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Sample records for ceftriaxone

  1. Ceftriaxone-induced toxic hepatitis

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    Erdal Peker; Eren Cagan; Murat Dogan

    2009-01-01

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

  2. Acute urine retention induced by ceftriaxone

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    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.

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

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    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.)

  4. Preclinical rodent toxicity studies for long term use of ceftriaxone

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    Elena Ratti

    2015-01-01

    Ceftriaxone showed rapid absorption with half-life values ranging between 1 and 1.5 h. Additionally, there was no evidence of accumulation and a virtually complete elimination by 16 h after the last dose. Overall there were no toxicologically meaningful drug-related animal findings associated with the long-term administration (6 months of ceftriaxone. These results support safety of long-term use of ceftriaxone in human clinical trials.

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

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

    1991-01-01

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

  6. 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?

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

    2012-07-01

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

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

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    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.

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

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    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.

  9. Report: Sensitivity pattern of ceftriaxone against different clinical isolates.

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    Bushra, Rabia; Sial, Ali Akbar; Rizvi, Mehwish; Shafiq, Yousra; Aslam, Nousheen; Bano, Nusrat

    2016-01-01

    Emerging resistance against broad-spectrum antibiotics for standard empiric therapy is a global concern. Ceftriaxone (broad spectrum, third generation cephalosporin) is widely used in tertiary care settings to treat severe bacterial infections usually non-responsive to other antibiotics. The aim of the study is to evaluate the current sensitivity pattern of ceftriaxone (30μg/disk) among different clinical isolates. For this purpose, three hundred clinical isolates including Escherichia coli (25%), Staphylococcus aureus (30%), Salmonella typhi (17%) and Klebsiella pneumoniae(20%) were collected from different pathological laboratories of Karachi, Pakistan. The in-vitro sensitivity of different Gram positive and Gram-negative bacteria was determined by disk-diffusion technique using 0.5 McFarland standard. Results showed that ceftriaxone was highly sensitive against Escherichia coli (90%) and least sensitive against Klebsiella pneumoniae (65%). It is concluded that the sensitivity of ceftriaxone is progressively decreasing in comparison with past studies creating an alarming situation. Therefore, continuous surveillance is required to determine the current resistance status of clinical pathogens and for effective anti-microbial therapy.

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

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

    2007-05-11

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

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

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    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.

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

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    Obaid, Ali

    2009-04-01

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

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

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    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.

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

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

    2013-01-01

    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 accompan

  15. Influence of subinhibitory concentrations of ceftriaxone on opsonization and killing of Pseudomonas aeruginosa by human neutrophils.

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    Labro, M T; Babin-Chevaye, C; Hakim, J

    1988-09-01

    Ceftriaxone, a 2-aminothiazolyl cephalosporin does not alter human neutrophil (PMN) bactericidal function. However, low concentrations of ceftriaxone induce some bacterial strains to be more sensitive to PMN killing. We have studied the effect of a subinhibitory concentration of ceftriaxone (10 mg/l) on Pseudomonas aeruginosa (MIC greater than 128 mg/l). After an overnight exposure to this concentration of ceftriaxone, P. aeruginosa elongated into filaments. PMN killing of ceftriaxone-treated bacteria was better than killing of control bacteria. This enhanced killing was correlated with an increased sensitivity to oxygen-dependent bacterial killing. Furthermore, the altered bacteria induced a greater oxidative response of PMN which was independent of their chemiluminescence response after stimulation by control P. aeruginosa. This increased oxidative burst was attributable to both non-opsonodependent stimulation and to increased deposit of opsonins.

  16. Ampicillin in Combination with Ceftaroline, Cefepime, or Ceftriaxone Demonstrates Equivalent Activities in a High-Inoculum Enterococcus faecalis Infection Model.

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    Luther, Megan K; Rice, Louis B; LaPlante, Kerry L

    2016-05-01

    Ampicillin-ceftriaxone combination therapy has become a predominant treatment for serious Enterococcus faecalis infections, such as endocarditis. Unfortunately, ceftriaxone use is associated with future vancomycin-resistant enterococcus colonization. We evaluated E. faecalis in an in vitro pharmacodynamic model against simulated human concentration-time profiles of ampicillin plus ceftaroline, cefepime, ceftriaxone, or gentamicin. Ampicillin-cefepime and ampicillin-ceftaroline demonstrated activities similar to those of ampicillin-ceftriaxone against E. faecalis.

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

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    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.

  18. Toxic epidermal necrolysis secondary to ceftriaxone use: A case report

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    Mustafa İçer

    2015-12-01

    Full Text Available Toxic epidermal necrolysis (TEN is a rare, life-threatening condition that is usually associated with medication use and characterized by separation of epidermis and dermis and a scalded skin appearance. A 71-year-old man presented to emergency department with fever, malaise, and hyperemic skin eruptions and bullae. Skin lesions covered more than 70% of total body surface area. Nikolsky sign was positive. He had been begun ceftriaxone for pneumonia before. TEN was considered as the initial diagnosis; the medication he used was stopped, appropriate supportive treatment was begun, and the patient was admitted to intensive care unit. He was discharged on 8th day after skin epithelization occurred. Toxic epidermal necrolysis is a highly fatal syndrome, in which early diagnosis, stopping the offensive drug, and administering appropriate supportive treatment are important components of the management.

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

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    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.

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

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    Basavaraj

    2014-12-01

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

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

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    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)....

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

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

    2012-02-16

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

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

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    Swapan K Nath

    1995-01-01

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

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

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

    1986-05-01

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

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

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

    2013-01-01

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

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

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    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.

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

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    Anurag Payasi

    2011-06-01

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

  8. Ceftriaxone attenuates acute cocaine‐evoked dopaminergic neurotransmission in the nucleus accumbens of the rat

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

    2015-01-01

    Background and Purpose 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. Experimental Approach 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. Key Results 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. Conclusions and Implications 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. PMID:26375494

  9. 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.

  10. 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.

  11. [Clinical and pharmacokinetic evaluation of ceftriaxone in children].

    Science.gov (United States)

    Fujita, K; Sakata, H; Murono, K; Yoshioka, H; Maruyama, S; Sanae, N

    1984-12-01

    Twenty-eight pediatric patients were treated with ceftriaxone (Ro 13-9904, CTRX) in the doses ranging from 8.75 to 25 mg/kg every 12 hours for 3.5 to 11.5 days, and the clinical efficacy and side effects were evaluated. Among the 21 children with bacterial infections including pneumonia, acute bronchitis, otitis media, tonsillitis and urinary tract infections, the results were excellent in 9, good in 11, and fair in 1 patient. Out of the 28 patients, 2 patients had diarrhea, 3 patients had slightly elevated serum concentrations of transaminases, and 2 patients showed eosinophilia. The serum concentrations of CTRX in 5 children ranged from 50.0 to 93.8 micrograms/ml (mean 75.0 micrograms/ml) at 15 minutes and from 10.2 to 15.6 micrograms/ml (mean 13.4 micrograms/ml at 6 hours after 10 mg/kg intravenous bolus injection of CTRX. The serum half-lives were from 2.61 to 8.30 hours (mean 6.16 hours), and urinary recovery rates were from 43.3 to 58.0% (mean 48.5%) during 0-6 hours and from 52.0 to 66.1% (mean 59.4%) during 0-12 hours. After 20 mg/kg intravenous bolus injection of CTRX in 4 children, the serum concentrations of CTRX were from 118.8 to 162.5 micrograms/ml (mean 139.1 micrograms/ml) at 15 minutes and from 18.0 to 21.1 micrograms/ml (mean 19.2 micrograms/ml) at 6 hours. The serum half-lives were 4.07 to 6.34 hours (mean 5.13 hours), and urinary recovery rates were 38.6 to 51.1% (mean 45.4%) during 0-6 hours and from 54.8 to 64.0% (mean 59.0%) during 0-12 hours. Patients with impairment of renal function were excluded from this pharmacokinetic study.

  12. [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 (faecalis.

  13. 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

    OpenAIRE

    Desbiolles, Norbert; Piroth, Lionel; Lequeu, Catherine; Neuwirth, Catherine; Portier, Henri; Chavanet, Pascal

    2001-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Swati V. Patil

    2016-10-01

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

  15. Synergistic protective role of ceftriaxone and ascorbic acid against subacute diazinon-induced nephrotoxicity in rats.

    Science.gov (United States)

    Abdel-Daim, Mohamed M

    2016-03-01

    Diazinon (DZN) is a synthetic organophosphrus 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-vitamin C against DZN-induced renal injury in male Wistar albino rats. DZN-treated animals revealed significant elevation in serum biochemical parameters related to renal injury: urea, uric acid and creatinine. DZN intoxication significantly increased renal lipid peroxidation, and significant inhibition in antioxidant biomarkers including, reduced glutathione, glutathione peroxidase, superoxide dismutase, catalase and total antioxidant capacity. In addition, DZN significantly reduced serum acetylcholinestrase level. Moreover, It induced serum and kidney tumor necrosis factor-α level. Both ceftriaxone and vitamin C protect against DZN-induced serum as well as renal tissue biochemical parameters when used alone or in combination along with DZN-intoxication. Furthermore, both ceftriaxone and vitamin C produced synergetic nephroprotective and antioxidant effects. Therefore, it could be concluded that ceftriaxone and/or vitamin C administration are able to minimize the toxic effects of DZN by its free radical-scavenging and potent antioxidant activity.

  16. 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.

  17. 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

    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/piva...

  18. Ceftriaxone (single dose) versus cefoxitin (multiple doses): success and failure of antibiotic prophylaxis in 1052 cesarean sections.

    Science.gov (United States)

    von Mandach, U; Huch, R; Malinverni, R; Huch, A

    1993-01-01

    The efficacy of perioperative antibiotic prophylaxis in cesarean section with a single dose of ceftriaxone, a long-acting cephalosporin not widely used for prophylaxis, was tested. Ceftriaxone as a single dose of 1 g i.v. versus three doses of cefoxitin 1 g i.v. respectively were used in a prospective, randomized, controlled study consisting of 1052 patients undergoing cesarean section. Postoperative infection rate as measured by fever, endometritis and wound infection was 6.5% with ceftriaxone and 6.4% with cefoxitin. Urinary tract infections were significantly more frequent in the cefoxitin than in the ceftriaxone group (17.8% vs. 9.7%, p < 0.001). Enterococci and Escherichia coli accounted for urinary tract infections 1.86-, respectively, 4.3-fold more frequently with cefoxitin than with ceftriaxone. The time of hospitalization in patients with urinary tract infections was significantly lower with ceftriaxone than with cefoxitin (11 vs. 12 days, p < 0.05). The tolerance in both groups was equally satisfactory. A single dose of ceftriaxone, which is simple, reliable (compliance), well tolerated, inexpensive (fewer urinary tract infections and therefore fewer treatment costs than with cefoxitin) and safe (no overgrowth of pathogens) in our opinion is the antibiotic regimen of choice for prophylaxis in cesarean section in the described circumstances.

  19. 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

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Billig Allan

    2009-12-01

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

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

    Science.gov (United States)

    Piscopo, Tonio; Cassar, Karen

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

  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-vancomycin drug toxicity reduction by VRP 1020 in Mus musculus mice.

    Science.gov (United States)

    Soni, Arvind; Chaudhary, Manu; Dwivedi, Vivek Kumar

    2009-05-01

    Drug toxicity is a common cause of liver injury and kidney failure. This study was designed to elucidate whether administration of high doses of Ceftriaxone or Vancomycin induce oxidative stress in liver as well as kidney, and to investigate the protective effects of VRP 1020 with fixed dose combination of ceftriaxone-vancomycin (Immunox-V). Twenty four Mus musculus mice (weighing 30 +/- 5 g) were divided into four groups containing six mice in each group. The activities of antioxidant enzymes such as superoxide dismutase, catalase and the level of malonaldialdehyde, as an marker of lipid per oxidation, were measured to evaluate oxidative stress in homogenates of the liver and renal tissue. Ceftriaxone or vancomycin administration significantly increased malonaldialdehyde levels (p VRP 1020 with FDC of Immunox-V injections caused significantly decreased malonaldialdehyde levels (pVRP 1020 with fixed dose combination of Immunox-V can prevent drug induced nephrotoxicity and oxidative stress which protects liver injury as well as renal tissue damage by reducing reactive oxygen species which improve the activities of free radical scavenging enzymes.

  7. Ceftriaxone Injection

    Science.gov (United States)

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

  8. Antimicrobial Resistance to Ceftazidime and Ceftriaxone, and Detection of TEM Gene in Esherchia Coli

    Directory of Open Access Journals (Sweden)

    Jahani, S. (MSc

    2014-11-01

    Full Text Available Background and Objective: In the past, most strains of E. coli were susceptible to a wide range of antimicrobial agents, but this situation is now changed by indiscriminate use of antibiotics. Ceftriaxone and Ceftazidime are the most current antibiotics used for Enterobacteriaceae infections in hospitals. The aim of this study was to determine antimicrobial resistance of Escherichia coli strains isolated from patients. Material and Methods: During a 12-month period, 200 clinical samples taken from patients referred to Zahedan hospitals were assessed to isolate Escherichia coli. Antibiotic susceptibility was determined by disk diffusion method and micro-broth dilution; and Bla TEM resistance genes were detected by PCR. Results: Following phenotype verification testing, 112 isolates (56% were produced Extended Spectrum Beta Lactamase (ESBLs and 130 isolates were potential producers of beta-lactamase (ESBL. Using PCR, 72 isolates (38.55% have TEM gene. Conclusion: The rate of antibiotic resistance of Escherichia coli isolates to ceftriaxone and ceftazidime is high; therefore, it seems reasonable to do antibiogram before treatment.

  9. Intraphagocytic bactericidal activity of ofloxacin compared with that of aztreonam and ceftriaxone against Serratia marcescens.

    Science.gov (United States)

    Traub, W H; Spohr, M; Bauer, D

    1986-02-01

    Addition of phenylbutazone (2 mg/ml) to 55 vol % of fresh defibrinated human blood permitted leukocytic ingestion of serum-resistant Serratia marcescens bacteria, but blocked phagocytic killing activity. The group A (phage tail) bacteriocin bA+ 16 served to kill extraphagocytic test bacteria. At greater than or equal to 2 X MBC, the DNA gyrase inhibitor ofloxacin revealed potent intraphagocytic bactericidal activity against S. marcescens test bacteria (99% kill; 3 h observation period) which corresponded to that of the control drug rifampin (97% kill). The monobactam aztreonam (11% kill) and the third generation cephalosporin ceftriaxone (14% kill) corresponded to cefotaxime (26% kill) in terms of suboptimal intraphagocytic activity. Ofloxacin and aztreonam yielded additive effects following combination of supra-(2 X MIC) and inhibitory (MIC), but not sub-inhibitory (0.5 X MIC) concentrations with 55 vol % of defibrinated human blood against S. marcescens and Escherichia coli control strain ATCC 25922; sub- and inhibitory concentrations of ceftriaxone yielded indifferent effects.

  10. Comparison of Ceftriaxone Plus Weekly Azithromycin or Daily Ofloxacin for Outpatient Treatment of Pelvic Inflammatory Disease: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Parisa Moghtadaei

    2008-06-01

    Full Text Available Objective: To compare the efficacy of ceftriaxone plus Ofloxacin or Azithromycin for cases of pelvic inflammatory disease (PID.Materials and Methods:  This clinical terial was performed on 180 women with PID from March 2005 to March 2007 in Parastarane-Shahed Hospital. Patients with PID were randomly divided to receive injection of Ceftriaxone 250 mg plus Ofloxacin 200 mg per day or Azithromycin 1 g per week for two weeks (90 cases in each group. The degree of pain was assessed on days 7, 14, 30 and clinical cure was assessed on days 14 and 30. Statistical analysis was done based on Fisher exact test, Mann-Whitny and student t-test.Results: From 180 patients eligible for the study, 138 cases were enrolled for protocol analysis. Significant differences were observed regarding the degree of pain between two groups. Clinical cure was 90% (70 of 78 for Azithromycin and 83.3% (50 of 60 for Ofloxacin. Conclusion: Combination of Ceftriaxone plus weekly Azithromycin for two weeks is not only equivalent to Ceftriaxone plus daily Ofloxacin for two weeks but also seems to be better for the treatment of mild PID.

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

    Directory of Open Access Journals (Sweden)

    Abdullah Demirtas

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

  13. Comparison of infection and urosepsis rates of ciprofloxacin and ceftriaxone prophylaxis before percutaneous nephrolithotomy: a prospective and randomised study.

    Science.gov (United States)

    Demirtas, Abdullah; Yildirim, Yunus Emre; Sofikerim, Mustafa; Kaya, Esma Gunduz; Akinsal, Emre Can; Tombul, Sevket Tolga; Ekmekcioglu, Oguz; Gulmez, Ibrahim

    2012-01-01

    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) (CIP(P) = 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.

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

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    Ana eWeiland

    2015-03-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  16. 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 re

  17. Short-course treatment with ceftriaxone for leptospirosis: a retrospective study in a single center in Eastern France.

    Science.gov (United States)

    Faucher, Jean-François; Chirouze, Catherine; Hoen, Bruno; Leroy, Joël; Hustache-Mathieu, Laurent; Estavoyer, Jean-Marie

    2015-03-01

    Short-course (less than 7 days) antibiotic treatments have been rarely assessed in the management of leptospirosis. We analyzed the charts of patients hospitalized with confirmed and probable leptospirosis in a teaching hospital between 1994 and 2012. Of 89 patients with confirmed or probable leptospirosis, 21 patients (11 confirmed, 10 probable - 14 uncomplicated and 7 severe forms) admitted between 2001 and 2012 received ceftriaxone (1-2 g daily) for less than 7 days. Apyrexia was obtained within 2 days of treatment in all patients and no relapse was observed. These data support the hypothesis that short-course treatments of 3-6 days with ceftriaxone (1-2 g per day) may be an option in the treatment of uncomplicated and severe forms of leptospirosis responding quickly to therapy. This hypothesis deserves being confirmed in further clinical studies.

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

    Science.gov (United States)

    Roberts, Tracey; Coughlin, Olivia; Sicard, Eric; Rufiange, Marianne; Fedorak, Richard; Carter, Christian; Adams, Marijke H.; Longstreth, James; Whalen, Heidi; Sliman, Joseph

    2017-01-01

    ABSTRACT 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). PMID:28052855

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

    Science.gov (United States)

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

    2016-01-01

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

  20. The efficacy of trovafloxacin versus ceftriaxone in the treatment of experimental brain abscess/cerebritis in the rat.

    Science.gov (United States)

    Nathan, Barnett R; Scheld, W Michael

    2003-08-22

    Current estimates of the mortality associated with brain abscesses range from 0-24%, with neurological sequellae in 30-55% of survivors. Although the incidence of brain abscess appears to be increasing, likely due to an increase in the population of immunosuppressed patients, the condition is still sufficiently uncommon to make human clinical trials of therapy problematic. An animal model to study the efficacy of new treatment regimens, specifically, new antimicrobial agents is therefore necessary. This study uses a well-defined experimental paradigm as an inexpensive method of inducing and studying the efficacy of antibiotics in brain abscess. The rat model of brain abscess/cerebritis developed at this institution was used to determine the relative efficacy of trovafloxacin as compared to ceftriaxone in animals infected with Staphylococcus aureus. S. aureus ( approximately 10(5) CFU in 1 microliter) was injected with a Hamilton syringe, very slowly, over the course of 70 minutes after a two mm burr hole was created with a spherical carbide drill just posterior to the coronal suture and four mm lateral to the midline. Eighteen hours later treatment was begun; every 8 hours the rats were dosed with subcutaneous ceftriaxone (n = 10), trovafloxacin (n = 11) or 0.9% sterile pyogen-free saline (n = 10). After four days of treatment the brains were removed and sectioned with a scalpel. The entire injected hemisphere was homogenized and quantitative cultures performed. The mean +/- SEM log(10) colony forming units/ml S. aureus recovered from homogenized brain were as follows: controls 6.10 +/- 0.28; ceftriaxone 3.43 +/- 0.33; trovafloxacin 3.65 +/- 0.3. There was no significant difference in bacterial clearance between ceftriaxone versus trovafloxacin (p = 0.39). Trovafloxacin or other quinolones may provide a viable alternative to intravenous antibiotics in patients with brain abscess/cerebritis.

  1. Riboflavin-sensitized photooxidation of Ceftriaxone and Cefotaxime. Kinetic study and effect on Staphylococcus aureus.

    Science.gov (United States)

    Reynoso, Eugenia; Spesia, Mariana B; García, Norman A; Biasutti, María A; Criado, Susana

    2015-01-01

    Trace amounts of the widely used β-lactam antibiotics (Atbs) in waste water may cause adverse effects on the ecosystems and contribute to the proliferation of antibiotic-resistant bacteria. On these grounds, kinetic and mechanistic aspects of photosensitized degradation of Ceftriaxone (Cft) and Cefotaxime (Ctx), have been studied in pure water by stationary and time-resolved techniques. Additionally, possible implications of these photoprocesses on the antimicrobial activity of the Atbs have also been investigated. Photoirradiation of aqueous solutions of Cft and Ctx produces the degradation of both Atbs in the presence of Riboflavin (vitamin B2), a well known pigment dissolved in natural aquatic systems. The process occurs through Type I and Type II mechanisms, with effective prevalence of the former. The participation of O2(-), OH and O2((1)Δg) is supported by experiments of oxygen consumption carried out in the presence of specific scavengers for such reactive oxygen species. Microbiological assays exhibit a parallelism between the rate of Cft and Ctx photodegradation and the loss of their bactericidal capacity on Staphylococcus aureus strains. Results contribute to both understanding kinetic and mechanism aspects of the degradation and predicting on natural decay of Atbs waste water-contaminants.

  2. Ceftriaxone attenuates locomotor activity induced by acute and repeated cocaine exposure in mice.

    Science.gov (United States)

    Tallarida, Christopher S; Corley, Gladys; Kovalevich, Jane; Yen, William; Langford, Dianne; Rawls, Scott M

    2013-11-27

    Ceftriaxone (CTX) decreases locomotor activation produced by initial cocaine exposure and attenuates development of behavioral sensitization produced by repeated cocaine exposure. An important question that has not yet been answered is whether or not CTX reduces behavioral sensitization to cocaine in cases in which the antibiotic is administered only during the period of cocaine absence that follows repeated cocaine exposure and precedes reintroduction to cocaine. We investigated this question using C57BL/6 mice. Mice pretreated with cocaine (15mg/kg×14 days) and then challenged with cocaine (15mg/kg) after 30 days of cocaine absence displayed sensitization of locomotor activity. For combination experiments, CTX injected during the 30 days of cocaine absence attenuated behavioral sensitization produced by cocaine challenge. In the case in which CTX was injected together with cocaine for 14 days, development of behavioral sensitization to cocaine challenge was also reduced. CTX attenuated the increase in locomotor activity produced by acute cocaine exposure; however, its efficacy was dependent on the dose of cocaine as inhibition was detected against 30mg/kg, but not 15mg/kg, of cocaine. These results from mice indicate that CTX attenuates locomotor activity produced by acute and repeated cocaine exposure and counters cocaine's locomotor activating properties in a paradigm in which the antibiotic is injected during the period of forced cocaine absence that follows repeated cocaine exposure.

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

    Science.gov (United States)

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

    2013-04-04

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

  4. [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 gonorrhoeae strains to ceftriaxone.

  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.

  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

    2016-01-01

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

  8. In vivo susceptibility of ESBL producing Escherichia coli to ceftriaxone in children with acute pyelonephritis

    Directory of Open Access Journals (Sweden)

    Peco-Antić Amira

    2012-01-01

    Full Text Available Introduction. The choice of empiric therapy of acute pyelonephritis (APN in children should be based on the knowledge of Escherichia coli (E. coli as the most common uropathogen and its antibiotic sensitivities considering that nowadays ESBL-producing [ESBL (+] E. coli is on the rise worldwide. Objective. To examine in vivo susceptibility of ESBL (+ E. coli to ceftriaxone (CTX, and to evaluate the options for empiric therapy for APN in children. Methods. Retrospective study of CTX empiric therapy of APN in children treated at the University Children΄s Hospital in Belgrade from January 2005 to December 2009. ESBL phenotypic confirmatory test with ceftazidime, CTX and cefotaxime was performed for all urine isolates by disc diffusion method on Mueller-Hinton agar plates. In vivo sensitivity of CTX documented by clinical response to empiric CTX therapy was compared between two groups of children: group I with ESBL (+ E. coli and group II with ESBL (- E. coli APN. Results. Group I with ESBL (+ APN consisted of 94 patients and group II of 120 patients with ESBL (- APN, respectively. All patients received CTX as empiric therapy at a mean dose of 66.9 mg during 7.2±2.6 days of therapy. Clinical effect of CTX was similar in patients with ESBL (+ compared to those with ESBL (- APN. Conclusions. In vitro resistance of ESBL E. coli to CTX determined by standard methods is not sufficiently predictive for its in vivo sensitivity. Therefore CTX may be used as empiric therapy for acute pyelonephritis in children.

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

    Science.gov (United States)

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

    2012-06-01

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

  10. 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.

  11. [Ceftriaxone in neonates and young infants; clinical efficacy, pharmacokinetic evaluation and effect on intestinal bacterial flora].

    Science.gov (United States)

    Fujita, K; Murono, K; Sakata, H; Kakehashi, H; Oka, T; Kaeriyama, M; Yoshioka, H; Maruyama, S; Sanae, N; Inyaku, F

    1988-02-01

    Twenty-two newborn and young infants, including 13 premature infants, were treated with ceftriaxone (CTRX) and the clinical efficacy and side effects were evaluated. Ages of the patients ranged from 0 to 106 days, and their body weights from 1.19 to 3.92 kg. Dose levels were 15 to 23 mg/kg every 12 to 24 hours for 2 to 13.5 days. Eighteen infants with sepsis and 1 infant with purulent coxitis were considered to have responded to the CTRX treatment. The results were excellent in 13 and good in 6 patients. The drug was well tolerated, although diarrhea occurred in 2 patients, eosinophilia in 6 patients, slightly elevated serum concentrations of transaminases in 2 patients and thrombocytosis in 1 among the 22 patients. The pharmacokinetic studies on CTRX were done in 8 patients including 3 premature infants. The ages ranged from 3 to 50 days, and body weight from 2.20 to 3.94 kg. Plasma concentrations 30 minutes after single 10 mg/kg intravenous bolus injection in two 4- to 5-day-old premature neonates were 48.4 and 50.0 micrograms/ml and those at 6 hours were 22.7 and 23.4 micrograms/ml, respectively. In 2 mature neonates, plasma levels were 42.2 and 39.1 micrograms/ml at 30 minutes and 23.4 and 26.6 micrograms/ml at 6 hours after single 20 mg/kg doses. In four 12- to 50-day-old patients, plasma concentrations ranged from 35.9 to 175.0 micrograms/ml at 30 minutes and from 21.9 to 32.8 micrograms/ml at 6 hours after multiple doses of 20 mg/kg intravenous bolus injection. The plasma half-lives of the drug ranged from 6.6 to 16.8 hours in these 8 patients. Excretion rates of this drug into urine within 12 hours were 21.4 to 63.4% in 7 patients. Urine concentrations of the drug in 34 samples collected at various times from the 7 patients ranged from 28.3 to 469.0 micrograms/ml. The cerebrospinal fluid level at 2 hours after a dose was 3.33 micrograms/ml on the 5th day of treatment in 1 patient with sepsis receiving 18 mg/kg of the drug every 12 hours. Its level at 3

  12. Comparison of ertapenem and ceftriaxone therapy for acute pyelonephritis and other complicated urinary tract infections in Korean adults: a randomized, double-blind, multicenter trial.

    Science.gov (United States)

    Park, Dae Won; Peck, Kyong Ran; Chung, Moon Hyun; Lee, Jin Seo; Park, Yoon Soo; Kim, Hyo Youl; Lee, Mi Suk; Kim, Jung Yeon; Yeom, Joon Sup; Kim, Min Ja

    2012-05-01

    The efficacy and safety of ertapenem, 1 g once daily, were compared with that of ceftriaxone, 2 g once daily, for the treatment of adults with acute pyelonephritis (APN) and complicated urinary tract infections (cUTIs) in a prospective, multicenter, double-blinded, randomized study. After ≥ 3 days of parenteral study therapy, patients could be switched to an oral agent. Of 271 patients who were initially stratified by APN (n = 210) or other cUTIs (n = 61), 66 (48.9%) in the ertapenem group and 71 (52.2%) in the ceftriaxone group were microbiologically evaluable. The mean duration of parenteral and total therapy, respectively, was 5.6 and 13.8 days for ertapenem and 5.8 and 13.8 days for ceftriaxone. The most common pathogen was Escherichia coli. At the primary efficacy endpoint 5-9 days after treatment, 58 (87.9%) patients in the ertapenem group and 63 (88.7%) in the ceftriaxone had a favorable microbiological response. When compared by stratum and severity, the outcomes in the two groups were equivalent. The frequency and severity of drug-related adverse events were generally similar in both treatment groups. The results indicate that ertapenem is highly effective and safe for the treatment of APN and cUTIs.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  14. 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.'

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

    Science.gov (United States)

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

    1986-12-20

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

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

    Science.gov (United States)

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

    2011-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Grau S

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Donald E Low

    1994-01-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

  20. Ertapenem versus ceftriaxone followed by appropriate oral therapy for treatment of complicated urinary tract infections in adults: results of a prospective, randomized, double-blind multicenter study.

    Science.gov (United States)

    Tomera, Kevin M; Burdmann, Emmanuel A; Reyna, Oscar G Pamo; Jiang, Qi; Wimmer, Wendy M; Woods, Gail L; Gesser, Richard M

    2002-09-01

    The efficacy and safety of intravenous (i.v.) ertapenem (1 g once a day) with the option to switch to an oral agent for treatment of adults with complicated urinary tract infections (UTIs) were compared with that of i.v. ceftriaxone (1 g daily) with the same oral switch option in a multicenter, double-blind, prospective, randomized study. At entry, 592 patients were assigned to one of two strata: acute pyelonephritis or other complicated UTI without acute pyelonephritis. After a minimum of 3 days, patients could be switched to an oral antimicrobial agent. A total of 159 patients in the ertapenem group and 171 patients in the ceftriaxone group were microbiologically evaluable. Approximately 95% of patients in each treatment group were switched to oral therapy. The most common pathogens were Escherichia coli and Klebsiella pneumoniae. At the primary efficacy endpoint 5 to 9 days after treatment, 91.8% of patients who received ertapenem and 93.0% of those who received ceftriaxone had a favorable microbiological response (95% confidence interval for the difference, adjusting for strata, -7.6 to 5.1%), indicating that outcomes in the two treatment groups were equivalent. Microbiological success rates for the two treatment groups were similar when compared by stratum and also by severity of infection. The frequency and severity of drug-related adverse events were generally similar in both treatment groups. In this study, ertapenem was as effective as ceftriaxone for the initial treatment of complicated UTIs in adults, was generally well tolerated, and had a similar overall safety profile.

  1. 头孢曲松治疗早期梅毒的Meta分析%A Meta-analysis of ceftriaxone in the treatment of early syphilis

    Institute of Scientific and Technical Information of China (English)

    梁思; 宋佩华

    2013-01-01

    Objectives: To evaluate the effectiveness and safety of ceftriaxone in treating early syphilis. Methods: Based on the inclusion and exclusion standards, we searched the clinical trial literatures which compared the efficacy and safety of ceftriaxone and procaine pencillin from Cochrane Library 、MEDLINE 、EMBASE and CNK. With these data, we used RevMan5. 2 to conduct meta - analysis. Results:The results of three randomized controlled trials showed that there was no significant difference between ceftriaxone and procaine penicillin in terms of deflorescence and RPR becoming negtive after one - year treatment of early syphilis. (OR =0.40,95% CI [0.09 to 1.71] ,P = 0.63). Conclusion; Ceftriaxone is an effective and safe medicine for treating early syphilis.%目的:评价头孢曲松治疗早期梅毒的有效性和安全性.方法:根据纳入和排除标准,通过检索Cochrane图书馆、MEDLINE、EMBASE、CNKI等数据库,查找头孢曲松和普鲁卡因青霉素治疗早期梅毒的随机对照试验.试验数据采取RevMan5.2软件进行Meta分析.结果:纳入3个随机对照试验,结果显示头孢曲松在治疗早期梅毒后1年内在皮疹消退和RPR转阴方面(OR=0.40,95%CI[0.09-1.71],P=0.63)和普鲁卡因青霉素相比无明显差异.结论:头孢曲松是治疗早期梅毒的有效药物.

  2. 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.

  3. 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

    2016-06-15

    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 1.3nM. This method is simple, sensitive and low cost.

  4. Analysis of amino acid sequences of penicillin-binding protein 2 in clinical isolates of Neisseria gonorrhoeae with reduced susceptibility to cefixime and ceftriaxone.

    Science.gov (United States)

    Osaka, Kazuyoshi; Takakura, Tadakazu; Narukawa, Kayo; Takahata, Masahiro; Endo, Katsuhisa; Kiyota, Hiroshi; Onodera, Shoichi

    2008-06-01

    Neisseria gonorrhoeae strains with reduced susceptibility to cefixime and ceftriaxone, with minimum inhibitory concentrations (MICs) of cefixime of 0.125-0.25 microg/ml and ceftriaxone of 0.031-0.125 microg/ml, were isolated from male urethritis patients in Tokyo, Japan, in 2006. The amino acid sequences of PenA, penicillin-binding protein 2, in these strains were of two types: PenA mosaic and nonmosaic strains. In the PenA mosaic strain, some regions in the transpeptidase-encoding domain in PenA were similar to those of Neisseria perflava/sicca, Neisseria cinerea, Neisseria flavescens, Neisseria polysaccharea, and Neisseria meningitidis. In the PenA nonmosaic strain, there was a mutation of Ala-501 to Val in PenA. In addition, we performed homology modeling of PenA wild-type and mosaic strains and compared them. The results of the modeling studies suggested that reduced susceptibility to cephems such as cefixime and ceftriaxone is due to a conformational alteration of the beta-lactam-binding pocket. These results also indicated that the mosaic structures and the above point mutation in PenA make a major contribution to the reduced susceptibility to cephem antibiotics.

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

    Science.gov (United States)

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

    1994-04-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

  8. Antibacterial activity and PK/PD of ceftriaxone against penicillin-resistant Streptococcus pneumoniae and beta-lactamase-negative ampicillin-resistant Haemophilus influenzae isolates from patients with community-acquired pneumonia.

    Science.gov (United States)

    Ohno, Akira; Ishii, Yoshikazu; Kobayashi, Intetsu; Yamaguchi, Keizo

    2007-10-01

    The suitability of ceftriaxone for penicillin-resistant Streptococcus pneumoniae (PRSP) and ampicillin-resistant Haemophilus influenzae (especially beta-lactamase-negative ampicillin-resistant (BLNAR) H. influenzae) and the relationship between in vitro antimicrobial activities and pharmacokinetic parameters were evaluated. The values for percentage of time above the MIC (%T>MIC) for ceftriaxone, cefotiam, flomoxef, sulbactam/cefoperazone, sulbactam/ampicillin, and meropenem, using 400 S. pneumoniae isolates and 430 H. influenzae isolates from patients with community-acquired pneumonia (CAP) from more than 100 geographically diverse medical centers during January to July of 2005, were calculated by measuring the MIC for each isolate and by using patameters of pharmacokinetics. A broth microdilution method was used to determine the MIC, using the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Meropenem showed the lowest MIC against penicillin-susceptible S. pneumoniae, followed by sulbactam/cefoperazone and ceftriaxone. Ceftriaxone had the best activity against penicillin-resistant S. pneumoniae and beta-lactamase-negative and beta-lactamase-producing ampicillin-resistant H. influenzae. Ceftriaxone was unique, showing a long elimination half-life and low MIC values where its serum level duration time was above the MIC for longer than other cephalosporins. Accordingly, the %T>MIC of ceftriaxone for a once-daily administration greatly exceeded the efficacy levels of those for the other antibacterial agents tested. Ceftriaxone has an excellent balance between in vitro antimicrobial activities and pharmacokinetic profiles; and therefore remains effective as a therapeutic agent against PRSP and BLNAR H. influenzae in CAP.

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

    Science.gov (United States)

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

    2012-03-01

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

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

    Directory of Open Access Journals (Sweden)

    T Bharara

    2015-01-01

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

  11. Comparison of Ertapenem and Ceftriaxone Therapy for Acute Pyelonephritis and Other Complicated Urinary Tract Infections in Korean Adults: A Randomized, Double-Blind, Multicenter Trial

    OpenAIRE

    PARK, DAE WON; Peck, Kyong Ran; Chung, Moon Hyun; Lee, Jin Seo; Park, Yoon Soo; Kim, Hyo Youl; Lee, Mi Suk; Kim, Jung Yeon; Yeom, Joon Sup; Kim, Min Ja

    2012-01-01

    The efficacy and safety of ertapenem, 1 g once daily, were compared with that of ceftriaxone, 2 g once daily, for the treatment of adults with acute pyelonephritis (APN) and complicated urinary tract infections (cUTIs) in a prospective, multicenter, double-blinded, randomized study. After ≥ 3 days of parenteral study therapy, patients could be switched to an oral agent. Of 271 patients who were initially stratified by APN (n = 210) or other cUTIs (n = 61), 66 (48.9%) in the ertapenem group an...

  12. Ertapenem versus Ceftriaxone Followed by Appropriate Oral Therapy for Treatment of Complicated Urinary Tract Infections in Adults: Results of a Prospective, Randomized, Double-Blind Multicenter Study

    OpenAIRE

    Tomera, Kevin M.; Burdmann, Emmanuel A.; PAMO REYNA, OSCAR G.; Jiang, Qi; Wimmer, Wendy M.; Woods, Gail L.; Gesser, Richard M.

    2002-01-01

    The efficacy and safety of intravenous (i.v.) ertapenem (1 g once a day) with the option to switch to an oral agent for treatment of adults with complicated urinary tract infections (UTIs) were compared with that of i.v. ceftriaxone (1 g daily) with the same oral switch option in a multicenter, double-blind, prospective, randomized study. At entry, 592 patients were assigned to one of two strata: acute pyelonephritis or other complicated UTI without acute pyelonephritis. After a minimum of 3 ...

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙双姣; 朱琪; 李明娟

    2015-01-01

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

  15. Study on preparation of SnO2-TiO2/Nano-graphite composite anode and electro-catalytic degradation of ceftriaxone sodium.

    Science.gov (United States)

    Guo, Xiaolei; Wan, Jiafeng; Yu, Xiujuan; Lin, Yuhui

    2016-12-01

    In order to improve the electro-catalytic activity and catalytic reaction rate of graphite-like material, Tin dioxide-Titanium dioxide/Nano-graphite (SnO2-TiO2/Nano-G) composite was synthesized by a sol-gel method and SnO2-TiO2/Nano-G electrode was prepared in hot-press approach. The composite was characterized by X-ray photoelectron spectroscopy, fourier transform infrared, Raman, N2 adsorption-desorption, scanning electrons microscopy, transmission electron microscopy and X-ray diffraction. The electrochemical performance of the SnO2-TiO2/Nano-G anode electrode was investigated via cyclic voltammetry and electrochemical impedance spectroscopy. The electro-catalytic performance was evaluated by the degradation of ceftriaxone sodium and the yield of ·OH radicals in the reaction system. The results demonstrated that TiO2, SnO2 and Nano-G were composited successfully, and TiO2 and SnO2 particles dispersed on the surface and interlamination of the Nano-G uniformly. The specific surface area of SnO2 modified anode was higher than that of TiO2/Nano-G anode and the degradation rate of ceftriaxone sodium within 120 min on SnO2-TiO2/Nano-G electrode was 98.7% at applied bias of 2.0 V. The highly efficient electro-chemical property of SnO2-TiO2/Nano-G electrode was attributed to the admirable conductive property of the Nano-G and SnO2-TiO2/Nano-G electrode. Moreover, the contribution of reactive species ·OH was detected, indicating the considerable electro-catalytic activity of SnO2-TiO2/Nano-G electrode.

  16. A randomised, double-blind trial comparing ceftobiprole medocaril with ceftriaxone with or without linezolid for the treatment of patients with community-acquired pneumonia requiring hospitalisation.

    Science.gov (United States)

    Nicholson, Susan C; Welte, Tobias; File, Thomas M; Strauss, Richard S; Michiels, Bart; Kaul, Pratibha; Balis, Dainius; Arbit, Deborah; Amsler, Karen; Noel, Gary J

    2012-03-01

    Community-acquired pneumonia (CAP) is a serious infection requiring hospitalisation in 20% of cases. The novel cephalosporin ceftobiprole has microbiological activity against the major bacterial pathogens causing CAP, including Streptococcus pneumoniae, Haemophilus influenzae and Klebsiella pneumoniae, as well as against Staphylococcus aureus, including meticillin-resistant S. aureus (MRSA). This was a multicentre, double-blind study in which 706 patients with CAP severe enough to require hospitalisation were randomised to ceftobiprole or to an expert-recommended course of ceftriaxone ± linezolid (comparator group). Clinical and microbiological outcomes were determined 7-14 days after completion of therapy (test-of-cure visit). For the 469 clinically evaluable patients, cure rates were 86.6% vs. 87.4% for ceftobiprole and comparator, respectively [95% confidence interval (CI) of the difference, -6.9% to 5.3%]; in the intention-to-treat (ITT) analysis of 638 CAP patients, these cure rates were 76.4% vs. 79.3%, respectively (95% CI of the difference, -9.3% to 3.6%). A typical bacterial pathogen was identified in 29% of the ITT population. Microbiological eradication rates in the 144 microbiologically evaluable patients were 88.2% and 90.8% for the respective treatment groups (95% CI of the difference, -12.6% to 7.5%). Both study drugs were well tolerated, with but a minority of patients requiring premature discontinuation due to an adverse event (6% in the ceftobiprole group and 4% in the comparator group). The overall incidence of treatment-related adverse events was higher in the ceftobiprole group, primarily owing to differences in rates of self-limited nausea (7% vs. 2%) and vomiting (5% vs. 2%). In summary, ceftobiprole was non-inferior to the comparator (ceftriaxone ± linezolid) in all clinical and microbiological analyses conducted, suggesting that ceftobiprole has a potential role in treating hospitalised patients with CAP. [ClinicalTrials.gov identifier

  17. Peroral ciprofloxacin therapy impairs the generation of a protective immune response in a mouse model for Salmonella enterica serovar Typhimurium diarrhea, while parenteral ceftriaxone therapy does not.

    Science.gov (United States)

    Endt, Kathrin; Maier, Lisa; Käppeli, Rina; Barthel, Manja; Misselwitz, Benjamin; Kremer, Marcus; Hardt, Wolf-Dietrich

    2012-05-01

    Nontyphoidal Salmonella (NTS) species cause self-limiting diarrhea and sometimes severe disease. Antibiotic treatment is considered only in severe cases and immune-compromised patients. The beneficial effects of antibiotic therapy and the consequences for adaptive immune responses are not well understood. We used a mouse model for Salmonella diarrhea to assess the effects of per os treatment with ciprofloxacin (15 mg/kg of body weight intragastrically 2 times/day, 5 days) or parenteral ceftriaxone (50 mg/kg intraperitoneally, 5 days), two common drugs used in human patients. The therapeutic and adverse effects were assessed with respect to generation of a protective adaptive immune response, fecal pathogen excretion, and the emergence of nonsymptomatic excreters. In the mouse model, both therapies reduced disease severity and reduced the level of fecal shedding. In line with clinical data, in most animals, a rebound of pathogen gut colonization/fecal shedding was observed 2 to 12 days after the end of the treatment. Yet, levels of pathogen shedding and frequency of appearance of nonsymptomatic excreters did not differ from those for untreated controls. Moreover, mice treated intraperitoneally with ceftriaxone developed an adaptive immunity protecting the mice from enteropathy in wild-type Salmonella enterica serovar Typhimurium challenge infections. In contrast, the mice treated intragastrically with ciprofloxacin were not protected. Thus, antibiotic treatment regimens can disrupt the adaptive immune response, but treatment regimens may be optimized in order to preserve the generation of protective immunity. It might be of interest to determine whether this also pertains to human patients. In this case, the mouse model might be a tool for further mechanistic studies.

