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Sample records for ceftriaxone

  1. Ceftriaxone-induced toxic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Erdal Peker; Eren Cagan; Murat Dogan

    2009-01-01

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

  2. Ceftriaxone: in vitro studies and clinical evaluation.

    OpenAIRE

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

    1982-01-01

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

  3. Intramuscular ceftriaxone in home parenteral therapy.

    OpenAIRE

    Russo, T A; Cook, S.; Gorbach, S L

    1988-01-01

    Ceftriaxone administered via the intramuscular route was evaluated as home parenteral therapy for 31 patients with a variety of serious but stable infections. Cure was achieved in 30 of the patients. When lidocaine was used for reconstitution of ceftriaxone, the intramuscular route was well tolerated by all patients.

  4. Ceftriaxone resistant Shigella Flexneri, an emerging problem

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    Soham Gupta

    2010-01-01

    Full Text Available Shigellosis is a disease of public health importance in developing countries. It may cause self-limited diarrhea to severe dysentery. Emergence of multi drug resistant (MDR strains is a growing concern globally. Ceftriaxone and ciprofloxacin are the drugs of choice for MDR cases. Here, we report a case of MDR Shigella flexneri from an immunocompromised patient. The strain was resistant to ceftriaxone [minimum inhibitory concentration (MIC ≥ 64 μg/ml], limiting the treatment option. Simultaneously, the strain was also found to be resistant to ciprofloxacin (MIC ≥ 4 μg/ml. However, it was susceptible to ceftazidime (MIC 4 μg/ml. This is the first case of ceftriaxone resistant Shigella spp. reported from our hospital.

  5. 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.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-09-01

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

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

    NARCIS (Netherlands)

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

    1991-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

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    Syed Hakim Masood

    2010-06-01

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

  12. 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.

  13. Ceftriaxone-related hemolysis and acute renal failure.

    Science.gov (United States)

    Demirkaya, Erkan; Atay, Abdullah Avni; Musabak, Ugur; Sengul, Ali; Gok, Faysal

    2006-05-01

    A 5-year-old girl with no underlying immune deficiency or hematologic disease was treated with a combination of ceftriaxone and ampicilline-sulbactam for pneumonia. On the ninth day of the therapy, she developed oliguria, paleness, malaise, immune hemolytic anemia (IHA) and acute renal failure (ARF). Laboratory studies showed the presence of antibodies against ceftriaxone. Acute interstitial nephritis (AIN) was diagnosed by renal biopsy. The patient's renal insufficiency was successfully treated with peritoneal dialysis without any complications. The patient recovered without any treatment using steroids or other immunosuppressive agents. PMID:16491410

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

    Science.gov (United States)

    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. PMID:26826836

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

    OpenAIRE

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

    1995-01-01

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

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

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    Amit G Bhagwat

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Obaid, Ali

    2009-04-01

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

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

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    Dias Cícero A.G.

    1998-01-01

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

  20. Increased in vitro activity of ceftriaxone by addition of tazobactam against clinical isolates of anaerobes.

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    Aldridge, K E; Morice, N; Schiro, D D

    1994-08-01

    A total of 461 clinical strains of anaerobes were tested using a broth microdilution test to determine the activity of the combination of ceftriaxone and tazobactam and other antimicrobials against these isolates. Ceftriaxone was combined with tazobactam in ratios of 1:1, 2:1, 4:1, and 8:1 and twofold dilutions of ceftriaxone in constant concentrations to tazobactam of 2, 4, 8, 16, and 32 micrograms/ml. Against beta-lactamase-producing strains of the Bacteroides fragilis group, B. capillosus, and Prevotella species all combinations of ceftriaxone and tazobactam showed enhanced in vitro activity and were eight- to 2048-fold more active than ceftriaxone alone. By comparison ceftriaxone and tazobactam showed superior or equal activity to ampicillin and sulbactam, piperacillin and tazobactam, amoxicillin and clavulanate, ticarcillin and clavulanate, and metronidazole against these same strains. Against beta-lactamase nonproducing strains of Porphyromonas, Fusobacterium, Clostridium, Eubacterium, Peptostreptococcus, and Veillonella parvula the addition of tazobactam produced no appreciable enhanced ceftriaxone activity. Fixed concentrations of tazobactam at 2 and 4 micrograms/ml appear to be most suitable for susceptibility testing and are within the pharmacologic profile of this inhibitor. Pharmacologic and toxicity studies will be needed to define the role of ceftriaxone and tazobactam in infectious diseases. PMID:7851086

  1. In vitro activity of ceftriaxone combined with tazobactam against anaerobic bacteria.

    Science.gov (United States)

    Wüst, J; Hardegger, U

    1994-02-01

    The in vitro activity of ceftriaxone combined with tazobactam against 190 strains of anaerobic bacteria was compared with that of amoxicillin with clavulanic acid, ampicillin with sulbactam, piperacillin alone and with tazobactam, cefoxitin, and imipenem, i.e. beta-lactam antibiotics established in the treatment of anaerobic infections. All anaerobes tested were susceptible to ceftriaxone when tazobactam was added at fixed ratios (ceftriaxone to tazobactam) of 2:1 and 8:1 and at constant concentrations of 2,4 and 8 mg/l, respectively. When 4 mg/l tazobactam was added, the MICs of ceftriaxone for 83 of 94 strains of the Bacteroides fragilis group were reduced by a factor of 8 to 512; for eight strains, this reduction was two to fourfold. Only the MICs of ceftriaxone for three Bacteroides fragilis strains were not influenced. PMID:8013494

  2. COMPARATIVE STUDY OF ANTIMICROBIAL ACTIVITY OF CEFTRIAXONE IN COMBINATION WITH SULBACTAM AND TAZOBACTAM USING DISC DIFFUSION METHOD

    OpenAIRE

    Kumar Vinay BM; Sharadamma KC; Rajpurohit Himanshu; Radhakrishna PM

    2012-01-01

    The present study includes comparative analysis of the antimicrobial effect of combination of ceftriaxone/sulbactam and ceftriaxone/tazobactam against Staphylococcus aureus (S. aureus).Isolate of β-lactamase producing S. aureus was cultured. Antibiotic discs of ceftriaxone/sulbactam and ceftriaxone/tazobactam combinations were prepared and their antimicrobial activity was compared against zone of inhibition produced in cultured isolates. National Committee for Clinical Laboratory Standards zo...

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

    Science.gov (United States)

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

    2016-07-01

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

  4. Crossover study of the pharmacokinetics of ceftriaxone administered intravenously or intramuscularly to healthy volunteers.

    OpenAIRE

    Meyers, B R; Srulevitch, E S; Jacobson, J; Hirschman, S Z

    1983-01-01

    The pharmacokinetics of ceftriaxone were investigated in six healthy adults. One-gram doses were administered either intramuscularly or intravenously in a crossover design study. Mean peak ceftriaxone concentrations in plasma of 79.2 and 123.2 micrograms/ml were achieved with intramuscular injection and intravenous infusion, respectively, with plasma half-lives of 5.4 and 5.8 h. The urinary recovery of ceftriaxone in the first 24 h was 37% after intravenous infusion and 25% after intramuscula...

  5. COMPARATIVE STUDY OF ANTIMICROBIAL ACTIVITY OF CEFTRIAXONE IN COMBINATION WITH SULBACTAM AND TAZOBACTAM USING DISC DIFFUSION METHOD

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    Kumar Vinay BM

    2012-05-01

    Full Text Available The present study includes comparative analysis of the antimicrobial effect of combination of ceftriaxone/sulbactam and ceftriaxone/tazobactam against Staphylococcus aureus (S. aureus.Isolate of β-lactamase producing S. aureus was cultured. Antibiotic discs of ceftriaxone/sulbactam and ceftriaxone/tazobactam combinations were prepared and their antimicrobial activity was compared against zone of inhibition produced in cultured isolates. National Committee for Clinical Laboratory Standards zone diameter criteria was used to measure and evaluate the diameter of zones of inhibition.Zones of inhibition produced by ceftriaxone/tazobactam combination were larger than those produced by ceftriaxone/sulbactam combination indicating comparative advantages. The study reveals that as compared to sulbactam, tazobactam is adding more synergistic action to the ceftriaxone activity against S. aureus.

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

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

    2011-03-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    1982-01-01

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

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

    OpenAIRE

    Basavaraj; Ravikumar; Sandeep; Shreyas

    2014-01-01

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

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

    OpenAIRE

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

    1982-01-01

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

  11. 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.

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

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    Daniyeh Khurram

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Spornraft-Ragaller P

    2011-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Derbew Fikadu Berhe

    2012-07-01

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

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

    OpenAIRE

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

    1992-01-01

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

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

    Directory of Open Access Journals (Sweden)

    James D Berry

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

  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 and tetracycline effect on biofilm-formation strains of Staphylococcus epidermidis

    Directory of Open Access Journals (Sweden)

    O. I. Sidashenko

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Isabel Montes

    2006-08-01

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

  20. IN-VITRO COMPARATIVE STUDY OF CEFOPERAZONE, CEFTAZIDIME, CEFTIZOXIME, CEFOTAXIME, CEFTRIAXONE AND CEFIXIME AGAINST PSEUDOMONAS AERUGINOSA

    Directory of Open Access Journals (Sweden)

    Humza Ahmad Ullah

    2013-01-01

    Full Text Available The prime intention of this study was the evaluation & accumulation of epidemiological data on the resistance of Pseudomonas aeruginosa, and to compare the activity of different third generation cephalosporins against Pseudomonas aeruginosa. For this purpose Modified Kirby-Bauer Method was used for the determination of sensitivity of antibacterial agents using strains of Pseudomonas aeruginosa ATCC 27853 as control. Total 250 isolates of Pseudomonas aeruginosa were collected from different public and private hospitals of Karachi, Pakistan. In-vitro qualities (i.e. sensitive, resistant and intermediate of six members of third generation cephalosporins (Cefoperazone, Ceftazidime, Ceftizoxime, Cefotaxime, Ceftriaxone and Cefixime were reviewed. Results showed that Cefoperazone was the most effective antibacterial agent (80% sensitive, while the second most effective antibacterial agent was Ceftazidime (70% sensitive. Cefotaxime and Ceftizoxime also showed intermediate activity. Cefixime and Ceftriaxone didn’t show any supportive activity i.e. 0% sensitive at all.

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

    Directory of Open Access Journals (Sweden)

    Eda Demir Onal

    2009-10-01

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

  2. Catering ESBL resistance challenge through strategic combination of Ceftriaxone, Sulbactam and Ethylenediaminetetraacetic Acid

    OpenAIRE

    Manu Chaudhary; Sudaroli M; Shailesh Kumar; Krishnaraju V

    2012-01-01

    Resistant development in ESBLs producing bacteria to third generation cephalosporin has emerged with alarming rapidity in recent years and become major cause of concern world wide. Therefore, in order to cater growing resistance problem, combination of third generation cephalosporin with beta-lactam inhibitors and Ethylenediaminetetraacetic acid, was studied. The in vitro antibacterial efficacy of various concentration of ceftriaxone +sulbactam and effective dose determination study of EDTA a...

  3. A Novel High Performance Liquid Chromatographic Method for Simultaneous Determination of Ceftriaxone and Sulbactam in Sulbactomax

    OpenAIRE

    Shrivastava, Sanjay Mohan; Singh, Rajkumar; Tariq, Abu; Siddiqui, Masoom Raza; Yadav, Jitendar; Negi, P. S.; Chaudhary, Manu

    2009-01-01

    An isocratic liquid chromatographic method with UV detection at 220 nm is described for simultaneous determination of ceftriaxone sodium and sulbactam sodium in Sulbactomax. Chromatographic separation of two drugs was achieved on a Hypersil ODS C-18 column using a mobile phase consisting of a binary mixture of acetonitrile and tetrabutyl ammonium hydroxide adjusted to pH7.0 with orthophosphoric acid in ratio 70:30. The developed Liquid Chromatographic method offers symmetric peak shape, good ...

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

    OpenAIRE

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

    2013-01-01

    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 questio...

  5. Antibacterial activity of ceftriaxone (Ro 13-9904), a beta-lactamase-stable cephalosporin.

    OpenAIRE

    Neu, H C; Meropol, N J; Fu, K P

    1981-01-01

    The in vitro activity of ceftriaxone (Ro 13-9904), a parenteral cephalosporin, was compared with that of other beta-lactam antibiotics. the compound was less active against Staphylococcus aureus and Staphylococcus epidermidis than was cephalothin or cefamandole, but it was comparable to cefoxitin, cefotaxime, and moxalactam in inhibiting most isolates of S. aureus at 3.1 microgram/ml. Ro 13-9904 inhibited Streptococcus pyogenes and Streptococcus pneumoniae at concentrations below 0.25 microgr...

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

    OpenAIRE

    Anurag Payasi; Shailesh Kumar; Manu Chaudhary

    2011-01-01

    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 μ...

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

    Science.gov (United States)

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

    2016-09-01

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

  8. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Catering ESBL resistance challenge through strategic combination of Ceftriaxone, Sulbactam and Ethylenediaminetetraacetic Acid

    Directory of Open Access Journals (Sweden)

    Manu Chaudhary

    2012-03-01

    Full Text Available Resistant development in ESBLs producing bacteria to third generation cephalosporin has emerged with alarming rapidity in recent years and become major cause of concern world wide. Therefore, in order to cater growing resistance problem, combination of third generation cephalosporin with beta-lactam inhibitors and Ethylenediaminetetraacetic acid, was studied. The in vitro antibacterial efficacy of various concentration of ceftriaxone +sulbactam and effective dose determination study of EDTA against various ESBLs producing micro organisms such as Escherichia coli (MTCC -739, Klebsiella pneumoniae(MTCC-109,Pseudomonas aeruginosa (MTCC-1688, and Staphylococcus aureus (MTCC-737 were investigated. From the AST and MIC report it was found that the 2:1 ratio has very good bactericidal activity in comparison to other ratios under study. It was found that ceftriaxone and sulbactam combination along with 3mg/ml of Disodium EDTA has significant (p8 fold and possess synergy against the most ESBL producing micro organisms. The combination was found to have beneficial property against troublesome strains and might be considered as a promising therapy for severe infections to overcome resistance.

  11. Clinical isolation and resistance patterns of and superinfection with 10 nosocomial pathogens after treatment with ceftriaxone versus ampicillin-sulbactam.

    Science.gov (United States)

    Carmeli, Y; Castro, J; Eliopoulos, G M; Samore, M H

    2001-01-01

    Isolation of pathogens from clinical cultures and their resistance patterns may be altered by antecedent antibiotic treatment. The objective of this study was to assess the influence of treatment with ceftriaxone versus that with ampicillin-sulbactam on recovery and superinfections with 10 nosocomial pathogens. The study was designed as a historical cohort study, using a propensity score to adjust for confounding by indication and multivariate survival analyses to adjust for other confounding. Two thousand four hundred forty-five patients were treated with ampicillin-sulbactam, and 1, 308 were treated with ceftriaxone. The study analyzed two outcomes: (i) recovery of pathogens from clinical cultures and (ii) microbiologically documented infections. Data were obtained from administrative, pharmacy, clinical, and laboratory databases and by chart extraction. Following treatment, new isolation of at least 1 of the 10 target pathogens occurred for 244 patients. After adjustment, more infections occurred in the ampicillin-sulbactam group (hazard ratio [HR], 1.55; P = 0.009). This was observed with all gram-negative rods combined (HR, 3.6; P ceftriaxone group (3.8% versus 5%; HR, 1.6; P = 0. 015). All the Escherichia coli and Klebsiella spp. isolates were susceptible to ceftriaxone, but half were resistant to ampicillin-sulbactam. The prevalence of oxacillin resistance among Staphylococcus aureus isolates was higher in the ceftriaxone group (63% versus 31%; odds ratio, 3.8; P = 0.08). Differences in the rates of superinfections and the likely causative organisms following treatment with ceftriaxone or ampicillin-sulbactam were evident. This may guide clinicians in empirical choices of antibiotics to treat superinfection. PMID:11120977

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

    International Nuclear Information System (INIS)

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

  13. Ceftriaxone as a single agent in empirical therapy of unexplained fever in granulocytopenic children with solid tumors.

    Science.gov (United States)

    Bartolozzi, S; Clerico, A; Properzi, E; Minori, A; Castello, M A

    1997-06-01

    The optimal management of fever in granulocytopenic cancer patients remains controversial. Antibiotic monotherapy is increasingly an option for the initial empiric treatment of febrile granulocytopenic patients with solid tumors. Available data show that response to empiric therapy is often more related to disease classification (solid tumors vs. acute leukemia) than to the regimen used. In this study we based empiric monotherapy on the underlying disease (solid tumors) in treating 33 episodes of fever in 26 granulocytopenic children with cancer. We investigated the potential effectiveness of single daily doses of ceftriaxone administered empirically in febrile granulocytopenic children with solid tumors. Fever was treated successfully with ceftriaxone monotherapy in 91% (30/33) of febrile episodes. None of the patients died as a result of primary infection. These results suggest that empirical monotherapy with once-daily ceftriaxone is safe and effective. In addition, when compared with other extended-spectrum cephalosporins such as ceftazidime, once-daily administration of ceftriaxone reduces cost and patient inconvenience, allowing convenient parenteral therapy even on an outpatient basis. PMID:9210007

  14. 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.

  15. Ceftriaxone-resistant Salmonella septicemia and osteomyelitis in sickle cell disease adults.

    Science.gov (United States)

    Morgan, James S; Laber, Damian A

    2006-06-01

    The majority of data evaluating Salmonella infections in sickle cell anemia (SCD) comes from studies performed in children. We report a SCD adult who presented with ceftriaxone-resistant Salmonella bacteremia. After appropriate initial therapy, persistent back pain prompted evaluation by magnetic resonance imaging of the spine, which revealed osteomyelitis and a psoas abscess. The patient responded to percutaneous drainage and antibiotics. This report summarizes some of the findings of large SCD studies evaluating Salmonella bacteremia and osteomyelitis, focusing on adults. Our case exemplifies the need for antibiotic coverage for Salmonella species in adult SCD patients with septicemia. We argue that imaging studies looking for osteomyelitis should be done routinely in SCD patients with Salmonella bacteremia. PMID:16800421

  16. Activity of sulbactam in combination with ceftriaxone in vitro and in experimental endocarditis caused by Escherichia coli producing SHV-2-like beta-lactamase.

    Science.gov (United States)

    Fantin, B; Pangon, B; Potel, G; Caron, F; Vallée, E; Vallois, J M; Mohler, J; Buré, A; Philippon, A; Carbon, C

    1990-04-01

    We studied the efficacy of sulbactam, a beta-lactamase inhibitor, in combination with ceftriaxone in vitro and in experimental endocarditis due to an Escherichia coli strain producing an extended-spectrum beta-lactamase most similar to SHV-2, a new mechanism of resistance to broad-spectrum cephalosporins among members of the family Enterobacteriaceae. In vitro, ceftriaxone demonstrated an important inoculum effect (MICs were 2 and 256 micrograms/ml with 5 X 10(5) and 5 X 10(7) CFU of inoculum per ml, respectively). Sulbactam inhibited the beta-lactamase degradation of ceftriaxone and enhanced the killing by ceftriaxone with both inocula tested. In vivo, sulbactam (100 mg/kg every 8 h) or ceftriaxone (15 or 30 mg/kg every 24 h) alone were ineffective after a 4-day therapy. The addition of sulbactam to ceftriaxone (15 mg/kg) or to the ceftriaxone (15 mg/kg)-netilmicin (6 mg/kg every 24 h) combination produced a reduction of 2 log10 CFU/g of vegetation greater than that produced by therapy without sulbactam. The sulbactam-ceftriaxone (30 mg/kg) combination produced a reduction of almost 5 log10 CFU/g of vegetation greater than that produced by single-drug therapy (P less than 0.01), sterilized five of eight vegetations (versus none of seven for ceftriaxone [30 mg/kg] alone; P less than 0.05), and was as effective as the ceftriaxone (15 mg/kg)-sulbactam-netilmicin combination. We concluded that (i) SHV-2 production was responsible for ceftriaxone failure in vivo, probably because of the high inoculum present in vegetations; (ii) sulbactam used in a regimen which provided levels in serum constantly above 4 micrograms/ml and a vegetation/serum peak ratio of approximately 1:3 enhanced the activity of a broad-spectrum cephalosporin in a severe experimental infection; and (iii) the highest dose of ceftriaxone in combination with sulbactam was as effective as the lowest dose of ceftriaxone plus sulbactam plus an aminoglycoside. PMID:2188586

  17. Ceftriaxone-sulbactam combination in rabbit endocarditis caused by a strain of Klebsiella pneumoniae producing extended-broad-spectrum TEM-3 beta-lactamase.

    OpenAIRE

    Caron, F.; Gutmann, L; Bure, A; B. Pangon; Vallois, J M; Pechinot, A; Carbon, C

    1990-01-01

    We studied the activity of the combination of sulbactam and ceftriaxone against a Klebsiella pneumoniae strain producing TEM-3, a new extended-broad-spectrum beta-lactamase, in an endocarditis model. In vitro, ceftriaxone was strongly inactivated in the presence of TEM-3 (MBC, 128 micrograms/ml with an inoculum of 5 x 10(5) CFU/ml). A marked inoculum effect was demonstrated with sulbactam: effective concentrations of inhibitor needed to reduce the MIC and MBC of ceftriaxone to similar levels ...

  18. 99mTc-ceftriaxone, as a targeting radiopharmaceutical for scintigraphic imaging of infectious foci due to Staphylococcus aureus in mouse model

    International Nuclear Information System (INIS)

    99mTc-labeled antibiotics have opened an exciting field of research in infectious diseases diagnosis. Direct labeling of ceftriaxone with 99mTc was carried out using the various amounts of ceftriaxone and SnCl2·2H2O at different pH and incubation time intervals to find the highest radiochemistry efficiency with high stability at room temperature and human blood serum. ITLC-SG and HPLC were performed to measure the radiochemical purity of the conjugate. The binding study showed 45 % specific binding to Staphylococcus aureus. The biodistribution study and scintigraphic imaging showed the localization of 99mTc-ceftriaxone at the site of infection in comparison with normal and inflamed muscles with high sensitivity and specificity in mouse model. The results showed that 99mTc-ceftriaxone is a promising candidate as a targeting radiopharmaceutical for Staphylococcal infection imaging in humans which needs further investigations. (author)

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

    OpenAIRE

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

    1982-01-01

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

  20. Clinical Isolation and Resistance Patterns of and Superinfection with 10 Nosocomial Pathogens after Treatment with Ceftriaxone versus Ampicillin-Sulbactam

    OpenAIRE

    Carmeli, Yehuda; Castro, Julio; Eliopoulos, George M.; Samore, Matthew H.

    2001-01-01

    Isolation of pathogens from clinical cultures and their resistance patterns may be altered by antecedent antibiotic treatment. The objective of this study was to assess the influence of treatment with ceftriaxone versus that with ampicillin-sulbactam on recovery and superinfections with 10 nosocomial pathogens. The study was designed as a historical cohort study, using a propensity score to adjust for confounding by indication and multivariate survival analyses to adjust for other confounding...

  1. In vitro activity, pharmacokinetics, clinical efficacy, safety and pharmacoeconomics of ceftriaxone compared with third and fourth generation cephalosporins: review.

    Science.gov (United States)

    Bijie, H; Kulpradist, S; Manalaysay, M; Soebandrio, A

    2005-02-01

    Due to their wide spectrum of activity, good pharmacokinetics, established clinical efficacy and high tolerability, cephalosporins are among the most widely used antibiotics worldwide. The third and fourth generation cephalosporins are predominantly parenteral agents, administered two or three times daily, used in the treatment of a wide range of moderate to severe infections. Ceftriaxone, a third generation cephalosporin, is unique in exhibiting an unusually long elimination half-life that allows for once-daily administration. Among third generation cephalosporins, ceftazidime and cefoperazone are unusual among cephalosporins in possessing activity, albeit moderate, against Pseudomonas aeruginosa. However, both of these agents also exhibit marked loss of activity against Gram-negative organisms producing high levels of Class A or C beta-lactamases. Sulperazone, a 1:1 combination of cefoperazone and the beta-lactamase inhibitor sulbactam, is more resistant to attack by Class A beta-lactamases but remains vulnerable to isolates producing Class C beta-lactamases. Ceftriaxone exhibits the widest antibacterial spectrum of third generation cephalosporins and this is reflected in clinical responses. Cefoperazone and sulperazone exhibit the poorest clinical responses. Although the fourth generation cephalosporins cefpirome and cefepime exhibit enhanced stability to bacterial beta-lactamases and marginally enhanced in vitro antibacterial activity over ceftriaxone, there is no clinical advantage in terms of clinical or bacteriological success. The cephalosporins are well tolerated, with few and generally transient adverse effects; the major exception being haematological abnormalities including blood coagulation disorders associated with cefoperazone. Several pharmacoeconomic studies indicate that the once-daily dosing regimen required for ceftriaxone is the major factor responsible for its cost-effectiveness over third and fourth generation cephalosporins. PMID:15828439

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

    OpenAIRE

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elisa Ramos-Sevillano

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

  4. 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. PMID:24120434

  5. 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

  6. Increasing spectrum in antimicrobial resistance of Shigella isolates in Bangladesh: resistance to azithromycin and ceftriaxone and decreased susceptibility to ciprofloxacin.

    Science.gov (United States)

    Rahman, Mahbubur; Shoma, Shereen; Rashid, Harunur; El Arifeen, Shams; Baqui, A H; Siddique, A K; Nair, G B; Sack, D A

    2007-06-01

    Antimicrobial resistance of Shigella isolates in Bangladesh, during 2001-2002, was studied and compared with that of 1991-1992 to identify the changes in resistance patterns and trends. A significant increase in resistance to trimethoprim-sulphamethoxazole (from 52% to 72%, p or =3 anti-Shigella drugs (multidrug-resistant [MDR]) compared to 52% of 369 strains (p or =32 microg/mL) and had 10-fold higher MIC90 (0.25 microg/mL) to ciprofloxacin than that of nalidixic acid-susceptible strains exhibiting decreased ciprofloxacin susceptibility, which were detected as ciprofloxacin-susceptible and nalidixic acid-resistant by the disc-diffusion method. These strains were frequently associated with MDR traits. High modal MICs were observed to azithromycin (MIC 6 microg/mL) and nalidixic acid (MIC 128 micdrog/mL) and low to ceftriaxone (MIC 0.023 microg/mL). Conjugative R-plasmids-encoded extended-spectrum beta-lactamase was responsible for resistance to ceftriaxone/cefixime. The growing antimicrobial resistance of Shigella is worrying and mandates monitoring of resistance. Pivmecillinam or ciprofloxacin might be considered for treating shigellosis with caution. PMID:17985817

  7. Activity of sulbactam in combination with ceftriaxone in vitro and in experimental endocarditis caused by Escherichia coli producing SHV-2-like beta-lactamase.

    OpenAIRE

    Fantin, B; B. Pangon; Potel, G.; Caron, F.; Vallée, E; Vallois, J M; Mohler, J.; Buré, A; Philippon, A; Carbon, C

    1990-01-01

    We studied the efficacy of sulbactam, a beta-lactamase inhibitor, in combination with ceftriaxone in vitro and in experimental endocarditis due to an Escherichia coli strain producing an extended-spectrum beta-lactamase most similar to SHV-2, a new mechanism of resistance to broad-spectrum cephalosporins among members of the family Enterobacteriaceae. In vitro, ceftriaxone demonstrated an important inoculum effect (MICs were 2 and 256 micrograms/ml with 5 X 10(5) and 5 X 10(7) CFU of inoculum...

  8. Protective role of ceftriaxone plus sulbactam with VRP1034 on oxidative stress, hematological and enzymatic parameters in cadmium toxicity induced rat model

    OpenAIRE

    Dwivedi, Vivek Kumar; Bhatanagar, Anuj; Chaudhary, Manu

    2012-01-01

    We investigated the protective role of ceftriaxone plus sulbactam with VRP1034 (Elores) on hematological, lipid peroxidation, antioxidant enzymatic activities and Cd levels in the blood and tissues of cadmium exposed rats. Twenty-four male rats were divided into three groups of eight rats each. The control group received distilled water whereas group II received CdCl2 (1.5 mg/4 ml/body weight) through gastric gavage for 21 days. Group III received CdCl2 and was treated with ceftriaxone plus s...

  9. 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.

  10. The potential use of cholestyramine to reduce the risk of developing Clostridium difficile-associated diarrhoea in patients receiving long-term intravenous ceftriaxone.

    Science.gov (United States)

    Puri, B K; Hakkarainen-Smith, J S; Monro, Jean A

    2015-01-01

    Intravenous pharmacotherapy with the third-generation cephalosporin ceftriaxone is unfortunately associated with a relatively high incidence of Clostridium difficile-associated diarrhoea. Cholestyramine (colestyramine) is an anion-binding resin which can bind luminal C.difficile toxin A (TcdA) and toxin B (TcdB) and which may be beneficial in the treatment of recurrent antibiotic-associated pseudomembranous colitis. We therefore hypothesised that concomitant oral cholestyramine might reduce the risk of C.difficile-associated diarrhoea in patients receiving long-term intravenous ceftriaxone. A pilot study was carried out in which it was found that only three out of 46 (6.5%) such patients being treated with 2 g ceftriaxone daily for Lyme borreliosis, who also received 4 g cholestyramine daily, developed C.difficile-associated diarrhoea. This is smaller than a published report of the incidence of this complication in six out of 26 (23.1%) patients following 1-3 days' treatment with 1 g intravenous ceftriaxone, but without oral cholestyramine (p=0.06). We therefore recommend that a larger, double-blind placebo-controlled trial be carried out to test this hypothesis. PMID:25497389

  11. Ceftriaxone-sulbactam combination in rabbit endocarditis caused by a strain of Klebsiella pneumoniae producing extended-broad-spectrum TEM-3 beta-lactamase.

    Science.gov (United States)

    Caron, F; Gutmann, L; Bure, A; Pangon, B; Vallois, J M; Pechinot, A; Carbon, C

    1990-11-01

    We studied the activity of the combination of sulbactam and ceftriaxone against a Klebsiella pneumoniae strain producing TEM-3, a new extended-broad-spectrum beta-lactamase, in an endocarditis model. In vitro, ceftriaxone was strongly inactivated in the presence of TEM-3 (MBC, 128 micrograms/ml with an inoculum of 5 x 10(5) CFU/ml). A marked inoculum effect was demonstrated with sulbactam: effective concentrations of inhibitor needed to reduce the MIC and MBC of ceftriaxone to similar levels increased from 1 microgram/ml in the presence of an inoculum of 5 x 10(5) CFU/ml to 20 micrograms/ml in the presence of an inoculum of 1 x 10(7) CFU/ml. In vivo, sulbactam given at 200 mg/kg of body weight every 12 h, a dosage higher than that previously reported to be effective against rabbit endocarditis caused by other microorganisms, was not sufficient to restore the complete activity of ceftriaxone given at 30 mg/kg once daily for 4 days. This insufficient activity may be correlated with the presence of a high level of beta-lactamase inside the vegetations, as indicated by a quantitative in vitro assay of beta-lactamase activity in the cardiac vegetation, suggesting an insufficient inactivation of the extended-broad-spectrum beta-lactamase in vivo. PMID:2073099

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

    Science.gov (United States)

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

    2011-07-01

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

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

    OpenAIRE

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

    2011-01-01

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

  14. A multicentre clinical study on the injection of ceftriaxone/sulbactam compared with cefoperazone/sulbactam in the treatment of respiratory and urinary tract infections

    OpenAIRE

    Xin, Xiaojuan; Jian, Li; Xia, Xiaoying; Jia, Bei; Huang, Wenxiang; Li, Chongzhi; Wang, Changzheng; Zhou, Lixin; Sun, Xiuzhen; Tang, Xinghuo; Huang, Yijiang; Zhu, Yunkui; Zhang, Weili

    2013-01-01

    Objective This clinical study was designed to evaluate the efficacy and safety of this therapy in the treatment of respiratory and urinary infections caused by ceftriaxone-resistant bacteria in comparison with the effect of cefoperazone/sulbactam on cefoperazone-resistant bacteria. Methods A total of 285 patients aged from 18 to 65 years old, with a respiratory or urinary tract bacterial infection, were enrolled into this multicentre, open-label, controlled clinical study, and bacteria that w...

  15. Susceptibilities of 200 penicillin-susceptible and -resistant pneumococci to piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin-clavulanate, ampicillin, ampicillin-sulbactam, ceftazidime, and ceftriaxone.

    OpenAIRE

    Pankuch, G A; Jacobs, M. R.; Appelbaum, P C

    1994-01-01

    MICs of eight beta-lactams (piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin-clavulanate, ampicillin, ampicillin-sulbactam, ceftazidime, and ceftriaxone) were determined by agar dilution against 64 penicillin-susceptible, 70 intermediately penicillin-resistant, and 66 fully penicillin-resistant pneumococci. The MICs of piperacillin with and without tazobactam for 90% of the susceptible, intermediately resistant, and resistant strains tested (MIC90s) were < or = 0.064, 2.0, and ...

  16. Protective role of ceftriaxone plus sulbactam with VRP1034 on oxidative stress, hematological and enzymatic parameters in cadmium toxicity induced rat model.

    Science.gov (United States)

    Dwivedi, Vivek Kumar; Bhatanagar, Anuj; Chaudhary, Manu

    2012-12-01

    We investigated the protective role of ceftriaxone plus sulbactam with VRP1034 (Elores) on hematological, lipid peroxidation, antioxidant enzymatic activities and Cd levels in the blood and tissues of cadmium exposed rats. Twenty-four male rats were divided into three groups of eight rats each. The control group received distilled water whereas group II received CdCl2 (1.5 mg/4 ml/body weight) through gastric gavage for 21 days. Group III received CdCl2 and was treated with ceftriaxone plus sulbactam with VRP1034 for 21 days. The hematological, biochemical, lipid peroxidation levels and enzymatic parameters were measured in plasma and tissues (brain, liver and kidney) of all groups. The Cd, Zn and Fe levels were measured in blood and tissues of all groups. Our findings showed significantly decreased cadmium (pceftriaxone plus sulbactam with VRP1034 treated group as compared to cadmium exposed group. Delta aminolevulinate dehydratase (δ-ALAD) activity was significantly (pceftriaxone plus sulbactam with VRP1034 treated group as compared with cadmium exposed group. The levels of hepatic and renal parameters were significantly (pceftriaxone plus sulbactam with VRP1034 treated group as compared to cadmium exposed group. These findings indicate that ceftriaxone plus sulbactam with VRP1034 acts as a potent free radical scavenger and exhibits metal chelating properties that reduce free radical mediated tissue injury and prevent dysfunction of hepatic and renal organs during metal intoxication. PMID:23554563

  17. 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.

  18. 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. PMID:27017523

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    卞蓉蓉; 孙骏

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

    While ceftriaxone 1 g q24h is commonly used for hospitalized patients with community-acquired pneumonia (CAP), the prescribing information recommends 2-4 g a day to treat methicillin-susceptible Staphylococcus aureus (MSSA). Similarly, recent pharmacodynamic analyses suggest shortcomings of 1 g q24h against the bulk of the MSSA. We evaluated the outcomes of empiric ceftriaxone 1 g q24h ± azithromycin in patients with MSSA pneumonia, as compared with Streptococcus pneumoniae. Adult patients admitted to Hartford Hospital from 1/2005 to 12/2014 with respiratory culture for MSSA or S. pneumoniae were considered for inclusion. Non-ICU, CAP patients were included. Early clinical failure (ECF) was defined as persistent signs/symptoms or change of antibiotic due to poor response at 72-96 h. A multivariate analysis was performed to evaluate predictors of ECF. Over the study period, 403 MSSA and 227 S. pneumoniae positive respiratory cultures were identified. The majority of patients were excluded due to the following: no signs/symptoms of pneumonia, hospital-acquired pneumonia, alternative antibiotics, and polymicrobial infection. Thirty-nine patients met inclusion/exclusion criteria. All but three patients in the S. pneumoniae group received ceftriaxone + azithromycin. ECF was greater in the MSSA group (53 vs. 4 %, P = 0.003), as was length of stay (7.5 ± 5.4 vs. 4.6 ± 3.3 days, P = 0.006). When controlling for disease severity and macrolide non-susceptibility in a multivariate analysis, MSSA was significantly correlated with ECF (OR 12.3, 95 % CI 0.8-188.8). Poor clinical outcomes were observed in patients empirically treated with ceftriaxone ± azithromycin for MSSA CAP. Despite the popularity of ceftriaxone 1 g q24h, these data suggest this dose or compound may be inadequate for CAP caused by MSSA. PMID:26531307

  2. Ceftriaxone prevents the neurodegeneration and decreased neurogenesis seen in a Parkinson's disease rat model: An immunohistochemical and MRI study.

    Science.gov (United States)

    Weng, Jun-Cheng; Tikhonova, Maria A; Chen, Jian-Horng; Shen, Mei-Shiuan; Meng, Wan-Yun; Chang, Yen-Ting; Chen, Ke-Hsin; Liang, Keng-Chen; Hung, Ching-Sui; Amstislavskaya, Tamara G; Ho, Ying-Jui

    2016-05-15

    Manganese-enhanced magnetic resonance imaging (MEMRI) is a widely used technique for detecting neuronal activity in the brain of a living animal. Ceftriaxone (CEF) has been shown to have neuroprotective effects in neurodegenerative diseases. The present study was aimed at clarifying whether, in an 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease (PD) rat model, the known CEF-induced neuronal protection was accompanied by neurogenesis and decreased loss of neuronal activity. After MPTP lesioning (day 0), the rats were treated with CEF (100mg/kg/day, i.p.) or saline for 15 days. They were then injected with MnCl2 (40mg/kg, i.p.) on day 13 and underwent a brain MRI scan on day 14, then the brain was taken for histological evaluation on day 15. The results showed that MPTP lesioning resulted in decreased neuronal activity and density in the nigrostriatal dopaminergic (DAergic) system and the hippocampal CA1, CA3, and dentate gyrus (DG) areas and reduced neurogenesis in the DG, but in hyperactivity in the subthalamic nucleus (STN). These neuronal changes were prevented by CEF treatment. Positive correlations between MEMRI R1 values and neuronal density in the hippocampus were evidenced. Neuronal densities in the hippocampus and SNc were positively correlated. In addition, the R1 value of the STN showed a positive correlation with its neuronal activity but showed a negative correlation with the density of DAergic neurons in the SNc. Therefore, MEMRI R1 value may serve as a good indicator for PD severity and the effect of treatment. To our knowledge, this is the first study showing that CEF prevents loss of neuronal activity and neurogenesis in the brain of PD rats. CEF may therefore have clinical potential in the treatment of PD. PMID:26940602

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

    Science.gov (United States)

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

    2012-03-01

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

  4. Assessing the Surrogate Susceptibility of Oxacillin and Cefoxitin for Commonly Utilized Parenteral Agents against Methicillin-Susceptible Staphylococcus aureus: Focus on Ceftriaxone Discordance between Predictive Susceptibility and in Vivo Exposures

    Directory of Open Access Journals (Sweden)

    Nayon Kang

    2015-07-01

    Full Text Available Susceptibility testing with the use of surrogate agents is common among clinical microbiology laboratories. One such example is oxacillin and cefoxitin for β-lactams against methicillin-susceptible Staphylococcus aureus (MSSA. This study aimed to assess the surrogate predictive value (SPV of oxacillin and cefoxitin for the susceptibility of commonly utilized parenteral β-lactams against MSSA as well as to evaluate the concordance between predictive susceptibility testing and the in vivo exposures for ceftriaxone. Broth microdilution MICs were determined for cefazolin, cefoxitin, ceftaroline, ceftriaxone, nafcillin, and oxacillin against a national collection of 1238 MSSA from US hospitals. Pharmacodynamic profiling was utilized to establish a clinical breakpoint for commonly utilized doses of ceftriaxone. Oxacillin had good SPVs for all the β-lactams tested, whereas cefoxitin produced unacceptable major errors for all four agents and thus appears to be an unacceptable susceptibility surrogate. While oxacillin is an adequate surrogate based on the currently defined laboratory criteria, our data also suggest that caution should be exercised when incorporating this testing approach in the clinical setting in view of the fact that the MIC distribution of MSSA coupled with the commonly utilized low doses of ceftriaxone may result in inadequate in vivo exposures against this pathogen.

