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Sample records for cilastatin

  1. Imipenem and Cilastatin Sodium Injection

    Science.gov (United States)

    ... combination of imipenem and cilastatin eliminates bacteria that cause many kinds of infections, including pneumonia and gynecological, skin, stomach, blood, bone, joint, urinary tract, and heart valve infections. This medication is ...

  2. Imipenem-cilastatin-induced leukocytoclastic vasculitis.

    Science.gov (United States)

    Reiner, M R; Brunetti, V A

    1997-05-01

    A maculopapular rash has been associated with the administration of imipenem-cilastatin, an antibiotic that was used for treatment of a postoperative infection. This is a first-time association of imipenem with a leukocytoclastic vasculitic reaction. Leukocytoclastic vasculitis has been previously documented with ciprofloxacin, zidovudine, piperazine, and lithium. PMID:9158321

  3. Protective Effects of Cilastatin against Vancomycin-Induced Nephrotoxicity

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    Blanca Humanes

    2015-01-01

    Full Text Available Vancomycin is a very effective antibiotic for treatment of severe infections. However, its use in clinical practice is limited by nephrotoxicity. Cilastatin is a dehydropeptidase I inhibitor that acts on the brush border membrane of the proximal tubule to prevent accumulation of imipenem and toxicity. The aim of this study was to investigate the potential protective effect of cilastatin on vancomycin-induced apoptosis and toxicity in cultured renal proximal tubular epithelial cells (RPTECs. Porcine RPTECs were cultured in the presence of vancomycin with and without cilastatin. Vancomycin induced dose-dependent apoptosis in cultured RPTECs, with DNA fragmentation, cell detachment, and a significant decrease in mitochondrial activity. Cilastatin prevented apoptotic events and diminished the antiproliferative effect and severe morphological changes induced by vancomycin. Cilastatin also improved the long-term recovery and survival of RPTECs exposed to vancomycin and partially attenuated vancomycin uptake by RPTECs. On the other hand, cilastatin had no effects on vancomycin-induced necrosis or the bactericidal effect of the antibiotic. This study indicates that cilastatin protects against vancomycin-induced proximal tubule apoptosis and increases cell viability, without compromising the antimicrobial effect of vancomycin. The beneficial effect could be attributed, at least in part, to decreased accumulation of vancomycin in RPTECs.

  4. Evaluation of the appropriateness of imipenem/cilastatin prescription and dosing in a tertiary care hospital

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    Kabbara WK

    2015-03-01

    Full Text Available Wissam K Kabbara, George T Nawas, Wijdan H RamadanDepartment of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon Background: Imipenem/cilastatin is an antibacterial agent of the carbapenem class of β-lactams that is known to have an extremely wide spectrum of activity against Gram-positive, Gram-negative, aerobic, anaerobic, and even multidrug-resistant strains. The objective of this study was to evaluate the appropriate use of imipenem/cilastatin in a local tertiary care hospital. The study assessed the indication both empirically and after the culture results were available, the dose and dose adjustment in renal failure, as well as the incidence of seizure in hospitalized patients receiving imipenem/cilastatin. Methods: This observational study was conducted in a tertiary care hospital over a 3-month period. The treatment of 100 patients with imipenem/cilastatin was evaluated both empirically and after culture results were available. Analysis of the appropriateness of imipenem/cilastatin indication, dose, and monitoring of seizure frequency was based on the package insert, updated published guidelines, and clinical judgment. Results: Patients from internal medicine and intensive care units comprised approximately 50% of the population in the study. The patients received imipenem/cilastatin mainly for urinary tract infections (27% or for sepsis of an unknown focus (22%. The use of imipenem/cilastatin empirically was appropriate in 97.2% (n=69/71 of the cases, and its use postculture in 86% of the cases. There were 29% of the patients who were not started on imipenem/cilastatin empirically. Four patients out of the 29 patients (13.8% who were not started on imipenem/cilastatin empirically inappropriately received imipenem/cilastatin post-culture results. Thirty-three patients (33% were not dosed appropriately, 30 of whom had renal impairment and creatinine clearance fluctuations. Only one patient developed a

  5. Evaluation of the appropriateness of imipenem/cilastatin prescription and dosing in a tertiary care hospital

    Science.gov (United States)

    Kabbara, Wissam K; Nawas, George T; Ramadan, Wijdan H

    2015-01-01

    Background Imipenem/cilastatin is an antibacterial agent of the carbapenem class of β-lactams that is known to have an extremely wide spectrum of activity against Gram-positive, Gram-negative, aerobic, anaerobic, and even multidrug-resistant strains. The objective of this study was to evaluate the appropriate use of imipenem/cilastatin in a local tertiary care hospital. The study assessed the indication both empirically and after the culture results were available, the dose and dose adjustment in renal failure, as well as the incidence of seizure in hospitalized patients receiving imipenem/cilastatin. Methods This observational study was conducted in a tertiary care hospital over a 3-month period. The treatment of 100 patients with imipenem/cilastatin was evaluated both empirically and after culture results were available. Analysis of the appropriateness of imipenem/cilastatin indication, dose, and monitoring of seizure frequency was based on the package insert, updated published guidelines, and clinical judgment. Results Patients from internal medicine and intensive care units comprised approximately 50% of the population in the study. The patients received imipenem/cilastatin mainly for urinary tract infections (27%) or for sepsis of an unknown focus (22%). The use of imipenem/cilastatin empirically was appropriate in 97.2% (n=69/71) of the cases, and its use postculture in 86% of the cases. There were 29% of the patients who were not started on imipenem/cilastatin empirically. Four patients out of the 29 patients (13.8%) who were not started on imipenem/cilastatin empirically inappropriately received imipenem/cilastatin post-culture results. Thirty-three patients (33%) were not dosed appropriately, 30 of whom had renal impairment and creatinine clearance fluctuations. Only one patient developed a seizure while on imipenem/cilastatin. Conclusion The prescription of imipenem/cilastatin at our setting was mostly appropriate to what is recommended in the guidelines

  6. [A case of Mycobacterium abscessus pulmonary infection; effectiveness of clarithromycin, amikacin and imipenem/cilastatin].

    Science.gov (United States)

    Shikama, Yusuke; Kamio, Yoshito; Kuriu, Kazuyuki; Shibuya, Yasuhiro; Kimura, Satoshi; Nakajima, Hiroaki

    2006-11-01

    A 42-year-old woman presented with persistent cough, bloody sputum and fever. Her chest X-ray film showed an infiltrative shadow with cavitation in the upper lobe of the left lung. Acid-fast-bacilli were shown by sputum smear staining. The anti-tuberculosis drugs isoniazid, refampicin, ethambutol and pyrazinamide were prescribed, but her symptoms and chest X-ray findings did not improve. Findings of MTD and MAC-PCR were negative but Mycobacterium abscessus was confirmed by sputum culture with the DNA hybridization method. Combination therapy with clarithromycin, amikacin and imipenem/cilastatin for one month improved her symptoms and chest X-ray shadow, and clarithromycin monotherapy was carried out for another ten months. Drug susceptibility tests revealed this mycobacterium was sensitive to clarithromycin and amikacin. To determine the environmental factors related to this infection, several samples were examined. Acid-fast-bacilli were present in a smear from the bath room drain. However, to confirm the infectious routes, longer observation is needed. Moreover, serum amyloid protein A and ESR were useful markers to estimate the clinical course. PMID:17144576

  7. Effects of beta-lactam antibiotics imipenem/cilastatin and cefodizime on cellular and humoral immune responses in BALB/c-mice.

    Science.gov (United States)

    Grochla, I; Ko, H L; Beuth, J; Roszkowski, K; Roszkowski, W; Pulverer, G

    1990-11-01

    The effects of a 7-day chemotherapy with two broad-spectrum beta-lactam antibiotics (imipenem/cilastatin and cefodizime) on the humoral and cellular immune responses in BALB/c-mice were investigated. Antibiotic dosages were calculated on a body weight basis from therapeutical dosages in human medicine. Treatment of experimental mice with imipenem/cilastatin and cefodizime did not influence the production of immunoglobulines (IgM and IgG) nor the delayed type hypersensitivity to oxazolone. In vitro, exposure of human granulocytes to imipenem/cilastatin and cefodizime did not interfere with their phagocytic activity as determined by chemiluminescence assay. Subinhibitory concentrations of both antibiotics modified Staphylococcus aureus and made them more susceptible for granulocyte phagocytosis in chemiluminescence assays. PMID:2085374

  8. Cefepime versus Imipenem-Cilastatin for Treatment of Nosocomial Pneumonia in Intensive Care Unit Patients: a Multicenter, Evaluator-Blind, Prospective, Randomized Study

    Science.gov (United States)

    Zanetti, G.; Bally, F.; Greub, G.; Garbino, J.; Kinge, T.; Lew, D.; Romand, J.-A.; Bille, J.; Aymon, D.; Stratchounski, L.; Krawczyk, L.; Rubinstein, E.; Schaller, M.-D.; Chiolero, R.; Glauser, M.-P.; Cometta, A.