  18. 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.

  19. 肾脏疾病合并头孢曲松相关假性胆结石患儿的临床分析%Reversible ceftriaxone-associated biliary pseudolithiasis in three children with renal diseases

    Institute of Scientific and Technical Information of China (English)

    钟旭辉; 陈环; 姚勇; 卓秀伟; 黄建萍; 肖慧捷; 艾乙

    2010-01-01

    目的 探讨肾脏疾病患儿合并头孢曲松相关假性胆结石的临床特点.方法 回顾性分析3例合并头孢曲松相关假性胆结石的肾脏疾病患儿临床资料.结果 病例1,男,11岁,诊断"肾病综合征",因"胃肠炎"予头孢曲松2g/d[50 mg/(kg·d)]抗感染,3 d后发现胆囊内泥沙样沉积,伴纳差、恶心;停药16 d后胆囊结石消失.病例2,男,10岁,诊断"急性链球菌感染后肾小球肾炎、肾功能不全",因"胃肠炎"予头孢曲松1.5 g/d[30 mg/(kg·d)],疗程6 d时发现胆囊结石,伴恶心、呕吐和腹痛,Murphy's征阳性;停药18 d后胆囊结石消失.病例3,男,12岁,诊断"肾病综合征",因"胃肠炎?"给予头孢曲松2g/d[40 mg/(kg·d)]联合甲硝唑抗感染、疗程2周,感染控制,但有中上腹压痛,停药3 d后发现胆囊结石;停药2个月后复查结石回声消失.结论 上述3例患儿出现胆囊结石时头孢曲松治疗剂量较低、结石出现早、临床表现相对重,可能与肾脏疾病患儿同时存在血液浓缩、高凝状态、肾功能不全或补充钙剂等高危因素有关.%Objective To study the clinical characteristics of ceftriaxone-associated biliary pseudolithiasis in children with renal diseases.Method Three children with renal diseases developed biliary pseudolithiasis when they were treated with ceftrriaxone.Their clinical and laboratory data were retrospectively analyzed.Results Case one was an 11-year-old boy.The initial diagnosis was primary nephrotic syndrome.Ceftriaxone was administered intravenously at a dose of 2 g/d[50 mg/(kg·d)]for gastroenteritis.After that the boy complained of nausea and loss of appetite.Abdominal sonogram obtained on day 3 of ceftriaxone therapy revealed gallbladder sludge.After cessation of ceftriaxone treatment,symptoms and ultrasound abnormalities gradually disappeared,with complete sonographic resolution after 16 days.Cage two was a 10-year-old boy.The primary diagnosis was post-streptococcal glomerulonephritis

  20. 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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Pires Pereira

    2008-01-01

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

  3. 头孢曲松钠相关双侧输尿管结石%Ceftriaxone sodium associated with bilateral ureteral calculi

    Institute of Scientific and Technical Information of China (English)

    陈锐; 岳明; 刘小勇

    2013-01-01

    1例26岁女性患者因上呼吸道感染静脉滴注头孢曲松钠2 g,1次/d.第4天突然出现下腹持续性胀痛,腹部超声及CT检查提示双侧输尿管结石.给予对症支持治疗.第5天患者尿中排出少许沉渣.当天腹痛缓解,尿频、尿急症状消失.第6天复查CT,双侧输尿管结石消失.%A 26-year-old female patient received an Ⅳ infusion of ceftriaxone 2 g once daily for upper respiratory tract infection.On day 4,the patient developed persistent distending pain in her lower abdomen.Abdominal ultrasonography and CT examinations revealed bilateral ureteral calculi.The patient received symptomatic treatments and supportive therapy.On day 5,little sediment was excreted in the urine.On the same day,the abdominal pain was alleviated and symptoms of urinary frequency and urgency disappeared.On day 6,CT reexamination showed that the bilateral ureteral calculi disappeared.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    1995-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张丽君; 李国明

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙静茹

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    蒋法兴; 胡白; 王千秋

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-06-21

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  11. Levofloxacin-ceftriaxone combination attenuates lung inflammation in a mouse model of bacteremic pneumonia caused by multidrug-resistant Streptococcus pneumoniae via inhibition of cytolytic activities of pneumolysin and autolysin.

    Science.gov (United States)

    Majhi, Arnab; Adhikary, Rana; Bhattacharyya, Aritra; Mahanti, Sayantika; Bishayi, Biswadev

    2014-09-01

    In this study, our objective was to determine whether a synergistic antimicrobial combination in vitro would be beneficial in the downregulation of pneumococcal virulence genes and whether the associated inflammation of the lung tissue induced by multidrug-resistant Streptococcus pneumoniae infection in vivo needs to be elucidated in order to consider this mode of therapy in case of severe pneumococcal infection. We investigated in vivo changes in the expression of these virulence determinants using an efficacious combination determined in previous studies. BALB/c mice were infected with 10(6) CFU of bacteria. Intravenous levofloxacin at 150 mg/kg and/or ceftriaxone at 50 mg/kg were initiated 18 h postinfection; the animals were sacrificed 0 to 24 h after the initiation of treatment. The levels of cytokines, chemokines, and C-reactive protein (CRP) in the serum and lungs, along with the levels of myeloperoxidase and nitric oxide the inflammatory cell count in bronchoalveolar lavage fluid (BALF), changes in pneumolysin and autolysin gene expression and COX-2 and inducible nitric oxide synthase (iNOS) protein expression in the lungs were estimated. Combination therapy downregulated inflammation and promoted bacterial clearance. Pneumolysin and autolysin expression was downregulated, with a concomitant decrease in the expression of COX-2 and iNOS in lung tissue. Thus, the combination of levofloxacin and ceftriaxone can be considered for therapeutic use even in cases of pneumonia caused by drug-resistant isolates.

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

    Institute of Scientific and Technical Information of China (English)

    张丽君; 王峰; 莫俊銮; 彭毅

    2015-01-01

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

  13. 199株淋球菌对环丙沙星和头孢三嗪的敏感性测定%Sensitivity test of 199 Neisseria gonorrhoeae strains in Nanning to ciprofloxacin and ceftriaxone

    Institute of Scientific and Technical Information of China (English)

    李伟; 赵秀梅; 覃善列; 唐桂林

    2001-01-01

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

  14. 肠杆菌科细菌对头孢曲松耐药趋势的国内文献分析%Drug resistant trend of enterobacteriaceae to ceftriaxone based on domestic literatures

    Institute of Scientific and Technical Information of China (English)

    陈昭丽; 张兴艳; 李苌青; 王广基; 王霆

    2011-01-01

    目的 了解我国2000年以来各地区肠杆菌科细菌对头孢曲松的耐药趋势.方法检索中国期刊全文数据库,筛选质量合格文献,文献中的数据按不同地区、不同年份、不同种类肠杆菌科细菌菌株进行归类、计算和分析.结果共筛选文献68篇,经分析,不同年份、不同地区以及不同种类肠杆菌科细菌对头孢曲松的耐药率存在差异;大肠埃希菌、肺炎克雷伯菌耐药率呈上升趋势,2000-2008年分别增长了18.4%、18.8%,肠杆菌科细菌耐药率与产ESBLs检出率增加密切相关,而非产ESBLs菌对头孢曲松的耐药率保持在较低水平,但2005年来有增长趋势.结论 2000-2008年我国临床分离肠杆菌科细菌对头孢曲松的耐药率呈上升趋势,其耐药率的增长可能主要由产ESBLs菌的流行所致,其次同非产ESBLs菌耐药率升高有关.%OBJECTIVE To investigate the situation and tendency of ceftriaxone resistance to clinical isolates of Enterobacteriaceae.METHODS The references related to ceftriaxone resistance were gathered by the CNKI datebase.The resistance rates of different strains of bacteria were assayed in various regions and years.RESULTS The results showed that the resistant rates of each strains of Escherichia coli, and Klebsiella pneumonia had been increasing by 18.4% and 18.8% in last nine years basing on 68 scientific references eventually chosen.There was a positive correlation between the resistance rates to cefriaxone and detection rate of ESBLs-producing Enterobacteriaceae, meanwhile the resistance rate of non-ESBLs producing Enterobacteriaceae to ceftriaxone remains in lower lever, but with its significant growing trends yearly since 2005.CONCLUSION The resistant rates to ceftriaxone of clinical Enterobacteriaceae display an upward tendency from 2000 to 2008.The resistance of Enterobacteriaceae to the antibiotics may be mainly due to its production of ESBLs, and the secondary causes may be the increasing

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

    Institute of Scientific and Technical Information of China (English)

    陈建新; 姚丽华; 王惠玲; 刘忠纯; 王晓萍; 陈抗松; 王高华

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘焕; Alex J.D. Kanu

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Laura Mazer

    2014-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  19. 2009-2011年深圳市头孢曲松低敏淋病奈瑟菌的流行特征%Molecular characteristics of Neisseria gonorrhoeae isolates with decreased susceptibilities to ceftriaxone in Shenzhen from 2009 to 2011

    Institute of Scientific and Technical Information of China (English)

    张丽君; 莫俊銮; 王峰; 彭毅; 赵广录; 吕德良

    2013-01-01

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

  20. 头孢曲松和亚胺培南对脓毒症大鼠肠道菌群及细菌耐药性的影响%Influence of ceftriaxone and imipenem to sepsis in the rat intestinal flora and bacterial drug resistance

    Institute of Scientific and Technical Information of China (English)

    边金泂; 周祖模; 张苏江

    2014-01-01

    Objective To study the influence of ceftriaxone and imipenem to sepsis in the rat intestinal flora and bacterial drug resistance.Methods 8 rats were randomly included in normal control group from 48 healthy SD,and the rest of them were built the endotoxin sepsis model using 15 mg/kg intraperitoneal injection of endotoxin.According to whether to apply antibiotics and application deadlines in 24 h after modeling,40 rats were randomly subdivided into sepsis without treatment group,sepsis ceftriaxone 3 d group,sepsis ceftriaxone 7 d group,sepsis imipenem 3 d group and sepsis imipenem 7 d group(n=8).During ceftriaxone and imipenem injection treatment,in the corresponding time,colon contents were taken for enterobacteriaceae,enterococcus strains of quantitative culture and bacteria and fungi identification. Results After treatment with antibiotics,the number of rat intestinal bacteria decreased significantly(P<0.05).Ceftriaxone selected pseudomonas aeruginosa and enterobacter cloacae,while imipenem selected klebsiella pneumoniae, proteus and excrement enterococcus conditional pathogenic bacteria.All showed the inclination resistance. Conclusion Ceftriaxone and imipenem antibiotics could decrease the original bacteria number,so pseudomonas aeruginosa and excrement enterococcus conditional pathogenic bacteria could become advantage bacterium group,causing intestinal micro ecological environment disruption.%目的:探讨头孢曲松和亚胺培南对脓毒症大鼠肠道各种菌类数量以及细菌耐药性的影响。方法从48只健康SD大鼠中随机抽取8只为正常对照组,其余40只按照15 mg/kg腹腔注射内毒素的方式建立内毒素脓毒症模型;根据建模后24 h是否应用抗生素以及抗生素应用时限再将40只内毒素脓毒症模型鼠细分为脓毒症未治疗组、脓毒症头孢曲松3 d组、脓毒症头孢曲松7 d组、脓毒症亚胺培南3d组和脓毒症亚胺培南7d组(n=8)。在用头孢曲松和亚胺培南腹

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  2. Changes of Calcium Concentration after Ceftriaxone Sodium Mixed with Different Concentrations of Calcium Solution%头孢曲松钠与不同浓度含钙溶液混合后钙离子浓度的变化研究

    Institute of Scientific and Technical Information of China (English)

    林金华; 周艳芳; 凌丽燕; 姜宠华; 陆卫良

    2013-01-01

    目的:研究头孢曲松钠与含钙溶液产生沉淀的浓度范围,指导临床合理用药.方法:采用全自动生化测定仪测定初始钙离子浓度为0.16、0.38、0.61、0.85、1.10、1.35、1.58、1.84、2.13、2.37 mmol/L的合钙溶液与1、0.5、0.25 g头孢曲松钠混合后0、0.5、1.0、2.0、3.0、4.0、6.0、24.0h内上清液中的钙离子浓度变化,并分析其变化规律.结果:1、0.5、0.25 g头孢曲松钠与各个初始浓度的含钙溶液混合后,上清液中钙离子浓度相互间区别不大;3种头孢曲松钠加入量的上清液中钙离子浓度0.5 h时均较0h时下降,但1.0~24.0h与0h比较均变化不大;3种头孢曲松钠加入量的上清液中钙离子浓度差别不大;且从0.5~24.0h初始钙离子浓度越高,上清液中的钙离子浓度反而更低;钙离子浓度≥1.35 mmol/L时均产生沉淀,浓度越大,产生的沉淀越多,钙离子浓度≤0.85mmol/L时并未见沉淀产生.结论:高血钙患者(血钙>2.6 mmol/L),特别是甲状旁腺危象患者(血钙>4 mmol/L),如需使用头孢曲松钠,使用前应该测定血清钙离子浓度,≥1.35 mmol/L时,风险较大,应避免使用;如果合用含钙制剂(包括口服),应增加水分的摄入,以稀释尿液中的钙离子浓度,从而降低使用风险.%OBJECTIVE: To study the range of concentration that the precipitation appears after ceftriaxone sodium mixed with solution containing calcium, and to provide reference for rational use of drugs in the clinic. METHODS:Using automatic biochemical analyzer, the changes of calcium concentrations in supernatant were determined within 0, 0.5, 1.0, 2.0, 3.0, 4.0, 6.0 and 24.0 h after solution containing calcium (initial concentrations of 0.16, 0.38, 0.61, 0.85, 1.10, 1.35, 1.58, 1.84, 2.13 and 2.37 mmol/L) mixed with ceftriaxone sodium (1, 0.5, 0.25 g); the variation regularity was analyzed. RESULTS: The concentration of calcium ions had no significant difference when ceftriaxone sodium

  3. 复合头孢曲松钠和BMP的壳聚糖抗菌成骨生物陶瓷的制备实验研究%Antimicrobiai bioceramic combined with chitosan and ceftriaxone sodium:Preparation and its in vitro and in vivo study

    Institute of Scientific and Technical Information of China (English)

    夏睿; 方诗元; 徐玮; 张亮; 董行; 赵伟亮; 方月娥

    2009-01-01

    Objective To synthesize antimicrobial bioceramic using chitosan and calcium phosphate cements mixed with ceftriaxone sodium. Methods The bioceramic was synthesized through the hardening of chitosan liquid combined with calcium phosphate cements and cefiriaxone sodium.The released ceftriaxone sodium was studied according to the linear equation between UV-VIS absorbance to concentration.The in vitro bactefiostatic effect of the chosen bioceramic was investigated via the microbiological method.The model of rats'contaminated bone defect were deployed to study the antimicrobial performance of the bioceramic. Results The best synthesis condition was chosen at:0.1g calcium phosphate cements and 10.4 mg ceftriaxone sodium combined with 2.4 ml hardening liquid C.then keeping the mixture at 60℃ and 100%humidity for 24 h.In vitro release of the resulting antimicrobial bioceramic remained stable,while that of ceftriaxone sodium lasted for a week,higher than the minimal inhibitory concentration(MIC) of Staphylococcus aureus.As proved by the WBC number and tissue sectioning,a lighter inflammatory response of treatment group was observed as compared with the control group. Conclusion The antimicrobial bioceramic combined with chitosan and ceftriaxone sodium shows promising antimicrobial performance.%目的 使用壳聚糖和磷酸钙骨水泥(CPC)复合头孢曲松钠和BMP,制备出一种具有成骨和抗感染作用的植骨材料.方法 使用不同成分和比例的壳聚糖固化液将磷酸钙骨水泥、头孢曲松钠和BMP共混制备抗菌成骨生物陶瓷,绘制头孢曲松钠的紫外吸光度-浓度标准直线,测定生物陶瓷中头孢曲松钠体外释放浓度.微生物法测定生物陶瓷体外抑菌效果.生物陶瓷埋于大鼠腿部肌袋研究其成骨性能.将生物陶瓷填充大鼠污染骨缺损模型,研究其抑菌和成骨作用.结果 生物陶瓷的优化制备方案为0.1 g磷酸钙骨水泥复合10.4 mg头孢曲松钠和0.5 mg BMP与2

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

    Institute of Scientific and Technical Information of China (English)

    周蕊; 李俊利

    2013-01-01

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

  5. GLT-1激动剂头孢曲松钠对慢性神经病理性痛的影响%Effect of ceftriaxone on chronic neuropathic pain and the expression of GLT-1 in r ats

    Institute of Scientific and Technical Information of China (English)

    卢丽莉; 杨倩; 仇艳玲; 易力

    2015-01-01

    目的:探讨头孢曲松钠(Ceftriaxone,Cef)对慢性神经病理性痛过敏及GLT-1表达的影响。方法雄性SD大鼠90只,随机分为Sham组、CCI 14 d组、Cef预防组、 Cef治疗组,后2组设腹腔注射NS组为对照,在不同时间点测定热缩足反射潜伏期;另设CCI 1 d、4 d、7 d组。应用免疫组化观察不同时间点脊髓后角GLT-1表达的变化。结果CCI诱导大鼠产生了热痛敏,腹腔注射NS对CCI诱导的热痛敏无影响。 Cef预防组大鼠CCI侧后肢热缩足反射潜伏期于CCI后第5天、第7天明显延长( P <0°.05);Cef 治疗组大鼠CCI侧后肢热缩足反射潜伏期在术后第11天、第14天明显延长( P <0.05)。免疫组化检测发现,Cef预防组和Cef治疗组分别抑制和逆转了GLT-1在CCI后期表达的降低。结论 Cef可通过上调GLT-1的表达对慢性神经病理性痛起到预防和治疗作用。%Objective To investigate the effects of ( Ceftriaxone ,Cef) on chronic neuropathic pain and the expression of GLT-1 in rats.Methods Ninety male Spague-Dawley rats were randomly divided into sham-operation group, CCI 14d group,Cef prevention group,Cef therapy group,at the same time,the two groups with intraperitoneal injection with NS were designed as control groups for the last two groups .The thermal withdrawal latency was measured in different time points , in addition,CCI 1d,CCI 4d and CCI 7d groups were designed to observe dynamic change of GLT-1 expression after CCI.The changes of GLT-1 expression in dorsal horn of spinal cord were detected by immunohistochemistry .Results The thermal hyperalgesia in rats was induced by chronic crushing injury (CCI),however,intraperitoneal injection with NS had no effect on thermal hyperalgesia induced by CCI .The thermal withdrawal latency was obviously prolonged in Cef prevention group on the 5th day,the 7th day after CCI( P <0.05),moreover,which in Cef therapy group was significantly prolonged on the 11th

  6. 头孢曲松钠联合胸腺五肽治疗早期梅毒血清固定患者的临床效果观察%Ceftriaxone Sodium Treatment of Patients with Early Syphilis Serum Fixed Joint with Thymopentin Clinical Effect Observation

    Institute of Scientific and Technical Information of China (English)

    孙继伟

    2015-01-01

    目的:分析头孢曲松钠联合胸腺五肽治疗早期梅毒血清固定患者的临床效果。方法对照组患者采用水剂青霉素钠和苄星青霉素治疗,试验组患者采用头孢曲松钠联合胸腺五肽治疗,对两组患者的治疗效果和一年复发率进行分析对比。结果研究结果显示,试验组患者的治疗效果明显优于对照组(P<0.05)。对患者实施为期一年的随访发现,试验组的复发率明显低于对照组(P<0.05)。结论头孢曲松钠联合胸腺五肽治疗早期梅毒血清固定患者具有良好的临床疗效,降低复发率。%Objective To analysis of ceftriaxone sodium treatment combination with thymopentin on patients with early syphilis serum fixed clinical ef ect. Methods The control group were treated by penicil in sodium and water benzathine penicil in treatment, treatment group were treated by ceftriaxone sodium treatment, combined with thymopentin on the therapeutic ef ect of two groups of patients and one year recurrence rate were analyzed. Results The results showed that the curative ef ect of experimental group patients was better than control group (P <0.05). To implement one ~ year fol ow ~ up found that patients with experimental recurrence rate is lower than the control group significantly (P<0.05). Conclusion Ceftriaxone sodium treatment combination with thymopentin on patients with early syphilis serum fixed has good clinical curative ef ect, reduce recurrence rate, is worth popularization in clinical application.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈绍椿; 尹跃平; 戴秀芹; 孙厚华; 于瑞星; 韩燕; 陈祥生

    2014-01-01

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

  9. 头孢曲松钠对大鼠脑皮质神经元氧糖剥夺损伤的保护作用及其机制%Protective effect and its mechanism of ceftriaxone on injured by rat's cerebral cortical cells oxygenglucose deprivational

    Institute of Scientific and Technical Information of China (English)

    刘春华; 王维治

    2011-01-01

    Objective To explore the protective effect and its mechanism of ceftriaxone(CTX) on cerebral cortical cells of rats injured by oxygen-glucose deprivational (OGD).Methods Cerebral cortical neurocytes of rats were cultured and divided into normal control group, OGD group and CTX pretreatment group.The OGD Models were established in OGD group and CTX pretreatment group.Cytoactive, the expression of glutamate transporter (GLT)-1mRNA, contents of brain-derived neurotrophic factor (BDNF) and interleukin (IL) -6 in the cell culture supernate in each group were assayed.Results Compared with normal control group, neural cytoactive and expression of GLT-1 mRNA were significantly decreased, BDNF and 1 IL-6 were significantly increased in OGD group and CTX pretreatment group( P <0.05 -0.01 ).Compared with OGD group, neural cytoactive, expression of GLT-1 mRNA and BDNF were significantly increase in CTX pretreatment groups (all P <0.01 ), and IL-6 level had no significantly change.Conclusion CTX pretreatment can protect cortical neurocytes from OGD injury by increasing the expression of GLT-1 and BDNF.%目的 研究头孢曲松钠对大鼠脑皮质神经元氧糖剥夺(OGD)损伤的保护作用及其可能的机制.方法 体外培养大鼠脑皮质神经细胞,分为正常对照组、氧糖剥夺(OGD)组和头孢曲松钠(CTX)预处理组.OGD组和CTX预处理组建立OGD模型.并检测各组的细胞活性、细胞谷氨酸转运体-1(GLT-1)mRNA表达、脑源性神经营养因子(BDNF)和白介素(IL)-6含量.结果 与正常对照组比较,OGD组及CTX预处理组神经细胞活性减低,GLT-1 mRNA表达显著下调,细胞培养上清液中BDNF及IL-6含昔显著增加(P<0.05~0.01);与OGD组比较,CTX预处理组神经细胞活性明显增加,GLT-1 mRNA表达上调,细胞培养上清液中BDNF含量增加(均P<0.01),IL-6含量无明显改变.结论 CTX预处理通过上调GLT-1和BDNF表达保护皮质细胞OGD损伤.

  10. 76 FR 14023 - Determination that ROCEPHIN (Ceftriaxone Sodium) Injection, 250 Milligrams, 500 Milligrams, 1...

    Science.gov (United States)

    2011-03-15

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

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

    Directory of Open Access Journals (Sweden)

    Hazel Talbot

    1992-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    汪东海; 王淑红; 马福顺; 轩书玉

    2007-01-01

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

  13. Analysis of Salmonella enterica with reduced susceptibility to the 3rd generation cephalosporin, ceftriaxone, isolated from US cattle during 2000-2004

    Science.gov (United States)

    Over the past decade enteric bacteria in Europe, Africa and Asia have become increasingly resistant to cephalosporin antimicrobials. This is largely due to the spread of genes encoding extended-spectrum ß-lactamase (ESBL) enzymes which can inactivate many cephalosporins. Recently these resistance me...

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

    Institute of Scientific and Technical Information of China (English)

    董磊; 其木格

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    其木格

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    叶顺章; 苏晓红; 戴秀芹; 孙厚华

    2003-01-01

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

  17. 头孢曲松和头孢曲松加头孢克罗序贯疗法治疗下呼吸道感染的成本-效果分析%Cost-effective analysis of ceftriaxone and sequential therapy of ceftriaxone followed by cefaclor in treatment of lower respiratory tract infections

    Institute of Scientific and Technical Information of China (English)

    孙伟; 李静; 曹玉

    2004-01-01

    目的头孢曲松与头孢曲松加头孢克罗序贯疗法治疗下呼吸道感染的成本效果分析.方法64例下呼吸道感染患者前瞻性随机对照研究和药物经济学成本效果分析,头孢曲松、头孢克罗序贯疗法组(n=34),先以头孢曲松2g,iv gtt,bid,3d后改用头孢克罗250mg,po,tid,5~7d;头孢曲松组(n=30)以头孢曲松2g,iv gtt,bid,8~10d.结果两组治疗总有效率分别为94.1%,93.3%,无显著性差异(P>0.05),序贯疗法每例可节省2000元左右.结论头孢曲松加头孢克罗序贯疗法治疗中、重度下呼吸道感染比单用头孢曲松静脉滴注更具成本效果.

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

    Institute of Scientific and Technical Information of China (English)

    黄夏梦; 李苌清; 田驰; 王广基; 王霆

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    龚子鉴; 赖维; 黄朝伟; 黄宇青; 谢小元

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陶小华; 洪福昌; 冯铁建; 王千秋; 龚匡隆

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    黎帆; 傅颖媛

    2002-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    袁柳凤; 尹跃平

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    其木格; 张秀丽; 塔娜; 董磊

    2013-01-01

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

  4. Antibacterial Acivity of Gold and Silver Nanoparticles Impregnated With Antimicrobial Agents

    OpenAIRE

    Savi, Geovana Dagostim; Universidade Federal de Santa Catarina – UFSC; Trombin, Ana Cláudia; Universidade do Extremo Sul Catarinense – UNESC; Generoso, Jaqueline da Silva; Universidade do Extremo Sul Catarinense – UNESC; Barichello, Tatiana; Universidade do Extremo Sul Catarinense – UNESC; Possato, Jonathann Correa; Universidade do Extremo Sul Catarinense – UNESC; Ronconi, João Vitor Vieira; Universidade do Extremo Sul Catarinense – UNESC; Paula, Marcos Marques da Silva; Universidade do Extremo Sul Catarinense – UNESC

    2013-01-01

    Introduction: The bactericidal activity of Ag-NPs and Au-NPs impregnated with ceftriaxone, rifampicin and vancomycin is evalauted. Results: Ag-NPs impregnated with rifampicin, vancomycin and ceftriaxone showed a respective inhibition zone of 15.0 mm, 11.3 mm and 26.0 mm to E.coli. Whereas Au-NPs impregnated with rifampicin and vancomycin showed a non inhibition zone, ceftriaxone showed a zone of 27.0 mm. When Ag-NPs were impregnated with rifampicin, vancomycin and ceftriaxone, they showed a z...

  5. 基于PK-PD研究确定头孢曲松舒巴坦Ⅱ期临床给药方案%Use of preclinical and phase Ⅰ data for determining a phase Ⅱ dose for ceftriaxone/sulbactam injection

    Institute of Scientific and Technical Information of China (English)

    李苌清; 陈昭丽; 王广基; 王霆

    2011-01-01

    目的:基于临床前药效学(PD)和Ⅰ期临床药动学(PK)资料,进行给药方案的Monte Carlo模拟,确定头孢曲松钠舒巴坦钠(2:1)Ⅱ期临床试验的给药方案.方法:整理临床前的药敏实验、后抑效应和Ⅰ期临床药动学等PK-PD相关研究资料.以静脉滴注0.5~2.5 g/次(以头孢曲松量计),每日1次(Qd)、2次(Bid)、3次(Tid)等多种给药方案,治疗常见产ESBLs致病菌感染进行Monte Carlo模拟,将获得的累积反应分数(CFR)做给药方案的比较.结果:以CFR>~90%的给药方案为最佳给药方案.按Qd、Bid和Tid等不同频率给药,治疗常见产ESBLs致病菌感染所需的每次最低给药剂量分别为2.2 g、1.3 g和1.1 g.结论:从药物安全性、药代动力学同步性、以及成本效益角度考虑,头孢曲松钠舒巴坦钠(2:1)Ⅱ期临床试验的最佳给药方案是1.3 g Bid.

  6. 2010年-2012年嘉兴港区头孢曲松非敏感淋病奈瑟菌流行现状及penA基因研究%Study of epidemic status and PenA gene of Neisseria gonorrhoeae isolates with nonsensitivity to ceftriaxone in Jiaxing port district from 2010 to 2012

    Institute of Scientific and Technical Information of China (English)

    丁琳; 凌丽燕; 陆卫良; 段达荣

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陶小华; 王千秋; 张津萍; 洪福昌; 冯铁建

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张亚梅; 董频; 陆培

    2003-01-01

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

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

    OpenAIRE

    Bharat, Amrita; Martin, Irene; Demczuk, Walter; Allen, Vanessa; Haldane, David; Hoang, Linda; Mulvey, Michael R.

    2016-01-01

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

  11. Drug: D07659 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ion [BR:br08303] J ANTIINFECTIVES FOR SYSTEMIC USE J01 ANTIBACTERIALS FOR SYSTEMIC USE J01D OTHER BETA-LACTA...M ANTIBACTERIALS J01DD Third-generation cephalosporins J01DD04 Ceftriaxone D07659 Ceftriaxone (INN) USP drug

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Fulminant hepatic failure caused by Salmonella paratyphi A infection

    Institute of Scientific and Technical Information of China (English)

    Fahmi Yousef Khan; Ahmed A Kamha; Ibrahim Y Alomary

    2006-01-01

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

  14. 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 previo

  15. Pattern of use of antibiotics in hospitalized patients in the medicine department of a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Muniza Bai

    2015-10-01

    Conclusion: Ceftriaxone, doxycycline, and metronidazole are commonly used antibiotics and significant proportion of the cost of drugs is spent for antimicrobials in a medicine unit. [Int J Basic Clin Pharmacol 2015; 4(5.000: 888-894

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

    Directory of Open Access Journals (Sweden)

    William R Bowie

    1993-01-01

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

  17. Beta-lactam antibiotic-mediated changes in platelet reactivity and vascular endothelial functions.

    Science.gov (United States)

    Togna, G I; Togna, A R; Caprino, L

    2001-05-01

    To evaluate vascular and platelet compatibility of intravenous administration of beta-lactam antibiotics, we assessed the effects of therapeutic concentrations of ceftriaxone, aztreonam, and ceftazidime on platelet reactivity to different agonists (sodium arachidonate, collagen and adenosine diphosphate) and on selected vascular endothelial functions (adenosine diphosphatase activity, prostacyclin production and t-PA release). Ceftriaxone and, to a lesser degree, aztreonam, enhanced platelet reactivity, evaluated as onset of platelet aggregating response, and increased thromboxane production to subthreshold concentrations of arachidonate. There was no modification in platelet reactivity after ceftazidime treatment. Ceftriaxone and ceftazidime, but not aztreonam, inhibited endothelial adenosine diphosphatase activity. Prostacyclin production and t-PA release were inhibited only by ceftriaxone at high concentrations. While it is difficult to establish which marker (platelet or endothelial functions) has more clinical reference in human vascular compatibility, it seems feasible to consider aztreonam the most compatible of the beta-lactams studied.

  18. 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.

  19. 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.

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

    Science.gov (United States)

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

    1994-05-01

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

  1. Estimated Incidence of Antimicrobial Drug–Resistant Nontyphoidal Salmonella Infections, United States, 2004–2012

    Science.gov (United States)

    Gu, Weidong; Mahon, Barbara E.; Judd, Michael; Folster, Jason; Griffin, Patricia M.; Hoekstra, Robert M.

    2017-01-01

    Salmonella infections are a major cause of illness in the United States. The antimicrobial agents used to treat severe infections include ceftriaxone, ciprofloxacin, and ampicillin. Antimicrobial drug resistance has been associated with adverse clinical outcomes. To estimate the incidence of resistant culture-confirmed nontyphoidal Salmonella infections, we used Bayesian hierarchical models of 2004–2012 data from the Centers for Disease Control and Prevention National Antimicrobial Resistance Monitoring System and Laboratory-based Enteric Disease Surveillance. We based 3 mutually exclusive resistance categories on susceptibility testing: ceftriaxone and ampicillin resistant, ciprofloxacin nonsusceptible but ceftriaxone susceptible, and ampicillin resistant but ceftriaxone and ciprofloxacin susceptible. We estimated the overall incidence of resistant infections as 1.07/100,000 person-years for ampicillin-only resistance, 0.51/100,000 person-years for ceftriaxone and ampicillin resistance, and 0.35/100,000 person-years for ciprofloxacin nonsusceptibility, or ≈6,200 resistant culture-confirmed infections annually. These national estimates help define the magnitude of the resistance problem so that control measures can be appropriately targeted. PMID:27983506

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

    Science.gov (United States)

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

    2013-01-01

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

  3. A beta-lactam antibiotic dampens excitotoxic inflammatory CNS damage in a mouse model of multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Nico Melzer

    Full Text Available In multiple sclerosis (MS and its animal model experimental autoimmune encephalomyelitis (EAE, impairment of glial "Excitatory Amino Acid Transporters" (EAATs together with an excess glutamate-release by invading immune cells causes excitotoxic damage of the central nervous system (CNS. In order to identify pathways to dampen excitotoxic inflammatory CNS damage, we assessed the effects of a beta-lactam antibiotic, ceftriaxone, reported to enhance expression of glial EAAT2, in "Myelin Oligodendrocyte Glycoprotein" (MOG-induced EAE. Ceftriaxone profoundly ameliorated the clinical course of murine MOG-induced EAE both under preventive and therapeutic regimens. However, ceftriaxone had impact neither on EAAT2 protein expression levels in several brain areas, nor on the radioactive glutamate uptake capacity in a mixed primary glial cell-culture and the glutamate-induced uptake currents in a mammalian cell line mediated by EAAT2. Moreover, the clinical effect of ceftriaxone was preserved in the presence of the EAAT2-specific transport inhibitor, dihydrokainate, while dihydrokainate alone caused an aggravated EAE course. This demonstrates the need for sufficient glial glutamate uptake upon an excitotoxic autoimmune inflammatory challenge of the CNS and a molecular target of ceftriaxone other than the glutamate transporter. Ceftriaxone treatment indirectly hampered T cell proliferation and proinflammatory INFgamma and IL17 secretion through modulation of myelin-antigen presentation by antigen-presenting cells (APCs e.g. dendritic cells (DCs and reduced T cell migration into the CNS in vivo. Taken together, we demonstrate, that a beta-lactam antibiotic attenuates disease course and severity in a model of autoimmune CNS inflammation. The mechanisms are reduction of T cell activation by modulation of cellular antigen-presentation and impairment of antigen-specific T cell migration into the CNS rather than or modulation of central glutamate homeostasis.

  4. Concurrent Drug-Induced Linear Immunoglobulin A Dermatosis and Immunoglobulin A Nephropathy

    OpenAIRE

    Kim, Ji Seok; Choi, Misoo; Nam, Chan Hee; Kim, Jee Young; Park, Byung Cheol; Kim, Myung Hwa; Hong, Seung Phil

    2015-01-01

    Diseases associated with immunoglobulin A (IgA) antibody include linear IgA dermatosis, IgA nephropathy, Celiac disease, Henoch-Schönlein purpura, etc. Although usually idiopathic, IgA antibody is occasionally induced by drugs (e.g., vancomycin, carbamazepine, ceftriaxone, and cyclosporine), malignancies, infections, and other causes. So far, only a few cases of IgA bullous dermatosis coexisting with IgA nephropathy have been reported. A 64-year-old female receiving intravenous ceftriaxone an...

  5. Affinity of ceftobiprole for penicillin-binding protein 2b in Streptococcus pneumoniae strains with various susceptibilities to penicillin.

    Science.gov (United States)

    Davies, Todd A; He, Wenping; Bush, Karen; Flamm, Robert K

    2010-10-01

    Wild-type penicillin-binding protein (PBP) 2b from penicillin-susceptible Streptococcus pneumoniae had high affinity for ceftobiprole and penicillin (50% inhibitory concentrations [IC(50)s] of ≤0.15 μg/ml) but not ceftriaxone (IC(50) of >8 μg/ml). In clinical isolates, ceftobiprole and PBP 2b affinities were reduced 15- to 30-fold with a Thr-446-Ala substitution and further still with an additional Ala-619-Gly PBP 2b substitution. Ceftobiprole remained active (MICs of ≤1 μg/ml) against all strains tested and behaved more like penicillin than ceftriaxone with respect to PBP 2b binding.

  6. 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.

  7. [Pharmaco-economic evaluation of antibiotic therapy in a ward for infections diseases

    Science.gov (United States)

    Sabbatani, S.; Cannella, B.; Fulgaro, C.; Pipitone, E.; Cesari, R.

    2000-01-01

    For all hospitalized patients admitted in the first six months of 1999, we recorded the data relative to antibiotic therapy (TA) administered, establishing the period of treatment in days and the dosage, including any variations during the period in question. We calculated the prescribed daily dose (PDD) and were thus able to establish the expense incurred in antibiotic therapy, comparing the real overall cost per product used. For all patients, the discharge diagnosis was reported, and the whole case-study was aggregated into homogeneous groups. PDD was compared with DDD (defined daily doses). The Pareto curve was used to highlight the antibiotics with higher overall cost. Besides cotrimoxazole, ceftriaxone and ciprofloxacin were the antibiotics most frequently prescribed, while ceftriaxone, imipenem-cilastatine and vancomycin were the antibiotics incurring the greatest expense. With reference to the average duration of the treatment cycle, ceftriaxone (9.75 dd) and ciprofloxacin tbl (6.75 dd) were the only antibiotics (in monotherapy) used for less than 10 treatment days. Special attention was paid to analysing the TA costs in treating pneumonia, which accounted for the highest percentage of cases (50 cases). Ceftriaxone, especially pulmonary infections, was the most commonly used drug. In hospitalized subjects treated who show good therapeutic response, we recommend early discharge and continuation of the therapy at home (switch therapy). This strategy will allow the patient to return to his/her family in good time, also thereby reducing hospital management costs.

  8. Microscopic haematuria: A rare presentation of typhoid fever.

    Science.gov (United States)

    Nisahan, Balasingam; Thirunavukarasu, Kumanan; Selvaratnam, Gowry

    2015-04-01

    Typhoid fever can cause a number of renal manifestations heretofore dubbed 'nephrotyphoid'. Haematuria in the absence of renal impairment is extremely rare among typhoid patients. We report a case of an adult who presented with a prolonged febrile illness and microscopic haematuria. Blood culture confirmed the diagnosis of typhoid and the patient was treated successfully with ceftriaxone.

  9. Antibiogram of Salmonella Isolates from Blood with an Emphasis on Nalidixic Acid and Chloramphenicol Susceptibility in a Tertiary Care Hospital in Coastal Karnataka: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Anup Kumar Shetty

    2012-01-01

    Conclusion: Routine screening of Nalidixic acid susceptibility is practical to predict fluorquinolone resistance in Salmonella and preventing therapeutic failure while treating with it. It is worthwhile to consider replacing fluorquinolones with Chloramphenicol or Ceftriaxone as the first line of therapy for enteric fever. Periodic analysis of Salmonella antibiogram should be done to formulate the best possible treatment strategies.

  10. Increase in isolation of extended spectrum beta lactamase producing multidrug resistant non typhoidal Salmonellae in Pakistan

    Directory of Open Access Journals (Sweden)

    Khan Erum

    2010-04-01

    Full Text Available Abstract Background Increasing resistance to quinolones and ceftriaxone in non typhoidal Salmonellae is a global concern. Resistance to quinolone and 3rd generation cephalosporin amongst non typhoidal Salmonellae (NTS from Pakistan has been reported in this study. Methods Retrospective analysis of laboratory data was conducted (1990-2006. NTS were isolated and identified from clinical samples using standard microbiological techniques. Antimicrobial susceptibility testing was performed by Kirby Bauer. Extended spectrum beta lactamase production (ESBL was detected using combined disc method. Ciprofloxacin sensitivity was detected by nalidixic acid screening method. Minimum inhibitory concentration (MIC of ciprofloxacin was determined by agar dilution method. Statistical analysis was performed using SPSS version 13. Results Analysis of 1967 NTS isolates showed a significant increase in ciprofloxacin resistance from 23% in 2002 to 50.5% in 2006, with increased mean MIC values from 0.6 to 1.3 ug/mL. Ceftriaxone resistant NTS also increased and ESBL production was seen in 98.7% isolates. These isolates exhibited high resistance against amoxicillin clavulanic acid (57%, gentamicin (69%, amikacin (44% and piperacillin tazobactam (30%. No resistance to carbapenem was seen. Ceftriaxone resistance was significantly higher in children Conclusions Increase in quinolone and ceftriaxone NTS is a serious threat to public health requiring continuous surveillance and use of appropriate screening tests for laboratory detection.

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

    Directory of Open Access Journals (Sweden)

    Hamid Mohammad-Jafari

    2012-02-01

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

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

    Science.gov (United States)

    Torgomyan, H

    2012-12-01

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

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

    Science.gov (United States)

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

    1993-01-01

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

  14. A Phase 3 Randomized Double-Blind Comparison of Ceftobiprole Medocaril Versus Ceftazidime Plus Linezolid for the Treatment of Hospital-Acquired Pneumonia

    NARCIS (Netherlands)

    Awad, Samir S.; Rodriguez, Alejandro H.; Chuang, Yin-Ching; Marjanek, Zsuszanna; Pareigis, Alex J.; Reis, Gilmar; Scheeren, Thomas W. L.; Sanchez, Alejandro S.; Zhou, Xin; Saulay, Mikal; Engelhardt, Marc

    2014-01-01

    Background:  Ceftobiprole, the active moiety of ceftobiprole medocaril, is a novel broad-spectrum cephalosporin, with bactericidal activity against a wide range of gram-positive bacteria, including Staphylococcus aureus (including methicillin-resistant strains) and penicillin-and ceftriaxone-resista

  15. Effect of ceftobiprole treatment on growth of and toxin production by Clostridium difficile in cecal contents of mice.

    Science.gov (United States)

    Nerandzic, Michelle M; Donskey, Curtis J

    2011-05-01

    Ceftobiprole and ceftobiprole medocaril did not promote growth of or toxin production by Clostridium difficile in mouse cecal contents, whereas ceftazidime, cefoxitin, ceftriaxone, cefotaxime, and ertapenem did. The relatively low propensity of ceftobiprole to promote C. difficile was attributable to inhibitory activity against C. difficile and sparing of anaerobic microflora.

  16. Effect of Ceftobiprole Treatment on Growth of and Toxin Production by Clostridium difficile in Cecal Contents of Mice▿

    OpenAIRE

    2011-01-01

    Ceftobiprole and ceftobiprole medocaril did not promote growth of or toxin production by Clostridium difficile in mouse cecal contents, whereas ceftazidime, cefoxitin, ceftriaxone, cefotaxime, and ertapenem did. The relatively low propensity of ceftobiprole to promote C. difficile was attributable to inhibitory activity against C. difficile and sparing of anaerobic microflora.

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

    Science.gov (United States)

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

    2012-11-01

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

  18. [NET WATER TRANSPORT VIA RAT COLON EPITELIUM UNDER THE EXPERIMENTAL DYSBIOSIS].