  5. Assessing the Surrogate Susceptibility of Oxacillin and Cefoxitin for Commonly Utilized Parenteral Agents against Methicillin-Susceptible Staphylococcus aureus: Focus on Ceftriaxone Discordance between Predictive Susceptibility and in Vivo Exposures.

    Science.gov (United States)

    Kang, Nayon; Housman, Seth T; Nicolau, David P

    2015-01-01

    Susceptibility testing with the use of surrogate agents is common among clinical microbiology laboratories. One such example is oxacillin and cefoxitin for β-lactams against methicillin-susceptible Staphylococcus aureus (MSSA). This study aimed to assess the surrogate predictive value (SPV) of oxacillin and cefoxitin for the susceptibility of commonly utilized parenteral β-lactams against MSSA as well as to evaluate the concordance between predictive susceptibility testing and the in vivo exposures for ceftriaxone. Broth microdilution MICs were determined for cefazolin, cefoxitin, ceftaroline, ceftriaxone, nafcillin, and oxacillin against a national collection of 1238 MSSA from US hospitals. Pharmacodynamic profiling was utilized to establish a clinical breakpoint for commonly utilized doses of ceftriaxone. Oxacillin had good SPVs for all the β-lactams tested, whereas cefoxitin produced unacceptable major errors for all four agents and thus appears to be an unacceptable susceptibility surrogate. While oxacillin is an adequate surrogate based on the currently defined laboratory criteria, our data also suggest that caution should be exercised when incorporating this testing approach in the clinical setting in view of the fact that the MIC distribution of MSSA coupled with the commonly utilized low doses of ceftriaxone may result in inadequate in vivo exposures against this pathogen. PMID:26264030

  6. 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.

  7. 52例头孢曲松钠不良反应分析%Analysis of 52 cases adverse reaction of ceftriaxone sodium

    Institute of Scientific and Technical Information of China (English)

    徐红冰; 石卫峰; 刘皋林

    2015-01-01

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

  8. 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 (Pminimum 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≤0.02). 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. PMID:24586792

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

    Directory of Open Access Journals (Sweden)

    Molly A Trecker

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

  10. 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.

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

    Institute of Scientific and Technical Information of China (English)

    肖敏; 邵从英; 葛宝宝; 訾言勤

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨景秀; 戈升荣

    2014-01-01

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

  13. 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.

  14. 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。

  15. 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. PMID:27060486

  16. 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

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

    Institute of Scientific and Technical Information of China (English)

    张威; 赵海涛; 张晓琳

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    赵艳梅

    2014-01-01

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

  19. 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

  20. 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.

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

    Institute of Scientific and Technical Information of China (English)

    王松挺; 阮黎明; 刘国英; 朱伟芳; 蒋筱凌; 舒国斌

    2015-01-01

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

  2. 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.

  3. Spectrophotometric determination of ceftriaxone using 4-dimethylaminobenzaldehyde

    International Nuclear Information System (INIS)

    A new spectrophotometric method has been developed for the determination of the potent antibiotic (CF) by derivatization with 4-dimethylaminobenzaldehyde (DAB). The derivative indicated molar absorptivity of 5.3 * 10/sup 3/ L mol/sup -1/ at lemda max 397 nm and obeyed the Beers law within 20-100 micro gmL/sup -1/. The color reaction was highly stable and did not show any change in absorbance up to 24h. The mehtod was successfully applied for the determination of CF from various pharmaceutical preparations available in local market. The amounts of CF found in various pharmaceutical preparations were within 237.4-990 mg ampoule/sup -1/ with standard deviation(SD)+-0.0003-0.44 (N=3) respectively. (author)

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

    Institute of Scientific and Technical Information of China (English)

    黄玉玲; 杨辉; 许沧海

    2012-01-01

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

  5. 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

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

    Institute of Scientific and Technical Information of China (English)

    鞠小玲; 杜坤; 程丰; 苏江维

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    洪志林; 柯凤兰; 李晓华

    2016-01-01

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

  8. Ceftriaxone-resistant Salmonella enterica serotype Newport, France

    OpenAIRE

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

    2008-01-01

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

  9. Ceftriaxone-Resistant Salmonella enterica Serotype Newport, France

    OpenAIRE

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

    2008-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  12. 76 FR 14023 - Determination that ROCEPHIN (Ceftriaxone Sodium) Injection, 250 Milligrams, 500 Milligrams, 1...

    Science.gov (United States)

    2011-03-15

    ... Application 050585, Were Not Withdrawn From Sale for Reasons of Safety or Effectiveness AGENCY: Food and Drug... new drug application (NDA) 050585, were not withdrawn from sale for reasons of safety or effectiveness... or effectiveness or if FDA determines that the listed drug was withdrawn from sale for reasons...

  13. [Comparative estimation of the application efficacy for ceftriaxon and Hepacef combi preparations in the abdominal infection treatment].

    Science.gov (United States)

    Boĭko, V V; Ivanova, Iu V

    2012-01-01

    A positive experience was described in the work, concerning application of Hepacef combi (cefoperazon/sulbactam, manufactured by "ARTERIUM" (Corporation, Ukraine) in the treatment of inflammatory-purulent diseases of abdominal organs as a method of empirical therapy. There was the preparation action efficacy estimated together with the diseases outcomes analysis, and possible recommendations for its application suggested. The preparation may be recommended for application as the empirical therapy agent in the abdominal infection treatment. PMID:22642085

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

    OpenAIRE

    Levitt, David G.

    2002-01-01

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

  15. Increasing Spectrum in Antimicrobial Resistance of Shigella Isolates in Bangladesh: Resistance to Azithromycin and Ceftriaxone and Decreased Susceptibility to Ciprofloxacin

    OpenAIRE

    Mahbubur, Rahman; Shoma, Shereen; Rashid, Harunur; Arifeen, Shams El; Baqui, A. H.; Siddique, A.K.; Nair, G. B.; Sack, D A

    2007-01-01

    Antimicrobial resistance of Shigella isolates in Bangladesh, during 2001-2002, was studied and compared with that of 1991-1992 to identify the changes in resistance patterns and trends. A significant increase in resistance to trimethoprim-sulphamethoxazole (from 52% to 72%, p

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

    OpenAIRE

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

    2009-01-01

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

  17. 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...

  18. 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.

  19. 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.

  20. Behavioral and Socioeconomic Risk Factors Associated with Probable Resistance to Ceftriaxone and Resistance to Penicillin and Tetracycline in Neisseria gonorrhoeae in Shanghai

    OpenAIRE

    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, 2...

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

    OpenAIRE

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

    1988-01-01

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

  2. Macro-to-micro porous special bioactive glass and ceftriaxone-sulbactam composite drug delivery system for treatment of chronic osteomyelitis: an investigation through in vitro and in vivo animal trial.

    Science.gov (United States)

    Kundu, Biswanath; Nandi, Samit Kumar; Dasgupta, Sudip; Datta, Someswar; Mukherjee, Prasenjit; Roy, Subhasis; Singh, Aruna Kumari; Mandal, Tapan Kumar; Das, Partha; Bhattacharya, Rupnarayan; Basu, Debabrata

    2011-03-01

    A systematic and extensive approach incorporating in vitro and in vivo experimentation to treat chronic osteomyelitis in animal model were made using antibiotic loaded special bioactive glass porous scaffolds. After thorough characterization for porosity, distribution, surface charge, a novel drug composite were infiltrated by using vacuum infiltration and freeze-drying method which was subsequently analyzed by SEM-EDAX and studied for in vitro drug elution in PBS and SBF. Osteomyelitis in rabbit was induced by inoculation of Staphylococcus aureus and optimum drug-scaffold were checked for its efficacy over control and parenteral treated animals in terms of histopathology, radiology, in vivo drug concentration in bone and serum and implant-bone interface by SEM. It was optimized that 60P samples with 60-65% porosity (bimodal distribution of macro- to micropore) with average pore size ~60 μm and higher interconnectivity, moderately high antibiotic adsorption efficiency (~49%) was ideal. Results after 42 days showed antibiotic released higher than MIC against S. aureus compared to parenteral treatment (2 injections a day for 6 weeks). In vivo drug pharmacokinetics and SEM on bone-defect interface proved superiority of CFS loaded porous bioactive glass implants over parenteral group based on infection eradication and new bone formation. PMID:21221731

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

    Institute of Scientific and Technical Information of China (English)

    方文刚; 兰宇

    2009-01-01

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

  4. Antibiotic-Resistant Gonorrhea (ARG)

    Science.gov (United States)

    ... 1993, ciprofloxacin, a fluoroquinolone, and cephalosporins ceftriaxone and cefixime were the recommended treatments for gonorrhea. However, in ... people in the United States. The cephalosporins, either cefixime or ceftriaxone, were the only remaining recommended treatments. ...

  5. Comparative efficacy of antibiotics in biofilms eradication formed by ESBL and non ESBL producing micro-organisms

    OpenAIRE

    Manu Chaudhary; Anurag Payasi

    2012-01-01

    Growth of bacterial cells within a biofilm complicate the treatment of infections. Therefore, in the present study biofilm eradication efficacy of (ceftriaxone and sulbactam plus EDTA; CSE1034) was compared with ceftriaxone alone, ceftriaxone plus EDTA and ceftriaxone plus sulbactam against biofilms of ESBL producing Escherichia coli, Klebsiella pneumoniae and Salmonella typhi. Susceptibility testing of each drug was performed on planktonic and biofilm cells in non ESBL producing and ESBL pro...

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

    International Nuclear Information System (INIS)

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

  7. SYNERGY OF A NOVEL ANTIBIOTIC ADJUVANT ENTITY AGAINST MULTI DRUG RESISTANT ENTEROBACTERIACEAE

    OpenAIRE

    Manu Chaudhary; Anurag Payasi

    2013-01-01

    In the present investigation, we investigated the in vitro interaction of ceftriaxone plus sulbactam with disodium edetate, a Non Antibiotic Adjuvant (NAA) against selected clinical isolates and in vitro susceptibility studies were also performed. The isolates were tested against a range of ratios of ceftriaxone and sulbactam using a microdilution checkerboard method. Having determined the appropriate ratios of ceftriaxone plus sulbactam, effect of various concentration of disodium edetate we...

  8. Pharmacokinetic study of sulbactomax.

    Science.gov (United States)

    Payasi, Anurag; Chaudhary, Manu; Gupta, Ankush; Dwivedi, Vivek Kumar; Bhatnagar, Anuj

    2010-08-01

    We have evaluated pharmacokinetics of a fixed dose combination (FDC) of ceftriaxone and sulbactam (2:1) or sulbactomax in eight healthy volunteers. A 1.5 g dose of sulbactomax, 1 g dose of ceftriaxone and 0.5 g sulbactam were given intravenously in a balanced two-ways cross-over study. Serially collected plasma sample was analyzed for ceftriaxone and sulbactam by high performance liquid chromatography (HPLC). The mean peaks of ceftriaxone and sulbactam concentrations in plasma were 152.06+/-6.65 microg/ml and 21.32+/-1.80 microg/ml, respectively and plasma half-lives for ceftriaxone and sulbactam were 5.2+/-0.35 hr and 0.94+/-0.038 hr, respectively. The AUC0-24 for ceftriaxone and sulbactam was 760.16+/-27.68 microg.hr/ml and 20.74+/-2.34 microg.hr/ml, respectively, with elimination rate constant of 0.133+/-0.009 hr(-1) and 0.732+/-0.029 hr(-1), respectively. The kinetics of ceftriaxone and sulbactum did not change in combination as compared to the alone treatment. Also, concentration of the ceftriaxone after 24 hr is higher than the minimum inhibitory concentration (MIC) of the most of the gram positive and gram negative bacteria indicating that one dose in a day is sufficient to treat the disease caused by these organisms. PMID:20686332

  9. Disease: H00334 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available Nafcillin sodium [DR:D00928] Oxacillin sodium [DR:D00929] Cefazolin [DR:D02299] Ceftriaxone sodium [DR:D00924] Monotherapy...xacillin sodium [DR:D00929] Cefazolin [DR:D02299] Ceftriaxone sodium [DR:D00924] Combination therapy Penicil

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

    Science.gov (United States)

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

    2014-01-01

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

  11. 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.

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

    OpenAIRE

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

    2012-01-01

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

  13. 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

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

    OpenAIRE

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

    1998-01-01

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

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

    OpenAIRE

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

    1986-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  17. Comparison of the inoculum effect of cefoxitin and other cephalosporins and of beta-lactamase inhibitors and their penicillin-derived components on the Bacteroides fragilis group.

    OpenAIRE

    Goldstein, E J; Citron, D M; Cherubin, C E

    1991-01-01

    We compared the inoculum effects for 109 recent clinical isolates of the Bacteroides fragilis group of cefoxitin, cefotetan, ceftizoxime, ceftriaxone, and three beta-lactamase inhibitors (clavulanic acid, sulbactam, and tazobactam) and their penicillin-derived components. Bactericidal activity was assayed and morphologic changes were monitored for selected strains exhibiting a large inoculum effect. Ceftizoxime demonstrated the largest inoculum effect, followed by cefotetan and ceftriaxone. T...

  18. Antibiotics for the treatment of dysentery in children

    OpenAIRE

    Traa, Beatrix S; Walker, Christa L. Fischer; Munos, Melinda; Black, Robert E.

    2010-01-01

    Background Ciprofloxacin, ceftriaxone and pivmecillinam are the antibiotics currently recommended by the World Health Organization (WHO) for the treatment of dysentery in children; yet there have been no reviews of the clinical effectiveness of these antibiotics in recent years. Methods We reviewed all literature reporting the effect of ciprofloxacin, ceftriaxone and pivmecillinam for the treatment of dysentery in children in the developing countries. We used a standardized abstraction and gr...

  19. Comparative efficacy of antibiotics in biofilms eradication formed by ESBL and non ESBL producing micro-organisms

    Directory of Open Access Journals (Sweden)

    Manu Chaudhary

    2012-06-01

    Full Text Available Growth of bacterial cells within a biofilm complicate the treatment of infections. Therefore, in the present study biofilm eradication efficacy of (ceftriaxone and sulbactam plus EDTA; CSE1034 was compared with ceftriaxone alone, ceftriaxone plus EDTA and ceftriaxone plus sulbactam against biofilms of ESBL producing Escherichia coli, Klebsiella pneumoniae and Salmonella typhi. Susceptibility testing of each drug was performed on planktonic and biofilm cells in non ESBL producing and ESBL producing strains according to the recommendations of clinical and laboratory standards institutes guidelines. CSE1034 inhibited the growth of planktonic cells of non ESBL producing strains with minimum inhibitory concentration (MIC from 0.25 to 1.0 μg/ml; the minimum biofilm eradication concentration (MBEC values ranged from 8 to 32 μg/ml where as ESBL producing strains MIC values were 2 to 4 times higher and corresponding MBEC values were higher by 4 to 8 times. When biofilms of ESBL producing organisms were treated with the half MBEC of drugs, CSE1034 decreased 3 log of bacteria present in biofilm when compared with ceftriaxone, ceftriaxone plus EDTA and ceftriaxone plus sulbactam. In conclusion, combination of CSE1034 acts synergistically and reduces the MIC and MBEC values, significantly. One dimensional polyacrlamide gel elctrophoresis of extracellular proteins revealed distinct difference in protein expression of the group treated with CSE1034. Hence, CSE1034 at low concentration showed greater efficacy in the eradication of biofilm as compared to other two drugs and could be one of the best choices to eradicate the biofilm infections caused by these organisms as compared to other drugs.

  20. SYNERGY OF A NOVEL ANTIBIOTIC ADJUVANT ENTITY AGAINST MULTI DRUG RESISTANT ENTEROBACTERIACEAE

    Directory of Open Access Journals (Sweden)

    Manu Chaudhary

    2013-01-01

    Full Text Available In the present investigation, we investigated the in vitro interaction of ceftriaxone plus sulbactam with disodium edetate, a Non Antibiotic Adjuvant (NAA against selected clinical isolates and in vitro susceptibility studies were also performed. The isolates were tested against a range of ratios of ceftriaxone and sulbactam using a microdilution checkerboard method. Having determined the appropriate ratios of ceftriaxone plus sulbactam, effect of various concentration of disodium edetate were also studied using the microdilution checkerboard method. All the results were analysed with the Fractional Inhibitory Concentration (FIC indices. Susceptibility studies were carried out according to the Clinical and Laboratory Standards Institute (CLSI methods. Results of this study demonstrated that 2:1 ratio of ceftriaxone and sulbactam was the more synergistic with FIC index values 0.4281, 0.4023, 0.4124 and 0.4325 for E. coli, A. baumannii, P. aeruginosa and K. pneumoniae. The synergicity of ceftriaxone and sulbactam was enhanced significantly with increasing concentration of disodium edetate and produced the lowest FIC index (4 log of killing reduction was observed with synergistic ratio of Elores in time kill curve study. This study suggest that Elores could be an alternative regimen in combating antibiotic resistance among multi drug resistant Enterobacteriaceae.

  1. Etiologies of illness among patients meeting integrated management of adolescent and adult illness district clinician manual criteria for severe infections in northern Tanzania: implications for empiric antimicrobial therapy.

    Science.gov (United States)

    Rubach, Matthew P; Maro, Venance P; Bartlett, John A; Crump, John A

    2015-02-01

    We describe the laboratory-confirmed etiologies of illness among participants in a hospital-based febrile illness cohort study in northern Tanzania who retrospectively met Integrated Management of Adolescent and Adult Illness District Clinician Manual (IMAI) criteria for septic shock, severe respiratory distress without shock, and severe pneumonia, and compare these etiologies against commonly used antimicrobials, including IMAI recommendations for emergency antibacterials (ceftriaxone or ampicillin plus gentamicin) and IMAI first-line recommendations for severe pneumonia (ceftriaxone and a macrolide). Among 423 participants hospitalized with febrile illness, there were 25 septic shock, 37 severe respiratory distress without shock, and 109 severe pneumonia cases. Ceftriaxone had the highest potential utility of all antimicrobials assessed, with responsive etiologies in 12 (48%) septic shock, 5 (14%) severe respiratory distress without shock, and 19 (17%) severe pneumonia illnesses. For each syndrome 17-27% of participants had etiologic diagnoses that would be non-responsive to ceftriaxone, but responsive to other available antimicrobial regimens including amphotericin for cryptococcosis and histoplasmosis; anti-tuberculosis therapy for bacteremic disseminated tuberculosis; or tetracycline therapy for rickettsioses and Q fever. We conclude that although empiric ceftriaxone is appropriate in our setting, etiologies not explicitly addressed in IMAI guidance for these syndromes, such as cryptococcosis, histoplasmosis, and tetracycline-responsive bacterial infections, were common. PMID:25385866

  2. Re-evaluation of the role of broad-spectrum cephalosporins against staphylococci by applying contemporary in-vitro results and pharmacokinetic-pharmacodynamic principles.

    Science.gov (United States)

    Sader, H S; Bhavnani, S M; Ambrose, P G; Jones, R N; Pfaller, M A

    2007-02-01

    The potency of cefepime, ceftriaxone, and ceftazidime was assessed by CLSI broth microdilution methods against 41,644 S. aureus (63.2% oxacillin-susceptible) and 14,266 coagulase-negative staphylococci (CoNS; 22.2% oxacillin-susceptible) through the SENTRY Antimicrobial Surveillance Program database (1998-2004). Using normal volunteer pharmacokinetic data and a linear intermittent intravenous infusion model, and an animal-derived pharmacokinetic/pharmacodynamic (PK-PD) target of > or = 40% time above MIC, expected probabilities of target attainment (PTA) for cephems were evaluated using Monte Carlo simulation. Current CLSI breakpoints would rank the tested agents cefepime > or = ceftriaxone > ceftazidime and by PK-PD PTA cefepime > ceftazidime > ceftriaxone. Cefepime has a potency advantage over ceftazidime (four- to eight-fold) and superiority at the usual dosing over ceftriaxone (22.7-66.1%) for oxacillin-susceptible staphylococci. Ceftazidime pharmacokinetic overcomes by-weight activity disadvantages, while a low proportion ( or = 0.9 to a breakpoint of 8 mg/L for cefepime (1 g q8 or 12 hours) and ceftazidime and to a breakpoint of 2 mg/L for ceftriaxone. Regardless of applied breakpoint (CLSI or PKPD), cefepime has the widest and most potent anti-staphylococcal activity among commonly used "third- or fourth-generation" cephems. When used at doses > or = 3 g/day, cefepime assures maximal coverage of oxacillin-susceptible staphylococci whether using existing (CLSI) or modified (PK-PD) breakpoints. Ceftriaxone should be used with caution. PMID:17309849

  3. Moxifloxacin in the Therapy of Experimental Pneumococcal Meningitis

    OpenAIRE

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

    1998-01-01

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

  4. The availability and cost of antibiotics for treating PID in the Central Region of Ghana and implications for compliance with national treatment guidelines.

    Science.gov (United States)

    Bosu, W K; Mabey, D

    1998-09-01

    The availability and cost of antibiotics for treating pelvic inflammatory disease (PID) were assessed in 17 drug-dispensing outlets in 5 districts of the Central Region, Ghana. The outlets included the dispensaries of 2 regional and 4 district hospitals, 4 privately-owned pharmacies and 7 chemical seller shops. The most common antibiotics available, including co-trimoxazole, metronidazole, benzylpenicillin, amoxycillin, chloramphenicol and gentamicin, were also the lowest-priced drugs. Conversely, the most expensive antibiotics including ceftriaxone, ciprofloxacin, cefuroxime and spectinomycin, were also the least commonly available. Recommended anti-gonococcal antibiotics (ciprofloxacin, ceftriaxone) may not be prescribed if they are not available in the districts. PMID:9764942

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

    OpenAIRE

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

    1998-01-01

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

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

    Science.gov (United States)

    GHANIZADEH, Ahmad; BERK, Michael

    2015-01-01

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

  7. Beta-lactam antibiotics as a possible novel therapy for managing epilepsy and autism, a case report and review of literature.

    Science.gov (United States)

    Ghanizadeh, Ahmad; Berk, Michael

    2015-01-01

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

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

    Science.gov (United States)

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

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

    OpenAIRE

    Sicklinger, Martin; Wienecke, Ralf; Neubert, Uwe

    2003-01-01

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

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

    OpenAIRE

    Sicklinger, Martin

    2006-01-01

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

  11. 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.

  12. Antimicrobial Disk Susceptibility Testing of Leptospira spp. Using Leptospira Vanaporn Wuthiekanun (LVW) Agar

    OpenAIRE

    Wuthiekanun, Vanaporn; Amornchai, Premjit; Langla, Sayan; White, Nicholas J; Day, Nicholas P. J.; Limmathurotsakul, Direk; Peacock, Sharon J.

    2015-01-01

    Leptospira Vanaporn Wuthiekanun (LVW) agar was used to develop a disk diffusion assay for Leptospira spp. Ten pathogenic Leptospira isolates were tested, all of which were susceptible to 17 antimicrobial agents (amoxicillin/clavulanic acid, amoxicillin, azithromycin, cefoxitin, ceftazidime, ceftriaxone, chloramphenicol, ciprofloxacin, clindamycin, doripenem, doxycycline, gentamicin, linezolid, nitrofurantoin, penicillin, piperacillin/tazobactam, and tetracycline). All 10 isolates had no zone ...

  13. Antimicrobial resistance among Escherichia coli that cause childhood community-acquired urinary tract infections in Northern Italy

    OpenAIRE

    Caracciolo Alessandra; Bettinelli Alberto; Bonato Claudio; Isimbaldi Clementina; Tagliabue Alessandro; Longoni Laura; Bianchetti Mario G

    2011-01-01

    Abstracts Background Resistance rate of Escherichia coli against antimicrobials that are commonly prescribed in pediatric urinary tract infections is currently a matter of concern. Methods The antimicrobial susceptibility patterns of uropathogenic Escherichia coli strains to the common antibimcrobials ampicillin, cotrimoxazole, coamoxyclav, ceftazidime, ceftriaxone, nitrofurantoin, and gentamycin were determined in 177 children aged from 2 to 36 months. They presented with their first symptom...

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

    OpenAIRE

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

    1997-01-01

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

  15. 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

  16. Nocardia Brain Abscess in a Liver Transplant Recipient

    OpenAIRE

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

    2011-01-01

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

  17. Kinetic Spectrophotometric Determination of Certain Cephalosporins in Pharmaceutical Formulations

    OpenAIRE

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

    2009-01-01

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

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

    Science.gov (United States)

    Torgomyan, H

    2012-12-01

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

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

    Science.gov (United States)

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

    1991-10-01

    We evaluated the pharmacokinetics and therapeutic efficacy of ampicillin combined with sulbactam in a rabbit model of meningitis due to a beta-lactamase-producing strain of Escherichia coli K-1. Ceftriaxone was used as a comparison drug. The MIC and MBC were 32 and greater than 64 micrograms/ml (ampicillin), greater than 256 and greater than 256 micrograms/ml (sulbactam), 2.0 and 4.0 micrograms/ml (ampicillin-sulbactam [2:1 ratio, ampicillin concentration]) and 0.125 and 0.25 micrograms/ml (ceftriaxone). All antibiotics were given by intravenous bolus injection in a number of dosing regimens. Ampicillin and sulbactam achieved high concentrations in cerebrospinal fluid (CSF) with higher dose regimens, but only moderate bactericidal activity compared with that of ceftriaxone was obtained. CSF bacterial titers were reduced by 0.6 +/- 0.3 log10 CFU/ml/h with the highest ampicillin-sulbactam dose used (500 and 500 mg/kg of body weight, two doses). This was similar to the bactericidal activity achieved by low-dose ceftriaxone (10 mg/kg), while a higher ceftriaxone dose (100 mg/kg) produced a significant increase in bactericidal activity (1.1 +/- 0.4 log10 CFU/ml/h). It appears that ampicillin-sulbactam, despite favorable CSF pharmacokinetics in animals with meningitis, may be of limited value in the treatment of difficult-to-treat beta-lactamase-producing bacteria, against which the combination shows only moderate in vitro activity. PMID:1759824

  20. 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.

  1. 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

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

    Science.gov (United States)

    Lee, Hyukmin; Lee, Kyungwon; Chong, Yunsop

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fahmi Yousef Khan

    2016-01-01

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

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

    Science.gov (United States)

    Khan, Fahmi Yousef

    2016-01-01

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

  5. Fourier transform infrared and Raman spectroscopy studies on magnetite/Ag/antibiotic nanocomposites

    Science.gov (United States)

    Ivashchenko, Olena; Jurga-Stopa, Justyna; Coy, Emerson; Peplinska, Barbara; Pietralik, Zuzanna; Jurga, Stefan

    2016-02-01

    This article presents a study on the detection of antibiotics in magnetite/Ag/antibiotic nanocomposites using Fourier transform infrared (FTIR) and Raman spectroscopy. Antibiotics with different spectra of antimicrobial activities, including rifampicin, doxycycline, cefotaxime, and ceftriaxone, were studied. Mechanical mixtures of antibiotics and magnetite/Ag nanocomposites, as well as antibiotics and magnetite nanopowder, were investigated in order to identify the origin of FTIR bands. FTIR spectroscopy was found to be an appropriate technique for this task. The spectra of the magnetite/Ag/antibiotic nanocomposites exhibited very weak (for doxycycline, cefotaxime, and ceftriaxone) or even no (for rifampicin) antibiotic bands. This FTIR "invisibility" of antibiotics is ascribed to their adsorbed state. FTIR and Raman measurements show altered Csbnd O, Cdbnd O, and Csbnd S bonds, indicating adsorption of the antibiotic molecules on the magnetite/Ag nanocomposite structure. In addition, a potential mechanism through which antibiotic molecules interact with magnetite/Ag nanoparticle surfaces is proposed.

  6. 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.

  7. Risk assessment of antimicrobial usage in Danish pig production on the human exposure to antimicrobial resistant bacteria from pork

    DEFF Research Database (Denmark)

    Struve, Tina

    antimicrobials are influenced by the use of antimicrobial agents, and the prudence of antimicrobial use have been emphasized since the Swann report in 1969 recommended that antibiotics used in human medicine should not be used as growth promoters in food-producing animals. In 2007, the World Health Organisation...... investigated using selective agar plates supplemented with ceftriaxone. The occurrence of ESC producing E. coli was used as the outcome in the data analysis, where the effect of using cephalosporins, extended spectrum penicillins and tetracyclines was estimated using regression analysis. In Objective 2, the...... samples collected for Objective 1 were diluted in 10 fold and spread on selective plates in two set of triplicates (one set containing three MacConkey agar plates, and one set containing three MacConkey agar plates supplemented with ceftriaxone). This provided quantitative data for the ESC producing E...

  8. 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; Mevius, D

    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...... 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...

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

    International Nuclear Information System (INIS)

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

  10. Pharmakawirkung auf in vitro kultivierte primäre humane Osteoblasten

    OpenAIRE

    Kalinowski, Ivonne

    2016-01-01

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

  11. Leptospirosis in pregnancy with pathological fetal cardiotocography changes

    OpenAIRE

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

    2014-01-01

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

  12. 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

  13. Culture Negative Listeria monocytogenes Meningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy

    DEFF Research Database (Denmark)

    Gaini, Shahin; Karlsen, Gunn Hege; Nandy, Anirban;

    2015-01-01

    A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy for...... catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically for Listeria monocytogenes in all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection and...

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

    OpenAIRE

    Unemo, Magnus; Nicholas, Robert A

    2012-01-01

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

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

    Science.gov (United States)

    Czell, D; Rodic, B; Imoberdorf, R

    2011-05-11

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

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

    OpenAIRE

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

    1987-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

  1. Multidrug Resistant Shigella flexneri Infection Simulating Intestinal Intussusception.

    Science.gov (United States)

    Sreenivasan, Srirangaraj; Kali, Arunava; Pradeep, Jothimani

    2016-01-01

    Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, which was effectively treated by ceftriaxone. PMID:27013815

  2. Assessment of Etest as an Alternative to Agar Dilution for Antimicrobial Susceptibility Testing of Neisseria gonorrhoeae

    OpenAIRE

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

    2014-01-01

    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 a...

  3. 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

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

    OpenAIRE

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

    2012-01-01

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

  5. Preoperative administration of cephalosporins for elective caesarean delivery

    Directory of Open Access Journals (Sweden)

    Bogavac Mirjana

    2010-01-01

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

  6. Novel plasmid-mediated beta-lactamase from Escherichia coli that inactivates oxyimino-cephalosporins.

    OpenAIRE

    Matsumoto, Y; Ikeda, F; Kamimura, T.; Yokota, Y.; Mine, Y

    1988-01-01

    A highly cephem-resistant Escherichia coli strain, FP1546, isolated from the fecal flora of laboratory dogs previously administered beta-lactam antibiotics was found to produce a beta-lactamase, FEC-1, of 48-kilodalton size and pI 8.2. FEC-1 hydrolyzed cefuroxime, cefotaxime, cefmenoxime, and ceftriaxone, as well as the enzymatically less-stable antibiotics cephaloridine, cefotiam, and cefpiramide. Of the oxyimino-cephalosporins, ceftizoxime was fairly stable to FEC-1. FEC-1 differed notably ...

  7. Antimicrobial susceptibilities of clinical isolates of Acinetobacter baumannii from Singapore.

    OpenAIRE

    Kuah, B G; Kumarasinghe, G; Doran, J.; Chang, H R

    1994-01-01

    The in vitro activities of 17 antimicrobial agents alone or in combination against 70 clinical isolates of Acinetobacter baumannii from Singapore were determined by broth microdilution. The MICs of amoxicillin, ampicillin, ceftazidime, ceftriaxone, gentamicin, and piperacillin for 90% of the strains were > or = 128 micrograms/ml. Addition of sulbactam to ampicillin produced improved activity, whereas adding tazobactam to piperacillin did not. The MICs of amikacin, ciprofloxacin, and imipenem ...

  8. Nosocomial Outbreak of Infections by Proteus mirabilis That Produces Extended-Spectrum CTX-M-2 Type β-Lactamase

    OpenAIRE

    Nagano, Noriyuki; Shibata, Naohiro; Saitou, Yuko; Nagano, Yukiko; Arakawa, Yoshichika

    2003-01-01

    Nineteen multidrug-resistant Proteus mirabilis strains were isolated from 19 patients suffering from infections probably caused by P. mirabilis. These strains were recovered from urine or other urogenital specimens of 16 inpatients and three outpatients with a hospitalization history in a urology ward of Funabashi Medical Center, from July 2001 to August 2002. These strains demonstrated resistance to cefotaxime, ceftriaxone, cefpodoxime, and aztreonam, while they were highly susceptible to ce...

  9. Detection of resistance due to inducible beta-lactamase in Enterobacter aerogenes and Enterobacter cloacae.

    OpenAIRE

    Huber, T W; Thomas, J. S

    1994-01-01

    Thirty-six of 36 strains of Enterobacter cloacae and E. aerogenes with inducible beta-lactamase developed resistance when cefoxitin (inducer) was added to cefuroxime disks. Constitutive beta-lactamase producers (n = 23) were all resistant to cefuroxime. Cefuroxime resistance correlated with the amount of induced or constitutive beta-lactamase. Cefuroxime was a better indicator of induced resistance than cefamandole, cefazolin, cephalothin, ceftriaxone, cefotaxime, ticarcillin with or without ...

  10. In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli.

    OpenAIRE

    Fass, R J; Barnishan, J; M C Solomon; Ayers, L W

    1996-01-01

    From 1991 to 1995, 8,975 nonfermentative gram-negative bacilli were isolated from patients at The Ohio State University Medical Center: 71% Pseudomonas aeruginosa, 14% Stenotrophomonas maltophilia, 7.6% Acinetobacter baumannii, and < 2% each of 25 other species. The MICs of trovafloxacin (CP-99,219), ciprofloxacin, ofloxacin, ampicillin-sulbactam, piperacillin, piperacillin-tazobactam, ceftazidime, cefoperazone, ceftriaxone, imipenem, tobramycin, and trimethoprim-sulfamethoxazole (TMP-SMZ) we...

  11. Different Dynamic Patterns of β-Lactams, Quinolones, Glycopeptides and Macrolides on Mouse Gut Microbial Diversity

    OpenAIRE

    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), q...

  12. Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes

    OpenAIRE

    Tablang, Michael Vincent F.

    2008-01-01

    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 compl...

  13. In vitro selection of one-step mutants of Streptococcus pneumoniae resistant to different oral beta-lactam antibiotics is associated with alterations of PBP2x.

    OpenAIRE

    Sifaoui, F; Kitzis, M D; Gutmann, L

    1996-01-01

    Many oral penicillins and cephalosporins are used to treat clinical infections caused by Streptococcus pneumoniae. Therefore, using different beta-lactams as selectors, we estimated the frequencies of one-step mutations leading to resistance. Resistant mutants were obtained from penicillin-susceptible, intermediately resistant, and penicillin resistant strains. For cefixime, cefuroxime, cefpodoxime, cefotaxime, and ceftriaxone, the frequencies of mutation ranged from 10(-6) to 10(-8) when res...

  14. TEM-4, a new plasmid-mediated beta-lactamase that hydrolyzes broad-spectrum cephalosporins in a clinical isolate of Escherichia coli.

    OpenAIRE

    Paul, G C; Gerbaud, G; Bure, A; Philippon, A M; B. Pangon; Courvalin, P.

    1989-01-01

    A clinical isolate of Escherichia coli, strain CB-134, recovered in 1986 from an abdominal abscess, exhibited resistance to penams, oxyimino-beta-lactams including broad-spectrum cephalosporins (cefotaxime, ceftriaxone, ceftazidime), and aztreonam but remained susceptible to cephamycins (cefoxitin, cefotetan) and to moxalactam and imipenem. Clavulanate (2 micrograms/ml) restored the susceptibility of the strain to broad-spectrum cephalosporins and aztreonam. A beta-lactamase with an isoelectr...

  15. A Challenge for Diagnosing Acute Liver Injury with Concomitant/Sequential Exposure to Multiple Drugs: Can Causality Assessment Scales Be Utilized to Identify the Offending Drug?

    OpenAIRE

    Roxanne Lim; Hassan Choudry; Kim Conner; Wikrom Karnsakul

    2014-01-01

    Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin/sulbactam, and clindamycin) for cervical lymphadenitis/retropharyngeal cellulitis. Histopathology of the liver ...

  16. Comparison of the inoculum effects of members of the family Enterobacteriaceae on cefoxitin and other cephalosporins, beta-lactamase inhibitor combinations, and the penicillin-derived components of these combinations.

    OpenAIRE

    Goldstein, E J; Citron, D M; Cherubin, C E

    1991-01-01

    We compared the inoculum effects of 105 recent clinical isolates of the family Enterobacteriaceae on cefoxitin, other cephalosporins, aztreonam, and three beta-lactamase inhibitors (clavulanic acid, sulbactam, and tazobactam) and their penicillin-derived components. Piperacillin and aztreonam showed the largest inoculum effect, and cefoxitin showed the smallest. The other cephalosporins tested (cefotetan, ceftizoxime, and ceftriaxone) showed an intermediate inoculum effect. In general, the in...

  17. Use of microdilution panels with and without beta-lactamase inhibitors as a phenotypic test for beta-lactamase production among Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter freundii, and Serratia marcescens.