    2003-01-01

    In a randomized, evaluator-blind, multicenter trial, we compared cefepime (2 g three times a day) with imipenem-cilastatin (500 mg four times a day) for the treatment of nosocomial pneumonia in 281 intensive care unit patients from 13 centers in six European countries. Of 209 patients eligible for per-protocol analysis of efficacy, favorable clinical responses were achieved in 76 of 108 (70%) patients treated with cefepime and 75 of 101 (74%) patients treated with imipenem-cilastatin. The 95% confidence interval (CI) for the difference between these response rates (−16 to 8%) failed to exclude the predefined lower limit for noninferiority of −15%. In addition, therapy of pneumonia caused by an organism producing an extended-spectrum β-lactamase (ESBL) failed in 4 of 13 patients in the cefepime group but in none of 10 patients in the imipenem group. However, the clinical efficacies of both treatments appeared to be similar in a secondary intent-to-treat analysis (95% CI for difference, −9 to 14%) and a multivariate analysis (95% CI for odds ratio, 0.47 to 1.75). Furthermore, the all-cause 30-day mortality rates were 28 of 108 (26%) patients in the cefepime group and 19 of 101 (19%) patients in the imipenem group (P = 0.25). Rates of documented or presumed microbiological eradication of the causative organism were similar with cefepime (61%) and imipenem-cilastatin (54%) (95% CI, −23 to 8%). Primary or secondary resistance of Pseudomonas aeruginosa was detected in 19% of the patients treated with cefepime and 44% of the patients treated with imipenem-cilastatin (P = 0.05). Adverse events were reported in 71 of 138 (51%) and 62 of 141 (44%) patients eligible for safety analysis in the cefepime and imipenem groups, respectively (P = 0.23). Although the primary end point for this study does not exclude the possibility that cefepime was inferior to imipenem, some secondary analyses showed that the two regimens had comparable clinical and microbiological

  9. Spectrophotometric and chemometric methods for determination of imipenem, ciprofloxacin hydrochloride, dexamethasone sodium phosphate, paracetamol and cilastatin sodium in human urine

    Science.gov (United States)

    El-Kosasy, A. M.; Abdel-Aziz, Omar; Magdy, N.; El Zahar, N. M.

    2016-03-01

    New accurate, sensitive and selective spectrophotometric and chemometric methods were developed and subsequently validated for determination of Imipenem (IMP), ciprofloxacin hydrochloride (CIPRO), dexamethasone sodium phosphate (DEX), paracetamol (PAR) and cilastatin sodium (CIL) in human urine. These methods include a new derivative ratio method, namely extended derivative ratio (EDR), principal component regression (PCR) and partial least-squares (PLS) methods. A novel EDR method was developed for the determination of these drugs, where each component in the mixture was determined by using a mixture of the other four components as divisor. Peak amplitudes were recorded at 293.0 nm, 284.0 nm, 276.0 nm, 257.0 nm and 221.0 nm within linear concentration ranges 3.00-45.00, 1.00-15.00, 4.00-40.00, 1.50-25.00 and 4.00-50.00 μg mL- 1 for IMP, CIPRO, DEX, PAR and CIL, respectively. PCR and PLS-2 models were established for simultaneous determination of the studied drugs in the range of 3.00-15.00, 1.00-13.00, 4.00-12.00, 1.50-9.50, and 4.00-12.00 μg mL- 1 for IMP, CIPRO, DEX, PAR and CIL, respectively, by using eighteen mixtures as calibration set and seven mixtures as validation set. The suggested methods were validated according to the International Conference of Harmonization (ICH) guidelines and the results revealed that they were accurate, precise and reproducible. The obtained results were statistically compared with those of the published methods and there was no significant difference.

  10. 亚胺培南西司他丁钠致中毒性表皮坏死松解型药疹1例%One case of toxic epidermal necrolysis induced by imipenem and cilastatin sodium

    Institute of Scientific and Technical Information of China (English)

    徐锦龙; 王雄雄; 陈武; 胡东军; 叶忠亮; 马卫成

    2014-01-01

    One 48-year-old male patient with head trauma surgery was hospitalized because of unconsciousness for 1 month. The patient had no drug and food allergic history. After the evacuation of hematoma by craniotomy in emergency, the patient was fever, and the cefoxitin was used according to the susceptibility test. After 5 days, cefoxitin was discontinued, and the antibacterial agent was adjusted to imipenem and cilastatin sodium. Three days later, red rash appeared mainly in the patient's back and chest, and gradually spread to the whole body with peeling. Patient was diagnosed with toxic epidermal necrolysis. Then imipenem and cilastatin sodium was stopped, cefoperazone and sulbactam sodium and fosfomycin sodium were used for anti-infection, and methylprednisolone sodium succinate and other antiallergic treatments were given. Since then, no new rash appeared, skin wound gradually dried, and lesion area gradually diminished.%1例48岁男性患者,因头颅外伤术后伴意识不清1个月入院。既往无药物、食物过敏史。急诊行开颅血肿清除术,术后患者出现发热,根据药敏试验结果给予头孢西丁。5d后停用头孢西丁,改为亚胺培南西司他丁钠,3d后患者出现红色皮疹,以胸背部为主,并逐步蔓延至全身,部分伴脱皮,皮肤科会诊后诊断为中毒性表皮坏死松解型药疹。遂停用亚胺培南西司他丁钠,改为头孢哌酮舒巴坦钠与磷霉素钠,并给予甲泼尼龙琥珀酸钠等抗过敏治疗,之后患者再无新发皮疹,皮损创面逐步干燥,面积也逐渐缩小。

  11. Therapeutic drug monitoring for peripartum use of imipenem/cilastatin%围生期孕产妇应用亚胺培南/西司他丁钠的治疗药物监测

    Institute of Scientific and Technical Information of China (English)

    刘维; 朱立勤; 张现化; 魏瑗; 熊歆; 刘洋; 杨丽

    2015-01-01

    目的:探讨治疗药物监测手段支持围生期孕妇应用亚胺培南/西司他丁钠治疗的作用。方法1名孕29周患者因宫内感染使用亚胺培南/西司他丁钠进行抗感染治疗,为明确药物使用的安全性,临床药师通过治疗药物监测手段,协助临床科室进行围生期抗感染治疗。结果与结论对母体静脉血及胎儿脐带血进行血药浓度监测发现,母体及胎儿的血药浓度均在安全范围,通过随访,母婴均恢复良好出院。临床药师为临床特殊患者进行治疗药物监测,为围生期使用美国食品药品监管理局妊娠分级C级的抗菌药物积累了应用经验和药学监护方法。%Objective To report a case of peripartum use of imipenem/cilastatin supported by therapeutic drug monitoring ( TDM ) technique. Methods A 29-week pregnant woman was prescribed imipenem/cilas-tatin because of intrauterine infection , to ensure the safety of this Food and Drug Administration ( FDA ) Class C drug , pharmacists carried out TDM for this patient.Results and Conclusion By establishing a rapid analyzing method , the parent venous blood and fetus umbilical cord blood was measured.The concentration of imipenem/cilastatin were within nor-mal range in both the mother and the baby .Through follow-up, no ad-verse event were developed and both were discharged later .By providing TDM and pharmaceutical care , the pharmacists supported the clinical us-age of peripartum anti -infectious therapy , and more experience and con-fidence would be gained and shared .

  12. A multicenter trial of the efficacy and safety of tigecycline versus imipenem/cilastatin in patients with complicated intra-abdominal infections [Study ID Numbers: 3074A1-301-WW; ClinicalTrials.gov Identifier: NCT00081744

    Directory of Open Access Journals (Sweden)

    Babinchak Timothy

    2005-10-01

    Full Text Available Abstract Background Complicated intra-abdominal infections (cIAI remain challenging to treat because of their polymicrobial etiology including multi-drug resistant bacteria. The efficacy and safety of tigecycline, an expanded broad-spectrum glycylcycline antibiotic, was compared with imipenem/cilastatin (IMI/CIS in patients with cIAI. Methods A prospective, double-blind, multinational trial was conducted in which patients with cIAI randomly received intravenous (IV tigecycline (100 mg initial dose, then 50 mg every 12 hours [q12h] or IV IMI/CIS (500/500 mg q6h or adjusted for renal dysfunction for 5 to14 days. Clinical response at the test-of-cure (TOC visit (14–35 days after therapy for microbiologically evaluable (ME and microbiological modified intent-to-treat (m-mITT populations were the co-primary efficacy endpoint populations. Results A total of 825 patients received ≥ 1 dose of study drug. The primary diagnoses for the ME group were complicated appendicitis (59%, and intestinal (8.8% and gastric/duodenal perforations (4.6%. For the ME group, clinical cure rates at TOC were 80.6% (199/247 for tigecycline versus 82.4% (210/255 for IMI/CIS (95% CI -8.4, 5.1 for non-inferiority tigecycline versus IMI/CIS. Corresponding clinical cure rates within the m-mITT population were 73.5% (227/309 for tigecycline versus 78.2% (244/312 for IMI/CIS (95% CI -11.0, 2.5. Nausea (31.0% tigecycline, 24.8% IMI/CIS [P = 0.052], vomiting (25.7% tigecycline, 19.4% IMI/CIS [P = 0.037], and diarrhea (21.3% tigecycline, 18.9% IMI/CIS [P = 0.435] were the most frequently reported adverse events. Conclusion This study demonstrates that tigecycline is as efficacious as imipenem/cilastatin in the treatment of patients with cIAI.