    Science.gov (United States)

    Dovbynchuk, T; Zakordonets, L; Putnikov, A; Vareniuk, I; Tiapko, O; Roslova, N; Sergiychuk, T; Lynchak, O; Dzerzhynsky, M; Beregova, T; Tolstanova, G

    2015-01-01

    The aim of the present study was to investigate the effect of cephalosporin antibiotic ceftriaxone (50 mg/kg, i/m) and mac- rolide antibiotic azithromycin (15 mg/kg, per.os.) on net water transport across rat colonic epithelium. Study was done on male Wistar rats (180-250 g). Azithromycin or ceftriaxone was injected daily for 5 days. Net water transport was evaluated on the 6th day by isolated colonic loop perfusion technique in vivo on anaesthetized rats. Treatment with azithromycin increased 2,4-fold the absorption of water, while ceftriaxone caused decrease 1,9-fold water absorption. The antibiotics treatment within five days didn't change the composition of the fecal and colonic parietal microbiota. Azithromycin-induced increase in water absorption was associated with upregulation of AQP 8 water channel expression (P < 0.05) in colonic mucosa. Ceftriaxone treatment didn't change protein level of AQP8 but induced pro-inflammatory changes in colonic mucosa structure and mast cells degranulation. We showed for the first time the opposite effects ofmacrolide and cephalosporin antibiotics on net water transport across rat colonic epithelium.

  19. Prevalence of extended-spectrum cephalosporinase (ESC)-producing Escherichia coli in Danish slaughter pigs and retail meat identified by selective enrichment and association with cephalosporin usage

    DEFF Research Database (Denmark)

    Agersø, Yvonne; Aarestrup, Frank Møller; Pedersen, Karl;

    2012-01-01

    with ceftriaxone (1 mg/L). ESC genotypes were detected using PCR, microtube array and sequencing. The MIC of cefotaxime was determined for 150 E. coli from the pigs and 606 E. coli from meat isolated without selective enrichment. RESULTS: Eleven percent (86/786) of slaughter pigs contained ESC E. coli...

  20. Empiric antibiotic choices for community-acquired biliary tract infections

    Directory of Open Access Journals (Sweden)

    Kuo-Kuan Chang

    2014-06-01

    Conclusion: The combination of ceftriaxone plus metronidazole appears to be the most appropriate empiric antibiotics for the treatment of CA-BTI at this hospital. Because different hospitals may encounter microorganisms of different antimicrobial susceptibilities, similar approaches may be followed by other hospitals where appropriate empiric therapy has not yet been established for the treatment of CA-BTI.

  1. Influence of penicillin/amoxicillin non-susceptibility on the activity of third-generation cephalosporins against Streptococcus pneumoniae.

    Science.gov (United States)

    Fenoll, A; Giménez, M J; Robledo, O; Aguilar, L; Tarragó, D; Granizo, J J; Martín-Herrero, J E

    2008-01-01

    To study the influence of penicillin/amoxicillin non-susceptibility on the activity of third-generation cephalosporins, 430 consecutive penicillin non-susceptible Streptococcus pneumoniae 2007 isolates received in the Spanish Reference Pneumococcal Laboratory were tested. For comparative purposes, 625 penicillin-susceptible 2007 isolates were also tested. Susceptibility was determined by agar dilution using Mueller-Hinton agar supplemented with 5% sheep blood. Penicillin-susceptible strains were susceptible to amoxicillin, cefotaxime and ceftriaxone, 99.8% to cefpodoxime and 99.5% to cefdinir, and were inhibited by 0.12 microg/ml of cefditoren and 4 microg/ml of cefixime. Penicillin-intermediate strains were susceptible to cefotaxime and ceftriaxone, with Penicillin-resistant strains were resistant to cefdinir and cefpodoxime, with 74.8% and 94.1% susceptibility to cefotaxime and ceftriaxone, respectively. Cefditoren MIC(50)/MIC(90) (0.5/1 microg/ml) were lower than cefotaxime and ceftriaxone. Among amoxicillin non-susceptible strains, susceptibility to cefdinir and cefpodoxime was penicillin/amoxicillin non-susceptibility, while parenteral third-generation cephalosporins exhibited higher intrinsic activity (MIC(90)=1 microg/ml for penicillin-resistant and 2 microg/ml for amoxicillin-resistant strains). Cefditoren exhibited one-dilution lower MIC(90) values for these strains, even against those of the most troublesome serotypes.

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Sunil S Gidamudi

    2015-09-01

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

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

    Science.gov (United States)

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

    1984-12-01

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

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

    Science.gov (United States)

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

    2010-07-25

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

  6. Evaluation of CLSI Agar Dilution Method and Trek Sensititre Broth Microdilution Panel for Determining Antimicrobial Susceptibility of Streptococcus pneumoniae▿

    Science.gov (United States)

    Zhang, Sean X.; Rawte, Prasad; Brown, Shirley; Lo, Steven; Siebert, Heather; Pong-Porter, Sylvia; Low, Donald E.; Jamieson, Frances B.

    2011-01-01

    Both the CLSI agar dilution method and Trek Sensititre broth microdilution panel for Streptococcus pneumoniae antimicrobial susceptibility testing were evaluated against the reference CLSI broth microdilution method using the most recently published CLSI breakpoints. While agar dilution was not an optimal method, the commercial panel appeared to be an acceptable method, with minor errors encountered for ceftriaxone, penicillin, and meropenem. PMID:21123533

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Jeevan Ranjan Dash

    2014-01-01

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

  9. Clinical Efficacy of Azithromycin in Typhoid and Paratyphoid Fever in Children

    Directory of Open Access Journals (Sweden)

    Md Atiqul Islam

    2015-01-01

    Full Text Available Background: Azithromycin sensitivity cannot precisely identify the strains of typhoid and paratyphoid fever for successful treatment. Most of the studies show that azithromycin is highly effective in uncomplicated typhoid fever. Very few studies have been carried out in Bangladesh to see the effectiveness and sensitivity of azithromycin in children with uncomplicated typhoid fever. Objective: To assess the clinical response of azithromycin in uncomplicated typhoid fever. Materials and Methods: This randomized clinical trial was conducted in Dhaka Shishu (children Hospital from January to December 2009. Children between 2–12 years of age with characteristic clinical presentation of uncomplicated typhoid fever with positive blood culture for S. typhi or S. paratyphi were included in this study. Patients were treated with oral azithromycin 20 mg/kg/day for 7 days in one group and intravenous ceftriaxone 100 mg/kg/day in another group. Effectiveness and sensitivity pattern were documented and compared. Results: Fifty patients were allocated randomly with azithromycin and 48 with ceftriaxone. Twenty two percent of the subjects were below 5 years and 78% above 5 years. Average time of defervescence was 4.44 ± 1.25 days in azithromycin group and 4.38 ± 1.21 days in ceftriaxone group. Response to treatment in both groups was excellent: 94% in azithromycin and 97.9% in ceftriaxone groups. The occurrence of complication was very low in both groups. Eighteen percent showed resistance to azithromycin and 2.1% to ceftriaxone. In azithromycin sensitive group 97.6% showed improvement and in resistant group 77.8% showed improvement. A good percentage of patients who were resistant to azithromycin showed clinical improvement following treatment with this drug. Conclusion: Current study recommends that azithromycin is effective in the treatment of enteric fever in children. The study also shows that some patients resistant to azithromycin showed clinical

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

    Directory of Open Access Journals (Sweden)

    C. Lazzaro

    2013-05-01

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

  11. Synergistic antibacterial effect of apigenin with β-lactam antibiotics and modulation of bacterial resistance by a possible membrane effect against methicillin resistant Staphylococcus aureus.

    Science.gov (United States)

    Akilandeswari, K; Ruckmani, K

    2016-12-30

    Methicillin-resistant Staphylococcus aureus (MRSA) infections are easily spread among infected patients, where resistance has dramatically increased resulted in serious health issues. Therefore, there is a need to develop alternative natural or combination drug therapies. Apigenin (AP) is a natural poly phenolic flavonoid has been found to possess many beneficial biological actions. The aim of this study was to investigate the anti-MRSA efficacy and synergistic effect of apigenin (AP) and in combination with ampicillin (AM) and ceftriaxone (CEF). The antibacterial activity of apigenin was assessed by the broth macro dilution, checkerboard micro dilution method and time-kill assay.  The mode of action was studied by outer and inner membrane permeabilisation assays, scanning electron microscopy and transmission electron microscopy. The minimum inhibitory concentration (MIC) of apigenin against gram positive and gram negative strain ranged from 32.5 to 62.5µg/ml. In checkerboard method apigenin markedly reduced the MIC of the antibiotics ampicillin 800 µg/ml shifted to 107 µg/ml (AM+AP) and ceftriaxone 58 µg/ml shifted to 2.6 µg/ml (CEF+AP) against MRSA. The synergistic activity of ampicillin and ceftriaxone plus apigenin combinations with FIC indices (CI) between 0.18-0.47. The modulation of methicillin-resistance by apigenin significantly enhanced the activities of ampicillin and ceftriaxone. The result of time-kill assays of the two drug combinations AM +AP and CEF+AP against MRSA showed significant inhibitory effect and reduced the colony count by approximately 99% after 8 h The results for outer membrane (OM) and inner membrane (IM) permeabilization showed that ampicillin and ceftriaxone in combination with apigenin damaged MRSA cytoplasmic membrane and caused subsequent leakage of intracellular constituents. Electron microscopy clearly showed that the above said combination also caused marked morphological damage of cell wall, cell shape and plasma

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

    Science.gov (United States)

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

    2006-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Claudio Farina

    2010-03-01

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

  14. 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.

  15. 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.

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

    Science.gov (United States)

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

    2016-03-01

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

  17. Risk Factors associated with Paraurethral Duct Dilatation following Gonococcal Paraurethral Duct Infection in Men

    Science.gov (United States)

    Fan, Wenge; Zhang, Qingsong; Wang, Lin; Ye, Xun; Jiang, Tingwang

    2016-01-01

    No studies have explored the risk factors for paraurethral duct dilatation following paraurethral duct infection by Neisseria gonorrhoeae in men undergoing ceftriaxone therapy. The present study was performed to explore the risk factors for paraurethral duct dilatation following paraurethral duct infection by N. gonorrhoeae in men undergoing ceftriaxone therapy and thus guide clinical interventions. We compared the demographic, behavioral, and clinical data of men with paraurethral duct infection by N. gonorrhoeae with and without dilatation of the paraurethral duct. Univariate analysis showed significant differences in age, disease course of the infected paraurethral duct, Chlamydia trachomatis infection in the paraurethral duct, and a history of paraurethral duct infection by N. gonorrhoeae between the patient and control groups (Pgonorrhoeae in men. Age, C. trachomatis infection in the paraurethral duct, and a history of paraurethral duct infection by N. gonorrhoeae are also risk factors. Thus, educating patients to undergo timely therapy and treating the C. trachomatis infection may be effective interventions. PMID:27861521

  18. Optic neuropathy in children with Lyme disease.

    Science.gov (United States)

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

    2001-08-01

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

  19. Concurrent Drug-Induced Linear Immunoglobulin A Dermatosis and Immunoglobulin A Nephropathy.

    Science.gov (United States)

    Kim, Ji Seok; Choi, Misoo; Nam, Chan Hee; Kim, Jee Young; Park, Byung Cheol; Kim, Myung Hwa; Hong, Seung Phil

    2015-06-01

    Diseases associated with immunoglobulin A (IgA) antibody include linear IgA dermatosis, IgA nephropathy, Celiac disease, Henoch-Schönlein purpura, etc. Although usually idiopathic, IgA antibody is occasionally induced by drugs (e.g., vancomycin, carbamazepine, ceftriaxone, and cyclosporine), malignancies, infections, and other causes. So far, only a few cases of IgA bullous dermatosis coexisting with IgA nephropathy have been reported. A 64-year-old female receiving intravenous ceftriaxone and metronidazole for liver abscess had purpuric macules and papules on her extremities. One week later, she had generalized edema and skin rash with bullae and was diagnosed with concurrent linear IgA dermatosis and IgA nephropathy. After steroid treatment, the skin lesion subsided within two weeks, and kidney function slowly returned to normal. As both diseases occurred after a common possible cause, we predict their pathogeneses are associated.

  20. Evaluation of Eight Different Cephalosporins for Detection of Cephalosporin Resistance in Salmonella enterica and Escherichia coli

    DEFF Research Database (Denmark)

    Aarestrup, Frank Møller; Hasman, Henrik; Veldman, K

    2010-01-01

    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......-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...

  1. 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.

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

    OpenAIRE

    Modi RS; Sattigeri BM; Patel AH

    2015-01-01

    Penicillin alone or with combination should be used in hospitalized patients to treat bacterial infections with great precautions since penicillin is known to produce hypersensitivity reactions very commonly. A 53 year old hospitalized male patient having tibia fracture was initially given ceftriaxone plus salbactum and amikacin as an antibacterial therapeutics. Subsequently patient was treated with Pipzo (Inj. Piperacillin plus Tezobactum; 4.5 gm.) on the basis of anti- bacterial sensitivity...

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

    Directory of Open Access Journals (Sweden)

    Juan Bosco Gonzalez

    2014-01-01

    Full Text Available Nicaragua does not have a national plan for folic acid fortification. Mothers are often very young. At La Mascota we operated more than 40 cases per year. Delayed arrival is a problem. Pre operative infection has to be ruled out. Vancomycin and Ceftriaxone are indicated. Strict scrub rules are applied. Restore the shape of the cord by suturing the placode. Do not close muscle layer.

  5. Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes Meningite bacteriana aguda por Streptococcus pneumoniae resistente aos antimicrobianos e seus sorotipos

    OpenAIRE

    Andrea Maciel de Oliveira Rossoni; Libera Maria Dalla Costa; Denize Bonato Berto; Sônia Santos Farah; Marilene Gelain; Maria Cristina de Cunto Brandileone; Vitor Hugo Mariano Ramos; Sergio Monteiro de Almeida

    2008-01-01

    The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from Apri...

  6. POLA PEMBERIAN ANTIBIOTIKA PENGOBATAN DEMAM TIFOID ANAK DI RUMAH SAKIT FATMAWATI JAKARTA TAHUN 2001 – 2002

    Directory of Open Access Journals (Sweden)

    Ascobat Gani

    2004-06-01

    Full Text Available The Pattern of the Use of Antibiotics in the Treatment of Children with Typhoid Fever in Fatmawati Hospital Jakarta, 2001-2002. This study was a retrospective study using a descriptive design on the treatment of typhoid fever involving 182 children at Fatmawati Hospital Jakarta. Chloramphenicol was still the drug of choice againts Salmolella typhi. It was also shown that ceftriaxone was an alternative drug used rather frequently for typhoid fever in children.

  7. Kinetic Features of L,D-Transpeptidase Inactivation Critical for β-Lactam Antibacterial Activity

    Science.gov (United States)

    Lecoq, Lauriane; Bougault, Catherine; Mainardi, Jean-Luc; Rice, Louis B.; Ethève-Quelquejeu, Mélanie; Gutmann, Laurent; Marie, Arul; Dubost, Lionel; Hugonnet, Jean-Emmanuel; Simorre, Jean-Pierre; Arthur, Michel

    2013-01-01

    Active-site serine D,D-transpeptidases belonging to the penicillin-binding protein family (PBPs) have been considered for a long time as essential for peptidoglycan cross-linking in all bacteria. However, bypass of the PBPs by an L,D-transpeptidase (Ldtfm) conveys high-level resistance to β-lactams of the penam class in Enterococcus faecium with a minimal inhibitory concentration (MIC) of ampicillin >2,000 µg/ml. Unexpectedly, Ldtfm does not confer resistance to β-lactams of the carbapenem class (imipenem MIC = 0.5 µg/ml) whereas cephems display residual activity (ceftriaxone MIC = 128 µg/ml). Mass spectrometry, fluorescence kinetics, and NMR chemical shift perturbation experiments were performed to explore the basis for this specificity and identify β-lactam features that are critical for efficient L,D-transpeptidase inactivation. We show that imipenem, ceftriaxone, and ampicillin acylate Ldtfm by formation of a thioester bond between the active-site cysteine and the β-lactam-ring carbonyl. However, slow acylation and slow acylenzyme hydrolysis resulted in partial Ldtfm inactivation by ampicillin and ceftriaxone. For ampicillin, Ldtfm acylation was followed by rupture of the C5–C6 bond of the β-lactam ring and formation of a secondary acylenzyme prone to hydrolysis. The saturable step of the catalytic cycle was the reversible formation of a tetrahedral intermediate (oxyanion) without significant accumulation of a non-covalent complex. In agreement, a derivative of Ldtfm blocked in acylation bound ertapenem (a carbapenem), ceftriaxone, and ampicillin with similar low affinities. Thus, oxyanion and acylenzyme stabilization are both critical for rapid L,D-transpeptidase inactivation and antibacterial activity. These results pave the way for optimization of the β-lactam scaffold for L,D-transpeptidase-inactivation. PMID:23861815

  8. 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

  9. 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

  10. Tricuspid valve endocarditis due to Neisseria cinerea.

    Science.gov (United States)

    Benes, J; Dzupova, O; Krizova, P; Rozsypal, H

    2003-02-01

    Reported here is a case of infective endocarditis caused by the saprophytic species Neisseria cinerea. To the best of our knowledge, this etiology has not been documented in the medical literature previously. The patient was an intravenous drug addict who developed tricuspid endocarditis with lung embolism. The disease was cured after treatment with ampicillin/clavulanate that was changed to ceftriaxone after an embolic event.

  11. 尿管皮膚瘻造設術後の尿管ステント交換に伴い発症した腸腰筋膿瘍の1例

    OpenAIRE

    2012-01-01

    A 69-year-old man underwent a radical cystectomy and cutaneous ureterostomy for carcinoma in situ of the urinary bladder. The ureteral stents were exchanged for cutaneous ureterostomy 35 days after the operation. The patient suffered from high fever with chills a few hours after the stent exchange, and was readmitted to our hospital. High fever was not improved by treatment with Ceftriaxone for 5 days. Five days after the stent exchange, computed tomography (CT) revealed a right psoas abscess...

  12. 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.

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

    Science.gov (United States)

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

    2016-08-01

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

  14. Extensive antibiotic prescription rate among hospitalized patients in Uganda: but with frequent missed-dose days

    Science.gov (United States)

    Kiguba, Ronald; Karamagi, Charles; Bird, Sheila M.

    2016-01-01

    Objectives To describe the patterns of systemic antibiotic use and missed-dose days and detail the prescription, dispensing and administration of frequently used hospital-initiated antibiotics among Ugandan inpatients. Methods This was a prospective cohort of consented adult inpatients admitted on the medical and gynaecological wards of the 1790 bed Mulago National Referral Hospital. Results Overall, 79% (603/762; 95% CI: 76%–82%) of inpatients received at least one antibiotic during hospitalization while 39% (300/762; 95% CI: 36%–43%) had used at least one antibiotic in the 4 weeks pre-admission; 1985 antibiotic DDDs, half administered parenterally, were consumed in 3741 inpatient-days. Two-fifths of inpatients who received at least one of the five frequently used hospital-initiated antibiotics (ceftriaxone, metronidazole, ciprofloxacin, amoxicillin and azithromycin) missed at least one antibiotic dose-day (44%, 243/558). The per-day risk of missed antibiotic administration was greatest on day 1: ceftriaxone (36%, 143/398), metronidazole (27%, 67/245), ciprofloxacin (34%, 39/114) and all inpatients who missed at least one dose-day of prescribed amoxicillin and azithromycin. Most patients received fewer doses than were prescribed: ceftriaxone (74%, 273/371), ciprofloxacin (90%, 94/105) and metronidazole (97%, 222/230). Of prescribed doses, only 62% of ceftriaxone doses (1178/1895), 35% of ciprofloxacin doses (396/1130) and 27% of metronidazole doses (1043/3862) were administered. Seven percent (13/188) of patients on intravenous metronidazole and 6% (5/87) on intravenous ciprofloxacin switched to oral route. Conclusions High rates of antibiotic use both pre-admission and during hospitalization were observed, with low parenteral/oral switch of hospital-initiated antibiotics. Underadministration of prescribed antibiotics was common, especially on the day of prescription, risking loss of efficacy and antibiotic resistance. PMID:26945712

  15. Prosthetic valve endocarditis due to Neisseria elongata subsp. elongata in a patient with Klinefelter's syndrome.

    Science.gov (United States)

    Evans, Morgan; Yazdani, Farah; Malnick, Henry; Shah, Jayesh J; Turner, David P J

    2007-06-01

    A case is reported of prosthetic valve endocarditis due to Neisseria elongata subsp. elongata in a patient with Klinefelter's syndrome. This is believed to be only the third case of endocarditis reported due to this subspecies. N. elongata is difficult to identify, and is morphologically and biochemically similar to Kingella spp. Sequencing of the 16S rRNA gene is useful for identification. The patient was successfully treated with amoxicillin and gentamicin, followed by ceftriaxone.

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

    Science.gov (United States)

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

    2014-11-01

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

  17. Ascariasis as a cause of hepatic abscess: A report of 3 cases.

    Science.gov (United States)

    Chauhan, V; Thakur, S; Rana, B

    2015-01-01

    We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

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

    Directory of Open Access Journals (Sweden)

    Ž. Žagar

    2007-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  20. Oxacillin disk diffusion testing for the prediction of penicillin resistance in Streptococcus pneumoniae.

    Science.gov (United States)

    Horna, Gertrudis; Molero, María L; Benites, Liliana; Roman, Sigri; Carbajal, Luz; Mercado, Erik; Castillo, María E; Zerpa, Rito; Chaparro, Eduardo; Hernandez, Roger; Silva, Wilda; Campos, Francisco; Saenz, Andy; Reyes, Isabel; Villalobos, Alex; Ochoa, Theresa J

    2016-08-01

    Objective To 1) describe the correlation between the zones of inhibition in 1-µg oxacillin disk diffusion (ODD) tests and penicillin and ceftriaxone minimum inhibitory concentrations (MICs) of meningeal and non-meningeal strains of Streptococcus pneumoniae and 2) evaluate the usefulness of the ODD test as a predictor of susceptibility to penicillin in S. pneumoniae and as a quick and cost-effective method easily implemented in a routine clinical laboratory setting. Methods S. pneumoniae isolates from healthy nasopharyngeal carriers less than 2 years old, obtained in a multicentric cross-sectional study conducted in various Peruvian hospitals and health centers from 2007 to 2009, were analyzed. Using Clinical and Laboratory Standards Institute (CLSI) breakpoints, the correlation between the zones of inhibition of the ODD test and the MICs of penicillin and ceftriaxone was determined. Results Of the 571 S. pneumoniae isolates, 314 (55%) showed resistance to penicillin (MIC ≥ 0.12 µg/mL) and 124 (21.7%) showed resistance to ceftriaxone (MIC ≥ 1 µg/mL). Comparison of the ODD test zones of inhibition and the penicillin MICs, using the CLSI meningeal breakpoints, showed good correlation (Cohen's kappa coefficient = 0.8239). Conclusions There was good correlation between ODD zones of inhibition and penicillin meningeal breakpoints but weak correlation between the ODD results and non-meningeal breakpoints for both penicillin and ceftriaxone. Therefore, the ODD test appears to be a useful tool for predicting penicillin resistance in cases of meningeal strains of S. pneumoniae, particularly in low- and middle- income countries, where MIC determination is not routinely available.

  1. Adjuvant treatment with dexamethasone plus anti-C5 antibodies improves outcome of experimental pneumococcal meningitis: a randomized controlled trial

    OpenAIRE

    2015-01-01

    Background We compared adjunctive treatment with placebo, dexamethasone, anti-C5 antibodies, and the combination of dexamethasone plus anti-C5 antibodies in experimental pneumococcal meningitis. Methods In this prospective, investigator-blinded, randomized trial, 96 mice were infected intracisternally with 107 CFU/ml Streptococcus pneumoniae serotype 3, treated with intraperitoneal ceftriaxone at 20 h, and randomly assigned to intraperitoneal adjunctive treatment with placebo (saline), dexame...

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

    Directory of Open Access Journals (Sweden)

    Khaki P

    2007-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  4. 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.

  5. [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.

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

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    Sébastien Triboulet

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

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

    Directory of Open Access Journals (Sweden)

    Hamed Molaabaszadeh

    2013-10-01

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

  8. 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.

  9. Glutamatergic Mechanisms of Comorbidity Between Acute Stress and Cocaine Self-administration

    Science.gov (United States)

    Garcia-Keller, Constanza; Kupchik, Yonatan; Gipson, Cassandra D; Brown, Robyn M; Spencer, Sade; Bollati, Flavia; Esparza, Maria A; Roberts-Wolfe, Doug; Heinsbroek, Jasper; Bobadilla, Ana-Clara; Cancela, Liliana M; Kalivas, Peter W

    2015-01-01

    There is substantial comorbidity between stress disorders and substance use disorders (SUDs), and acute stress augments the locomotor stimulant effect of cocaine in animal models. Here we endeavor to understand the neural underpinnings of comorbid stress disorders and drug use by determining if the glutamatergic neuroadaptations that characterize cocaine self-administration are induced by acute stress. Rats were exposed to acute (2 h) immobilization stress and 3 weeks later the nucleus accumbens core was examined for changes in glutamate transport, glutamate mediated synaptic currents, and dendritic spine morphology. We also determined if acute stress potentiated the acquisition of cocaine self-administration. Acute stress produced an enduring reduction in glutamate transport, and potentiated excitatory synapses on medium spiny neurons. Acute stress also augmented the acquisition of cocaine self-administration. Importantly, by restoring glutamate transport in the accumbens core with ceftriaxone the capacity of acute stress to augment the acquisition of cocaine self-administration was abolished. Similarly, ceftriaxone treatment prevented stress-induced potentiation of cocaine-induced locomotor activity. However, ceftriaxone did not reverse stress-induced synaptic potentiation, indicating that this effect of stress exposure did not underpin the increased acquisition of cocaine self-administration. Reversing acute stress-induced vulnerability to self-administer cocaine by normalizing glutamate transport poses a novel treatment possibility for reducing comorbid SUDs in stress disorders. PMID:26821978

  10. 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.)

  11. Ceftobiprole medocaril (BAL5788) treatment of experimental Haemophilus influenzae, Enterobacter cloacae, and Klebsiella pneumoniae murine pneumonia.

    Science.gov (United States)

    Rouse, Mark S; Hein, Melanie M; Anguita-Alonso, Paloma; Steckelberg, James M; Patel, Robin

    2006-08-01

    Ceftobiprole (BAL9141) is an investigational cephalosporin active against methicillin- and vancomycin-resistant staphylococci administered as a water-soluble prodrug, ceftobiprole medocaril (BAL5788). Using an immunocompetent murine pneumonia model of Haemophilus influenzae, Enterobacter cloacae, or extended-spectrum beta-lactamase (ESBL) nonproducing or producing Klebsiella pneumoniae pneumonia, we compared results of treatment with ceftobiprole medocaril (71 mg/kg, sc, qid), ceftriaxone (50 mg/kg, im, bid), or cefepime (50 mg/kg, ip, q.i.d.). Results were expressed as median and 25th to 75th percentile log10 colony forming units per gram of lung tissue. Ceftobiprole, ceftriaxone, and cefepime were each more active than was no treatment and were equally active for treatment of experimental H. influenzae, E. cloacae, or ESBL-nonproducing K. pneumoniae pneumonia. For ESBL-producing K. pneumoniae, no differences were detected between no treatment and treatment with ceftobiprole, ceftriaxone, or cefepime. Ceftobiprole is active against H. influenzae, E. cloacae, and ESBL-nonproducing K. pneumoniae in an immunocompetent experimental murine pneumonia model.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Kauser Jabeen

    2011-01-01

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

  14. The CroRS Two-Component Regulatory System Is Required for Intrinsic β-Lactam Resistance in Enterococcus faecalis

    Science.gov (United States)

    Comenge, Yannick; Quintiliani, Richard; Li, Ling; Dubost, Lionnel; Brouard, Jean-Paul; Hugonnet, Jean-Emmanuel; Arthur, Michel

    2003-01-01

    Enterococcus faecalis produces a specific penicillin-binding protein (PBP5) that mediates high-level resistance to the cephalosporin class of β-lactam antibiotics. Deletion of a locus encoding a previously uncharacterized two-component regulatory system of E. faecalis (croRS) led to a 4,000-fold reduction in the MIC of the expanded-spectrum cephalosporin ceftriaxone. The cytoplasmic domain of the sensor kinase (CroS) was purified and shown to catalyze ATP-dependent autophosphorylation followed by transfer of the phosphate to the mated response regulator (CroR). The croR and croS genes were cotranscribed from a promoter (croRp) located in the rrnC-croR intergenic region. A putative seryl-tRNA synthetase gene (serS) located immediately downstream from croS did not appear to be a target of CroRS regulation or to play a role in ceftriaxone resistance. A plasmid-borne croRp-lacZ fusion was trans-activated by the CroRS system in response to the presence of ceftriaxone in the culture medium. The fusion was also induced by representatives of other classes of β-lactam antibiotics and by inhibitors of early and late steps of peptidoglycan synthesis. The croRS null mutant produced PBP5, and expression of an additional copy of pbp5 under the control of a heterologous promoter did not restore ceftriaxone resistance. Deletion of croRS was not associated with any defect in the synthesis of the nucleotide precursor UDP-MurNAc-pentapeptide or of the d-Ala4→l-Ala-l-Ala-Lys3 peptidoglycan cross-bridge. Thus, the croRS mutant was susceptible to ceftriaxone despite the production of PBP5 and the synthesis of wild-type peptidoglycan precursors. These observations constitute the first description of regulatory genes essential for PBP5-mediated β-lactam resistance in enterococci. PMID:14645279

  15. Paratyphoid fever- Emerging problem in South India

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  16. The First Report of a Fully Sequenced Resistance Plasmid from Shigella boydii

    Science.gov (United States)

    Wang, Li; Liu, Lei; Liu, Dong; Yin, Zhe; Feng, Jiao; Zhang, Defu; Fang, Haihong; Qiu, Yefeng; Chen, Weijun; Yang, Ruisheng; Wang, Jinglin; Fa, Yunzhi; Zhou, Dongsheng

    2016-01-01

    The purpose of this study was to characterize mechanisms of plasmid-mediated antimicrobial resistance in Shigella boydii. S. boydii strain 2246 with resistance to ciprofloxacin, ceftriaxone and azithromycin was isolated from a human case of watery diarrhea in a Chinese public hospital. Resistance in strain 2246 to ceftriaxone and azithromycin was attributable to the presence of blaCTX-M-14, and erm(B) and mph(A), respectively, which were co-located on a multidrug-resistant (MDR) plasmid p2246-CTXM. p2246-CTXM represented a novel IncFII-type MDR plasmid with a very complex chimera structure. Its master backbone was genetically closely related to the R100 plasmid, but p2246-CTXM had evolved to integrate additional R100-unrelated backbone regions as well as massive exogenous mobile elements that carried multiple resistance determinants. In p2246-CTXM, erm(B) together with its leading peptide gene erm(C), mph(A) together with its regulatory genes mrx and mphR(A), and blaCTX-M-14 were captured by three different mobile elements Tn6295, the IS26-mph(A)-mrx-mphR(A)-IS6100 unit, and a truncated ISEcp1-blaCTX-M-14-IS903D-iroN transposition unit, respectively, all of which were harbored in a large Tn3-family transposon Tn6285. p2246-CTXM still carried additional resistance determinants mer (mercury resistance), aacA4 (aminoglycoside resistance), cmlA1 (chloramphenicol resistance), and qacED1 (quaternary ammonium compound resistance). This is the first report of identifying a clinical S. boydii strain simultaneously resistant to ciprofloxacin, ceftriaxone, and azithromycin, and determining the complete sequence of a resistance plasmid from S. boydii. PMID:27766094

  17. Biotic and abiotic degradation of four cephalosporin antibiotics in a lake surface water and sediment.

    Science.gov (United States)

    Jiang, Muxian; Wang, Lianhong; Ji, Rong

    2010-09-01

    Cephalosporins are widely used veterinary and human antibiotics, but their environmental fate and impacts are still unclear. We studied degradation of four cephalosporins (cefradine, cefuroxime, ceftriaxone, and cefepime) from each generation in the surface water and sediment of Lake Xuanwu, China. The four cephalosporins degraded abiotically in the surface water in the dark with half-lives of 2.7-18.7d, which were almost the same as that in sterilized surface water. Under exposure to simulated sunlight, the half-lives of the cephalosporins decreased significantly to 2.2-5.0d, with the maximal decrease for ceftriaxone from 18.7d in the dark to 4.1d under the light exposure. Effects of dissolved organic matter (DOM) and nitrate on photodegradation of the cephalosporins were compound-specific. While DOM (5 mg L(-1)) stimulated the photodegradation of only cefradine (by 9%) and cefepime (by 34%), nitrate (10 microM) had effects only on cefepime (stimulation by 13%). Elimination rates of the cephalosporins in oxic sediment (half-lives of 0.8-3.1d) were higher than in anoxic sediment (half-lives of 1.1-4.1d), mainly attributed to biodegradation. The data indicate that abiotic hydrolysis (for cefradine, cefuroxime, and cefepime) and direct photolysis (for ceftriaxone) were the primary processes for elimination of the cephalosporins in the surface water of the lake, whereas biodegradation was responsible for the elimination of the cephalosporins in the sediment. Further studies are needed on chemical structure, toxicity, and persistence of transformation products of the cephalosporins in the environment.

  18. The role of Gr-1(+) cells and tumour necrosis factor-α signalling during Clostridium difficile colitis in mice.

    Science.gov (United States)

    McDermott, Andrew J; Higdon, Kathryn E; Muraglia, Ryan; Erb-Downward, John R; Falkowski, Nicole R; McDonald, Roderick A; Young, Vincent B; Huffnagle, Gary B

    2015-04-01

    The host response to Clostridium difficile infection in antibiotic-treated mice is characterized by robust recruitment of Gr-1(+) cells, increased expression of inflammatory cytokines including tumour necrosis factor-α (TNF-α), and the development of severe epithelial damage. To investigate the role of Gr-1(+) cells and TNF-α during C. difficile colitis, we treated infected mice with monoclonal antibodies against Gr-1 or TNF-α. Mice were challenged with vegetative cells of C. difficile strain VPI 10463 following treatment with the third-generation cephalosporin ceftriaxone. Ceftriaxone treatment alone was associated with significant changes in cytokine expression within the colonic mucosa but not overt inflammatory histopathological changes. In comparison, C. difficile infection following ceftriaxone treatment was associated with increased expression of inflammatory cytokines and chemokines including Cxcl1, Cxcl2, Il1b, Il17f and Tnfa, as well as robust recruitment of Ly6C(Mid)  Gr-1(High) neutrophils and Ly6C(High) Gr-1(Mid) monocytes and the development of severe colonic histopathology. Anti-Gr-1 antibody treatment resulted in effective depletion of both Ly6C(Mid) Gr-1(High) neutrophils and Ly6C(High) Gr-1(Mid) monocytes: however, we observed no protection from the development of severe pathology or reduction in expression of the pro-inflammatory cytokines Il1b, Il6, Il33 and Tnfa following anti-Gr-1 treatment. By contrast, anti-TNF-α treatment did not affect Gr-1(+) cell recruitment, but was associated with increased expression of Il6 and Il1b. Additionally, Ffar2, Ffar3, Tslp, Tff and Ang4 expression was significantly reduced in anti-TNF-α-treated animals, in association with marked intestinal histopathology. These studies raise the possibility that TNF-α may play a role in restraining inflammation and protecting the epithelium during C. difficile infection.

  19. [Changes in ion transport through membranes, ATPase activity and antibiotics effects in Enterococcus hirae after low intensity electromagnetic irradiation of 51,8 and 53,0 GHz frequencies].

    Science.gov (United States)

    Torgomian, É; Oganian, V; Blbulian, C; Trchunian, A

    2013-01-01

    It was ascertained that one-hour exposure of Enterococcus hirae ATCC9790 bacteria grown under anaerobe condition during sugar (glucose) fermentation to coherent electromagnetic irradiation (EMI) of 51,8 and 53,0 GHz frequencies or millimeter waves (5,79 and 5,66 mm wavelengths) of low-intensity (flux capacity of 0,06 mW/sm2) caused a significant decrease in energy-dependent H+ and K+ transports across the membranes of whole cells. Therewith, K+ influx into cells was appreciably less at the frequency of 53,0 GHz. Likewise, a significant decrease of total and N,N'-dicyclohexylcarbodiimide-sensitive ATPase activity of the membrane vesicles occurred after EMI of 51,8 and 53,0 GHz. These results indicated the input of membranous changes in bacterial action of low intensity extremely high frequency EMI, when the F0F1-ATPase was probably playing a key role. Additionally, the enhancement of the effects of antibiotics--ceftriaxone, kanamycin and ampicillin at their minimal inhibitory concentrations (100, 200 and 1,4 microM, correspondingly) on the bacterial growth by these irradiations was shown. Also, combined action of EMI and antibiotics depressed strongly H+ and K+ fluxes across membrane. Especially, H+ flux was more sensitive to the action of ceftriaxone, but K+ flux was sensitive to kanamycin. All these made the assumption that EMI of 51,8 and 53,0 GHz frequencies, especially 53,0 GHz, was followed by change in bacterial sensitivity toward antibiotics that was more obvious with ceftriaxone and ampicillin.

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

    Directory of Open Access Journals (Sweden)

    Iraj Sedighi

    2014-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

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

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

    Science.gov (United States)

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

    1986-01-01

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

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

    Science.gov (United States)

    2011-07-01

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

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

    Science.gov (United States)

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

    2009-10-01

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

  5. The first report of fully sequenced resistance plasmid from Shigella boydii

    Directory of Open Access Journals (Sweden)

    Li Wang

    2016-10-01

    Full Text Available The purpose of this study was to characterize mechanisms of plasmid-mediated antimicrobial resistance in Shigella boydii. S. boydii strain 2246 with resistance to ciprofloxacin, ceftriaxone and azithromycin was isolated from a human case of watery diarrhea in a Chinese public hospital. Resistance in strain 2246 to ceftriaxone and azithromycin was attributable to the presence of blaCTX-M-14, and erm(B and mph(A, respectively, which were co-located on a multidrug-resistant (MDR plasmid p2246-CTXM. p2246-CTXM represented a novel IncFII-type MDR plasmid with a very complex chimera structure. Its master backbone was genetically closely related to the R100 plasmid, but p2246-CTXM had evolved to integrate additional R100-unrelated backbone regions as well as massive exogenous mobile elements that carried multiple resistance determinants. In p2246-CTXM, erm(B together with its leading peptide gene erm(C, mph(A together with its regulatory genes mrx and mphR(A, and blaCTX-M-14 were captured by three different mobile elements Tn6295, the IS26-mph(A-mrx-mphR(A-IS6100 unit, and a truncated ISEcp1-blaCTX-M-14-IS903D-iroN transposition unit, respectively, all of which were harbored in a large Tn3-family transposon Tn6285. p2246-CTXM still carried additional resistance determinants mer (mercury resistance, aacA4 (aminoglycoside resistance, cmlA1 (chloramphenicol resistance and qacED1 (quaternary ammonium compound resistance. This is the first report of identifying a clinical S. boydii strain simultaneously resistant to ciprofloxacin, ceftriaxone and azithromycin, and determining the complete sequence of a resistance plasmid from S. boydii.

  6. 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.

  7. Case Fatality among Patients Hospitalized for Community-acquired Pneumonia according to Initial Antibiotic Treatment. A Comparison of Two Case Series

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martínez

    2016-04-01

    Full Text Available Background: community-acquired pneumonia is one of the major health problems worldwide and in the hospital of Cienfuegos.Objective: to determine the changes in the relationship between the type of antimicrobial agent used empirically at admission and case fatality for community-acquired pneumonia in two case series designed at different times.Methods: an observational, descriptive study was conducted to compare two case series of patients hospitalized due to the condition under study. The relationship between the antimicrobial agents selected (amoxicillin/sulbactam, cefuroxime, ceftriaxone and cefotaxime and case fatality was analyzed taking into account potentially confounding variables. In the statistical analysis, the Chi-square test was used to compare the proportions, and Fisher's exact test was applied, with a 95% confidence level (p <.05. Results: in the two case series, the same pattern was observed in terms of the antimicrobial agents associated with the lowest and highest case fatality: cefuroxime and cefotaxime, respectively. In contrast to the A series, the B series showed a more uniform behavior of case fatality with the use of the antimicrobials selected, which meant a considerable reduction in case fatality among patients treated initially with third-generation cephalosporins in the B series. In this sense, the most significant impact on case fatality was observed in patients receiving ceftriaxone.Conclusions: cefuroxime remains the initial empirical antimicrobial agent associated with the lowest case fatality among patients with community-acquired pneumonia. In the second case series, a clear reduction in case fatality was found in patients treated with ceftriaxone and cefotaxime.

  8. Integrated Food Chain Surveillance System for Salmonella spp. in Mexico1

    OpenAIRE

    Zaidi, Mussaret B.; Calva, Juan Jose; Estrada-Garcia, Maria Teresa; Leon, Veronica; Vazquez, Gabriela; Figueroa, Gloria; Lopez, Estela; Contreras, Jesus; Abbott, Jason; Zhao, Shaohua; McDermott, Patrick; Tollefson, Linda

    2008-01-01

    Few developing countries have foodborne pathogen surveillance systems, and none of these integrates data from humans, food, and animals. We describe the implementation of a 4-state, integrated food chain surveillance system (IFCS) for Salmonella spp. in Mexico. Significant findings were 1) high rates of meat contamination (21.3%–36.4%), 2) high rates of ceftriaxone-resistant S. Typhimurium in chicken, ill humans, and swine (77.3%, 66.3%, and 40.4% of S. Typhimurium T isolates, respectively), ...

  9. Cephalosporin Induced Toxic Epidermal Necrolysis and Subsequent Penicillin Drug Exanthem

    OpenAIRE

    Amanda Lam; Inderpal Randhawa; William Klaustermeyer

    2008-01-01

    Background: Drug hypersensitivity is classically divided into IgE mediated and non-IgE mediated disease. We report a rare case of consequent IgE mediated and non-IgE mediated reactions within the beta lactam class of antibiotics. Case Summary: An 84-year-old man developed toxic epidermal necrolysis (TEN) due to ceftriaxone, a third generation cephalosporin, involving 72% of the body surface area. The patient recovered but within weeks subsequently developed an acute IgE mediated allergic r...

  10. [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.

  11. [Typhoid fever].

    Science.gov (United States)

    Marchou, B

    1996-01-15

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

  12. Brain abscesses resulting from Bacillus cereus and an Aspergillus-like mold.

    Science.gov (United States)

    Psiachou-Leonard, Elene; Sidi, Vasiliki; Tsivitanidou, Maria; Gompakis, Nicolas; Koliouskas, Dimitrios; Roilides, Emmanuel

    2002-10-01

    An 11-year-old boy with alveolar rhabdomyosarcoma of the thigh experienced three instances of catheter-related bacteremia resulting from After two episodes of seizures, two low-density lesions in the right parietal lobe and the left corpus callosum with enhanced pericavitary opacity were detected. The catheter was removed. A brain biopsy sample grew and revealed dichotomously branched septate hyphae compatible with The patient was treated with ceftriaxone and liposomal amphotericin B for 12 and 52 weeks, respectively, until biopsy-confirmed resolution of the infections.

  13. Lyme disease presenting as isolated acute urinary retention caused by transverse myelitis: an electrophysiological and urodynamical study.