    Science.gov (United States)

    Thomson, K S; Sanders, C C; Moland, E S

    1999-06-01

    Over the past decade, a number of new beta-lactamases have appeared in clinical isolates of Enterobacteriaceae that, unlike their predecessors, do not confer beta-lactam resistance that is readily detected in routine antibiotic susceptibility tests. Because optimal methodologies are needed to detect these important new beta-lactamases, a study was designed to evaluate the ability of a panel of various beta-lactam antibiotics tested alone and in combination with beta-lactamase inhibitors to discriminate between the production of extended-spectrum beta-lactamases, AmpC beta-lactamases, high levels of K1 beta-lactamase, and other beta-lactamases in 141 isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, and Serratia marcescens possessing well-characterized beta-lactamases. The microdilution panels studied contained aztreonam, cefpodoxime, ceftazidime, cefotaxime, and ceftriaxone, with and without 1, 2, and 4 microg of clavulanate per ml or 8 microg of sulbactam per ml and cefoxitin and cefotetan with and without 8 microg of sulbactam per ml. The results indicated that a minimum panel of five tests would provide maximum separation of extended-spectrum beta-lactamase high AmpC, high K1, and other beta-lactamase production in Enterobacteriaceae. These included cefpodoxime, cefpodoxime plus 4 microg of clavulanate per ml, ceftazidime, ceftriaxone, and ceftriaxone plus 8 microg of sulbactam per ml. Ceftriaxone plus 2 microg of clavulanate per ml could be substituted for cefpodoxime plus 4 microg of clavulanate per ml without altering the accuracy of the tests. This study indicated that tests with key beta-lactam drugs, alone and in combination with beta-lactamase inhibitors, could provide a convenient approach to the detection of a variety of beta-lactamases in members of the family Enterobacteriaceae. PMID:10348759

  18. Role of Class A Penicillin-Binding Proteins in PBP5-Mediated β-Lactam Resistance in Enterococcus faecalis

    OpenAIRE

    Arbeloa, Ana; Segal, Heidi; Hugonnet, Jean-Emmanuel; Josseaume, Nathalie; Dubost, Lionnel; Brouard, Jean-Paul; Gutmann, Laurent; Mengin-Lecreulx, Dominique; Arthur, Michel

    2004-01-01

    Peptidoglycan polymerization complexes contain multimodular penicillin-binding proteins (PBP) of classes A and B that associate a conserved C-terminal transpeptidase module to an N-terminal glycosyltransferase or morphogenesis module, respectively. In Enterococcus faecalis, class B PBP5 mediates intrinsic resistance to the cephalosporin class of β-lactam antibiotics, such as ceftriaxone. To identify the glycosyltransferase partner(s) of PBP5, combinations of deletions were introduced in all t...

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

    OpenAIRE

    Piyadigamage, A; Wilson, J.

    2005-01-01

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

  20. Intermediate uveitis and Lyme borreliosis.

    OpenAIRE

    Breeveld, J; Rothova, A.; Kuiper, H

    1992-01-01

    A case of chronic intermediate uveitis and associated classic snowbanking (pars planitis) with severe cystoid macular oedema probably due to Lyme borreliosis is reported. Despite a disease duration of 10 years the patient's ocular symptoms and visual acuity responded promptly to intravenous ceftriaxone treatment. This case demonstrates that periodic reevaluation of patients with intermediate uveitis is necessary to obtain a specific diagnosis which may include Lyme borreliosis.

  1. Detection Of Extended-Spectrum Beta Lactamase in Klebsiella pneumoniae and Klebsiella oxytoca Bacteria with the Combined Disc Method

    OpenAIRE

    Ebru Yılmaz; Güven Uraz

    2011-01-01

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

  2. Ceftriaxone–Associated Nephrolithiasis in Children

    OpenAIRE

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

    2013-01-01

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

  3. Detection Of Extended-Spectrum Beta Lactamase in Klebsiella pneumoniae and Klebsiella oxytoca Bacteria with the Combined Disc Method

    OpenAIRE

    Yılmaz, Ebru; Uraz, Güven

    2000-01-01

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

  4. Multiple cerebral sinus thromboses complicating meningococcal meningitis: a pediatric case report

    OpenAIRE

    Bozzola, Elena; Bozzola, Mauro; Colafati, Giovanna Stefania; Calcaterra, Valeria; Vittucci, Annachiara; Luciani, Matteo; Villani, Alberto

    2014-01-01

    Background Cerebral venous sinus thrombosis (CVT) is a rare and potentially life-threatening condition in the pediatric population. The clinical presentation is frequently nonspecific; thus diagnosis is often delayed or missed. Case presentation A previously healthy 8 month-old boy was diagnosed with meningococcal meningitis. At hospital admission, an urgent non contrast-enhanced computed tomography (CT) of the head and neck was performed with normal results. Ceftriaxone was promptly started ...

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

    OpenAIRE

    Jeevan Ranjan Dash; Tapas Kumar Sar; Indranil Samanta; Subodh Pal; Madhuchhanda Khan; Nimai Chand Patra; Uttam Sarkar; Asit Kumar Maji; Tapan Kumar Mandal

    2014-01-01

    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. varieg...

  6. A case of Aggregatibacter actinomycetemcomitans endocarditis presenting as quadriceps myositis

    Directory of Open Access Journals (Sweden)

    Angeline Reid

    2012-03-01

    Full Text Available An 80 year old female was admitted with an eight week history of fever associated with painful swelling of her right thigh, and a long history of poor dentition. Culture of blood stained fluid aspirated from the abscess grew Aggregatibacter actinomycetemcomitans (Aa sensitive to ampicillin and cephalosporins. Transoesophageal echocardiography indicated endocarditis. Four weeks treatment with intravenous ceftriaxone and appropriate dental care was followed by full recovery.

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

    Science.gov (United States)

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

    2016-08-01

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

  8. Outpatient parenteral antimicrobial therapy in children with febrile urinary tract infection: a prospective randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Nasiri Kalmarzi R

    2009-01-01

    Full Text Available "nBackground: Acute pyelonephritis may lead to permanent renal scarring. The standard recommendation for treatment of febrile children with urinary tract infection (UTI is hospitalization for intravenous antibiotics. The purpose of this study was to compare the efficacy of outpatient intravenous ceftriaxone and cefixime versus inpatient of the same regimen for children with febrile UTI.   "nMethods: In a randomized clinical trial, we compared the efficacy of administration two days intravenous ceftriaxone followed by an oral cefixime for eight days (as outpatient group versus four days intravenous ceftriaxone followed by an oral cefixime for six days (as inpatient group, in 203 children (99 cases in outpatient group and 104 cases in inpatient group 3 months to 15 years of age with febrile UTI, in terms of short-term clinical outcomes (sterilization of the urine and defeverescence and long-term morbidity (incidence of reinfection and renal scarring documented by DMSA scintigraphy. "nResults: Repeat urine cultures were sterile within 48 hours in all children, mean time to defeverescence was 27.58 (SD=±12.62 and 31.44 (SD=±17.06 hours for children in outpatient and inpatient groups, respectively (P=0.067. Reinfection occurred in 9.1% of outpatient and 13.4% of inpatient group (P=0.326. Renal scarring developed in 11% of children of outpatient and 7.6% of children of inpatient group (P=0.884. There was no significant difference between the two groups in respect of renal scarring. "nConclusions: Outpatient ceftriaxone for two days followed by cefixime to complete a 10 days course can be recommended as a safe and effective treatment for children with febrile UTI.

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

    OpenAIRE

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

    2014-01-01

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

  10. CTX-M–producing Non-Typhi Salmonella spp. Isolated from Humans, United States

    OpenAIRE

    Sjölund-Karlsson, Maria; Howie, Rebecca; Krueger, Amy; Rickert, Regan; Pecic, Gary; Lupoli, Kathryn; Folster, Jason P.; Whichard, Jean M.

    2011-01-01

    CTX-M–type β-lactamases are increasing among US Enterobacteriaceae isolates. Of 2,165 non-Typhi Salmonella isolates submitted in 2007 to the National Antimicrobial Resistance Monitoring System, 100 (4.6%) displayed elevated MICs (>2 mg/L) of ceftriaxone or ceftiofur. Three isolates (serotypes Typhimurium, Concord, and I 4,5,12:i:–) contained bla CTX-M-5, bla CTX-M-15, and bla CTX-M-55/57, respectively.

  11. Molecular Basis of AmpC Hyperproduction in Clinical Isolates of Escherichia coli

    OpenAIRE

    Nelson, E C; Elisha, B. Gay

    1999-01-01

    DNA sequencing data showed that five clinical isolates of Escherichia coli with reduced susceptibility to ceftazidime, ceftriaxone, and cefotaxime contain an ampC gene that is preceded by a strong promoter. Transcription from the strong promoter was 8- to 18-fold higher than that from the promoter from a susceptible isolate. RNA studies showed that mRNA stability does not play a role in the control of AmpC synthesis.

  12. In vitro susceptibility of cephalothin-resistant Enterobacteriaceae and Pseudomonas aeruginosa to Amikacin and selected new beta-lactam agents.

    OpenAIRE

    McNamara, B T; Meyer, R D; Pasiecznik, K A

    1982-01-01

    Amikacin was evaluated in vitro by agar dilution testing against 148 different clinical isolates of cephalothin-resistant Enterobacteriaceae and Pseudomonas aeruginosa in parallel with cephalothin, cefoxitin, moxalactam, N-formimidoyl thienamycin, ceftriaxone, and cefmenoxime. Cefsulodin was also evaluated against 39 isolates of P. aeruginosa. More than 80% of all isolates tested were also gentamicin resistant, as determined by disk testing. Moxalactam and amikacin had comparable high activit...

  13. In vitro and in vivo activities of LB10522, a new catecholic cephalosporin.

    OpenAIRE

    Kim, M.Y.; Oh, J. I.; Paek, K S; Kim, Y Z; Kim, I. C.; Kwak, J. H.

    1996-01-01

    In vitro activity of LB10522 was compared with those of cefpirome, ceftazidime, ceftriaxone, and cefoperazone against clinical isolates. Against gram-positive bacteria, LB10522 was most active among the compounds tested. It was fourfold more active than cefpirome against methicillin-susceptible Staphylococcus aureus and Enterococcus faecalis. LB10522 was highly effective against most members of the family Enterobacteriaceae tested. Ninety percent of isolates of Escherichia coli, Klebsiella ox...

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

    OpenAIRE

    Ali Abdollahi, Ahad Bavili-Tabrizi

    2016-01-01

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

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

    OpenAIRE

    Hancu Gabriel; Kelemen Hajnal; Rusu Aura; Gyéresi Árpád

    2013-01-01

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

  16. Enterococcus faecalis infective endocarditis

    DEFF Research Database (Denmark)

    Dahl, Anders; Bruun, Niels Eske

    2013-01-01

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

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

    OpenAIRE

    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...

  18. 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. PMID:26068350

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

    OpenAIRE

    Then, R L; Angehrn, P

    1982-01-01

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

  20. PCR-Based Quantification of Borrelia burgdorferi Organisms in Canine Tissues over a 500-Day Postinfection Period

    OpenAIRE

    Straubinger, Reinhard K.

    2000-01-01

    Borrelia burgdorferi infection in beagle dogs was studied quantitatively with skin punch biopsy samples and blood samples collected at 4- and 2-week intervals, respectively, over a 500-day period. Thereafter, 25 tissue samples of each dog were collected for further analysis. Starting at day 120 after tick challenge, 12 dogs were treated with antibiotics (azithromycin, ceftriaxone, or doxycycline) for 30 consecutive days. Four dogs received no antibiotic therapy. Quantification of B. burgdorfe...

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

    OpenAIRE

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

    1983-01-01

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

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

    OpenAIRE

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

    1986-01-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

  4. 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

    OpenAIRE

    Jayter Silva Paula; Antonio Augusto Velasco e Cruz; Patrícia Mitiko Santelo Akaishi; Tiana Burman

    2008-01-01

    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 gr...

  5. Early Diagnosis of Leptospirosis

    OpenAIRE

    Andrea Babic-Erceg; Diana Karlovic-Martinkovic; Marija Santini; Zdenka Persic; Tatjana Vilibic-Cavlek

    2014-01-01

    A 25-years old man from Zagreb, Croatia, was admitted to the University Hospital for Infectious Diseases four days after the onset of symptoms such as fever, intense pain in the calves and anuria. The patient owned a rabbit and, before the onset of the disease, repaired some rubber pipes damaged by rodents. At admission, he had a severe clinical picture with fever, hypotension, jaundice, immobility, and pain in leg muscles. Treatment with ceftriaxone was initiated in combination with volume r...

  6. Microbial profile in women with puerperal sepsis in Gadarif State, Eastern Sudan

    Directory of Open Access Journals (Sweden)

    Mohamed Issa Ahmed

    2013-01-01

    Full Text Available Background: Increasingly, women in rural areas in Sudan reported to hospital with puerperal sepsis. Aims: This study was design to identify the common pathogens causing puerperal sepsis and their susceptibility to current antibiotics. Materials and Methods: We prospectively studied 170 women from January 2011 through December 2012 who attended Hussein Mustafa Hospital for Obstetrics and Gynecology at Gadarif State, Sudan. We included patients if they met the criteria proposed by the World Health Organization (WHO for definition of puerperal sepsis. Results: Out of the 170 patients, 124 (72.9% were pathogen-positive samples. Out of 124 positive isolates, aerobes were the predominant isolates 77 (62.1% which included Staphylococcus aureus 49 (39.5%, Staphylococcus epidermidis 7(5.6%, and Listeria monocytogenes 21 (16.9%. The anaerobe isolates were Clostridium perfringens 34 (27.4% and Enterobactor cloacae 13 (10.5%. Standard biochemical test were for bacterial isolation. Higher rate of infections followed vaginal delivery compared to Cesarean section, 121 (97.6% and 3 (2.5%, respectively. All strains of Staph were sensitive to vancomycin, gentamicin, and ceftriaxone. C. perfringens were sensitive to ceftriaxone, penicillin, vancomycin, and metronidazole, while E. cloacae was sensitive to gentamicin and ceftriaxone. Conclusion: In this study, the main bacteriological isolates were S. aureus, S. epidermidis, L. monocytogenes, C. perfringens, and E. cloacae. Despite the limited resources in the developing countries, treatment based on cultures remains the only solution to reduce maternal morbidity and mortality rates following puerperal sepsis.

  7. In vitro effects of sulbactam combinations with different antibiotic groups against clinical Acinetobacter baumannii isolates.

    Science.gov (United States)

    Deveci, Aydin; Coban, Ahmet Yilmaz; Acicbe, Ozlem; Tanyel, Esra; Yaman, Gorkem; Durupinar, Belma

    2012-10-01

    Treatment of multidrug resistant (MDR) Acinetobacter baumannii infections causes some problems as a result of possessing various antibacterial resistance mechanisms against available antibiotics. Combination of antibiotics, acting by different mechanisms, is used for the treatment of MDR bacterial infections. It is an important factor to determine synergy or antagonism between agents in the combination for the constitution of effective therapy. The study aimed to determine In vitro interactions interpreted according to calculated fractional inhibitory concentration (FIC) index between sulbactam and ceftazidime, ceftriaxone, cefepime, ciprofloxacin, gentamicin, meropenem, tigecycline, and colistin. Ten clinical isolates of A. baumannii were tested for determination of synergistic effects of sulbactam with different antimicrobial combinations. Minimal inhibitory concentration (MIC) values of both sulbactam and combined antibiotics decreased 2- to 128-fold. Synergy and partial synergy were determined in combination of sulbactam with ceftazidime and gentamicin (FIC index: ≤ 0.5 or >0.5 to sulbactam. Although synergistic and partial synergistic effects were observed in the combination of sulbactam and ceftriaxone, all isolates remained resistant to ceftriaxone. The effect of cefepime-sulbactam combination was synergy in five, partial synergy in one and indifferent in four isolates. Meropenem and sulbactam showed a partial synergistic effect (FIC index: >0.5 to 1-2) in six isolates. Antagonism was not determined in any combination for clinical A. baumannii isolates in the study. In conclusion, sulbactam is a good candidate for combination treatment regimes for MDR A. baumannii infections. PMID:23182043

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

    Science.gov (United States)

    Ijyuuin, Toshiro; Umehara, Fujio

    2012-01-01

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

  9. Possible transfer of plasmid mediated third generation cephalosporin resistance between Escherichia coli and Shigella sonnei in the human gut.

    Science.gov (United States)

    Rashid, Harunur; Rahman, Mahbubur

    2015-03-01

    Choice of antibiotic for treatment of serious bacterial infection is rapidly diminishing by plasmid mediated transfer of antibiotic resistance. Here, we report a possible horizontal transfer of plasmid carrying third-generation-cephalosporin (TGC) resistance between Escherichia coli and Shigella sonnei. Two different types of colonies were identified in MacConkey agar plate from a faecal specimen collected from a patient with shigellosis. The colonies were identified as E. coli and S. sonnei. Both of the isolates were resistant to ampicillin, chloramphenicol, co-trimoxazole, erythromycin, azithromycin, nalidixic acid, ceftriaxone, cefixime, ceftazidime, cefotaxime and susceptible to co-amoxiclave, amikacin, imipenam, astreonam, levofloxacin, moxifloxacin, mecillinam. These two strains were positive for extended spectrum β-lactamase. We were able to transfer ESBL producing property from both ceftriaxone-resistant isolates to the ceftriaxone susceptible recipient E. coli K12 and S. sonnei. Plasmid profile analysis revealed that the first-generation E. coli K12 and S. sonnei transconjugants harbored a 50MDa R plasmid, as two-parent ESBL-producing S. sonnei and E. coli strains. Similar patterns of ESBL producing plasmid and transferable antimicrobial phenotype suggests that the ESBL producing plasmid might transferred between E. coli and S. sonnei through conjugation in the human gut. PMID:25461693

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

    Directory of Open Access Journals (Sweden)

    L. Yu. Chernikova

    2016-02-01

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

  11. [In vitro activity of piperacillin-tazobactam against Klebsiella pneumoniae clinical isolates, producers or not of extended spectrum beta-lactamases].

    Science.gov (United States)

    Alarcón, T; de la Obra, P; López-Hernandez, S; de las Cuevas, C; López-Brea, M

    1999-09-01

    The aim of this study was to determine the in vitro activity of piperacillin-tazobactam against 81 clinical isolates of Klebsiella pneumoniae. The clinical specimens were processed according to standard microbiological procedures and 81 K. pneumoniae isolates were identified using MicroScan Panels following the manufacturer's recommendations. A double disk diffusion method was applied to detect extended spectrum betalactamases (ESBL) (43 isolates were positive and 38 were negative). Minimum inhibitory concentrations (MIC) were determined by an agar dilution technique using Mueller-Hinton. The following antibiotics were studied: piperacillin with 4 mg/l of tazobactam, amoxicillin-clavulanic acid in a 2:1 proportion, cefotaxime, ceftriaxone, cefepime, imipenem and meropenem. The MIC(90) were 16/4 mg/l for piperacillin-tazobactam, 16/8 for amoxicillin-clavulanic acid, 16 for ceftriaxone, 16 for cefotaxime, 4 for cefepime, 0.25 for imipenem and 0.032 for meropenem in ESBL-positive strains. In ESBL-negative strains the MIC90 were as follows: 4/4 mg/l for piperacillin-tazobactam, 8/4 for amoxicillin-clavulanic acid, 0.064 for ceftriaxone, 0.125 for cefotaxime, 0.125 for cefepime, 0.125 for imipenem and 0.016 for meropenem. All betalactams showed excellent in vitro activity against ESBL non-producer K. pneumoniae. Moreover, piperacillin-tazobactam and both carbapenems showed good in vitro activity against EBSL-producer K. pneumoniae. PMID:10878513

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

    International Nuclear Information System (INIS)

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

  13. 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.

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

    Science.gov (United States)

    Davis, Johnnie A; Jackson, Charlene R

    2009-03-01

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

  15. Susceptibility of respiratory isolates of Streptococcus pneumoniae isolated from children hospitalized in the Clinical center Niš

    Directory of Open Access Journals (Sweden)

    Dinić Marina M.

    2016-01-01

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

  16. Case report: papillitis as the sole ocular sign in Lyme disease

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    McVeigh K

    2012-07-01

    Full Text Available Katherine McVeigh, Georgios VakrosDepartment of Ophthalmology, Raigmore Hospital, Inverness, United KingdomBackground: Lyme disease is a spirochetal disease responsible for a multitude of ocular and systemic manifestations, and patients may present to ophthalmologists and general clinicians with a wide variety of generalized and ocular signs which can result in chronic and disabling sequelae. Here we report two cases of patients suffering with Lyme disease who developed a rare associated papillitis.Methods: A 48-year-old Scottish man presented with diminished visual acuity, painful ocular eye movements, photophobia, and mild ataxia. Fundus examination revealed bilateral disc swelling with associated hemorrhages in the right eye. Following exclusion of raised intracranial pressure as the cause of the findings, enzyme-linked immunosorbent assay and Western blot serology confirmed a positive result for Borrelia burgdorferi which, along with ophthalmic signs and exposure to an endemic area, confirmed the diagnosis of Lyme disease. A 79-year-old gentleman presented with intermittent short-duration “gray film” in his left eye. Fundus examination revealed left optic disc swelling. He was positive for Lyme’s serology and his condition was treated with 2 weeks of intravenous ceftriaxone.Results: The first patient’s inflammation resolved and visual acuity returned to normal following a course of high-dose steroids and intravenous ceftriaxone, followed by oral doxycycline. The second patient’s condition improved with high-dose intravenous ceftriaxone.Conclusion: These patients highlight the fact that Lyme disease should be considered as a differential diagnosis for patients presenting with papillitis. With the incidence of this disease rising and more cases being reported, practitioners in Lyme-endemic areas need to be aware of the various manifestations so that appropriate referrals for treatment can be made.Keywords: Lyme disease, ocular

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

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    Azita Fesharakinia

    2012-08-01

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

  18. 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.

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

    OpenAIRE

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

    1991-01-01

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

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

    OpenAIRE

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

    1990-01-01

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

  1. 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.

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

    Science.gov (United States)

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

    2013-02-01

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

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

    Science.gov (United States)

    Unemo, Magnus

    2015-01-01

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

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

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    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.

  5. Antibiotic Adjuvant Therapy for Multi-Drug Resistant Carbapenemases Producing Klebsiella pneumoniae Associated Sepsis: A Case Study.

    Science.gov (United States)

    Gupta, Robin

    2016-04-01

    Rising resistance and spread of K. pneumoniae strains, create great concerns in treating sepsis patients due to high incidence of mortality and morbidity. The current study is a case of a 20-year-old male with sepsis and bilateral lung lesions infected with Multi-Drug Resistant (MDR) carbapenemase producing K. pneumoniae (KPC) showing resistance to carbapenem and polymyxin. Based on sensitivity report, patient was put on antibiotic adjuvant: Elores (ceftriaxone, sulbactam, disodium edetate) along with fluconazole for 10 days. Elores was instituted with remarkable recovery and patient was discharged. PMID:27190808

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

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    Manu Chaudhary

    2012-03-01

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

  7. Liver abscess caused by Brevundimonas vesicularis in an immunocompetent patient.

    Science.gov (United States)

    Yoo, Seu Hee; Kim, Min Ja; Roh, Kyoung Ho; Kim, Si Hyun; Park, Dae Won; Sohn, Jang Wook; Yoon, Young Kyung

    2012-10-01

    Invasive infections caused by Brevundimonas vesicularis are very rare in humans. We experienced an unusual case of liver abscess due to B. vesicularis in an immunocompetent young male. The patient was successfully treated by liver abscess drainage and with antimicrobial therapy of ceftriaxone followed by ampicillin/sulbactam. The organism found in the aspiration culture of the abscess material was initially reported, by using a VITEK 2 system, as Sphingomonas paucimobilis. However, later, B. vesicularis was confirmed as the true pathogen through 16S rRNA gene sequencing. To our knowledge, this is the first case of liver abscess caused by B. vesicularis. PMID:22767540

  8. Comparison of the activity of imipenem and beta-lactams combined with sulbactam and clavulanic acid in beta-lactamase-producing strains of Bacteroides fragilis.

    Science.gov (United States)

    Martín, M A; Castillo, A M; Liébana, J; Marín, A; Alados, J C; Piédrola, G

    1991-01-01

    We compared the "in vitro" activity of imipenem with 14 beta-lactams, both alone and in combination with clavulanic acid, and sulbactam against 110 beta-lactamase-producing strains of Bacteroides fragilis. The following antibiotics were tested: amoxycillin, penicillin, mezlocillin, piperacillin, cephalothin, cephazolin, cefamandole, cefmetazole, cefonicid, cefoxitin, cefotaxime, ceftazidime, ceftizoxime, and ceftriaxone. In all cases, except those of cefoxitin and cefmetazole, these combinations showed a statistically significant increase in beta-lactam activity, which was, however, never higher than that of imipenem, the antibiotic which performed best against Bacteroides fragilis. PMID:1940333

  9. Antimicrobial susceptibilities of clinical isolates of Acinetobacter baumannii from Singapore.

    Science.gov (United States)

    Kuah, B G; Kumarasinghe, G; Doran, J; Chang, H R

    1994-10-01

    The in vitro activities of 17 antimicrobial agents alone or in combination against 70 clinical isolates of Acinetobacter baumannii from Singapore were determined by broth microdilution. The MICs of amoxicillin, ampicillin, ceftazidime, ceftriaxone, gentamicin, and piperacillin for 90% of the strains were > or = 128 micrograms/ml. Addition of sulbactam to ampicillin produced improved activity, whereas adding tazobactam to piperacillin did not. The MICs of amikacin, ciprofloxacin, and imipenem for 90% of the strains were 32, 32, and 16 micrograms/ml, respectively. PMID:7840598

  10. Tocilizumab Efficacy in a Patient with Positive Anti-CCP Chronic Lyme Arthritis

    Science.gov (United States)

    Hirsch, Julianna; Rosner, Itzhak; Rimar, Doron; Kaly, Lisa; Rozenbaum, Michael; Boulman, Nina; Slobodin, Gleb

    2016-01-01

    Context: Lyme arthritis, a manifestation of tick-borne Lyme disease, can prove to be refractory to classic treatment. Case Report: We present a case of a 48-year-old male, diagnosed with chronic Lyme arthritis, refractory to recurrent and prolonged courses of doxycycline, ceftriaxone, as well as hydroxychloroquine and methotrexate. The patient responded partially to tumor necrosis factor (TNF)-alpha blockade by etanercept and, finally, entered long-term remission after his treatment was switched to tocilizumab. Conclusion: Off label treatment by biologic disease modifying antirheumatic drugs can be considered in selected patients with severe antibiotic-resistant Lyme arthritis.C. PMID:27213145

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

    OpenAIRE

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

    2012-01-01

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

  12. [Follow-up after non-typhoidal Salmonella bacteraemia is important due to risk of endovascular infection].

    Science.gov (United States)

    Sydenham, Thomas Vognbjerg; Andersen, Åse Bengård

    2015-01-26

    An 81-year-old male with atherosclerosis had an episode of bacteraemia with Salmonella dublin six weeks prior to admission to hospital. He presented with confusion, fever and abdominal pain. Blood cultures revealed S. dublin, and an 18F-fluor deoxyglucose positron emission tomography/computed tomography showed aortitis. Ceftriaxon and ciprofloxacin was administered. The patient was not a candidate for surgery and two weeks later he died from multiple organ failure. Follow-up visits with blood cultures after the first bacteraemia episode might have allowed for earlier diagnosis of the relapse. PMID:25612984

  13. Haemophilus parainfluenzae urethritis among homosexual men.

    Science.gov (United States)

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

    2015-08-01

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

  14. Acquisition of Extended-Spectrum β-Lactamases by Escherichia coli and Klebsiella pneumoniae in Gut Microbiota of Pilgrims during the Hajj Pilgrimage of 2013.

    Science.gov (United States)

    Leangapichart, Thongpan; Dia, Ndèye Méry; Olaitan, Abiola Olumuyiwa; Gautret, Philippe; Brouqui, Philippe; Rolain, Jean-Marc

    2016-05-01

    We reported the acquisition of extended-spectrum-β-lactamase (ESBL)-producing bacteria in rectal samples of 129 pilgrims during the 2013 Hajj (pilgrimage to Makkah). When returning from the Hajj, there was a significant increase in the number of pilgrims carrying E. coli resistant to ceftriaxone (P = 0.008). The CTX-M gene was detected in rectal samples, with the detection rate increasing from 10.08% to 32.56% of samples after the Hajj (P < 0.001). PMID:26976866

  15. Disease: H00305 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ycin [DR:D08526] Pregnant women should be treated with either erythromycin or ceftriaxone regimens. ...id: clinical manifestations, diagnosis, and management. Sex Transm Infect 79:68-7...ol 42:182-90 (2003) PMID:15918786 (description) Annan NT, Lewis DA Treatment of chancroid in resource-poor c...der bacterium Haemophilus ducreyi. It is a classical genito-ulcerative disease accom...lidum, and herpes simplex virus types 1 and 2 from genital ulcers. J Clin Microbiol 34:49-54 (1996) ...

  16. Antibiotic Adjuvant Therapy for Multi-Drug Resistant Carbapenemases Producing Klebsiella pneumoniae Associated Sepsis: A Case Study

    Science.gov (United States)

    2016-01-01

    Rising resistance and spread of K. pneumoniae strains, create great concerns in treating sepsis patients due to high incidence of mortality and morbidity. The current study is a case of a 20-year-old male with sepsis and bilateral lung lesions infected with Multi-Drug Resistant (MDR) carbapenemase producing K. pneumoniae (KPC) showing resistance to carbapenem and polymyxin. Based on sensitivity report, patient was put on antibiotic adjuvant: Elores (ceftriaxone, sulbactam, disodium edetate) along with fluconazole for 10 days. Elores was instituted with remarkable recovery and patient was discharged. PMID:27190808

  17. Salmonella pneumonia complicated with encysted empyema in an immunocompromised youth: Case report and literature Review.

    Science.gov (United States)

    Saeed, Nermin Kamal

    2016-01-01

    In this case report we described a Bahraini male patient of twenty years of age, a smoker and diagnosed with stage IV B Hodgkin lymphoma. He presented with fever, nonproductive cough, upper back pain and shortness of breath due to right upper lobe pneumonia with right encysted pleural effusion. Salmonella enterica serotype Enteritidis was isolated from the sputum. He was successfully treated with 2 weeks of ceftriaxone followed by 2 weeks of oral cefixime. This was the first case of encysted empyema caused by Salmonella enterica serotype Enteritidis reported in the Kingdom of Bahrain. The different aspects of pulmonary Salmonella infections were discussed and the literature was reviewed. PMID:27131011

  18. Availability of cefixime 400 mg tablets--United States, April 2008.

    Science.gov (United States)

    2008-04-25

    The only current CDC-recommended options for treating Neisseria gonorrhoeae infections are from a single class of antibiotics, the cephalosporins. Within this class, ceftriaxone, available only as an injection, is the recommended treatment for all types of gonorrhea infections (i.e., urogenital, rectal, and pharyngeal). The only oral agent recommended currently by CDC for treatment of uncomplicated urogenital or rectal gonorrhea is a single dose of cefixime 400 mg. Availability of cefixime had been limited since July 2002, when Wyeth Pharmaceuticals (Collegeville, Pennsylvania) discontinued manufacturing cefixime tablets in the United States. Beginning in April 2008, cefixime (Suprax) 400 mg tablets are again available in the United States. PMID:18437119

  19. 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. PMID:21914415

  20. Inhibitor-Based Methods for Detection of Plasmid-Mediated AmpC β-Lactamases in Klebsiella spp., Escherichia coli, and Proteus mirabilis

    OpenAIRE

    Coudron, Philip E.

    2005-01-01

    Non-beta-lactam inhibitor-based methods were evaluated for detecting plasmid-mediated AmpC β-lactamases in Klebsiella spp., Escherichia coli, and Proteus mirabilis. Using CLSI methodology and disks containing cefotetan alone and in combination with 400 μg of boronic acid, 9 of 10 positive control strains and 54 of 55 AmpC-PCR-positive clinical isolates were detected. Importantly 71% and 40% of these clinical isolates were susceptible by routine testing to ceftriaxone and ceftazidime, respecti...

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    M. Taherzadeh

    2014-01-01

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

  3. 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.

  4. [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. PMID:15566265

  5. 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.

  6. 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.

  7. 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......, 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...

  8. Gonorrhoea of the sigmoid neovagina in a male-to-female transgender.

    Science.gov (United States)

    van der Sluis, Wouter B; Bouman, Mark-Bram; Gijs, Luk; van Bodegraven, Adriaan A

    2015-07-01

    A 33-year-old male-to-female transgender consulted our outpatient clinic with perneovaginal bleeding during and following coitus. Four years before, she underwent a total laparoscopic sigmoid neovaginoplasty. Physical, histological and endoscopic examination revealed neither focus of active bleeding nor signs of active inflammation. A polymerase chain reaction test performed on a neovaginal swab showed gonococcal infection. Treatment consisted of 500 mg intramuscular ceftriaxone. Three weeks later, our patient reported resolution of symptoms, consistent with eradication of the infection demonstrated by a follow-up neovaginal swab polymerase chain reaction. To our knowledge, this is the first case report of gonococcal infection of the sigmoid neovagina. PMID:25060698

  9. 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.

  10. Antimicrobial resistance among Clostridium perfringens isolated from various sources in Thailand.

    Science.gov (United States)

    Tansuphasiri, Unchalee; Matra, Wiriya; Sangsuk, Leelaowadee

    2005-07-01

    Antimicrobial resistance among Clostnridium perfringens isolated from feces of humans and pigs, food and other environmental sources was examined by testing of 201 PCR-confirmed strains for resistance to 7 antimicrobial agents. The minimal inhibitory concentrations (MICs) were determined by the agar dilution method. Overall, C. perfringens showed the highest resistance to tetracycline (56.2%), followed by imipenem (24.9%), metronidazole (9.5%), penicillin G (9%), vancomycin (4.5%), chloramphenicol (3%) and ceftriaxone (1%). The majority of the isolated strains from pig feces (77.8%), environment (72.7%), human feces (44.9%) and food (28%) showed resistance to tetracycline. Strains isolated from human feces only showed low resistance to ceftriaxone (2.5%) and vancomycin (10.1%). Penicillin G had high activity, with overall MIC50 and MIC90 of 0.06 and 1.0 microg/ml, respectively, and low rate of resistance (10-12% for strains isolated from humans, animals and food). Among 62.7% of antimicrobial resistant strains, 39.3% were resistant to a single drug and 23.4% were multiple-drug resistant (MDR). Of overall 47 MDR strains, 63.8% were derived from human feces and were resistant to two to six drugs. PMID:16295551

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

    Directory of Open Access Journals (Sweden)

    Gouveia Edilane L

    2011-11-01

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

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

    Science.gov (United States)

    Unemo, Magnus; Shafer, William M

    2011-08-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Sunniva eFoerster

    2015-12-01

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

  15. 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

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

    Science.gov (United States)

    2016-05-01

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

  17. 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.

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

    Science.gov (United States)

    2016-05-01

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

  19. Characterization of extended-spectrum beta-lactamases and antimicrobial resistance of Klebsiella pneumoniae in intra-abdominal infection isolates in Latin America, 2008-2012. Results of the Study for Monitoring Antimicrobial Resistance Trends.

    Science.gov (United States)

    Kazmierczak, Krystyna M; Lob, Sibylle H; Hoban, Daryl J; Hackel, Meredith A; Badal, Robert E; Bouchillon, Samuel K

    2015-07-01

    The Study for Monitoring Antimicrobial Resistance Trends has monitored the in vitro activity of several recommended antimicrobials used in the management of intra-abdominal infections (IAIs) globally since 2002. In this report, we document the changing susceptibility patterns to recommended antimicrobials in Klebsiella pneumoniae isolates from patients with IAIs in 11 Latin American countries between 2008 and 2012 and describe the beta-lactamases encoded by phenotypically extended-spectrum beta-lactamase (ESBL)-positive and ertapenem-nonsusceptible isolates. Overall, the incidence of phenotypically ESBL-positive K. pneumoniae did not change significantly from 2008 (40.4%) to 2012 (41.2%) (P > 0.05). However, trend analysis documented an increase in isolates encoding K. pneumoniae carbapenemase (KPC) or both KPC and an ESBL. Decreasing susceptibility (P ceftriaxone, ertapenem, and imipenem among all K. pneumoniae, as well as for cefepime, cefotaxime, cefoxitin, ceftriaxone, ertapenem, and imipenem among ESBL-positive isolates, while susceptibility of ESBL-negative isolates to ampicillin-sulbactam actually increased (P < 0.05). PMID:25956930

  20. Antimicrobial treatment of lower respiratory tract infections in the hospital setting.

    Science.gov (United States)

    Grossman, Ronald F; Rotschafer, John C; Tan, James S

    2005-07-01

    Respiratory tract infections (RTIs) that may require hospitalization include acute exacerbations of chronic bronchitis (AECB), community-acquired pneumonia (CAP), and hospital-acquired pneumonia (HAP), which includes ventilator-associated pneumonia (VAP). Healthcare-associated pneumonia (HCAP) is treated similar to HAP and may be considered with HAP. For CAP requiring hospitalization, the current guidelines for the treatments of RTIs generally recommend either a beta-lactam and macrolide combination or a fluoroquinolone. The respiratory fluoroquinolones (levofloxacin, gatifloxacin, moxifloxacin, and gemifloxacin) are excellent antibiotics due to high levels of susceptibility among gram-negative, gram-positive, and atypical pathogens. The fluoroquinolones are active against > 98% of Streptococcus pneumoniae, including penicillin-resistant strains. Fluoroquinolones are also recommended for AECB requiring hospitalization. Evidence from clinical trials suggests that levofloxacin monotherapy is as efficacious as combination ceftriaxone-erythromycin therapy in the treatment of patients hospitalized with CAP. For early-onset HAP, VAP, and HCAP without the risk of multidrug resistance, ceftriaxone, ampicillin-sulbactam, ertapenem, or one of the fluoroquinolones is recommended. High-dose, short-course therapy regimens may offer improved treatment due to higher drug concentrations, more rapid killing, increased adherence, and the potential to reduce development of resistance. Recent studies have shown that short-course therapy with levofloxacin, azithromycin, or telithromycin in patients with CAP was effective, safe, and tolerable and may control the rate of resistance. PMID:15993675

  1. The in vitro activity of beta-lactamase inhibitors in combination with cephalosporins against M. tuberculosis.

    Science.gov (United States)

    Chen, C H; Yang, M H; Lin, J S; Lee, Y C; Perng, R P

    1995-04-01

    Although there are reports that the addition of a beta-lactamase inhibitor to ampicillin or amoxicillin greatly improves their in vitro activity against M. tuberculosis, there are no written reports about the antituberculosis effects of beta-lactamase inhibitors in combination with cephalosporins against M. tuberculosis. In this report, we have determined the minimal inhibitory concentrations (MIC) of 5 cephalosporins with or without combination with beta-lactamase inhibitor against M. tuberculosis strains isolated from patients before antituberculosis treatment and checked the production of beta-lactamase by bacteria before this procedure. Four strains of M. tuberculosis were contaminated during the experiment, and all the other 16 strains hydrolyzed the nitrocefin disc, thus indicating a beta-lactamase producer. The MICs of cephalosporins alone against M. tuberculosis were 200-400 micrograms/ml for ceforanide, 100-400 micrograms/ml for cephapirin, 400-1600 micrograms/ml for cefamandole, 200-1600 micrograms/ml for cefotaxime, and 800-1600 micrograms/ml for ceftriaxone. After adding the equimolar concentrations of sulbactam, the MICs were reduced to 100-200 micrograms/ml for ceforanide, 12.5-100 micrograms/ml for cephapirin, 100-400 micrograms/ml for cefamandole, 25-200 micrograms/ml for cefotaxime, and 100-800 micrograms/ml for ceftriaxone. We concluded that sulbactam enhanced the antituberculosis effect of cephalosporins. PMID:7624446

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    M. Liconti

    2001-09-01

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

  4. 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

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

    Directory of Open Access Journals (Sweden)

    R Nalini

    2014-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  8. 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.