  13. 两种亚胺培南/西司他丁钠制剂治疗中性粒细胞缺乏伴发热的对照研究及成本-效果分析%The Clinical Efficacy and Cost-Effectiveness of Two Kinds of Imipenem/Cilastatin Sodium Formulations for Febrile Neutropenia: A Controlled Clinical Trial

    Institute of Scientific and Technical Information of China (English)

    卢双龙; 周宁; 乔晓红; 邵越霞; 谢晓恬

    2013-01-01

    Objective: To evaluate the clinical efficacy and cost-effectiveness of two kinds of imipenem/cilastatin sodium formulations: Bacqure and Tienam for febrile neulropenia. Methods: Fifty one cases of palients wilh febrile neutropenia were randomly divided into two groups. Bacqure was used in one group (29 cases) and the other group (22 cases) was treated with Tienam. Evaluate the efficacy of the two groups and use the pharmacological economic principle to analyze the cost-effectiveness of the two groups. Results: The effective rates of Bacqure group and Tienam group in the treatment of febrile neutropenia were 86. 20 % and 86. 36 % (P>0. 05) respectively; the cost-effectiveness ralio ( C/E) were 28.54 and 42. 15. The cost for every one unit increment of effectiveness in Tienam group was 7,375 RMB. which was higher than thai in Bacqure group. Conclusions: There was no significant difference between Bacqure group and Tienam group in the clinical efficacy for febrile neutropenia. The cost-effectiveness ratio of Bacqure is superior to that of Tienam and Bacqure is likely to have pharmacoeconomical advantage over Tienam in the treatment of febrile neutropenia.%目的:比较分析两种亚胺培南/西司他丁钠制剂齐佩能(Bacqure)与泰能(Tienam)治疗中性粒细胞缺乏伴发热的疗效及成本.方法:将51例次中性拉细胞缺乏伴发热患儿随机分为齐佩能组29例和泰能组22例,分别选用齐佩能和泰能进行治疗,比较两组临床疗效,并运用药物经济学原理对两种治疗方案进行成本-效果分析.结果:齐佩能与泰能治疗中性粒细胞缺乏伴发热的有效率分别为86.20%和86.36% (P>0.05),成本-效果比(C/E)分别为28.54和42.15;与齐佩能相比,泰能每增加一个单位效果需多花费7 375元结论:齐佩能与泰能治疗中性粒细胞缺乏伴发热临床疗效比较差异无统计学意义,但齐佩能的成本-效果比低于泰能,有一定的经济学优势.

  14. Efficacies of Imipenem, Meropenem, Cefepime, and Ceftazidime in Rats with Experimental Pneumonia Due to a Carbapenem-Hydrolyzing β-Lactamase-Producing Strain of Enterobacter cloacae

    OpenAIRE

    Mimoz, Olivier; Leotard, Sophie; Jacolot, Anne; Padoin, Christophe; Louchahi, Kamel; Petitjean, Olivier; Nordmann, Patrice

    2000-01-01

    The antibacterial activities of imipenem-cilastatin, meropenem-cilastatin, cefepime and ceftazidime against Enterobacter cloacae NOR-1, which produces the carbapenem-hydrolyzing β-lactamase NmcA and a cephalosporinase, and against one of its in vitro-obtained ceftazidime-resistant mutant were compared by using an experimental model of pneumonia with immunocompetent rats. The MICs of the β-lactams with an inoculum of 5 log10 CFU/ml were as follows for E. cloacae NOR-1 and its ceftazidime-resis...

  15. Pharmacodynamics of Imipenem in Combination with beta-Lactamase Inhibitor MK7655 in a Murine Thigh Model

    NARCIS (Netherlands)

    Mavridou, E.; Melchers, M.J.B.; Mil, A.C. van; Mangin, E.; Motyl, M.R.; Mouton, J.W.

    2015-01-01

    MK7655 is a newly developed beta-lactamase inhibitor of class A and class C carbapenemases. Pharmacokinetics (PK) of imipenem-cilastatin (IMP/C) and MK7655 were determined for intraperitoneal doses of 4 mg/kg to 128 mg/kg of body weight. MIC and pharmacodynamics (PD) studies of MK7655 were performed

  16. Comparison of the Carba NP, Modified Carba NP, and Updated Rosco Neo-Rapid Carb Kit Tests for Carbapenemase Detection

    OpenAIRE

    AbdelGhani, Sameh; Thomson, Gina K.; Snyder, James W.; Thomson, Kenneth S.

    2015-01-01

    The accurate detection of carbapenemase-producing organisms is a major challenge for clinical laboratories. The Carba NP test is highly accurate but inconvenient, as it requires frequent preparation of fresh imipenem solution. The current study was designed to compare the Carba NP test to two alternative tests for accuracy and convenience. These were a modified Carba NP test that utilized intravenous (i.v.) imipenem-cilastatin, which is less expensive than reference standard imipenem powder, ...

  17. Determination of Susceptibilities of 26 Leptospira sp. Serovars to 24 Antimicrobial Agents by a Broth Microdilution Technique

    OpenAIRE

    Murray, Clinton K.; Hospenthal, Duane R.

    2004-01-01

    The MICs of 24 antimicrobials for 26 Leptospira spp. serovars were determined using a broth microdilution technique. The MICs at which 90% of isolates tested were inhibited (MIC90s) of cefepime, imipenem-cilastatin, erythromycin, clarithromycin, and telithromycin were all ≤0.01 μg/ml. The MIC90s of amoxicillin, aztreonam, cefdinir, chloramphenicol, and penicillin G were ≥3.13 μg/ml. Many antimicrobials have excellent in vitro activity against Leptospira.

  18. Increased GVHD-related mortality with broad-spectrum antibiotic use after allogeneic hematopoietic stem cell transplantation in human patients and mice.

    Science.gov (United States)

    Shono, Yusuke; Docampo, Melissa D; Peled, Jonathan U; Perobelli, Suelen M; Velardi, Enrico; Tsai, Jennifer J; Slingerland, Ann E; Smith, Odette M; Young, Lauren F; Gupta, Jyotsna; Lieberman, Sophia R; Jay, Hillary V; Ahr, Katya F; Porosnicu Rodriguez, Kori A; Xu, Ke; Calarfiore, Marco; Poeck, Hendrik; Caballero, Silvia; Devlin, Sean M; Rapaport, Franck; Dudakov, Jarrod A; Hanash, Alan M; Gyurkocza, Boglarka; Murphy, George F; Gomes, Camilla; Liu, Chen; Moss, Eli L; Falconer, Shannon B; Bhatt, Ami S; Taur, Ying; Pamer, Eric G; van den Brink, Marcel R M; Jenq, Robert R

    2016-05-18

    Intestinal bacteria may modulate the risk of infection and graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT recipients often develop neutropenic fever, which is treated with antibiotics that may target anaerobic bacteria in the gut. We retrospectively examined 857 allo-HSCT recipients and found that treatment of neutropenic fever with imipenem-cilastatin and piperacillin-tazobactam antibiotics was associated with increased GVHD-related mortality at 5 years (21.5% for imipenem-cilastatin-treated patients versus 13.1% for untreated patients, P = 0.025; 19.8% for piperacillin-tazobactam-treated patients versus 11.9% for untreated patients, P = 0.007). However, two other antibiotics also used to treat neutropenic fever, aztreonam and cefepime, were not associated with GVHD-related mortality (P = 0.78 and P = 0.98, respectively). Analysis of stool specimens from allo-HSCT recipients showed that piperacillin-tazobactam administration was associated with perturbation of gut microbial composition. Studies in mice demonstrated aggravated GVHD mortality with imipenem-cilastatin or piperacillin-tazobactam compared to aztreonam (P short-chain fatty acids or numbers of regulatory T cells. Notably, imipenem-cilastatin treatment of mice with GVHD led to loss of the protective mucus lining of the colon (P intestinal barrier function (P < 0.05). Sequencing of mouse stool specimens showed an increase in Akkermansia muciniphila (P < 0.001), a commensal bacterium with mucus-degrading capabilities, raising the possibility that mucus degradation may contribute to murine GVHD. We demonstrate an underappreciated risk for the treatment of allo-HSCT recipients with antibiotics that may exacerbate GVHD in the colon. PMID:27194729

  19. Pharmacokinetics of imipenem in serum and skin window fluid in healthy adults after intramuscular or intravenous administration.