    Science.gov (United States)

    Olivares, J P; Pallas, F; Ceccaldi, M; Viton, J M; Raoult, D; Planche, D; Delarque, A

    1995-12-01

    Several neurological manifestations of Lyme disease, both central and peripheral, have been described. Reported here is a case of acute transverse myelitis related to a Lyme neuroborreliosis that presented with isolated acute urinary retention and no lower-extremity impairment. This case, documented by urodynamic and electrophysiological investigations, partially resolved after 6 weeks of intravenous ceftriaxone, affording the removal of the indwelling catheter. Alpha blocker therapy was needed for 3 months, until the complete normalisation of urodynamic and electrophysiological records. This case study indicates that whenever urinary retention is encountered associated with acute transverse myelitis or alone, the patient should be investigated for Lyme disease.

  14. Salmonella typhi infection: a rare cause of endocarditis.

    Science.gov (United States)

    Khan, Javaid Arif; Ali, Basharat; Masood, Tariq; Ahmed, Faisal; Sial, Jawaid A; Balooch, Zafer Haleem

    2011-09-01

    A 21 years old male with a history of mitral valve repair for mitral regurgitation is discussed. He was presented with a history of fever and loose motions for one month and shortness of breath for 03 days. Chest radiograph and ECG was within normal limits. Total leukocyte count was elevated and antibodies to salmonella typhi were positive. Blood culture revealed Salmonella typhi growth. Echocardiography revealed small echogenic masses on mitral valve. He responded to treatment with ceftriaxone given for 4 weeks. This is a rare case where Somonella typhi was isolated from blood of a patient with echocardiographic evidence of documented mitral valve disease and endcarditis.

  15. A Rare Case of Disseminated Pyogenic Gonococcal Infection in an Immunocompetent Woman

    Science.gov (United States)

    Romiopoulos, Iordanis; Pyrpasopoulou, Athina; Varouktsi, Anna; Simoulidou, Elisavet; Kontopoulou, Konstantina; Karantani, Ekaterini; Georgopoulou, Vivian; Kitsios, Konstantinos; Mamopoulos, Apostolos; Antachopoulos, Charalampos; Karagiannis, Asterios

    2016-01-01

    We present a case of previously healthy, immunocompetent, 41-year-old woman who developed systemic inflammatory response syndrome secondary to Neisseria gonorrhoeae bacteremia. Clinical course was complicated by the simultaneous formation of multiple muscular abscesses, epidural abscess, and septic spondylodiscitis. The patient responded well to prolonged ceftriaxone treatment and was released 10 weeks after initial admission. Spinal lesions and/or pyomyositis individually constitute rare complications of disseminated gonococcal infection. This case, combining both manifestations, is to our knowledge unique. Apropos, diversity of the clinical presentation, and therapeutic challenges for this historical disease are discussed for the practicing physician. PMID:28116187

  16. 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.

  17. Salmonella pyomyositis with concurrent sacroiliac osteomyelitis presenting as piriformis syndrome: A rare case.

    Science.gov (United States)

    Phadke, P S; Gandhi, A R; More, S A; Joshirao, R P

    2017-01-01

    A-21-year old male admitted with fever and piriformis syndrome, typically associated with gluteal region pain radiating down the thigh, was evaluated and found to have pyomyositis involving piriformis and osteomyelitis with sacroiliac joint affection on radiological imaging. Salmonella serotype typhi was isolated from blood culture. He was treated with intravenous Ceftriaxone for 6 weeks with signs of recovery documented clinically as well as on imaging studies. Salmonella pyomyositis with osteomyelitis in an immunocompetent patient with no previous hematological or endocrine disorder makes this case an unusual presentation.

  18. Pancreatic abscess following scrub typhus associated with multiorgan failure

    Institute of Scientific and Technical Information of China (English)

    Sun Young Yi; Jung Hyun Tae

    2007-01-01

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

  19. Lichen sclerosus et atrophicans, scleroderma en coup de sabre and Lyme borreliosis

    OpenAIRE

    Serena Bonin; Nicoletta Gubertini; Giusto Trevisan

    2011-01-01

    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 ...

  20. 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.

  1. 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...

  2. 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.

  3. [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.

  4. 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.

  5. Bug on the back: vertebral osteomyelitis secondary to fluoroquinolone resistant Salmonella typhi in an immunocompetent patient.

    Science.gov (United States)

    Shrestha, Pragya; Mohan, Sachin; Roy, Satyajeet

    2015-11-27

    Although Salmonella osteomyelitis is commonly seen in immunocompromised patients, it may occasionally affect an immunocompetent host. Symptoms are usually non-specific, such as fever, abdominal or back pain; hence it should be considered in the differential diagnosis of patients with a history of travel to endemic regions. Fluoroquinolone resistance is rising and non-responsive patients should be treated with ampicillin, trimethoprim-sulfamethoxazole and ceftriaxone. We present a case of acute T8-T11 osteomyelitis with cord compression caused by a fluoroquinolone resistant strain of Salmonella typhi.

  6. Ciprofloxacin resistant osteomyelitis following typhoid fever

    OpenAIRE

    Ayeni, Itunuayo V; Calver, Graeme

    2012-01-01

    Salmonella typi is a rare cause of chronic osteomyelitis in a non-sickle cell patient. The authors report the case of a 25-year-old gentleman with a history of typhoid fever and an infected skin nodule on his left forearm 5 years prior to the diagnosis. He was referred to our orthopaedic colleagues with chronic osteomyelitis and underwent debridement of the bone for which samples grew Salmonella typhi. He was commenced on intravenous ceftriaxone 2 g once daily for 6 weeks followed by oral azi...

  7. 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

  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. 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.

  10. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  12. Neonatal listeriosis: A case report from sub-Himalayas

    Directory of Open Access Journals (Sweden)

    Mokta K

    2010-01-01

    Full Text Available Perinatal listerial infection is the most common clinical syndrome caused by Listeria monocytogenes and includes abortion, still birth, neonatal sepsis, and meningitis. Reports of listeriosis from India are limited. Sub Himalayan . We report a case of neonatal listeriosis from Himachal Pradesh. A two-day-old full term male baby was referred from a peripheral hospital with fever listlessness, skin rash and non-acceptance of feed. Ceftriaxone was already started as an empirical therapy. Listeria monocytogenes was isolated from cerebrospinal fluid (CSF and blood of the baby, and also from the genital tract of the mother. Unfortunately, the baby died before the preliminary report could be communicated.

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

    Directory of Open Access Journals (Sweden)

    MR Zali

    2010-12-01

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

  14. Ascariasis as a cause of hepatic abscess: A report of 3 cases

    Directory of Open Access Journals (Sweden)

    V Chauhan

    2015-01-01

    Full Text Available We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

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

    Science.gov (United States)

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

    2013-02-01

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

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

    Directory of Open Access Journals (Sweden)

    D. Golparian

    2014-09-01

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

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

    Science.gov (United States)

    Unemo, Magnus

    2015-08-21

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

  18. Third-generation cephalosporins: a critical evaluation.

    Science.gov (United States)

    Barriere, S L; Flaherty, J F

    1984-01-01

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

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

    Science.gov (United States)

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

    2005-08-01

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

  20. Recurrent meningitis due to Salmonella enteritidis: a case report from Kashmir India.

    Science.gov (United States)

    Fomda, B A; Charoo, B A; Bhat, J A; Reyaz, N; Maroof, P; Naik, M I

    2012-01-01

    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.

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

    Science.gov (United States)

    Acevedo, Juan

    2015-01-01

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

  2. Late prosthetic valve endocarditis due to Cardiobacterium hominis, an unusual complication

    Directory of Open Access Journals (Sweden)

    Shivaprakasha S

    2007-01-01

    Full Text Available We report a case of prosthetic valve endocarditis caused by Cardiobacterium hominis in a patient who had undergone atrial septal defect closure and mitral valve replacement of the heart in 1978. He presented with pyrexia of unknown origin and congestive cardiac failure. Investigations revealed infective endocarditis of prosthetic valve in mitral portion. Blood culture samples grew C. hominis . The patient was empirically started on vancomycin and gentamicin intravenously and ceftriaxone was added after isolation of the organism. Though subsequent blood cultures were negative, patient remained in congestive cardiac failure and died due to complications.

  3. 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.

  4. Salmonella pyomyositis with concurrent sacroiliac osteomyelitis presenting as piriformis syndrome: A rare case

    Directory of Open Access Journals (Sweden)

    P S Phadke

    2017-01-01

    Full Text Available A-21-year old male admitted with fever and piriformis syndrome, typically associated with gluteal region pain radiating down the thigh, was evaluated and found to have pyomyositis involving piriformis and osteomyelitis with sacroiliac joint affection on radiological imaging. Salmonella serotype typhi was isolated from blood culture. He was treated with intravenous Ceftriaxone for 6 weeks with signs of recovery documented clinically as well as on imaging studies. Salmonella pyomyositis with osteomyelitis in an immunocompetent patient with no previous hematological or endocrine disorder makes this case an unusual presentation.

  5. Relationship between pharmacokinetics and pharmacodynamics of beta-lactams and outcome.

    Science.gov (United States)

    Sádaba, B; Azanza, J R; Campanero, M A; García-Quetglas, E

    2004-11-01

    The in-vitro susceptibility of an organism and the pharmacokinetics of an antimicrobial agent are two basic factors on which the choice of standardised treatment regimens is based. However, the inter-individual variability of these factors, which modifies the exposure of bacteria to an antibiotic in terms of time and quantity, is not usually taken into account. In 87 patients treated with beta-lactams (ceftriaxone, cefepime or piperacillin), the probability of failure was greater when the infectious process was located in tissues with barriers to the distribution of beta-lactams. Mean MICs of piperacillin and cefepime, but not ceftriaxone, were below the breakpoints in cases of both recovery and failure, but organisms isolated from patients with a poor outcome had higher MICs. Therefore, the use of breakpoints to determine the susceptibility of microorganisms was not satisfactory in predicting the outcome for a large number of patients. If MICs are determined and plasma concentrations are monitored, dosages can be adjusted according to these parameters, thereby allowing antibiotic treatment to be individualised.

  6. Thoracic spinal epidural abscess caused by Salmonella typhi.

    Science.gov (United States)

    Abdullah, Saad Hamdan; Ata, Osama Abu; El-Adwan, Nael

    2008-03-01

    A 56-year-old man presented with a rare spinal epidural abscess manifesting as attacks of back pain associated with fever, weight loss, generalized weakness and fatigability, and constipation. He had multiple skin pustules in the last 4 months treated with oral amoxicillin. He had suffered diabetes mellitus for the last 5 years and was insulin dependent. Physical examination found slight paraparesis with sensory loss around the nipple and sphincteric urgency, and diabetic retinopathy. Magnetic resonance imaging showed edematous T2, T3, and T4 vertebral bodies, and narrow enhanced T3-4 disk space with a soft tissue enhanced mass mostly anterior to the spinal cord and indenting the cord. T3-4 costotransversectomy was performed to remove the extradural mass and evacuate the intradiscal material. Histological examination of the bone found osteomyelitis, and culture of the soft tissue showed Salmonella typhi sensitive to ceftriaxone and ciprofloxacin. Intravenous ceftriaxone administration was started, and the patient was discharged after 6 days in good condition. The outcome of spinal epidural abscess is devastating unless recognized and treated early. The present case of spinal epidural abscess in the thoracic spine caused by Salmonella typhi infection illustrates the importance of cultures to assess the drug sensitivity of the specific strain detected and adjusting the treatment accordingly.

  7. 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.

  8. [Emergence of beta-lactam-dependent Bacillus cereus associated with prolonged treatment with cefepime in a neutropenic patient].

    Science.gov (United States)

    Ko, Sun-Young; Chung, Hee-Jung; Sung, Heong-Sup; Kim, Mi-Na

    2007-06-01

    Antibiotic dependence in clinical isolates has been reported, albeit rarely, such as vancomycin-dependent enterococcus and beta-lactam-dependent Staphylococcus saprophyticus. We report herein a clinical isolate of beta-lactam-dependent Bacillus cereus. A 16-yr-old female was admitted on 8 September 2005 with neutropenic fever during chemotherapy following surgical removal of peripheral neuroectodermal tumor. She had had an indwelling chemoport since August 2004 and experienced B. cereus bacteremia three times during the recent 3-month period prior to the admission; the bacteremias were treated with cefepime-based chemotherapy. On hospital days 1 and 3, B. cereus was isolated from blood drawn through the chemoport. The isolates were resistant to penicillin, ceftriaxone, and erythromycin, and susceptible to vancomycin and ciprofloxacin. The isolate of hospital day 3 grew only nearby the beta-lactam disks including penicillin and ceftriaxone on disk diffusion testing. The beta-lactam-dependent isolate required a minimum of 0.064 microg/mL of penicillin or 0.023 microgram/mL of cefotaxime for growth, which was demonstrated by E test (AB Biodisk, Sweden). Light microscopy and transmission electron microscopy revealed a marked elongation of the dependent strain compared with the non-dependent strain. Prolonged therapy with beta-lactams in the patient with an indwelling intravenous catheter seemed to be a risk factor for the emergence of beta-lactam-dependence in B. cereus.

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

    Directory of Open Access Journals (Sweden)

    Tetiana Shevtsova

    2013-08-01

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

  10. Antibiogram pattern of bacteria causing endometritis in cows

    Directory of Open Access Journals (Sweden)

    S. Udhayavel

    2013-04-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

  12. Structural enzymology using X-ray free electron lasers.

    Science.gov (United States)

    Kupitz, Christopher; Olmos, Jose L; Holl, Mark; Tremblay, Lee; Pande, Kanupriya; Pandey, Suraj; Oberthür, Dominik; Hunter, Mark; Liang, Mengning; Aquila, Andrew; Tenboer, Jason; Calvey, George; Katz, Andrea; Chen, Yujie; Wiedorn, Max O; Knoska, Juraj; Meents, Alke; Majriani, Valerio; Norwood, Tyler; Poudyal, Ishwor; Grant, Thomas; Miller, Mitchell D; Xu, Weijun; Tolstikova, Aleksandra; Morgan, Andrew; Metz, Markus; Martin-Garcia, Jose M; Zook, James D; Roy-Chowdhury, Shatabdi; Coe, Jesse; Nagaratnam, Nirupa; Meza, Domingo; Fromme, Raimund; Basu, Shibom; Frank, Matthias; White, Thomas; Barty, Anton; Bajt, Sasa; Yefanov, Oleksandr; Chapman, Henry N; Zatsepin, Nadia; Nelson, Garrett; Weierstall, Uwe; Spence, John; Schwander, Peter; Pollack, Lois; Fromme, Petra; Ourmazd, Abbas; Phillips, George N; Schmidt, Marius

    2017-07-01

    Mix-and-inject serial crystallography (MISC) is a technique designed to image enzyme catalyzed reactions in which small protein crystals are mixed with a substrate just prior to being probed by an X-ray pulse. This approach offers several advantages over flow cell studies. It provides (i) room temperature structures at near atomic resolution, (ii) time resolution ranging from microseconds to seconds, and (iii) convenient reaction initiation. It outruns radiation damage by using femtosecond X-ray pulses allowing damage and chemistry to be separated. Here, we demonstrate that MISC is feasible at an X-ray free electron laser by studying the reaction of M. tuberculosis ß-lactamase microcrystals with ceftriaxone antibiotic solution. Electron density maps of the apo-ß-lactamase and of the ceftriaxone bound form were obtained at 2.8 Å and 2.4 Å resolution, respectively. These results pave the way to study cyclic and non-cyclic reactions and represent a new field of time-resolved structural dynamics for numerous substrate-triggered biological reactions.

  13. Enteric fever in Cambodian children is dominated by multidrug-resistant H58 Salmonella enterica serovar Typhi with intermediate susceptibility to ciprofloxacin.

    Science.gov (United States)

    Emary, Kate; Moore, Catrin E; Chanpheaktra, Ngoun; An, Khun Peng; Chheng, Kheng; Sona, Soeng; Duy, Pham Thanh; Nga, Tran Vu Thieu; Wuthiekanun, Vanaporn; Amornchai, Premjit; Kumar, Varun; Wijedoru, Lalith; Stoesser, Nicole E; Carter, Michael J; Baker, Stephen; Day, Nicholas P J; Parry, Christopher M

    2012-12-01

    Infections with Salmonella enterica serovar Typhi isolates that are multidrug resistant (MDR: resistant to chloramphenicol, ampicillin, trimethoprim-sulphamethoxazole) with intermediate ciprofloxacin susceptibility are widespread in Asia but there is little information from Cambodia. We studied invasive salmonellosis in children at a paediatric hospital in Siem Reap, Cambodia. Between 2007 and 2011 Salmonella was isolated from a blood culture in 162 children. There were 151 children with enteric fever, including 148 serovar Typhi and three serovar Paratyphi A infections, and 11 children with a non-typhoidal Salmonella infection. Of the 148 serovar Typhi isolates 126 (85%) were MDR and 133 (90%) had intermediate ciprofloxacin susceptibility. Inpatient antimicrobial treatment was ceftriaxone alone or initial ceftriaxone followed by a step-down to oral ciprofloxacin or azithromycin. Complications developed in 37/128 (29%) children admitted with enteric fever and two (1.6%) died. There was one confirmed relapse. In a sample of 102 serovar Typhi strains genotyped by investigation of a subset of single nucleotide polymorphisms, 98 (96%) were the H58 haplotype, the majority of which had the common serine to phenylalanine substitution at codon 83 in the DNA gyrase. We conclude that antimicrobial-resistant enteric fever is common in Cambodian children and therapeutic options are limited.

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  16. Uncomplicated Urinary Tract Infections in Women in a Sao Paulo Quaternary Care Hospital: Bacterial Spectrum and Susceptibility Patterns

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    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.

  17. 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.

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

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    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.

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

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    Sunniva eFoerster

    2015-12-01

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

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

    Science.gov (United States)

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

    2011-09-27

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

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

    Science.gov (United States)

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

    2011-08-01

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

  2. Electromagnetic irradiation of Enterococcus hirae at low-intensity 51.8- and 53.0-GHz frequencies: changes in bacterial cell membrane properties and enhanced antibiotics effects.

    Science.gov (United States)

    Torgomyan, Heghine; Ohanyan, Vahe; Blbulyan, Syuzanna; Kalantaryan, Vitaly; Trchounian, Armen

    2012-04-01

    Exposure to electromagnetic irradiation (EMI) of 51.8 and 53.0 GHz and low intensity (flux capacity of 0.06 mW cm(-2) ) for 1 h markedly decreased the energy-dependent H(+) and K(+) transport across membranes of Enterococcus hirae ATCC 9790. After EMI, there was also a significant decrease of overall and N,N'-dicyclohexylcarbodiimide (DCCD)-sensitive ATPase activity of the membrane vesicles. These measures were considerably lower at 53.0 GHz. EMI in combination with different antibiotics, such as ceftriaxone and kanamycin at their minimal inhibitory concentrations (100 and 200 μM, respectively), enhanced bacterial cell growth and altered their membrane transport properties. Total H(+) efflux was most sensitive to ceftriaxone but DCCD-inhibited H(+) efflux and total K(+) influx were sensitive to kanamycin. The results indicate that cell membrane proteins could be a target in the action of EMI and enhanced antibacterial effects in combination with antibiotics. The DCCD-sensitive F(0) F(1) -ATPase or this ATPase in combination with K(+) uptake protein probably plays a key role in these effects.

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

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    MAHADEVAMMA L

    2012-03-01

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

  4. Development of SYN-004, an oral beta-lactamase treatment to protect the gut microbiome from antibiotic-mediated damage and prevent Clostridium difficile infection.

    Science.gov (United States)

    Kaleko, Michael; Bristol, J Andrew; Hubert, Steven; Parsley, Todd; Widmer, Giovanni; Tzipori, Saul; Subramanian, Poorani; Hasan, Nur; Koski, Perrti; Kokai-Kun, John; Sliman, Joseph; Jones, Annie; Connelly, Sheila

    2016-10-01

    The gut microbiome, composed of the microflora that inhabit the gastrointestinal tract and their genomes, make up a complex ecosystem that can be disrupted by antibiotic use. The ensuing dysbiosis is conducive to the emergence of opportunistic pathogens such as Clostridium difficile. A novel approach to protect the microbiome from antibiotic-mediated dysbiosis is the use of beta-lactamase enzymes to degrade residual antibiotics in the gastrointestinal tract before the microflora are harmed. Here we present the preclinical development and early clinical studies of the beta-lactamase enzymes, P3A, currently referred to as SYN-004, and its precursor, P1A. Both P1A and SYN-004 were designed as orally-delivered, non-systemically available therapeutics for use with intravenous beta-lactam antibiotics. SYN-004 was engineered from P1A, a beta-lactamase isolated from Bacillus licheniformis, to broaden its antibiotic degradation profile. SYN-004 efficiently hydrolyses penicillins and cephalosporins, the most widely used IV beta-lactam antibiotics. In animal studies, SYN-004 degraded ceftriaxone in the GI tract of dogs and protected the microbiome of pigs from ceftriaxone-induced changes. Phase I clinical studies demonstrated SYN-004 safety and tolerability. Phase 2 studies are in progress to assess the utility of SYN-004 for the prevention of antibiotic-associated diarrhea and Clostridium difficile disease.

  5. Antibiotic resistance of Neisseria gonorrhoeae isolated from gonorrhoeae patients

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    Mohammad Bokaeian

    2010-06-01

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

  6. Synthesis, spectral, computational and thermal analysis studies of metalloceftriaxone antibiotic

    Science.gov (United States)

    Masoud, Mamdouh S.; Ali, Alaa E.; Elasala, Gehan S.

    2015-03-01

    Binary ceftriaxone metal complexes of Cr(III), Mn(II), Fe(III), Co(II), Ni(II), Cu(II), Zn(II), Cd(II), Hg(II) and six mixed metals complexes of (Fe, Cu), (Fe, Co), (Co, Ni), (Co, Cu), (Ni, Cu) and (Fe, Ni) were synthesized and characterized by elemental analysis, IR, electronic spectra, magnetic susceptibility and ESR spectra. The studies proved that the ligand has different combination modes and all complexes were of octahedral geometry. Molecular modeling techniques and quantum chemical methods have been performed for ceftriaxone to calculate charges, bond lengths, bond angles, dihedral angles, electronegativity (χ), chemical potential (μ), global hardness (η), softness (σ) and the electrophilicity index (ω). The thermal decomposition of the prepared metals complexes was studied by TGA, DTA and DSC techniques. The kinetic parameters and the reaction orders were estimated. The thermal decomposition of all the complexes ended with the formation of metal oxides and carbon residue as a final product except in case of Hg complex, sublimation occurs at the temperature range 297.7-413.7 °C so, only carbon residue was produced during thermal decomposition. The geometries of complexes may be altered from Oh to Td during the thermal decomposition steps. Decomposition mechanisms were suggested.

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

    Science.gov (United States)

    Bodoev, I N; Il'ina, E N

    2015-01-01

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

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

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    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.

  9. Serotype Prevalence and Penicillin-susceptibility of Streptococcus pneumoniae in Oman

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    Mubarak M. Al-Yaqoub

    2011-01-01

    Full Text Available Objectives: to determine the prevalent serotypes of Streptococcus pneumoniae and the rate of penicillin-nonsusceptibility among pneumococci in Oman.Methods: Pneumococcal isolates encountered during the period of September 2002 to December 2007 in the Royal Hospital were serotyped. Clinical information as well as the penicillin susceptibility reports were retrieved from the hospital information system and medical records.Results: 120 strains of Streptococcus pneumoniae were isolated of which 85 strains were seroptyped. 20 different serotypes were identified; the most common seroptypes were 9A, 6B, 19F, 14 and 23F. 56�0of the strains were not susceptible to pencillin, while 99�0of these were susceptible to ceftriaxone. 74.3�0and 46.1�0of the serotypes are covered by the pneumococcal polysaccharide vaccine and the 7-valent pneumococcal conjugate vaccine respectively.Conclusion: Certain few pneumococcal serotypes such as 9A, 6B and 19F are more prevalent in the Omani community than others. More than half of S. pneumoniae are not susceptible to penicillin while the great majority of the strains are susceptible to ceftriaxone.

  10. Corynebacterium propinquum: A Rare Cause of Prosthetic Valve Endocarditis

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    Umair Jangda

    2016-01-01

    Full Text Available Nondiphtheria Corynebacterium species are often dismissed as culture contaminants, but they have recently become increasingly recognized as pathologic organisms. We present the case of a 48-year-old male patient on chronic prednisone therapy for rheumatoid arthritis with a history of mitral valve replacement with prosthetic valve. He presented with fever, dizziness, dyspnea on exertion, intermittent chest pain, and palpitations. Transesophageal echocardiography revealed two medium-sized densities along the inner aspect of the sewing ring and one larger density along the atrial surface of the sewing ring consistent with vegetation. Two separate blood cultures grew Corynebacterium propinquum, which were sensitive to ceftriaxone but highly resistant to vancomycin and daptomycin. The patient completed a course of ceftriaxone and repeat TEE study and after 6 weeks demonstrated near complete resolution of the vegetation. To our knowledge, this case represents the first in the literature of Corynebacterium propinquum causing prosthetic valve endocarditis. The ability of these organisms to cause deep-seated systemic infections should be recognized, especially in immune-compromised patients.

  11. Striatal adenosine signaling regulates EAAT2 and astrocytic AQP4 expression and alcohol drinking in mice.

    Science.gov (United States)

    Lee, Moonnoh R; Ruby, Christina L; Hinton, David J; Choi, Sun; Adams, Chelsea A; Young Kang, Na; Choi, Doo-Sup

    2013-02-01

    Adenosine signaling is implicated in several neuropsychiatric disorders, including alcoholism. Among its diverse functions in the brain, adenosine regulates glutamate release and has an essential role in ethanol sensitivity and preference. However, the molecular mechanisms underlying adenosine-mediated glutamate signaling in neuroglial interaction remain elusive. We have previously shown that mice lacking the ethanol-sensitive adenosine transporter, type 1 equilibrative nucleoside transporter (ENT1), drink more ethanol compared with wild-type mice and have elevated striatal glutamate levels. In addition, ENT1 inhibition or knockdown reduces glutamate transporter expression in cultured astrocytes. Here, we examined how adenosine signaling in astrocytes contributes to ethanol drinking. Inhibition or deletion of ENT1 reduced the expression of type 2 excitatory amino-acid transporter (EAAT2) and the astrocyte-specific water channel, aquaporin 4 (AQP4). EAAT2 and AQP4 colocalization was also reduced in the striatum of ENT1 null mice. Ceftriaxone, an antibiotic compound known to increase EAAT2 expression and function, elevated not only EAAT2 but also AQP4 expression in the striatum. Furthermore, ceftriaxone reduced ethanol drinking, suggesting that ENT1-mediated downregulation of EAAT2 and AQP4 expression contributes to excessive ethanol consumption in our mouse model. Overall, our findings indicate that adenosine signaling regulates EAAT2 and astrocytic AQP4 expressions, which control ethanol drinking in mice.

  12. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    1985-02-01

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

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

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    Raja N

    2006-01-01

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

  16. Antibiotic Susceptibilities and Serotyping of Clinical Streptococcus Agalactiae Isolates

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    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.

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

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    Carmen Puig

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Maksum Radji; Siti Fauziah; Nurgani Aribinuko

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张丽君; 王峰; 彭毅; 桂静; 莫俊銮

    2013-01-01

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

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

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    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

  4. Antimicrobial susceptibility profile, treatment outcome and serotype distribution of clinical isolates of Salmonella enterica subspecies enterica: a 2-year study from Kerala, South India

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    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

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

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    A. O. Okesola

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    秦梦春

    2015-01-01

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

  7. Clostridium difficile colonization and antibiotics response in PolyFermS continuous model mimicking elderly intestinal fermentation

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    Sophie Fehlbaum

    2016-12-01

    Full Text Available Abstract Background Clostridium difficile (CD, a spore-forming and toxin-producing bacterium, is the main cause for antibiotic-associated diarrhea in the elderly. Here we investigated CD colonization in novel in vitro fermentation models inoculated with immobilized elderly fecal microbiota and the effects of antibiotic treatments. Methods Two continuous intestinal PolyFermS models inoculated with different immobilized elder microbiota were used to investigate selected factors of colonization of CD in proximal (PC, model 1 and transverse-distal (TDC, model 1 and 2 colon conditions. Colonization of two CD strains of different PCR ribotypes, inoculated as vegetative cells (ribotype 001, model 1 or spores (ribotypes 001 and 012, model 2, was tested. Treatments with two antibiotics, ceftriaxone (daily 150 mg L−1 known to induce CD infection in vivo or metronidazole (twice daily 333 mg L−1 commonly used to treat CD, were investigated in TDC conditions (model 2 for their effects on gut microbiota composition (qPCR, 16S pyrosequencing and activity (HPLC, CD spore germination and colonization, and cytotoxin titer (Vero cell assay. Results CD remained undetected after inoculating vegetative cells in PC reactors of model 1, but was shown to colonize TDC reactors of both models, reaching copy numbers of up to log10 8 mL−1 effluent with stable production of toxin correlating with CD cell numbers. Ceftriaxone treatment in TDC reactors showed only small effects on microbiota composition and activity and did not promote CD colonization compared to antibiotic-free control reactor. In contrast, treatment with metronidazole after colonization of CD induced large modifications in the microbiota and decreased CD numbers below the detection limit of the specific qPCR. However, a fast CD recurrence was measured only 2 days after cessation of metronidazole treatment. Conclusions Using our in vitro fermentation models, we demonstrated that stable CD

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

    Institute of Scientific and Technical Information of China (English)

    陶小华; 关杨; 洪福昌; 冯铁建; 蓝丽娜

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李燕娃; 潘洪亮; 吴兴中

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  11. Clinical outcomes in typhoid fever: adverse impact of infection with nalidixic acid-resistant Salmonella typhi

    Directory of Open Access Journals (Sweden)

    Kabra SK

    2005-05-01

    Full Text Available Abstract Background Widespread use of fluoroquinolones has resulted in emergence of Salmonella typhi strains with decreased susceptibility to fluoroquinolones. These strains are identifiable by their nalidixic acid-resistance. We studied the impact of infection with nalidixic acid-resistant S. typhi (NARST on clinical outcomes in patients with bacteriologically-confirmed typhoid fever. Methods Clinical and laboratory features, fever clearance time and complications were prospectively studied in patients with blood culture-proven typhoid fever, treated at a tertiary care hospital in north India, during the period from November 2001 to October 2003. Susceptibility to amoxycillin, co-trimoxazole, chloramphenicol, ciprofloxacin and ceftriaxone were tested by disc diffusion method. Minimum inhibitory concentrations (MIC of ciprofloxacin and ceftriaxone were determined by E-test method. Results During a two-year period, 60 patients (age [mean ± SD]: 15 ± 9 years; males: 40 [67%] were studied. All isolates were sensitive to ciprofloxacin and ceftriaxone by disc diffusion and MIC breakpoints. However, 11 patients had clinical failure of fluoroquinolone therapy. Infections with NARST isolates (47 [78%] were significantly associated with longer duration of fever at presentation (median [IQR] 10 [7-15] vs. 4 [3-6] days; P = 0.000, higher frequency of hepatomegaly (57% vs. 15%; P = 0.021, higher levels of aspartate aminotransferase (121 [66–235] vs. 73 [44–119] IU/L; P = 0.033, and increased MIC of ciprofloxacin (0.37 ± 0.21 vs. 0.17 ± 0.14 μg/mL; P = 0.005, as compared to infections with nalidixic acid-susceptible isolates. All 11 patients with complications were infected with NARST isolates. Total duration of illness was significantly longer in patients who developed complications than in patients who did not (22 [14.8–32] vs. 12 [9.3–20.3] days; P = 0.011. Duration of prior antibiotic intake had a strong positive correlation with the

  12. Clinical outcomes in typhoid fever: adverse impact of infection with nalidixic acid-resistant Salmonella typhi

    Science.gov (United States)

    Kadhiravan, Tamilarasu; Wig, Naveet; Kapil, Arti; Kabra, SK; Renuka, K; Misra, Anoop

    2005-01-01

    Background Widespread use of fluoroquinolones has resulted in emergence of Salmonella typhi strains with decreased susceptibility to fluoroquinolones. These strains are identifiable by their nalidixic acid-resistance. We studied the impact of infection with nalidixic acid-resistant S. typhi (NARST) on clinical outcomes in patients with bacteriologically-confirmed typhoid fever. Methods Clinical and laboratory features, fever clearance time and complications were prospectively studied in patients with blood culture-proven typhoid fever, treated at a tertiary care hospital in north India, during the period from November 2001 to October 2003. Susceptibility to amoxycillin, co-trimoxazole, chloramphenicol, ciprofloxacin and ceftriaxone were tested by disc diffusion method. Minimum inhibitory concentrations (MIC) of ciprofloxacin and ceftriaxone were determined by E-test method. Results During a two-year period, 60 patients (age [mean ± SD]: 15 ± 9 years; males: 40 [67%]) were studied. All isolates were sensitive to ciprofloxacin and ceftriaxone by disc diffusion and MIC breakpoints. However, 11 patients had clinical failure of fluoroquinolone therapy. Infections with NARST isolates (47 [78%]) were significantly associated with longer duration of fever at presentation (median [IQR] 10 [7-15] vs. 4 [3-6] days; P = 0.000), higher frequency of hepatomegaly (57% vs. 15%; P = 0.021), higher levels of aspartate aminotransferase (121 [66–235] vs. 73 [44–119] IU/L; P = 0.033), and increased MIC of ciprofloxacin (0.37 ± 0.21 vs. 0.17 ± 0.14 μg/mL; P = 0.005), as compared to infections with nalidixic acid-susceptible isolates. All 11 patients with complications were infected with NARST isolates. Total duration of illness was significantly longer in patients who developed complications than in patients who did not (22 [14.8–32] vs. 12 [9.3–20.3] days; P = 0.011). Duration of prior antibiotic intake had a strong positive correlation with the duration of fever at

  13. 4种抗菌药物与转化糖电解质注射液配伍稳定性与安全性评价%Study on the stability and security of four antimicrobial agents in compatibility with conversion sugar electrolyte injection

    Institute of Scientific and Technical Information of China (English)

    魏燕华; 成差群; 黄健虹

    2012-01-01

    目的 探讨评价头孢曲松、头孢米诺、头孢哌酮/舒巴坦及阿奇霉素4种抗菌药物与转化糖电解质注射液配伍的稳定性与安全性.方法 将4种抗菌药物与转化糖电解质注射液分别配伍,0h、1h、4h观察各自外观与pH值变化,采用HPLC法测定各配伍溶液中主药成分的相对含量变化,观察动物实验注射配伍溶液后变态反应发生情况.结果 头孢曲松、头孢米诺、头孢哌酮/舒巴坦及阿奇霉素4种抗菌药物与转化糖电解质注射液配伍4h内外观无变化、pH值无显著变化(P>0.05),相对含量均在98%以上;动物实验未见变态反应发生.结论 头孢曲松、头孢米诺、头孢哌酮/舒巴坦及阿奇霉素4种抗菌药物与转化糖电解质注射液配伍稳定安全.%OBJECTIVE To investigate the stability and security of ceftriaxone, cefminox, cefoperazone/sulbactam and azithroraycin in compatibility with conversion sugar electrolyte injection. METHODS The four kinds of antimicrobial agents and conversion sugar electrolyte injection were respectively matched, their own appearance and pH changes were observed at the time of 0 h, 1 h and 4 h, and HPLC method was used for determining the main drug ingredient in various compatibility solutions. We observed the allergic reaction occurred for animal experiments after injected the compatibility solution. RESULTS The appearance and PH had no changes in 4 h after the four kinds of antibiotics ceftriaxone, minocycline, cefoperazone/sulbactam and azithromycin in compatibility with conversion sugar electrolyte injection (P > 0.05), and relative content was more than 98%. There was no allergic reaction occurred in animal experiments. CONCLUSION The stability and security is good for ceftriaxone , cefminox, cefoperazone/sulbactam and azithromycin in compatibility with conversion sugar electrolyte injection.

  14. 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.

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

    Science.gov (United States)

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

    2012-03-07

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

  16. Osteomyelitis due to Salmonella enterica subsp. arizonae: the price of exotic pets.

    Science.gov (United States)

    Kolker, S; Itsekzon, T; Yinnon, A M; Lachish, T

    2012-02-01

    We describe a 31-year-old immunocompromised patient who developed sepsis and osteomyelitis due to Salmonella enterica subsp. arizonae secondary to exposure to iguana and snakes kept as pets at her home, and review all 23 previously published cases of bone and joint infections due to this organism, for a total of nine children and 15 adults. Eleven of the adults were female (73%), compared with three (33%) of the children (p child only (17%) (p child only (11%, p <0.01). Antibiotic therapy was prolonged in both adults and children, and in most cases consisted of 4-6 weeks of parenteral treatment. Complete cure and survival was attained in 11 of 15 adults (73%) and all nine children (NS). Optimal antibiotic treatment probably consists of ceftriaxone or a fluoroquinolone, if the organism is susceptible.

  17. Development of carbapenem resistance during therapy for non-typhoid Salmonella infection.

    Science.gov (United States)

    Su, L H; Wu, T L; Chiu, C H

    2012-04-01

    Multidrug-resistant Salmonella infection is a global problem, and carbapenems may represent the last therapeutic choice. We report a case of infection caused by ceftriaxone-resistant and ciprofloxacin-resistant Salmonella enterica serotype Typhimurium. A bla(CMY-2) -containing Tn6092, located on a self-transferable IncI1 plasmid, was found in all isolates derived from the patient. During ertapenem treatment, the strain developed carbapenem resistance. Apart from the OmpD deficiency found in all isolates, the strain further developed OmpC deficiency through a single gene mutation, and became carbapenem-resistant. Salmonella appears to be very plastic in developing antimicrobial resistance. Care must be taken by physicians when treating multidrug-resistant Salmonella infection.

  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. Klebsiella pneumoniae Spinal Epidural Abscess treated conservatively: case report and review.

    Science.gov (United States)

    Araújo, Filipe; Ribeiro, Célia; Silva, Inês; Nero, Patrícia; Branco, Jaime C

    2012-01-01

    Spinal infections are rare but potentially life-threatening disorders. A high level of clinical suspicion is necessary for rapid diagnosis and treatment initiation. The treatment combines both antibiotics and surgical intervention in the vast majority of cases. The authors report the case of a 84-year old female patient with a three week history of persistent lumbar back pain radiating to both thighs following a lower respiratory tract infection. She had lumbar spine tenderness but no neurological compromise. Her inflammatory markers were elevated and lumbar spine magnetic resonance imaging revealed L4-L5 spondylodiscitis with spinal epidural abscess. Blood cultures isolated Klebsiella pneumoniae and, since she was neurologically stable, conservative treatment with two-week intravenous gentamicin and eight-week intravenous ceftriaxone was initiated with positive inpatient and outpatient evolution.

  20. Spinal epidural abscess treated with antibiotics alone.

    Science.gov (United States)

    Pathak, Ashish; Singh, Poonam; Gehlot, Prateek; Dhaneria, Mamta

    2013-04-30

    Spinal epidural abscess (SEA) is a rare clinical condition among children. Most patients do not present with classical signs. A 13-year-old boy without any predisposing factors presented with paraparesis, bladder and bowel involvement. MRI spine demonstrated an SEA at the C7 and D1 levels on both sides of the midline with cord oedema at the C2-3 to C6 level with minimal marrow oedema in the C6 vertebral body. We treated the patient with antibiotics (ceftriaxone and vancomycin) alone. The patient showed excellent response with only minimal residual gait disturbance at the end of 6 weeks of antibiotic therapy. This is the first paediatric report of complete recovery of a patient at clinical stage 4 following antibiotic treatment alone from India. However, caution should be exercised to closely monitor the patient's recovery as any progression in the neurological state warrants surgery.

  1. Enteric fever in a British soldier from Sierra Leone.

    Science.gov (United States)

    Osborne, Lucy G; Brown, M; Bailey, M S

    2016-06-01

    Enteric fever (typhoid and paratyphoid) remains a threat to British troops overseas and causes significant morbidity and mortality. We report the case of a soldier who developed typhoid despite appropriate vaccination and field hygiene measures, which began 23 days after returning from a deployment in Sierra Leone. The incubation period was longer than average, symptoms started 2 days after stopping doxycycline for malaria chemoprophylaxis and initial blood cultures were negative. The Salmonella enterica serovar Typhi eventually isolated was resistant to amoxicillin, co-amoxiclav, co-trimoxazole and nalidixic acid and had reduced susceptibility to ciprofloxacin. He was successfully treated with ceftriaxone followed by azithromycin, but 1 month later he remained fatigued and unable to work. The clinical and laboratory features of enteric fever are non-specific and the diagnosis should be considered in troops returning from an endemic area with a febrile illness. Multiple blood cultures and referral to a specialist unit may be required.

  2. 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%).

  3. Lyme neuroborreliosis mimics stroke: a case report.

    Science.gov (United States)

    Zhang, Y; Lafontant, G; Bonner, F J

    2000-04-01

    Lyme neuroborreliosis is diagnostically challenging because of its diverse manifestations. The well-documented neurologic spectrum includes lymphocytic meningitis, cranial neuropathy, and radiculoneuritis in the early disseminated stage; and peripheral neuropathy, chronic encephalomyelitis, and mild encephalopathy in the late persistent stage. This case report describes a 74-year-old man who developed progressive left hemiparesis and facial palsy. The patient was hospitalized to rule out a cerebral vascular accident. The diagnosis of Lyme borreliosis was established with serologic studies. The patient was treated with intravenous ceftriaxone and responded with rapid clinical and functional recovery. Lyme neuroborreliosis presenting as hemiparesis has rarely been reported. Prompt diagnosis and treatment appear to facilitate symptomatic relief and prevent persistent neurologic deficits.

  4. Carbapenem-resistant Serratia marcescens isolates producing Bush group 2f beta-lactamase (SME-1) in the United States: results from the MYSTIC Programme.

    Science.gov (United States)

    Gales, A C; Biedenbach, D J; Winokur, P; Hacek, D M; Pfaller, M A; Jones, R N

    2001-02-01

    Two carbapenem (imipenem, meropenem)-resistant Serratia marcescens strains were isolated in the United States (Chicago, IL) through the 1999 MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) Programme. The S. marcescens antimicrobial susceptible patterns were: susceptible to ceftriaxone, ceftazidime, and cefepime (MICs, 32 microg/ml) and aztreonam (MIC, > = 16 microg/ml). Each S. marcescens isolate shared an identical epidemiologic type (ribotype and PFGE) and the outer membrane protein profile was also identical to those of the wild type susceptible strains from the same medical center. The PCR utilizing bla(sme-1) primers amplified a gene product that was identified as consistent with SME-1 after DNA sequencing. Imipenem and meropenem resistance due to production of carbapenem-hydrolyzing enzymes among clinical isolates is still very rare, but microbiology laboratories should be aware of these chromosomally encoded enzymes among class C beta-lactamases producing enteric bacilli such as S. marcescens and Enterobacter cloacae.

  5. 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...

  6. 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...

  7. 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.

  8. Progressive multifocal leucoencephalopathy in an immunocompetent patient with favourable outcome. A case report

    Directory of Open Access Journals (Sweden)

    Mørk Sverre J

    2010-05-01

    Full Text Available Abstract Background To report the clinical course of PML in an apparently immunocompetent patient treated with cidofovir. Case Presentation A 35-year-old immunocompetent man who developed progressive hemianopsia, aphasia, and limb weakness underwent repeated MRI scans of the brain, spinal fluid analyses, and brain biopsy. Before diagnosis was established based on brain biopsy, he was consecutively treated with methylprednisolone, acyclovir, ceftriaxone and plasmapheresis, but he deteriorated rapidly suggestive of the immune reconstitution inflammatory syndrome (IRIS. He started to recover two weeks after the initiation of treatment with cidofovir and has had no relapse at 3 1/2 years of follow-up. MRI has shown marked improvement. Conclusions PML should be considered in immunocompetent patients with a typical clinical course and MRI findings compatible with PML. Treatment with cidofovir should be considered as early as possible in the disease course.