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

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    Ivan S. Pradipta

    2012-03-01

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

  10. Cocaine-induced loss of white matter proteins in the adult mouse nucleus accumbens is attenuated by administration of a β-lactam antibiotic during cocaine withdrawal.

    Science.gov (United States)

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

    2012-12-01

    We report significantly decreased white matter protein levels in the nucleus accumbens in an adult mouse model of chronic cocaine abuse. Previous studies from human cocaine abuse patients show disruption of white matter and myelin loss, thus supporting our observations. Understanding the neuropathological mechanisms for white matter disruption in cocaine abuse patients is complicated by polydrug use and other comorbid factors, hindering the development of effective therapeutic strategies to ameliorate damage or compliment rehabilitation programs. In this context, our data further demonstrate that cocaine-induced loss of white matter proteins is absent in mice treated with the β-lactam antibiotic, ceftriaxone, during cocaine withdrawal. Other studies report that ceftriaxone, a glutamate transporter subtype-1 activator, is neuroprotective in murine models of multiple sclerosis, thereby demonstrating potential therapeutic properties for diseases with white matter loss. Cocaine-induced white matter abnormalities likely contribute to the cognitive, motor, and psychological deficits commonly afflicting cocaine abusers, yet the underlying mechanisms responsible for these changes remain unknown. Our observations describe an adult animal model for the study of cocaine-induced myelin loss for the first time, and highlight a potential pharmacological intervention to ameliorate cocaine-induced white matter loss. PMID:23031254

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

    Science.gov (United States)

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

    2012-10-15

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

  12. 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

  13. 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.

  14. Antibiotic susceptibility patterns of Crossiella equi and Amycolatopsis species causing nocardioform placentitis in horses.

    Science.gov (United States)

    Erol, Erdal; Williams, Neil M; Sells, Stephen F; Kennedy, Laura; Locke, Stephen J; Donahue, James M; Carter, Craig N

    2012-11-01

    Nocardioform actinomycetes are significant causes of placentitis and abortions in horses. In the current study, antimicrobial susceptibility patterns of 38 Amycolatopsis spp. and 22 Crossiella equi isolates, the most common nocardioform actinomycetes causing placentitis in horses, were evaluated. Antimicrobial susceptibilities of these isolates were tested by broth microdilution method in a commercial system, which was designed for Nocardia spp., fast-growing Mycobacterium spp., and other aerobic actinomycetes. The minimum inhibitory concentration required to inhibit the growth of 90% of organisms (MIC(90)) of the following antibiotics tested for Amycolatopsis spp. were: 4 µg/ml for linezolid, trimethophrim-sulfametaxazole (TMP-SMX), and ciprofloxacin; 8 µg/ml for ceftriaxone, doxycycline, and minocycline; 16 µg/ml for amoxicillin-clavulanic acid, clarithromycin, and imipenem; >16 µg/ml for tobramycin; 32 µg/ml for amikacin and cefepime; and 128 µg/ml for cefoxitin. The MIC(90) levels for C. equi were 0.25 µg/ml for doxycycline; ≤1 µg/ml for minocycline; 2 µg/ml for linezolid and TMP-SMX; 4 µg/ml for ciprofloxacin; 8 µg/ml for amoxicillin-clavulanic acid, ceftriaxone, and imipenem; 16 µg/ml for clarithromycin; >16 µg/ml for tobramycin; 32 µg/ml for cefepime; >64 µg/ml for amikacin; and 128 µg/ml for cefoxitin. PMID:23051830

  15. Acute Haemophilus parainfluenzae endocarditis: a case report

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    Christou Leonidas

    2009-07-01

    Full Text Available Abstract Introduction Numerous pathogens can cause infective endocarditis, including Haemophilus parainfluenzae. H. parainfluenzae is part of the H. aphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae group that may cause about 3% of the total endocarditis cases, and is characterized by a subacute course and large vegetations. Case presentation Acute H. parainfluenzae endocarditis developed in a 54-year-old woman, with no underlying predisposing factors. The patient presented with fever of 3 days duration and a severe headache. Magnetic resonance imaging of the brain revealed multiple cerebral emboli with hemorrhagic foci. Upon suspicion of endocarditis, cardiac transesophageal ultrasonography was performed and revealed massive vegetations. The patient underwent emergency mitral valve replacement, and was further treated with ceftriaxone. Blood cultures grew H. parainfluenzae only after valve replacement, and a 6-week course of ceftriaxone was prescribed. Conclusion We underline the typical presentation of large vegetations in H. parainfluenzae endocarditis, which are associated with embolic phenomena and resulting severity. Although the majority of the few cases reported in the literature are subacute in progress, our case further underlines the possibility that H. parainfluenzae endocarditis may develop rapidly. Thus, awareness of the imaging characteristics of the pathogen may enhance early appropriate diagnosis and therapeutic response.

  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. Outbreak of meningococcal disease in and around New Delhi, India, 2005-2006: a report from a tertiary care hospital.

    Science.gov (United States)

    Nair, D; Dawar, R; Deb, M; Capoor, M R; Singal, S; Upadhayay, D J; Aggarwal, P; DAS, B; Samantaray, J C

    2009-04-01

    The first of several cases of meningococcal meningitis was reported in April 2005, in New Delhi, India. Subsequent to this the Government declared an outbreak, which persisted for two periods, from April-July 2005 and January-March 2006. The National Institute of Communicable Diseases (NICD) recommended using WHO criteria for diagnosis of disease. During the outbreak 380 clinically suspected cases were investigated. Of 55 cases diagnosed as confirmed/probable the mortality rate was 14.6%. Meningitis was reported in 60% of cases and meningococcaemia in 40%. Microscopy of petechial rash was positive in 87.5%, CSF Gram stain positive in 68.3%, and latex agglutination test of CSF positive in 64.9% of samples. Neisseria meningitidis (serogroup A) was isolated from 37.7% of cases, 57.7% from CSF. Blood culture was positive in 10.4% of cases. CrgA polymerase chain reaction for N. meningitidis confirmed the isolates. All isolates were susceptible to third-generation cephalosporins, azithromycin and rifampicin, with increasing resistance to ceftriaxone. Penicillin resistance was encountered in 15.4% of strains. Resistance to quinolones was very high at 100% for levofloxacin, 84.6% for ofloxacin and 65.4% for ciprofloxacin. All patients with penicillin-resistant organisms (4) or intermediate sensitivity (4) succumbed to the disease. These patients also had a higher minimum inhibitory concentration to ceftriaxone. PMID:18840317

  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. 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.

  20. 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

  1. The use of antibiotics in hospitalized adult typhoid patients in an Indonesian hospital

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    Anggita Bunga Anggraini

    2014-08-01

    in the Indonesian Red Cross Hospital in Bogor (West Java during the period of July to December 2012. The analysis for typhoid was qualitatively (DU90% and quantitatively (DDD /hbd using ATC/DDD method.Results: From 459 typhoid patients, the total use of antibiotics in hospitalized adult typhoid patients during the period of July to December 2012 was6.35 DDD/hbd. The use of ceftriaxone had the highest DDD/hbd which was equal to 4.10 DDD/hbd. This meant out of 100 typhoid patients, 4 patients received 2 g ceftriaxone per day. Ceftriaxone was given in injection form. Furthermore, there were more drugs in segment 10% than 90% segment. From 26 types of antibiotics, 7 were included in the DU 90% segment which were ceftriaxone (64.54%; levofloxacin (13.90%; ciprofloxacin (3.57%; meropenem (2.80%; metronidazole (2.52%; ampicillin-sulbactam (1.65%; cefditoren pivoxil (1.60%.Conclusion: Ceftriaxone was the most widely used antibiotics in the treatment of hospitalized adult typhoid patients in a hospital in Indonesia. (Health Science Indones 2014;1:40-3Key words: antibiotics, typhoid, ATC/DDD, DU 90%

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

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

    2013-02-01

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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. To evaluate the clinical efficacy of a 99mTc-Scintibact for the diagnosis of orthopedic infections: first results

    International Nuclear Information System (INIS)

    Full text: A novel approach to infection imaging is the use of radiolabeled antibiotics. With the advent of time, the micro-organisms develop resistance to the extensively used antibiotics and there is a need to radiolabel newer generation antibiotics to increase the sensitivity and specificity of this imaging modality. In this study, we evaluated the clinical utility of 99mTc labeled ceftriaxone for the detection of orthopedic infections. Materials and Methods: Ceftriaxone- a third-generation cephalosporin antibiotic was successfully labeled with 99mTc with radiolabeling efficiency (≤99%) and formulated into a ready to use single vial kit preparation (Brand Name: Scintibact). Fourteen patients (10M; 4F, mean age 37.7 yrs, range 22-65 yrs) with clinical and radiological suspicion of orthopedic infection were recruited. All the patients underwent a 3-phase bone scan (740 MBq, 99mTc-MDP, i.v. injection) followed by (4 days later) 99mTc- ceftriaxone scanning (static/isotime images at 1h, 4h, 24h after i.v. administration of 555.0 MBq activity of the radiotracer). Whole body Scintibact scanning was also done to study the biodistribution of the radiotracer. The sample aspirates from site involved were taken and analyzed for the microbial growth. Results: Scintibact scan findings were positive in 11/14 and culture positive in 11/14 patients. The diagnostic accuracy of the technique was found to be 71.0%, sensitivity and specificity were 80% and 75% respectively. The bio-distribution studies indicated that 2/3rd and 1/3rd of the radiotracer excretes through the renal and hepato-biliary routes which corroborated with our animal experimentation performed using this preparation. Conclusions: Single vial kit preparation of Scintibact has reasonably good accuracy in the diagnosis of orthopedic infections. The use of this formulation needs to be validated in a large cohort of patients also in few treated and symptomatic cases of bone infection

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

    Institute of Scientific and Technical Information of China (English)

    于增照; 史同新; 李永喜; 徐敬星; 李民; 曲才杰; 陈官芝

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fung Chang-Phone

    2007-07-01

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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Chun Ian Soo

    2015-01-01

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

  12. Eyes can See What Mind Can’t see

    International Nuclear Information System (INIS)

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

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Judith P. M. Schots

    2014-01-01

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

  15. Pasteurella multocida bacterial meningitis caused by contact with pigs

    Directory of Open Access Journals (Sweden)

    C. López

    2013-01-01

    Full Text Available Pasteurella multocida belongs to the normal flora of the respiratory and digestive tract of many animals. Animal exposure is a considerable risk factor for Pasteurella infection. P. multocida is the most common cause of local infection after an animal bite but is an unusual cause of meningitis. We present a case of bacterial meningitis by P. multocida in a 37-year-old man who worked in a pig farm and was bitten by a pig. The patient had a defect located in the lamina cribosa and this lesion could be the gateway of the infection, although in this case the infection could also be acquired through the pig bite. The bacteria was identified as P. multocida with the biochemical test API 20E (bioMérieux. In agreement with findings in the literature, the strain was susceptible in vitro to penicillin, ampicillin, cefotaxime, ceftriaxone ciprofloxacin, levofloxacin, imipenem and tetracycline.

  16. Doxorubicine and antibiotics influence on dynamics of population development of Staphylococcus aureus and Escherichia coli

    Directory of Open Access Journals (Sweden)

    O.G. Shapoval

    2010-03-01

    Full Text Available Infectious complications in oncologic patients often occur as a result of antitumor therapy that demands the prescription of antimicrobic preparations. one of the main infectious agents in oncology is Staphylococci and Escherichia coli. The aim of this work is to study doxorubicine and ceftriaxon influence on dynamics of population development of strains of Staphylococcus aureus, doxorubicine and amikacine - on dynamics of population development of strains of Escherichia coli. Five strains of each type (one-standard and four-clinical cultivated in meatpeptone broth, which contains non-inhibitory concentrations of experimental preparations. in any period of time after the sowing the measurement of optical density of growing cultures has been carried out. it has been determined, that doxorubicine in non-inhibitory concentrations increases overwhelming effect of these antibiotics on dynamics of population development of experimental strains

  17. A case of meningococcal meningitis that was difficult to treat owing to concurrent ventriculitis.

    Science.gov (United States)

    Nakahara, Hiroaki; Oda, Toshimi; Fukao, Eri; Horiuchi, Izumi; Honma, Yutaka; Uchigata, Masanobu

    2016-05-31

    A 64-year-old male came to our hospital emergency department with fever and consciousness disturbance. Culture tests of blood and spinal fluid samples revealed meningococci (Neisseria meningitidis), and we made a diagnosis of meningococcal meningitis. Brain magnetic resonance imaging (MRI) findings revealed ventriculitis. Ceftriaxone was administered for 17 days, however, relapse was noted after that was discontinued, with neutropenia and renal impairment thought to be adverse reactions to the beta-lactam antibiotic. Hence, treatment was switched to oral administration of moxifloxacin for a total of 12 weeks, including in an outpatient setting. After moxifloxacin was discontinued, no side effects or relapse were seen, and treatment was ended. Although antibacterial agents generally show favorable effects for meningococcal meningitis, we consider that sufficient antimicrobial therapy is difficult in cases complicated with ventriculitis. PMID:27151225

  18. Cavity Forming Pneumonia Due to Staphylococcus aureus Following Dengue Fever.

    Science.gov (United States)

    Miyata, Nobuyuki; Yoshimura, Yukihiro; Tachikawa, Natsuo; Amano, Yuichiro; Sakamoto, Yohei; Kosuge, Youko

    2015-11-01

    While visiting Malaysia, a 22-year-old previously healthy Japanese man developed myalgia, headache, and fever, leading to a diagnosis of classical dengue fever. After improvement and returning to Japan after a five day hospitalization, he developed productive cough several days after defervescing from dengue. Computed tomography (CT) thorax scan showed multiple lung cavities. A sputum smear revealed leukocytes with phagocytized gram-positive cocci in clusters, and grew an isolate Staphylococcus aureus sensitive to semi-synthetic penicillin; he was treated successfully with ceftriaxone and cephalexin. This second reported case of pneumonia due to S. aureus occurring after dengue fever, was associated both with nosocomial exposure and might have been associated with dengue-associated immunosuppression. Clinicians should pay systematic attention to bacterial pneumonia following dengue fever to establish whether such a connection is causally associated. PMID:26304914

  19. [Borreliosis--simultaneous Lyme carditis and psychiatric disorders--case report].

    Science.gov (United States)

    Legatowicz-Koprowska, Marta; Gziut, Aneta I; Walczak, Ewa; Gil, Robert J; Wagner, Teresa

    2008-05-01

    Borreliosis is a multisystemic disease transmitted by ticks. Its diagnosis still remains a challenge because of the varied clinical picture and of difficulties in detection of the etiological agent (Borrelia burgdorferi). We report a case of a 53-years-old woman admitted to the Clinic of Cardiology due to life-threatening arhythmias with simultaneous deficits in concentration and memory. A suspicion of borreliosis was driven from the presence of cardiac symptoms as well as of psychiatric and from the case histories of a tick bite. The diagnosis was confirmed both by specific serological test and endomyocardial biopsy which revealed spirochetes. The patient responded to treatment with doxycyclin and ceftriaxone. Cardiologic disorders retreated entirely, while cognitive deficits did only partly. PMID:18634389

  20. Prolonged dysphagia due to Listeria-rhombencephalitis with brainstem abscess and acute polyradiculoneuritis.

    Science.gov (United States)

    Smiatacz, Tomasz; Kowalik, Maciej Michal; Hlebowicz, Maria

    2006-06-01

    We report a case of previously healthy student with acute rhombencephalitis and brainstem abscess caused by Listeria monocytogenes. The disease begun with uncharacteristic prodromal symptoms of gastrointestinal infection followed by headache and vertigo. After hospital admission the patient rapidly deteriorated, presenting pronounced dysphagia and respiratory failure requiring mechanical ventilation. The diagnosis was established upon clinical symptoms of infection, brainstem involvement, typical MRI findings and positive for L. monocytogenes blood culture. Infection was complicated by acute, demyelinating neuropathy, diagnosed upon clinical symptoms of frail palsy confirmed by ENG. Initially introduced empirical doxycyclin/ceftriaxon treatment was subsequently changed to targeted ampicillin/gentamycin therapy, mechanical ventilation, intravenous human immunoglobulin treatment, tracheostomy and endoscopic gastrostomy. Prolonged dysphagia resolved after rehabilitation. After one year the patient remains well with only slight dysmetria. PMID:16260041

  1. Low back pain after a dental procedure: a case of Streptococcus viridans vertebral osteomyelitis.

    Science.gov (United States)

    Nazir, Salik; Lohani, Saroj; Tachamo, Niranjan; Rajagopalan, Priya

    2016-01-01

    Vertebral osteomyelitis due to Streptococcus viridans following a dental procedure is a rarely reported phenomenon. We discuss the case of a 67-year-old immunocompetent woman who presented with low back pain of 3 weeks duration associated with subjective fever and chills. On admission, the MRI of the lumbar spine showed L5-S1 vertebral osteomyelitis with associated paravertebral and epidural abscesses. Subsequently, detailed history was retaken and the patient reported having had a maxillary tooth extraction followed by a dental implant 2 months prior to the onset of her symptoms. Blood and abscess fluid cultures grew S. viridans Transthoracic echocardiogram showed no evidence of endocarditis. The patient was started on intravenous ceftriaxone but her treatment course was complicated by agranulocytosis requiring a switch to vancomycin. She required a total of 9 weeks of intravenous antibiotics for complete clinical cure. PMID:27268493

  2. 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.

  3. Antibiotic-modified hydrogel coatings on titanium dental implants.

    Science.gov (United States)

    Cometa, S; Mattioli-Belmonte, M; Cafagna, D; Iatta, R; Ceci, E; De Giglio, E

    2012-01-01

    Implant-associated infections represent an occasional but serious problem in dental and/or orthopaedic surgery. A possible solution to prevent the initial bacterial adhesion may be the coating of the implant surface with a thin layer of antibiotic-loaded biocompatible polymer. Hydrogels are one of the promising and versatile materials as antibiotic controlled release systems. In this work, antibiotic-modified poly(ethylene-glycol diacrylate) hydrogel coatings on titanium substrates were prepared by electrochemical polymerization and tested against methicillin resistant Staphylococcus aureus (ATCC 33591). Two different methods to load vancomycin and ceftriaxone were used. We show that the proposed titanium coatings displayed an interesting antibacterial activity, however, further studies on their effective cytotoxicity will furnish evidence of their real clinical efficacy. PMID:23164329

  4. 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

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

    Science.gov (United States)

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

    2015-09-01

    Drug-resistant Neisseria gonorrhoeae has become a global health concern that requires immediate attention. Due to increasing resistance to cephalosporins, pursuing novel alternatives for treating N. gonorrhoeae infections is paramount. Whilst new drug development is often cumbersome, reviving antiquated antibiotic agents for treatment of modern infections has become prevalent in clinical practice. Fosfomycin exhibits bactericidal activity through a unique mechanism of action, and a variety of organisms including N. gonorrhoeae are susceptible. In vitro studies have demonstrated that fosfomycin can retain activity against ceftriaxone-resistant N. gonorrhoeae; however, it remains unclear whether there is synergy between fosfomycin and other antibiotics. Clinical investigations evaluating fosfomycin for the treatment of N. gonorrhoeae infections are confounded by methodological limitations, none the less they do provide some perspective on its potential role in therapy. Future studies are needed to establish a safe, convenient and effective fosfomycin regimen for treating N. gonorrhoeae infections. PMID:26145201

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

    Science.gov (United States)

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

    2016-01-01

    We tested the activity of ETX0914 against 187 Neisseria gonorrhoeae isolates from men with urethritis in Nanjing, China, in 2013. The MIC50, MIC90, and MIC range for ETX0914 were 0.03 μg/ml, 0.06 μg/ml, and ≤0.002 to 0.125 μg/ml, respectively. All isolates were resistant to ciprofloxacin, and 36.9% (69/187) were resistant to azithromycin. Of the isolates, 46.5% were penicillinase-producing N. gonorrhoeae (PPNG), 36% were tetracycline-resistant N. gonorrhoeae (TRNG), and 13% (24 isolates) had an MIC of 0.125 μg/ml for ceftriaxone. ETX0914 may be an effective treatment option for gonorrhea. PMID:26482313

  7. Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes

    Directory of Open Access Journals (Sweden)

    Michael Vincent F. Tablang

    2008-11-01

    Full Text Available Spontaneous bacterial peritonitis is a severe and life-threatening complication in patients with ascites caused by advanced liver disease. The organisms most commonly involved are coliform bacteria and third-generation cephalosporins are the empiric antibiotics of choice. This is an uncommon case of spontaneous bacterial peritonitis caused by Listeria monocytogenes in a female patient with liver cirrhosis from autoimmune hepatitis. She did not improve with ceftriaxone and her course was complicated by hepatic encephalopathy, seizures and multi-organ failure. This case emphasizes that a high index of suspicion should be maintained for timely diagnosis and treatment. Listerial peritonitis should be suspected in patients with end-stage liver disease and inadequate response to conventional antibiotics within 48–72 h. Ampicillin/sulbactam should be initiated while awaiting results of ascitic fluid or blood culture.

  8. Drug Repurposing for the Development of Novel Analgesics.

    Science.gov (United States)

    Sisignano, Marco; Parnham, Michael J; Geisslinger, Gerd

    2016-03-01

    Drug development consumes huge amounts of time and money and the search for novel analgesics, which are urgently required, is particularly difficult, having resulted in many setbacks in the past. Drug repurposing - the identification of new uses for existing drugs - is an alternative approach, which bypasses most of the time- and cost-consuming components of drug development. Recent, unexpected findings suggest a role for several existing drugs, such as minocycline, ceftriaxone, sivelestat, and pioglitazone, as novel analgesics in chronic and neuropathic pain states. Here, we discuss these findings as well as their proposed antihyperalgesic mechanisms and outline the merits of pathway-based repurposing screens, in combination with bioinformatics and novel cellular reprogramming techniques, for the identification of novel analgesics. PMID:26706620

  9. 头孢曲松治疗葡萄球菌烫伤样皮肤综合征的观察

    Institute of Scientific and Technical Information of China (English)

    钟永军

    2006-01-01

    葡萄球菌烫伤样皮肤综合征(Staphylococca Scalded Skin Syndronme,SSSS)由金葡球菌产生的表皮剥脱毒素(Exfoliative Toxin,ET)引起,是好发于新生儿、婴幼儿的疾病.笔者于2002年3月至2005年9月使用注射用头孢曲松钠(Ceftriaxone Sodium for Injection,规格1.0g,海南海口奇力制药有限公司生产)治疗小儿SSSS16例取得良好疗效,现将结果报告如下.

  10. [Standardization of the Neisseria meningitidis antibiogram. Detection of strains relatively resistant to penicillin].

    Science.gov (United States)

    Nicolas, P; Cavallo, J D; Fabre, R; Martet, G

    1998-01-01

    Studying the susceptibility of 189 Neisseria meningitidis strains to penicillin, amoxicillin, cefotaxime, ceftriaxone, chloramphenicol and rifampicin by determination of minimum inhibitory concentrations (MICs) by agar dilution (reference method), E-test and disc diffusion method on Mueller-Hinton agar at 37 degrees C with 5% CO2 enabled us to standardize the antibiograms. While MIC determination by agar dilution is still the reference method, it is possible to obtain exact or approximate MIC values using the E-test. For laboratories that cannot determine penicillin MICs, it is impossible to detect strains that are relatively resistant to penicillin (RRP strains: 0.1 oxacillin disc allows MIC to be determined in most cases when the oxacillin inhibition zone is pharmacokinetics, we propose critical concentrations for these various antibiotics as well as critical diameters for chloramphenicol and rifampicin discs. PMID:9803590

  11. 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.

  12. 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.

  13. RECURRENT SALMONELLA TYPHI CHEST WALL ABSCESSES IN A DIABETIC LADY

    Directory of Open Access Journals (Sweden)

    Jayasri Helen

    2014-09-01

    Full Text Available : Salmonella enterica serovar typhi causing typhoid fever is common in many parts of the world particularly in developing countries. Extra intestinal manifestations are uncommon and occur in immunocompromised individuals such as patients with diabetes, HIV infection, chronic steroid use, chemotherapy and malignancy. We report a case of Salmonella typhi causing recurrent chest wall abscesses in a lady with uncontrolled diabetes. She was admitted with high grade fever, left sided chest wall abscess and a previous history of two similar chest wall abscesses. After hospitalization prompt incision and drainage was done and aerobic culture of pus grew moderate growth of Salmonella typhi resistant to ciprofloxacin and sensitive to cephalosporins. Based on culture report our patient was treated with oral azithromycin for ten days and parenteral ceftriaxone for six weeks. There was rapid and full recovery and six months follow up revealed no recurrence.

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Antibiogram of multidrug resistant Acinetobacter baumannii isolated from clinical specimens at King Hussein Medical Centre, Jordan: a retrospective analysis.

    Science.gov (United States)

    Batarseh, A; Al-Sarhan, A; Maayteh, M; Al-Khatirei, S; Alarmouti, M

    2016-11-01

    This study was conducted to determine the prevalence and the local antibiogram of multidrug-resistant Acinetobacter baumannii isolates in Al-Hussein Hospital at King Hussein Medical Centre in Amman, Jordan. In a retrospective study from January to December 2013, data on 116 non-repetitive positive clinical samples were retrieved from patients' laboratory records. The resistance rates of A. baumannii isolates were high for ceftriaxone, cefotaxime and ticarcillin (100%), ceftazidime, cefepime and piperacillin (98.3%), imipenem (97.4%), piperacillin/tazobactam (96.6%), quinolones (94.8%), ampicillin/sulbactam (89.7%), gentamicin, (87.9%), tobramycin and tetracycline (76.7%) and trimethoprim/sulfamethoxazole (75.9%), but lower for minocycline (26.7%) and colistin (1.7%). A. baumannii in our hospital were highly resistant to all antibiotics, including tigecycline, except for minocycline and colistin which are considered the last resort treatment for multidrug-resistant A. baumannii. PMID:26857720

  16. Emergence of resistance to third-generation cephalosporin in Shigella--a case report.

    Science.gov (United States)

    Mandal, Jharna; Mondal, Nivedita; Mahadevan, S; Parija, Subhash Chandra

    2010-08-01

    The emergence of ciprofloxacin resistance in Shigella has shifted the attention to cephalosporins. The first occurrence of third generation cephalosporin-resistant Shigella flexneri was from France. This article reports the first case of cephalosporin-resistant S. flexneri from India. A 12-month-old child was admitted for a 20-day episode of loose stools, non-fetid, with mucus and blood. The stool sample showed the presence of blood and mucus and S. flexneri which was resistant to Ampicillin, Nalidixic acid, Ciprofloxacin, Furoxone, Ceftriaxone and sensitive only to Cefoperazone and sulbactam combination. The child was promptly admitted and treated with a combination of Cefoperazone and sulbactam. The use of this combination was met with success in the present case, and may be considered as a temporary answer to the emerging cephalosporin-resistance. PMID:19955258

  17. Nosocomial pneumonia and bacteremia caused by delftia acidovorans related to arterial catheter

    Directory of Open Access Journals (Sweden)

    Tekin Taş

    2012-09-01

    Full Text Available Delftia acidovorans, formerly called as Comamonas acidovorans,is a non-fermentative gram-negative bacteria.A 79 year-old male with chronic obstructive pulmonarydisease was hospitalized in the intensive care unit. Bilateralrespiratory sounds were diminished, he had roughrhonchi. He was started sulbactam/ampicilline. On theseventh day of hospitalization, White Blood Cells increasedand infiltration was occured on the left lung,blood and deep tracheal aspirate culture samples weretaken; ceftriaxone was replaced. Cultures revealed D. acidovorans.Meropenem was started for septicemia due toD. acidovorans on the 11th day of admission. On followup,the patient died on the 17th day.Key words: Delftia acidovorans, bacteremia, pneumonia,

  18. Resistance of Xanthomonas maltophilia to antibiotics and the effect of beta-lactamase inhibitors.

    Science.gov (United States)

    Neu, H C; Saha, G; Chin, N X

    1989-01-01

    We examined the susceptibility of 50 isolates of Xanthomonas maltophilia and the effect of beta-lactamase inhibitors upon the susceptibility. The majority of isolates were resistant to azlocillin, piperacillin, mezlocillin, ticarcillin, cefotaxime, ceftizoxime, ceftriaxone, cefoperazone, and ceftazidime. All isolates were resistant to imipenem, CGP 31608, aztreonam, and carumonam. Although disk susceptibility tests showed that the combination of clavulanate with ticarcillin inhibited many isolates, at a ratio of 1:20 few isolates were susceptible to the combination. Addition of clavulanate to aztreonam and to imipenem failed to make organisms susceptible. Sulbactam combined with cefoperazone made some organisms susceptible, but ampicillin-sulbactam was ineffective, whereas tazobactam combined with piperacillin at a ratio of 1:4 made half the isolates have MICs of 32 micrograms/ml or less. The beta-lactamases from the isolates hydrolyzed all of the beta-lactams. PMID:2791491

  19. Antimicrobial susceptibility of clinical isolates of Haemophilus influenzae to ampicillin-sulbactam.

    Science.gov (United States)

    Mortensen, J E; LaRocco, M; Himes, S L; Inderlied, C; Daly, J A; Campos, J M; Mendelman, P M

    1990-01-01

    A total of 1092 clinical isolates of Haemophilus influenzae (306 type b; 786 non-type-b), from five medical centers were obtained during 1987 and 1988. Disk diffusion antimicrobial susceptibilities were obtained for all isolates, and broth microdilution susceptibilities were obtained for 502 isolates. Beta-lactamase was produced by 34.3% of type-b and 22.1% of non-type-b isolates, with some geographic variations. Using disk diffusion antimicrobial susceptibility testing, all isolates were susceptible to ampicillin-sulbactam, ceftriaxone, cefuroxime, and rifampin; two isolates were resistant to chloramphenicol. Whether tested using a fixed ratio of ampicillin to sulbactam of 2:1 or a fixed concentration of sulbactam, the ampicillin-sulbactam combination demonstrated good activity against clinical isolates of H. influenzae. Only 8 of the 1092 isolates did not produce beta-lactamase but demonstrated MICs of greater than or equal to 2 micrograms/ml for ampicillin. PMID:2076596

  20. Antimicrobial susceptibility of clinical isolates of Acinetobacter baumannii.

    Science.gov (United States)

    Shi, Z Y; Liu, P Y; Lau, Y; Lin, Y; Hu, B S; Shir J-M

    1996-02-01

    The in-vitro activity of 18 antimicrobial agents alone or in combination against 248 clinical isolates of Acinetobacter baumannii from Taiwan were tested by agar dilution. The MIC90S of ampicillin, amoxicillin, piperacillin, cefuroxime, cefotaxime, ceftriaxone, gentamicin, and amikacin were at least 128 mu g/ml. Ceftazidime, cefepime, sulbactam, clavulanic acid, and tazobactam presented moderate activity with MIC90S of 32, 16, 16, 32, and 32 mu g/ml, respectively. The increased activity of ampicillin/sulbactam, amoxicillin/clavulanic acid, and piperacillin/tazobactam was due to the intrinsic effect of sulbactam, clavulanic acid, and tazobactam, respectively. Imipenem, meropenem, and ciprofloxacin were the most active antimicrobial agents with MIC90S of 1, 1, and 0.5 mu g/ml, respectively. Nineteen isolates (7.7%) were resistant to all aminoglycosides and beta-lactam antibiotics, except carbapenems and ciprofloxacin. We are concerned about the multidrug resistance of A. baumannii in this study. PMID:9147913

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

    Directory of Open Access Journals (Sweden)

    Kaskhedikar

    2009-02-01

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

  2. Adjuvant glycerol is not beneficial in experimental pneumococcal meningitis

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2010-03-01

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

  3. Detection Of Extended-Spectrum Beta Lactamase in Klebsiella pneumoniae and Klebsiella oxytoca Bacteria with the Combined Disc Method

    Directory of Open Access Journals (Sweden)

    Ebru Yılmaz

    2011-06-01

    Full Text Available Extended-spectrum beta lactamases (ESBLs are responsible for resistance to cephalosporins (ceftazidime, ceftriaxone, and cefotaxime and aztreonam in gram-negative bacilli. ESBL producing Klebsiella bacteria are a major problem for clinicians, ESBLs increase are cause of failure in treatment particularly paediatric patients and also in medical and surgical units. In this research ESBL was investigated by combined disc method. In this research, 128 clinical isolates of Klebsiella ssp. were collected from different microbiology laboratories in Ankara. All isolates were identified with classical methods and API 20E. According to the results of identification, 103 K. pneumoniae, 25 K. oxytoca were obtained. ESBL has been detected 59,37% in Klebsiella bacteria by the combined disk method.

  4. Salmonella Typhi Vertebral Osteomyelitis and Epidural Abscess

    Science.gov (United States)

    Chua, Ying Ying; Chen, John L. T.

    2016-01-01

    Salmonella vertebral osteomyelitis is an uncommon complication of Salmonella infection. We report a case of a 57-year-old transgender male who presented with lower back pain for a period of one month following a fall. Physical examination only revealed tenderness over the lower back with no neurological deficits. MRI of the thoracic and lumbar spine revealed a spondylodiscitis at T10-T11 and T12-L1 and right posterior epidural collection at the T9-T10 level. He underwent decompression laminectomy with segmental instrumentation and fusion of T8 to L3 vertebrae. Intraoperatively, he was found to have acute-on-chronic osteomyelitis in T10 and T11, epidural abscess, and discitis in T12-L1. Tissue and wound culture grew Salmonella Typhi and with antibiotics susceptibility guidance he was treated with intravenous ceftriaxone for a period of six weeks. He recovered well with no neurological deficits. PMID:27034871

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

    Directory of Open Access Journals (Sweden)

    Nikolić Katarina

    2015-01-01

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

  6. [South African tick bite fever in a group of Russian tourists].

    Science.gov (United States)

    Kozhevnikova, G M; Tokmalaev, A K; Voznesensky, S L; Karan, L S

    2014-01-01

    The paper describes a clinical case of South African tick bite fever in a group of Russian tourists. The group of 5 people who had been ill with this disease after a tourist trip to the South African Republic (the Kruger National Park in the north-eastern province of Mpumalanga) were followed up. During their trip, all of them were bitten by different insects many times. The disease exhibited different clinical presentations; however, all the patients were noted to have a fever with slight intoxication and a maculopapular rash at different sites of the body; 3 had lymphadenopathy and one had a primary effect at the site of tick sticking. The diagnosis was verified by indirect immunofluorescence for the detection of high titers to Rickettsia conorii. The course of the disease was favorable in all the patients treated with antibiotics (doxycycline or ceftriaxone). PMID:25715493

  7. Comparative in vitro activity of oral antimicrobial agents against Enterobacteriaceae from patients with community-acquired urinary tract infections in three European countries.

    Science.gov (United States)

    Kresken, M; Körber-Irrgang, B; Biedenbach, D J; Batista, N; Besard, V; Cantón, R; García-Castillo, M; Kalka-Moll, W; Pascual, A; Schwarz, R; Van Meensel, B; Wisplinghoff, H; Seifert, H

    2016-01-01

    Enterobacteriaceae causing community-acquired urinary tract infections were examined in selected outpatient clinics and hospitals in Belgium, Germany and Spain using EUCAST breakpoints for susceptibility. A total of 1190 isolates were collected. Escherichia coli isolates were resistant to amoxicillin-clavulanic acid (28.1%), ciprofloxacin (23.4%) and trimethoprim-sulfamethoxazole (21.4%) compared with fosfomycin and nitrofurantoin (each, <1.5%). Ceftibuten (MIC50/90 0.25/0.5 mg/L) and ceftriaxone activity (MIC50/90 ≤0.25 mg/L) was comparable. Ceftibuten (MIC90 ≤0.25 mg/L) was also active against Proteus mirabilis and Klebsiella spp. Extended-spectrum β-lactamase phenotypes were 7.1% for E. coli, 5.6% for Klebsiella pneumoniae and 0.4% for P. mirabilis. Resistance was common among men and elderly women. PMID:26321667

  8. 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...

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

    Science.gov (United States)

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

    2012-01-01

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

  10. Discordance between MRI and bone scan findings in a child with acute complicated osteomyelitis: scintigraphic features that contribute to the early diagnosis.

    Science.gov (United States)

    Mpalaris, V; Arsos, G; Iakovou, I; Dalpa, E; Karatzas, N

    2014-01-01

    Early diagnosis and prompt treatment of acute osteomyelitis are of paramount importance in children because they can prevent irreversible bone damage. Magnetic resonance imaging (MRI) with its superior spatial resolution and lack of ionizing radiation is routinely preferred over bone scan for this purpose. Increased blood flow, hyperemia and focally increased tracer uptake shown by "three phase" bone scan are the typical scintigraphic findings of acute osteomyelitis. In addition, diffuse uptake along the shaft of long bones and focal "cold" lesions are two special features that may be highly suggestive of infective periostitis, soft tissue sepsis and subperiosteal abscess formation, due to the loose attachment of periosteum to bone during childhood. We present a case of complicated osteomyelitis in a child with inconclusive MRI correctly diagnosed on the basis of these special scintigraphic findings resulting in treatment change from double i.v. Vancomycin--Ceftriaxone scheme to surgical intervention. PMID:23938190

  11. Klebsiella pneumoniae liver abscess in an immunocompetent child

    Directory of Open Access Journals (Sweden)

    Jang Mi Kwon

    2013-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Serena Bonin

    2011-09-01

    Full Text Available Lichen sclerosus et atrophicans (LSA is a chronic, inflammatory skin disease of unknown etiology, characterized by atrophy. We report a case of LSA with frontoparietal distribution, mimicking scleroderma en coup de sabre, causing scarring alopecia. The case was associated with Borrelia infection. The lesion improved with 2 cycles of antibiotic therapy with ceftriaxone 2 gr /day i.v for 21 days associated with UVA-1 therapy and local and systemic vitamin E supply (400 mg 2x/day per os for 3 months. This case stresses the importance of identifying clinical manifestations associated with Lyme disease and the use of tissue PCR to detect borrelial DNA in patients with these lesions, but characterized by negative serology for Borrelia.

  13. From past sailors' eras to the present day: scurvy as a surprising manifestation of an uncommon gastrointestinal disease.