    OpenAIRE

    Signs, S A; Tan, J S; Salstrom, S J; File, T M

    1992-01-01

    The pharmacokinetic profiles of imipenem after intramuscular (i.m.) and intravenous injections were examined in adult volunteers. Levels of imipenem in serum after i.m. injection of a microcrystalline suspension of imipenem-cilastatin (500 mg each) reached a peak (8.0 micrograms/ml) at 1.5 h after administration, and concentrations were maintained in excess of 1.5 micrograms/ml for 6 h. Serum elimination half-life (1.3 h), volume of distribution (14.5 liters), and area under the curve (AUC; 2...

  20. Pharmacodynamics of Imipenem in Combination with β-Lactamase Inhibitor MK7655 in a Murine Thigh Model

    OpenAIRE

    Mavridou, Eleftheria; Melchers, Ria J. B.; van Mil, Anita C. H. A. M.; Mangin, E.; Motyl, Mary R.; Mouton, Johan W.

    2014-01-01

    MK7655 is a newly developed beta-lactamase inhibitor of class A and class C carbapenemases. Pharmacokinetics (PK) of imipenem-cilastatin (IMP/C) and MK7655 were determined for intraperitoneal doses of 4 mg/kg to 128 mg/kg of body weight. MIC and pharmacodynamics (PD) studies of MK7655 were performed against several beta-lactamase producing Pseudomonas aeruginosa and Klebsiella pneumoniae strains to determine its effect in vitro and in vivo. Neutropenic mice were infected in each thigh 2 h bef...

  1. Imipenem-induced clostridium difficile diarrhea in a patient with chronic renal failure

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    R Enríquez

    2011-01-01

    Full Text Available An 80-year-old man was diagnosed to have pneumonia and advanced chronic kidney disease. He presented with anuria and hemodialysis, by temporary femoral catheter, was initiated. He was empirically treated with imipenem/cilastatin 500 mg/24 h after hemodialysis. After 10 days of antibiotic intake, he developed severe diarrhea. Diagnosis of Clostridium difficile (CD-associated diarrhea was confirmed by detection of the toxins A and B in his stool. Imipenem therapy was discontinued; Vancomycin 500 mg orally every 6 h and 1000 mg per rectum every day was added. After two weeks of this treatment, the patient reported complete resolution of the diarrhea and stool samples were negative for Clostridium toxin. In this case, the most possible cause of CD colitis was considered to be imipenem because of the temporal relationship between exposure to the drug and onset of symptoms.

  2. [Intravenous antimicrobial use among different hospital in Chile during 2005].

    Science.gov (United States)

    Fica C, Alberto; Cabello M, Angela; Juliet L, Chrystal; Prado D, Priscilla; Bavestrello F, Luis

    2008-12-01

    Intravenous antimicrobial consumption has not been evaluated previously in Chile. In order to know this consumption (in DDD per 100 bed days), associated factors and antimicrobial control systems across the country, a questionnaire was sent to evaluate these features during 2005. A total of 29 public hospitals and private clinics answered this poll, 20 belonging to the public health system (69%). Only 48.1% declared to have an independent antimicrobial committee and 17.2% allowed unrestricted antimicrobial use. Glycopeptides and carbapenems were the most regulated compounds (75.9 and 82.8%, respectively). Antimicrobial controls systems were more frequently declared among public hospitals and only non-public hospitals permitted free use of antimicrobials. Global consumption reached 59.98 DDD per 100 bed-days, with beta-lactams representing 74.3% of this consume (44.57 DDD per 100), and cephalosporins 43% (25.78 DDD per 100). Chloramphenicol, penicillin G and cloxacillin use was significantly higher among public hospitals. The opposite was observed for imipenem-cilastatin, linezolid, cefuroxime and caspofungin with higher consumes observed among non-public hospitals. In a multivariate analysis, increased cefazolin use was independently associated with sites allowing unrestricted use, and ciprofloxacin consumption with non-public hospitals. Institutions with decreased susceptibility to imipenem-cilastatin among non-fermentative gram negative bacilli showed a higher use of this compound and linezolid consumption paralleled vancomycin-resistant enterococci prevalence. It is necessary to reinforce governmental regulations about antimicrobial use issued during 1999. PMID:19194604

  3. Clinical outcomes of tigecycline alone or in combination with other antimicrobial agents for the treatment of patients with healthcare-associated multidrug-resistant Acinetobacter baumannii infections.

    Science.gov (United States)

    Lee, Y-T; Tsao, S-M; Hsueh, P-R

    2013-09-01

    Tigecycline (TG) has been shown to be active in vitro against Acinetobacter baumannii, although data on the clinical efficacy of TG alone or in combination for the treatment of infections due to multidrug-resistant A. baumannii (MDRAB) remain limited. The purpose of this study was to investigate the clinical outcomes of patients with healthcare-associated infections (HAIs) caused by MDRAB who were treated with imipenem/cilastatin and sulbactam, and TG alone or in combination with other antibiotics. A total of 386 patients with HAIs caused by MDRAB were retrospectively analyzed and grouped into TG and non-TG groups, depending on whether they received TG treatment. Of the 266 patients in the TG group, 108 were treated with TG alone and 158 were treated with TG in combination with ceftazidime, ceftriaxone, piperacillin/tazobactam, or a carbapenem. All 120 patients in the non-TG group were treated with imipenem/cilastatin and sulbactam. The primary outcome measure was 30-day mortality after TG treatment and the secondary outcome was clinical outcome. There were no significant differences in survival rates between the two groups. However, the rate of unfavorable outcome was significantly lower (p < 0.05) among patients in the TG group than among patients in the non-TG group. The most significant predictor of unfavorable outcome was sepsis, whereas TG treatment and microbial eradication were the most significant predictors of favorable outcomes. Our study represents the largest study of patients with MDRAB infection treated with TG and expands our understanding of the role of TG therapy alone or in combination with other agents for the treatment of HAI caused by MDRAB. PMID:23553594

  4. Tigecycline: a critical update.

    Science.gov (United States)

    Shakil, S; Akram, M; Khan, A U

    2008-08-01

    Tigecycline is the first Food and Drug Administration (FDA) approved glycylcycline antibiotic. It has shown remarkable in vitro activity against a wide variety of gram-positive, gram-negative and anaerobic bacteria including many multidrug resistant (MDR) strains. However, it has minimal activity against Pseudomonas aeruginosa and Proteus spp. To date, little resistance to tigecycline has been reported. Clinical trials studying complicated skin and skin-structure infections (cSSSIs) demonstrated that tigecycline has equivalent efficacy and safety compared with the combination of vancomycin and aztreonam. For complicated intra-abdominal infections (cIAIs), tigecycline was found to be as effective as imipenem/cilastatin. Adverse events related to tigecycline therapy, i.e. nausea and vomiting, were tolerable. Currently available data suggest that tigecycline may play an important role in the future as a monotherapy alternative to older broad-spectrum antibiotics, such as advanced generation cephalosporins, carbapenems, fluoroquinolones, piperacillin/tazobactam, and gram-positive directed agents (e.g. daptomycin, linezolid and quinupristin/dalfopristin) for which resistance is being increasingly reported from all parts of the world. PMID:18676218

  5. 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.

  6. Implantable cardioverter defibrillator endocarditis caused by Klebsiella pneumoniae complicated by liver abscess and septic pulmonary embolism

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    Ilaria Izzo

    2013-11-01

    Full Text Available A 63-year old diabetic male patient carrying an implantable cardioverter defibrillator (ICD was hospitalized with a 7- day history of fever, notwithstanding an antibiotic therapy. The white-blood cell count was 11,000/mm3, the platelet count was 135,000/mm3 and C-reactive protein (CRP 13 mg/dL. Chest X-rays showed right infiltrates. Ceftriaxone was started. Defervescence was rapid, but CRP was still 12 mg/dL after 6 days. A trans-thoracic ecochacardiogram (TTE incidentally showed a liver hypoechoic lesion. A computed tomography scan revealed bilateral cavitated lung nodules and a large liver abscess. Klebsiella pneumoniae was isolated in blood cultures and TTE showed ICD endocarditis and a patent foramen ovalis. Levofloxacin and imipenem/cilastatin were started. The liver abscess was drained. After 30 days, the ICD was removed and re-implanted. At discharge, blood tests were within the normal range and the patient was asymptomatic. Follow up showed improvement of lung and hepatic lesions. To our knowledge, this is the second reported case of K. pneumoniae infective endocarditis with multiple septic emboli. Endocarditis should be suspected in presence of fever after the device implantation, in particular if risk factors are present.