  9. Citrobacter koseri folliculitis of the face.

    Science.gov (United States)

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

    2015-10-01

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

  10. Bacteremia and conventional diagnosis of Sphingobacterium spiritivorum. A case report

    Directory of Open Access Journals (Sweden)

    Elio Jesús Núñez Tamayo

    2003-12-01

    Full Text Available This is a case report of septicaemia due to Sphingobacterium Spiritovirum that caused acute symmetric acronecrosis in a previously healthy man who received medical assistance at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province in November 2002. The clinical symptoms were: fever, lumbar pain and chills which evolved to shock with general malaise, accompanied with paresthesia, symptoms of distal necrosis in the four members, nose and ear. Sphingobacterium Spiritovirum was diagnosed by the conventional diagnosis of growing in the marrow tests and serial blood cultures. Susceptibility antimicrobial tests were sensible to sulphametoxazole – trimetropin and resistant to tetracycline, aztreonam, ceftriaxone and imipenem. The bibliography consulted did not evidence any previous isolation in Cuba .

  11. 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).

  12. Neisseria gonorrhoeae and fosfomycin: Past, present and future.

    Science.gov (United States)

    Tesh, Lauren D; Shaeer, Kristy M; Cho, Jonathan C; Estrada, Sandy J; Huang, Vanthida; Bland, Christopher M; DiMondi, V Paul; Potter, Alicia N; Hussein, Gamal; Bookstaver, P Brandon

    2015-09-01

    Drug-resistant Neisseria gonorrhoeae has become a global health concern that requires immediate attention. Due to increasing resistance to cephalosporins, pursuing novel alternatives for treating N. gonorrhoeae infections is paramount. Whilst new drug development is often cumbersome, reviving antiquated antibiotic agents for treatment of modern infections has become prevalent in clinical practice. Fosfomycin exhibits bactericidal activity through a unique mechanism of action, and a variety of organisms including N. gonorrhoeae are susceptible. In vitro studies have demonstrated that fosfomycin can retain activity against ceftriaxone-resistant N. gonorrhoeae; however, it remains unclear whether there is synergy between fosfomycin and other antibiotics. Clinical investigations evaluating fosfomycin for the treatment of N. gonorrhoeae infections are confounded by methodological limitations, none the less they do provide some perspective on its potential role in therapy. Future studies are needed to establish a safe, convenient and effective fosfomycin regimen for treating N. gonorrhoeae infections.

  13. Multidrug-Resistant Neisseria gonorrhoeae Isolates from Nanjing, China, Are Sensitive to Killing by a Novel DNA Gyrase Inhibitor, ETX0914 (AZD0914).

    Science.gov (United States)

    Su, Xiao-Hong; Wang, Bao-Xi; Le, Wen-Jing; Liu, Yu-Rong; Wan, Chuan; Li, Sai; Alm, Richard A; Mueller, John P; Rice, Peter A

    2015-10-19

    We tested the activity of ETX0914 against 187 Neisseria gonorrhoeae isolates from men with urethritis in Nanjing, China, in 2013. The MIC50, MIC90, and MIC range for ETX0914 were 0.03 μg/ml, 0.06 μg/ml, and ≤0.002 to 0.125 μg/ml, respectively. All isolates were resistant to ciprofloxacin, and 36.9% (69/187) were resistant to azithromycin. Of the isolates, 46.5% were penicillinase-producing N. gonorrhoeae (PPNG), 36% were tetracycline-resistant N. gonorrhoeae (TRNG), and 13% (24 isolates) had an MIC of 0.125 μg/ml for ceftriaxone. ETX0914 may be an effective treatment option for gonorrhea.

  14. 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.

  15. Study of Pseudomonas Aeroginosa resistance to Penicillines, Cephalosporins and Aminoglycosides

    Directory of Open Access Journals (Sweden)

    Maleknezhad P

    1998-07-01

    Full Text Available Drug therapy and prophylaxy in infectious diseases, from hygienic and economical point of view, are very important. Infections caused by pseudomonas aeroginosa were particularly severe, with high mortality rates. In the recent years pseudomonas aeroginosa continued to cause the most severe, life-thereating infections in burned patients, in spite of the introduction of a wide variety of antibiotics advised specifically for their anti pseudomonal activity. The aim of this study, in which many cases of ps.aeroginosa infections are assessed is to identify the drug resistance of this bacteria to penicillines, cephalosporins and aminoglycosides by antibiotic sensitivity test (disk ager diffusion. Results as percent of resistance to each antibiotic were 89% to carbenicillin, 55% to piperacillin, 89% to mezlocillin, 89.5% to ticarcillin+clavulonic acid, 85% to ceftriaxone, 95% to tobramycin, 5% of all isolates were not sensitive to any antibiotics.

  16. Typhoid fever: case report and literature review.

    Science.gov (United States)

    Sanhueza Palma, Natalia Carolina; Farías Molina, Solange; Calzadilla Riveras, Jeannette; Hermoso, Amalia

    2016-06-21

    Typhoid fever remains a major health problem worldwide, in contrast to Chile, where this disease is an isolated finding. Clinical presentation is varied, mainly presenting with fever, malaise, abdominal discomfort, and nonspecific symptoms often confused with other causes of febrile syndrome. We report a six-year-old, male patient presenting with fever of two weeks associated with gastrointestinal symptoms, malaise, hepatomegaly and elevated liver enzymes. Differential diagnoses were considered and a Widal reaction and two blood cultures were requested; both came back positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Prior to diagnosis confirmation, empirical treatment was initiated with ceftriaxone and metronidazole, with partial response; then drug therapy was adjusted according to ciprofloxacin susceptibility testing with a favorable clinical response. We discuss diagnostic methods and treatment of enteric fever with special emphasis on typhoid fever.

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

    Science.gov (United States)

    Yokota, Kazuhisa; Gomi, Harumi; Morisawa, Yuji

    2011-07-01

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

  18. BASHH UK guideline for the management of epididymo-orchitis, 2010.

    Science.gov (United States)

    Street, E; Joyce, A; Wilson, J

    2011-07-01

    The BASHH UK guideline for the management of epididymo-orchitis has been updated in 2010. Consideration should be made of the changing potential aetiologies of epididymo-orchitis - mumps in non-immune individuals and tuberculosis in the immunocompromised and men from countries of high prevalence. The treatment of sexually acquired epididymo-orchitis has changed given the high levels of quinolone-resistant gonorrhoea such that ceftriaxone and doxycycline are recommended in those at high risk of gonorrhoea and doxycycline or ofloxacin in those patients where gonorrhoea is considered unlikely (negative microscopy for Gram-negative intracellular diplococci and no risk factors for gonorrhoea identified). A clinical care pathway has also been produced to simplify the management of epididymo-orchitis.

  19. Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography

    Institute of Scientific and Technical Information of China (English)

    Ulku Saritas; Bunyamin Aydin; Yucel Ustundag

    2007-01-01

    Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure.After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with corticosteroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow-up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure.

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

    Science.gov (United States)

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

    2011-03-01

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

  1. Case of a cerebral abscess caused by Porphyromonas gingivalis in a subject with periodontitis

    Science.gov (United States)

    Grisar, Koenraad; Maes, Honorine; Politis, Constantinus

    2017-01-01

    We report the case of a 65-year-old man presenting with generalised seizures after developing a right frontal brain abscess. Stereotactic aspiration and subsequent matrix assisted laser desorption/ionisation time-of-flight analyzer (MALDI-TOF) spectrometry revealed Porphyromonas gingivalis as the only causative anaerobe microorganism. Secondary incision and drainage was required due to neurological deterioration with increased dimensions of the abscess, intracranial pressure and formation of a subdural occipitoparietal empyema. Oral imaging was positive for apical periodontitis of multiple elements; therefore, the remaining dentition was removed. Targeted antibiotic treatment included intravenous ceftriaxone and ornidazole. The patient was discharged to our revalidation unit 59 days after admission to make a full recovery. To the best of our knowledge, this is the sixth reported case of P. gingivalis causing an intracranial abscess and the third case of a true intracerebral parenchymal abscess caused by this bacterium. PMID:28228396

  2. Aortic and tricuspid endocarditis in hemodialysis patient with systemic and pulmonary embolism.

    Science.gov (United States)

    Rosa, Silvia Aguiar; Germano, Nuno; Santos, Ana; Bento, Luis

    2015-01-01

    This is a case report of a 43-year-old Caucasian male with end-stage renal disease being treated with hemodialysis and infective endocarditis in the aortic and tricuspid valves. The clinical presentation was dominated by neurologic impairment with cerebral embolism and hemorrhagic components. A thoracoabdominal computerized tomography scan revealed septic pulmonary embolus. The patient underwent empirical antibiotherapy with ceftriaxone, gentamicin and vancomycin, and the therapy was changed to flucloxacilin and gentamicin after the isolation of S. aureus in blood cultures. The multidisciplinary team determined that the patient should undergo valve replacement after the stabilization of the intracranial hemorrhage; however, on the 8th day of hospitalization, the patient entered cardiac arrest due to a massive septic pulmonary embolism and died. Despite the risk of aggravation of the hemorrhagic cerebral lesion, early surgical intervention should be considered in high-risk patients.

  3. [A case of pseudothrombocytopenia during antibiotic administration].

    Science.gov (United States)

    Kinoshita, Yoshimitsu; Yamane, Takahisa; Kamimoto, Akio; Oku, Hiroko; Iwata, Yasuhiro; Kobayashi, Toru; Hino, Masayuki

    2004-02-01

    A 70 year-old woman was prescribed of levofloxacin and ceftriaxone for acute bronchitis. On the seventh day of administration she was hospitalized with a dry cough and a decreased platelet count(2.1 x 10(4)/microliter). However, bleeding tendency was not seen. So, we changed anticoagulants with citric acid and heparin from EDTA, and measured platelet count because we suspected pseudothrombocytopenia(PTCP), then platelet count became elevated (respectively, 12.5 x 10(4)/microliter and 15.0 x 10(4)/microliter). In addition, platelet associated IgG increased to 309.3 ng/10(7) cells. Based on drug lymphocyte stimulation test, she was diagnosed as having antibiotic-induced PTCP, especially as she had no history of thrombocytopenia. PTCP should be considered when thrombocytopenia occurs during antibiotic treatment.

  4. Clinical implications and treatment of multiresistant Streptococcus pneumoniae pneumonia.

    Science.gov (United States)

    File, T M

    2006-05-01

    Streptococcus pneumoniae is the leading bacterial cause of community-acquired respiratory tract infections. Prior to the 1970s this pathogen was uniformly susceptible to penicillin and most other antimicrobials. However, since the 1990s there has been a significant increase in drug-resistant Streptococcus pneumoniae (DRSP) due, in large part, to increased use of antimicrobials. The clinical significance of this resistance is not definitely established, but appears to be most relevant to specific MICs for specific antimicrobials. Certain beta-lactams (amoxicillin, cefotaxime, ceftriaxone), the respiratory fluoroquinolones, and telithromycin are among several agents that remain effective against DRSP. Continued surveillance studies, appropriate antimicrobial usage campaigns, stratification of patients based on known risk factors for resistance, and vaccination programmes are needed to appropriately manage DRSP and limit its spread.

  5. In vitro susceptibility of six fluoroquinolones against invasive Streptococcus pneumoniae isolated from 1996 to 2001 in Taiwan.

    Science.gov (United States)

    Chen, J Y; Fung, C P; Wang, C C; Chu, M L; Siu, L K

    2003-01-01

    A total of 331 invasive nonduplicated Streptococcus pneumoniae isolates from three sampling periods during 1996 to 2001 were tested for susceptibility to recently developed fluoroquinolones. Five major serotypes, 23F, 6B, 14, 19F, and 3, were frequently encountered in this collection. Penicillin nonsusceptible isolates constituted 52.9% from 1996 to 1997, 61.6% from 1998 to 1999, and 60.0% from 2000 to 2001. Fifty-seven percent of the isolates were susceptible to cefotaxime, 56.5% to ceftriaxone, 54.1% to cefepime, and 52.6% to cefuroxime. Macrolide-susceptible isolates constituted less than 14% of the total sample, and no vancomycin-resistant isolates were detected. For fluoroquinolones, MIC90 was lowest for gemifloxacin (MIC90 = fluoroquinolones are very effective against invasive S. pneumoniae isolates in Taiwan. Nevertheless, emerging fluoroquinolone resistance should be acknowledged and clinicians alerted. Surveillance should be carried out to monitor any changes in antibiotic resistance of S. pneumoniae.

  6. 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.

  7. Nosocomial diarrhea in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Paula Marcon

    2006-12-01

    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.

  8. Lichen sclerosus et atrophicans, scleroderma en coup de sabre and Lyme borreliosis.

    Science.gov (United States)

    Gubertini, Nicoletta; Bonin, Serena; Trevisan, Giusto

    2011-08-03

    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.

  9. 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.

  10. [Pyelonephritis table during the pregnancy: think of the listeriosis].

    Science.gov (United States)

    El Ameri, A; Achenani, M; Hmamouche, K; Ghazouani, M; Benaouda, A; El Ouennass, M

    2011-10-01

    Listeriosis in pregnancy is usually benign; however the foetal consequences are serious. We report a case of atypical listeriosis simulating pyelonephritis, in a pregnant woman who presented at 25 weeks gestation a left renal colic, operating in a febrile context; it was treated as urinary tract infection with gentamicin and ceftriaxon. The evolution was marked by the exacerbation of symptoms followed by in utero foetal death. Blood culture was performed in post abortion; the diagnosis was retained after bacteriological examination of the placenta. This observation suggested evoking listeriosis in any case of unexplained fever during pregnancy, even with clinical signs suggestive of pyelonephritis, and not delay making blood cultures and prescribing antibiotics in general an amoxicillin.

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

    Directory of Open Access Journals (Sweden)

    Voitenko O. Yu.

    2014-02-01

    Full Text Available The antimicrobial properties of complex materials containing ultradispersed silver particles directly formed in the Candida albіcans, Escherichia сolі, Pseudomonas fluorescens, and Bacillus cereus cell walls were investigated. Complex material based on pseudomonas was more active against gram-positive bacteria, the yeast like fungi based material was mainly active against colibacillus. After a cell-matrix treatment in a hypertonic solution or by acid hydrolysis, the antimicrobial properties of complex materials increased by 20—40%. In a liquid-phase medium, the complex materials with incorporated silver particles in composition with antibiotics strengthened anti-microbial properties of chloramphenicol, tetracycline and amoxiclav antibiotics with respect to E. faecalis, as well as penicillin antibiotics (ceftriaxone, cefotaxime, amoxicillin, amoxiclav against E. coli. The obtained data can serve as a basis for development of the new antibacterial and fungicide cells based materials impregnated with ultradispersed substances.

  12. ISOLATION, IDENTIFICATION, PATHOTYPING AND ANTIBIOGRAM OF ESCHERICHIA COLI FROM RECTAL SWAB OF PET DOGS AND CATS

    Directory of Open Access Journals (Sweden)

    S. Das

    2012-07-01

    Full Text Available Two hundred seventy two rectal swabs were examined from diarrhoeic and nondiarrhoeic pet dogs and cats. Out of 240 samples from dogs, 131 (54.58% and out of 32 samples from cats, 15 (46.87% were positive for E. coli by cultural characteristic, gram staining, motility,biochemical reactions and sugar fermentation tests. Out of 146 total positive isolates, only 12 isolates were pathogenic. Out of 12 pathogenic isolates of E. coli 6 isolates were O group non- typable and rest 6 E. coli strains were O25, O86a, O44 and O1 from dogs and O36 and O8 from cats. Out of 12 isolates 9 were sensitive to ceftriaxone, 8 were sensitive to ciprofloxacin and gentamicin, 4 were sensitive to amikacin, neomycin and norfloxacin, 2 were to Co-trimoxazole and 1 was sensitive to lomefloxacin. None of the isolate was sensitive to amoxyclav & cephotaxime.

  13. Analysis of Etiology and Drug Resistance of Biliary Infections

    Institute of Scientific and Technical Information of China (English)

    王欣; 李秋; 邹声泉; 孙自庸; 朱峰

    2004-01-01

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

  14. Raoultella planticola bacteremia following consumption of seafood.

    Science.gov (United States)

    Lam, Philip W; Salit, Irving E

    2014-07-01

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

  15. Population dynamics and antimicrobial susceptibility of Aeromonas spp. along a salinity gradient in an urban estuary in Northeastern Brazil.

    Science.gov (United States)

    Silva, Camila Magalhães; Evangelista-Barreto, Norma Suely; Vieira, Regine Helena Silva Dos Fernandes; Mendonça, Kamila Vieira; de Sousa, Oscarina Viana

    2014-12-15

    The main objective of this study was to quantify population and identify culturable species of Aeromonas in sediment and surface water collected along a salinity gradient in an urban estuary in Northeastern Brazil. Thirty sediment samples and 30 water samples were collected from 3 sampling locations (A, B and C) between October 2007 and April 2008. The Aeromonas count was 10-7050CFU/mL (A), 25-38,500CFU/mL (B) andAeromonas caviae, A. sobria, A. trota, A. salmonicida and A. allosaccharophila) were identified among 41 isolates. All strains were sensitive to chloramphenicol and ceftriaxone, whereas 33 (80, 4%) strains were resistant to at least 2 of the 9 antibiotics tested. Resistance to erythromycin was mostly plasmidial. In conclusion, due to pollution, the Cocó River is contaminated by pathogenic strains of Aeromonas spp. with a high incidence of antibacterial resistance, posing a serious risk to human health.

  16. 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.

  17. 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

  18. 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.

  19. Management of gonococcal infection among adults and youth

    Science.gov (United States)

    Pogany, Lisa; Romanowski, Barbara; Robinson, Joan; Gale-Rowe, Margaret; Latham-Carmanico, Cathy; Weir, Christine; Wong, Tom

    2015-01-01

    Abstract Objective To provide recommendations on the management of gonococcal infection among adults and youth. Quality of evidence Treatment recommendations in the Canadian guidelines on sexually transmitted infections are based on review of the literature, as well as the grades of recommendations and the levels of evidence quality determined by a minimum of 2 reviewers. The recommendations are peer-reviewed and require approval by the expert working group. Main message The new key recommendations for managing gonococcal infection among adults and youth include using culture as a diagnostic tool when practical, providing treatment with combination antibiotic therapy (ceftriaxone combined with azithromycin), and promptly reporting all cases with treatment failure to public health. Conclusion Following these new key recommendations might reduce treatment failure, contribute to better surveillance of antibiotic-resistance trends in Neisseria gonorrhoeae, and contribute to the prevention of transmission of multidrug-resistant gonorrhea. PMID:26472793

  20. Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

    Directory of Open Access Journals (Sweden)

    Daniel Bunker

    2015-01-01

    Full Text Available Disseminated gonococcal infection (DGI is a rare complication of primary infection with Neisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions.

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

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    Kaskhedikar

    2009-02-01

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

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

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    Nikolić Katarina

    2015-01-01

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

  3. 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...... in surviving animals was comparable (16/44 versus 9/29, p=0.8). Pre-treatment with fucoidin attenuated CSF pleocytosis 24 h after infection (median 400 versus 800x10(6) cells/l, p=0.01) without affecting CSF bacterial counts (2.3x10(5) versus 3.6x10(5) CFU/ml, p=0.54). A significant increase in blood bacterial...

  4. Klebsiella pneumoniae liver abscess in an immunocompetent child

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    Jang Mi Kwon

    2013-09-01

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

  5. Identifikasi Bakteri Infeksi Saluran Pernafasan Bawah Non Tuberkulosis (Non TB dan Pola Resistensinya pada Penderita Diabetes Melitus di RSUP M. Djamil

    Directory of Open Access Journals (Sweden)

    Virgi Anggia Lubis

    2016-09-01

    Full Text Available AbstrakKadar gula darah yang tinggi pada pasien diabetes mellitus (DM menyebabkan pasien ini rentan akan terjadinya infeksi, salah satunya infeksi saluran pernafasan bawah non tuberkulosis (Non TB yang disebabkan oleh bakteri Gram negatif dan Gram positif, maka terapi pilihannya antibiotik spektrum luas. Survei awal di Bagian Penyakit Dalam RSUP M. Djamil didapatkan bahwa terapi yang dilakukan adalah terapi empiris yang  mengakibatkan meningkatnya resistensi. Tujuan penelitian ini adalah mengidentifikasi bakteri penyebab infeksi pernafasan bawah non tuberkulosis dan pola resistensinya pada penderita DM di  RSUP M. Djamil. Penelitian deskriptif ini dilakukan di Laboratorium Mikrobiologi FK Unand Padang dan Bagian Penyakit Dalam RSUP M. Djamil terhadap 16 pasien dengan diagnosis DM disertai infeksi saluran pernafasan bawah dari Januari sampai Februari 2014. Hasil penelitian menunjukkan Klebsiella pneumonia (56,25% sebagai penyebab terbanyak, diikuti Staphylococcus aureus (18,25%, Pseudomonas aeruginosa (12,50%, dan Streptococcus pneumonia (12.50%. Uji resistensi menunjukkan Klebsiella pneumonia mengalami resistensi yang besar terhadap Ceftriaxone (66,63%, Pseudomonas aeruginosa resisten terhadap Ceftriaxone dan Amoxicilin Clavulanat Acid (50%, Staphylococcus aureus resisten terhadap Ciprofloxacin (33,33, sedangkan Streptococcus pneumonia  sensitif terhadap Azitromicin (100%. Dapat disimpulkan bakteri yang ditemukan mengalami resistensi yang cukup besar terhadap beberapa antibiotik yang digunakan.Kata kunci: diabetes melitus, infeksi saluran pernafasan bawah no TB, bakteri, resistensi AbstractHigh concentration of blood glucose in patients with diabetes mellitus cause susceptible to be infected, including lower respiratory infections non tuberculosis caused by Gram negatif and Gram positif. Treatment of these infections are broad spectrum antibiotics. The objective of this study was to indentify the causal bacteria of lower respiratory

  6. 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.

  7. Ceftobiprole for the treatment of pneumonia: a European perspective.

    Science.gov (United States)

    Liapikou, Adamantia; Cillóniz, Catia; Torres, Antonio

    2015-01-01

    Ceftobiprole, a new broad spectrum, parenteral cephalosporin, exhibits potent in vitro activity against a number of Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae, and Gram-negative pathogens associated with hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP). Ceftobiprole has demonstrated noninferiority in two large-scale pivotal studies comparing it to ceftriaxone with or without linezolid in CAP, with clinical cure rates 86.6% versus 87.4%, or ceftazidime in HAP, with clinical cure rates of 77% versus 76%, respectively. However, ceftobiprole was inferior in the subgroup of patients undergoing mechanical ventilation. Ceftobiprole has so far demonstrated a good safety profile in preliminary studies, with similar tolerability to comparators. The most commonly observed adverse events of ceftobiprole included headache and gastrointestinal upset. It is the first cephalosporin monotherapy approved in the EU for the treatment of both CAP and HAP (excluding ventilator-associated pneumonia).

  8. Brain abscess with an unexpected finding: Actinomyces meyeri CNS infection

    DEFF Research Database (Denmark)

    Eiset, Andreas Halgreen; Thomsen, Marianne Kragh; Wejse, Christian

    oedema. By MRI an abscess was suspected and the patient was transferred to the department of neurosurgery, where drainage was performed. Microscopy revealed gram-positive cocci and gram-negative rods and iv. treatment with ceftriaxone 4g x 1 and metronidazole 1g x 1 was commenced. Pus cultures showed...... Prevotella spp. and A. meyeri and the initial treatment was changed to penicillin G 5 MIU x 4 and metronidazole 500 mg x 3 for four weeks followed by oral amoxicillin 500 mg x 3 for three months. The abscess regressed on this treatment and there were no CNS related symptoms at three months follow......-up. The source of infection was most likely periodontitis with spread to the lungs from aspiration or oropharyngeal secretion into the respiratory tract, alternatively from haematogenous spread. Conclusions: We report of the successful treatment of a cerebral abscess caused by A. meyeri with narrow spectrum...

  9. 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

  10. Study of Antimicrobial Resistance of Acinetobacter Strains Isolated From Blood Cultures

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    H Zandi

    2007-06-01

    Full Text Available Background: Acinetobacter spp are associated with various nosocomial infections like as septicemia and are isolated form blood cultures in hospitalized patients. Methods: In this study, 45 Acinetobacter strains were isolated from blood samples in Yazd shahid sadoughi hospital from 21 March 2005 to 20 September 2006 and were identified by biochemical tests. Antibiotic susceptibility of the strains was tested by standard disk diffusion method. Results: In this research, 45 isolates identified as Acinetobacter and of isolated strains, 88.8% of them found sensitive to imipenem and 80% to ciprofloxacin. Also 51.5% to nalidixic Acid 24.5% to trimethoprim/sulphametoxazole, 11.1% to ceftazidim and ceftriaxone, 8.8% to cefotaxime and cefexime and also 6.6% to ceftizoxime. Conclusion: Because of increasing of drug resistance in Acinetobacter spp. Isolated from blood samples, it is necessary to perform susceptibility testing, also imipenem and ciprofloxacin recommended for drug therapy.

  11. Verified clinical failure with cefotaxime 1g for treatment of gonorrhoea in the Netherlands: a case report.

    Science.gov (United States)

    van Dam, Alje P; van Ogtrop, Marc L; Golparian, Daniel; Mehrtens, Jan; de Vries, Henry J C; Unemo, Magnus

    2014-11-01

    We describe the first case of treatment failure of gonorrhoea with a third generation cephalosporin, cefotaxime 1g intramuscularly, in the Netherlands. The case was from a high-frequency transmitting population (men having sex with men) and was caused by the internationally spreading multidrug-resistant gonococcal NG-MAST ST1407 clone. The patient was clinically cured after treatment with ceftriaxone 500 mg intramuscularly and this is the only third generation cephalosporin that should be used for first-line empiric treatment of gonorrhoea. Increased awareness of failures with third generation cephalosporins, enhanced monitoring and appropriate verification of treatment failures including more frequent test-of-cures, and strict adherence to regularly updated treatment guidelines are essential globally.

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

    Science.gov (United States)

    Tsai, Wen-Cheng; Chang, Liang-Kai

    2002-09-01

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

  13. Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes

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    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.

  14. Abdominal lymphadenopathy:An atypical presentation of enteric fever

    Institute of Scientific and Technical Information of China (English)

    Nayla Ahmed; Zeb I Saeed; Muhammad Tariq

    2012-01-01

    This is a case report of a patient who presented to the Aga Khan University Hospital with generalized abdominal lymphadenopathy and high-grade fever. Due to ambiguous clinical findings, which were suggestive of either abdominal tuberculosis, or a lymphoma, the patient was started on empirical anti-tuberculous treatment due to the endemicity of tuberculosis in this region. The blood culture reports, however, were reported to grow colonies of Salmonellaparatyphi A; thus the diagnosis of the patient was changed to enteric fever, and the patient improved on the subsequently started therapy of ceftriaxone 2 000 mg bid. To the best of our knowledge, this is the first reported case of a patient suffering from enteric fever whose primary clinical findings were abdominal lymphadenopathy and fever.

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

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    Hancu Gabriel

    2013-01-01

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

  16. Antimicrobial susceptibility of Streptococcus pneumoniae and genotypic characterization of erythromycin-resistant strains in Porto Alegre, Brazil

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    F. T. Weber

    2010-03-01

    Full Text Available The antimicrobial susceptibility of 64 strains of S. pneumoniae obtained from three hospitals in Porto Alegre, Brazil, isolated between 2004 and 2005, was determined, using the agar-dilution method. The prevalence of resistant (intermediate and full resistance strains to trimethoprim/sulphamethoxazole, penicillin, tetracycline, erythromycin, chloramphenicol, and ceftriaxone were 68%, 28%, 18%, 15%, 3%, and 1%, respectively. All strains were susceptible to vancomycin. Among 18 penicillin-resistant strains, 7 were resistant to at least two other antimicrobial drugs. All erythromycin-resistant strains, except one, contained the erm(B and/or mef(A/E genes, with a predominance of the former. The resistance rate to penicillin and erythromycin in Porto Alegre remained stable. The combination of trimethoprim/ sulphamethoxazole should not be recommended to treat pneumococcal infections, because of the high rate of resistant strains.

  17. Raoultella Planticola Bacteremia Following Consumption of Seafood

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    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.

  18. Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease

    Science.gov (United States)

    Lee, Kyung Jin; Shin, Dong Hwan; Jung, Jun Oh; Koh, Seokyoung; Kim, Ka Young; Lee, Jae Min

    2015-01-01

    We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved. PMID:26730366

  19. Acute Myopericarditis Likely Secondary to Disseminated Gonococcal Infection

    Science.gov (United States)

    Bunker, Daniel; Kerr, Leslie Dubin

    2015-01-01

    Disseminated gonococcal infection (DGI) is a rare complication of primary infection with Neisseria gonorrhoeae. Cardiac involvement in this condition is rare, and is usually limited to endocarditis. However, there are a number of older reports suggestive of direct myocardial involvement. We report a case of a 38-year-old male with HIV who presented with chest pain, pharyngitis, tenosynovitis, and purpuric skin lesions. Transthoracic echocardiogram showed acute biventricular dysfunction. Skin biopsy showed diplococci consistent with disseminated gonococcal infection, and treatment with ceftriaxone improved his symptoms and ejection fraction. Though gonococcal infection was never proven with culture or nucleic acid amplification testing, the clinical picture and histologic findings were highly suggestive of DGI. Clinicians should consider disseminated gonococcal infection when a patient presents with acute myocarditis, especially if there are concurrent skin and joint lesions. PMID:26246922

  20. Genotyping of two Neisseria gonorrhoeae fluroquinolone-resistant strains in the Brazilian Amazon Region

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    William Antunes Ferreira

    2011-08-01

    Full Text Available We report two ciprofloxacin and ofloxacin-resistant Neisseria gonorrhoeae strains that were isolated from the urethral discharge of male patients at the sexually transmitted diseases outpatient clinic of the Alfredo da Matta Foundation (Manaus, state of Amazonas, Brazil. The gonococci displayed minimal inhibitory concentrations (> 32.00 µg/mL and three mutations in the quinolone resistance-determining region (S91F and D95G in GyrA and S87R in ParC. Both isolates were genotyped using N. gonorrhoeae multi-antigen sequence typing and the analysis showed that the ST225 which represented an emerging widespread multi-resistant clone that has also been associated with reduced susceptibility to ceftriaxone. We recommend continued surveillance of this pathogen to assess the efficacy of anti-gonococcal antibiotics in Brazil.

  1. 淋菌对β-内酰胺类抗菌药物的药敏试验结果回顾性分析%Drug susceptibility tests of neisseria gonorrhoeae to β-lactams antibiotics:a retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    刘明章; 沈翠芬; 吴原; 张晓祥; 王翔

    2011-01-01

    目的 了解淋菌对β-内酰胺类抗菌药物的敏感性,为淋病的防治提供科学依据.方法 回顾性分析纸片扩散法检测86株淋菌对6种β-内酞胺类抗菌药物的药敏试验结果,产色头孢硝噻吩法检测β-内酰胺酶.结果 质粒介导的产青霉素酶淋菌阳性菌株30株,占34.88%;淋菌对青霉素、头孢呋辛、头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率分别为8.14%,75.58%,90.70%,93.02%,86.05%,94.19%;青霉素的药物敏感性显著低于头孢呋辛,差异有统计学意义(X2=80.36,P<0.01);头孢呋辛的药物敏感性比头孢曲松的药物敏感性低,差异无统计学意义,但是头孢呋辛有5株耐药菌株;头孢噻肟、头孢他啶、头孢曲松、头孢吡肟的敏感率,差异无统计学意义.结论 第三、四代头孢菌素可作为治疗淋菌感染的一线药物.%OBJECTIVE To investigate the β-lactams susceptibility of Neisseria gonorrhoeae and provide scientific basis for the treatment and prevention of gonorrhea. METHODS A retrospective survey was conducted. β-lactams susceptibility tests were tested by Disk diffusion, and βlactamase was determined by nitrocefin. RESULTS Plasmid mediated penicillinase producing Neisseria gonorrhoeae(PPNG) were 30 straines(34. 88 %). Susceptive rates of penicillin, cefuroxime, cefotaxime, ceftazidime, ceftriaxone and cefepime were 8. 14%, 75. 58%, 90.70%, 93. 02%, 86. 05% and 94. 19%, respectively. The sensitivity of penicillin was lower than that of cefuroxime with significant difference(x2 =80.36, P<0. 001). The sensitivity of cefuroxime was lower than that of ceftriaxone without significant difference (x2 =3.04, P = 0. 08), while there were 5 resistant strains for cefuroxine. There was no significant difference (x2=4.08,P= 2. 53) among the sensitivities of cefotaxime, ceftazidime, ceftriaxone and cefepime. CONCLUSION The third generation of cephalosporins such as cefotaxime, ceftazidime, ceftriaxone and the

  2. Analysis on sensitivity of Neisseria gonorrhoea to cephalosporin antibiotics and multi-antigen sequence typing%淋病奈瑟球菌对头孢菌素类药物的敏感性及多抗原序列分型研究

    Institute of Scientific and Technical Information of China (English)

    蓝银苑; 吴兴中; 覃晓琳; 黄进梅; 薛耀华; 曾维英; 欧江丽; 唐三梅; 方铭恒

    2015-01-01

    Objective To understand the molecular types of clinical isolated Neisseria gonorrhoeae (NG) in Guangzhou, and to analyze the sensitivity to the cephalosporin antibiotics. Methods A total of 121 NG strains isolated from Guangzhou Skin Disease Prevention and Control Center were included in this study. The agar dilution method was used to determine the minimum inhibitory concentrations (MIC) to ceftriaxone and cefixime. DNA was extracted for NG multi-antigen sequence typing (NG-MAST). Results The drug-resistance analysis showed that none of the strains appeared to be resistant to ceftriaxone and cefixime. However, the low sensitivity rates were 13.2%(16/121) and 2.5%(3/121), respectively. A total of 82 genotypes were identified among the 121 isolates. The most prevalent genotype was ST1768 (n=6) in NG strains isolated, followed by ST2083 (n=4), ST5062 (n=4), ST10229 (n=4), ST1766 (n=3), ST1866 (n=3), and ST10339 (n=3). There were 12 genotypes containing 2 NG strains, and 63 genotypes [76.8%(63/121) ] containing only one NG strain. Among the 13 NG strains with low sensitivity to ceftriaxone , there were 2 strains of ST10339 and 2 strains of ST10242 , and the rest were single genotype. Conclusions The 121 NG strains have relatively high sensitivity to ceftriaxone and cefixime. The genotypes of these NG-MAST strains are high diversity.%目的 了解广州市临床分离淋病奈瑟球菌 (NG) 的分子型别及其对头孢菌素类抗生素的敏感性. 方法 收集广东省皮肤性病防治中心临床分离的121株NG,用琼脂稀释法测定菌株对头孢曲松和头孢克肟的最小抑菌浓度(MIC),并进行NG多抗原测序分型(NG-MAST). 结果 未发现NG对头孢曲松和头孢克肟耐药的菌株,但它们的低敏率分别达到13.2%(16/121)和2.5%(3/121). 121株NG共有82个型别,其中ST1768共6株,ST2083、ST5062和ST10229各4株,ST1766、ST1866和ST10339各3株, 有12个ST族群包含2株菌株,其余63 个型别仅含1 株菌株,占76.8%(63/121).

  3. [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.

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

    Periti, P; Mazzei, T

    1999-07-01

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

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

    Science.gov (United States)

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

    2006-09-01

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

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

    Science.gov (United States)

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

    1996-09-13

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

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

    Science.gov (United States)

    Kidd, Sarah; Workowski, Kimberly A

    2015-12-15

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

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

    Science.gov (United States)

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

    2015-12-11

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

  10. Effects of two eflfux pump inhibitors on the drug susceptibility of Riemerella anatipestiferisolates from China

    Institute of Scientific and Technical Information of China (English)

    LI Ya-fei; JIANG Hong-xia; XIANG Rong; SUN Na; ZHANG Ya-nan; ZHAO Li-qing; GU Peng; WANG Li-qiao; ZENG Zhen-ling

    2016-01-01

    The objective of this study was to verify the supposition that eflfux might be involved in the drug resistance ofRiemerela anatipestiferisolates. Two broad-spectrum eflfux pump inhibitors, carbonyl cyanide 3-chlorophenylhydrazone (CCCP) and Phe-Arg-β-naphthylamide (PAβN), on the contribution of minimum inhibitory concentrations of amikacin, streptomycin, chloramphenicol, tetracycline, ceftriaxone, ceftazidime, nalidixic acid, levolfoxacin, enrolfoxacin, as wel as ciprolfoxacin against 69 clinicalR. anatipestiferisolates were investigated. We ifrst reported that the two eflfux pump inhibitors could restore the antimicrobial susceptibility ofR. anatipestifer isolates. It is suggested that active eflfux system is possible to be linked with the development of resistance inR. anatipestifer isolates.

  11. 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.

  12. Melioidosis in a returning traveller

    Science.gov (United States)

    Ismail, Alaa; Buckley, Adam; Dubrey, Simon William

    2013-01-01

    A 66-year-old man returned to the UK from Thailand with a 2-week history of new confusion, hallucinations, fever with rigours and productive cough. He had not responded to (unspecified) antibiotic treatment in Thailand. On examination he was afebrile, with an abbreviated mental test score of 8/10 and no other findings on systemic examination. He was treated with ceftriaxone in response to discovery of a Gram-negative organism in blood. This was converted to meropenem on the clinical suspicion of our microbiologist, on the basis of a history of contact with surface water in the Far East. A blood culture subsequently confirmed Burkholderia pseudomallei. His condition remained stable for approximately 4 days, but then deteriorated over the course of the next 2 weeks with pneumonia and subsequent formation of disseminated abscesses. Treatment was withdrawn as his condition deteriorated to the point at which survival was deemed impossible and he subsequently died. PMID:23605844

  13. Genital trauma during a complicated domiciliary childbirth assisted by a non-expert midwife

    Directory of Open Access Journals (Sweden)

    Ada Arleny Pérez Mayo

    2015-06-01

    Full Text Available The study presents the case of a 20-year-old puerpera seen at San Pedro Necta National Hospital of the Department of Huehuetenango, Guatemala, due to a persisting vaginal bleeding and genital tear. The clinical picture was determined as a genital trauma by domiciliary childbirth assisted by a midwife. As there was no abdominal echography and there were signs of hypovolemia, a gynecological checkup was performed at the operating room, having circulatory support with intravenous crystalloid solutions. A careful preoperative preparation was carried out which included local antisepsis with tincture of iodine and hydrogen peroxide, as well as the administration of ceftriaxone as a prophylactic antibiotic for the infection. The surgical intervention consisted in repairing the cervical tears, as well as the traumatic lesions caused by an inadequate manipulation of the external genitals, with absorbable suture material. No complications were reported and the patient progressed satisfactorily, with a 5-day hospital stay.

  14. Salmonella enterica serovar Minnesota urosepsis in a patient with Crohn's disease in the absence of recent or current gastrointestinal symptoms.

    Science.gov (United States)

    Steinebrunner, Niels; Sandig, Catharina; Zimmermann, Stefan; Stremmel, Wolfgang; Eisenbach, Christoph; Mischnik, Alexander

    2013-09-01

    Salmonella enterica serovar Minnesota is a rarely isolated organism in clinical samples mainly grown from stool cultures. Sepsis due to Salmonella is known in severely immunocompromised patients, but so far urosepsis due to S. enterica serovar Minnesota has not been described. We report a case of a 31-year-old patient suffering from Crohn's disease treated with infliximab and azathioprine, in whom was implanted a double-J ureteric catheter for urolithiasis. The patient presented with urinary tract infection and severe sepsis. S. enterica serovar Minnesota was grown from urine and blood cultures. After empiric antimicrobial treatment with meropenem and vancomycin, treatment was changed to ceftriaxone. Antimicrobial treatment was continued for a total of 3 weeks without evidence of Salmonella recurrence on follow-up visits. Salmonella spp. rarely cause urinary tract infection and sepsis. However, in immunocompromised patients, non-typhoidal salmonellosis merits a thorough clinical and microbiological evaluation.

  15. Chronic meningitis with intracranial hypertension and bilateral neuroretinitis following Mycoplasma pneumoniae infection.

    Science.gov (United States)

    Karampatsas, Konstantinos; Patel, Himanshu; Basheer, Sheikh N; Prendergast, Andrew J

    2014-12-23

    A previously well 12-year-old boy presented with a 2-week history of headache, nausea, vomiting and left-sided weakness. He subsequently developed meningism, right abducens nerve palsy, persistent papilloedema and reduced visual acuity in association with a bilateral macular star, consistent with neuroretinitis. Cerebrospinal fluid (CSF) examination indicated chronic meningitis and serological testing confirmed recent Mycoplasma pneumoniae infection, although PCR in CSF was negative. He was treated for aseptic meningitis with ceftriaxone, aciclovir, azithromycin and acetazolamide for intracranial hypertension, with gradual improvement in clinical condition and visual acuity over several weeks. This is the first report of M. pneumoniae chronic meningitis further complicated with bilateral neuroretinitis and intracranial hypertension. Evidence of central nervous system inflammation in the absence of direct infection suggests an immune-mediated pathophysiology. Although the use of macrolides with antibiotic and immunomodulatory activity might be beneficial, it was not possible to ascertain whether it influenced clinical recovery in this case.

  16. Spread of Extended Spectrum Cephalosporinase-Producing Escherichia coli Clones and Plasmids from Parent Animals to Broilers and to Broiler Meat in a Production Without Use of Cephalosporins

    DEFF Research Database (Denmark)

    Agersø, Yvonne; Jensen, Jacob Dyring; Hasman, Henrik

    2014-01-01

    Objectives: This study investigated the occurrence of extended spectrum cephalosporinase (ESC)–producing Escherichia coli in a broiler production with no cephalosporin use and a low use of antimicrobials in general. Furthermore, it investigated whether the current consumption of aminopenicillins....... Isolates with blaCMY-2 were subtyped by pulsed-field gel electrophoresis (PFGE), phylotyping, and antimicrobial susceptibility testing. Selected isolates were used as donors in filter-mating experiments, multilocus sequence typing (MLST), and plasmid replicons were typed. Aminopenicillin use at the farm...... 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...

  17. The antibiotic susceptibility and extended spectrum β-lactamase genotype of clinical Klebsiella pneumoniae%肺炎克雷伯菌药敏分析及其超广谱β内酰胺酶基因分型研究

    Institute of Scientific and Technical Information of China (English)

    杨朵; 王占伟; 郭宇; 张正

    2011-01-01

    Objective To analyze the antibiotic susceptibility, ESBL genotype of clinical Klebsiella pneumoniae strains isolated from People′s hospital and facilitate the control of resistance spread. Methods Identification and antibiotic susceptibility tests of 1 205 strains from 2001 to 2007 were done by VITEK-2 system.The antibiotic susceptibility results were analyzed by whonet5.3.The ESBL gene was detected by PCR and the Chi-square test was used for statistical analysis.Results The rate of ESBL-producing strains in klebsiella pneumoniae has increased from 2001 to 2007[18.8% (40/213) in 2001, 20.9% (53/253) in 2002, 32.8% (42/128) in 2003, 33.6% (45/137) in 2004, 36.6% (60/164) in 2005, 45.3% (68/150) in 2006 and 45.6% (73/160) in 2007].The SHV gene was the most dominant in ESBL genotypes.There were 83.3% (50/60) ESBL strains in 2005 with SHV gene, 82.3%(56/68) in 2006 and 83.6%(61/73) in 2007.The rated of strains with CTX-M gene were increasing.There were 26.7%(16/60) ESBL strains with CTX-M gene in 2005, 36.7%(25/68) in 2006 and 54.8%(40/73) in 2007.The isolates with more than one type of ESBL gene were increasing.There were 45%(27/60) ESBL strains in 2005 with two types of ESBL gene, and no one had more than two types of ESBL gene in that year.There were 47.9%(35/73) ESBL strains in 2007 with two types of ESBL gene.In 2007 there were 9.6%(7/73) and 2.7%(2/73) ESBL strains with three types and four types of ESBL gene respectively.There was a statistical difference between the antibiotic resistance rates of cefotaxime, ceftriaxone and ceftazidime in SHV-gene-phore strains (χ2=13.22, P<0.01).The strains with SHV gene were more resistant to cefotaxime than ceftriaxone and ceftazidime.There also was a statistical difference of the antibiotic resistance rate of cefotaxime, ceftriaxone and ceftazidime between strains with TEM gene (χ2=9.91, P<0.01) and CTX-M gene (χ2=34.84, P<0.01) respectively.None of the strains with CTX-M gene was sensitive to cefotaxime, and

  18. Antimicrobial susceptibility pattern of bacterial isolates from surgical wound infections in Tertiary Care Hospital in Allahabad, India

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    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.