    Science.gov (United States)

    Branquinho, Diogo Ferreira; Pinto-Gouveia, Miguel; Mendes, Sofia; Sofia, Carlos

    2015-01-01

    A 45-year-old man presented with follicular exanthema in his lower limbs, alternating bowel habits and significant weight loss. His medical history included seronegative arthritis, bipolar disease and an inconclusive diagnostic laparoscopy. Diagnostic work up revealed microcytic anaemia and multivitamin deficiency. Skin biopsy of the exanthema suggested scurvy. Owing to these signs of malabsorption, upper endoscopy with duodenal biopsies was performed, exhibiting villous atrophy and extensive periodic acid-Schiff-positive material in the lamina propria, therefore diagnosing Whipple's disease (WD). After starting treatment with ceftriaxone and co-trimoxazole, an impressive recovery was noted, as the wide spectrum of malabsorption signs quickly disappeared. After a year of antibiotics, articular and cutaneous manifestations improved, allowing the patient to stop taking corticosteroids and antidepressants. This truly unusual presentation reflects the multisystemic nature of WD, often leading to misdiagnosis of other entities. Scurvy is a rare finding in developed countries, but its presence should raise suspicion for small bowel disease. PMID:26376699

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

    Directory of Open Access Journals (Sweden)

    Hancu Gabriel

    2013-01-01

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

  15. Renal abscess due to Escherichia coli in a child

    Directory of Open Access Journals (Sweden)

    V P Baradkar

    2011-01-01

    Full Text Available Among the various intraabdominal abscesses, renal abscess is a rare entity, especially in children and accounts for a number of cases of "missed diagnoses." Drainage of pus and appropriate antibiotic therapy is the gold standard for treatment. Here we report a case of left renal abscess in a 6-year-old female child secondary to renal calculus. The patient presented with abdominal pain and mild fever for three months and the diagnosis was made by X-ray in the kidney, ureter and bladder (KUB region, intravenous pyelography and ultrasonography of the abdomen. Escherichia coli was isolated from pus obtained by percutaneous drainage under sonographic guidance. The patient responded to intra-venous ceftriaxone, amikacin, and percutaneous drainage.

  16. Analysis of 12 beta-lactam antibiotics in human plasma by HPLC with ultraviolet detection.

    Science.gov (United States)

    McWhinney, Brett C; Wallis, Steven C; Hillister, Tara; Roberts, Jason A; Lipman, Jeffrey; Ungerer, Jacobus P J

    2010-07-15

    A simple and economical high performance liquid chromatography method was developed and validated for routine analysis of 12 Penicillin, Cephalosporin and Carbapenem antibiotics in 200 microL of human plasma. Antibiotics determined were Ceftazidime, Meropenem, Ceftriaxone, Ampicillin, Cefazolin, Ertapenem, Cephalothin, Benzylpenicillin, Flucloxacillin, Dicloxacillin, Piperacillin and Ticarcillin. There was a common sample preparation approach involving precipitation of proteins with acetonitrile and removal of lipid-soluble components by a chloroform wash. Separations were performed on a Waters X-bridge C18 column with, depending on analytes, one of three acetonitrile-phosphate buffer mobile phases. Detection was by UV at 210, 260 and 304 nm. Validation has demonstrated the method to be linear, accurate and precise. The method has been used in a pathology laboratory for therapeutic drug monitoring (TDM) of beta-lactams in critically ill patients. PMID:20561826

  17. DETECTION & PREVALENCE OF EXTENDED SPECTRUM ΒETA - LACTAMASES AMONG ENTEROBACTERIACEAE SPECIES FROM VARIOUS CLINICAL SAMPLES AT KIMS, AMALAPURAM.

    Directory of Open Access Journals (Sweden)

    Padmaja

    2012-10-01

    Full Text Available ABSTRACT: The present study was conducted in the Department of Microbiology, KIMS, Amalapuram, East Godavari from January 2012 to July 2012. Out of 100 different clinical samples, 50 were culture positive. Of the 100 samples collected, more were from post operative wound sepsis - 44 (44%, followed by cellulites - 20 (20%, Ulcers - 17 (17%, Injuries 15 (15%. Least number of cases are from burns - 4 (4% . Among 50 culture positive cases, 38 (76% isolates belonged to Enterobacteriaceae famil y, followed by Pseudomonas aeruginosa - 8 (16%, followed by Staphylococcus aureus - 4 (8%. Among 38 of Enterobacteriaceae family isolates, 15 were ESBL producers. Among ESBL positiv e strains, more drug resistance was seen to Ceftazidime and Ampicillin (93.33%, followed by Ceftriaxone (86.66%, Aztreonam & Cefotaxime (80%.

  18. A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis

    Directory of Open Access Journals (Sweden)

    Vivek Verma

    2014-12-01

    Full Text Available A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.

  19. Carrying pharyngeal of Streptococcus pyogenes and sensitivity profiles in schoolchild from Cartagena

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    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.

  20. 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.

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

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    Modi RS

    2015-11-01

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

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

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    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 .

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    Objectives: This study investigated the occurrence of extended spectrum cephalosporinase (ESC)–producing Escherichia coli in a broiler production with no cephalosporin use and a low use of antimicrobials in general. Furthermore, it investigated whether the current consumption of aminopenicillins...... selects for ESC-producing E. coli and whether certain clones or plasmids spread from imported parent flocks to the meat. Materials and Methods: ESC-producing E. coli was isolated using MacConkey broth with 1 mg/L of ceftriaxone. ESC genes were identified using polymerase chain reaction and sequencing...... (not flock) level was obtained from VetStat, a database for mandatory registration of veterinary prescriptions in Denmark. Results: ESC-producing E. coli occurred in 93% (27/29) of broiler parent farms in 2011, 27% (53/197) of broiler flocks in 2010, and 3.3% (4/121) of Danish retail broiler meat in...

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

    Science.gov (United States)

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

    1999-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

    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

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

    International Nuclear Information System (INIS)

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

  7. Multidrug-induced erythema multiforme.

    Science.gov (United States)

    Isik, S R; Karakaya, G; Erkin, G; Kalyoncu, A F

    2007-01-01

    Adverse skin reactions to drugs are frequent, with rates of reaction to many commonly used drugs exceeding 1%. We describe a 29-year-old woman admitted with a history of itching, rash, vesicles on her hands and soles, and edema on her tongue and oropharynx after trimethoprim-sulfamethoxazole, ciprofloxacin, methenamine anhydromethylene citrate, piroxicam, azithromycin, and ceftriaxone intake. Erythema multiforme (EM) was diagnosed by skin biopsy after oral challenge with piroxicam. EM lesions reappeared after oral challenge with levofloxacin. Although EM is quite common with trimethoprim-sulfamethoxazole and there are some reports of EM appearing after intake of ciprofloxacin, it has rarely been attributed to piroxicam and no reports have identified levofloxacin as a cause. PMID:17583109

  8. Disseminated gonococcal infection presenting as vasculitis: a case report.

    Science.gov (United States)

    Jain, Sangita; Win, Htet Nwe; Chalam, Venkat; Yee, Lian

    2007-01-01

    A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted. PMID:17213353

  9. Clinical profile of group A meningococcal outbreak in Delhi.

    Science.gov (United States)

    Jhamb, Urmila; Chawla, V; Khanna, S

    2009-09-01

    We present a retrospective analysis of clinical profile of 100 children admitted to a Government hospital at Delhi between April 2005 and December 2006 with group A meningococcal infection. Maximum children presented in late winter and spring. Younger children were less affected (5% children rash (63%) were the most common presenting symptoms. All children presented within 5 days of onset of symptoms and 52% within 24 hours. 67 % children had meningococcal meningitis; 20% had meningococcemia; and 13% had both. Overall mortality was 17%. Altered sensorium and shock at presentation significantly increased the mortality. All culture positive cases had group A Neisseria meningitides. All meningococcal isolates were sensitive to penicillin/ampicillin, ciprofloxacin, ceftriaxone, chloramphenicol and erythromycin except, one each resistant to ampicillin and erythromycin. PMID:19179744

  10. [Gastroenteritis with fever, headache and rash after travelling in India].

    Science.gov (United States)

    Hecht, A; Seilmaier, M; Guggemos, W; Löscher, T

    2011-05-01

    A 63-year-old patient presented to our emergency unit two days after returning from India suffering from watery diarrhea, nausea, fever and headache. On admission we found a maculopapular rash on his trunk and forehead. Laboratory findings revealed a leuko-thrombopenia and elevated levels of CRP and procalcitonin. We started treatment with ciprofloxacin. After 48 hours of treatment the diarrhea subsided, whereas the rush on his trunk increased. Under the suspicion of rickettsial fever we started doxycycline 200 mg/d. Because of an incipient pneumonia we added ceftriaxon. The patient improved rapidly and the laboratory abnormalities resolved. Serological investigations revealed a significant increase of specific antibodies against Rickettsia typhi. In conclusion, headache with fever and maculopapular rash after traveling to endemic countries should rise suspicion for murine typhus. PMID:20945058

  11. Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania.

    Science.gov (United States)

    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. PMID:20734713

  12. Community Acquired Spondylodiscitis caused by Escherichia Coli; Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    F Javier Fonseca del Pozo

    2016-07-01

    Full Text Available Vertebral osteomyelitis, or spondylodiscitis, is a rare disease with increasing prevalence in recent years due to a greater number of spinal surgical procedures, nosocomial bacteraemia, an aging population and intravenous drug addiction. Haematogenous infection is the most common cause of spondylodiscitis. We report a 47-year-old man diagnosed with Escherichia coli spondylodiscitis. The patient initially presented with a 4-day history of inflammatory, mechanical pain in the lower back suggesting sciatica. Treatment included NSAIDs and opioids. Two days after discharge from hospital following an admission due to an upper GI bleeding, the back pain intensified, precipitating a new attendance to the emergency department; during which lumbosacral radiography showed marked reduction of L2/L3 intervertebral space. After a new admission to the rheumatology unit due to worsening of symptoms and raised inflammatory markers, an expedited MRI showed loss of intervertebral disc space at L2/L3, with an irregular high intensity area at L2; suggesting a fluid collection extending to adjacent soft tissues. Fluoroscopy-guided core needle bone biopsies were reported positive for Escherichia coli sensitive to ceftriaxone. The patient was treated (received treatment with a three week course of ceftriaxone following a formal diagnosis of E. coli spondylodiscitis. Follow-up MRI demonstrated complete recovery with the patient able to return (has returned to normal activity. In this case we highlight the importance of correct and timely diagnosis of spondylodiscitis. Diagnosis of spondylodiscitis is often difficult, delayed or even missed due to the rarity of the disease but can lead to devastating consequences. Therefore a high index of suspicion is needed for prompt diagnosis to ensure improved long-term outcomes.

  13. 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.

  14. [A meningitis case of Brucella and tuberculosis co-infection].

    Science.gov (United States)

    Karsen, Hasan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Demiröz, Ali Pekcan

    2008-10-01

    Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucella and tuberculosis co-infection has been presented. A 19-years-old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucella meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucella spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14th day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30th day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucella and tuberculosis co-infection, this report emphasizes that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis

  15. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients attending a public referral center for sexually transmitted diseases in Belo Horizonte, State of Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Ligia Maria Bedeschi Costa

    2013-06-01

    Full Text Available Introduction The aim of this study was to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates obtained from patients attending a public referral center for sexually transmitted diseases and specialized care services (STD/SCS in Belo Horizonte, Brazil. Methods Between March 2011 and February 2012, 201 specimens of Neisseria gonorrhoeae were consecutively obtained from men with symptoms of urethritis and women with symptons of cervicitis or were obtained during their initial consultation. The strains were tested using the disk diffusion method, and the minimum inhibitory concentrations of azithromycin, cefixime, ceftriaxone, ciprofloxacin, chloramphenicol, penicillin, tetracycline and spectinomycin were determined using the E-test. Results The specimens were 100% sensitive to cefixime, ceftriaxone and spectinomycin and exhibited resistances of 4.5% (9/201, 21.4% (43/201, 11.9% (24/201, 22.4% (45/201 and 32.3% (65/201 to azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. Intermediate sensitivities of 17.9% (36/201, 4% (8/201, 16.9% (34/201, 71.1% (143/201 and 22.9% (46/201 were observed for azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. The specimens had plasmid-mediated resistance to penicillin PPNG 14.5% (29/201 and tetracycline TRNG 11.5% (23/201. Conclusions The high percentage of detected resistance to penicillin, tetracycline, chloramphenicol and ciprofloxacin indicates that these antibiotics are not appropriate for gonorrhea treatment at the Health Clinic and possibly in Belo Horizonte. The resistance and intermediate sensitivity of these isolates indicates that caution is recommended in the use of azithromycin and emphasizes the need to establish mechanisms for the surveillance of antimicrobial resistance for the effective control of gonorrhea.

  16. 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.

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    Unemo, Magnus; Ringlander, Johan; Wiggins, Catherine; Fredlund, Hans; Jacobsson, Susanne; Cole, Michelle

    2015-09-01

    Resistance in Neisseria gonorrhoeae against all antimicrobials available for the treatment of gonorrhea has emerged. The first gonococcal strains with high-level resistance to ceftriaxone, the last option for first-line empirical antimicrobial monotherapy, were recently described. Consequently, new treatment options are essential. In this study, the in vitro activity of the novel spiropyrimidinetrione ETX0914 (AZD0914), a DNA topoisomerase II inhibitor, was investigated among contemporary consecutive clinical N. gonorrhoeae isolates obtained in 21 European countries and compared to the activities of antimicrobials currently or previously recommended for treatment. Consecutive clinical N. gonorrhoeae isolates (n = 873) cultured in 21 European countries from 2012 to 2014 were examined for their susceptibility to ETX0914. The MICs of ETX0914 were determined using the agar dilution method. For comparison, the MICs of ceftriaxone, cefixime, azithromycin, and ciprofloxacin were determined using Etest or the agar dilution method. For ETX0914, the MIC range, modal MIC, MIC50, and MIC90 were ≤0.002 to 0.25 mg/liter, 0.125 mg/liter, 0.064 mg/liter, and 0.125 mg/liter, respectively. The MIC values were substantially lower than those of the fluoroquinolone ciprofloxacin and most other antimicrobials examined. No cross-resistance with any other examined antimicrobial was observed. In conclusion, the in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical isolates from 21 European countries was high, and no cross-resistance to antimicrobials currently or previously used for gonorrhea treatment was indicated. Additional studies investigating the in vitro and in vivo induction and mechanisms of ETX0914 resistance in gonococci, pharmacokinetics/pharmacodynamics in modeling/simulations and in humans, and performance in randomized controlled gonorrhea treatment trials are essential. PMID:26077246

  17. Bacterial-resistance among outpatients of county hospitals in China: significant geographic distinctions and minor differences between central cities.

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    Xiao, Yonghong; Wei, Zeqing; Shen, Ping; Ji, Jinru; Sun, Ziyong; Yu, Hua; Zhang, Tiantuo; Ji, Ping; Ni, Yuxing; Hu, Zhidong; Chu, Yunzhuo; Li, Lanjuan

    2015-06-01

    The purpose of this study was to survey antibacterial resistance in outpatients of Chinese county hospitals. A total of 31 county hospitals were selected and samples continuously collected from August 2010 to August 2011. Drug sensitivity testing was conducted in a central laboratory. A total of 2946 unique isolates were collected, including 634 strains of Escherichia coli, 606 Klebsiella pneumoniae, 476 Staphylococcus aureus, 308 Streptococcus pneumoniae, and 160 Haemophilus influenzae. Extended-spectrum β-lactamases were detected in E. coli (42.3% strains), K. pneumoniae (31.7%), and Proteus mirabilis (39.0%). Ciprofloxacin-resistance was detected in 51.0% of E. coli strains. Salmonella spp. and Shigella spp. were sensitive to most antibacterial agents. Less than 8.0% of Pseudomonas aeruginosa isolates were resistant to carbapenem. For S. aureus strains, 15.3% were resistant to methicillin, and some strains of S. pneumoniae showed resistance to penicillin (1.6%), ceftriaxone (13.0%), and erythromycin (96.4%). β-lactamase was produced by 96.5% of Moraxella catarrhalis strains, and 36.2% of H. influenzae isolates were resistant to ampicillin. Azithromycin-resistant H. influenzae, imipenem-resistant but meropenem-sensitive Proteus, and ceftriaxone- and carbapenem non-sensitive M. catarrhalis were recorded. In conclusion, cephalosporin- and quinolone-resistant strains of E. coli and Klebsiella pneumonia and macrolide-resistant Gram-positive cocci were relatively prominent in county hospitals. The antibacterial resistance profiles of isolates from different geographical locations varied significantly, with proportions in county hospitals lower than those in their tertiary counterparts in the central cities, although the difference is diminishing. PMID:25708671

  18. Clinical, Paraclinical, and Antimicrobial Resistance Features of Community-Acquired Acute Bacterial Meningitis at a Large Infectious Diseases Ward in Tehran, Iran.

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    Heydari, Behrooz; Khalili, Hossein; Karimzadeh, Iman; Emadi-Kochak, Hamid

    2016-01-01

    In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients' medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected. Kirby-Bauer disc diffusion method was used to determine their antimicrobial susceptibility profile. Details of medical management including antibiotic regimen, duration, patients' outcome, and possible sequelae of meningitis were recorded. The most commonly isolated microorganism from CSF or blood of patients was Streptococcus pneumonia (33.33%) followed by Neisseria meningitidis (27.78%) and Haemophilus influenza (16.67%). The most common antimicrobial regimen was ceftriaxone plus vancomycin (69.44%) followed by ceftriaxone plus vancomycin plus ampicillin (11.11%). Neurological sequelae of meningitis including cranial nerve palsy, deafness, and hemiparesis were identified in 4 (11.11%), 2 (5.56%), and 1 (2.78%) subjects, respectively. Regarding mortality, only 3 (8.33%) patients died from bacterial meningitis and the remaining 33 individuals discharged from the hospital. In conclusion, findings of the current study demonstrated that the mean incidence of acute bacterial meningitis in a referral infectious diseases ward in Iran was 9 episodes per year. The majority cases of community-acquired acute bacterial meningitis admitted to our center had negative CSF culture and classic triad of meningitis was absent in them. PMID:27610176

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

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    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.

  20. 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.

  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. Prevalence of pneumococcal serotypes and resistance to antimicrobial agents in patients with meningitis: ten-year analysis

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    Jackelline Rodrigues Alvares

    2011-02-01

    Full Text Available OBJECTIVES: To determine the prevalence of pneumococcal serotypes and antimicrobial susceptibility in patients with meningitis, and to evaluate the implications for vaccine coverage. METHODS: Pneumococcal strains obtained from normally sterile fluids from patients admitted with meningitis were isolated at the Hospital de Clínicas of the Universidade Federal de Uberlândia, Minas Gerais State, and sent to the Instituto Adolfo Lutz, city of São Paulo, São Paulo State, for further identification, serotyping, and antimicrobial susceptibility determination. RESULTS: From April 1999 to April 2009, 338 pneumococcal strains were isolated, and 72 obtained from patients with meningitis, were analyzed. Patients' ages varied from one month to 82.2 years (mean of 18.4 ± 22.9 years; median of 5.2 years and 46 (63.9% patients were male. Strains were isolated from cerebrospinal fluid [66 occasions (91.7%] and blood [6 occasions (8.3%]. The most commonly identified serotypes were 14, 19F, 3, 7F, 6A, 6B, 10A, 18C, 23F, 5, and 34. Of the 20 [27.8%] oxacillin-resistant strains, 17 [23.6%] were resistant to penicillin and nine [12.5%] to ceftriaxone, both resistance patterns being more common in children aged two years or less and during the 2005-2009 period. CONCLUSIONS: Resistance to penicillin and ceftriaxone was detected in 23.6% and 12.5% of the strains, respectively, and predominated in children aged two years or less and during the 2005-2009 period. There were 24 different serotypes of pneumococcus and 79.8% of the serotypes were represented in the 7-valent conjugated vaccine [PVC7].

  3. 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. PMID:25672408

  4. Spontaneous bacterial peritonitis caused by Aeromonas caviae in a patient with cirrhosis.

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    Huang, Deyu; Zhao, Ying; Jiang, Yueping; Li, Zhongbin; Yang, Wucai; Chen, Guofeng

    2015-03-01

    Spontaneous bacterial peritonitis (SBP) is a common complication of cirrhosis. Based on our current understanding of SBP, the most common etiologies for SBP in cirrhosis are Enterobacter and Streptococcal species. Th e Aeromonas species are ubiquitous in fresh or sea water. Aeromonas caviae is never identified as etiology in cases of SBP. A patient, who had a history of liver cirrhosis related to chronic hepatitis B virus infection for 1 year, presented with diarrhea. He had diarrhea 1 week later returned from coastal city. He was hospitalized and treated with norfloxacin after 7 days of severe symptoms, including fever, abdominal distention, and diarrhea. Analysis of the ascitic specimen revealed a white-cell count of 4.42 × 109 cells/L with 88% neutrophils. Analysis of stool specimen showed a white-cell count of 60 cells per high-power field. Th e patient started the injection of cefriaxone at a dose of 4 g/d. However, the situation was not improved. Th ree days later, stool and ascitic fluid culture showed positive for Aeromonas caviae. Antibiotic susceptibility testing revealed that imipenem, meropenem, amikacin, and cefoperazone-sulbactam were highly sensitive to the Aeromonas caviae. However, the bacilli resisted to ceftriaxone, ceftazidime, ampicillin-sulbactam, levofloxacin, and sulfamethoxazole. Ceftriaxone was then switched to imipenem. The patient was fully recovered 14 days later. Aeromonas caviae is a rare pathogen of SBP in cirrhosis. It resists to third-generation of cephalosporin and fluroquinolone, which are of frequently used dependent on clinical experience. It needs a special attention. PMID:25832540

  5. [A rare cause of pneumonia: Shewanella putrefaciens].

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    Durdu, Bülent; Durdu, Yasemin; Güleç, Nuray; Islim, Filiz; Biçer, Mualla

    2012-01-01

    Shewanella putrefaciens is a gram-negative, non-fermentative, oxidase positive, motile bacillus that produces hydrogen sulphide. It is found widely in the nature especially in marine environments. Although it is accepted as saprophytic, different clinical syndromes, most commonly skin or soft tissue infections, have been associated with S.putrefaciens, mainly in immunocompromised cases and patients with underlying diseases. However, pneumonia cases due to S.putrefaciens are quite limited in the literature. In this report, a case of pneumonia caused by S.putrefaciens was presented. A 43-year-old female patient was admitted to our hospital with the complaints of fever, cough, sputum and weakness. The patient has had brochiectasis since childhood and has used periodical antibiotic therapies due to pneumoniae episodes. She was diagnosed to have pneumonia based on the clinical, radiological and laboratory findings, and empirical antibiotic treatment with ciprofloxacin and ceftazidime combination was initiated. Gram-stained smear of sputum yielded abundant leucocytes and gram-negative bacteria, and the isolate grown in the sputum culture was identified as S.putrefaciens by conventional methods and API 20 NE (BioMerieux, France) system. The isolate was found susceptible to ceftriaxone, ceftazidime, cefepime, ciprofloxacin, piperacillin-tazobactam, cephoperazon-sulbactam, imipenem, amikacin, gentamicin and trimethoprime-sulphametoxazole; whereas resistant to ampicillin, amoxycillin-clavulanate, cefazolin and cefuroxime, by Kirby-Bauer disk diffusion method. According to the antibiogram results, the therapy was changed to ceftriaxone (1 x 2 g, intravenous). The patient was discharged with complete cure after 14 days of therapy. In conclusion, S.putrefaciens should be considered in patients with predisposing factors as an unusual cause of pneumonia and the characteristics such as H2S production and sensitivity to third generation cephalosporins and penicillins should be used

  6. Ceftaroline versus isolates from animal bite wounds: comparative in vitro activities against 243 isolates, including 156 Pasteurella species isolates.

    Science.gov (United States)

    Goldstein, Ellie J C; Citron, Diane M; Merriam, C Vreni; Tyrrell, Kerin L

    2012-12-01

    More than 5 million Americans are bitten by animals, usually dogs, annually. Bite patients comprise ∼1% of all patients who visit emergency departments (300,000/year), and approximately 10,000 require hospitalization and intravenous antibiotics. Ceftaroline is the bioactive component of the prodrug ceftaroline fosamil, which is FDA approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs), including those containing methicillin-resistant Staphylococcus aureus (MRSA). There are no in vitro data about the activity of ceftaroline against Pasteurella multocida subsp. multocida and Pasteurella multocida subsp. septica, other Pasteurella spp., or other bite wound isolates. We therefore studied the in vitro activity of ceftaroline against 243 animal bite isolates. MICs were determined using the broth microdilution method according to CLSI guidelines. Comparator drugs included cefazolin, ceftriaxone, ertapenem, ampicillin-sulbactam, azithromycin, doxycycline, and sulfamethoxazole-trimethoprim (SMX-TMP). Ceftaroline was the most active agent against all 5 Pasteurella species, including P. multocida subsp. multocida and P. multocida subsp. septica, with a maximum MIC of ≤0.008 μg/ml; more active than ceftriaxone and ertapenem (MIC(90)s, ≤0.015 μg/ml); and more active than cefazolin (MIC(90), 0.5 μg/ml) doxycycline (MIC(90), 0.125 μg/ml), azithromycin (MIC(90), 0.5 μg/ml), ampicillin-sulbactam (MIC(90), 0.125 μg/ml), and SMX-TMP (MIC(90), 0.125 μg/ml). Ceftaroline was also very active against all S. aureus isolates (MIC(90), 0.125 μg/ml) and other Staphylococcus and Streptococcus species, with a maximum MIC of 0.125 μg/ml against all bite isolates tested. Ceftaroline has potential clinical utility against infections involving P. multocida, other Pasteurella species, and aerobic Gram-positive isolates, including S. aureus. PMID:23027193

  7. Different Dynamic Patterns of β-Lactams, Quinolones, Glycopeptides and Macrolides on Mouse Gut Microbial Diversity.

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    Jia Yin

    Full Text Available 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.

  8. Different Dynamic Patterns of β-Lactams, Quinolones, Glycopeptides and Macrolides on Mouse Gut Microbial Diversity.

    Science.gov (United States)

    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. PMID:25970622

  9. Surveillance of antibiotic consumption using the "focus of infection" approach in 2 hospitals in Ujjain, India.

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    Ashish Pathak

    Full Text Available Antibiotic surveillance initiatives are limited in resource-constrained settings. In the present study, a quantitative comparison of antibiotic use rates for suspected infections in 2 hospitals in India was performed using the "focus of infection" approach to identify targets for quality improvement in antibiotic prescription patterns in hospitalized patients.This observational study was carried out in one teaching and one nonteaching hospital. All the patients with suspected bacterial etiology were included. Data on the prescribed antibiotics and the focus of infection were prospectively collected using a structured questionnaire. Each diagnosis was further reviewed and confirmed by an independent consultant. The prescribed antibiotics were coded according to the World Health Organization Anatomic Therapeutic Classification (ATC index with the defined daily dose (DDD methodology. Focus-specific DDDs were calculated per hundred patient days (DDD/HPD.A total of 6026 patients were included from 72 participating physicians out of available 75 physicians. Overall antibiotic prescribing was higher by 5 percentage points in the teaching hospital (95% than in the nonteaching hospital (90%. Quinolones (ciprofloxacin constituting 86% of DDD/HPD were the highest prescribed class in the teaching hospital, and third-generation cephalosporins (with ceftriaxone and ceftriaxone/sulbactam constituting 40% and 28% of the DDD/HPD, respectively, in the nonteaching hospital. The targets identified for improvement were the following: longer than recommended duration of prophylaxis and lack of distinction between prophylaxis and therapy among surgical patients; irrational antibiotic prescribing in gastroenteritis; overuse of quinolones and lack of use of penicillin in pneumonia; overuse of quinolones and lack of use of doxycycline and macrolides in genital infections; and overreliance on antibiotics for treating skin and soft tissue infections.Providing a

  10. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian Regions, 2010.

    Science.gov (United States)

    Lahra, Monica M

    2012-03-01

    The World Health Organization (WHO) Gonococcal Antimicrobial Surveillance Programme (GASP) has conducted continuous surveillance of antimicrobial resistance in Neisseria gonorrhoeae in the WHO Western Pacific Region (WPR) to optimise antibiotic treatment and control of gonococcal disease since 1992. From 2007, this has been enhanced by the inclusion of data from the WHO South East Asian Region (SEAR). Over time, there has been recruitment of additional centres in both regions. This report provides an analysis of antimicrobial resistance in N. gonorrhoeae in the WHO WPR and SEAR derived from results of the 2010 GASP surveillance. In 2010 there were 9,744 N. gonorrhoeae isolates examined for their susceptibility to one or more of the antibiotics used for the treatment of gonorrhoea, incorporating External Quality Assurance controlled methods, from reporting centres in 19 countries and/or jurisdictions. A high proportion of penicillin and quinolone resistance was again detected amongst isolates tested in the 'Asian' countries of WHO WPR and SEAR. In contrast, lower levels of penicillin and quinolone resistance were reported from the Pacific Islands of Fiji and New Caledonia. The proportion of gonococci reported as having 'decreased susceptibility' to the third-generation cephalosporin antibiotic ceftriaxone varied widely, ranging from 1.3% to 55.8%. There is a continued need for revision and clarification of some of the in vitro criteria that are currently used to categorise the clinical importance of gonococci with different ceftriaxone and oral cephalosporin MIC levels, and to relate these to treatment outcome. Azithromycin resistance was very low in most countries reporting, except in Mongolia where it was 34%. The number of instances of spectinomycin resistance remained low. A high proportion of strains tested continued to exhibit high-level plasmid mediated resistance to tetracyclines. The continuing emergence and spread of antibiotic resistant gonococci in and

  11. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian regions, 2007-2008.

    Science.gov (United States)

    Tapsall, J W; Limnios, E A; Abu Bakar, Hjh Mahani Hj; Darussalam, Brunei; Ping, Yin Yue; Buadromo, E M; Kumar, P; Singh, S; Lo, J; Bala, M; Risbud, A; Deguchi, T; Tanaka, M; Watanabe, Y; Lee, K; Chong, Y; Noikaseumsy, S; Phouthavane, T; Sam, I-Ching; Tundev, O; Lwin, K M; Eh, P H; Goarant, C; Goursaud, R; Bathgate, T; Brokenshire, M; Latorre, L; Velemu, E; Carlos, C; Leano, S; Telan, E O; Goh, S S; Koh, S T; Ngan, C; Tan, A L; Mananwatte, S; Piyanoot, N; Lokpichat, S; Sirivongranson, P; Fakahau, M; Sitanilei, H; Hung, Le Van

    2010-03-01

    Long-term surveillance of antimicrobial resistance in Neisseria gonorrhoeae has been conducted in the World Health Organization (WHO) Western Pacific Region (WPR) to optimise antibiotic treatment of gonococcal disease since 1992. In 2007 and 2008, this Gonococcal Antimicrobial Surveillance Programme (GASP) was enhanced by the inclusion of data from the South East Asian Region (SEAR) and recruitment of additional centres within the WPR. Approximately 17,450 N. gonorrhoeae were examined for their susceptibility to one or more antibiotics used for the treatment of gonorrhoea by external quality controlled methods in 24 reporting centres in 20 countries and/or jurisdictions. A high proportion of penicillin and/or quinolone resistance was again detected amongst isolates tested in North Asia and the WHO SEAR, but much lower rates of penicillin resistance and little quinolone resistance was present in most of the Pacific Island countries. The proportion of gonococci reported as 'resistant', 'less susceptible' or 'non-susceptible' gonococci to the third-generation cephalosporin antibiotic ceftriaxone lay in a wide range, but no major changes were evident in cephalosporin minimal inhibitory concentration (MIC) patterns in 2007-2008. Altered cephalosporin susceptibility was associated with treatment failures following therapy with oral third-generation cephalosporins. There is a need for revision and clarification of some of the in vitro criteria that are currently used to categorise the clinical importance of gonococci with different ceftriaxone and oral cephalosporin MIC levels. The number of instances of spectinomycin resistance remained low. A high proportion of strains tested continued to exhibit a form of plasmid mediated high level resistance to tetracyclines. The continuing emergence and spread of antibiotic resistant gonococci in and from the WHO WPR and SEAR supports the need for gonococcal antimicrobial resistance surveillance programs such as GASP to be

  12. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian Regions, 2009.

    Science.gov (United States)

    2011-03-01

    Long-term surveillance of antimicrobial resistance in Neisseria gonorrhoeae has been conducted in the World Health Organization (WHO) Western Pacific Region (WPR) to optimise antibiotic treatment of gonococcal disease since 1992. From 2007, the Gonococcal Antimicrobial Surveillance Programme (GASP) has been enhanced by the inclusion of data from the South East Asian Region (SEAR) and recruitment of additional centres in the WPR. Approximately 8,704 isolates of N. gonorrhoeae were examined for their susceptibility to one or more antibiotics used for the treatment of gonorrhoea, incorporating External Quality Assurance controlled methods, from reporting centres in 21 countries and/or jurisdictions. A high proportion of penicillin and/or quinolone resistance was again detected amongst isolates tested in North Asia and the WHO SEAR. In contrast, from the Pacific Island states Fiji reported low penicillin and quinolone resistance, New Caledonia again reported no penicillin resistance and little quinolone resistance, Tonga reported no penicillin resistance and there was a continued absence of quinolone resistance reported in Papua New Guinea in 2009. The proportion of gonococci reported as 'decreased susceptibility' and 'resistant' to the third-generation cephalosporin antibiotic ceftriaxone varied widely but no major changes were evident in cephalosporin minimum inhibitory concentrations (MIC) patterns in 2009. Altered cephalosporin susceptibility has been associated with treatment failures following therapy with oral third-generation cephalosporins. There is a need for revision and clarification of some of the in vitro criteria that are currently used to categorise the clinical importance of gonococci with different ceftriaxone and oral cephalosporin MIC levels. The number of instances of spectinomycin resistance remained low. A high proportion of strains tested continued to exhibit high-level plasmid mediated resistance to tetracyclines. The continuing emergence and

  13. In vitro antibiotic susceptibility testing of Brucella isolates from Egypt between 1999 and 2007 and evidence of probable rifampin resistance

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    Abdel-Maksoud Mohamed

    2012-08-01

    Full Text Available Abstract Background Brucellosis poses a significant public health problem in Mediterranean countries, including Egypt. Treatment of this disease is often empirical due to limited information on the antibiotic susceptibility profiles of Brucella spp. in this region of the world. The aim of this study was to determine the antibiotic susceptibility profiles of Brucella blood isolates in Egypt, a country endemic for brucellosis. Methods Brucella spp. isolates were identified from the blood cultures of acute febrile illness (AFI patients presenting to a network of infectious disease hospitals from 1999–2007. Minimum inhibitory concentrations were determined for tetracycline, gentamicin, doxycycline, trimethoprim-sulfamethoxazole, streptomycin, ceftriaxone, ciprofloxacin and rifampin using the E-test. Interpretations were made according to Clinical and Laboratory Standards Institute (CLSI guidelines. Results A total of 355 Brucella spp. isolates were analyzed. All were susceptible to tetracycline, doxycycline, trimethoprim-sulfamethoxazole, streptomycin and ciprofloxacin; probable resistance to rifampin and ceftriaxone was observed among 277 (64% and 7 (2% of the isolates, respectively. Percentages of isolates showing probable resistance to rifampin were significantly lower before 2001 than in the following years (7% vs. >81%, p  Conclusions Despite the high burden of brucellosis in Egypt and frequent empirical treatment, isolates have remained susceptible to the majority of tested antibiotics. However, this is the first report of high rates of probable resistance to rifampin among Brucella isolates from Egypt. Patients should be closely monitored while following standard treatment regimens. Continued surveillance, drug susceptibility studies and updated CLSI interpretive criteria are needed to monitor and update antibiotic prescribing policies for brucellosis.

  14. 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. PMID:26369958

  15. 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.

  16. 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

  17. 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.

  18. Antimicrobial susceptibility and genetic characteristics of Neisseria gonorrhoeae isolates from India, Pakistan and Bhutan in 2007–2011

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    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.

  19. Antimicrobial agents’ utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India

    Science.gov (United States)

    Anand, Nikhilesh; Nagendra Nayak, I. M.; Advaitha, M. V.; Thaikattil, Noble J.; Kantanavar, Kiran A.; Anand, Sanjit

    2016-01-01

    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. PMID:27275075

  20. THE EFFECTS OF ANTIBIOTIC PROPHYLAXIS ON INFECTIOUS COMPLICATIONS AFTER CAESAREAN SECTION: A RANDOMISED CONTROLLED TRIAL IN A TERTIARY HOSPITAL OF EASTERN INDIA

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    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.

  1. Comparison of double disk synergy test, VITEK 2 and Check-MDR CT102 for detection of ESBL producing isolates

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    Fatima Numanovic

    2013-05-01

    Full Text Available Objective. This study is to define the statistical significance for detection of ESBL producers by the double disk synergy test and molecular test (Check-MDR CT102, microdilution test (VITEK 2 with AES and double disk synergy test (DDST, as well as the microdilution test and molecular test. Materials and methods. Phenotypic testing of 55 isolates Enterobacteriaceae (Escherichia coli (14/55, Klebsiella pneumonia (34/55, Klebsiella oxytoca (3/55 and Proteus mirabilis (4/55 was performed by VITEK 2 Compact/AES. When this test showed positive results for the ESBL phenotype, then DDST with amoxicillin/clavulanate, ceftazidime, cefpodoxime, aztreonam, ceftriaxone and cefoxitin disks was performed along with Check-MDR CT102 which identified CTX-M, TEM and SHV β-lactamases. Results. Applying the McNemar test, we determined that there was a statistically significant difference in the results of detection of ESBLs bacteria using DDST compared to molecular methods (95% CI=41.92 to 54.55; p<0.0001, as well as a DDST and VITEK 2/AES (95% CI=40.13 to 52.73; p<0.0001. We did not find any statistically significant difference in the results of detection of ESBL producers using molecular techniques and VITEK 2/AES (CI=-4,43 to 5,36; p=1. Also we did not find any statistical difference between the resistance to cefpodoxime and ceftriaxone (50/50 compared to the results of molecular tests. Conclusion. In routine daily testing, good detection of ESBLs bacteria, especially CTX-M can be obtained with phenotypic methods with VITEK 2/AES and by DDST with cefpodoxime, and ceftriaksone disks.

  2. 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

  3. Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

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    Vacek TP

    2014-09-01

    Full Text Available Thomas P Vacek, Shahnaz Rehman, Shipeng Yu, Ankush Moza, Ragheb Assaly Department of Internal Medicine, The University of Toledo Medical Center, Toledo OH, USAAbstract: Chest pain requires a detailed differential diagnosis with good history-taking skills to differentiate between cardiogenic and noncardiogenic causes. Moreover, when other symptoms such as fever and elevated white blood cell count are involved, it may be necessary to consider causes that include infectious sources. A 53-year-old female with no significant past medical history returned to the hospital with recurrent complaints of chest pain that was constant, substernal, reproducible, and exacerbated with inspiration and expiration. The chest pain was thought to be noncardiogenic, as electrocardiography did not demonstrate changes, and cardiac enzymes were found to be negative for signs of ischemia. The patient's blood cultures were analyzed from a previous admission and were shown to be positive for Staphylococcus aureus. The patient was started empirically on vancomycin, which was later switched to ceftriaxone as the bacteria were more sensitive to this antibiotic. A transthoracic echocardiogram did not demonstrate any vegetation or signs of endocarditis. There was a small right pleural effusion discovered on X-ray. Therefore, computed tomography as well as magnetic resonance imaging of the chest were performed, and showed osteomyelitis of the chest. The patient was continued on intravenous ceftriaxone for a total of 6 weeks. Tests for HIV, hepatitis A, B, and C were all found to be negative. The patient had no history of childhood illness, recurrent infections, or previous trauma to the chest, and had had no recent respiratory infections, pneumonia, or any underlying lung condition. Hence, her condition was thought to be a case of primary sternal osteomyelitis without known cause.Keywords: substernal, pleuritic, myocardial infarction, differential

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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。

  11. 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.