  7. Multi-drug resistant Pseudomonas aeruginosa keratitis and its effective treatment with topical colistimethate

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    Samrat Chatterjee

    2016-01-01

    Full Text Available The purpose was to evaluate the clinical outcome in multi-drug resistant Pseudomonas aeruginosa (MDR-PA bacterial keratitis and report the successful use of an alternative antibiotic, topical colistimethate in some of them. The medical records of 12 culture-proven MDR-PA keratitis patients, all exhibiting in vitro resistance by Kirby–Bauer disc diffusion method to ≥ three classes of routinely used topical antibiotics were reviewed. Eight patients were treated with 0.3% ciprofloxacin or ofloxacin, 1 patient with 5% imipenem/cilastatin and 3 patients with 1.6% colistimethate. The outcomes in 8 eyes treated with only fluoroquinolones were evisceration in 4 eyes, therapeutic corneal graft in 1 eye, phthisis bulbi in 1 eye, and no improvement in 2 eyes. The eye treated with imipenem/cilastin required a therapeutic corneal graft. All the three eyes treated with 1.6% colistimethate healed. Colistimethate may prove to be an effective alternative antibiotic in the treatment of MDR-PA keratitis.

  8. Evaluation of the in vitro ocular toxicity of the fortified antibiotic eye drops prepared at the Hospital Pharmacy Departments.

    Science.gov (United States)

    Fernández-Ferreiro, Anxo; González-Barcia, Miguel; Gil-Martínez, María; Santiago Varela, María; Pardo, María; Blanco-Méndez, José; Piñeiro-Ces, Antonio; Lamas Díaz, María Jesús; Otero-Espinar, Francisco J

    2016-01-01

    The use of parenteral antibiotic eye drop formulations with non-marketed compositions or concentrations, commonly called fortified antibiotic eye drops, is a common practice in Ophthalmology in the hospital setting. The aim of this study was to evaluate the in vitro ocular toxicity of the main fortified antibiotic eye drops prepared in the Hospital Pharmacy Departments. We have conducted an in vitro experimental study in order to test the toxicity of gentamicin, amikacin, cefazolin, ceftazidime, vancomycin, colistimethate sodium and imipenem-cilastatin eye drops; their cytotoxicity and acute tissue irritation have been evaluated. Cell-based assays were performed on human stromal keratocytes, using a cell-based impedance biosensor system [xCELLigence Real-Time System Cell Analyzer (RTCA)], and the Hen's Egg Test for the ocular irritation tests. All the eye drops, except for vancomycin and imipenem, have shown a cytotoxic effect dependent on concentration and time; higher concentrations and longer exposure times will cause a steeper decline in the population of stromal keratocytes. Vancomycin showed a major initial cytotoxic effect, which was reverted over time; and imipenem appeared as a non-toxic compound for stromal cells. The eye drops with the highest irritating effect on the ocular surface were gentamicin and vancomycin. Those antibiotic eye drops prepared at the Hospital Pharmacy Departments included in this study were considered as compounds potentially cytotoxic for the ocular surface; this toxicity was dependent on the concentration used. PMID:27570987

  9. Experimental models of epilepsy

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    Stanojlović Olivera P.

    2004-01-01

    Full Text Available Introduction An epileptic seizure is a clinical event and epilepsy is rather a group of symptoms than a disease. The main features all epilepsies have in common include: spontaneous occurrence, repetitiveness, and ictal correlation within the EEG. Epilepsies are manifested with distinct EEG changes, requiring exact clinical definition and consequential treatment. Current data show that 1% of the world's population (approximately 50 million people suffers from epilepsy, with 25% of patients being refractory to therapy and requiring search for new substances in order to decrease EEG and behavioral manifestations of epilepsies. Material and methods In regard to discovery and testing of anticonvulsant substances the best results were achieved by implementation of experi- mental models. Animal models of epilepsy are useful in acquiring basic knowledge regarding pathogenesis, neurotransmitters (glutamate, receptors (NMDA/AMPA/kainate, propagation of epileptic seizures and preclinical assessment of antiepileptics (competitive and non-competitive NMDA antagonists. Results and conclusions In our lab, we have developed a pharmacologic model of a (metaphit, NMDA and remacemide-cilastatin generalized, reflex, and audiogenic epilepsy. The model is suitable for testing various anticonvulsant substances (e.g. APH, APV, CPP, Mk-801 and potential antiepileptics (e.g. DSIP, its tetra- and octaanalogues.

  10. A clinical examination of antibiotics in continuous regional arterial infusion (CRAI) therapy for severe acute pancreatitis (SAP). A prospective randomized controlled trial of BIPM and IPM/CS

    International Nuclear Information System (INIS)

    Continuous regional arterial infusion (CRAI) therapy using both protease inhibitors and antibiotics are one of the specific therapeutic methods for severe acute pancreatitis (SAP). As for the administered antibiotics, imipenem/cilastatin sodium (IPM/CS) is generally chosen as a first step, but there are only a few reports comparing IPM/CS with other antibiotics. Therefore, we performed a prospective randomized controlled trial between biapenem (BIPM) and IPM/CS as CRAI antibiotics. Twelve patients with SAP were admitted to our institution during April, 2009 since August, 2006, and were randomized into two groups. They were treated with 120 mg/day of nafamostat mesilate and either 1.2 g/day of BIPM (n=6) or 2.0 g/day of IPM/CS (n=6) for CRAI therapy within 48 hours after the administration. The clinical data, inflammatory markers (WBC, CRP), serum pancreatic enzymes (lipase, tripsin, phospholipase A2, elastase 1 and pancreatic secretory trypsin inhibitor (PSTI) and contrast-enhanced abdominal Computed Tomography findings were compared between the two groups and the adverse effects were monitored. CRAI therapy was performed for seven days. The curative effect of this therapy was evaluated at the beginning of the treatment, the day 7 and the day 14. Our results suggested that BIPM was a non-recessive antibiotic which had an equal effect in CRAI therapy in comparison with IPM/CS. (author)

  11. Clinical efficacy of ciprofloxacin in lower respiratory tract infections.

    Science.gov (United States)

    Pedersen, S S

    1989-01-01

    The sputum pharmacokinetics and clinical efficacy of ciprofloxacin in lower respiratory tract infections is reviewed. Following intravenous administration, ciprofloxacin penetrates rapidly into bronchial tissue; the elimination half life is between 3 and 4 h and a dose dependency is seen. Following oral intake, the time to reach maximal concentrations is approximately two hours and after a dose of 750 mg the concentration may reach 1.7 mg/l in patients without cystic fibrosis and range from 0.5 to 3.4 mg/l in cystic fibrosis patients. Coadministration of ciprofloxacin increases serum levels and decreases total body clearance of theophylline. In controlled comparative clinical trials, ciprofloxacin has been found to have similar clinical efficacy as amoxycillin, ampicillin, cefalexin, doxycycline, co-trimoxazole, imipenem-cilastatin and ceftazidime for the treatment of a range of lower respiratory tract infections. Ciprofloxacin has been found to be superior in clinical efficacy to cefaclor. Experimental animal models suggest a role for ciprofloxacin in infections caused by Legionella pneumophila and Mycoplasma pneumoniae. The clinical and bacteriological efficacy of ciprofloxacin is less pronounced in lung infections caused by Pseudomonas aeruginosa, but is comparable to the combination of beta-lactams and aminoglycosides. Development of resistance is frequently observed during ciprofloxacin treatment of Ps. aeruginosa. Because of the availability of other oral and effective agents, ciprofloxacin is not recommended for empirical treatment of community acquired lower respiratory infections, but should be reserved for infections caused by multiply resistant organisms. PMID:2667111

  12. Cost - minimization Analysis of 2 Therapeutic Schemes in the Empirical Treatment for Patients with Neutropenia and Fever%2种用药方案经验性治疗中性粒细胞缺乏伴发热的最小成本分析

    Institute of Scientific and Technical Information of China (English)

    田元春; 伍小燕; 卢锡京

    2009-01-01

    目的:比较2种用药方案经验性治疗中性粒细胞缺乏伴发热的经济学效果.方法:采用已发表的经验性治疗中性粒细胞缺乏伴发热患者的资料,按其给药方案分为A组(头孢哌酮/舒巴坦联合阿米卡星)与B组(亚胺培南/西司他丁),采用药物经济学最小成本法进行比较.结果:A、B组临床有效率分别为69.05%、74.44%(P>0.05),细菌学有效率分别为62.50%、40.43%(P0.05); the bacteriological ef-fection rates were 62.50% vs. 40.43%(P<0.05); the total cost was 2 313.6 yuan vs. 5 709.2 yuan (P<0.05), and the drug cost was 2 258.9 yuan vs. 5 709.2 yuan(P<0.05) . CONCLUSION: Cefoperazone/sulbactam combined with amikacin is superior to imipenem/cilastatin in pharmacoeconomic efficacy in the empirical treatment of patients with neutropenia and fever.