  19. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients attending a public referral center for sexually transmitted diseases in Belo Horizonte, State of Minas Gerais, Brazil

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    Ligia Maria Bedeschi Costa

    2013-06-01

    Full Text Available Introduction The aim of this study was to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates obtained from patients attending a public referral center for sexually transmitted diseases and specialized care services (STD/SCS in Belo Horizonte, Brazil. Methods Between March 2011 and February 2012, 201 specimens of Neisseria gonorrhoeae were consecutively obtained from men with symptoms of urethritis and women with symptons of cervicitis or were obtained during their initial consultation. The strains were tested using the disk diffusion method, and the minimum inhibitory concentrations of azithromycin, cefixime, ceftriaxone, ciprofloxacin, chloramphenicol, penicillin, tetracycline and spectinomycin were determined using the E-test. Results The specimens were 100% sensitive to cefixime, ceftriaxone and spectinomycin and exhibited resistances of 4.5% (9/201, 21.4% (43/201, 11.9% (24/201, 22.4% (45/201 and 32.3% (65/201 to azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. Intermediate sensitivities of 17.9% (36/201, 4% (8/201, 16.9% (34/201, 71.1% (143/201 and 22.9% (46/201 were observed for azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. The specimens had plasmid-mediated resistance to penicillin PPNG 14.5% (29/201 and tetracycline TRNG 11.5% (23/201. Conclusions The high percentage of detected resistance to penicillin, tetracycline, chloramphenicol and ciprofloxacin indicates that these antibiotics are not appropriate for gonorrhea treatment at the Health Clinic and possibly in Belo Horizonte. The resistance and intermediate sensitivity of these isolates indicates that caution is recommended in the use of azithromycin and emphasizes the need to establish mechanisms for the surveillance of antimicrobial resistance for the effective control of gonorrhea.

  20. Antimicrobial susceptibility and molecular epidemiology of Neisseria gonorrhoeae in Germany.

    Science.gov (United States)

    Horn, Nicole Nari; Kresken, Michael; Körber-Irrgang, Barbara; Göttig, Stephan; Wichelhaus, Cornelia; Wichelhaus, Thomas A

    2014-07-01

    Antimicrobial drug resistance in Neisseria gonorrhoeae has become an increasing public health problem. Hence, surveillance of resistance development is of crucial importance to implement adequate treatment guidelines. Data on the spread of antibiotic resistance among gonococcal isolates in Germany, however, is scarce. In a resistance surveillance study conducted by the Paul Ehrlich Society for Chemotherapy between October 2010 and December 2011, 23 laboratories all over Germany were requested to send N. gonorrhoeae isolates to the study laboratory in Frankfurt am Main. Species verification was performed biochemically using ApiNH and with Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing was performed using the Etest method. For molecular epidemiological analysis, N. gonorrhoeae strains were genotyped by means of N. gonorrhoeae multi-antigen sequence typing. A total of 213 consecutive gonococcal isolates were analyzed in this nationwide study. Applying EUCAST breakpoints, high resistance rates were found for ciprofloxacin (74%) and tetracycline (41%). Penicillin non-susceptibility was detected in 80% of isolates. The rate of azithromycin resistance was 6%, while all strains were susceptible to spectinomycin, cefixime, and ceftriaxone. Molecular typing of gonococcal isolates revealed a great heterogeneity of 99 different sequence types (ST), but ST1407 predominated (n=39). This is the first comprehensive German multi-centre surveillance study on antibiotic susceptibility and molecular epidemiology of N. gonorrhoeae with implications for antibiotic choice for treatment of gonorrhoea. The World Health Organization supports the concept that an efficacious treatment of gonorrhoea results in at least 95% of infections being cured. Accordingly, as spectinomycin is not available on the German market, only the third generation cephalosporins cefixime and ceftriaxone are regarded as valuable drugs

  1. Antimicrobial agents' utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India

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    Nikhilesh Anand

    2016-01-01

    Full Text Available Background and Aims: High utilization and inappropriate usage of antimicrobial agents (AMAs in an Intensive Care Unit (ICU increases resistant organisms, morbidity, mortality, and treatment cost. Prescription audit and active feedback are a proven method to check the irrational prescription. Measuring drug utilization in DDD/100 bed-days is proposed by the WHO to analyze and compare the utilization of drugs. Data of AMAs utilization are required for planning an antibiotic policy and for follow-up of intervention strategies. Hence, in this study, we proposed to evaluate the utilization pattern and cost analysis of AMA used in the ICU. Methodology: A prospective observational study was conducted for 1 year from January 1, 2014, to December 31, 2014, and the data were obtained from the ICU of a tertiary care hospital. The demographic data, disease data, relevant investigation, the utilization of different classes of AMAs (WHO-ATC classification as well as individual drugs and their costs were recorded. Results: One thousand eight hundred and sixty-two prescriptions of AMAs were recorded during the study period with an average of 1.73 ± 0.04 prescriptions/patient. About 80.4% patients were prescribed AMAs during admission. Ceftriaxone (22.77% was the most commonly prescribed AMA followed by piperacillin/tazobactam (15.79%, metronidazole (12%, amoxicillin/clavulanic acid (6.44%, and azithromycin (4.34%. Ceftriaxone, piperacillin/tazobactam, metronidazole, and linezolid were the five maximally utilized AMAs with 38.52, 19.22, 14.34, 8.76, and 8.16 DDD/100 bed-days respectively. An average cost of AMAs used per patient was 2213 Indian rupees (INR. Conclusion: A high utilization of AMAs and a high cost of treatment were noticed which was comparable to other published data, though an increased use of newer AMAs such as linezolid, clindamycin, meropenem, colistin was noticed.

  2. Preliminary exploration of the development of a collagenous artificial dura mater for sustained antibiotic release

    Institute of Scientific and Technical Information of China (English)

    WANG Hao; DONG Hui; KANG Cheng-gui; LIN Cheng; YE Xun; ZHAO Yuan-li

    2013-01-01

    Background Intracranial infection is one of the most common complications of open craniocerebral injury and of conventional craniotomy in neurosurgery.The presence of blood-brain barrier leads to lower drug concentrations in the cerebrospinal fluid than in the venous blood.Increasing the intravenous dosage or frequency carries the risk of systemic adverse reactions or infections in other parts of the body.Developing an artificial dura mater (ADM) for sustained antibiotic release for use during neurosurgery can solve the problems perfectly.Methods Three types of drug-loaded ADMs made of collagen and containing cefuroxime sodium,ceftriaxone sodium,or norvancomycin were prepared.The antibacterial activity and sustained release characteristics of the ADMs were examined using bacteriostatic and release tests.Results Single-layered collagen based ADMs (40 mm×50 mm×5 mm) containing 18 mg cefuroxime sodium or ceftriaxone sodium were not suitable for continued development because of drug preservation and stability issues.Using smaller ADMs (20 mm×30 mm×7 mm),containing 4.86 mg of norvancomycin,with increased collagen density and a three-layered film with two outer drug-free films above and below the antibiotic layer resulted in sustained cumulative release of 2.91 mg (59.9%) of norvancomycin over 72 hours.The similar factor (f2) comparison method proved that products from a same batch were statistically significant similar (f2 >50).Conclusions Artificial ADMs made of collagen can be processed to provide a mature dural repair material for the sustained release of norvancomycin.This system may provide a basis for developing sustained release materials for other drugs.

  3. Spectrum and potency of ceftaroline against leading pathogens causing community-acquired respiratory tract and skin and soft tissue infections in Latin America, 2010

    Directory of Open Access Journals (Sweden)

    Robert K. Flamm

    2013-10-01

    Full Text Available Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil, is a cephalosporin with in vitro bactericidal activity against Gram-positive organisms, including methicillinsusceptible and -resistant Staphylococcus aureus, β-haemolytic and viridans group streptococci, and Streptococcus pneumoniae, as well as common Gram-negative organisms. In this study a total of 986 isolates collected in 2010 from patients in 15 medical centers in five Latin American countries from the Assessing Worldwide Antimicrobial Resistance Evaluation Program were identified as community-acquired respiratory tract or skin and soft tissue infection pathogens. Ceftaroline was the most potent agent tested against S. pneumoniae with a MIC90 value (0.12 µg/mL that was eight-fold lower than ceftriaxone, levofloxacin, and linezolid. Its spectrum of coverage (100.0% susceptible was similar to tigecycline, linezolid, levofloxacin and vancomycin. Against Haemophilus influenzae and Moraxella catarrhalis, ceftaroline was the most active agent tested. The activity of ceftaroline against S. aureus (including MRSA was similar to that of vancomycin and tetracycline (MIC90,1 µg/mL and linezolid (MIC90,2 Jg/mL. The 1-haemolytic streptococci exhibited 100.0% susceptibility to ceftaroline. Ceftaroline activity against Escherichia coli, Klebsiella spp., and Enterobacter spp. was similar to that of ceftriaxone and ceftazidime. These parenteral cephalosporin agents have potent activity against non-extended-spectrum These parenteral cephalosporin agents have potent activity against non-extended-spectrum-lactamase-phenotype strains, but are not active against extended-spectrum β-lactamase-phenotype strains. These results confirm the in vitro activity of ceftaroline against pathogens common in communityacquired respiratory tract and skin and soft tissue infection in Latin America, and suggest that ceftaroline fosamil could be an important therapeutic option for these infections.

  4. Different Dynamic Patterns of β-Lactams, Quinolones, Glycopeptides and Macrolides on Mouse Gut Microbial Diversity.

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    Yin, Jia; M, Prabhakar; Wang, Shan; Liao, Shuo-Xi; Peng, Xin; He, Yan; Chen, Yi-Ran; Shen, Hua-Fang; Su, Jin; Chen, Ye; Jiang, Yun-Xia; Zhang, Guo-Xia; Zhou, Hong-Wei

    2015-01-01

    The adverse impact of antibiotics on the gut microbiota has attracted extensive interest, particularly due to the development of microbiome research techniques in recent years. However, a direct comparison of the dynamic effects of various types of antibiotics using the same animal model has not been available. In the present study, we selected six antibiotics from four categories with the broadest clinical usage, namely, β-lactams (Ceftriaxone Sodium, Cefoperazone/Sulbactam and meropenem), quinolones (ofloxacin), glycopeptides (vancomycin), and macrolides (azithromycin), to treat BALB/c mice. Stool samples were collected during and after the administration of antibiotics, and microbial diversity was analyzed through Illumina sequencing and bioinformatics analyses using QIIME. Both α and β diversity analyses showed that ceftriaxone sodium, cefoperazone/sulbactam, meropenem and vancomycin changed the gut microbiota dramatically by the second day of antibiotic administration whereas the influence of ofloxacin was trivial. Azithromycin clearly changed the gut microbiota but much less than vancomycin and the β-lactams. In general, the community changes induced by the three β-lactam antibiotics showed consistency in inhibiting Papillibacter, Prevotella and Alistipes while inducing massive growth of Clostridium. The low diversity and high Clostridium level might be an important cause of Clostridium difficile infection after usage of β-lactams. Vancomycin was unique in that it inhibited Firmicutes, mainly the genus Clostridium. On the other hand, it induced the growth of Escherichia and effect lasted for months afterward. Azithromycin and meropenem induced the growth of Enterococcus. These findings will be useful for understanding the potential adverse effects of antibiotics on the gut microbiome and ensuring their better usage.

  5. Prevalence and etiologic agents of female reproductive tract infection among in-patients and out-patients of a tertiary hospital in Benin city, Nigeria

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    Christopher Aye Egbe

    2010-10-01

    Full Text Available Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and Methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48% and out-patients (47.02%, although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01. Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out

  6. Prevalence and etiologic agents of female reproductive tract infection among in-patients and out-patients of a tertiary hospital in Benin city, Nigeria

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    Richard Omoregie

    2010-01-01

    Full Text Available Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48% and out-patients (47.02%, although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01. Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out

  7. Comparative Effectiveness of Single versus Combination Antibiotic Prophylaxis for Infections after Transrectal Prostate Biopsy.

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    Marino, Kaylee; Parlee, Anne; Orlando, Ralph; Lerner, Lori; Strymish, Judith; Gupta, Kalpana

    2015-12-01

    An increase in fluoroquinolone resistance and transrectal ultrasound-guided prostate (TRUS) biopsy infections has prompted the need for alternative effective antibiotic prophylaxis. We aimed to compare ciprofloxacin and other single-agent therapies to combination therapy for efficacy and adverse effects. Men who underwent a TRUS biopsy within the VA Boston health care system with documented receipt of prophylactic antibiotics periprocedure were eligible for inclusion. Postprocedure infections within 30 days were ascertained by chart review from electronic records, including any inpatient, outpatient, or urgent-care visits. Among 455 evaluable men over a 3-year period, there were 25 infections (5.49%), with sepsis occurring in 2.4%, urinary tract infections (UTI) in 1.54%, and bacteremia in 0.44% of patients. Escherichia coli was the most common urine (89%) and blood (92%) pathogen, with fluoroquinolone resistance rates of 88% and 91%, respectively. Ciprofloxacin alone was associated with significantly more infections than ciprofloxacin plus an additional agent (P = 0.014). Intramuscular gentamicin alone was also significantly associated with a higher infection rate obtained with all other regimens (P = 0.004). Any single-agent regimen, including ciprofloxacin, ceftriaxone, or gentamicin, was associated with significantly higher infection rates than any combination regimen (odds ratio [OR], 4; 95% confidence interval [CI], 1.47, 10.85; P = 0.004). Diabetes, immunosuppressive condition or medication, hospitalization within the previous year, and UTI within the previous 6 months were not associated with infection risk. Clostridium difficile infections were similar. These findings suggest that ciprofloxacin, ceftriaxone, and gentamicin alone are inferior to a combination regimen. Institutions with high failure rates of prophylaxis for TRUS biopsies should consider combination regimens derived from their local data.

  8. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002

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    Thornsberry Clyde

    2004-05-01

    Full Text Available Abstract Background Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia. Methods From January to December of 2002, 82,569 bacterial blood culture isolates were reported to The Surveillance Network (TSN Database-USA by 268 laboratories. Susceptibility to relevant antibiotic compounds was analyzed using National Committee for Clinical Laboratory Standards guidelines. Results Coagulase-negative staphylococci (42.0%, Staphylococcus aureus (16.5%, Enterococcus faecalis (8.3%, Escherichia coli (7.2%, Klebsiella pneumoniae (3.6%, and Enterococcus faecium (3.5% were the most frequently isolated bacteria from blood cultures, collectively accounting for >80% of isolates. In vitro susceptibility to expanded-spectrum β-lactams such as ceftriaxone were high for oxacillin-susceptible coagulase-negative staphylococci (98.7%, oxacillin-susceptible S. aureus (99.8%, E. coli (97.3%, K. pneumoniae (93.3%, and Streptococcus pneumoniae (97.2%. Susceptibilities to fluoroquinolones were variable for K. pneumoniae (90.3–91.4%, E. coli (86.0–86.7%, oxacillin-susceptible S. aureus (84.0–89.4%, oxacillin-susceptible coagulase-negative staphylococci (72.7–82.7%, E. faecalis (52.1%, and E. faecium (11.3%. Combinations of antimicrobials are often prescribed as empiric therapy for bacteremia. Susceptibilities of all blood culture isolates to one or both agents in combinations of ceftriaxone, ceftazdime, cefepime, piperacillin-tazobactam or ciprofloxacin plus gentamicin were consistent (range, 74.8–76.3% but lower than similar β-lactam or ciprofloxacin combinations with vancomycin (range, 93.5–96.6%. Conclusion Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread.

  9. Involvement of spinal glutamate transporter-1 in the development of mechanical allodynia and hyperalgesia associated with type 2 diabetes

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    Shi J

    2016-11-01

    Full Text Available Jinshan Shi,1,* Ke Jiang,2,* Zhaoduan Li,3 1Department of Anesthesiology, Guizhou Provincial People’s Hospital, 2Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 3Department of Anesthesiology, Tianjin Nankai Hospital, Tianjin, People’s Republic of China *These authors contributed equally to this work Abstract: Little is known about the effects of the development of type 2 diabetes on glutamate homeostasis in the spinal cord. Therefore, we quantified the extracellular levels of glutamate in the spinal cord of Zucker diabetic fatty (ZDF rats using in vivo microdialysis. In addition, protein levels of glutamate transporter-1 (GLT-1 in the spinal cord of ZDF rats were measured using Western blot. Finally, the effects of repeated intrathecal injections of ceftriaxone, which was previously shown to enhance GLT-1 expression, on the development of mechanical allodynia and hyperalgesia as well as on basal extracellular level of glutamate and the expression of GLT-1 in the spinal cord of ZDF rats were evaluated. It was found that ZDF rats developed mechanical hyperalgesia and allodynia, which were associated with increased basal extracellular levels of glutamate and attenuated levels of GLT-1 expression in the spinal cord, particularly in the dorsal horn. Furthermore, repeated intrathecal administrations of ceftriaxone dose-dependently prevented the development of mechanical hyperalgesia and allodynia in ZDF rats, which were correlated with enhanced GLT-1 expression without altering the basal glutamate levels in the spinal cord of ZDF rats. Overall, the results suggested that impaired glutamate reuptake in the spinal cord may contribute to the development of neuropathic pains in type 2 diabetes. Keywords: diabetes, peripheral neuropathy, spinal cord, Zucker diabetic fatty rats, glutamate, glutamate transporter-1

  10. [A meningitis case of Brucella and tuberculosis co-infection].

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    Karsen, Hasan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Demiröz, Ali Pekcan

    2008-10-01

    Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucella and tuberculosis co-infection has been presented. A 19-years-old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucella meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucella spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14th day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30th day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucella and tuberculosis co-infection, this report emphasizes that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis.

  11. Community Acquired Spondylodiscitis caused by Escherichia Coli; Case Report and Literature Review

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    F Javier Fonseca del Pozo

    2016-07-01

    Full Text Available Vertebral osteomyelitis, or spondylodiscitis, is a rare disease with increasing prevalence in recent years due to a greater number of spinal surgical procedures, nosocomial bacteraemia, an aging population and intravenous drug addiction. Haematogenous infection is the most common cause of spondylodiscitis. We report a 47-year-old man diagnosed with Escherichia coli spondylodiscitis. The patient initially presented with a 4-day history of inflammatory, mechanical pain in the lower back suggesting sciatica. Treatment included NSAIDs and opioids. Two days after discharge from hospital following an admission due to an upper GI bleeding, the back pain intensified, precipitating a new attendance to the emergency department; during which lumbosacral radiography showed marked reduction of L2/L3 intervertebral space. After a new admission to the rheumatology unit due to worsening of symptoms and raised inflammatory markers, an expedited MRI showed loss of intervertebral disc space at L2/L3, with an irregular high intensity area at L2; suggesting a fluid collection extending to adjacent soft tissues. Fluoroscopy-guided core needle bone biopsies were reported positive for Escherichia coli sensitive to ceftriaxone. The patient was treated (received treatment with a three week course of ceftriaxone following a formal diagnosis of E. coli spondylodiscitis. Follow-up MRI demonstrated complete recovery with the patient able to return (has returned to normal activity. In this case we highlight the importance of correct and timely diagnosis of spondylodiscitis. Diagnosis of spondylodiscitis is often difficult, delayed or even missed due to the rarity of the disease but can lead to devastating consequences. Therefore a high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes.

  12. Comparing the disk-diffusion and agar dilution tests for Neisseria gonorrhoeae antimicrobial susceptibility testing

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    Hsi Liu

    2016-11-01

    Full Text Available Abstract Background We assessed the validity of testing for antimicrobial susceptibility of clinical and mutant Neisseria gonorrhoeae (GC isolates by disk diffusion in comparison to agar dilution, and Etest® (bioMerieux, France, respectively, for three third generation extended spectrum cephalosporins (ESC: ceftriaxone (CRO, cefixime (CFX, and cefpodoxime (CPD. Methods One hundred and five clinical isolates and ten laboratory-mutants were tested following Clinical Laboratory Standard Institute (CLSI and manufacturer’s standards for each of the three methods. The measured diameters by the disk diffusion method were tested for correlation with the MIC values by agar dilution. In addition, comparisons with the Etest® were made. Categorical results for concordance, based on standard CLSI cutoffs, between the disk diffusion and the other two methods, respectively, were tested using the Chi-square statistics. Reproducibility was tested for CFX across a 6-month interval by repeated disk tests. Results Across all 115 specimens, the disk diffusion tests produced good categorical agreements, exhibiting concordance of 93.1%, 92.1%, and 90.4% with agar dilution and 93.0%, 92.1%, and 90.4% with Etest®, for CRO, CFX, and CPD, respectively. Pearson correlations between disk-diffusion diameters and agar dilution MIC’s were -0.59, -0.67, and -0.81 for CRO, CFX, and CPD, respectively. The correlations between disk diffusion and Etest® were -0.58, -0.73, and -0.49. Pearson correlation between the CFX disk readings over a 6-month interval was 91%. Conclusions Disk diffusion tests remain to be a useful, reliable and fast screening method for qualitative antimicrobial susceptibility testing for ceftriaxone, cefixime, and cefpodoxime.

  13. Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania.

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    Masinde, A; Gumodoka, B; Kilonzo, A; Mshana, S E

    2009-07-01

    Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women attending Bugando Medical centre (BMC) in Mwanza, Tanzania. A total of 247 pregnant women were enrolled, of these 78 (31.5%) were symptomatic and 169 (68.4%) asymptomatic. UTI was diagnosed using mid stream urine (MSU) culture on standard culture media and urinalysis was done using rapid dip stick. The prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were 17.9% and 13.0% respectively, with no significant difference between the two groups (p = 0.307). Using univariate analysis there was no association of parity (p = 0.825), gestational age (p = 0.173), education (p = 0.615), age (p = 0.211) and marital status (p = 0.949) with bacteriuria. The sensitivity and specificity of urine dipstick was 38.9% and 86.7% respectively. Escherichia coli (47.2%) and Enterococcus spp (22.2%) were the most commonly recovered pathogens. The rate of resistance of Escherichia coli to ampicillin, tetracycline, sulfamethaxazole/trimethoprim, gentamicin, ciprofloxacin, nitrofurantoin, ceftriaxone, and imipenem were 53%, 58.8%, 64.7%, 5.9%, 11.8%, 5.9%, 29.4% and 0%, respectively. In conclusion, asymptomatic bacteriuria among pregnant women is prevalent in our setting and majority of Escherichia coli are resistant to ampicillin, tetracycline, SXT and ceftriaxone. Due to low sensitivity of rapid dip stick, routine urine culture and susceptibility testing is recommended to all pregnant women at booking.

  14. Comparison of Two Different Disk Diffusion Agar Tests in Determination of Antibiotic Susceptibility for E-Coli Isolated from Urinary Tract Infection in Pediatrics

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    I. Sedighi

    2010-04-01

    Full Text Available Introduction & Objective: Urinary Tract Infection (UTI is one of the most common infections during childhood and E-Coli is the more predominant pathogen recovered in UTI. Disk Diffusion agar test is a method of choice because it is cost effective, simple, and now routinely used for detection of antibiotic susceptibility. A rapid increase in antibiotic resistance in our region made the authors to design a study to compare this traditional method with two different disk diffusion agar tests.Materials & Methods: Our study was conducted between 2009 and 2010 in Be’sat teaching hospital on 100 pediatric patients ranged 15 days to 13 years old with positive urine culture for E-coli. Antibiogram detection was performed by disk diffusion agar test with two different kits as Padtan-Teb (made in Iran and Mast (made in the U.K. for Co-trimoxazol, Amikacin, Ceftriaxone, Nalidixic Acid, Cefixime, and Nitrofurantoin. At last the data was analyzed by McNemar test.Results: Co-trimoxazol obtained the lowest (23% Padtan-Teb and 26% Mast and Nitrofurantoin had the highest (86% Padtan-Teb and 97% Mast sensitivity in the two methods which were used in our study. The results were statistically significant for Amikacin, Ceftriaxone, Cefixime, and Nitrofurantoin. The data was analyzed by Mc Memar test.Conclusion: According to our study the results of antibiotic susceptibility were more compatible with other non national Disk diffusion agar test and thus we recommend that our manufactures in Iran should increase the quality of their products.

  15. Prevalence of Aeromonas Hydrophila and Yersinia Enterocolitica in Children with Acute Diarrhea Attending Health Centers in Hamadan

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    S. Kazemi

    2016-01-01

    Full Text Available Introduction & Objective: Diarrhea is the most common cause of morbidity and mortality in all age groups, especially children, the elderly and immunocompromised patients. Various studies have been reported regarding the relationship between the children acute diarrhea and Aeromonashydrophila and Yersinia enterocolitica. This study aimed to investigate the prevalence of the bacteria and their sensitivity to common antibiotics and the prevalence of virulence genes in the bacteria in Hamadan, Iran. Materials & Methods: In this study, 120 stool samples collected from children less than 10 years of age with acute diarrhea were examined for Aeromonashydrophila and Yersinia enterocolitica. Identification of the bacteria was performed by biochemical reactions and PCR using 16S rRNA genes. Moreover, the prevalence of virulence genes earA and hyl of Aeromonashydrophila and ail and ystB genes of Yersinia enterocolitica were investigated using PCR. Antibiotic susceptibility of isolated bacteria was performed by disk diffusion method. Results: Out of 120 stool samples, 2 (1.7 % Aeromonashydrophila and 3 (2.5% Yersinia enterocolitica were isolated. All isolates of Aeromonashydrophila were sensitive to the chloramphenicol, co-trimoxazole, gentamicin, meropenem, amikacin and 50% of isolates were sensitive to the ceftriaxone and azithromycin. All Aeromonashydrophila isolates were resistant to erythromycin. All isolates of Yersinia enterocolitica were sensitive to the chloramphenicol, co-trimoxazole and meropenem. The 33.3% of the isolates were sensitive to gentamicin and amikacin and 66.6% of them were susceptible to ceftriaxone. However, all of Yersinia enterocolitica isolates were resistant to erythromycin and azithromycin. The prevalence aerA and hyl genes in Aeromonashydrophila were reported 100% and 50%, respectively. The prevalence of ail and ystB genes in Yersinia enterocolitica was reported as 66.6%. Conclusions: Identification and analysis of

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

    Institute of Scientific and Technical Information of China (English)

    Maksum; Radji; Siti; Fauziah; Nurgani; Aribinuko

    2011-01-01

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

  17. [Streptococcus pyogenes: penicillin and erythromycin susceptibility in the cities of Neuquen and Cipolletti].

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    Soriano, S V; Brasili, S; Saiz, M; Carranza, C; Vidal, P; Calderón, J; Lopardo, H A

    2000-01-01

    Penicillin resistance has not yet been detected in Streptococcus pyogenes. However macrolide-resistant streptococci have emerged in several countries. Only low rates of erythromycin-resistant S. pyogenes were reported in Argentina, with the exception of a 11.1% observed in Mendoza. The aim of the present study was to determine the susceptibility to penicillin and to erythromycin of 251 consecutive clinically-significant isolates of S. pyogenes obtained from four centers of Cipolletti and Neuquén during the period April-December 1998. The double disk test with erythromycin and clindamycin disks was employed as a screening method to detect ERY-resistant streptococci and to determine the phenotype of macrolide resistance. Disk diffusion was also employed for determining penicillin susceptibility. Macrolide-resistant isolates were also tested for penicillin, ceftriaxone, erythromycin, clindamycin and azithromycin susceptibility by the agar dilution method. Additionally they were also tested for erythromycin susceptibility by E-test (AB Biodisk, Solna, Sweden). All streptococci studied were susceptible to penicillin and thirty of them (12.0%) were resistant to erythromycin. All these resistant isolates were also resistant to azithromycin but susceptible to ceftriaxone and clindamycin. They showed the phenotype M (probably efflux-mediated mechanism) and the MICs of erythromycin ranged between 8 and 16 micrograms/ml. According to these results we conclude that in spite of universal susceptibility to penicillin in S. pyogenes, macrolide resistance is a matter of concern in Neuquén and Cipolletti. At least in those cities it appears to be necessary to routinely perform macrolide susceptibility tests in beta-hemolytic streptococci.

  18. [Evaluation of antimicrobial consumption en 15 Chilean hospitals: Results of a collaborative work, 2013].

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    Domínguez, Isabel; Rosales, Ruth; Cabello, Ángela; Bavestrello, Luis; Labarca, Jaime

    2016-06-01

    Surveillance of antimicrobial consumption is a central part in programs of antibiotic stewardship. However, in Chile there are no national data on antibiotic consumption representing a significant number of hospitals by clinical services. In 2013 a survey was sent to multiple Chilean hospitals to evaluate antimicrobial consumption in medical services (MS), surgery services (SS) and critical care units (ICU). We used the standardized methodology recommended by the WHO, using the number of DDD/100 days beds. In the MS and SS beta-lactam and no beta-lactam antibiotics commonly used were evaluated. In the ICU consumption vancomycin, linezolid, imipenem, merope-nem, colistin and tigecycline was evaluated. Fifteen hospitals reported the density of antimicrobial consumption. Ceftriaxone and cloxacillin were the most commonly used antibiotics in general services (average cloxacillin 4,9 DDD/100 bed days in MS and 8,0 DDD/100 in SS; ceftriaxone 13,5 DDD/100 in MS and 16,7 DDD/100 in SS). In the SS there was also a significant consumption of metronidazole (average 14,5 DDD/100 bed days). In the ICU there was an important variability of consumption of selected antibiotics. This study reports the average and range of antibiotic consumption in MS, SS, and ICU from a significant number of hospitals in the country, during 2013. This information allows hospitals to compare their consumption of antibiotics with a significant sample of Chilean hospitals. Analysis of this information should consider a careful interpretation according to the sample shown here and the reality of each hospital.

  19. Antimicrobial susceptibility patterns of Streptococcus pneumoniae over 6 years at Gondar University Hospital, Northwest Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Belay Anagaw; Chandrashekhar Unakal; Mucheye Gezachew; Fantahun Biadgelgene; Berhanu Anagaw; Tariku Geleshe; Birke Taddese; Birhanu Getie; Mengistu Endris; Andargachew Mulu

    2013-01-01

    Objective:To assess the magnitude and antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates from various clinical specimens. Methods:A record based on retrospective study was conducted at Gondar University Teaching Hospital from September 2007 to January 2012. All patients who visited Gondar University Hospital and provided clinical specimens (body fluids, discharge, swab and blood) for routine bacteriological culturing and antimicrobial susceptibility testing were taken for analysis. Clinical specimens were processed for bacterial culture according to the standard procedures. Antimicrobial susceptibility test for isolated organisms was done using agar disk diffusion method. The data were entered and analyzed using SPSS software version 16 package. Results: One hundred and fifty three Streptococcus pneumoniae were isolated from patients who visited Gondar University Teaching Hospital bacteriology laboratory for culture. Majority of the pneumococcal isolates were from inpatients [111(72.5%)], and 74(48.4%) were from body fluids. Out of the total isolates, 93(61%) were found to be resistant to at least one antibiotic used for susceptibility testing. Forty eight (43.2%) of the isolates were multi-drug resistant (resistant to two or more drugs). The resistance rate noted for both ciprofloxacin 17(11.1%) and ceftriaxone 15(9.8%) were alarming. Conclusions: High proportions of the isolates tend to be increasingly resistant to the commonly prescribed drugs. The recommended drug of choice like ciprofloxacin and ceftriaxone were found to be less susceptible in the study area. Based on the findings, we therefore recommend that antimicrobial agents should be inspected for acceptable activity before they are prescribed and administered empirically. Further study with a better design and survey of antimicrobial susceptibility at large scale shoule be performed to draw advanced information.

  20. Impact of penicillin nonsusceptibility on clinical outcomes of patients with nonmeningeal Streptococcus pneumoniae bacteremia in the era of the 2008 clinical and laboratory standards institute penicillin breakpoints.

    Science.gov (United States)

    Choi, Seong-Ho; Chung, Jin-Won; Sung, Heungsup; Kim, Mi-Na; Kim, Sung-Han; Lee, Sang-Oh; Kim, Yang Soo; Woo, Jun Hee; Choi, Sang-Ho

    2012-09-01

    To investigate the impact of penicillin nonsusceptibility on clinical outcomes of patients with nonmeningeal Streptococcus pneumoniae bacteremia (SPB), a retrospective cohort study was performed. The characteristics of 39 patients with penicillin-nonsusceptible SPB (PNSPB) were compared to those of a group of age- and sex-matched patients (n = 78) with penicillin-susceptible SPB (PSSPB). Susceptibility to penicillin was redetermined by using the revised Clinical and Laboratory Standards Institute (CLSI) penicillin breakpoints in CLSI document M100-S18. Although the PNSPB group tended to have more serious initial manifestations than the PSSPB group, the two groups did not differ significantly in terms of their 30-day mortality rates (30.8% versus 23.1%; P = 0.37) or the duration of hospital stay (median number of days, 14 versus 12; P = 0.89). Broad-spectrum antimicrobial agents, such as extended-spectrum cephalosporins, vancomycin, and carbapenem, were frequently used in both the PNSPB and PSSPB groups. Multivariate analysis revealed that ceftriaxone nonsusceptibility (adjusted odds ratio [aOR] = 4.88; 95% confidence interval [CI] = 1.07 to 22.27; P = 0.041) was one of the independent risk factors for 30-day mortality. Thus, when the 2008 CLSI penicillin breakpoints are applied and the current clinical practice of using wide-spectrum empirical antimicrobial agents is pursued, fatal outcomes in patients with nonmeningeal SPB that can be attributed to penicillin nonsusceptibility are likely to be rare. Further studies that examine the clinical impact of ceftriaxone nonsusceptibility in nonmningeal SPB may be warranted.

  1. Microbiology of discharging ears in Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Getachew Tesfaye; Daniel Asrat; Yimtubezinash Woldeamanuel; Messele Gizaw

    2009-01-01

    Objectives:To isolate and identify the bacterial etiologic agents,including their antibiotic susceptibility pat-tern isolated from patients with discharging ear infections.Methods:Between September 2006 and February 2007,178 patients with discharging ear visiting ENT clinics of St.Paul and Tikur Anbessa University Hospi-tals Addis Ababa,Ethiopia were investigated.Results:Of the patients investigated,52.8% were males and 47.2% were females resulting in an overall male to female ratio of 1.1:1.Ear discharge was the commonest clinical finding followed by hearing problem (91.2%),otalgia (ear pain)(74.7%),fever (17.9%)and itching of external ear (5.1%).S.aureus accounted for 30.2% of the total isolates followed by Proteus ssp. (P.mirabilis,P.vulgaris )(25.4%),and P.aeruginosa (13.4%).Both gram positive and negative bac-teria isolated from ear infections showed low resistance rates to most antimicrobial agents tested.Overall ceftri-axone and ciprofloxacin were the most effective drugs when compared to other drugs tested against the gram-positive and gram-negative bacteria.Conclusion:Otitis media was the most common clinical finding in pa-tients with ear infection.With discharging ear,the gram-negative bacteria were the predominant isolates.The susceptibility pattern of isolates from the study showed that ceftriaxone,ciprofloxacin and gentamicin were the most effective drugs.It is recommended that treatment of ear infections should be based on culture and sensi-tivity at the study sites.Therefore,efforts should be directed towards early diagnosis and treatment of acute ear infection and continued re-evaluation of the resistant patterns of organisms to optimize treatments and reduce complications.

  2. Antibiotic-resistant fecal bacteria, antibiotics, and mercury in surface waters of Oakland County, Michigan, 2005-2006

    Science.gov (United States)

    Fogarty, Lisa R.; Duris, Joseph W.; Crowley, Suzanne L.; Hardigan, Nicole

    2007-01-01

    Water samples collected from 20 stream sites in Oakland and Macomb Counties, Mich., were analyzed to learn more about the occurrence of cephalosporin-resistant Escherichia coli (E. coli) and vancomycin-resistant enterococci (VRE) and the co-occurrence of antibiotics and mercury in area streams. Fecal indicator bacteria concentrations exceeded the Michigan recreational water-quality standard of 300 E. coli colony forming units (CFU) per 100 milliliters of water in 19 of 35 stream-water samples collected in Oakland County. A gene commonly associated with enterococci from humans was detected in samples from Paint Creek at Rochester and Evans Ditch at Southfield, indicating that human fecal waste is a possible source of fecal contamination at these sites. E. coli resistant to the cephalosporin antibiotics (cefoxitin and/ or ceftriaxone) were found at all sites on at least one occasion. The highest percentages of E. coli isolates resistant to cefoxitin and ceftriaxone were 71 percent (Clinton River at Auburn Hills) and 19 percent (Sashabaw Creek near Drayton Plains), respectively. Cephalosporin-resistant E. coli was detected more frequently in samples from intensively urbanized or industrialized areas than in samples from less urbanized areas. VRE were not detected in any sample collected in this study. Multiple antibiotics (azithromycin, erythromycin, ofloxacin, sulfamethoxazole, and trimethoprim) were detected in water samples from the Clinton River at Auburn Hills, and tylosin (an antibiotic used in veterinary medicine and livestock production that belongs to the macrolide group, along with erythromycin) was detected in one water sample from Paint Creek at Rochester. Concentrations of total mercury were as high as 19.8 nanograms per liter (Evans Ditch at Southfield). There was no relation among percentage of antibiotic-resistant bacteria and measured concentrations of antibiotics or mercury in the water. Genetic elements capable of exchanging multiple antibiotic

  3. High in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical Neisseria gonorrhoeae isolates from 21 European countries from 2012 to 2014.

    Science.gov (United States)

    Unemo, Magnus; Ringlander, Johan; Wiggins, Catherine; Fredlund, Hans; Jacobsson, Susanne; Cole, Michelle

    2015-09-01

    Resistance in Neisseria gonorrhoeae against all antimicrobials available for the treatment of gonorrhea has emerged. The first gonococcal strains with high-level resistance to ceftriaxone, the last option for first-line empirical antimicrobial monotherapy, were recently described. Consequently, new treatment options are essential. In this study, the in vitro activity of the novel spiropyrimidinetrione ETX0914 (AZD0914), a DNA topoisomerase II inhibitor, was investigated among contemporary consecutive clinical N. gonorrhoeae isolates obtained in 21 European countries and compared to the activities of antimicrobials currently or previously recommended for treatment. Consecutive clinical N. gonorrhoeae isolates (n = 873) cultured in 21 European countries from 2012 to 2014 were examined for their susceptibility to ETX0914. The MICs of ETX0914 were determined using the agar dilution method. For comparison, the MICs of ceftriaxone, cefixime, azithromycin, and ciprofloxacin were determined using Etest or the agar dilution method. For ETX0914, the MIC range, modal MIC, MIC50, and MIC90 were ≤0.002 to 0.25 mg/liter, 0.125 mg/liter, 0.064 mg/liter, and 0.125 mg/liter, respectively. The MIC values were substantially lower than those of the fluoroquinolone ciprofloxacin and most other antimicrobials examined. No cross-resistance with any other examined antimicrobial was observed. In conclusion, the in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical isolates from 21 European countries was high, and no cross-resistance to antimicrobials currently or previously used for gonorrhea treatment was indicated. Additional studies investigating the in vitro and in vivo induction and mechanisms of ETX0914 resistance in gonococci, pharmacokinetics/pharmacodynamics in modeling/simulations and in humans, and performance in randomized controlled gonorrhea treatment trials are essential.

  4. Rapid spread of Neisseria gonorrhoeae ciprofloxacin resistance due to a newly introduced resistant strain in Nuuk, Greenland, 2012–2015: a community-based prospective cohort study

    Science.gov (United States)

    Pedersen, Michael Lynge; Poulsen, Peter; Berthelsen, Lene; Nørgaard, Christina; Hoffmann, Steen; Jensen, Jørgen Skov

    2016-01-01

    Objectives To determine the antimicrobial susceptibility and genotype distribution of Neisseria gonorrhoeae strains isolated from a cohort of patients in Nuuk, Greenland in order to assess the risk of rapid spread in the event of introduction of new strains. Methods Gonococcal isolates (n=102) obtained from a prospective cohort study of ciprofloxacin resistance were collected between March 2012 and February 2013. Etest minimal inhibitory concentrations (MICs) were determined for ciprofloxacin, azithromycin, ceftriaxone, penicillin, tetracycline, spectinomycin and gentamicin. All isolates were subjected to molecular typing using N. gonorrhoeae multiantigen sequence typing (NG-MAST). After the introduction of a ciprofloxacin-resistant strain in early 2014, an additional 18 isolates were characterised. Results During the study period, all 102 isolates were fully susceptible to ciprofloxacin (≤0.03 mg/L), azithromycin, spectinomycin, gentamicin and ceftriaxone. 10 different NG-MAST types circulated in Nuuk but 7 were found as single isolates, and 3 of the 7 belonged to 1 of the 3 major genogroups (G210, G9816 and G9817) together comprising 96% of the 102 isolates. ST210 accounted for 55% of the 102 strains. The newly introduced ciprofloxacin resistant strain belonged to ST2400 and dominated the population with 59% resistant strains within 6 months after its introduction. All G2400 strains had MICs≥2 mg/L. Conclusions Introduction of a ciprofloxacin-resistant strain into a very homogeneous N. gonorrhoeae population led to an explosive spread of the resistant clone, probably as a result of large sexual networks suggested by the strain homogeneity. Careful surveillance of antimicrobial susceptibility is essential to avoid widespread treatment failure in closed populations. PMID:27577587

  5. Antimicrobial susceptibility and genetic characteristics of Neisseria gonorrhoeae isolates from India, Pakistan and Bhutan in 2007–2011

    Directory of Open Access Journals (Sweden)

    Sethi Sunil

    2013-01-01

    Full Text Available Abstract Background Knowledge on antimicrobial drug resistance and genetic characteristics of Neisseria gonorrhoeae isolates circulating in India, Pakistan, and Bhutan is sorely lacking. In this paper, we describe the prevalence of antimicrobial resistance and molecular characteristics of N. gonorrhoeae isolates from India, Pakistan, and Bhutan in 2007–2011. Methods Antimicrobial susceptibility and β-lactamase production were tested for 65 N. gonorrhoeae isolates from India (n=40, Pakistan (n=18 and Bhutan (n=7 using Etest methodology (eight antimicrobials and nitrocefin solution, respectively. Resistance determinants, i.e. penA, mtrR, porB1b, gyrA, and parC, were sequenced. N. gonorrhoeae multiantigen sequence typing (NG-MAST was performed for molecular epidemiology. Results The highest resistance level was observed for ciprofloxacin (94%, followed by penicillin G (68%, erythromycin (62%, tetracycline (55%, and azithromycin (7.7%. All the isolates were susceptible to ceftriaxone, cefixime, and spectinomycin. Thirty-four (52% of the isolates were producing β-lactamase. No penA mosaic alleles or A501-altered alleles of penicillin-binding protein 2 were identified. Forty-nine NG-MAST STs were identified, of which 42 STs have not been previously described worldwide. Conclusions Based on this study, ceftriaxone, cefixime, and spectinomycin can be used as an empirical first-line therapy for gonorrhoea in India, Pakistan, and Bhutan, whereas ciprofloxacin, penicillin G, tetracycline, erythromycin, and azithromycin should not be. It is imperative to strengthen the laboratory infrastructure in this region, as well as to expand the phenotypic and genetic surveillance of antimicrobial resistance, emergence of new resistance, particularly, to extended-spectrum cephalosporins, and molecular epidemiology.