  12. 超剂量拉莫三嗪与丙戊酸钠联用致全身皮疹%Generalized skin eruptions related to overdose of lamotrigine combined with valproate sodium

    Institute of Scientific and Technical Information of China (English)

    王丽君; 刘刚; 王宇; 战寒秋; 汤艳芬; 陈奇

    2015-01-01

    1例41岁男性患者胶质母细胞瘤切除术后出现癫痫,给予奥卡西平(初始剂量为0.3 g、2次/ d,后加至0.6 g、2次/ d)和丙戊酸钠(500 mg、1次/ d)口服,因癫痫控制不佳加用拉莫三嗪(25 mg 鼻饲、2次/ d)。加用拉莫三嗪第17天因出现肺感染给予头孢曲松(2 g 静脉滴注、1次/ d)。加用拉莫三嗪第19天,患者面颈部、胸背部、双上肢、腹部、双下肢依次出现鲜红色斑丘疹,部分融合成片,诊断为药疹。停用拉莫三嗪和头孢曲松,奥卡西平和丙戊酸钠继续应用,并给予地塞米松,葡萄糖酸钙、维生素 C 等治疗。5 d 后患者皮损好转,9 d 后皮疹消退。%A 41-year-old man with epilepsy after glioblastoma resection received oral oxcarbazepine (an initial dose of 0. 3 g twice daily,which was increased to 0. 6 g twice daily)and valproate sodium (500 mg,once daily). Nasal feeding lamotrigine 25 mg twice daily was added to her regimen due to poor control of epileptic condition. On day 17 of lamotrigine therapy,an IV infusion of ceftriaxone 2 g once daily was given for pulmonary infection. On day 19 of lamotrigine therapy, the patient developed red maculopapular eruptions successively on the face,neck,chest,back,arms,abdomen and legs,some rashes fused into lamella. He was diagnosed drug eruptions. Lamotrigine and ceftriaxone were discontinued immediately. Oxcarbazepine and valproate sodium were continued. He was given dexamethasone,calcium gluconate and vitamin C. Five days later,his skin lesions were improved. Nine days after lamotrigine withdrawal,the skin eruptions subsided.

  13. 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

  14. [Guidelines for treatment of pneumonia in intensive care units].

    Science.gov (United States)

    Emmi, V

    2005-01-01

    Patients affected by pneumonia can be admitted in Intensive Care Units (ICUs) independently by the setting where the infection has been acquired (community, hospital, long-term care facilities); even more frequently pneumonia can develop in patients already hospitalized in ICU especially in those requiring mechanical ventilation for different reasons. Within the severe community acquired pneumonia requiring admission in ICU, the most frequently responsible micro-organisms are mainly represented by Streptococcus pneumoniae, but also by Legionella and Haemophilus. Pseudomonas aeruginona, anyway, cannot be excluded. The most recent Canadian and American guidelines for treatment of the above mentioned infections suggest the use of a combination therapy with beta-lactams (ceftriaxone, cefotaxime, ampicillin/sulbactam, piperacillin/tazobactam) and a new generation macrolide or respiratory fluoroquinolone. In case of allergy to beta-lactams, the association fluoroquinolone-clindamycin should be preferred. Whenever a Pseudomonas etiology is suspected because of the presence of risk factors such as COPD, cystic fibrosis, bronchiectasis, previous and/or frequent therapies with antibiotics and/or steroids, the same guidelines suggest the use of an anti-pseudomonas beta-lactam (such as piperacillin/tazobactam, carbapenems, cefepime) associated with an anti-pseudomonas fluoroquinolone (high doses ciprofloxacin). An anti-pseudomonas beta-lactam plus an aminoglycoside or aminoglicosyde plus fluoroquinolone can be an alternative. Early onset Hospital Acquired Pneumonia (HAP) and early onset Ventilator Associated Pneumonia (VAP) in patients without risk factors for multi-resistant etiological agents are generally sustained by S. pneumoniae, H. influenzae, methicillin-susceptible Staphylocccus aureus e Gram negative enteric rods. These infections can be treated with one of the following antibiotics: ceftriaxone or fluoroquinolones (moxifloxacin or ciprofloxacin or levofloxacin) or

  15. Synthesis and characterization of amoxicillin derived silver nanoparticles: Its catalytic effect on degradation of some pharmaceutical antibiotics

    International Nuclear Information System (INIS)

    Graphical abstract: - Highlights: • Amp-Ag (0) NPs were prepared by simple one-pot chemical reduction method. • Ampicillin as an antibiotic was used as both reducing and capping agents in this study. • Amp-Ag (0) NPs have proved as the remarkably efficient catalysts with enhanced rate of reduction for cefdinir, cefditoren, cefixime, ceftriaxone sodium and doxycycline. • Amp-Ag (0) NPs were showed excellent catalytic activity as catalyst for the 100% reduction of these antibiotics. - Abstract: We synthesized novel amoxicillin derived silver nanoparticles (Amp-Ag (0) NPs) in aqueous solution by one-pot simple synthetic method by reducing silver nitrate by the help of amoxicillin antibiotic as a reducing/capping agent and NaOH as the catalyst for reaction enhancement. The formation of the Amp-Ag (0) NPs was monitored using UV–Vis absorption spectroscopy which confirmed the formation of Amp-Ag (0) NPs by exciting the typical surface plasmon absorption maxima at 404 nm. Transmission electron microscopy (TEM) confirmed the spherical morphology and monodispersed Amp-Ag (0) NPs with particle size 6.87 ± 2.2 nm. The antibacterial activities of the antibiotics were evaluated against Gram-negative bacteria Escherichia coli, Salmonella enteritidis, Pseudomonas aeruginosa and Gram-positive bacteria Streptococcus pneumonia, Streptococcus pyogenes, Staphylococcus aureus by the disk diffusion method. Whereas standard antibiotics showed normal zone of inhibition, the reduced ones with Amp-Ag (0) NPs showed no inhibition zone. The antimicrobial results therefore reveal that newly synthesized Amp-Ag (0) NPs had an excellent catalytic activity as catalyst for the 100% reduction of antibiotics i.e. cefdinir, cefditoren, cefiximee, ceftriaxone sodium and doxycycline, which was carried out in just 2–5 min. They were recovered easily from reaction medium and reused with enhanced catalytic potential five times. Based upon these results it has been concluded that Amp-Ag (0) NPs

  16. 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

  17. [A sepsis case caused by a rare opportunistic pathogen: Bacillus pumilus].

    Science.gov (United States)

    Borsa, Barış Ata; Aldağ, Mehmet Ersoy; Tunalı, Birsen; Dinç, Uğur; Güngördü Dalar, Zeynep; Özalp, Veli Cengiz

    2016-07-01

    trimethoprim-sulfamethoxazole. Initial treatment of patient was started with intravenous ceftriaxone and metronidazole empirically. Hypotension and fever returned to normal levels at the second and third days of the treatment, respectively. Metronidazole treatment was stopped at seventh day, and treatment was completed to 14 day with ceftriaxone alone. At the end of the treatment course, general condition of the patient was completely good, ESR and CRP were also decreased to normal levels. In conclusion, although most of the reported bloodstream infections that are caused by B.pumilus are intravascular catheter-related, artificial heart valves should also be considered as a risk factor even though vegetation was not detected in our patient. PMID:27525402

  18. 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

  19. Investigation of the sensitivity of E. coli strains isolated from domestic animals to antibiotics and hemiotherapeutics in vitro

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    Gavrović Miloš

    2011-01-01

    Full Text Available Resistance to antibiotics is not a modern phenomenon. On the contrary, penicillin resistance in some bacterial strains developed quickly after its introduction into daily practice. At the same time some bacterial strains developed resistance to almost all known antibiotics, vancomycin included. Vancomycin was for a long time the only efficient antibiotic against staphylococcal infections. It is of special concern the fact that antibiotics are in everyday exploitation in agriculture and veterinary clinical practice which use them not only as a mean of therapeutic treatment, but as an additive in animal feedstuffs in order to promote growth and prevent bacterial infections. The same antibiotics are used in human medicine, which is a persistent problem. In such a way it is possible to develop resistance which can be transferred to human pathogenic bacteria via mobile genetic elements. The incidence of resistant bacterial strains increases year after year not only on a local level, but on a global scale, as well. Monitoring of the use of antibiotics and chemotherapeutics in the Republic of Serbia is not established as such, our intention was to study a number of bacteria isolated from cattle, pigs, poultry, dogs and cats. At this time we are presenting the results for pathogenic strains of E. coli in order to determine the use of antibiotics and chemotherapeutics of the old and new generations in domestic animals. E. coli sensitivity was investigated with the disc diffusion test for: ampicillin, amoxicillin with clavulanic acid, tetracycline, chloramphenicol, gentamicin, and ceftriaxon, sulphamethoxasole with trimethoprim, ciprofloxacin and florfenicol. E. coli strains resistant to three or more antibiotics were tested by means of agar dilution method for ciprofloxacin, tetracycline, chloramphenicol, gentamicin and amoxicillin with clavulanic acid by determination of the minimal inhibitory concentration (MIC. The tested E. coli strains resulted

  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. Asymptomatic bacteriuria among pregnant women

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    Paul Erhunmwunse Imade

    2010-06-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  2. Asymptomatic bacteriuria among pregnant women

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    Paul Erhunmwunse Imade

    2010-01-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion : Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  3. Antibiotic Resistance in Children with Bloody Diarrhea

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    Hamedi Abdolkarim

    2009-05-01

    Full Text Available Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(TMP-SMX; however multidrug-resistance has occurred and careful antibiotic selection must be considered in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroquinolones may be used in adults and oral third-generation cephalosporins and nalidixic acid in children. All children (n=2400 with acute diarrhea who were admitted to the Pediatric department of Dr.sheykh Hospital Mashhad, Iran from March 2004 to March 2005 were selected and their stool culture were obtained, then positive cultures (312 cases,13% were evaluated by antibiogram. This study showed that in heavily populated areas of IRAN like Mashhad, 97% shigella strain isolated from children with bloody diarrhea were sensitive to nalidixic acid, ciprofloxacin and cefixime and rarely susceptible to ampicillin and cotrimoxazole. There is increasing resistance of Shigella to most of the antibiotics in use, and for this reason, careful selection of antibiotics must use considered in each area. Development and use of new drugs are expensive and have severe limitations in the third world. Simple prophylactic alternatives are therefore, required, such as awareness of hygienic child care practices and early promotion of breast feeding. For treatment of shigellosis in infants Ceftriaxon, and in children Nalidixic Acid is recommended.

  4. Comb-Type Grafted Hydrogels of PNIPAM and PDMAEMA with Reversed Network-Graft Architectures from Controlled Radical Polymerizations

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    Sheng-Qi Chen

    2016-02-01

    Full Text Available Dual thermo- and pH-responsive comb-type grafted hydrogels of poly(N,N-dimethylaminoethyl methacrylate (PDMAEMA and poly(N-isopropylacrylamide (PNIPAM with reversed network-graft architectures were synthesized by the combination of atom transfer radical polymerization (ATRP, reversible addition-fragmentation chain transfer (RAFT polymerization and click chemistry. Two kinds of macro-cross-linkers with two azido groups at one chain-end and different chain length [PNIPAM–(N32 and PDMAEMA–(N32] were prepared with N,N-di(β-azidoethyl 2-halocarboxylamide as the ATRP initiator. Through RAFT copolymerization of DMAEMA or NIPAM with propargyl acrylate (ProA using dibenzyltrithiocarbonate as a chain transfer agent, two network precursors with different content of alkynyl side-groups [P(DMAEMA-co-ProA and P(NIPAM-co-ProA] were obtained. The subsequent azido-alkynyl click reaction of macro-cross-linkers and network precursors led to the formation of the network-graft hydrogels. These dual stimulus-sensitive hydrogels exhibited rapid response, high swelling ratio and reproducible swelling/de-swelling cycles under different temperatures and pH values. The influences of cross-linkage density and network-graft architecture on the properties of the hydrogels were investigated. The release of ceftriaxone sodium from these hydrogels showed both thermal- and pH-dependence, suggesting the feasibility of these hydrogels as thermo- and pH-dependent drug release devices.

  5. Procalcitonin implication in renal cell apoptosis induced by acute pyelonephritis in children

    Science.gov (United States)

    Belhadj-Tahar, Hafid; Coulais, Yvon; Tafani, Mathieu; Bouissou, François

    2008-01-01

    The aim of this biomedical trial was to clarify the physiological role of procalcitonin (PCT) in renal parenchyma apoptosis and fibrosis caused by acute childhood pyelonephritis. This prospective study enrolled 183 children. All children were treated with bi-therapy according to the French consensus on acute pyelonephritis treatment dated November 16, 1990: intra-vascular administration of ceftriaxone 50 mg/kg/day and netromicine 7 mg/kg/day during the first 48 hours, followed by specific antibiotherapy suited to antibiogram. On admission, PCT, C-reactive protein, and phospholipase A2 were quantified in serum. Scintigraphy monitoring with 99mTc-DMSA was performed on day 4 and 9 months later, in the presence of persistent abnormalities. On day 4, 78% presented renal parenchyma alterations and 30% renal fibrosis 9 months after admission. Paradoxically, PCT level was significantly lower in the presence of renal fibrosis due to cell apoptosis (4.19 vs 7.59 μgL−1). A significant increase in PCT indicated favorable progress (recovery 7.55 vs aggravation 3.34) and no difference between recovery and improvement. This result suggests the protective effect of PCT against apoptosis by nitric oxide down-regulation. PMID:21694876

  6. Systemic lupus erythematosus and splenic abscess

    International Nuclear Information System (INIS)

    Systemic lupus erythematosus is an autoimmune disease in which there is an increase risk of infections by common germ as by opportunistic germs. This fact is explained by the alterations in the humoral and cellular immunity, and phagocytic mononuclear system due to the disease and the immunosuppressive therapy use for its treatment. Multiple infectious processes have been describes in patients with SLE and within them, the splenic abscess, although in few cases. Usually its presence is associated with an underlying disease such as sepsis or peritonitis, with multiple outcomes. Due to its low frequency as well as the unusual presentation, we reported a case of a solitary splenic abscess documented by ultrasound in a teenager with SLE and immunosuppressive treatment, without any underlying infection, who presents with fever, abdominal pain, leucocytosis and elevation of acute phase reactants. He received antibiotic therapy with clindamycin and ceftriaxone and percutaneous drainage of the abscess guided by ultrasound and sent to culture in which grew non-typificable anaerobe germs, with a favorable evolution after 5 year of follow up

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

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    Liapikou A

    2015-08-01

    Full Text Available Adamantia Liapikou,1 Catia Cillóniz,2 Antonio Torres216th Respiratory Department, Sotiria Chest Diseases Hospital, Athens, Greece; 2Pulmonology Department, Clinic Institute of Thorax (ICT, Hospital Clinic of Barcelona, Spain Insitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS, Barcelona, SpainAbstract: 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.Keywords: antibiotic resistance, methicillin-resistant staphylococci, community-acquired pneumonia, hospital-acquired pneumonia, cephalosporins

  8. Primary swenson′s pull-through in children with chronic constipation: A preliminary report

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    Bakare Tajudeen I

    2010-01-01

    Full Text Available Background: The discrepancy in diameters of the resected ends coupled with the heavy faecal loads in the colon of chronically constipated children with Hirschsprung′s disease makes definitive primary pull-through procedure quite difficulty in this group. Patients and Methods: Four consecutive patients (aged 5 months to 11 years who presented with chronic constipation were given warm saline enema along with Castor oil per oram twice daily for 1 week before and 2 weeks after full-thickness biopsies that confirmed Hirschsprung′s disease. All patients had intravenous Cefuroxime or Ceftriaxone plus Metronidazole at induction of anaesthesia. Intra-operatively, the levels of resections were 6-8 cm proximal to the most contractile part of the colon adjacent to the transition zone observed after complete division of mesenteric vessels. Results: There were three males and one female, aged 5 months to 11 years. The levels of aganglionosis were in the rectosigmoid region, except one in the descending colon. There was one case each of anastomotic stenoses, mild enterocolitis and deep peri-anal excoriation. The bowel motions were two to four times daily within 1 month post-operatively. Conclusion: It can be concluded from this preliminary study that with pre-operative saline enema and oral Castor oil for about 3 weeks in chronically constipated children with Hirschsprung′s disease primary pull-through procedures can be performed successfully. However, further prospective work is required with this method.

  9. Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria

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    Ikefuna Anthony N

    2011-09-01

    Full Text Available Abstract Background Urinary tract infection (UTI is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Methods One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml on two consecutive cultures were regarded as having asymptomatic bacteriuria. Results Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1 when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%. All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones. Conclusion The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.

  10. MICROBIOLOGICAL PROFILE OF BILE IN CHOLELITHIASIS AND THEIR IMPLICATION IN CAUSING POST OPERATIVE WOUND INFECTIONS

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    Shahi

    2014-12-01

    Full Text Available BACKGROUND: Cholecystitis is a common indication for major abdominal surgeries. It may occur with or without obstruction of common bile duct. Obstruction leads to secondary bacterial infection of bile. Bactibilia is an important predisposing factor for post-operative complications. Hence, this study was designed to determine the prevalence of bacteria in bile samples of cholecystitis patients and to correlate bactibilia and post-operative wound infection. MATERIALS AND METHODS: Bile samples collected intra-operatively were subjected to gram stain, culture, and antibiotic sensitivity testing. The patients were followed-up for post-operative complications. If post-operative wound infection was found, cultures were done and correlated with bacteria isolated from bile samples. RESULTS: Bactibilia was found in 43/100 (43% of patients. Polymicrobial flora was found in 7% of bile samples. Escherichia coli, citrobacter, Klebsiella pneumoniae and pseudomonas were the predominant organisms isolated. Post-operative wound infection was found in ten (10% patients who had bactibilia. Amikacin, gentamicin, ceftriaxone sulbatum, pipracillin tazobactum, imipenem were among most effective in prophylactic regimen. CONCLUSION: The organisms responsible for bactibilia were found to cause post-operative infections in the same patient warranting the use of prophylactic antibiotics in every patient undergoing cholecystectomy. All patients undergoing cholecystectomy should receive prophylactic antibiotic to prevent post-operative wound infections.

  11. Alternative Pathway Inhibition by Exogenous Factor H Fails to Attenuate Inflammation and Vascular Leakage in Experimental Pneumococcal Sepsis in Mice.

    Science.gov (United States)

    van der Maten, Erika; van Selm, Saskia; Langereis, Jeroen D; Bootsma, Hester J; van Opzeeland, Fred J H; de Groot, Ronald; de Jonge, Marien I; van der Flier, Michiel

    2016-01-01

    Streptococcus pneumoniae is a common cause of sepsis. Effective complement activation is an important component of host defence against invading pathogens, whilst excessive complement activation has been associated with endothelial dysfunction and organ damage. The alternative pathway amplification loop is important for the enhancement of complement activation. Factor H is a key negative regulator of the alternative pathway amplification loop and contributes to tight control of complement activation. We assessed the effect of inhibition of the alternative pathway on sepsis associated inflammation and disease severity using human factor H treatment in a clinically relevant mice model of pneumococcal sepsis. Mice were infected intravenously with live Streptococcus pneumoniae. At the first clinical signs of infection, 17 hours post-infection, mice were treated with ceftriaxone antibiotic. At the same time purified human factor H or in controls PBS was administered. Treatment with human factor H did not attenuate disease scores, serum pro-inflammatory cytokines, or vascular permeability and did not significantly affect C3 and C3a production at 26 h post-infection. Therefore, we conclude that inhibition of the alternative complement pathway by exogenous human factor H fails to attenuate inflammation and vascular leakage at a clinically relevant intervention time point in pneumococcal sepsis in mice. PMID:26872035

  12. Stroke as an Unusual First Presentation of Lyme Disease

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    Mohamad Almoussa

    2015-01-01

    Full Text Available Introduction. Lyme neuroborreliosis is a nervous system infection caused by spirochete Borrelia burgdorferi with diverse neurological complications. Stroke due to cerebral vasculitis is a rare consequence of neuroborreliosis and has been described in just a few case reports. Case Presentation. Here, we report the case of a 43-year-old patient who presented with discrete left-sided hemiparesis and amnestic cognitive impairment. Brain magnetic resonance imaging showed a thalamic infarct, and serological and cerebrospinal fluid (CSF tests confirmed the diagnosis of active neuroborreliosis. The antibiotic treatment with intravenous ceftriaxone for three weeks led to an improvement of the symptoms and remarkable regression of radiological findings, but not to full recovery of the amnestic cognitive disorder. Conclusion. Lyme neuroborreliosis should be suspected in patients with cerebrovascular events without obvious risk factors, especially those living in endemic areas such as northern Europe or those who have been exposed to ticks and those with clinical or radiological findings suggesting Lyme neuroborreliosis, in order to establish the diagnosis and start a proper antibiotic therapy.

  13. DURACION DE LA ESTADIA HOSPITALARIA POR NEUMONIA COMUNITARIA CON LA APLICACION RIGUROSA DEL CONSENSO CHILENO 2005.

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    Dr Luis Sanhueza A.

    2007-12-01

    Full Text Available INTRODUCTION: Community adquired pneumonia (CAP isan acute respiratory infection prevalent in our country. Ourgoal is to evaluate impact of national guideline implementation(Chilean CAP consensus 2005, in patients diagnosed with CAPGroup 3 (G3, in terms of the clinical evolution and hospitalizationtime among others variables assessed. For this purposeclinical records from the Medicine Service of the Yumbel Hospitalwere reviewed, between January 2006 and March 2007. ceftriaxone1 gr/day in 92 patients (95,83%. A Macrolide was associateafter 48 hours in 10 patients (10,4%. DISCUSION: In our seriesit was safe changing oral antibiotic and early discharging patientsas compared with other national registries.

  14. Speciation of coagulase negative Staphylococcal isolates from clinically significant specimens and their antibiogram

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    M G Usha

    2013-01-01

    Full Text Available Background: Despite their frequency as contaminants, coagulase-negative Staphylococci (CONS have become important nosocomial pathogens, accounting for 9% of all nosocomial infections. These infections are difficult to treat because of the risk factors and the multiple drug resistance nature of these organisms. Materials and Methods: One hundred and two consecutive CONS were isolated from various clinical samples like blood, pus, urine, urine catheter tip and gastric lavage. Most of the blood samples were from patients with risk factors (immunocompromised or on medical devices. After confirming the isolates as CONS, species-level identification was performed by simple, non-expensive conventional methods and antibiotic sensitivity testing was also carried out. Results: Of 102 CONS isolates, 100 isolates could be identified to the species level. Among the 100 isolates, epidermidis was the most common species isolated, seen in 32%, followed by S. hemolyticus (18%, S. lugdunensis (12%, S. hominis (10%, S. saprophyticus (8%, S. capitis (6%, S. caprae (4%, S. xylosus (4%, S. cohni and S. warneri (3% each. In the present study, 56% of the isolates were methicillin-resistant CONS. Most of the isolates showed resistance to ampicillin and amoxyclav (89% each, followed by ceftriaxone (52%, cotrimoxazole (46%, cefotaxime (32%, gentamicin (25%, amikacin (21%. Conclusion: The increased pathogenic potential and multiple-drug resistance demonstrates the need to adopt simple, reliable and non-expensive methods for identifying and determining the antibiotic sensitivity of CONS.

  15. A Case of Neonatal Neutropenia Due to Anti-Fc Gamma Receptor IIIb Isoantibodies Treated with Recombinant Human Granulocyte Colony Stimulating Factor

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    Maja Tomicic

    2009-01-01

    Full Text Available Alloimmunization to granulocyte-specific antigens can occur during pregnancy. Maternal antibodies of IgG class can cross the placenta to result in alloimmune neonatal neutropenia. Antibodies to human neutrophil antigens anti-HNA-1a, HNA-1b, and HNA-2a have been most commonly reported to cause alloimmune neonatal neutropenia. Isoantibodies to Fc gamma RIIIb (CD16 if mother is a HNA-null phenotype are rarely involved in neonatal neutropenia. We report on a case of severe neutropenia (440 neutrophils/μL due to anti-Fc gamma RIIIb (CD16 isoimmunization. On day 14 severe omphalitis developed, which was treated for 7 days by an antibiotic (ceftriaxone in a dose of 80 mg/kg/d according to umbilical swab finding. Omphalitis persisted for 10 days in spite of antibiotic therapy and only resolved upon the introduction of rhG-CSF therapy. Therapy with rh-GCSF proved efficient and led to neutrophil count increase to 1970/μL and cure of omphalitis. However, therapeutic effect on granulocyte count was of transient nature, as granulocyte count fell to 760 n/μL on day 4 of therapy discontinuation. Neutropenia persisted for 2 months. The newborn was discharged from the hospital on day 26 with normal clinical status with clinical and laboratory control examinations at 2-week intervals. No additional infections were observed during the course of neutropenia.

  16. Adult bacterial meningitis

    DEFF Research Database (Denmark)

    Meyer, C N; Samuelsson, I S; Galle, M;

    2004-01-01

    Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin susceptibi......Episodes of adult bacterial meningitis (ABM) at a Danish hospital in 1991-2000 were identified from the databases of the Department of Clinical Microbiology, and compared with data from the Danish National Patient Register and the Danish National Notification System. Reduced penicillin...... susceptibility occurred in 21 (23%) of 92 cases of known aetiology, compared to an estimated 6% in nationally notified cases (p <0.001). Ceftriaxone plus penicillin as empirical treatment was appropriate in 97% of ABM cases in the study population, and in 99.6% of nationally notified cases. The notification rate...... was 75% for penicillin-susceptible episodes, and 24% for penicillin-non-susceptible episodes (p <0.001). Cases involving staphylococci, Pseudomonas spp. and Enterobacteriaceae were under-reported. Among 51 ABM cases with no identified risk factors, nine of 11 cases with penicillin...

  17. [Lyme disease--clinical manifestations and treatment].

    Science.gov (United States)

    Stock, Ingo

    2016-05-01

    Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings. PMID:27348896

  18. Metformin-Associated L actic A cidosis: A Case Report

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    Salih İNAL

    2015-09-01

    Full Text Available A 65-year-old man was admitted to the emergency department with the complaints of general discomfort, nausea, vomiting, abdominal pain, dysuria and shortness of breath. Type II diabetes mellitus, essential hypertension, atrial fibrillation and chronic obstructive pulmonary disease were noted in his medical history. He was using metformin, warfarin and diltiazem besides inhaler medications. Laboratory test results were as follows: BUN 52 mg/dl, creatinine 2.9 mg/dl (one month ago it was 0.9 mg/dl, potassium 6.3 mmol/L, PT-INR 17.78, arterial blood pH 7.05, bicarbonate 5.3 mmol/L, partial carbon dioxide pressure 19 mmHg, and lactate level 175 mg/dl. The urine examination revealed pyuria and urinary density was 1028. The patient was considered to suffer from acute kidney injury, urinary tract infection and metformin-associated lactic acidosis (MALA. Metformin was withdrawn immediately and acute hemodialysis was planned. However, a central venous catheter could not be inserted because of high PT-INR values. Parenteral 0.9% NaCl, glucose – insulin solution infusions, sodium bicarbonate infusion as well as empirical intravenous ceftriaxone treatments were started. He dramatically responded to medical therapy and did not require any dialysis support. In the literature, hemodialysis has been proposed as the initial treatment modality of MALA. However, herein, we presented a favorable outcome without utilizing hemodialysis.

  19. The frequency of resistance to antibiotics of most frequently isolated bacteria from blood cultures during the period 1997-2002

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    Mirović Veljko

    2004-01-01

    Full Text Available The aim of this study was to determine the frequency of resistance to antibiotics of the most frequently isolated bacteria from blood cultures of hospitalized patients during the period 1997-2002. The resistance to antibiotics was determined by disk diffusion method according to National Committee for Clinical Laboratory Standards procedures. The majority of staphylococci isolates were resistant to methicillin, and the proportion of methicillin-resistant Staphylococcus aureus was stable (76.8-81.6%, during the follow-up period. None of the staphylococci isolates were resistant to vancomycin, but there was a very high incidence of high-level resistance of enterococci to aminoglycosides (47.2-72.2%. In 1998, only one strain among enterococci was resistant to vancomycin (Enterococcus faecium, VanA fenotype. Enterococcus spp isolates expressed variable frequency of resistance to ampicillin (15-40.1% during the follow-up period. Among Enterobacteriaceae there were no isolates resistant to imipenem, but dramatic increase of the resistance to ceftriaxone was found from 35.9% in 1997 to 95.9% in 2002 (p<0.001. Extended spectrum beta-lactamases production was found in all the species of enterobacteria isolates. Resistance to imipenem was observed in Acinetobacter spp isolates in 2002 for the first time. Pseudomonas spp isolates expressed high and very variable resistance to all antibiotics tested during the follow-up period.

  20. Enterococcal surface protein Esp is not essential for cell adhesion and intestinal colonization of Enterococcus faecium in mice

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    van Luit-Asbroek Miranda

    2009-01-01

    Full Text Available Abstract Background Enterococcus faecium has globally emerged as a cause of hospital-acquired infections with high colonization rates in hospitalized patients. The enterococcal surface protein Esp, identified as a potential virulence factor, is specifically linked to nosocomial clonal lineages that are genetically distinct from indigenous E. faecium strains. To investigate whether Esp facilitates bacterial adherence and intestinal colonization of E. faecium, we used human colorectal adenocarcinoma cells (Caco-2 cells and an experimental colonization model in mice. Results No differences in adherence to Caco-2 cells were found between an Esp expressing strain of E. faecium (E1162 and its isogenic Esp-deficient mutant (E1162Δesp. Mice, kept under ceftriaxone treatment, were inoculated orally with either E1162, E1162Δesp or both strains simultaneously. Both E1162 and E1162Δesp were able to colonize the murine intestines with high and comparable numbers. No differences were found in the contents of cecum and colon. Both E1162 and E1162Δesp were able to translocate to the mesenteric lymph nodes. Conclusion These results suggest that Esp is not essential for Caco-2 cell adherence and intestinal colonization or translocation of E. faecium in mice.

  1. Characteristics of Salmonella spp. Isolated from Wild Birds Confiscated in Illegal Trade Markets, Rio de Janeiro, Brazil

    Science.gov (United States)

    Matias, Carlos Alexandre Rey; Pereira, Ingrid Annes; de Araújo, Maiara dos Santos; Santos, André Felipe Mercês; Lopes, Rudi Pereira; Christakis, Sandra; Rodrigues, Dália dos Prazeres; Siciliano, Salvatore

    2016-01-01

    The prevalence of Salmonella spp. was investigated in 109 wild birds poached in the illegal wildlife trade in Rio de Janeiro; most of them are passerines from Thraupidae family and three from Psittacidae. One strain of Salmonella ser. Typhimurium and two strains of Salmonella ser. Panama were isolated from passerine species and all of them showed resistance to multiple antimicrobial drugs, like ampicillin, ceftriaxone, ceftiofur, tetracycline, gentamicin, nalidixic acid, ciprofloxacin, and enrofloxacin. PFGE showed 100% similarity among the Salmonella ser. Typhimurium strain isolated from a Temminck's seedeater (Sporophila falcirostris) and the strains isolated from a human outbreak, in southern Brazil. The two Salmonella ser. Panama strains isolated from two chestnut-capped blackbirds (Chrysomus ruficapillus) present in the same catch showed the same clonal origin and have never been associated with epizooties and human outbreaks. Potential for dissemination of resistant Salmonella through situations offered by captive management and the isolation of the same strain from wild birds and human sources may become a problem for the conservation of natural populations and to public health. PMID:26881216

  2. Salmonella bacteraemia among healthcare workers and their dependents

    International Nuclear Information System (INIS)

    Objectives: To determine the incidence and resistance pattern of Salmonella infection in healthcare workers and their dependents. Methods: The retrospective analysis was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and comprised records of employees and their dependents with bacteraemia from January 2007 to December 2011. Person-years were calculated using data from the human resources department. SPSS 19 was used for statistical analyses. Results: Of the total 2532 records available, 82(3.23%) patients were identified with Salmonella bacteraemia. Of them, 34(41.5%) patients were in age group 1-10, 15(18.3%) in 11-20, 26(31.7%) in 21-30, and 7(8.5%) were above 30 years. Besides, 48(58.5%) were males. Salmonella typhi was found in 44(53.7%) patients, Salmonella paratyphi A in 35(42.7%) and Salmonella species in 3(3.7%) patients. The yearly incidence of Salmonella infection in the study population ranged from 206 to 596 per 100000 person-years. Ciprofloxacin resistance was noted to be 56 (68.2%) followed by Ampicillin 29 (35.3%) and Co-trimoxazole 24 (29.2%). No strains were resistant to Cefiximeor Ceftriaxone. Conclusion: The yearly incidence of Salmonella bacteraemia ranged from 200 to 600 per 100000 person years. There was significant quinolone resistance among the isolates. (author)

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

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    Kai-zhong DONG

    2015-01-01

    Full Text Available Objective To observe the effect of Cordyceps sinensis mycelium on serum vasoactive intestinal peptide (VIP and substance P (SP in mice with dysbacteriosis induced by antibiotics. Methods Forty-eight healthy SPF BALB/c mice were randomly divided into the normal control group (normal drink, the dysbacteriosis model group (induced by oral administration of 0.5 g/L ceftriaxone sodium, the natural recovery group (oral sterile water to replace antibiotic after reproduction of dysbacteriosis, and Cordyceps sinensis mycelium treatment group (treated by intragastric administration of Cordyceps sinensis mycelium. The feces were collected without contamination, and the change in intestinal bacterial number was observed with the plate dilution method. The volatile fatty acid was detected by chromatography. The serum VIP and SP contents were assayed with enzyme linked immunosorbent assay (ELISA. Results Compared with the normal control group, the numbers of probiotics, volatile fatty acids and serum VIP significantly decreased in the model group, while the serum SP markedly increased (P<0.01. Compared with the natural recovery group, the bacteria number, the quantities of volatile fatty acids and serum VIP significantly increased after the Cordyceps sinensis mycelium treatment, while the serum SP significantly decreased (P<0.01, P<0.05. Conclusion Cordyceps sinensis mycelium may effectively adjust the proportion of the probiotics in the mice with dysbacteriosis, and the mechanism is apparently related to alteration in the VIP and SP. DOI: 10.11855/j.issn.0577-7402.2014.11.06

  4. Genomic Epidemiology and Molecular Resistance Mechanisms of Azithromycin-Resistant Neisseria gonorrhoeae in Canada from 1997 to 2014.

    Science.gov (United States)

    Demczuk, Walter; Martin, Irene; Peterson, Shelley; Bharat, Amrita; Van Domselaar, Gary; Graham, Morag; Lefebvre, Brigitte; Allen, Vanessa; Hoang, Linda; Tyrrell, Greg; Horsman, Greg; Wylie, John; Haldane, David; Archibald, Chris; Wong, Tom; Unemo, Magnus; Mulvey, Michael R

    2016-05-01

    The emergence of Neisseria gonorrhoeae strains with decreased susceptibility to cephalosporins and azithromycin (AZM) resistance (AZM(r)) represents a public health threat of untreatable gonorrhea infections. Genomic epidemiology through whole-genome sequencing was used to describe the emergence, dissemination, and spread of AZM(r) strains. The genomes of 213 AZM(r) and 23 AZM-susceptible N. gonorrhoeae isolates collected in Canada from 1989 to 2014 were sequenced. Core single nucleotide polymorphism (SNP) phylogenomic analysis resolved 246 isolates into 13 lineages. High-level AZM(r) (MICs ≥ 256 μg/ml) was found in 5 phylogenetically diverse isolates, all of which possessed the A2059G mutation (Escherichia coli numbering) in all four 23S rRNA alleles. One isolate with high-level AZM(r) collected in 2009 concurrently had decreased susceptibility to ceftriaxone (MIC = 0.125 μg/ml). An increase in the number of 23S rRNA alleles with the C2611T mutations (E. coli numbering) conferred low to moderate levels of AZM(r) (MICs = 2 to 4 and 8 to 32 μg/ml, respectively). Low-level AZM(r) was also associated with mtrR promoter mutations, including the -35A deletion and the presence of Neisseria meningitidis-like sequences. Geographic and temporal phylogenetic clustering indicates that emergent AZM(r) strains arise independently and can then rapidly expand clonally in a region through local sexual networks. PMID:26935729

  5. The frequency of Neisseria gonorrhoeae endocervical infection among female carrier and changing trends of antimicrobial susceptibility patterns in Kashan, Iran.

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    Shima Afrasiabi

    2014-06-01

    Full Text Available Neisseria gonorrhoeae is the second most sexually transmitted diseases agents in developing countries. Antimicrobial resistance strains have created serious health concern. The aim of this study was to determine the frequency of endocervical gonococcal infection and antimicrobial susceptibility of N. gonorrhoeae in Kashan, Iran.In this study, 294 endocervical swabs were collected from married women referred to the obstetrics and gynecology clinics in Kashan from December 2012 to May 2013. The samples were cultured in modified Thayer Martin in 37°C with 5-10% CO2 for 72 hours. Gram staining, oxidase, catalase and carbohydrate utilization tests were used to identify the isolated species. All isolates were tested for their susceptibilities to antimicrobials using the Kirby Bauer-disk diffusion techniques.N. gonorrhoeae was detected in 2.38% of studied cases (95% confidence interval [CI] 1.5-3.26%. All isolates were resistance to ceftriaxone, penicillin G, ciprofloxacin, cefepime, and two isolate (28.5% showed intermediate sensitivity to tetracycline.Continued monitoring of prevalence of N. gonorrhoeae is important for preventing the dissemination of this microorganism. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in order to manage the rate of resistant strains and to revise the treatment policies.

  6. In vitro growth of multidrug-resistant Neisseria gonorrhoeae isolates is inhibited by ETX0914, a novel spiropyrimidinetrione.