  13. In vitro antibacterial activity of fosfomycin combined with nine antimicrobial agents against acinetobacter%磷霉素与9种抗菌药物分别联用对不动杆菌的体外抗菌活性研究

    Institute of Scientific and Technical Information of China (English)

    杨莹莹; 王镇山; 薛欣; 聂大平; 李玉中

    2011-01-01

    [ Objective] To study the antibacterial activity of fosfomycin combined with other 9 antimicrobial agents against 47 strains of Acinetobacter in vitro, in order to provide laboratory data for clinical combination application. [ Methods] The 47 strains of acinetobacter isolated from sputum samples were treated by 10 antimicrobial agents alone and by fosfomycin combined with other 9 antimicrobial agents. Through the minimal inhibitory concentration (MIC) and fractional inhibitory concentration (FIC) index, using a two -fold agar dilution method, we could evaluate the antibacterial activity of fosfomycin combined with other 9 antimicrobial agents in vitro. [ Results] All the 47 strains of acinetobacter were resistant to fosfomycin, levofloxacin, ciprofloxacin, cefuroxime, ceftazidime, cefepime, cefoperazone/sulbactam, amikacin, and were intermedium to meropenem and imipenem/cilastatin. The ratio of antimicrobial agents was 1: 1. The MICs of fosfomycin combined with other 9 antimicrobial agents were lower than those of 10 antimicrobial agents alone and FIC index≤2. The primary action was synergistic/additional effect. There was no antagonistic effect observed. [ Conclusion] Synergistic/additional effect was observed in fosfomycin combined with levofloxacin, ciprofioxacin, cefuroxime, ceftazidime, cefepime, cefoperazone/sulbactam, amikacin, meropenem and imipenem/cilastatin against acinetobacter in vitro. The antimicrobial activities of combination were increased.%[目的]研究磷霉素与其它9种临床常用抗菌药物分别联合应用对47株不动杆菌的体外抗菌活性.[方法]收集痰标本中分离出的不动杆菌47株,将磷霉素与其它9种抗菌药物在体外单独以及联合应用,采用琼脂二倍稀释法,测定最低抑菌浓度(MIC)、计算部分抑菌浓度(FIC)指数,评价磷霉素与其它9种抗菌药物分别联合应用的体外抗菌活性.[结果]磷霉素、左氧氟沙星、环丙沙星、头孢呋辛、头孢他啶、头孢

  14. Assessing the pharmacodynamic profile of intravenous antibiotics against prevalent Gram-negative organisms collected in Colombia

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    Maria Virginia Villegas

    2011-10-01

    Full Text Available OBJECTIVES: This study was designed to simulate standard and optimized dosing regimens for intravenous antibiotics against contemporary populations of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa using MIC distribution data to determine which of the tested carbapenem regimens provided the greatest opportunity for obtaining maximal pharmacodynamic (PD activity. METHODS: The isolates studied were obtained from the COMPACT-COLOMBIA surveillance program conducted between February and November 2009. Antimicrobial susceptibility testing was conducted by broth microdilution method according to the CLSI guidelines. Doripenem, imipenem-cilastatin, and meropenem, were the modeled antibiotics. A 5,000 patient Monte Carlo simulation was performed for each regimen and PD targets were defined as free drug concentrations above the MIC for at least 40% of the dosing interval. RESULTS: All carbapenem regimens obtained optimal exposures against E. coli, unlike the other Enterobacteriaceae tested. Against P. aeruginosa, only a prolonged infusion of doripenem exceeded the 90% cumulative fraction of response (CFR threshold. Worrisomely, no regimens for any of the drugs tested obtained optimal CFR against A. baumannii. For P. aeruginosa intensive care unit (ICU isolates, CFR was approximately 20% lower for isolates collected in the respiratory tract compared with bloodstream or intra-abdominal for imipenem and meropenem. Noteworthy, all doripenem and meropenem regimens achieved greater than 90% CFR against bloodstream and respiratory isolates of K. pneumoniae. CONCLUSIONS: Our data suggests that higher dosing and prolonged infusion of doripenem or meropenem may be suitable for empirically treating ICU P. aeruginosa, while none of the carbapenems achieved optimal cumulative fraction of response against A. baumannii. Standard dosing regimens of all the carbapenems tested achieved optimal CFR against E. coli isolates, but

  15. Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

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    Okuno, Yuji, E-mail: how-lowlow@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan); Korchi, Amine Mohamed, E-mail: amine.korchi@gmail.com [Geneva University Hospitals, Department of Diagnostic and Interventional Radiology (Switzerland); Shinjo, Takuma, E-mail: shin.takuma@a7.keio.jp [Keio University, Institute for Integrated Sports Medicine, School of Medicine (Japan); Kato, Shojiro, E-mail: shojiro7@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan)

    2015-04-15

    PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

  16. Comparison of the Carba NP, Modified Carba NP, and Updated Rosco Neo-Rapid Carb Kit Tests for Carbapenemase Detection.

    Science.gov (United States)

    AbdelGhani, Sameh; Thomson, Gina K; Snyder, James W; Thomson, Kenneth S

    2015-11-01

    The accurate detection of carbapenemase-producing organisms is a major challenge for clinical laboratories. The Carba NP test is highly accurate but inconvenient, as it requires frequent preparation of fresh imipenem solution. The current study was designed to compare the Carba NP test to two alternative tests for accuracy and convenience. These were a modified Carba NP test that utilized intravenous (i.v.) imipenem-cilastatin, which is less expensive than reference standard imipenem powder, and an updated version of the Rosco Neo-Rapid Carb kit, which does not require the preparation of imipenem solution and has a shelf life of 2 years. The comparison included 87 isolates that produced class A carbapenemases (including KPC-2, -3, -4, -5, -6, and -8, NMC-A, and SME type), 40 isolates that produced metallo-β-lactamases (including NDM-1, GIM-1, SPM-1, IMP-1, -2, -7, -8, -18, and -27, and VIM-1, -2, and -7), 11 isolates that produced OXA-48, and one isolate that produced OXA-181. Negative controls consisted of 50 isolates that produced extended-spectrum β-lactamases (ESBLs), AmpCs (including hyperproducers), K1, other limited-spectrum β-lactamases, and porin and efflux mutants. Each test exhibited 100% specificity and high sensitivity (Carba NP, 100%; Rosco, 99% using modified interpretation guidelines; and modified Carba NP, 96%). A modified approach to interpretation of the Rosco test was necessary to achieve the sensitivity of 99%. If the accuracy of the modified interpretation is confirmed, the Rosco test is an accurate and more convenient alternative to the Carba NP test. PMID:26311862

  17. Modification and evaluation of the Carba NP test by use of paper strip for simple and rapid detection of carbapenemase-producing Enterobacteriaceae.

    Science.gov (United States)

    Srisrattakarn, Arpasiri; Lulitanond, Aroonlug; Wilailuckana, Chotechana; Charoensri, Nicha; Wonglakorn, Lumyai; Piyapatthanakul, Sirikan; Supajeen, Ampai; Chanawong, Aroonwadee

    2016-07-01

    Carbapenemase-producing Enterobacteriaceae (CPE) isolates have now emerged worldwide. We therefore modified the phenotypic Carba NP test by use of a filter paper strip for easily and rapidly identifying CPE in routine laboratory. A collection of 56 CPE and carbapenemase-producing Pseudomonas spp. isolates (including 28 NDM-1, 11 IMP-14a, 1 IMP-1, 1 IMP-4, 1 IMP-9, 1 IMP-15, 4 VIM-2, 1 VIM-1, 1 IMP-14a with VIM-2, 3 OXA-48, 3 OXA-181 and 1 KPC-2 producers) and 41 non-CPE isolates (including 19 ESBL, 7 pAmpC, 3 AmpC, 9 ESBL with pAmpC and 3 non-ESBL & non-AmpC producers) as confirmed by the PCR methods were tested by the paper strip method using pharmaceutical imipenem/cilastatin as a substrate. Bacterial colonies of each isolate were applied directly on filter paper strips dropped with either imipenem-phenol red (test strip) or phenol red solution alone (control strip). The reaction was read within 5 min. This test failed to detect 3 OXA-181, 2 OXA-48 and 3 IMP-14a producers (85.7 % sensitivity), whereas no false positives were seen (100 % specificity). Further evaluation of the paper strip test in 267 CPE screening-positive isolates from three hospitals by their medical technologists showed 92.0 % sensitivity (100 % for NDM producers) and 100 % specificity compared with the PCR methods. Because of its ease, rapidness and cost effective, the paper strip test has a potential for routine CPE testing in low-resource laboratories particularly in areas with high prevalence of NDM enzymes, leading to appropriate antimicrobial therapy and infection control strategy. PMID:27263012

  18. Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

    International Nuclear Information System (INIS)

    PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function

  19. 临床合理用药基本原则(下)

    Institute of Scientific and Technical Information of China (English)

    赵香兰; 潘启超

    2000-01-01

    @@ 5 合理配伍用药 5.1 联合用药目的明确 5.1.1 增强疗效:例如(1)抗菌药磺胺加TMP:在细菌叶酸代谢过程中呈双重阻断,抗菌力增加,抗菌谱扩大;(2)青霉素类加氨基甙类抗生素:青霉素类妨碍细菌胞壁合成,增加氨基甙类进入细菌胞内,增强杀菌作用;(3)棒酸加羟氨苄青霉素:棒酸抑制β_内酰胺酶,使羟氨苄青霉素对耐药株仍有效;(4)亚胺硫霉素加脱氢肽酶抑制西拉斯他丁(Cilastatin),而保持亚胺硫霉素在泌尿道强大的抗菌力;(5)氟尿嘧啶(5Fu)加醛氢叶酸可增加药物与TMPS酶的结合,而增强抗癌效果;(6)在高血压治疗中,降血压药的联合应用也常可增强疗效,如①血管紧张素转换酶抑制剂加β_受体阻断剂;②长期应用胍乙啶、长压定(Minoxidil)二氮嗪(Diazoxide)或肼苯达嗪等降压药可产生水钠潴留,降压作用减弱,此时,伍用利尿药可增强降压药的治疗效果;(7)急性哮喘时,β2_受体激动药如沙丁胺醇(Salbutamol)与茶碱类合用可收到相加的疗效;(8)抗癌药物只有在联合应用时才能获得较好效果.