  6. Antibiotic persistence: the role of spontaneous DNA repair response.

    Science.gov (United States)

    Debbia, E A; Roveta, S; Schito, A M; Gualco, L; Marchese, A

    2001-01-01

    Persisters are a small proportion of a bacterial population that exists in a physiological state permitting survival despite the lethal activity of antibiotics. To explain this phenomenon, it has been suggested that persisters are bacteria repairing spontaneous errors of DNA synthesis. To verify this assumption, Escherichia coli AB1157 and its lexA3 derivative were exposed to a dose 6x MIC of various antibiotics representative of different molecular mechanisms of action (ampicillin, ceftriaxone, meropenem, amikacin, ciprofloxacin). Bacterial cell counts, after 24 hr of exposure to the antimicrobials, revealed a reduction of about 90% of viable organisms in the lexA3 strains in comparison to the lexA+. In several cases, the number of colony-forming units decreased below the limit of assay. This behavior was noted with all antibiotics used, alone or in combination (amikacin plus ceftriaxone and amikacin plus ciprofloxacin). The same experiments were repeated using E. coli AB1157 cultured in the presence of mitomycin C (0.25x MIC), and the number of survivors exceeded by about 90% the values found in the nonexposed control. In contrast, in the sulA background, mitomycin C reacted synergically with all the antibiotics tested causing a strong reduction of the survivors in comparison with the control. The addition of chloramphenicol (0.125x MIC), on the contrary, caused a reduction of the number of survivors of about 90%. These findings indicate that, when DNA repair is active (a mechanism known to block cell division), the number of survivors is greater than that observed with lexA3. Thus, in addition to other possible explanations, persisters might be a fraction of bacteria that during antibiotic treatment are not growing because they are repairing spontaneous errors of DNA synthesis.

  7. THE EFFECTS OF ANTIBIOTIC PROPHYLAXIS ON INFECTIOUS COMPLICATIONS AFTER CAESAREAN SECTION: A RANDOMISED CONTROLLED TRIAL IN A TERTIARY HOSPITAL OF EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Shelley

    2013-04-01

    Full Text Available ABSTRACT: CONTEXT: Infectious complications after caesarean deliveries are an important and substantial cause of maternal morbidity and inc rease in the hospital stay and cost of treatment. Routine prophylaxis with antibiotics may reduce this risk. AIMS: To determine whether prophylactic antibiotic administration using ceftriaxone at the time of caesarean section significantly reduces maternal and neonatal infectious complications . SETTINGS AND DESIGN: The study was conducted in a tertiary teaching hospi tal of eastern India during March 2011 to October 2011. It was a prospective, double-b lind randomised placebo-controlled trial. METHODS AND MATERIAL: After exclusion due to different reasons, 288 patien ts were enrolled in study group and received prophylactic inje ction ceftriaxone. 293 patients were enrolled in control group who received placebo. Patie nts were randomly selected according to computerized randomization protocol. Postpartum infect ious complications were recorded, as were the duration of hospital stay and neonatal compl ications. STATISTICAL ANALYSIS USED: Analysis of statistical data was done by using stat istical software Open Epi, 8version 2.3.1. RESULTS: Wound indurations, discharge, erythema were 2.43% a nd 5.80% in study and control group respectively and it was statistically significa nt with p value 0.043 (RR=0.419, 95% confidence interval [CI] 0.405. Endomyometritis was more in control group (1.04% vs. 3.75% with p value 0.036 and RR=0.279 and CMLE OR= 0.272. No significant relationship with neonatal morbidities was found. Maternal stay in ho spital was significantly more with p=0.01 in control group. CONCLUSIONS: Antibiotic prophylaxis prior to skin incision of caes arean sections resulted in better maternal outcome when i nfectious morbidity and postoperative hospital stay were concerned, without influencing th e neonatal outcome.

  8. 两组不同药物治疗小儿腹泻130例临床观察%Clinical observation of two different drugs in the treatment of 130 cases of infantile diarrhea

    Institute of Scientific and Technical Information of China (English)

    吴冰竹; 古丽扎尔阿不都克然木; 高风梅

    2014-01-01

    Objective:To observe the clinical efficacy of two different drug in the treatment of infantile diarrhea.Methods:130 cases of infantile diarrhea were selected from February 2012 to October 2013,70 cases in the first group,and 60 cases in the second group.On the basis of comprehensive treatment and guidance feeding,the first group was given bifidobacterium triple viable enteric capsules,ceftriaxone sodium injection,Chuanhuning injections and vitamins.The second group was given montmorillonite powder,ceftriaxone sodium injection and ribavirin injection.Results:The total efficiency of the first group was 98%,it was significantly higher than that of the second group.Conclusion:The drug of the first group in the treatment of infantile diarrhea is safe and effective.It is worthy of clinical promotion.%目的:观察两组不同药物治疗小儿腹泻的临床疗效。方法:2012年2月-2013年10月收治腹泻患儿130例,甲组70例,乙组60例。在综合治疗并指导喂养的基础上,甲组患儿给予双歧杆菌三联活菌肠溶胶囊、头胞曲松钠注射液、穿琥宁注射液和维生素,乙组患儿给予蒙脱石散、头胞曲松钠注射液和利巴韦林注射液。结果:甲组总有效率98%,明显高出乙组。结论:甲组药物治疗小儿腹泻安全、有效,值得临床推广使用。

  9. Epidemiology, Antimicrobial Resistance and β-lactamase Genotypic Features of Enteropathogenic Escherichia coli Isolated from Children with Diarrhea in Southern China.

    Science.gov (United States)

    Huang, Yong; Shan, Xue-feng; Deng, Haijun; Huang, Yu-jun; Mu, Xiao-ping; Huang, Ai-long; Long, Quan-xin

    2015-01-01

    The main objective of this study was to investigate the epidemiology, drug resistance and β-lactamase genotype distribution of enteropathogenic Escherichia coli (EPEC) isolated from pediatric patients with diarrhea in southern China. The prevalence of EPEC in children with diarrhea was 3.53%. The commonest serotypes were O55:K59 and O126:K71, and the typical EPEC were more prevalent than atypical EPEC (51 vs 7). Isolates from this region were most commonly found to be resistant to ampicillin and cotrimoxazole, followed by chloramphenicol, ceftriaxone, and ceftazidime. More than 96% of the strains were susceptible to cefoperazone/sulbactam and imipenem. The most common β-lactamase genotypes identified in 58 strains were blaCTX-M-1 (60.3%), blaTEM (56.9%), blaCTX-M-9 (27.6%), and blaSHV (15.5%). Among 58 isolates, 22 strains were found to harbor one β-lactamase gene, and the proportions of resistance to ampicillin, cotrimoxazole, chloramphenicol, ceftriaxone, and ceftazidime, were 81.8%, 63.6%, 40.9%, 18.2%, and 9.1%, respectively. A further 30 strains carrying multiple β-lactamase genes had increased resistance to the above antimicrobial agents (100%, 83.3%, 70.0%, 60.0%, and 30.0%, respectively). In contrast, antibiotic resistance in the last 6 strains without a detectable β-lactamase gene was substantially reduced. Drug resistance may be associated with the β-lactamase gene number, with a greater the number of β-lactamase genes resulting in higher antibiotic resistance.

  10. Susceptibility of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae According to the New CLSI Breakpoints ▿

    Science.gov (United States)

    Wang, Peng; Hu, Fupin; Xiong, Zizhong; Ye, Xinyu; Zhu, Demei; Wang, Yun F.; Wang, Minggui

    2011-01-01

    In 2010 the Clinical and Laboratory Standards Institute (CLSI) lowered the susceptibility breakpoints of some cephalosporins and aztreonam for Enterobacteriaceae and eliminated the need to perform screening for extended-spectrum β-lactamases (ESBLs) and confirmatory tests. The aim of this study was to determine how many ESBL-producing strains of three common species of Enterobacteriaceae test susceptible using the new breakpoints. As determined with the CLSI screening and confirmatory tests, 382 consecutive ESBL-producing strains were collected at Huashan Hospital between 2007 and 2008, including 158 strains of Escherichia coli, 164 of Klebsiella pneumoniae, and 60 of Proteus mirabilis. Susceptibility was determined by the CLSI agar dilution method. CTX-M-, TEM-, and SHV-specific genes were determined by PCR amplification and sequencing. blaCTX-M genes alone or in combination with blaSHV were present in 92.7% (354/382) of these ESBL-producing strains. Forty-two (25.6%) strains of K. pneumoniae harbored SHV-type ESBLs alone or in combination. No TEM ESBLs were found. Utilizing the new breakpoints, all 382 strains were resistant to cefazolin, cefotaxime, and ceftriaxone, while 85.0 to 96.7% of P. mirabilis strains tested susceptible to ceftazidime, cefepime, and aztreonam, 41.8 to 45.6% of E. coli strains appeared to be susceptible to ceftazidime and cefepime, and 20.1% of K. pneumoniae were susceptible to cefepime. In conclusion, all ESBL-producing strains of Enterobacteriaceae would be reported to be resistant to cefazolin, cefotaxime, and ceftriaxone by using the new CLSI breakpoints, but a substantial number of ESBL-containing P. mirabilis and E. coli strains would be reported to be susceptible to ceftazidime, cefepime, and aztreonam, which is likely due to the high prevalence of CTX-M type ESBLs. PMID:21752977

  11. Doença pneumocócica invasiva em crianças e adolescentes soropositivos para HIV Invasive pneumococcal disease in HIV seropositive children and adolescents

    Directory of Open Access Journals (Sweden)

    Sonia M. Mattei

    2008-06-01

    Full Text Available OBJETIVO: Doença Invasiva Pneumocócica (DPI afeta crianças principalmente menores de 5 anos, idosos e grupos de risco, especialmente pessoas infectadas pelo vírus da Imunodeficiência Humana (HIV. O objetivo deste trabalho foi analisar as doenças pneumocócicas invasivas (DPI em crianças e adolescentes infectados pelo vírus da imunodeficiência humana (HIV, de acordo com morbiletalidade, sorotipos, sensibilidade à penicilina e ceftriaxona e distribuição de Streptococcus pneumoniae (Sp sensíveis e resistentes presentes na vacina antipneumocócica conjugada 7-valente, já licenciada. MÉTODOS: Foram identificados 19 casos de DPI entre pacientes HIV soropositivos com idade entre 1 mês e 20 anos hospitalizados de 1993 a 2000. Os dados foram registrados em fichas padronizadas, contendo informações sobre idade, diagnóstico clínico e evolução, sorotipos e perfil de sensibilidade para penicilina e ceftriaxona das cepas de Sp isoladas em cultura. Sp com concentração inibitória mínima OBJECTIVE: Invasive pneumococcal disease (IPD primarily affects children less than 5 years old, the elderly and certain at-risk groups; especially people infected by the human immunodeficiency virus (HIV. The objective of this study was to analyze invasive pneumococcal diseases (IPD in children and adolescents infected by the human immunodeficiency virus (HIV, with relation to morbidity, the case fatality ratio, pneumococcus serotypes, susceptibility to penicillin and ceftriaxone and to the proportion of susceptible and resistant Streptococcus pneumoniae (Sp included in the 7-valent pneumococcal conjugate vaccine that has already been licensed. METHODS: A total of 19 cases of IPD were identified among HIV seropositive patients aged from 1 month to 20 years and hospitalized between 1993 and 2000. Data were recorded on standardized charts containing information on age, clinical diagnosis and progression, serotypes and the susceptibility to penicillin and

  12. 西安地区2002-2009年淋球菌耐药性趋势分析%Trend analysis of antibiotic resistance in Neisseria gonorrhoeae in Xi'an region, 2002-2009

    Institute of Scientific and Technical Information of China (English)

    冯莲凤; 任昭; 孙明德; 郭旭昌

    2011-01-01

    declined from 2006 to 2009 (32.3%). The prevalence of resistance to spectinomycin maintained at a low level (0 to 2.8%) over these years, while that to ciprofloxacin remained higher than 80% from 2002 to 2009, and accounted for 100% in 2005, with the exception of 51% in 2006. Ceftriaxone resistance was observed in none of these strains except 4 isolates in 2003, but the susceptibility to ceftriaxone decreased yearly. Conclusions Neisseria gonorrhoeae is highly sensitive to spectinomycin, which should serve as the first treatment choice for gonorrhea.Full dose is necessary for the application of ceftriaxone in the treatment of gonorrhea. Ciprofloxacin should not be used to treat gonorrhea.

  13. The Antibacterial Test in vitro of Andrographis paniculata Aqueous Extract Used Combination with 10 Kinds of Clinical Common Antimicrobial Agents%穿心莲水提物与10种临床常用抗菌药联用的体外抑菌试验

    Institute of Scientific and Technical Information of China (English)

    张国祖; 贾艳华; 刘梅; 张帅帅; 郭振环; 李荣誉; 陈献忠

    2012-01-01

    为研究穿心莲水提物与临床常用10种抗菌药联用对鸡致病性大肠杆菌的体外抑菌效果,本试验采用传统的水提法制备穿心莲中药液并浓缩至浓度为1 g/mL,用琼脂平板稀释法测定穿心莲水提物分别与阿莫西林、头孢曲松等10种常用抗菌药物联用对临床分离的10株鸡致病性大肠杆菌的体外抑菌作用.结果表明,穿心莲和头孢曲松、穿心莲和氟苯尼考联用100%呈现协同作用;穿心莲和头孢噻呋联用90%呈现协同作用,10%呈现无关作用;穿心莲和大观霉素联用80%呈现协同作用,20%呈现无关作用;穿心莲和林可霉素联用50%呈现协同作用,40%为无关或颉颃作用,10%为无关作用;穿心莲与阿莫西林、安普霉素、阿米卡星、多西环素、恩诺沙星联用以无关或颉颃作用为主.以上结果表明,在体外,穿心莲与头孢曲松、头孢噻呋、大观霉素、氟苯尼考联用对鸡致病性大肠杆菌呈现协同作用,与阿莫西林、安普霉素、阿米卡星、林可霉素、多西环素、恩诺沙星联用呈现无关或颉颃作用.%To study the antibacterial effect in vitro of Andrographis aqueous extract associated with clinical qommonly used 10 kinds of antimicrobial agents to the chicken pathogenic Escherichia colt. Andrographis prepared by the traditional water extraction liquid and concentrated to a concentration of 1 g/mL,determined the invitro inhibitory effect of Andrographis aqueous extract respectively, associated with amoxicilhn, ceftriaxone, and other 10 kinds of commonly used clinical antimicrobial drugs, using the agar dilution method, to the clinical 10 chicken pathogenic Escherichia coli. The results show that Andrographis paniculata and ceftriaxone, Andrographis paniculata and florfenicol associated with 100% showing a synergistic effect; Andrographis paniculata and ceftiofur associated with 90% showing a synergistic effect, 10% showing unrelated; Andrographis

  14. An 0bservation on the curative effects of meropenem in the treatment of bacterial meningitis%美罗培南治疗细菌性脑膜炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘见民

    2014-01-01

    Objective To observe the clinical effects of meropenem in the treatment of bacterial meningitis. Methods 56 adult patients with bacterial meningitis who were admitted to our hospital from June 2010 to June 2013 were selected and randomLy assigned to two groups, with 28 patients in each group. The control group received intravenous drip of ceftriaxone sodium, while the observation group received intravenous drip of meropenem based on ceftriaxone sodium. The curative effects were compared between the two groups. Results Total effective rate for one week of treatment in the observation group was 67.9%, and 92.9%for two weeks, which were significantly higher than those of 21.4%and 53.6%respectively (P<0.01);bacteria eliminating rate in the observation group was 92.9%, significantly higher than that of 67.2%in the control group (P<0.01). Conclusion A proper use of meropenem treatment based on the results of drug sensitive test in early stages helps improve the curative effects of bacterial meningitis.%目的:观察美罗培南治疗细菌性脑膜炎的临床疗效。方法选取2010年6月~2013年6月我院确诊为细菌性脑膜炎的成人患者56例,随机分为两组,每组28例,对照组用头孢曲松钠静脉滴注;观察组在对照组的基础上加用美罗培南静脉滴注治疗,对比两组疗效。结果观察组治疗1周总有效率为67.9%、2周为92.9%,显著高于对照组的21.4%、53.6%(P<0.01);观察组细菌清除率(92.9%)显著高于对照组(67.2%)(P<0.01)。结论早期根据药敏试验结果合理使用美罗培南治疗方案能有助于提高细菌性脑膜炎的治疗效果。

  15. The Clinical Observation of Severe Community Acquired Pneumonia Merger Atelectasis in Children%儿童重症社区获得性肺炎合并肺不张的临床观察

    Institute of Scientific and Technical Information of China (English)

    鲁金玲

    2013-01-01

    Objective:To explore the clinical treatment of severe community acquired pneumonia merger atelectasis in children. Methods:80 cases of children being diagnosed with severe community acquired pneumonia merger atelectasis were randomly divided into the observation group and the control group, 40 cases in each group. 2 groups were given conventional treatment, observation group was given Ceftriaxone sodium treatment on the basis of conventional therapy, each group's therapy was 4 weeks. Compared cough mitigation, pyretolysis and lung reexpansion situation of two groups. Results:The cough mitigation time, pyretolysis time and lung reexpansion situation time of observation group significantly lower than control group(P<0.01);the effective power of observation group higher than control group(P<0.05). Conclusions:Azithromycin combined with Ceftriaxone sodium in the treatment of severe community acquired pneumonia merger atelectasis in children had obviously effect.%目的:探讨儿童重症社区获得性肺炎合并肺不张的临床治疗。方法:儿童重症社区获得性肺炎合并肺不张的患儿80例,随机分为观察组和对照组,每组40例。2组均给予常规治疗,观察组在常规治疗基础上加用头孢曲松钠治疗,疗程4周,对比两组咳嗽缓解、退热、肺复张及疗效情况。结果:观察组的咳嗽缓解时间、退热时间及肺复张时间均明显低于对照组(P<0.01);观察组的有效率高于对照组(P<0.05)。结论:阿奇霉素联合头孢曲松钠治疗儿童重症社区获得性肺炎合并肺不张效果明显。

  16. Antimicrobial resistance in respiratory pathogens isolated in Brazil during 1999-2000

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    Critchley Ian A.

    2001-01-01

    Full Text Available The in vitro antimicrobial susceptibility of the respiratory pathogens Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis to commonly tested and prescribed agents was investigated during 1999-2000 and compared with results obtained during a previous 1997-1998 study. Of 448 isolates of S. pneumoniae collected and tested in 1999-2000, 77.2% were susceptible, 19.9% were intermediate, and 2.9% were resistant to penicillin, demonstrating that there were no major changes in susceptibility to penicillin from 1997-1998 (77.1% susceptible, 18.7% intermediate, 4.2% resistant. All S. pneumoniae isolates from 1999-2000 were susceptible to levofloxacin and vancomycin, and >90% were susceptible to the beta-lactams (amoxicillin-clavulanate, ceftriaxone, and cefuroxime and macrolides (azithromycin and clarithromycin, showing that susceptibility to these agents also remained unchanged since 1997-1998. The most notable increase in resistance between the two studies was demonstrated by trimethoprim-sulfamethoxazole, which increased from 23.4% to 38.6%. Penicillin resistance correlated with resistance to beta-lactams, macrolides, and trimethoprim-sulfamethoxazole in both studies. In H. influenzae, the prevalence of beta-lactamase-producing isolates remained unchanged (10.6% in 1999-2000; 11.0% in 1997-1998. All H. influenzae isolates were susceptible to levofloxacin, ceftriaxone, cefuroxime, and azithromycin, and showed no change between the two studies. Trimethoprim-sulfamethoxazole resistance was present in 40.1% of isolates in 1999-2000, and in 45.2% in 1997-1998. In M. catarrhalis, the prevalence of beta-lactamase-producing isolates was unchanged (97.9% in 1999-2000; 98.0% in 1997-1998. The most active agents against M. catarrhalis were azithromycin (MIC90, <0.03 mug/ml and levofloxacin (MIC90, 0.03 mug/ml. Overall, these results suggest that, in Brazil, between 1999-2000 and 1997-1998, there have been no significant changes in the

  17. Prevalence and antimicrobial resistance of Salmonella isolated from two pork processing plants in Alberta, Canada.

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    Sanchez-Maldonado, Alma Fernanda; Aslam, Mueen; Service, Cara; Narváez-Bravo, Claudia; Avery, Brent P; Johnson, Roger; Jones, Tineke H

    2017-01-16

    This study investigated the frequency of Salmonella serovars on pig carcasses at various processing steps in two commercial pork processing plants in Alberta, Canada and characterized phenotypic and genotypic antimicrobial resistance (AMR) and PFGE patterns of the Salmonella isolates. Over a one year period, 1000 swab samples were collected from randomly selected pigs at two slaughter plants. Sampling points were: carcass swabs after bleeding (CSAB), carcass swabs after de-hairing (CSAD, plant A) or skinning (CSASk, plant B), carcass swabs after evisceration (CSAE), carcass swabs after pasteurization (CSAP, plant A) or washing (CSAW, plants B) and retail pork (RP). For plant A, 87% of CSAB and 8% of CSAE were positive for Salmonella while at plant B, Salmonella was recovered from 94% of CSAB and 10% of CSAE. Salmonella was not recovered from the RP samples at either plant, indicating that the plants used effective control measures. Salmonella enterica serovar Derby was the most common serotype (23%, 29/127) recovered in plant A and plant B (61%, 76/124). For plant A, 35% (45/127) of isolates were resistant to at least one antimicrobial. Five isolates (3.9%), 4 serovar Ohio strains and one serovar I:Rough-O:I,v:-, strain were simultaneously resistant to antimicrobials of very high (Category I), high (Category II), and medium (Category III) importance to human medicine. The 4 S. Ohio isolates were recovered from 3 different steps of pork processing on the same sampling day and displayed resistance to 5-7 antimicrobials, with all of them displaying resistance to ceftiofur and ceftriaxone (Category I). An I:Rough-O:l,v:- isolate, recovered on a different sampling day, was resistant to 7 antimicrobials that included resistance to ampicillin/clavulanic acid, ceftiofur and ceftriaxone (Category I). Salmonella strains isolated from plant A harbored 12 different AMR genes. The most prevalent genes were sul1, sul2, tet(A), tet(B), aadA, strA/strB, aac(3)IV and aphA1. For

  18. Change of drug resistance of Acinetobacter baumannii causing respiratory tract infection in ICU and effect of intervention%ICU呼吸道感染鲍氏不动杆菌耐药性变迁及干预效果

    Institute of Scientific and Technical Information of China (English)

    陈炜; 屠传建; 金玲玲; 罗佳

    2012-01-01

    目的 了解重症监护病房(ICU)呼吸道感染鲍氏不动杆菌耐药性变迁,为临床控制多药耐药菌感染提供依据.方法 对2008-2010年医院痰标本分离的908株鲍氏不动杆菌进行药敏测定,并针对多药耐药性进行干预.结果 2009年鲍氏不动杆菌的耐药性比2008年增加,氨曲南、头孢曲松、头孢噻肟、哌拉西林耐药率>90.0%,2010年通过干预措施后鲍氏不动杆菌的耐药性比2009年有延缓趋势,氨曲南、头孢曲松、哌拉西林耐药率<75.0%.结论 鲍氏不动杆菌呈多药耐药性,应重视医护人员手卫生,加强口腔护理和消毒隔离,合理使用抗菌药物.%OBJECTIVE To study the change of drug resistance of Acinetobacter baumannii in the intensive care unit of our hospital, and to provide the reference for controlling the infection of drug resistant bacteria. METHODS Antibiotics susceptibility test of 908 strains of A. Baumannii was performed from 2008 to 2010, and multidrug resistance was intervened. RESULTS Drug resistance of A. Baumannii was increased in 2009 compared to 2008. The resistance rates to aztreonam, ceftriaxone, cefotaxime, piperacillin were > 90. 0%. Through intervention measures, drug resistance was reduced in 2010, the resistance rates to aztreonam, ceftriaxone, piperacillin declined to <75. 0%. CONCLUSION A. Baumannii are multiple antimicrobial-resistant bacteria. To control the infection caused by A. Baumannii in ICU, medical staff hand hygiene, oral care, disinfection, isolation, rational use of antimicrobial agents should be highlighted.

  19. Antibiotic therapy for acute uncomplicated pyelonephritis in women. Take resistance into account.

    Science.gov (United States)

    2014-12-01

    Acute uncomplicated pyelonephritis is a bacterial infection of the renal parenchyma, common in women. The bacterium responsible is usually Escherichia coli. Empirical antibiotic therapy should be initiated promptly to prevent serious complications. As of 2014, which empirical antibiotic regimen should be offered to non-pregnant adult women with acute uncomplicated pyelonephritis, while awaiting the results of antimicrobial susceptibility testing? We reviewed the available evidence using the standard Prescrire methodology. Certain oral fluoroquinolones were effective in a few clinical trials in the 2000s and 2010s: ciprofloxacin and levofloxacin, an isomer of ofloxacin. Symptoms resolved within 5 to 7 days in about 96% of the women. In France, in 2011, about 10% of E. coli isolated in community laboratories from outpatients with urinary tract infections were resistant to ciprofloxacin. Resistance is mainly a problem in patients treated with a quinolone during the preceding months and in recently hospitalised patients. In hospital laboratories, the fluoroquinolone resistance rate was about 18% in 2012 in France, and even higher in some other European countries. The main harms of fluoroquinolones are neuropsychiatric disorders, photosensitivity, tendon disorders, arrhythmia and cardiac conduction disorders, and Clostridium difficile infection. Injectable "third-generation" cephalosporins, such as ceftriaxone, are often effective against enterobacteria, in particular E. coli, and have good kidney penetration. The prevalence of E. coli resistance to third-generation cephalosporins is rising rapidly in France, particularly in hospitals: 1% in 2005 versus 10% in 2012. The main harms of cephalosporins are hypersensitivity reactions and C. difficile infection. Monotherapy with an aminoglycoside is an alternative that has not been evaluated in this clinical situation. Due to the serious irreversible adverse effects of aminoglycosides (nephrotoxicity, ototoxicity), they

  20. The analysis of rational use of antibiotics in 150 patients with respiratory in respiratory medicine%呼吸内科150例患者抗生素合理使用情况分析

    Institute of Scientific and Technical Information of China (English)

    王庆莲

    2014-01-01

    Objective To analyze and evaluate the rational use of antibiotics in patients with respiratory disease. Methods Total 150 cases of hospitalized patients with respiratory medicine were included into this study and considered as the research object. The usage of antibiotics was analyzed by looking at the medical records,investigating. Results All 150 patients with respiratory medicine received antibiotic therapy. The rate of antibiotics usage is 100. 00% . The highest use frequency antibiotics is cephalosporins,followed by the large ring lactone class. The use fre-quency is highest is ceftriaxone,cefoperazone in cephalosporin antibiotics. DUI( drug use prime Numbers)are more than 1in cephalosporin cefepime and ceftriaxone. there is unreasonable use. Combined use of antibiotics and the frequency is too high. Conclusion There was unreasona-ble phenomenon in antibiotic drug use in patients with respiratory disease. Clinical respiratory physicians should adjust the use of antibiotics, strengthen rational drug use,promote health of patients.%目的:分析评价呼吸内科患者抗生素合理使用情况。方法选取某医院150例呼吸内科住院患者为研究对象,通过查看病历等方式,调查分析抗生素的使用情况。结果150例呼吸内科患者全部采用抗生素治疗,抗生素使用率为100.00%。其中抗生素使用频度最高的是头孢类,其次是大环内酯类。头孢类抗生素中以头孢曲松、头孢哌酮和头孢他定使用频度最高,且头孢曲松和头孢哌酮的药物利用指数( DUI)均超过1,存在不合理使用现象;抗生素联合应用频率略高。结论呼吸内科疾病患者存在抗生素药物使用不完全合理现象,建议临床呼吸内科医生调整患者抗生素的使用,加强合理用药,促进患者健康。

  1. Etiología y sensibilidad bacteriana en infección urinaria en niños. Hospital Infantil Club Noel y Hospital Universitario del Valle, Cali, Colombia.

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    Iris de Castaño

    2009-11-01

    Full Text Available Introduction: Urinary tract infection (UTI is the most common renal disease in childhood. To find the etiologic microorganism and an early adequate antibiotic therapy are essential to avoid permanent kidney injuries. Objectives: To know the etiologic bacteria and their antibiotic sensibility in urine cultures of children with UTI consulting University Hospital and Club Noel Hospital in Cali, Colombia. Methodology: A total of 123 children under 14 years of age that came into Emergency Service or outpatient clinics at University Hospital or Club Noel Hospital with clinical suspicion of UTI from August 2004 to February 2005 were included in a descriptive transversal study. Urine cultures were taken by supra-pubic aspiration, urine catheterization or mid strain urine. UTI definition was based on colony counts according to recollection method. Positive urine cultures, type of bacteria and antibiotic sensibility were considered for the analysis. Children having either urine cultures with colony counts inferior to recollection method, asymptomatic bacteriuria, occasional catheterization, immunosuppression, vesicostomy or previous admission to intensive care unit, were excluded. Results: Among 123 children entering to the study, 31 were eliminated for colony counts inferior to the recollection method. A total of 123 urine cultures were left for the analysis: 50% of urine cultures were obtained by catheterization, 33% via mid void stream and 17% by supra-pubic aspiration; 58% of patients were females. Escherichia coli was cultured in 72% of the cases, Klebsiella in 16.4%, Proteus 2.5% and other type of bacteria account for 9%. Antibiotics and antibacterials with sensibility over 80% were: cefixime, norfloxocin, cefuroxime, cefprozil, nalidixic acid, ceftriaxone, amikacin, and gentamicin. Intermediate sensibility from 61 to 70%: amoxicillin-clavulinic, cefaclor, ciprofloxacin, and nitrofurantoin. Sensibility under 60% was found for amoxicillin, ampicillin

  2. 大理地区志贺菌的血清型分布及耐药性分析%Study on Serotype Distribution and Drug Resistance of Shigellae in Dali

    Institute of Scientific and Technical Information of China (English)

    王国富; 薛士鹏; 白丽; 吴利先

    2012-01-01

    目的:了解大理地区志贺菌的血清型分布及对12种常用抗生素的耐药性。方法:通过分离培养和鉴定得到68株志贺菌,血清学鉴定其血清型,K-B法检测其对12种抗生素的敏感性。结果:血清学鉴定显示68株志贺菌中福氏志贺菌41株,宋内氏志贺菌25株,鲍氏志贺菌2株。志贺菌对萘啶酸耐药率最高,对复方磺胺甲噁唑和氨苄西林耐药率较高;对头孢曲松和头孢噻肟较敏感,对喹诺酮类显示出不同程度的耐药。结论:大理地区以福氏志贺菌感染为主。在志贺菌治疗中可首选头孢曲松和头孢噻肟。%Objective: To investigate the serotype distribution of Shigellae in Dali and evaluate the resistance of Shigellae to 12 common used drugs. Methods: Serotypes of 68 isolated and identified strains of Shigellae were measured. K-B test was applied to define the drug-resistance of Shigellae to 12 different drugs. Results: Among 68 strains examined, 41 were Shigella Flexner, 25 were Shigella sonnei and 2 were Shigella boydii identified by serotype. Shigellae showed the highest drug resistance to nalidixic acid, with followed sulfalene and nalidixic and varying extents of drug resistance to quinolones; Shigellae was sensitive to ceftriaxone and cefotaxime. Conclusion: These results suggest that Shigella Flexner is the main infection strains in Dali and ceftriaxone and cefotaxime should be preferred in the treatment with Shigellae.

  3. [Plasmodium falciparum and Salmonella Typhi co-infection: a case report].

    Science.gov (United States)

    Sümer, Sua; Ural, Gaye; Ural, Onur

    2014-01-01

    Malaria and salmonella infections are endemic especially in developing countries, however malaria and salmonella co-infection is a rare entity with high mortality. The basic mechanism in developing salmonella co-infection is the impaired mobilization of granulocytes through heme and heme oxygenase which are released from haemoglobin due to the breakdown of erythrocytes during malaria infection. Thus, a malaria infected person becomes more susceptible to develop infection with Salmonella spp. In this report a case with Plasmodium falciparum and Salmonella Typhi co-infection was presented. A 23-year-old male patient was admitted to hospital with the complaints of diarrhea, nausea, vomiting, abdominal pain, fatigue and fever. Laboratory findings yielded decreased number of platelets and increased ALT, AST and CRP levels. Since he had a history of working in Pakistan, malaria infection was considered in differential diagnosis, and the diagnosis was confirmed by the detection of P.falciparum trophozoites in the thick and thin blood smears. As he came from a region with chloroquine-resistant Plasmodium, quinine (3 x 650 mg) and doxycycline (2 x 100 mg/day) were started for the treatment. No erythrocytes, parasite eggs or fungal elements were seen at the stool microscopy of the patient who had diarrhoea during admission. No pathogenic microorganism growth was detected in his stool culture. The patient's blood cultures were also taken in febrile periods starting from the time of his hospitalization. A bacterial growth was observed in his blood cultures, and the isolate was identified as S. Typhi. Thus, the patient was diagnosed with P.falciparum and Salmonella Typhi coinfection. Ceftriaxone (1 x 2 g/day, 14 days) was added to the therapy according to the results of antibiotic susceptibility test. With the combined therapy (quinine, doxycycline, ceftriaxone) the fever was taken under control, his general condition improved and laboratory findings turned to normal values

  4. Incidence, clinical presentation, and antimicrobial resistance trends in Salmonella and Shigella infections from children in Yucatan, Mexico

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    Mussaret Bano Zaidi

    2013-10-01

    Full Text Available Background: Salmonella and Shigella cause significant morbidity and mortality among children worldwide. Increased antimicrobial resistance results in greater burden of disease. Methods: From 2005 to 2011, Salmonella and Shigella isolates collected from ill children at a major hospital in Yucatan, Mexico, were subjected to serotyping and antimicrobial susceptibility testing by disk diffusion and agar dilution. The identification of blaCTX, blaCMY, blaSHV, blaTEM, and blaOXA and qnr resistance genes was conducted by PCR and sequencing. Results: Among 2344 children with acute gastroenteritis, salmonellosis decreased from 17.7% in 2005 to 11.2% in 2011 (p<0.001. In contrast, shigellosis increased from 8.3% in 2010 to 12.1% in 2011. Compared to children with Salmonella, those with Shigella had significantly more bloody stools (59% vs 36%, p<0.001, dehydration (27% vs 15%, p=0.031, and seizures (11% vs 3%, p=0.03. In Salmonella (n=365, there was a significant decrease in resistance to ampicillin (43% to 16%, p<0.001, trimethoprim-sulfamethoxazole (44% to 26%, p=0.014, and extended-spectrum cephalosporins (27% to 10%, p=0.009. Reduced susceptibility to ciprofloxacin in Salmonella rose from 30% to 41% (p<0.001. All ceftriaxone-resistant isolates harbored the blaCMY-2 gene. qnr genes were found in 42 (36% of the 117 Salmonella isolates with a ciprofloxacin MIC ≥ 0.125 µg/ml. Four were qnrA1 and 38 were qnrB19. Resistance to ampicillin (40% and trimethoprim-sulfamethoxazole (58% was common in Shigella (n=218, but isolates remained fully susceptible to ceftriaxone and ciprofloxacin. Conclusions:Illness from Salmonella has decreased while severe Shigella infections have increased among children with gastroenteritis in the Yucatan Peninsula. While Shigella resistance to clinically important antibiotics remained unchanged, resistance to most of these, except ciprofloxacin, declined in Salmonella. blaCMY-2 and qnr genes are common in Salmonella isolates.

  5. Bactericidal activities of parenteral antibiotics and genotype of penicillin-binding protein in Streptococcus pneumoniae and Haemophilus influenzae isolated from children's blood.

    Science.gov (United States)

    Sakata, Hiroshi

    2006-10-01

    A total of 16 isolates of Streptococcus pneumoniae and 18 isolates of Haemophilus influenzae were obtained from the blood of children admitted to the pediatric wards of hospitals in Hokkaido Kamikawa subprefecture between January 2003 and December 2005. The ages of the patients with S. pneumoniae or H. influenzae infection ranged from 2 months to 9 years and from 1 month to 4 years, respectively. The diagnoses of S. pneumoniae infection were as follows: pneumonia in 8 patients, occult bacteremia in 5 patients, and meningitis in 3 patients. The diagnoses of H. influenzae were: meningitis in 6 patients, pneumonia in 4 patients, occult bacteremia in 4 patients, epiglotitis in 2 patients, and facial cellulitis in 2 patients. Out of 16 S. pneumoniae isolates, penicillin-resistant strains with a mutation of 3 genes were observed in 7 children, and penicillin intermediate-resistant strains with a mutation of 1 or 2 genes were observed in 8 children. Out of 18 H. influenzae isolates, the beta-lactamase-negative ampicillin-resistant strain with a substitution of 2 points in the ftsI gene was revealed in 2 children, the beta-lactamase-negative ampicillin-resistant strain with a substitution of 1 point in the ftsI gene was observed in 4 children, the beta-lactamase-positive amoxicillin/clavulanic acid-resistant strain with blaTEM-1 and ftsI with 2 substitutions in the ftsI gene was observed in 3 children, and the beta-lactamase-positive ampicillin-resistant strain with blaTEM-1was not observed. The MBC90s of ampicillin, ceftriaxone, cefotaxime, meropenem, panipenem, and vancomycin against S. pneumoniae were 8 microg/ml, 1 microg/ml, 1 microg/ml 1 microg/ml, 0.25 microg/ml, and 0.5 microg/ml, respectively. Those of ampicillin, piperacillin, ceftriaxone, cefotaxime, meropenem, and panipenem against H. influenzae were >128 microg/ml, >128 microg/ml, 0.25 microg/mL, 1 microg/ml, 0.12 microg/ml, and 0.5 g/ml, respectively. It is suggest that the minimum bactricidal concentration

  6. [A sepsis case caused by a rare opportunistic pathogen: Bacillus pumilus].

    Science.gov (United States)

    Borsa, Barış Ata; Aldağ, Mehmet Ersoy; Tunalı, Birsen; Dinç, Uğur; Güngördü Dalar, Zeynep; Özalp, Veli Cengiz

    2016-07-01

    trimethoprim-sulfamethoxazole. Initial treatment of patient was started with intravenous ceftriaxone and metronidazole empirically. Hypotension and fever returned to normal levels at the second and third days of the treatment, respectively. Metronidazole treatment was stopped at seventh day, and treatment was completed to 14 day with ceftriaxone alone. At the end of the treatment course, general condition of the patient was completely good, ESR and CRP were also decreased to normal levels. In conclusion, although most of the reported bloodstream infections that are caused by B.pumilus are intravascular catheter-related, artificial heart valves should also be considered as a risk factor even though vegetation was not detected in our patient.

  7. 猪大肠杆菌和葡萄球菌的分离鉴定及耐药性分析%Isolation, Identification and Analysis of Drug Resistance on E.coli and Staphylococcus in Pigs

    Institute of Scientific and Technical Information of China (English)

    李淑红; 王京仁; 成钢; 曾文虎

    2012-01-01

    对湘西北地区某猪场患病的仔猪的粪便及病变的脾脏、肝脏、淋巴结、肺脏、肾水肿液进行病原菌分离鉴定,并用Kirby-Bauer法测定分离菌株对15种抗菌药的敏感性.结果表明,患病仔猪分离到大肠杆菌和猪葡萄球菌两种细菌.其中大肠杆菌对庆大霉素、头孢呋肟、丁胺卡那霉素、四环素、先锋必素敏感,对氯霉素、氧哌嗪青霉素、先锋五号、头孢曲松钠、新霉素中介,对羧苄青霉素、强力霉素、青霉素、氨苄青霉素、红霉素有较高的耐药性.葡萄球菌对先锋霉素V、丁胺卡那霉素敏感,对头孢曲松钠中介,对其他抗生素耐药.其中大肠杆菌对药物敏感率、中介率、耐药率均为33.33%;葡萄球菌的敏感率为13.33%,中介率为6.67%,耐药率为80.00%.%he pathogen were isolated and identified on feces of sick piglets and disease of the spleen, liver, lymph nodes, lung, kidney edema fluidin a pig farm in Hunan northwestern region. Susceptibility of 15 kinds antimicrobial drug was determined with the Kirby-Bauer for isolated strains. The results showed piglets were infected with E. coli and Staphylococcus. Escherichia coli was sensitive to gentamicin, cefuroxime, Amikacin, tetracycline, cefoperazone sodium, to chloramphenicol, piperacillin, pioneer V, ceftriaxone, neomycin was intermediate, to carbenicillin, doxycycline, penicillin, ampicillin, erythro-mycin had a higher resistance. Staphylococcus was sensitive to pioneer V, Amikacin, to ceftriaxone was intermediate, on the other antibiotic was resistance. Which was 33.33% the rate of drug sensitivity, intermediate and resistance to E. coli. Which was 13. 33% sensitive rate, intermediate rate was 6. 67%, resistance rate was 80. 00% to Staphylococcus.