    Science.gov (United States)

    Papp, John R; Lawrence, Kenneth; Sharpe, Samera; Mueller, John; Kirkcaldy, Robert D

    2016-09-01

    Antimicrobial resistance in Neisseria gonorrhoeae has severely limited the number of treatment options, and the emergence of extended-spectrum cephalosporin resistance threatens the effectiveness of the last remaining recommended treatment regimen. This study assessed the in vitro susceptibility of N. gonorrhoeae to ETX0914, a novel spiropyrimidinetrione that inhibits DNA biosynthesis. In vitro activity was determined by agar dilution against 100 N. gonorrhoeae isolates collected from men presenting with urethritis in the USA during 2012-2013 through the Gonococcal Isolate Surveillance Project. The minimum inhibitory concentration (MIC) that inhibited growth in 50% (MIC50) and 90% (MIC90) of isolates was calculated for each antimicrobial agent. ETX0914 demonstrated a high level of antimicrobial activity against N. gonorrhoeae, including isolates with decreased susceptibility or resistance to currently available agents. The ability of ETX0914 to inhibit the growth of N. gonorrhoeae was similar to ceftriaxone, which is currently recommended in combination with azithromycin to treat gonorrhoea. The data presented in this study strongly suggest that ETX0914 should be evaluated in a clinical trial for the treatment of N. gonorrhoeae. PMID:27499432

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

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    Elena eIlina

    2013-07-01

    Full Text Available Spectinomycin remains a useful reserve option for therapy of gonorrhea. The emergence of multidrug-resistant Neisseria gonorrhoeae strains with decreased susceptibility to cefixime and to ceftriaxone makes it the only medicine still effective for treatment of gonorrhea infection in analogous cases. However, adoption of spectinomycin as a routinely used drug of choice was soon followed by reports of spectinomycin resistance. The main molecular mechanism of spectinomycin resistance in N. gonorrhoeae was C1192T substitution in 16S rRNA genes. Here we reported a Thr-24→Pro mutation in ribosomal protein S5 found in spectinomycin resistant clinical N. gonorrhoeae strain, which carried no changes in 16S rRNA. In a series of experiments, the transfer of rpsE gene allele encoding the mutant ribosomal protein S5 to the recipient N. gonorrhoeae strains was analyzed. The relatively high rate of transformation (ca. 10-5 CFUs indicates the possibility of spread of spectinonycin resistance within gonococcal population due to the horizontal gene transfer.

  8. Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis

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    Satoshi Takahashi

    2014-04-01

    Full Text Available To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011–2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33. The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43 and 37.2% (16/43, respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50. The microbiological eradication rates for the pathogens were 90.9% (30/33 for Neisseria gonorrhoeae, 91.5% (43/47 for Chlamydia trachomatis, 71.4% (5/7 for Mycoplasma genitalium, and 100% (13/13 for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120. The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.

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

    Science.gov (United States)

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

    2013-01-01

    Spectinomycin remains a useful reserve option for therapy of gonorrhea. The emergence of multidrug-resistant Neisseria gonorrhoeae strains with decreased susceptibility to cefixime and to ceftriaxone makes it the only medicine still effective for treatment of gonorrhea infection in analogous cases. However, adoption of spectinomycin as a routinely used drug of choice was soon followed by reports of spectinomycin resistance. The main molecular mechanism of spectinomycin resistance in N. gonorrhoeae was C1192T substitution in 16S rRNA genes. Here we reported a Thr-24→Pro mutation in ribosomal protein S5 (RPS5) found in spectinomycin resistant clinical N. gonorrhoeae strain, which carried no changes in 16S rRNA. In a series of experiments, the transfer of rpsE gene allele encoding the mutant RPS5 to the recipient N. gonorrhoeae strains was analyzed. The relatively high rate of transformation [ca. 10(-5) colony-forming units (CFUs)] indicates the possibility of spread of spectinonycin resistance within gonococcal population due to the horizontal gene transfer (HGT). PMID:23847609

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

    Science.gov (United States)

    Unemo, Magnus; Nicholas, Robert A

    2012-12-01

    The new superbug Neisseria gonorrhoeae has retained resistance to antimicrobials previously recommended for first-line treatment and has now demonstrated its capacity to develop resistance to the extended-spectrum cephalosporin, ceftriaxone, the last remaining option for first-line empiric treatment of gonorrhea. An era of untreatable gonorrhea may be approaching, which represents an exceedingly serious public health problem. Herein, we review the evolution, origin and spread of antimicrobial resistance and resistance determinants (with a focus on extended-spectrum cephalosporins) in N. gonorrhoeae, detail the current situation regarding verified treatment failures with extended-spectrum cephalosporins and future treatment options, and highlight essential actions to meet the large public health challenge that arises with the possible emergence of untreatable gonorrhea. Essential actions include: implementing action/response plans globally and nationally; enhancing surveillance of gonococcal antimicrobial resistance, treatment failures and antimicrobial use/misuse; and improving prevention, early diagnosis and treatment of gonorrhea. Novel treatment strategies, antimicrobials (or other compounds) and, ideally, a vaccine must be developed. PMID:23231489

  11. Phenotypic and genotypic properties of Neisseria gonorrhoeae isolates in Norway in 2009: antimicrobial resistance warrants an immediate change in national management guidelines.

    Science.gov (United States)

    Hjelmevoll, S O; Golparian, D; Dedi, L; Skutlaberg, D H; Haarr, E; Christensen, A; Jørgensen, S; Nilsen, Ø J; Unemo, M; Skogen, V

    2012-06-01

    Despite rapidly diminishing treatment options for Neisseria gonorrhoeae and high levels of ciprofloxacin resistance worldwide, Norwegian guidelines still recommend ciprofloxacin as empirical treatment for gonorrhea. The present study aimed to characterize phenotypical and genotypical properties of N. gonorrhoeae isolates in Norway in 2009. All viable N. gonorrhoeae isolates (n = 114) from six university hospitals in Norway (2009) were collected, representing 42% of all notified gonorrhea cases. Epidemiological data were collected from the Norwegian Surveillance System for Communicable Diseases and linked to phenotypical and genotypical characteristics for each N. gonorrhoeae isolate. Resistance levels to the antimicrobials examined were: ciprofloxacin 78%, azithromycin 11%, cefixime 3.5%, ceftriaxone 1.8%, and spectinomycin 0%. The minimum inhibitory concentrations of gentamicin varied from 1.5 to 8 mg/L. Forty-one (36%) of the isolates were β-lactamase-producing, 17 displayed penA mosaic alleles, and 72 different N. gonorrhoeae multiantigen sequence types (ST; 37 novel) were identified. The most common ST was ST1407 (n = 11), containing penA mosaic allele. Four of these isolates displayed intermediate susceptibility/resistance to cefixime. The N. gonorrhoeae strains circulating in Norway were highly diverse. The level of ciprofloxacin resistance was high and the Norwegian management guidelines should promptly exclude ciprofloxacin as an empirical treatment option for gonorrhea. PMID:21960034

  12. Challenges with gonorrhea in the era of multi-drug and extensively drug resistance - are we on the right track?

    Science.gov (United States)

    Unemo, Magnus; Golparian, Daniel; Shafer, William M

    2014-06-01

    Neisseria gonorrhoeae has retained antimicrobial resistance to drugs previously recommended for first-line empiric treatment of gonorrhea, and resistance to ceftriaxone, the last option for monotherapy, is evolving. Crucial actions to combat this developing situation include implementing response plans; considering use of dual antimicrobial regimens; enhancing surveillance of gonorrhea, gonococcal antimicrobial resistance, treatment failures and antimicrobial use/misuse and improving prevention, early diagnosis, contact tracing and treatment. The ways forward also include an intensified research to identify novel antimicrobial resistance determinants and develop and evaluate appropriate use of molecular antimicrobial resistance testing, ideally point-of-care and with simultaneous detection of gonococci, to supplement culture-based methods and ideally guide tailored treatment. It is crucial with an enhanced understanding of the dynamics of the national and international emergence, transmission and evolution of antimicrobial-resistant gonococcal strains. Genome sequencing combined with epidemiological metadata will detail these issues and might also revolutionize the molecular antimicrobial resistance testing. Ultimately, novel antimicrobials are essential and some antimicrobials in development have shown potent in vitro activity against gonococci. Several of these antimicrobials deserve further attention for potential future treatment of gonorrhea. PMID:24702589

  13. Febrile neutropenia in paediatric peripheral blood stem cell transplantation, in vitro sensitivity data and clinical response to empirical antibiotic therapy

    International Nuclear Information System (INIS)

    To find the in-vitro sensitivity data and clinical response in order to determine the changes required in empiric antibiotic therapy for management of febrile neutropenia in paediatric patients undergoing peripheral blood stem cell transplantation. All patients were treated according to institutional protocol for febrile neutropenia. Empirical antibiotics include Ceftriaxone and Amikacin. In non-responders, changes made included Imipenem and Amikacin, Piperacillin Tazobactum/Tiecoplanin or Vancomycin/Cloxacilin/Ceftazidime. In non-responders, amphotaracin was added until recovery. Out of 52 patients, 5 did not develop any fever; in the remaining 47 patients there were 57 episodes of febrile neutropenia. The mean days of febrile episodes were 4.71 (range 3-8). Fever of unknown origin (FUO) occurred in 31 (54.3%) episodes. Microbiologically documented infection (MDI) occurred in 17 (29.8%) episodes of fever. Clinically documented infection (CDI) occurred in 9 (15.7%) episodes. Gram-negative organisms were isolated in 10 while gram-positive organisms in 7. Klebseilla, S. aureus were the most common isolates. Empirical therapy was effective in 12 of the 33 (36%) episodes. Out of 28, 26 (92%) responded to Imipenem/Amikacin as second line therapy while those who received any other second line combination, only 11 out of 22 (50%) showed response. Systemic Amphotericin was used in 4 patients, 2 responded. Infection related mortality rate was 4%. (author)

  14. Etiology and resistance of asymptomatic bacteriuria isolates among school going children in Sanadaj-Iran

    Institute of Scientific and Technical Information of China (English)

    Sofei-Majidpur H; Kalantar E; Verdi F; Khaksar N; Shahsavari S; Beiranvand S

    2008-01-01

    Objective:The objective of this study was to determine the etiology and antimicrobial susceptibility patterns of asymptomatic bacteriuria pathogens isolated among school going children in Sanandaj,Iran.Methods:A total of 1 457 urine samples of 5 to 10 years children from forty different schools of Sanandaj city were screened to see asymptomatic bacteriuria during November 2007 to June 2008.Results:Bacterial colony count of over (105)colony forming units CFU /mL were found in 28 (1.90%)of total cases,with 767 (52.64%)girls and 690 (47.35%)boys.The highest class-specific prevalence was found in the fourth standard (2.8%)and the lowest in the first standard (1.0%).The dominant bacterial isolates were E.coli 20 (74.1%),followed by Klebsiella pneumoniae 04 (14.8%)and Staphylococcus aureus 04 (14.8%).Cefotaxime,Cefixime,Kana-mycin,Co-trimoxazole,nalidicxic acid,nitrofurantoin and Amoxicillin,resistance rates were above 90.0%. Ceftriaxone expressed the highest susceptibility among E.coli isolates.Surprisingly,S.aureus showed 100. 0% resistance to oxacillin.Conclusion:In the present study in which Escherichia coli is the most frequently incriminated as the causative agents.The results show a very serious antibiotic resistance of E.coli isolated. Surveillance and monitoring studies will be essential in preventing of renal scarring or other abnormalities.

  15. Frequency and Antibiotic Resistance Pattern in Staphylococcus aureus Strains Isolated from Clinical Samples of Tehran’s Araad Hospital in 2007-2011

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    Hamed Molaabaszadeh

    2014-01-01

    Full Text Available ABSTRACT Background and objective: Todays, 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 Staphylococcus aureus bacteria’s sensitivity, this study was done to examine the pattern of sensitivity and antibiotic resistance of Staphylococcus aureus strains collected from clinical samples of patients hospitalized in Tehran’s Araad hospital. Materials and methods: In this descriptive examination, after extracting Staphylococcus aureus derivations from clinical samples (urine, catheter, phlegm, wound, bronchial and blood, their sensitivity was measured using standard Kirby-Bauer test, in contract with following antibiotics Amikacin, Ciprofloxacin, Vancomycin, Imipenem, Sulfametoxazole Trimetoprime, Tetracycline, Oxacillin, Ceftriaxone and Penicillin. Results: In this study 260 samples of Staphylococcus aureus isolated from clinical specimens in three years. The most sensivity was to Vancomycin and the most resistance was to Penicillin and Oxacillin. Conclusion: The results of this study are indicating that Staphylococcus aureus strains resistance has increased against Penicillin and Oxacillin; 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.

  16. Chronic meningococcemia: a rare presentation of meningococcal disease: case report

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    Antonio Adolfo Guerra Soares Brandão

    2012-03-01

    Full Text Available Chronic meningococcemia is a rare clinical presentation within the spectrumof infections due to Neisseria meningitidis, which was first described in 1902.It is defined as a chronic and benign meningococcal bacteremia withoutmeningeal signs or symptoms with at least one week’s duration, characterizedby intermittent or continuous fever, polymorphic cutaneous rash, and migratoryarthropathy. The incidence is believed to be around 1:200,000 inhabitants. Itaffects predominantly young people and adults, and it is equally distributedbetween genders. Diagnosis may be challenging in the early stages of thedisease because of the difficulty in isolating Neisseria meningitidis (it reaches74% of positivity in advanced stages. Recently, the use of PCR for detectingNeisseria sp antigen in skin biopsies specimens has been considered for thoseculture-negative cases. The authors report a case of a 54-year-old femalepatient who sought medical attention for a five-day fever followed by arthralgiaand skin lesions predominantly in the lower limbs. The patient progressed toa toxemic clinical status that improved after the administration of antibiotictherapy, which consisted of oxacillin and ceftriaxone. The diagnosis of chronicmeningococcemia was performed after the isolation of Neisseria meningitidisin two different blood sample cultures. This is, to our knowledge, the firstcase of chronic meningococcemia described in Brazil (up to the writing of thisreport.

  17. Sensitivity patterns of pseudomonas aeruginosa isolates obtained from clinical specimens in peshawar

    International Nuclear Information System (INIS)

    Pseudomonas aeruginosa (P. aeruginosa) is a highly virulent opportunistic pathogen and a leading cause of nosocomial infections.Affected patients are often hospitalized in an intensive care unit, and are immuno-compromised as a result of disease and treatment. Suspected P. aeruginosa require timely, adequate and empirical antibiotic therapy to ensure improved outcomes. The purpose of the study was to find the sensitivity and resistance pattern of P. aeruginosa to various groups of drugs, in clinical isolates collected from two major tertiary care hospitals of Peshawar. Methods: Different clinical isolate were taken from patients admitted in various wards of Khyber Teaching Hospital and Lady Reading Hospital Peshawar. Results: A total of 258 clinical isolates were positive for P. aeruginosa out of 2058 clinical isolates. Pseudomonas showed high degree of resistance to third generation Cephalosporins (Ceftazidime, and Ceftriaxone) and moderate degree of resistance to Quinolones and Aminoglycosides (Ofloxacin, Ciprofloxacin, Levofloxacin and Amikacin). Low resistance was observed to different combinations (Cefoperazone + Sulbactum, Piperacillin + Tazobactum). Meropenem and Imipenem had negligible resistance. Conclusion: There is growing resistance to different classes of antibiotics. Combination drugs are useful approach for empirical treatment in suspected Pseudomonas infection. Imipenem and Meropenem are extremely effective but should be in reserve. (author)

  18. Antimicrobial susceptibility pattern of acinetobacter species-one year experience in a tertiary care setting

    International Nuclear Information System (INIS)

    Objective: To find out antimicrobial susceptibility pattern of Acinetobacter species isolated from 1 January 2009 through 31 December 2009 at Department of Microbiology, Armed Forces Institute of Pathology Rawalpindi. Materials and Methods: A total of 276 isolates of Acinetobacter spp yielded from various clinical specimens during the study period were included Routine conventional methods were used to identify various species of Acinetobacter and modified Kirby-Bauer disk diffusion method was used for susceptibility testing. Out of total 276 isolates, 176 (63.8%) turned out to be Acinetobacter baumannii and 100 (36.2%) were Acinetobacter johnsonii. Overall sensitivity of Acinetobacter spp against piperacillin/sulbactam, tigecycline, sulbactam/cefoperazone, piperacillin/tazobactam, imipenem, doxycycline, ceftazidime, ciprofloxacin, chloramphenicol, trimethoprim /sulfamethoxazole, ampicillin, gentamycin, ceftriaxone, amoxicillin/clavulanic acid and ampicillin were 64%,63%, 48%, 47%, 41%,39%,35%, 34%, 32%, 31 %, 29%, 19%, 18% and 5% respectively. Out of 276 isolates, 181 (66 %) were multidrug resistant while 33 (18 %) isolates were pan-drug resistant. (author)

  19. A novel approach for assessing the susceptibility of Escherichia coli to antibiotics

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The dynamic growth process of Escherichia coli CVCC249 under different concentrations of antibiotics was analyzed. The results suggested that the main reason that definitive results cannot be obtained by antibiotic susceptibility testing (AST) is that the ratio of drug concentration to the population of bacteria and the combined effect of drug concentration and action time cannot be completely determined with the methods used. Based on the analysis of the growth process with a series of concentrations of gentamicin acting for a certain time, and according to the forward difference method, a novel method for AST was proposed. The net increase in turbidity of the bacterial population was used to eliminate the existing effects of resting cells, and then the recurrent coefficient for a growing sequence was used to characterize the effect of antibiotics on bacterial division, and the contour plot was used to display and analyze the combined effect of drug concentration and action time. The inhibition rate of the antibiotics can be characterized as the dynamic change in the composite function of the antibiotic concentration and action time, which indicated that the inhibition rate was dependent on the combined effect of time and concentration of antibiotics. The effectiveness of this new method has been verified with different kinds of antibiotics, such as enrofloxacin, levofloxacin, and ceftriaxone, having different antibacterial mechanisms.

  20. Medication use and potential drug interactions in pediatric patients with infectious diseases.

    Science.gov (United States)

    Lisby, S M; Nahata, M C

    1987-04-01

    Infectious diseases are the most common type of illness in pediatric patients. Limited data are available, however, about the most frequently prescribed drugs for children in pediatric infectious diseases units. The authors prospectively evaluated medication records of 493 children over a 5-month period to determine the pattern of drug prescribing and incidence of potential drug interactions in children admitted to the infectious diseases unit in a pediatric hospital. Antimicrobial agents were the most frequently prescribed class of drugs, comprising 60% of all drug orders. Of all antibiotics used during this period, ampicillin was the most common (24% of antibiotic orders). Ceftriaxone, cefuroxime, and gentamicin were also used frequently and consisted of 15%, 10%, and 14% of all orders for anti-infective agents, respectively. Other classes of drugs frequently given to patients on the infectious disease unit were antipyretics (14%), bronchodilators (10%), and anticonvulsants (7%). The incidence of potential drug interactions was 3.5%, the majority involving anticonvulsants. A clinically significant drug interaction was not documented in any of these cases. Observations made from this study may assist in developing clinical pharmacy services and educational programs for pharmacy students. In addition, knowledge of drug use patterns may aid in conducting antibiotic use reviews. PMID:10281735

  1. Management of levofloxacin induced anaphylaxis and acute delirium in a palliative care setting

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    Arunangshu Ghoshal

    2015-01-01

    Full Text Available Levofloxacin is a commonly prescribed antibiotic for managing chest and urinary tract infections in a palliative care setting. Incidence of Levofloxacin-associated anaphylaxis is rare and delirium secondary to Levofloxacin is a seldom occurrence with only few published case reports. It is an extremely rare occurrence to see this phenomenon in combination. Early identification and prompt intervention reduces both mortality and morbidity. A 17-year-old male with synovial sarcoma of right thigh with chest wall and lung metastasis and with no prior psychiatric morbidity presented to palliative medicine outpatient department with community-acquired pneumonia. He was initiated on intravenous (IV Ceftriaxone and IV Levofloxacin. Post IV Levofloxacin patient developed anaphylaxis and acute delirium necessitating IV Hydrocortisone, IV Chlorpheneramine, Oxygen and IV Haloperidol. Early detection and prompt intervention helped in complete recovery. Patient was discharged to hospice for respite after 2 days of hospitalization and then discharged home. Acute palliative care approach facilitated management of two life-threatening medical complications in a palliative care setting improving both quality and length of life.

  2. Antibiotic Therapy in Pyogenic Meningitis in Paediatric Patients

    International Nuclear Information System (INIS)

    Objective: To isolate and identify the causative pathogen, antibiotic sensitivity testing and success rate of empirical antibiotic therapy in pyogenic meningitis. Study Design: Analytical study. Place and Duration of Study: The Children's Hospital and Institute of Child Health, Lahore, Pakistan, from March to July 2012. Methodology: The study was performed on 72 culture positive meningitis cases in children less than 15 years of age. This therapy was evaluated by monitoring the patient's clinical picture for 14 - 21 days. The collected data was analyzed by Chi-square test. Results: Seventeen different bacteria were isolated. The most commonly occurring bacteria were coagulase negative Staphylococci (25%), E. coli (12.5%), Klebsiella pneumoniae (8.3%), Streptococcus pneumoniae (8.3%) and Pseudomonas aeruginosa (8.3%). All the bacteria were sensitive to vancomycin (96.7%), meropenem (76.7%), amikacin (75%), ciprofloxacin (65.3%), chloramphenicol (46.5%), ceftazidime (44.2%), cefepime (41.9%), co-amoxiclav (38.0%), oxacillin (34.8%), cefotaxime (21.4%), penicillin (20.7%), ceftriaxone (18.6%), cefuroxime (14%) and ampicillin (6.9%). The combination of sulbactam and cefoperazone showed antimicrobial sensitivity of 81.4%. The success rate of empirical antibiotic therapy was 91.7%. Conclusion: It was found that Gram negative bacteria were the major cause of pyogenic meningitis. Mostly there were resistant strains against all commonly used antibiotics except vancomycin. All empirical antibiotic therapies were found to be most successful. (author)

  3. Detection of Beta-Lactamase and Extended-Spectrum Beta-Lactamase of Pathogens Isolated from Pig and Chicken and Their Antibiotic Susceptibility Test

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The antibacterial activity of beta-lactam antibiotics or their combinations with inhibitor sulbactum against non-lactamaseproducing strains, lactamase-producing and ESBLs-producing isolates was evaluated with twofold dilution method after pathogens isolated from pigs and chickens were detected, respectively, for beta-lactamase and extended-spectrum betalactamases (ESBLs). The results revealed that most of 43 clinically isolated strains could produce beta-lactamase and 3strains of shigella isolated from chicken samples produced ESBLs. All of 30 lactamase-producing strains isolated and only one of 16 non-lactamase-producing strains were resistant to amoxicillin and ampicillin. MICs of ampicillin against lactamaseproducing isolates decreased 10-40 and 10-20 times respectively, when it was conbined with sulbactam at ration of 1:2 and 1:4. All clinical isolates were susceptible to third-generation cephalosporins. The MICs of third-generation cephalosporins against lactamase-producing isolates did not change when they were conbined with sulbactam. MICs of ceftiofur and ceftriaxone against ESBLs-producing isolates decreased 2-4 times when they were conbined with sulbactam.

  4. A Challenge for Diagnosing Acute Liver Injury with Concomitant/Sequential Exposure to Multiple Drugs: Can Causality Assessment Scales Be Utilized to Identify the Offending Drug?

    Directory of Open Access Journals (Sweden)

    Roxanne Lim

    2014-01-01

    Full Text Available Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin/sulbactam, and clindamycin for cervical lymphadenitis/retropharyngeal cellulitis. Histopathology of the liver biopsy specimen revealed acute cholestatic hepatitis. All known causes of acute liver injury were appropriately excluded and (only drug-induced liver injury was left as a cause of his cholestasis. Liver-specific causality assessment scales such as Council for the International Organization of Medical Sciences/Roussel Uclaf Causality Assessment Method scoring system (CIOMS/RUCAM, Maria and Victorino scale, and Digestive Disease Week-Japan were applied to seek the most likely offending drug. Although clindamycin is the most likely cause by clinical diagnosis, none of causality assessment scales aid in the diagnosis.

  5. Changes in Gram Negative Microorganisms' Resistance Pattern During 4 Years Period in a Referral Teaching Hospital; a Surveillance Study

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    Hossein Khalili

    2012-09-01

    Full Text Available Background and purpose Surveillance studies evaluating antimicrobial susceptibilities are of great value in preventing the spread of resistant pathogens by elucidating the trend of resistance in commonly used antibiotics and as a consequence providing information for prescribing the most appropriate agent. This study is a longitudinal antimicrobial resistance surveillance study designed to evaluate the trend in antimicrobial resistance to gram negative microorganisms from 2007 to 2010. Method:During a four-year period (2007-2010 isolates derived from all patients admitted to infectious diseases ward of Imam Khomeini Hospital, the major referral center for infectious disease in Iran with the highest admission rates, were evaluated. Based on disk diffusion method and zone of inhibition size, the microorganism was regarded as to be sensitive, resistant or has intermediate susceptibility to the antimicrobial agents. Results:The widest spread Gram-negative microorganism in all of isolates taken together in our study was E.coli (30% followed by Stenotrophomonas maltophilia in 28.6% and Enterobacter spp. in 11.9%, respectively. The susceptibility to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin was equal or above 50% for all microorganisms over four years. However, the susceptibility to ampicillin, ampicillin/sulbactam, cefotaxim, and ceftriaxone was less than 50% in derived isolates during the study period.Conclusion:In conclusion, the finding of the present study revealed that resistance rate to common antimicrobial agents in Iran is growing and isolates were susceptible mostly to broadspectrum antibiotics including imipenem and piperacillin/tazobactam

  6. Modern aspects of atibiotic sensitivity of prominent pathogens of infectious complications

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    Nazarchuk O.A.

    2016-05-01

    Full Text Available In the research antibiotic sensitivity of opportunistic pathogens was studied. In 2011-2015 from 405 patients with burns there were isolated clinical strains of S. aureus (n 130, P. aeruginosa (n 127, A. baumannii (n 176, being the prominent pathogens of infectious complications. Clinical strains of S. aureus, P. aeruginosa, A. baumannii obtained all morphological, tentorial, cultural and biochemical qualities, typical for these species of bacteria. On the basis of the received results there was carried out approximation and interpolation of these data, dynamic prognostic indexes of changes in S. aureus, P. aeruginosa, A. baumannii antibiotic sensitivity were obtained. Low sensitivity to ampicillini/sulbactam (58,63±8,58%, ceftriaxone (55,75±14,24%, gentamicin (57,92±10,76%, tobramycin (64,67±10,3% in clinical strains of S. аureus was proved. Prognostic optimizations of S. аureus sensitivity to amoxicillini/clavulanat (82,35%, gatifloxacin (94,12% were determined. Clinical strains of P. aeruginosa, A. baumannii were shown to have low sensitivity to ceftazidime, cefoperazone, cefoperazone/sulbactam (20,08±2,98%; 48,88±6,49%, respectively. Progressive decrease of sensitivity to amikacin in P. aeruginosa (29,77±7,55%, A. baumannii (17,0±1,34 % and to gatifloxacin in P. aeruginosa (28,53±1,35%, isolated from patients with burns were determined.

  7. Antibiotic resistance and OXA-type carbapenemases-encoding genes in airborne Acinetobacter baumannii isolated from burn wards.

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    Gao, Jing; Zhao, Xiaonan; Bao, Ying; Ma, Ruihua; Zhou, Yufa; Li, Xinxian; Chai, Tongjie; Cai, Yumei

    2014-03-01

    The study was conducted to investigate drug resistance, OXA-type carbapenemases-encoding genes and genetic diversity in airborne Acinetobacter baumannii (A. baumannii) in burn wards. Airborne A. baumannii were collected in burn wards and their corridors using Andersen 6-stage air sampler from January to June 2011. The isolates susceptibility to 13 commonly used antibiotics was examined according to the CLSI guidelines; OXA-type carbapenemases-encoding genes and molecular diversity of isolates were analyzed, respectively. A total of 16 non-repetitive A. baumannii were isolated, with 10 strains having a resistance rate of greater than 50% against the 13 antibiotics. The resistance rate against ceftriaxone, cyclophosvnamide, ciprofloxacin, and imipenem was 93.75% (15/16), but no isolate observed to be resistant to cefoperazone/sulbactam. Resistance gene analyses showed that all 16 isolates carried OXA-51, and 15 isolates carried OXA-23 except No.15; but OXA-24 and OXA-58 resistance genes not detected. The isolates were classified into 13 genotypes (A-M) according to repetitive extragenic palindromic sequence PCR (REP-PCR) results and only six isolates had a homology ≥90%. In conclusion, airborne A. baumannii in the burn wards had multidrug resistance and complex molecular diversity, and OXA-23 and OXA-51 were dominant mechanisms for resisting carbapenems. PMID:23886986

  8. Sub-acute mastitis associated with Methicillin Resistant Staphylococcus aureus in a cow: A case report

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    Duraisamy Chandrasekaran

    2014-12-01

    Full Text Available A 5-year old Holstein Friesian cross breed cow was presented to Madras Veterinary College Teaching Hospital with the history of reduced milk yield. Clinical examination of udder revealed normal milk color and soft udder. The milk pH was 7.0, with California Mastitis Test score 3+, Electrical Conductivity 270U, and Somatic Cell Count as 328,000. Isolation and identification of causative agent revealed Methicillin Resistant Staphylococcus aureus (MRSA from the sub-acute mastitis sample. Agar disc diffusion method for antimicrobial susceptibility revealed that the MRSA was sensitive to Enrofloxacin, Gentamicin, Oxytetracycline and Amoxicillin+Sulbactam. On the other hand, the isolate was resistance to Amoxicillin, Penicillin G, Ceftriaxone and Methicillin. The isolate was positive for β-lactamase resistance by Nitrocefin test. The MRSA was confirmed for the presence of mecA and blaZ target genes by polymerase chain reaction (PCR. The cow was treated with Enrofloxacin, Vitamin E and inorganic Selenium, and was recovered after 5 days of post-treatment.

  9. [Infective endocarditis by Rhizobium radiobacter. A case report].

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    Piñerúa Gonsálvez, Jean Félix; Zambrano Infantinot, Rosanna del Carmen; Calcaño, Carlos; Montaño, César; Fuenmayor, Zaida; Rodney, Henry; Rodney, Marianela

    2013-03-01

    Rhizobium radiobacter is a Gram-negative, nitrogen-fixing bacterium, which is found mainly on the ground. It rarely causes infections in humans. It has been associated with bacteremia, secondary to colonization of intravascular catheters, in immunocompromised patients. The aim of this paper was to report the case of an infective endocarditis caused by R. radiobacter, in a 47-year-old male, diagnosed with chronic kidney disease stage 5, on replacement therapy with hemodialysis and who attended the medical center with fever of two weeks duration. The patient was hospitalized and samples of peripheral blood were taken for culture. Empirical antibiotic therapy was started with cefotaxime plus vancomycin. The transthoracic echocardiogram revealed fusiform vegetation on the tricuspid valve, with grade III-IV/IV regurgitation. On the seventh day after the start of antibiotic therapy, the patient had a clinical and paraclinical improvement. The bacterium identified by blood culture was Rhizobium radiobacter, ceftriaxone-resistant and sensitive to imipenem, amikacin, ampicillin and ampicillin/sulbactam. Because of the clinical improvement, it was decided to continue treatment with vancomycin and additionally, with imipenem. At 14 days after the start of antibiotic therapy, the patient was discharged with outpatient treatment with imipenem up to six weeks of treatment. The control echocardiogram showed the absence of vegetation on the tricuspid valve. This case suggests that R. radiobacter can cause endocarditis in patients with intravascular catheters. PMID:23781714

  10. Characterization of Salmonella Isangi possessing a CTX-M15 ESBL associated with an outbreak in a US Hospital.

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    Suleyman, Geehan; Perri, Mary; Vager, Dora; Samuel, Linoj; Zervos, Marcos J; Alangaden, George; Tibbetts, Robert J

    2016-07-01

    Over an approximately 50-day period in 2015, an outbreak of CTX-M-15 extended spectrum β-lactamase-(ESBL)-possessing Salmonella Isangi occurred among 19 adult surgical patients and one healthcare worker (HCW) at a large urban tertiary care hospital in the United States. A total of 45 S. Isangi isolates were isolated from stool (35), blood (4), urine (3), respiratory (2), and wound (1) cultures. Phenotypically, all but three isolates demonstrated resistance to ampicillin, ampicillin/sulbactam, ceftriaxone, and cefepime, and one isolate was resistant to ertapenem. Genotypically, a single CTX-M-15 ESBL was identified in all but three isolates by real-time PCR. Interestingly, two of the CTX-M-15 negative, susceptible isolates were isolated from a single patient who initially had a CTX-M positive, resistant strain. Isolates were clonally related, including both resistant and susceptible strains, as confirmed by pulse field gel electrophoresis (PFGE). This is the first case of a novel Salmonella outbreak at this hospital, and we believe it to be the first case of an S. Isangi serotype outbreak in the United States. PMID:27130476

  11. Distribution, detection of enterotoxigenic strains and antimicrobial drug susceptibility patterns of Bacteroides fragilis group in diarrheic and non-diarrheic feces from Brazilian infants

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    Débora Paula Ferreira

    2010-10-01

    Full Text Available Despite the importance of gastrointestinal diseases and their global distribution, affecting millions of individuals around the world, the role and antimicrobial susceptibility patterns of anaerobic bacteria such as those in the Bacteroides fragilis group (BFG are still unclear in young children. This study investigated the occurrence and distribution of species in the BFG and enterotoxigenic strains in the fecal microbiota of children and their antimicrobial susceptibility patterns. Diarrheic (n=110 and non-diarrheic (n=65 fecal samples from children aged 0-5 years old were evaluated. BFG strains were isolated and identified by conventional biochemical, physiological and molecular approaches. Alternatively, bacteria and enterotoxigenic strains were detected directly from feces by molecular biology. Antimicrobial drug susceptibility patterns were determined by the agar dilution method according to the guidelines for isolated bacteria. BFG was detected in 64.3% of the fecal samples (55% diarrheic and 80.4% non-diarrheic, and 4.6% were enterotoxigenic. Antimicrobial resistance was observed against ampicillin, ampicillin/sulbactam, piperacillin/tazobactam, meropenem, ceftriaxone, clindamycin and chloramphenicol. The data show that these bacteria are prevalent in fecal microbiota at higher levels in healthy children. The molecular methodology was more effective in identifying the B. fragilis group when compared to the biochemical and physiological techniques. The observation of high resistance levels stimulates thoughts about the indiscriminate use of antimicrobial drugs in early infancy. Further quantitative studies are needed to gain a better understanding of the role of these bacteria in acute diarrhea in children.

  12. Antibiotics Susceptibility of the Microorganisms which Reproducing the Culture of Patients with Chronic Otitis Media

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    Omer Coskun

    2010-02-01

    Full Text Available AIM: Study; we aimed the isolation of bacteria and establishment of their susceptibility to antibiotics in patients diagnosed as Chronic Supurative Otitis Media. METHOD: Sixty-three patients were included in the study. The samples of suppurative material were cultured. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI and species was identified. RESULTS: S.aureus was isolated in 36,5 % of the 63 patients enrolled in the study. For this bacterium, increased rates of resistance to antibiotics penicillin G, ampicillin /sulbactam, gentamicin, amicacin ve TMP/SMX are detected. The other mostly isolated bacteria are P. aeruginosa (32.69% and E. coli (23.07% in turn. P. aeruginosa showed increased ratio of resistance to ceftriaxone, cefuroxime, amicacin, gentamicin, ampicillin, TMP/SMX and amoxicillin/clavulanate and also E. coli showed increased rates of resistance to gentamicin, ampicillin, ampicillin /sulbactam and amoxicillin/clavulanate. CONCLUSION: We consider Chronic Supurative Otitis Media therapy regarding antimicrobial susceptibility rates will be more rational and satisfying. [TAF Prev Med Bull 2010; 9(1.000: 51-54

  13. Antibiotic resistance profiles and quorum sensing-dependent virulence factors in clinical isolates of pseudomonas aeruginosa.

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    Wang, Huafu; Tu, Faping; Gui, Zhihong; Lu, Xianghong; Chu, Weihua

    2013-06-01

    Pseudomonas aeruginosa produces multiple virulence factors that have been associated with quorum sensing. The aim of this study was to evaluate the prevalence of drug resistant profiles and quorum sensing related virulence factors. Pseudomonas aeruginosa were collected from different patients hospitalized in China, the isolates were tested for their susceptibility to different common antimicrobial drugs and detected QS-related virulence factors. We identified 170 isolates displaying impaired phenotypic activity, approximately 80 % of the isolates were found to exhibit the QS-dependent phenotypes, among them, 12 isolates were defective in AHLs production, and therefore considered QS-deficient strains. Resistance was most often observed to Cefazolin (81.2 %), followed by trimethoprim-sulfamethoxazole (73.5 %), ceftriaxone (62.4 %) and Cefotaxime, Levofloxacin, Ciprofloxacin (58.8 %), and to a lesser extent Meropenem (20.0 %), Cefepime (18.8 %), and Cefoperazone/sulbactam (2.4 %) The QS-deficient isolates that were negative for virulence factor production were generally less susceptible to the antimicrobials. The results showed a high incidences of antibiotic resistance and virulence properties in P. aeruginosa, and indicate that the clinical use of QS-inhibitory drugs that appear superior to conventional antimicrobials by not exerting any selective pressure on resistant strains. PMID:24426103

  14. Antibiotic susceptibility and imaging findings of the causative microorganisms responsible for acute urinary tract infection in children: a five-year single center study

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    Ji Eun Yoon

    2011-02-01

    Full Text Available Purpose : We studied the differences in the antibiotic susceptibilities of the microorganisms that causeing urinary tract infections (UTI in children to obtain useful information on appropriate drug selection for childhood UTI. Methods : We retrospectively analyzed the antibiotic susceptibilities of 429 microorganisms isolated from 900 patients diagnosed with UTI in the Department of Pediatrics, Chungbuk National University Hospital, from 2003 to 2008. Results : The most common causative microorganisms for UTI were Escherichia coli (81.4%, Klebsiella pneumoniae (8.4%, Enterobacter spp. (1.7%, and Proteus spp. (0.4%. E. coli showed relatively high susceptibility as compared to imipenem (100%, amikacin (97.7%, aztreonam (97.9%, cefepime (97.7%, and ceftriaxone (97.1%, while it showed relatively low susceptibility to gentamicin (GM (79.0%, trimethoprim/sulfamethoxazole (TMP/SMX (68.7%, ampicillin/sulbactam (33.0%, and ampicillin (AMP (28.6%. There were no significant differences in the image findings for causative microorganisms. Conclusion : Gram-negative organisms showed high susceptibility to amikacin and third-generation cephalosporins, and low susceptibility to AMP, GM, and TMP/SMX. Therefore, the use of AMP or TMP/SMX as the first choice in empirical and prophylactic treatment of childhood UTI in Korea should be reconsidered and investigated further.

  15. Evaluation of the Use and Effectiveness of Antibiotics for Prophylactic in Patients with Cesarean Section at Hospitals in Surakarta in 2010

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    Nurul Mutmainah

    2014-06-01

    Full Text Available The use of antibiotics for prophylactic in sectio cesarean can reduce the risk of infection-related complications and postoperative infections. This study aims to describe and evaluate the usage and the effectiveness of prophylactic antibiotics in cesarean section patients in two hospitals in Surakarta in year 2010. The study used retrospective data from medical records. The analysis was then conducted on the use of antibiotic including the appropriateness of antibiotic (compare to the standard of WHO, the appropriateness of dose and the time of administration. The data from two hundred of patients showed that 76% of patients were between 20–35 years old and the patients with aterm pregnancy were 90.5%, 46.5% of patients had the length of stay in hospital more than 5 days and 29% of cesarean delivery indicated by amniotic premature rupture. Antibiotics that used for prophylactic were ampicillin (24%, ampicillin-sulbactam (23%, ceftriaxone (19.5%, cefotaxime (16%, amoxicillin-clavulanate (11%, and cefazolin (6.5%. It was found that 30,5% of drugs were selected based on standard, 6.5% of drugs were given in the appropriate dose and 52% of drugs were administrated on-time. In conclusion, the antibiotics are 100% effective to prevent the incidence of surgical wound infection.