  20. 急诊重症监护病房机械通气相关性肺炎患者病原菌耐药性及死亡因素分析%Analysis of pathogenic bacteria resistance and risk factors of death on ventilator-associated pneumonia pa-tients in emergency intensive care unit

    Institute of Scientific and Technical Information of China (English)

    龚黎; 郁念明; 刘海峰

    2014-01-01

    Objective To analyze the clinical characteristics of ventilator-associated pneumonia ( VAP) in patients admitted to the emergency intensive care unit ( EICU) , pathogen distribution and drug resistance char-acteristics;to explore the risk factors for death in VAP patients .Methods The clinical data of 190 cases of VAP patients from June 2012 to May 2013 in the Second Hospital of Jiaxing city , were retrospectively analyzed .Clinical characteristics , distribution and drug resistance of pathogenic bacteria and death risk factors of death were ana -lyzed.Results Two hundred and forty-two strains of pathogens were isolated from 190 patients, with 184 strains of Gram-negative bacteria.74 Pseudomonas aeruginosa (40.2%) and 70 Escherichia coli (38.0%) were most com-mon pathogenic bacteria in Gram-negative bacilli.Antibiotic sensitive rate of Pseudomonas aeruginosa was 77.0%(57/74) and 73.0%(54/70) to amikacin and imipenem/cilastatin sodium.Antibiotic sensitivity rate of Esche-richia coli was 71.4%to ceftazidime and imipenem/cilastatin sodium.Age≥60 years [odds ratio (OR)=6.675, 95%confidence interval (CI):2.620-9.731], the cumulative organ ≥3[OR=3.225, 95%CI:1.337-7.806] and lack of nutrition therapy [OR=1.912, 95% CI: 1.043-8.522] were death risk factors for VAP patients . Conclusions Gram-negative bacteria are the main pathogenic bacteria of VAP patients in EICU .Comprehensive treatment should be applied to treat complicated multiple organ dysfunction and malnutrition to reduce VAP mortality.%目的:分析急诊重症监护病房(EICU)中机械通气相关性肺炎(VAP)患者临床特点、病原菌分布及耐药性特点,探讨导致VAP患者死亡的危险因素。方法对浙江省嘉兴市第二医院2010年6月至2013年5月收治的190例VAP患者的临床资料作回顾性分析,分析患者的临床特点、病原菌的分布及耐药性以及死亡危险因素。结果190例VAP患者分离革兰阴性菌184株(76.0

  1. 胆道感染患者的病原菌分布及耐药性分析%Distribution and drug resistance of Pathogenic bacteria in patients with biliary tract infection

    Institute of Scientific and Technical Information of China (English)

    杨培; 马春华; 罗华

    2012-01-01

    OBJECTIVE To study the microbiologed distribution of biliary tract infection in patients with resistant strains so as to guide rational drug use. METHODS There were 275 cases with submission sample. The isolation and culture of bacteria and drug susceptibility test were executed according to'National Clinical Laboratory Operating Procedures' (third edition) standards using automated microbial (VITEK-32, France) analyzer. KB method was used for drug susceptibility testing and the results were judged by Clinical Laboratory Standards (CLSI) standards. RESULTS A total of 183 strains were detected from 275 samples, with the detection rate of 66. 55%. They included 95 strains of gram-negative bacteria accounting for 51. 91%, 63 strains of gram-positive bacteria accounting for 34. 43% and 12 strains of fungi accounting for 6. 56%. The resistance rates of the major bacteria Escherichia coli and Klebsiella pneumoniae to imipenem/cilastatin was 0, and the resistance rate of Enterococcus faecalis, Enterococci feces, Staphylococcus aureus to quinolones was low. CONCLUSION The biliary system is widely distributed with microbial infections, and some strains may cause multidrug resistance. We suggest clinicians emphasize the monitoring of the dynamic distribution of pathogenic bacteria and changes in drug susceptibility to guide rational antibiotics use.%目的 了解胆道感染患者的病原菌分布及耐药性特点,指导合理用药.方法 送检标本275例,菌种分离培养和药物敏感试验执行《全国临床检验操作规程》(第3版)标准;分析仪器采用全自动微生物(VITEK-32法国)分析仪鉴定,用K-B法进行药物敏感试验,操作规程执行《全国临床检验操作规程》,结果判断执行美国临床实验室标准化研究所(CLSI)标准.结果 送检标本275份,检出病原菌183株,检出率为66.55%;其中革兰阴性菌95株,占51.91%,革兰阳性菌63株,占34.43%,真菌12株,占6.56%;大肠埃希菌、肺炎克

  2. Study on Acinetobacter baumannii plasmid with 3 types of beta-lactamase genes in a burn ward%关于携带3种β内酰胺酶基因的鲍氏不动杆菌质粒的研究

    Institute of Scientific and Technical Information of China (English)

    李蓉; 李文林; 石小玉; 曾元临; 徐小文; 赵林

    2008-01-01

    Objective To study the transferrable character of Aciuetobacter baumanni i(AB)plasraids with 3 types of beta-lactamase gene. Methods The plasmid of multi-drug resistant AB(donor)isolated from burn wound were transferred to E.coil ATCC25922 (receptor) through conjugation,and drug sensitivity was also observed.Drug-resistant gene and Stability of filial generation and zygote were analyzed by PCR. Results The dug-resistance of donor plasmids to Sulfamethoxazole, Ampicillin, Cefalotin, Cetpodoxime,Cefuroxime,Imipenem/Cilastatin and Ampicillin/SuIbactam,and three types of beta-lactamase gene were transferred to the receptor,and were also stably transmitted for passages. The minimum inhibitor concentration ot receptor to Sulfamethoxazole was>2 mg/L after conjugation with donor,and inhibitory character could be transferred to next generation. Conclusion blaTEM-1,blaPER-1 and blaOXA-23 genes carried in the ptasmid of AB can be transferred through conjugation and stably transmitted for passages,and it is one of the molecular mechanisms for AB with multi-drug resistance after burn infections.%目的 了解携带3种β内酰胺酶基因的鲍氏不动杆菌质粒的町传递性.方法 选取从烧伤创面分离出的多重耐药鲍氏不动杆菌(供体菌),将之与大肠埃希菌ATCC 25922(受体菌)进行耐药质粒接合、药物敏感试验,并采用PCR分析接合子及其子代的耐药基因型、传代稳定性. 结果鲍氏不动杆菌通过接合将其携带对磺胺甲恶唑、氨苄西林、头孢噻吩、头孢博肟、头孢呋辛、亚胺培南/两司他丁和氨苄西林/舒巴坦的耐药性质粒及3种耐药基因传递给受体菌(例如经接合,使受体菌对磺胺甲恶唑的最低抑菌浓度>2 mg/L),且可稳定传代. 结论鲍氏不动杆菌质粒上携带可接合传递并稳定传代的β内酰胺酶基冈(blaTEM-1、blaPER-1、blaOXAS-23),是烧伤感染后其具有多重耐药性的分子生物学机制之一.