  8. Antimicrobial Resistance Patterns of Aerobic Organisms in Patients With Chronic Rhinosinusitis in Hamadan, Iran

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    Farahani

    2014-08-01

    Full Text Available Background Although effective strategies have been presented for preventing the spread of antibiotic resistance in Iran, recent reports have revealed increasing antibiotic resistance among children and adults. Objectives In the present study, we tried to provide a clear view of the antibiotic resistance status of aerobic organism as the most prevalent organism in patients with rhinosinusitis in Hamadan, Iran. Patients and Methods A cross-sectional study was conducted on 216 consecutive patients referred to otolaryngology clinics of Imam Khomeini and Besat University hospitals in Hamadan with clinical and radiological manifestations of chronic rhinosinusitis. Two specimens were taken from each patient; one from the affected maxillary sinus by aspiration and another from the middle meatus and nasopharynx by swabbing. Antibiotic susceptibility was tested by Kirby Bauer’s method; distributions of the isolates from middle meatus, nasopharynx and sinus were determined and the results of susceptibility test were analyzed. Results Among the aerobic organism from meatus and oropharynx, the most frequent isolated strains were alpha-hemolytic Streptococcus (15.4%, followed by coagulase-negative Staphylococcus (14.6%, and Branhamella catarrhalis (13.2%, and the most prevalent isolated strains from sinus were S. aureus (19.1%, Klebsiella pneumonia (16.4%, and B. catarrhalis (15.6%, respectively. The highest antibiotic susceptibility was detected to ciprofloxacin and ceftriaxone in most of the strains; susceptibility to ciprofloxacin ranged from 76.7% (for Pseudomonas aeruginosa to 100% (for Escherichia coli and Haemophilus influenza; susceptibility to ceftriaxone ranged from 71.4% (for Acinetobacter baumannii to 100% (for S. pneumonia, Corynebacterium diphtheria, and H. influenza. Besides, regardless of strain, the highest resistance was mostly detected to penicillin (ranging from 33.3% to 91.7%, and to ampicillin (ranging from 38.4% to 83.7%. Conclusions

  9. Prevalence of antimicrobial resistance of Streptococcus pneumoniae in Chinese children: four hospitals surveillance

    Institute of Scientific and Technical Information of China (English)

    沈叙庄; 陆权; 叶启慈; 张国成; 俞桑洁; 张泓; 邓秋莲; 杨永弘

    2003-01-01

    Objective To investigate the nasal carriage of antibiotic-resistant pneumococci in children of <5 years old in the following four cities, Beijing, Shanghai, Guangzhou and Xi'an.Methods A total of 647 pneumococci strains were isolated and detected. Minimal inhibition concentrations (MICs) of antibiotics were determined by E-test. Disk diffusion test was used for the measurement of antimicrobial susceptibility.Results Prevalence of penicillin non-susceptible Streptococcus pneumoniae in the four cities was 41%, with Guangzhou (60.8%) ranking first, followed by Xi'an (45%), Shanghai (37%) and Beijing (25.9%). The majority of penicillin non-susceptibility isolates (23.9%-53.8%) had a low level of resistance (MIC 0.64-1.5 μg/ml). The most sensitive antimicrobials in terms of percentage of susceptible organisms were amoxicillin-clavulanic acid (99.4%), followed by ceftriaxone (92.1%); cefurxime and cefaclor were slightly more sensitive than penicillin with susceptibility of 74.8% and 77.9%. Erythromycin, tetracycline and TMP-SMZ were highly resistant (83.6%, 82.1% and 76.2% respectively). Among erythromycin resistant isolates, 100% were resistant to azithromycin, 98.6% to clarithromycin, 97.2% to roxithromycin and spiramycin, and 96.6% to clindamycin. 97.2% (141/145) were typical of the macrolides-lincosamides-streptogramons B (MLSB ) resistance phenotype, and 2.8% (4/145) were M phenotype. The group of PRSP was with significantly higher rates of non-susceptibility for ceftriaxone (18.4%), cefurxime (58.6%), cefaclor (53.4%), compared with the group of PEN-S (0.5%, 1.8% and 0.2%, respectively) and the rate of multi-drug resistance in the isolates of PRSP group (92.9%) was significantly higher than that of PEN-S group (59.2%).Conclusion The rates of penicillin and multi-drug resistance among isolates of pneumococci carried nasally in are high children and the high prevalence of multi-drug resistance in the Chinese population may be becoming one of the most serious

  10. Detection of pneumolysin and autolysin genes among antibiotic resistant Streptococcus pneumoniae in invasive infections

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    Sourav S

    2010-01-01

    Full Text Available Purpose: To detect the presence of autolysin and pneumolysin genes among Streptococcus pneumoniae strains isolated from different disease entities among Indian patients. The study also attempted to determine antimicrobial susceptibility of the isolates. Materials and Methods: A total of 24 S. pneumoniae isolates were checked for the presence of lytA gene coding for autolysin and ply gene coding for pneumolysin using polymerase chain reaction (PCR. All the isolates were subjected to susceptibility testing by disc diffusion method for 10 different therapeutically relevant antibiotics. Minimum inhibition concentration (MIC was determined using broth dilution method for ampicillin, penicillin and ciprofloxacin. Results: Eleven isolates from ocular infections and 13 isolates from different invasive diseases showed susceptibility to most of the antibiotics tested except chloramphenicol and ciprofloxacin. Fifty percentage of the isolates showed resistance to chloramphenicol and ciprofloxacin. A moderate level of resistance of 18% was noted for cefepime and ceftriaxone. Only 6% of resistance was observed for amoxicillin and ceftazidime. MIC levels ranged from 0.015 to 1 μg/mL for ampicillin and only one isolate had an MIC of 1 μg/mL. The MIC levels for penicillin ranged from 0.062 to 4 μg/mL, wherein nine isolates showed high levels of MICs ranging from 2 to 4 μg/mL. Six isolates had a very high resistance levels for ciprofloxacin with MIC ranging from 32-128 μg/mL. The presence of lytA was observed in 23 out of 24 isolates tested whereas only 17 isolates were positive for pneumolysin. Four ocular isolates and one isolate from ear infection were negative for pneumolysin. Conclusion: Emerging resistance observed for cefepime and ceftriaxone might be due their increased and frequent usage nowadays. Presence of pneumolysin appears to be more critical for pathogenesis of invasive infections than the ocular infections. However, presence of lytA gene in

  11. Emerging resistance among bacterial pathogens in the intensive care unit – a European and North American Surveillance study (2000–2002

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    Thornsberry Clyde

    2004-07-01

    Full Text Available Abstract Background Globally ICUs are encountering emergence and spread of antibiotic-resistant pathogens and for some pathogens there are few therapeutic options available. Methods Antibiotic in vitro susceptibility data of predominant ICU pathogens during 2000–2 were analyzed using data from The Surveillance Network (TSN Databases in Europe (France, Germany and Italy, Canada, and the United States (US. Results Oxacillin resistance rates among Staphylococcus aureus isolates ranged from 19.7% to 59.4%. Penicillin resistance rates among Streptococcus pneumoniae varied from 2.0% in Germany to as high as 20.2% in the US; however, ceftriaxone resistance rates were comparably lower, ranging from 0% in Germany to 3.4% in Italy. Vancomycin resistance rates among Enterococcus faecalis were ≤ 4.5%; however, among Enterococcus faecium vancomycin resistance rates were more frequent ranging from 0.8% in France to 76.3% in the United States. Putative rates of extended-spectrum β-lactamase (ESBL production among Enterobacteriaceae were low, Escherichia coli in the five countries studied. Ceftriaxone resistance rates were generally lower than or similar to piperacillin-tazobactam for most of the Enterobacteriaceae species examined. Fluoroquinolone resistance rates were generally higher for E. coli (6.5% – 13.9%, Proteus mirabilis (0–34.7%, and Morganella morganii (1.6–20.7% than other Enterobacteriaceae spp (1.5–21.3%. P. aeruginosa demonstrated marked variation in β-lactam resistance rates among countries. Imipenem was the most active compound tested against Acinetobacter spp., based on resistance rates. Conclusion There was a wide distribution in resistance patterns among the five countries. Compared with other countries, Italy showed the highest resistance rates to all the organisms with the exception of Enterococcus spp., which were highest in the US. This data highlights the differences in resistance encountered in intensive care units in

  12. Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

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    Owusu Michael

    2012-10-01

    Full Text Available Abstracts Background Meningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health. Methods We retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a Microsoft® excel spreadsheet. Results Records of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8% were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6% were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8% culture positive bacteria, 19 (11.7% culture positive Cryptococcus neoformans and 27(16.6% Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%, followed by E.coli 4 (3.4%, Salmonella species 4 (3.4%, Neisseria meningitidis 3 (2.5%, Pseudomonas species 3(2.5% and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%, 83.0% (95%CI: 73.4% to 90.1% and 100.0% (95%CI: 95.8% to 100.0% respectively. Conclusion Streptococcus pneumoniae is an important cause of meningitis among all age groups and its

  13. Study on Drug Resistance of 103 Strains of Neisseria gonorrhoeae%103株淋球菌耐药性研究

    Institute of Scientific and Technical Information of China (English)

    蒋英; 刘键; 谢延; 林惠玲; 王怡心

    2013-01-01

    目的 了解深圳市福田区慢性病防治院2008-2012年103株淋球菌对五种抗菌药的耐药性及产青霉素酶淋球菌PPNG和高水平耐四环素淋球菌TRNG的流行趋势. 方法 用琼脂稀释法测定头孢曲松、大观霉素、环丙沙星、四环素及阿奇霉素的最低抑菌浓度(MIC),用头孢硝噻吩纸片检测β-内酰胺酶. 结果 103株淋球菌检出PPNG35株(34.0%),TRNG62株(60.2%),环丙沙星耐药率达96.1%,高度耐药株(MIC≥16mg/L)51株(49.5%),阿奇霉素耐药率为16.5%,头孢曲松、大观霉素未发现耐药菌株、抗菌活性均很强. 结论 持续性监测淋球菌的耐药性变迁是临床减少淋球菌耐药菌珠出现的有效办法.%Objective To investigate the drug resistance of 103 strains of Neisseria gonorrhoeae to 5 antibiotics and the prevalence of penicillinase - producing Neisseria gonorrhoeae (PPNG) and high-level tetracycline resistant Neisseria gonorrhoeae (TRNG) isolated from Futian District Institute for Prevention and Control of Chronic Diseases during the period of 2008 - 2011. Methods Agar dilution method was used to determine minimum inhibitory concentrations (MICs) to ceftriaxone, spectino-mycin, ciprofloxacin, tetracycline and azithromycin. (3- lactamase was tested using nitrocefin disk. Results Among 103 strains of Neisseria gonorrhoeae, 35 strains of PPNG (34.0%) and 62 strains of TRNG (60.2%) were detected. The resistance to ciprofloxacin accounted for 96.1% , including 51 (49.5%) highly resistant strains (MIC≥16 mg/L). The resistance to azithromycin accounted for 16.5%. No strain was found to be resistant to ceftriaxone and spectinomycin, which both had strong antibiotic activity. Conclusions It is the effective method to reduce drug resistant Neisseria gonorrhoeae by continuously monitoring the changes of antibiotic resistance of Neisseria gonorrhoeae in clinical practice.

  14. Antibiotic resistance of Neisseria gonorrhoeae in Guangzhou: an analysis result%2010年广州地区淋球菌耐药监测结果分析

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

    目的 了解广州地区淋球菌对抗生素耐药性的变化及PPNG和TRNG的流行趋势.方法 用琼脂稀释法测定头孢曲松、大观霉素、环丙沙星、阿奇霉素和四环素的最低抑菌浓度(MIC);用纸片碘量法检测β-内酰胺酶.结果 83株淋球菌检出PPNG 24株(28.9%)、TRNG 50株(60.2%)、环丙沙星耐药率高达98.8%,高度耐药株(MIC≥16mg/L)43株(51.8%),而76株淋球菌中阿奇霉素耐药株11株(14.5%),均未出现对头孢曲松、大观霉素耐药的菌株,抗菌活性强.结论 合理规范使用抗生素及动态监测淋球菌耐药性变迁是临床减少淋球菌耐药菌株出现的有效办法.%Objective To investigate the antibiotic resistance and the prevalence of PPNC and TRNG in Guangzhou. Method Minimum inhibitory concentrations (MICs) to ceftriaxone, spectiomycin, ciprofloxacin, azithromyc and tetracyciine were determined using the agar dilution method, and (J-lactama.se by paper iodine quantitative method. Result 24 strains of Neisseria gonorrhoeae producing β-lactamase were detected in 83 strains, while 50 strains showed plasmid-mediated, high-level resistance to tetracyciine (TRNG). Resistance rate to ciprofloxacin was 98. 8%. 43 strains were highly resistant (MIC≥16 mg/L) (51.8%). Resistance rate to azithromyc was 14. 5% (11/76). No strains were found to be resistant to ceftriaxone and specitinomycin. Conclusion Using antibiotics rationally and the changes of resistance being monitored dynamically can effectively reduce the occurance of more resistant strains of Neisseriae gonorrhoeae.

  15. Surveillance of Antibiotic Susceptibility of Neisseria gonorrhoeae Isolated from Ten Cities of China from 1993~ 1998%1993~ 1998年中国十城市分离的淋球菌对抗生素的敏感性监测

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    目的研究我国 1993~ 1998年分离的淋球菌对青霉素、四环素、环丙沙星、大观霉素和头孢曲松的敏感性,作为制定治疗方案和防治对策的参考依据。方法测定菌株对抗生素的敏感性用琼脂稀释法,测定产青霉素酶淋球菌菌株用纸片酸度法。结果 6年来,共检测了 3 186株淋球菌对抗生素的敏感性。发现青霉素的耐药菌百分率为 66.70%,产青霉素酶淋球菌菌株占 8.14%;对四环素的耐药菌株占 93.02% ,高度耐药的四环素耐药淋球菌菌株占 4.65%。结论我国近 6年分离的淋球菌对青霉素、四环素和环丙沙星耐药菌百分率较高,对大观霉素和头孢曲松仍较敏感。%Objective To investigate the antimicrobial susceptibility of Neisseria gonorrhoeae isolated from 10 cities of China, and to provide reference for the formulation of treatment guideline and making control strategy. Methods Agar dilution was used to detect antimicrobial susceptibility and acidometric method for PPNG testing. Results A total of 3186 gonococcal isolates were tested from 1993 to 1998. The resistant rate for penicillin was 66.70% . PPNG isolates accounted for 8.14% . Tetracycline- resistant isolates accounted for 93.02% , and high level tetracycline- resistant isolates (TRNG) accounted for 4.65% . The resistant rate for ciprofloxacin was also high (34.25% ). The resistant rates for spectinomycin and ceftriaxone were 0.44% and 0.57% respectively. Conclusions The gonococcal isolates are highly resistant to penicillin, tetracycline, and ciprofloxacin, while still sensitive to spectinomycin and ceftriaxone. These results suggest that the present treatment for gonorrhea can still be used.

  16. 1999年广州地区所见淋球菌对抗生素耐药性结果分析%Analysis of Antibiotic Resistance of Neisseria gonorrhoeae in Guangzhou, 1999

    Institute of Scientific and Technical Information of China (English)

    曹文苓; 费实; 李平; 颜景兰; 梁艳华; 宋卫忠

    2001-01-01

    Objective To survey the antibiotic resistance and the prevalence of penicillinase-producing Neisseria gonorrhoeae(PPNG) and high-level tetracycline resistant Neisseria gonorrhoeae(TRNG) in Guangzhou. Methods Minimum inhibitory concentrations(MIC) were determined using the agar dilution method and that of β-lactamase by paper iodin quantitative method.Results There were 9(5.4% ) strains PPNG and 16(9.6% ) strains TRNG in 167 strains Neisseriae gonorrhoeae. Resistant rates of ciprofloxacin was as much as 78.4 %. The high-level resistant stains(MIC≥ 16mg/L) were 37 (22.2 % ). No resistance strain to ceftriaxone and specitinomycin, ceftriaxone susceptibility was improving. Conclusion The study showed that it is important to successively survey the antibiotic resistance of Neisseriae gonorrhoeae.%目的了解广州地区所见淋球菌对抗生素的耐药性及产青霉素酶淋球菌(PPNG)和高水平耐四环素淋球茵(TRNG)的流行状况。方法用琼脂稀释法测定最低抑茵浓度(MIC)以及用纸片碘量法检测β-内酰胺酶。结果167株淋球菌检出PPNG 9株(5.4%)、TRNG 16株(9.6%)、环丙沙星耐药率达78.4%,高度耐药株(MIC≥16mg/L)37株(22.2%),头孢三嗪、壮观霉素未发现耐药菌株,且抗茵活性最强,头孢三嗪敏感性呈上升趋势。结论持续监测淋球菌的耐药性十分重要。

  17. Study of sensitivity test to neisseria gonorrhoeae antibiotic drug in NanTong district%南通地区2006~2008年淋球菌耐药性分析

    Institute of Scientific and Technical Information of China (English)

    孙亚军; 袁建芬; 喻海忠

    2009-01-01

    Objective To explore the sensitivity of Neisseria Gonorrhoea in Nantong to antibiotic remedy.Methods To select and identify 147 cases of Neisseria Gonorrhoeae specimens.Then drug sensitivity test was carried out through making five sorts of antibiotics.Results Of all the 3 antibiotic agents,the higher resistances to Neisseria Gonorrhoeae were penicillin,acheomycin, ciprofloxacin in turn,the percentages of resistance were 72.10%,68.08% and 8.85% respectively.On the other hand,the higher susceptibilities to Neisseria Gonorrhoeae were ceftriaxone and spectinomycin the percentages of susceptibility were 100% and 94.56% respectively.Conclusion Ceftriaxone and spectinomycin can still be used as primary agents to cure the disease like Neisseria Gonorrhoeae specimens in Nantong,but clinical doctors need to pay more attention to the fact that resistant strains to spectinomycin have come into existence.The result suggests that these antibiotics may be used under guidance of drug sensitivity test in clinic .%目的 探讨南通地区淋病奈瑟菌(NG) 对抗菌药物的敏感性.方法 选择147株NG标本进行菌株鉴定和5种抗菌药物的敏感试验.结果 NG对青霉素、四环素及环丙沙星的耐药率分别为72.10%、68.08%和8.85%,NG对菌必治(头孢三嗪)、壮观霉素的敏感率为100.00%、94.56%.结论 菌必治(头孢三嗪)和壮观霉素仍可作为南通地区淋病治疗的首选药物,但淋球菌对壮观霉素已出现耐药株,应引起临床医生的高度警惕;建议临床应在药敏试验的指导下用药.

  18. STUDY OF ANTIBIOTIC SUSCEPTIBILITY TEST OF MODERN GENERATION OF DRUGS AGAINST UPPER RESPIRATORY TRACT PATHOGENS

    Directory of Open Access Journals (Sweden)

    Vinod Singh et al

    2012-10-01

    Full Text Available Nasal infection or sinusitis is an inflammation of nasal passages caused by both viral and bacteriological pathogens. Antimicrobial resistance has universally recognized as growing problem concern about suitable therapy for nasal infection. The study was aimed at determining the prevalence and antimicrobial susceptibility against nasal infecting microorganisms. 50 clinical samples were taken from OPD of GMC Hospital, Bhopal (MP, India. Of the samples analyzed, 47 bacterial strains were isolated out of which 29 strains were of Gram positive bacteria (8 strains were of Staphylococcus aureus, 6 of Staphylococcus epidermidis, 7 of Streptococcus pneumoniae and 8 of Corynebacterium diptheriae and 18 strains were of Gram negative bacteria (8 of Escherichia coli, 6 of Pseudomonas aeruginosa and 4 of Neisseria meningitidis. Antimicrobial susceptibility assay was performed by disc diffusion method according to the reference criteria of clinical and laboratory standard institute guidelines. In the present study antibiotic susceptibility pattern results showed maximum level of resistance in gram positive strains S. aureus 8 (100%, S. epidermidis 6 (100% and C. diptheriae (8 (100% against penicillin, S. aureus 8 (100%, S. epidermidis 6 (100% and S. pneumoniae 7 (100% were resistant to Cefuroxime, S. aureus 7 (87.5%, S. epidermidis 6 (100%, S. pneumoniae 7 (100% and C. diptheriae (8 (100% were resistant to erythromycin and azithromycin whereas, rest of gram positive strains showed satisfactory antibiotic susceptibility against chloramphenical, cefazolin, cephalexin, ciprofloxacin, ofloxacin and tetracyclin. Similarly for gram negative strains multi-drug resistance was observed in 8 (100% isolates of E. coli against aztreonam, cefdinir, cefixime, cefotaxime, ceftriaxone, ceftazidime, cefuroxime, ciprofloxacin, nalidixic acid and ofloxacin, P. aeruginosa 6 (100% were resistant to aztreonam, cefdinir, cefixime, cefotaxime, ceftazidime, ceftriaxone, cefuroxime

  19. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    The use of cochlear implants is increasingly common, particularly in children younger than 3 years. Bacterial meningitis, often with associated acute otitis media, is more common in children with cochlear implants than in groups of control children. Children with profound deafness who are candidates for cochlear implants should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza. In addition, starting at 24 months of age, a single dose of 23-valent pneumococcal polysaccharide vaccine should be administered. Before implant surgery, primary care providers and cochlear implant teams should ensure that immunizations are up-to-date, preferably with completion of indicated vaccines at least 2 weeks before implant surgery. Imaging of the temporal bone/inner ear should be performed before cochlear implantation in all children with congenital deafness and all patients with profound hearing impairment and a history of bacterial meningitis to identify those with inner-ear malformations/cerebrospinal fluid fistulas or ossification of the cochlea. During the initial months after cochlear implantation, the risk of complications of acute otitis media may be higher than during subsequent time periods. Therefore, it is recommended that acute otitis media diagnosed during the first 2 months after implantation be initially treated with a parenteral antibiotic (eg, ceftriaxone or cefotaxime). Episodes occurring 2 months or longer after implantation can be treated with a trial of an oral antimicrobial agent (eg, amoxicillin or amoxicillin/clavulanate at a dose of approximately 90 mg/kg per day of amoxicillin component), provided the child does not appear toxic and the implant does not have a spacer/positioner, a wedge that rests in the cochlea next to the electrodes present in certain implant models available between 1999 and 2002. "Watchful waiting" without antimicrobial

  20. Synthesis and characterization of amoxicillin derived silver nanoparticles: Its catalytic effect on degradation of some pharmaceutical antibiotics

    Energy Technology Data Exchange (ETDEWEB)

    Junejo, Y. [National Center of Excellence in Analytical Chemistry, University of Sindh Jamshoro, Jamshoro 76080 (Pakistan); Department of Chemistry, Fatih University, Buyukcekmece, 34500 Istanbul (Turkey); Güner, A., E-mail: aguner@fatih.edu.tr [Department of Biology, Fatih University, Buyukcekmece, 34500 Istanbul (Turkey); Baykal, A. [Department of Chemistry, Fatih University, Buyukcekmece, 34500 Istanbul (Turkey)

    2014-10-30

    Graphical abstract: - Highlights: • Amp-Ag (0) NPs were prepared by simple one-pot chemical reduction method. • Ampicillin as an antibiotic was used as both reducing and capping agents in this study. • Amp-Ag (0) NPs have proved as the remarkably efficient catalysts with enhanced rate of reduction for cefdinir, cefditoren, cefixime, ceftriaxone sodium and doxycycline. • Amp-Ag (0) NPs were showed excellent catalytic activity as catalyst for the 100% reduction of these antibiotics. - Abstract: We synthesized novel amoxicillin derived silver nanoparticles (Amp-Ag (0) NPs) in aqueous solution by one-pot simple synthetic method by reducing silver nitrate by the help of amoxicillin antibiotic as a reducing/capping agent and NaOH as the catalyst for reaction enhancement. The formation of the Amp-Ag (0) NPs was monitored using UV–Vis absorption spectroscopy which confirmed the formation of Amp-Ag (0) NPs by exciting the typical surface plasmon absorption maxima at 404 nm. Transmission electron microscopy (TEM) confirmed the spherical morphology and monodispersed Amp-Ag (0) NPs with particle size 6.87 ± 2.2 nm. The antibacterial activities of the antibiotics were evaluated against Gram-negative bacteria Escherichia coli, Salmonella enteritidis, Pseudomonas aeruginosa and Gram-positive bacteria Streptococcus pneumonia, Streptococcus pyogenes, Staphylococcus aureus by the disk diffusion method. Whereas standard antibiotics showed normal zone of inhibition, the reduced ones with Amp-Ag (0) NPs showed no inhibition zone. The antimicrobial results therefore reveal that newly synthesized Amp-Ag (0) NPs had an excellent catalytic activity as catalyst for the 100% reduction of antibiotics i.e. cefdinir, cefditoren, cefiximee, ceftriaxone sodium and doxycycline, which was carried out in just 2–5 min. They were recovered easily from reaction medium and reused with enhanced catalytic potential five times. Based upon these results it has been concluded that Amp-Ag (0) NPs

  1. Haemophilus parainfluenzae Mural Endocarditis: Case Report and Review of the Literature.

    Science.gov (United States)

    Giurgea, Luca T; Lahey, Tim

    2016-01-01

    Haemophilus parainfluenzae, which uncommonly causes endocarditis, has never been documented to cause mural involvement. A 62-year-old immunocompetent female without predisposing risk factors for endocarditis except for poor dentition presented with fever, emesis, and dysmetria. Echocardiography found a mass attached to the left ventricular wall with finger-like projections. Computed tomography showed evidence of embolic phenomena to the brain, kidneys, spleen, and colon. Cardiac MRI revealed involvement of the chordae tendineae of the anterior papillary muscles. Blood cultures grew Haemophilus parainfluenzae. The patient was treated successfully with ceftriaxone with resolution of symptoms, including neurologic deficits. After eleven days of antibiotics a worsening holosystolic murmur was discovered. Worsening mitral regurgitation on echocardiography was only found three weeks later. Nine weeks after presentation, intraoperative evaluation revealed chord rupture but no residual vegetation and mitral repair was performed. Four weeks after surgery, the patient was back to her baseline. This case illustrates the ability of Haemophilus parainfluenzae to form large mural vegetations with high propensity of embolization in otherwise normal cardiac tissue among patients with dental risk factors. It also underscores the importance of physical examination in establishing a diagnosis of endocarditis and monitoring for progression of disease.

  2. Biocompatible cephalosporin-hydroxyapatite-poly(lactic-co-glycolic acid)-coatings fabricated by MAPLE technique for the prevention of bone implant associated infections

    Energy Technology Data Exchange (ETDEWEB)

    Rădulescu, Dragoş [Bucharest University Hospital, Department of Orthopedics and Traumatology, Bucharest (Romania); Grumezescu, Valentina [Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest (Romania); Lasers Department, National Institute for Lasers, Plasma & Radiation Physics, Magurele, Bucharest (Romania); Andronescu, Ecaterina [Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest (Romania); Holban, Alina Maria [Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest (Romania); Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 1–3 Portocalelor Lane, Sector 5, 77206 Bucharest (Romania); Research Institute of the University of Bucharest –ICUB, 91-95 Splaiul Independentei, 050095 Bucharest (Romania); Grumezescu, Alexandru Mihai, E-mail: grumezescu@yahoo.com [Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest (Romania); Socol, Gabriel [Lasers Department, National Institute for Lasers, Plasma & Radiation Physics, Magurele, Bucharest (Romania); Oprea, Alexandra Elena [Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest (Romania); Rădulescu, Marius [Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Polizu Street, 011061 Bucharest (Romania); and others

    2016-06-30

    Graphical abstract: - Highlights: • HAp/PLGA thin coatings by Matrix Assisted Pulsed Laser Evaporation. • Anti-adherent coating on medical surfaces against S. aureus and P. aeruginosa colonization. • Coatings with potential applications in implant osseointegration. - Abstract: In this study we aimed to obtain functionalized thin films based on hydroxyapatite/poly(lactic-co-glycolic acid) (HAp/PLGA) containing ceftriaxone/cefuroxime antibiotics (ATBs) deposited by Matrix Assisted Pulsed Laser Evaporation (MAPLE) technique. The prepared thin films were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-Ray diffraction (XRD), selected area electron diffraction (SAED), and infra red (IR) analysis. HAp/PLGA/ATBs thin films sustained the growth of human osteoblasts, proving their good biocompatibility. The microscopic evaluation and the culture-based quantitative assay of the E. coli biofilm development showed that the thin films inhibited the initial step of microbial attachment as well as the subsequent colonization and biofilm development on the respective surfaces. This study demonstrates that MAPLE technique could represent an appealing technique for the fabrication of antibiotics-containing polymeric implant coatings. The bioevaluation results recommend this type of surfaces for the prevention of bone implant microbial contamination and for the enhanced stimulation of the implant osseointegration process.

  3. Acute hypocomplementemic post-infectious glomerulonephritis as a complication of sinus-related orbital cellulitis: case report Glomerulonefrite pós-infecciosa hipocomplementêmica aguda como complicação de celulite orbitária relacionada aos seios paranasais: relato de caso

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    Jayter Silva Paula

    2008-08-01

    Full Text Available Group A beta-hemolytic streptococcus is the most common agent implicated in post-infectious acute glomerulonephritis. We report a case of acute poststreptococcal glomerulonephritis associated with sinus-related orbital abscess in an 11-year-old boy treated with surgical drainage and intravenous ceftriaxone and clindamycin. Twelve days after supportive measures, renal function was normalized. We also discuss this potentially severe nonsuppurative complication of orbital cellulitis caused by group A beta-hemolytic streptococcus.Os estreptococos beta-hemolíticos do grupo A são os agentes mais comumente envolvidos na glomerulonefrite aguda pós-infecciosa. Relatamos um caso de glomerulonefrite pós-estreptocócica aguda associada a um abscesso orbitário secundário à sinusite, em menino de 11 anos de idade, o qual foi tratado com ceftriaxona e clindamicina endovenosas e drenagem cirúrgica. Doze dias após tratamento de suporte, a função renal se normalizou. Também discutimos a importância desta grave e potencial complicação não supurativa das celulites orbitárias causadas pelos estreptococos beta-hemolíticos do grupo A.

  4. [Antibiotic Susceptibility of Vibrio cholerae non O1/non O139 Serogroups Isolated from Environment in the Rostov Region].

    Science.gov (United States)

    Selyanskaya, N A; Trishina, A V; Verkina, L M; Arkhangelskaya, I V; Kruglikov, V D; Zlenko, Yu M

    2014-01-01

    Analysis of the antibioticograms of 22 strains of Vibrio cholerae non O1/non O139 serogroups (ctxA- tepA-) isolated from the environment in the Rostov Region in 2011 showed that all the cultures were susceptible to ciprofloxacin, aminoglycosides, ceftriaxone, trimetoprime/sulfamethoxazole and resistant to levomycetin and furazolidone. 32%, 18% and 9% of the isolates were resistant to tetracycline, rifampicin and nalidixic acid respectively. No strains of V. cholerae susceptible to all the tested antimicrobials were detected. 37% of the V. cholerae isolates was resistant to two antibacterials and the others showed multiple resistance and contained 3-6 r-determinants of antibiotic resistance. Since the antibiotic resistance genes in Vibrio cholerae non O1/non O139 serogroups are often located on mobile genetic elements (plasmids, interferons, SXT elements), many strains of such organisms, the same as the natural environment, could serve as reservoirs of antibiotic resistance. The presence of antibiotic resistance r-determinants in the investigated strains in various combinations, the antibiotic resistance variability in the isolates collected on the same territory within a relatively short period of time require monitoring of antibiotic susceptibility in them and the use of the antibiotic for the etiotropic therapy only in strict accordance with the antibioticogram of the culture isolated from the concrete patient.

  5. Antimicrobial susceptibility of Escherichia coli isolated from shrimp (Litopenaeus vannamei) and pond environment in northeastern Brazil.

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    Vieira, Regine H S Dos F; Carvalho, Edirsana M R; Carvalho, Fatima C T; Silva, Camila M; Sousa, Oscarina V; Rodrigues, Dalia P

    2010-04-01

    This study aimed to test the susceptibility of Escherichia coli strains isolated from the water, bottom sediments and individuals cultivated in shrimp farm ponds, to antibiotics belonging to different families, namely B-Lactams: Imipenem (IPM; 10 micro g), Ampicillin (AMP; 10 micro g), Cephalothin (CEP; 30 micro g), Cefoxitin (FOX; 30 micro g), Ceftriaxone (CRO; 30 micro g); Tetracycline: Tetracycline (TCY; 30 micro g); Aminoglycosides: Gentamicin (GEN; 10 micro g), Amikacin (AMK; 30 micro g); Chloramphenicol: Chloramphenicol (CHO; 30 micro g); Fluoroquinolones: Ciprofloxacin (CIP; 5 micro g); Nitrofurans: Nitrofurantoin (NIT; 300 micro g); Sulfonamides: Trimethoprim-Sulfamethoxazole (SXT; 30 micro g); Quilononas: Nalidixic Acid (NAL; 30 micro g). In the laboratory, the method of dissemination (Test Kirby-Bauer) was performed in order to fulfill the antibiogram tests. The results showed high indices of resistance to Imipenem, Cephalothin and Ampicillin. Chloramphenicol, Nitrofurantoin, Cefoxitin, Ceftiaxone and Ciprofloxacin have displayed the highest index of sensitive strains. The antibiotic resistance index (ARI) and the multiple resistance index (MAR) varied within the ranges of 0.068-0.077 and 0.15-0.39, respectively. More than 90.5% of strains of Escherichia coli showed a variety of resistance profiles to the tested antibiotics. The high indices of resistance may be a consequence of indiscriminate use of antibiotics, but also the transfer of resistance through mobile genetic elements found in shrimp farms.

  6. Ischemic Stroke and Septic Shock After Subacute Endocarditis Caused by Haemophilus parainfluenzae: Case Report

    Science.gov (United States)

    Menegueti, Mayra Goncalves; Machado-Viana, Jaciara; Gaspar, Gilberto Gambero; Nicolini, Edson Antonio; Basile-Filho, Anibal; Auxiliadora-Martins, Maria

    2017-01-01

    Haemophilus parainfluenzae, which belongs to the HACEK (Haemophilus ssp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) group, is a rare cause of subacute endocarditis and may lead to ischemic stroke. A 65-year-old female patient previously diagnosed with rheumatic valve disease was submitted to surgical mitral valve repair in 1996. Physical examination did not reveal any murmurs; physical examination of the lungs and abdomen was normal. The patient was admitted to hospital with progressive dyspnea, dry cough, and fever. Transesophageal echocardiogram revealed an approximately 8-mm filamentous image with chaotic motion in the ventricular face of the anterior mitral valve leaflet compatible with vegetation. Treatment with ceftriaxone and gentamicin was initiated. Haemophilus parainfluenzae grew in five blood culture samples. Along the hospital stay, the patient’s level of consciousness decreased, and she was diagnosed with ischemic stroke of cardioembolic etiology. The patient developed septic shock refractory to the prescribed treatment and died 12 days after admission. Even though the patient started being treated for endocarditis before the infectious agent was identified, the prompt use of antimicrobials hindered the growth of Haemophilus parainfluenzae and made its isolation difficult. PMID:27924179

  7. Cardiobacterium hominis Endocarditis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Andrew Walkty

    2005-01-01

    Full Text Available The present case report describes the clinical course of a patient who presented with Cardiobacterium hominis endocarditis. A review of the literature follows the case presentation. C hominis, a fastidious Gram-negative bacillus, is a member of the HACEK group of microorganisms (Haemophilus species, Actinobacillus actinomycetemcomitans, C hominis, Eikenella corrodens and Kingella kingae. Endocarditis caused by C hominis is uncommon and generally follows a subacute course. Patients may present with constitutional symptoms, symptoms related to valvular destruction or symptoms secondary to embolic events. Diagnosis requires identification of the pathogen from blood or vegetation by either culture or molecular techniques. Blood cultures may require prolonged incubation, highlighting the importance of incubating blood cultures for at least two to three weeks in patients with suspected endocarditis. In the past, C hominis was generally sensitive to penicillin. However, reports of beta-lactamase-producing C hominis have appeared in the literature over the past decade. The current recommendation for first-line treatment is a third-generation cephalosporin (ceftriaxone for four weeks (six weeks if a prosthetic valve is in place.

  8. Clavulanic acid enhances glutamate transporter subtype I (GLT-1) expression and decreases reinforcing efficacy of cocaine in mice.

    Science.gov (United States)

    Kim, Jae; John, Joel; Langford, Dianne; Walker, Ellen; Ward, Sara; Rawls, Scott M

    2016-03-01

    The β-lactam antibiotic ceftriaxone (CTX) reduces cocaine reinforcement and relapse in preclinical assays through a mechanism involving activation of glutamate transporter subtype 1 (GLT-1). However, its poor brain penetrability and intravenous administration route may limit its therapeutic utility for indications related to CNS diseases. An alternative is clavulanic acid (CA), a structural analog of CTX that retains the β-lactam core required for GLT-1 activity but displays enhanced brain penetrability and oral activity relative to CTX. Here, we tested the hypothesis that CA (1, 10 mg/kg ip) would enhance GLT-1 expression and decrease cocaine self-administration (SA) in mice, but at lower doses than CTX. Experiments revealed that GLT-1 transporter expression in the nucleus accumbens of mice treated with repeated CA (1, 10 mg/kg) was enhanced relative to saline-treated mice. Repeated CA treatment (1 mg/kg) reduced the reinforcing efficacy of cocaine (0.56 mg/kg/inf) in mice maintained on a progressive-ratio (PR) schedule of reinforcement but did not affect acquisition of cocaine SA under fixed-ratio responding or acquisition or retention of learning. These findings suggest that the β-lactamase inhibitor CA can activate the cellular glutamate reuptake system in the brain reward circuit and reduce cocaine's reinforcing efficacy at 100-fold lower doses than CTX.

  9. Chronic administration of the methylxanthine propentofylline impairs reinstatement to cocaine by a GLT-1-dependent mechanism.

    Science.gov (United States)

    Reissner, Kathryn J; Brown, Robyn M; Spencer, Sade; Tran, Phuong K; Thomas, Charles A; Kalivas, Peter W

    2014-01-01

    In recent years, interactions between neurons and glia have been evaluated as mediators of neuropsychiatric diseases, including drug addiction. In particular, compounds that increase expression of the astroglial glutamate transporter GLT-1 (N-acetylcysteine and ceftriaxone) can decrease measures of drug seeking. However, it is unknown whether the compounds that influence broad measures of glial physiology can influence behavioral measures of drug relapse, nor is it clear whether the upregulated GLT-1 is functionally important for suppressing of drug seeking. To address these questions, we sought to determine whether the glial modulator and neuroprotective agent propentofylline (PPF) modifies drug seeking in rats using a reinstatement model of cocaine relapse. We found that 7 days of chronic (but not acute) administration of PPF significantly decreased both cue- and cocaine-induced reinstatement of cocaine seeking. We next determined whether the effect of systemic PPF on reinstatement depended upon its ability to restore expression of GLT-1 in the nucleus accumbens. PPF restored the cocaine-induced decrease in GLT-1 in the accumbens core; then, using an antisense strategy against glutamate transporter GLT-1, we found that restored transporter expression was necessary for PPF to inhibit cue-primed cocaine seeking. These findings indicate that modulating glial physiology with atypical xanthine derivatives like PPF is a potential avenue for developing new medications for cocaine abuse, and support the hypothesis that neuron-glial interactions contribute to mechanisms of psychostimulant addiction, particularly via expression and function of astroglial glutamate transporters.

  10. Neurobrucellosis: three case reports and literature review

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    WANG Jia-wei

    2013-01-01

    Full Text Available Background Brucellosis is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of this infection. This article aims to present clinical manifestations and to discuss the clinical features and management of 3 neurobrucellosis cases. Methods The diagnosis, treatment, laboratory results and accessory examination findings of 3 patients with neurobrucellosis between August 2010 and March 2012 were retrospectively analyzed, and relevant literature was reviewed. Results All the 3 cases had definite history of exposure to epidemic areas or infectious diseases, and history of being infected with Brucella by drinking raw milk. During the screening because of fever for reasons unknown, they were proved to be infected with Brucella by etiological or serological tests. Initial clinical manifestations consisted of fever and headache, with meningitis symptoms and signs, spondylitis, uroschesis and constipation (which might be caused by lumbosacral nerve root lesion, or neurological manifestations in auditory nerve and abducent nerve, such as hearing loss and diplopia. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Conclusion Neurobrucellosis presents with various clinical signs and symptoms, and is often accompanied by systemic infection. Brucellosis should be kept in mind during the screening of fever for reasons unknown, and be differentiated from Mycobacterium tuberculosis infection. The combined treatment by antibotics of different pharmacological mechanisms with full dose and long range is effective, and the prognosis is favorable.

  11. Brucellosis With Multi-Organ Involvement in a Patient With History of Composite Aortic Graft and Hepatitis B.

    Science.gov (United States)

    Dehghan Manshadi, Seyed Ali; Rezahosseini, Omid; Abdi Liaei, Zahra

    2016-11-01

    The brucellosis with multi-organ involvement in a patient with a history of the composite aortic graft (Bentall procedure) and Hepatitis B infection is rare. A 35-year-old man presented to us with fever and loss of consciousness. Four years ago, he was IDU and underwent cardiac surgery because of endocarditis. Recently lumbar spondylodiscitis was diagnosed. The Wright (1/320) and Coombs Wright tests (1/640) were positive. After CNS imaging, lumbar puncture was done. The CSF pleocytosis was lymphocyte dominant. In cardiac echocardiography, large vegetation on prosthetic aortic valve leaflets was seen. The brain MRI was reported abnormal. Treatment of brucellosis started with Ceftriaxone, Doxycycline, Rifampin and Gentamycin. After 4 days, he became oriented, and fever was disappeared then we continued the treatment for 16 days. The patient discharged and followed by daily phone calls. As symptoms of abdominal pain and jaundice were presented on the fifth day, he re-admitted. The patient expired because of hepatorenal and cardiac insufficiency. Drug side effects, activation of Hepatitis B and embolism of cardiac vegetation to other organs were suspected causes of death. We do not suggest medical therapy without cardiac surgery in such cases. When combination therapy is necessary for brucellosis in an HBsAg-positive patient, hepatitis virus activity should be assess by HBV-DNA PCR and the dose of drugs with known hepatotoxic effects such as rifampin and co-trimoxazole should be adjust. Combination therapy with quinolones instead of hepatoxic drugs is one of our suggustions.

  12. Leptospirosis presenting as honeymoon fever.

    Science.gov (United States)

    de Sainte Marie, B; Delord, M; Dubourg, G; Gautret, P; Parola, P; Brouqui, P; Lagier, J C

    2015-05-01

    An increasing number of travelers from western countries visit tropical regions, questioning western physicians on the prophylaxis, the diagnosis and the therapeutic management of patients with travel-associated infection. In July 2014, a French couple stayed for an adventure-travel in Columbia without malaria prophylaxis. A week after their return the woman presented with fever, myalgia, and retro-orbital pain. Three days later, her husband presented similar symptoms. In both patients, testing for malaria, arboviruses and blood cultures remained negative. An empirical treatment with doxycycline and ceftriaxone was initiated for both patients. Serum collected from the female patient yielded positive IgM for leptospirosis but was negative for her husband. Positive Real-Time PCR were observed in blood and urine from both patients, confirming leptospirosis. Three lessons are noteworthy from this case report. First, after exclusion of malaria, as enteric fever, leptospirosis and rickettsial infection are the most prevalent travel-associated infections, empirical treatment with doxycycline and third generation cephalosporin should be considered. In addition, the diagnosis of leptospirosis requires both serology and PCR performed in both urine and blood samples. Finally, prophylaxis using doxycycline, also effective against leptospirosis, rickettsial infections or travellers' diarrhea should be recommended for adventure travelers in malaria endemic areas.

  13. Leptospirosis in a Japanese urban area: a case report and literature review.

    Science.gov (United States)

    Shimizu, Yukiko; Sakamoto, Naoya; Ainoda, Yusuke; Hikone, Mayu; Kobayashi, Kenichiro; Iwabuchi, Sentaro; Koizumi, Nobuo; Ohnishi, Kenji

    2014-04-01

    Leptospirosis is not a major disease in urban areas of Japan. We describe a 49-year-old man with leptospirosis, who lived in an urban area and had no history of living in endemic area of leptospirosis. As he worked at a fish market infested with rats, he was suspected of having contracted leptospirosis and received antimicrobial agent treatment. Serum and urinary tests confirmed the diagnosis of leptospirosis. Although it took six days from the onset until treatment initiation, the patient improved in response to receiving ceftriaxone for seven days. Analyzing past reports of Japanese patients with leptospirosis who had no history of overseas travel, we identified 90 patients with courses similar to that of our patient, and the period from onset to treatment initiation was about six days on average (described in 46 cases). Health care providers as well as patients need to recognize that even people with no history of being in an endemic area of leptospirosis may still be at risk of developing this disease depending on occupations and activities.

  14. Nontyphoid salmonella infection: microbiology, clinical features, and antimicrobial therapy.

    Science.gov (United States)

    Chen, Hung-Ming; Wang, Yue; Su, Lin-Hui; Chiu, Cheng-Hsun

    2013-06-01

    Nontyphoid Salmonella is the most common bacterial pathogen causing gastrointestinal infection worldwide. Most nontyphoid Salmonella infection is limited to uncomplicated gastroenteritis that seldom requires antimicrobial treatment. Nevertheless, invasive infections, such as bacteremia, osteomyelitis, and meningitis, may occur and require antimicrobial therapy. Continuous genetic and genomic evolution in Salmonella leading to increased virulence and resistance to multiple drugs are of significant public health concern. Two major changes in the epidemiology of nontyphoid salmonellosis in Europe and in the USA occurred in the second half of the 20(th) century: the emer