  16. Application of an innovative design space optimization strategy to the development of LC methods for the simultaneous screening of antibiotics to combat poor quality medicines.

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    Mbinze, J K; Dispas, A; Lebrun, P; Mavar Tayey Mbay, J; Habyalimana, V; Kalenda, N; Rozet, E; Hubert, Ph; Marini, R D

    2013-11-01

    The poor quality of medicines is a crucial problem of public health. Therefore, it is important to have analytical tools to attend decisions of the legal authorities while combating this offense. In this context, the main objective of this study was to develop generic methods able to trace, screen and determine several antibiotics and common associated molecules by mean of liquid chromatographic techniques. For that purpose, an innovative Design Space optimization strategy was applied, targeting 16 antibiotics and 3 beta-lactamase inhibitors. The robustness of the developed method allowed using its use in an environment where operational factors such as temperature are not easy to control and eased its transfer to Ultra High Performance Liquid Chromatography. To demonstrate its ability to quantify the targeted molecules, the developed and transferred method was fully validated for two active ingredients commonly used in association, sulbactam and ceftriaxone, using the accuracy profile as decision tool. Based on this successful step, the method was then used for the quantitative determination of these two active ingredients in three pharmaceutical brands marketed in the Democratic Republic of Congo. Two out of the three pharmaceutical products did not comply with the specifications. PMID:23912056

  17. Distribution and antimicrobial resistance of enteric pathogens in Chinese paediatric diarrhoea: a multicentre retrospective study, 2008-2013.

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    Zhang, H; Pan, F; Zhao, X; Wang, G; Tu, Y; Fu, S; Wang, J; Pan, J; Song, J; Wang, W; Jin, Z; Xu, H; Ren, Y; Li, Y; Zhong, N

    2015-09-01

    The enteric pathogens causing diarrhoea impair children's health severely. This study retrospectively analysed 1577 pathogens isolated from inpatients and outpatients in six hospitals located in Northern (Inner Mongolia), Northeastern (Hebei), Eastern (Shanghai and Jiangsu), Southern (Hainan) and Central (Hubei) China between 2008 and 2013. Of the 1577 enteric pathogens, Salmonella presented with the highest frequency (36·0%), followed by diarrhoeagenic Escherichia coli (23·7%), Staphylococcus aureus (15·0%), Shigella (13·1%), and Aeromonas (4·6%). The predominant pathogens varied in different regions of China, with Salmonella most prevalent in Shanghai and Hainan, diarrhoeagenic E. coli most prevalent in Inner Mongolia, Jiangsu and Hubei, and Shigella most prevalent in Hebei. Enteric pathogens were more frequently isolated in males (56·9%) than in females (43·1%). The highest proportion of all enteric pathogens was found in infants (67·6%) with a peak in summer and autumn (68·5%). Antimicrobial susceptibility assay demonstrated that Shigella was more resistant to ampicillin, ceftriaxone and sulfamethoxazole than Salmonella. Of the top two serotypes in Salmonella, Typhimurium was more resistant to ciprofloxacin, sulfamethoxazole and chloramphenicol than Enteritidis (P sulbactam, ciprofloxacin, and chloramphenicol were significantly higher than those of Shigella sonnei (P < 0·001). Multidrug resistance was apparent in 58·2% of Shigella and 45·9% of Salmonella, and this phenomenon was more pronounced in S. flexneri. PMID:25586929

  18. Current efficacy of antibiotics against Klebsiella isolates from urine samples - a multi-centric experience in Karachi.

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    Abdullah, Farhan Essa; Mushtaq, Ammara; Irshad, Mubashira; Rauf, Hiba; Afzal, Noureen; Rasheed, Abdur

    2013-01-01

    Due to emergence of bacterial resistant strains, the effectiveness of current antibiotic treatment without culture/sensitivity testing is questionable. Our study aims to assess the present sensitivity profiles of Klebsiella isolates from urine samples and provide options for empiric prescription in critically ill patients. Klebsiella pneumoniae isolates collected over a period of 28 months till January 2011 from 1,617 urine samples of subjects presenting with Urinary Tract Infections were identified at a local diagnostic lab using standard protocol and subjected to Kirby-Bauer disk diffusion sensitivity testing. MICs were also estimated by E-nephelometry. Among 20 drugs used, low sensitivity was found to amoxicillin (0.1%), doxycycline (11.5%), nitrofurantoin (15.5%), amoxiclav (18.2%), gentamicin (35.4%), pipemidic acid, cephradine (40.3%) and cotrimoxazole (43.1%). The isolates were more sensitive to cefuroxime (55.9%), cefixime (57.7%), ciprofloxacin (62.5%), ofloxacin (63%), ceftriaxone (66.2%), ceftazidime (66.4%), cefotaxime (66.6%), fosfomycin (77.5%) and amikacin (89.4). Most effective were cefroperazone.sulbactam (95.8%), piperacillin.tazobactam (95.7%) and imipenem (97.7%). Self-medication, lack of awareness, and the misuse of antibiotics by doctors has exacerbated the menace of microbial resistance. The study warrants the prudent choice of drugs in adherence with prevailing sensitivity profiles. PMID:23261722

  19. Systematic approach to treat chronic osteomyelitis through localized drug delivery system: bench to bed side.

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    Bhattacharya, Rupnarayan; Kundu, Biswanath; Nandi, Samit Kumar; Basu, Debabrata

    2013-10-01

    Chronic osteomyelitis is a challenging setback to the orthopedic surgeons in deciding an optimal therapeutic strategy. Conversely, patients feel frustrated of the therapeutic outcomes and development of adverse drug effects, if any. Present investigation deals with extensive approach incorporating in vivo animal experimentation and human application to treat chronic osteomyelitis, using antibiotic loaded porous hydroxyapatite scaffolds. Micro- to macro-porous hydroxyapatite scaffolds impregnated with antibiotic ceftriaxone-sulbactam sodium (CFS) were fabricated and subsequently evaluated by in vivo animal model after developing osteomyelitis in rabbit tibia. Finally 10 nos. of human osteomyelitis patients involving long bone and mandible were studied for histopathology, radiology, pus culture, 3D CT etc. up to 8-18 months post-operatively. It was established up to animal trial stage that 50N50H samples [with 50-55% porosity, average pore size 110 μm, higher interconnectivity (10-100 μm), and moderately high drug adsorption efficiency (50%)] showed efficient drug release up to 42 days than parenteral group based on infection eradication and new bone formation. In vivo human bone showed gradual evidence of new bone formation and fracture union with organized callus without recurrence of infection even after 8 months. This may be a new, alternative, cost effective and ideal therapeutic strategy for chronic osteomyelitis treatment in human patients. PMID:23910305

  20. Drug-resistant Gram-negative bacilli in urinary tract infection: A need for strict antibiotic prescription policy

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    Vinita Dogra

    2012-01-01

    Full Text Available Introduction: The etiology of urinary tract infections (UTIs and the antibiotic resistance of uropathogens have been changing over the past years. This retrospective study was conducted to survey the resistance pattern of Gram-negative uropathogens to first-line agents for UTIs; this would be helpful for the clinicians to facilitate the empiric treatment and management of patients with UTI and maybe useful for the formulation of guidelines of antibiotic policies. Materials and Methods: Isolated uropathogens were tested against ampicillin-sulbactam, amikacin, ceftriaxone, cefotaxime, cefoperazone, gentamicin, norfloxacin, ofloxacin, piperacillin-tazobactam, and imipenem. Result: A total of 2,146 urine samples were cultured, of which 448 samples were positive for Gram-negative bacilli. The most common Gram-negative isolate was Esherichia coli (52% followed by Klebsiella pneumoniae (17.6% and Pseudomonas aeruginosa (12.9%. E. coli was found to be most resistant to ampicillin-sulbactam (90.1%, followed by norfloxacin (76.3%, and most sensitive to imipenem. P. aeruginosa was least resistant to amikacin (27.5%. Overall resistance to imipenem is less than 20% among the Gram-negative uropathogens except Acinetobacter spp. and P. aeruginosa. Conclusion: Ofloxacin and amikacin are recommended as the drugs of choice for the empirical treatment of UTI, whereas specific treatment should be based on the etiological agent isolated in the urine culture. There is a strict need for developing specific guidelines for antibiotic prescriptions for UTI in India.

  1. Retrospective analysis of antibiotic susceptibility patterns of respiratory isolates of Pseudomonas aeruginosa in a Turkish University Hospital

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    Akkurt Ibrahim

    2003-03-01

    Full Text Available Abstract Background Lower respiratory tract infections due to Pseudomonas aeruginosa have a high mortality rate. Antibacterial activity of various antibiotics against P. aeruginosa isolated from each hospital depends on the variety or amount of antibiotics used in each hospital. Method A total of 249 respiratory isolates of Pseudomonas aeruginosa in Sivas (Turkey were included between January-1999 and January-2002. Isolates were tested against 14 different antibiotics by a disc diffusion method or standardized microdilution technique. Results Organisms were cultured from the following specimens: sputum (31.3%, transtracheal/endotracheal aspirates (37.8%, and bronchial lavage (30.9%. Isolates in bronchial lavage were highly susceptible to cefoperazone and aminoglycosides. Resistance to ampicillin/sulbactam was 98.8%, ticarcillin 40.1%, ticarcillin/clavulanic acid 11.2%, piperacillin 21.8%, aztreonam 66.6%, cefotaxim 75.4%, ceftriaxone 84.2%, cefoperazone 39.0%, ceftazidime 50.8%, gentamicin 57.5%, tobramycin 58.4%, amikacin 25.4%, ciprofloxacin 16.1%, and imipenem/cilastatin 21.6%. The term multidrug-resistant P. aeruginosa covered resistance to imipenem, ciprofloxacin, ceftazidime, gentamicin, and piperacillin. 1.2% of isolates were multidrug-resistant. Conclusions These findings suggest that amikacin resistance increases progressively in Turkey. Piperacillin and ticarcillin/clavulanate were the most active agents against both imipenem- and ciprofloxacin-resistant isolates in our region.

  2. Development and validation of a reversed-phase column liquid chromatographic method for the determination of five cephalosporins in pharmaceutical preparations.

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    Elkady, Ehab F; Abbas, Samah S

    2011-01-01

    A new, simple, rapid, and precise RP-HPLC method has been developed and validated for the determination of five cephalosporins, namely, cefalexin, cefoperazone, ceftriaxone, ceftazidime, and cefepime. The method has been applied successfully for simultaneous determination of cefalexin in a binary mixture with sodium benzoate in a suspension, and cefoperazone in a binary mixture with sulbactam in vials. Chromatographic separation was achieved on a Waters microBondapak C18 column (250 x 4.6 mm id, 10 pm particle size) using the mobile phase monobasic potassium phosphate (50 mM, pH 4.6)-acetonitrile (80 + 20, v/v) with UV detection. A flow rate of 1 mL/min was applied. Linearity, accuracy, and precision were found to be acceptable over the concentration range of 30-300, 3-30, and 15-120 microg/mL for the studied cephalosporins, sodium benzoate, and sulbactam, respectively. The optimized method proved to be specific, robust, and accurate for QC of the cited drugs in their pharmaceutical preparations. PMID:22165008

  3. Changes in antibiotic usage and susceptibility in nosocomial Enterobacteriaceae and Pseudomonas isolates following the introduction of ertapenem to hospital formulary.

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    Graber, C J; Hutchings, C; Dong, F; Lee, W; Chung, J K; Tran, T

    2012-01-01

    There is concern that widespread usage of ertapenem may promote cross-resistance to other carbapenems. To analyse the impact that adding ertapenem to our hospital formulary had on usage of other broad-spectrum agents and on susceptibilities of nosocomial Enterobacteriaceae and Pseudomonas isolates, we performed interrupted time-series analyses to determine the change in linear trend in antibiotic usage and change in mean proportion and linear trend of susceptibility pre- (March 2004-June 2005) and post- (July 2005-December 2008) ertapenem introduction. Usage of piperacillin-tazobactam (P=0·0013) and ampicillin-sulbactam (P=0·035) declined post-ertapenem introduction. For Enterobacteriaceae, the mean proportion susceptible to ciprofloxacin (P=0·016) and piperacillin-tazobactam (P=0·038) increased, while the linear trend in susceptibility significantly increased for cefepime (P=0·012) but declined for ceftriaxone (P=0·0032). For Pseudomonas, the mean proportion susceptible to cefepime (P=0·011) and piperacillin-tazobactam (P=0·028) increased, as did the linear trend in susceptibility to ciprofloxacin (P=0·028). Notably, no significant changes in carbapenem susceptibility were observed. PMID:21303590

  4. Distribution, detection of enterotoxigenic strains and antimicrobial drug susceptibility patterns of bacteroides fragilis group in diarrheic and non-diarrheic feces from brazilian infants.

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    Ferreira, Débora Paula; Silva, Vânia Lúcia; Guimarães, Danielle Aparecida; Coelho, Cíntia Marques; Zauli, Danielle Alves Gomes; Farias, Luiz Macêdo; Carvalho, Maria Auxiliadora Roque; Diniz, Claudio Galuppo

    2010-07-01

    Despite the importance of gastrointestinal diseases and their global distribution, affecting millions of individuals around the world, the role and antimicrobial susceptibility patterns of anaerobic bacteria such as those in the Bacteroides fragilis group (BFG) are still unclear in young children. This study investigated the occurrence and distribution of species in the BFG and enterotoxigenic strains in the fecal microbiota of children and their antimicrobial susceptibility patterns. Diarrheic (n=110) and non-diarrheic (n=65) fecal samples from children aged 0-5 years old were evaluated. BFG strains were isolated and identified by conventional biochemical, physiological and molecular approaches. Alternatively, bacteria and enterotoxigenic strains were detected directly from feces by molecular biology. Antimicrobial drug susceptibility patterns were determined by the agar dilution method according to the guidelines for isolated bacteria. BFG was detected in 64.3% of the fecal samples (55% diarrheic and 80.4% non-diarrheic), and 4.6% were enterotoxigenic. Antimicrobial resistance was observed against ampicillin, ampicillin/sulbactam, piperacillin/tazobactam, meropenem, ceftriaxone, clindamycin and chloramphenicol. The data show that these bacteria are prevalent in fecal microbiota at higher levels in healthy children. The molecular methodology was more effective in identifying the B. fragilis group when compared to the biochemical and physiological techniques. The observation of high resistance levels stimulates thoughts about the indiscriminate use of antimicrobial drugs in early infancy. Further quantitative studies are needed to gain a better understanding of the role of these bacteria in acute diarrhea in children. PMID:24031535

  5. A challenge for diagnosing acute liver injury with concomitant/sequential exposure to multiple drugs: can causality assessment scales be utilized to identify the offending drug?

    Science.gov (United States)

    Lim, Roxanne; Choudry, Hassan; Conner, Kim; Karnsakul, Wikrom

    2014-01-01

    Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin/sulbactam, and clindamycin) for cervical lymphadenitis/retropharyngeal cellulitis. Histopathology of the liver biopsy specimen revealed acute cholestatic hepatitis. All known causes of acute liver injury were appropriately excluded and (only) drug-induced liver injury was left as a cause of his cholestasis. Liver-specific causality assessment scales such as Council for the International Organization of Medical Sciences/Roussel Uclaf Causality Assessment Method scoring system (CIOMS/RUCAM), Maria and Victorino scale, and Digestive Disease Week-Japan were applied to seek the most likely offending drug. Although clindamycin is the most likely cause by clinical diagnosis, none of causality assessment scales aid in the diagnosis. PMID:25506455

  6. False-positive serum and bronchoalveolar lavage Aspergillus galactomannan assays caused by different antibiotics.

    Science.gov (United States)

    Boonsarngsuk, Viboon; Niyompattama, Anuchit; Teosirimongkol, Chalermporn; Sriwanichrak, Kanchana

    2010-07-01

    Our objective was to identify false-positive serum and bronchoalveolar lavage (BAL) fluid galactomannan (GM) tests caused by various antibiotics commonly used in general practice. Serum and BAL samples from patients who did not have the diagnostic criteria of invasive aspergillosis and received different antibiotics were prospectively analyzed for GM. Serum and BAL samples were also collected from patients who did not receive antibiotics. At the cut-off index of >or=0.5, false-positive serum results were found in patients who received amoxicillin-clavulanate, piperacillin-tazobactam, cefepime, and cefoperazone-sulbactam (26.7%, 58.3%, 14.3%, and 66.7%, respectively). Fungal colonization in BAL samples had a higher BAL GM than those without fungal colonization. In 71 patients who had a negative BAL culture for fungi, at the cut-off value of >or=1.0, false-positive BAL fluid results were found in patients who received amoxicillin-clavulanate (27.3%), piperacillin-tazobactam (50%), cefepime (16.7%), carbapenem (45.5%), and ceftriaxone (45.5%). False-positive serum and BAL GM assays were also detected in patients who did not receive any antibiotics. In summary, this study demonstrates the false-positive GM levels in serum and BAL caused by beta-lactam antibiotics that are commonly used in general practice. Physicians should be aware of this possible interference. PMID:20192889

  7. Extended-spectrum beta-lactamase-producing Shigella strains in Israel, 2000-2004.

    Science.gov (United States)

    Vasilev, V; Japheth, R; Yishai, R; Andorn, N; Valinsky, L; Navon-Venezia, S; Chmelnitsky, I; Carmeli, Y; Cohen, D

    2007-03-01

    Routine susceptibility testing of 5,616 Shigella isolates at the National Shigella Reference Centre in Israel over a 5-year period (2000-2004) revealed resistance to ceftriaxone in one strain of Shigella boydii 2 and in two strains each of Shigella flexneri 2a, S. flexneri 6, and Shigella sonnei. All seven isolates were confirmed as producers of extended-spectrum beta-lactamase (ESBL) by the combination disk method, the Vitek 1 system, and a modification of the double-disk synergy test, which is based on the inhibitory properties of clavulanic acid, tazobactam, and sulbactam. Tazobactam had the strongest effect in all seven strains. Molecular characterization of the ESBLs identified CTX-M-type enzymes, consisting of the CTX-M-9 group (n = 3), CTX-M-3 (n = 2), CTX-M-39 (n = 1), and CTX-M-2 group (n = 1). Three of the strains also carried bla-(OXA) genes and a bla-(TEM) gene. Although the prevalence of ESBLs in this study was low, further research is needed on the spread and transfer of resistance genes, both in hospitals and in the community. PMID:17265070

  8. [Strict anaerobic bacteria: comparative study of various beta-lactam antibiotics in combination with tazobactam or sulbactam].

    Science.gov (United States)

    Dubreuil, L; Sedallian, A

    1991-05-01

    The minimal inhibitory concentrations of piperacillin (PIP) or cefotaxime (CTX) alone or in combination with tazobactam (TAZ) were determined against 168 anaerobes. All the strains were inhibited by PIP + TAZ, but certain strains resistant to CTX + TAZ were found among B. fragilis, Eubacterium and Peptostreptococcus. The second investigations included 30 strains of Bacteroides fragilis. Concentrations of 2, 4 and 8 mg/l of TAZ and sulbactam (SUL) were combined with piperacillin or cefotaxime. The two beta-lactamase-inhibitors had similar activities when used at 2 or 4 mg/l, but at 8 mg/l TAZ was more active than SUL. All B. fragilis strains were inhibited by PIP + TAZ or PIP + SUL, whereas resistance was observed with CTX + SUL or CTX + TAZ. On the same strains the activities of 6 beta-lactams (PIP, mezlocillin, ticarcillin (TIC), CTX, ceftriaxone and ceftazidime) were determined in combination with either SUL 4 mg/l or TAZ 8 mg/l. Only PIP or TIC + SUL or TAZ were able to inhibit at least 90% of tested strains. No resistance could be detected with PIP + TAZ combination. As conclusion, the two inhibitors when combined with PIP or TIC offered greater activity against both Gram positive or negative anaerobes and PIP + TAZ remained the more potent combination. PMID:1652729

  9. Antimicrobial activity of antibiotics in combination with natural flavonoids against clinical extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae.

    Science.gov (United States)

    Lin, Rong-Dih; Chin, Yi-Ping; Lee, Mei-Hsien

    2005-07-01

    Extended-spectrum beta-lactamases (ESBLs) are plasmid-mediated class A enzymes commonly found in the family Enterobacteriaceae, mainly in Klebsiella pneumoniae. Flavonoids have also been reported to possess antimicrobial activity. In this study, the in vitro activities of 18 antibiotics and 12 flavonoids against 20 ESBL-producing K. pneumoniae isolates were evaluated. All of these isolates were susceptible to imipenem and cefmetazole, but were resistant to ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefoperazone, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, piperacillin and ticarcillin. Susceptibilities to amikacin, amoxicillin/clavulanate, cefoxitin, ciprofloxacin and gentamicin were variable. Myricetin, a flavonol, inhibited ESBL-producing K. pneumoniae isolates at a high minimum inhibitory concentration (MIC) (MIC(90) value 256 mg/mL), but exhibited significant synergic activity against ESBL-producing K. pneumoniae in separate combination with amoxicillin/clavulanate, ampicillin/sulbactam and cefoxitin. Because of the low-toxic nature of flavonoids, the combination of antibiotics and flavonoids is a potential new strategy for developing therapies for infections caused by ESBL-producing bacteria in the future. PMID:16161024

  10. Prediction of piperacillin-tazobactam susceptibility among Enterobacteriaceae, Pseudomonas aeruginosa, and other bacteria using ticarcillin-clavulanic acid, ceftazidime, and other broad-spectrum antimicrobial in vitro test results.

    Science.gov (United States)

    Jones, R N; Sutton, L D; Cantrell, H F; Lankford, R B

    1994-11-01

    The ability of various in vitro beta-lactam susceptibility test results to predict the susceptibility of piperacillin-tazobactam (a new beta-lactam-beta-lactamase inhibitor combination) was assessed using more than 46,000 recent clinical isolates. The organisms were tested by reference-quality National Committee for Clinical Laboratory Standards (NCCLS) broth microdilution procedures and interpreted by the currently published NCCLS criteria. The recommended antimicrobial tests that would accurately predict the piperacillin-tazobactam in vitro efficacy had an overall very major, false-susceptible rate of only 0.6% (sulbactam (1.8%) results; for Haemophilus influenzae and Moraxella catarrhalis use cefotaxime or cefuroxime or ceftriaxone (1.5%); and for staphylococci use oxacillin by NCCLS recommendations. When the piperacillin-tazobactam testing reagents become available, the direct testing of this combination should be applied to relevant clinical isolates. The piperacillin-tazobactam break points should be reassessed as indicated by the cited minimum inhibitory concentration population analysis to improve predictive accuracy; H. influenzae susceptibility modified to < or = 2/4 micrograms/ml and Enterococcus species susceptibility tested at < or = 16/4 micrograms. PMID:7874881

  11. Magnetic core/shell nanoparticle thin films deposited by MAPLE: Investigation by chemical, morphological and in vitro biological assays

    Energy Technology Data Exchange (ETDEWEB)

    Cristescu, R., E-mail: rodica.cristescu@inflpr.ro [National Institute for Lasers, Plasma and Radiation Physics, Lasers Department, P.O. Box MG-36, Bucharest-Magurele (Romania); Popescu, C.; Socol, G.; Iordache, I.; Mihailescu, I.N. [National Institute for Lasers, Plasma and Radiation Physics, Lasers Department, P.O. Box MG-36, Bucharest-Magurele (Romania); Mihaiescu, D.E.; Grumezescu, A.M. [Faculty of Applied Chemistry and Materials Science, ' Politehnica' University of Bucharest, 1-7 Polizu Street, 011061 Bucharest (Romania); Balan, A.; Stamatin, I. [University of Bucharest, 3Nano-SAE Research Center, PO Box MG-38, Bucharest-Magurele (Romania); Chifiriuc, C. [Faculty of Biology, University of Bucharest, Microbiology Immunology Department, Aleea Portocalilor 1-3, Sector 5, 77206 Bucharest (Romania); Bleotu, C. [Stefan S. Nicolau Institute of Virology, 285 Mihai Bravu, 030304 Bucharest (Romania); Saviuc, C.; Popa, M. [Faculty of Biology, University of Bucharest, Microbiology Immunology Department, Aleea Portocalilor 1-3, Sector 5, 77206 Bucharest (Romania); Chrisey, D.B. [Rensselaer Polytechnic Institute, School of Engineering, Departments of Materials Science and Biomedical Engineering, Troy, 12180-3590, NY (United States)

    2012-09-15

    Highlights: Black-Right-Pointing-Pointer We deposit magnetic Fe{sub 3}O{sub 4}/oleic acid/cephalosporin nanoparticle thin films by MAPLE. Black-Right-Pointing-Pointer Thin films have a chemical structure similar to the starting material. Black-Right-Pointing-Pointer Cephalosporins have an additive effect on the grain size and induce changes in grain shape. Black-Right-Pointing-Pointer MAPLE can be used to develop novel strategies for fighting medical biofilms associated with chronic infections. - Abstract: We report on thin film deposition of nanostructured Fe{sub 3}O{sub 4}/oleic acid/ceftriaxone and Fe{sub 3}O{sub 4}/oleic acid/cefepime nanoparticles (core/shell/adsorption-shell) were fabricated by matrix assisted pulsed laser evaporation (MAPLE) onto inert substrates. The thin films were characterized by profilometry, Fourier transform infrared spectroscopy, atomic force microscopy, and investigated by in vitro biological assays. The biological properties tested included the investigation of the microbial viability and the microbial adherence to the glass coverslip nanoparticle film, using Gram-negative and Gram-positive bacterial strains with known antibiotic susceptibility behavior, the microbial adherence to the HeLa cells monolayer grown on the nanoparticle pellicle, and the cytotoxicity on eukaryotic cells. The proposed system, based on MAPLE, could be used for the development of novel anti-microbial materials or strategies for fighting pathogenic biofilms frequently implicated in the etiology of biofilm associated chronic infections.

  12. Serotypes, antibiotic susceptibilities, and multi-locus sequence type profiles of Streptococcus agalactiae isolates circulating in Beijing, China.

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    Ping Wang

    Full Text Available To investigate the serotypes, antibiotic susceptibilities, and multi-locus sequence type (MLST profiles of Streptococcus agalactiae (S. agalactiae in Beijing to provide references for the prevention and treatment of S. agalactiae infections.All isolates were identified using the CAMP test and the latex-agglutination assay and serotyped using a Strep-B-Latex kit, after which they were assessed for antibiotic susceptibility, macrolide-resistance genes, and MLST profiles.In total, 56 S. agalactiae isolates were identified in 863 pregnant women (6.5%. Serotypes Ia, Ib, II, III, and V were identified, among which types III (32.1%, Ia (17.9%, Ib (16.1%, and V (14.3% were the predominant serotypes. All isolates were susceptible to penicillin and ceftriaxone. The nonsusceptiblity rates measured for erythromycin, clarithromycin, azithromycin, telithromycin, clindamycin, tetracycline, and levofloxacin were 85.7%, 92.9%, 98.2%, 30.4%, 73.2%, 91%, and 39.3%, respectively. We identified 14 sequence types (STs for the 56 isolates, among which ST19 (30.4% was predominant. The rate of fluoroquinolone resistance was higher in serotype III than in the other serotypes. Among the 44 erythromycin-resistant isolates, 32 (72.7% carried ermB.S. agalactiae isolates of the serotypes Ia, Ib, III, and V are common in Beijing. Among the S. agalactiae isolates, the macrolide and clindamycin resistance rates are extremely high. Most of the erythromycin-resistant isolates carry ermB.

  13. Severe sepsis and septic shock in pre-hospital emergency medicine: survey results of medical directors of emergency medical services concerning antibiotics, blood cultures and algorithms.

    Science.gov (United States)

    Casu, Sebastian; Häske, David

    2016-06-01

    Delayed antibiotic treatment for patients in severe sepsis and septic shock decreases the probability of survival. In this survey, medical directors of different emergency medical services (EMS) in Germany were asked if they are prepared for pre-hospital sepsis therapy with antibiotics or special algorithms to evaluate the individual preparations of the different rescue areas for the treatment of patients with this infectious disease. The objective of the survey was to obtain a general picture of the current status of the EMS with respect to rapid antibiotic treatment for sepsis. A total of 166 medical directors were invited to complete a short survey on behalf of the different rescue service districts in Germany via an electronic cover letter. Of the rescue districts, 25.6 % (n = 20) stated that they keep antibiotics on EMS vehicles. In addition, 2.6 % carry blood cultures on the vehicles. The most common antibiotic is ceftriaxone (third generation cephalosporin). In total, 8 (10.3 %) rescue districts use an algorithm for patients with sepsis, severe sepsis or septic shock. Although the German EMS is an emergency physician-based rescue system, special opportunities in the form of antibiotics on emergency physician vehicles are missing. Simultaneously, only 10.3 % of the rescue districts use a special algorithm for sepsis therapy. Sepsis, severe sepsis and septic shock do not appear to be prioritized as highly as these deadly diseases should be in the pre-hospital setting. PMID:26719078

  14. Azithromycin, fluoroquinolone and chloramphenicol resistance of non-chlamydia conjunctival bacteria in rural community of Ethiopia

    Directory of Open Access Journals (Sweden)

    Bayeh Abera

    2014-01-01

    Full Text Available Aim: To determine profiles of non-chlamydia conjunctival bacteria and their antimicrobial susceptibility from adults who underwent trachomatous trichiasis surgery in rural areas of Ethiopia. Materials and Methods: A cross-sectional study was conducted in rural districts in West Gojjam administrative zone. Conjunctival swabs were collected during surgery and transported using Stuart transport broth (Oxoid, UK. Antibiotic susceptibility of conjunctival isolates was determined using the Kirby-Bauer disc-diffusion method. Results: Non-chlamydia pathogenic bacteria were recovered from conjunctiva of 438 (31% participants before treatment. The isolated conjunctival bacteria were Staphylococcus aureus, coagulase-negative Staphylococci, Streptococcus group (A, C, F and G, Enterococci, Streptococcus pneumoniae, Moraxella spp., Escherichia coli, Citrobacter spp., Proteus spp., Klebsiella spp., Pseudomonas spp. and Enterobacter spp. Overall, resistance rates of 57.8% to azithromycin and 68.5% to chloramphenicol were found. However, 86-94.4% sensitivity was demonstrated to ciprofloxacin and norfloxacin. Moderate sensitivity rates (61.8-78.4% were observed to ceftriaxone, tetracycline and cotrimoxazole. Conclusion: Fluoroquinolones that have activity against the majority of bacterial isolates were potent at in vitro. However, unacceptably high levels of resistance to azithromycin and chloramphenicol in rural community indicated a need for further study and antimicrobial resistance surveillance.

  15. Prevalence and emerging resistance of Moraxella catarrhalis in lower respiratory tract infections in Karachi

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence of Moraxella catarrhalis in sputum cultures from patients with lower respiratory tract infection and their antimicrobial sensitivity profiles. Methods: The study comprised sputum specimens of 776 patients at various branches of Dr Essa's Diagnostic Lab, Karachi. The specimens were cultured on blood, chocolate, and eosin methylene blue agars between October 2010 and October 2011. The isolates were identified by conventional methods and anti-biograms were determined by the Kirby-Bauer Agar Disc Diffusion Method. Results: Moraxella catarrhalis was isolated from 39 (5.02%) sputa of which 18 (46.15%) belonged to males. The bimodal age prevalence was 238 (30.7%) in age group 20-29 years, and 180 (23.1%) in 70 years and above. Amoxicillin/clavulanate, cefotaxime, and ceftriaxone were most effective (100%). Very high resistance was seen with amikacin (92.3%), cefixime (92.3%), fosfomycin (84.6%), cefuroxime (84.6%), erythromycin and amoxicillin (76.9%), cotrimoxazole (90%) and doxycycline (76.9%). Conclusions: The incidence of Moraxella catarrhalis in sputum encourages routine culture and sensitivity of sputa from patients suffering from lower respiratory tract infection, especially the elderly and immunocompromised, for tailored drug prescription. (author)

  16. An Unrecognized Rash Progressing to Lyme Carditis: Important Features and Recommendations Regarding Lyme Disease.

    Science.gov (United States)

    Lee, Shawn; Singla, Montish

    2016-01-01

    We present a case report of 46-year-old man with no medical history, who complained of extreme fatigue, near-syncope, and palpitations. He initially presented in complete heart block. A transvenous pacemaker was placed in the emergency department, and he was started empirically on Ceftriaxone for Lyme disease. He was admitted and over the course of the next few days, his rhythm regressed to Mobitz type I first-degree atrioventricular block and then to normal sinus rhythm. This case report highlights some important features regarding Lyme carditis, a rare presentation of early disseminated Lyme disease (seen in a few weeks to months after the initial tick bite). In 25%-30% of patients, the characteristic targetoid rash may not be seen, a likely culprit of the disease not being detected early and progressing to disseminated disease. The most common cardiac complaint of Lyme disease is palpitations, occurring in 6.6% of patients, which may not accurately reflect progression into disseminated Lyme disease because it is a nonspecific finding. Conduction abnormality, occurring in 1.8% of patients, is a more specific finding of Borrelia invading cardiac tissue. Finally, this case report highlights a recommendation that patients with confirmed Lyme disease or those presenting with cardiac abnormalities or symptoms who have an atypical profile for a cardiac event should be screened with a 12-lead electrocardiogram, Lyme serology, and be considered for antibiotic therapy with the possibility of temporary pacing. PMID:25730155

  17. Antimicrobial Resistant Pattern of Escherichia Coli Strains Isolated from Pediatric Patients in Jordan

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    Mohammad Alshara

    2011-05-01

    Full Text Available The present study was conducted to investigate antimicrobial resistant pattern of Escherichia coli (E. coli strains isolated from clinical specimens of Jordanian pediatric patients during the period from January to December 2008. A total of 444 E. coli strains were isolated from clinical specimens and tested for their susceptibility to different antimicrobial drugs. Overall, high resistance rate was observed for ampicillin (84%, followed by amoxicillin-clavulanic acid (74.3%, cotrimoxazole (71%, nalidixic acid (47.3%, cephalothin (41%. Lower resistance rates were observed for amikacin (0% followed by Cefotaxime (11%, Ceftriaxone (11.7%, ciprofloxacin (14.5%, Norfloxacin (16.5%, gentamicin (17.3% cephalexin (20.9%, Ceftazidime (22.5%, cefixime (29.6%, and cefaclor (32.8%. Ampicillin, amoxicillin-clavulanic acid and cotrimoxazole were found to be ineffective at in vitro inhibition of the E. coli of pediatric origin. Amikacin was highly effective for E. coli with susceptibility rate of 100%. The majority of E. coli strains were susceptible to third generation cephalosporins and fluoroquinolones.

  18. In vitro activity of fluoroquinolones (gatifloxacin, levofloxacin and trovafloxacin and seven other antibiotics against Streptococcus pneumoniae

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    Nicodemo A.C.

    2001-01-01

    Full Text Available In recent years, the level of resistance of S. pneumoniae to beta-lactam and/or macrolides has increased around the world including some countries in South America. Because of this resistance, it is necessary to test the therapeutic alternatives for treating this pathogen, including the newer quinolones. This study was carried out in order to compare the in vitro activity of fluoroquinolones gatifloxacin, levofloxacin and trovafloxacin, to penicillin G, amoxicillin, amoxicillin-clavulanate, cufuroxime sodium, ceftriaxone, azithromycin and clarithromycin, against 300 strains of S. pneumoniae. Of the 300 samples tested, 18.6% were not susceptible to penicillin (56 strains and 7% (21 strains were resistant to the second generation cephalosporin. Among the macrolides, resistance ranged from 6.7% for clarithromycin to 29.6% for azithromycin. Susceptibility to the newer quinolones was 100% including the 56 strains not susceptible to penicillin. Among the 10 antibiotics evaluated, the fluoroquinolones gatifloxacin, levofloxacin, and trovafloxacin displayed high levels of in vitro activity against S. pneumoniae.

  19. Urinary Tract Infections due to Multidrug-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Chicago Emergency Department

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    Thana Khawcharoenporn

    2013-01-01

    Full Text Available Background. Selection of empiric antibiotics for urinary tract infections (UTIs has become more challenging because of the increasing rates of multidrug-resistant Enterobacteriaceae (MDRE infections. Methods. This retrospective study was conducted to determine antibiotic resistance patterns, risk factors, and appropriate empiric antibiotic selection for MDRE UTIs. Adult patients seen in the Emergency Department (ED with Enterobacteriaceae UTIs during 2008-2009 were identified from review of microbiology records. MDRE were defined as organisms resistant to at least 3 categories of antibiotics. Results. There were 431 eligible patients; 83 (19% had MDRE UTIs. Resistance rates for individual antibiotics among MDRE UTIs were significantly greater than non-MDRE UTIs: levofloxacin, 72% versus 14%; TMP-SMX, 77% versus 12%; amoxicillin-clavulanate, 35% versus 4%; nitrofurantoin, 21% versus 12%, and ceftriaxone, 20% versus 0%. All Enterobacteriaceae isolates were susceptible to ertapenem (MIC ≤ 2 mg/L. Independent risk factors for MDRE UTI were prior fluoroquinolone use within 3 months (adjusted odds ratio (aOR 3.64; , healthcare-associated risks (aOR 2.32; , and obstructive uropathy (aOR 2.22; . Conclusion. Our study suggests that once-daily intravenous or intramuscular ertapenem may be appropriate for outpatient treatment of ED patients with MDRE UTI.

  20. Drug Utilization Study on Antibiotics Use in Lower Respiratory Tract Infection

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    Harish Govind Naik

    2013-08-01

    Full Text Available ABSTRACT Antibiotics are commonly prescribed for the lower respiratory tract infection. But if antibiotics are not used rationally then there will be increase chances of resistance of bacteria as well as increase in the total cost of treatment. This study was conducted to see the antibiotics utilization pattern. Aim: This drug utilization study was conducted to evaluate the pattern of antibiotics use in Medicine Department of a Krishna Hospital, Karad, Maharashtra, India. 96 case records were examined, of which 46.87% were LRTI (nonspecific LRTI and acute bronchitis and 51% were pneumonia. Female accounted for 53.12% and male for 46.87 % of total cases. The World Health Organization (WHO indicators (utilization in defined daily doses (DDD; DDD/1000inhibitant/day were used and the ATC/DDD method was implemented. The most frequently prescribed antibiotic was ceftriaxone, followed by Azithromycin. The DDD/1000inhibitant/day of Azithromycin was the highest (5.74. Average treatment period was found to be 5.42 and 6.52 for LRTI (nonspecific LRTI and Acute Bronchitis and pneumonia respectively. A total of 96 cases studied; in which 33 cases had mono-antibiotic therapy (33.37% and rest contained poly-antibiotics therapy (66.63%. Prescribing by generic names has to be encouraged. [Natl J Med Res 2013; 3(4.000: 324-327