, Arif; Ali, Ghani

    2016-01-01

    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

  16. [Streptococcus suis meningitis in a meat factory employee].

    Science.gov (United States)

    de Ceuster, Laura M E; van Dillen, Jeroen J; Wever, Peter C; Rozemeijer, Wouter; Louwerse, Elisabeth S

    2012-01-01

    In the Netherlands, Streptococcus suis is a rare cause of meningitis. Over the past few years, the number of reported cases worldwide has increased. The bacterium is mainly isolated in pigs, but humans can also become infected. At the Emergency Department, a 60-year-old man presented with headache, confusion, fever and nuchal rigidity. He worked at a meat factory. Laboratory testing showed abnormalities linked to bacterial meningitis. S. suis was cultured from blood and cerebrospinal fluid. The patient was treated with dexamethasone, ceftriaxone and later benzylpenicillin intravenously. He recovered well, but had bilateral perceptive hearing loss as a sequela. Particularly people who are in close contact with pigs have an increased risk of S. suis infection. S. suis meningitis can be very severe and lead to serious complications and even death. Rapid diagnosis and adequate treatment are critical. Permanent hearing loss is the most frequent sequela.

  17. A comparison of different antibiotic regimens for the treatment of infective endocarditis.

    Science.gov (United States)

    Martí-Carvajal, Arturo J; Dayer, Mark; Conterno, Lucieni O; Gonzalez Garay, Alejandro G; Martí-Amarista, Cristina Elena; Simancas-Racines, Daniel

    2016-04-19

    alone reporting uncertain effects on all-cause mortality (8/31 (26%) with levofloxacin plus standard treatment versus 9/39 (23%) with standard treatment alone; RR 1.12, 95% CI 0.49 to 2.56, very low quality evidence). The second trial compared daptomycin versus low-dose gentamicin plus an anti-staphylococcal penicillin (nafcillin, oxacillin or flucloxacillin) or vancomycin. This showed uncertain effects in terms of cure rates (9/28 (32.1%) with daptomycin versus 9/25 (36%) with low-dose gentamicin plus anti-staphylococcal penicillin or vancomycin, RR 0.89 95% CI 0.42 to 1.89; very low quality evidence). The third trial compared cloxacillin plus gentamicin with a glycopeptide (vancomycin or teicoplanin) plus gentamicin. In participants receiving gentamycin plus glycopeptide only 13/23 (56%) were cured versus 11/11 (100%) receiving cloxacillin plus gentamicin (RR 0.59, 95% CI 0.40 to 0.85; very low quality evidence). The fourth trial compared ceftriaxone plus gentamicin versus ceftriaxone alone and found no conclusive differences in terms of cure (15/34 (44%) with ceftriaxone plus gentamicin versus 21/33 (64%) with ceftriaxone alone, RR 0.69, 95% CI 0.44 to 1.10; very low quality evidence).The trials reported adverse events, need for cardiac surgical interventions, uncontrolled infection and relapse of endocarditis and found no conclusive differences between comparison groups (very low quality evidence). No trials assessed septic emboli or quality of life. Limited and very low quality evidence suggested that there were no conclusive differences between antibiotic regimens in terms of cure rates or other relevant clinical outcomes. However, because of the very low quality evidence, this needs confirmation. The conclusion of this Cochrane review was based on randomised controlled trials with high risk of bias. Accordingly, current evidence does not support or reject any regimen of antibiotic therapy for treatment of infective endocarditis.

  18. Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient

    Directory of Open Access Journals (Sweden)

    Maiana Darwich Mendes

    Full Text Available Abstract Objective: To report a case septic arthritis with a rare pathogen in a immunosuppressed child. Case description: Male patient, 6 years old, had liver transplant five and half years ago due to biliary atresia. Patient was using tacrolimus 1mg q.12h. This patient started to have pain in left foot and ankle and had one episode of fever 3 days before hospital admission. Physical examination showed weight 17kg, height 109cm, temperature 36.4°C, with pain, swelling and heat in the left ankle, without other clinical signs. Initial tests: hemoglobin 11.7g/dL hematocrit 36.4%, leukocyte count 17,600µL-1 (7% banded neutrophils, 70% segmented neutrophils, 2% eosinophils, basophils 1%, 13% lymphocytes, 7% monocytes C-reactive protein 170.88mg/L. Joint ultrasound showed moderate effusion in the site. Patient was submitted to surgical procedure and Sphingobacterium multivorum was isolated from the effusion. The germ was susceptible to broad spectrum cephalosporins (ceftriaxone and cefepime and fluoroquinolones (ciprofloxacin and levofloxacin, and it was resistant to carbapenemic antibiotics and aminoglycosides. He was treated intravenously with oxacillin for 15 days and ceftriaxone for 13 days, and orally with ciprofloxacin for 15 days, with good outcome. Comments: The S. multivorum is a gram negative bacillus that belongs to Flavobacteriaceae family and it is considered non-pathogenic. It has rarely been described as a cause of infections in humans, especially in hospital environment and in immunosuppressed patients. This case report is relevant for its unusual etiology and for the site affected, which may be the first case of septic arthritis described.

  19. 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

    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.

  20. 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.