  3. Change of drug resistance of Proteus mirabilis causing nosocomial infections and clinical strategies%奇异变形菌医院感染的耐药性变迁及临床对策

    Institute of Scientific and Technical Information of China (English)

    王晓慧; 王银存

    2012-01-01

    OBJECTIVE To analyze the change in antibiotic resistance of clinical isolates of Proteus mirabilis 30 as to provide basis for clinical reasonable use of antibiotics. METHODS A total of 385 P. mirabilis strains isolated from various clinical specimens from Jan 2008 to Dec 2010 were collected. Drug susceptibility testing was performed for 17 antimicrobial agents; the changes of the drug resistance during the 3 years were compared. RESULTS Of the P. mirabilis isolated, the susceptibility rate to imipenem/cilastatin was the highest (100. 0%) , the drug susceptibility rates to meropenem, piperacillin / methimazole, aztreonam, ceftriaxone, cephaiosporin, ceftazidime, and tobramycin were above 90. 0% ; the drug resistance rates to nitrofurantoin and sulfamethoxazole / trimethoprim were above 50. 0%, and the resistance rate to cefoperazone /sulbactam was 0. 2% , the resistance rates to ampicillin/sulhactam, eiprofloxacin, and levofloxacin kept an increasing upward tendency. CONCLUSION The isolation rate of P. mirabilis is high, the susceptibility is high ta many antimicrobial agents, but the drug resistance rates to some antibacterial agents are on the rise ;it is necessary to strengthen the monitoring and reasonably use of antibiotics on the basis of drug susceptibility testing.%目的 分析临床分离的奇异变形菌的耐药性及其变迁,为临床合理用药提供依据.方法 对医院2008年1月-2010年12月住院患者各种标本中分离到的奇异变形菌385株,采用17种抗菌药物进行药敏试验;并比较3年的变迁情况.结果 分离到的奇异变形菌对亚胺培南/西司他丁的敏感率最高为100.0%,对美罗培南、哌拉西林/他巴唑、氨曲南、头孢曲松、头孢匹美、头孢他啶、妥布霉素的敏感率均>90.0%;对呋喃妥因、磺胺甲噁唑/甲氧苄啶的耐药率均>50.0%,头孢哌酮/舒巴坦为0.3%,对氨苄西林/舒巴坦、环丙沙星、左氧氟沙星耐药率呈升高趋势.结论 医

  4. 呼吸道161株鲍曼不动杆菌的临床分布及耐药性分析%Clinical distribution and drug resistance analysis of 161 strain Acinetobacter baumannii in respiratory tract

    Institute of Scientific and Technical Information of China (English)

    温燕; 陆华; 唐双意; 杨天燕; 蒋霞

    2013-01-01

    目的 了解痰液标本分离的鲍曼不动杆菌的临床分布及对各种常用抗菌药物的耐药情况,为临床合理治疗提供依据.方法 从2011年1月至12月广西医科大学第一附属医院患者的痰液标本中分离出161株鲍曼不动杆菌,采用WHONET 5.4软件对数据进行统计分析.结果 在161株鲍曼不动杆菌标本中,其临床分布以重症监护病房为主(47.83%),其次为内科(24.23%)和外科(13.04%);鲍曼不动杆菌对常用抗菌药物的耐药率以头孢哌酮/舒巴坦最低(6.21%),其次为亚胺培南/西司他丁及美罗培南(分别为46.58%、47.83%);哌拉西林、哌拉西林/他唑巴坦、头孢他啶、安曲南、庆大霉素、阿米卡星、环丙沙星、左氧氟沙星、复方磺胺甲噁唑及头孢吡肟等的耐药率均在50%以上.结论 鲍曼不动杆菌主要分布于各重症监护病房,对多种常见抗生素耐药率有升高趋势,提示临床应加强抗生素的合理应用,防止耐药率进一步增长.%Objective To investigate the clinical distribution and the drug resistance to various antibacterials of Acinetobacter baumannii from sputum specimen,and provide reference for the clinical rational therapy.Methods The 161 strain Acinetobacter baumaniis were separated from sputum specimen of patients in the First Affiliated Hospital of Guangxi Medical University from January to December in 2011,and the data were analyzed by WHONET 5.4 software.Results Among the 161 specimens of Acinetobacter baumannii,the dominant clinical distribution was intensive care unit(47.83%)followed by medical department(24.23%)and surgery department(13.04%).The drug resistance rate of Acinetobacter baumanii to cefoperazone/sulbactam was the lowest (6.21%),then was the i mipenem/cilastatin (46.58 %)and meropenem (47.83 %).The drug resistance rates of Acinetobacter baumanii to piperacilli,piperacilli

  5. Distribution and drug resistance of pathogens causing pulmonary infections in patients with chronic heart failure%慢性心力衰竭患者肺部感染的病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    陈贵艳; 张秀义; 勾建强; 周江

    2015-01-01

    OBJECTIVE To explore the distribution and drug resistance of pathogens causing pulmonary infections in patients with chronic heart failure so as to provide guidance for reasonable clinical use of antibiotics .METHODS The sputum specimens were collected from 132 chronic heart failure patients complicated with pulmonary infec‐tions who were treated from Dec 2011 to Dec 2012 ,then the bacterial culture and identification were conducted on the basis of National guidelines for clinical laboratory procedures ,the drug susceptibility testing was performed ac‐cording to the criteria of CLSI 2009 ,and the distribution and drug resistance of the pathogens were observed . RESULTS A total of 146 strains of pathogens have been isolated from the sputum specimens obtained from the 132 patients ,including 104 (71 .23% ) strains of gram‐negative bacteria ,36 (24 .66% ) strains of gram‐positive bacte‐ria ,and 6 (4 .11% ) strains of fungi;the Acinetobacter baumannii ,Pseudomonas aeruginosa ,and Escherichiacoli were the predominant species of gram‐negative bacteria ,accounting for 23 .28% ,16 .44% ,and 12 .33% ,respec‐tively ;the Staphylococcus aureus and Staphylococcus epidermidis were dominant among the gram‐positive bacte‐ria ,accounting for 16 .44% and 5 .48% ,respectively .The gram‐negative bacteria were susceptible to cefopera‐zone‐sulbactam and imipenem‐cilastatin ,and the gram‐positive bacteria were highly susceptible to vancomycin and teicoplanin ,with the drug susceptibility rate of 100 .00% .CONCLUSION The gram‐negative bacteria are dominant among the pathogens causing pulmonary infections in the patients with chronic heart failure ,and the reasonable use of antibiotics may contribute to the reduction of drug resistance rate of the pathogens .%目的:探讨慢性心力衰竭并发肺部感染患者的病原菌分布及耐药性,为临床合理用药提供参考。方法采集2011年12月-2012年12月132例慢性心力衰竭并发肺部

  6. Death from hypersensitivity syndrome and acute exacerbation of renal insufficiency due to allopurinol overdose%别嘌醇过量致超敏综合征合并肾功能不全急性加重死亡

    Institute of Scientific and Technical Information of China (English)

    江宇泳; 刘洋; 侯艺鑫

    2014-01-01

    liver injury and acute exacerbation of chronic renal insufficiency were diagnosed. Allopurinol was discontinued and he was given IV infusions of compound glycyrrhizin,glutathione,vitamin C,vitamin B6 ,imipenem and cilastatin sodium, and human albumin. On day 5 after administration,the patient developed fever,cough and gastrointestinal hemorrhage. Then he was transferred into intensive care unit and received methylprednisolone pulse therapy. The patient developed pulmonary infection,typeⅠrespiratory failure,reduced urine and kidney failure successively in the following two weeks. On day 31 of admission,the patient died from liver and renal failure and septic shock.

  7. 2005-2007年山西省儿童医院儿童细菌性肺炎病原菌分布及耐药性变迁分析%Pathogen distribution and antibiotic resistance diversification of children bacterial pneumonia in Shanxi Province Children Hospital from 2005 to 2007

    Institute of Scientific and Technical Information of China (English)

    刘克战; 张俊艳

    2008-01-01

    were gram-positive bacterium;362 strains were gram-negative bacterium.Streptococcus viridans,Streptococcus pneumoniae,Streptococcus C group,enterococcus group and methicillin resistant staphylococcus epidermidis were gram-positive bacterium's primary pathogens by turns;for gram-negative bacterium,they were ESBLs E.coil,Ps.aeruginosa,Stenotrophomonas maltophilia,E,coli and A.baumanii by turns.The increase of detection rates are statistically significant for Streptococcus viridans,Streptococcus C group and Ps.aeruginosa(P < 0.001) ;the increase of detection rate of ESBLs strain is also significant (P < 0.001).In gram-positive bacterium,The better antibiotics for Streptococcus viridans and Streptococcus pneumoniae were piperacillin and ceftriaxone;vancocin was sensitive to all gram-positive bacterium.In gram-negative bacterium,imipenem/cilastatin was the best sensitive to all ESBLs E.coli and ESBLs (-) E.coli,the next was cefoperazone/ sulbactam;nevertheless cefoperazone/ sulbactam was best for Ps.aernginosa.Conclusion The popular strains and their drug sensitivity of children bacterial pneumonia were maybe different in various regions.We must notice these situations and take more effective measures against them.

  8. 地震伤患儿感染创面病原菌分布与耐药性分析%Distribution and drug resistance of pathogenic bacteria isolated from infected wounds of children after Wenchuan earthquake

    Institute of Scientific and Technical Information of China (English)

    冉迎春; 敖晓晓; 刘岚; 符宜龙; 庹慧; 许峰

    2009-01-01

    infections (the infection rate was 67.7%). Ninety-nine pathogens were isolated, gram positive bacteria accounted for 16.16% (16 strains), Gram negative bacteria accounted for 81.82% (81 strains), and fungus 2.02% (2 strains). Staphylococcus aureus (5 strains, 5.05%), Enterococcus faecalis (3 strains, 3.03%) and Enterococcus faecium (2 strains, 2.02%)were the primary Gram-positive bacteria identified and Gram-negative infections typically included Acinetobacter baumanii (27 strains, 27.27%), Enterobacter cloacae (18 strains, 18.18%)and Pseudomonas aeruginosa(13 strains, 13.13%). Acinetobacter baumanii was the most common organism isolated from wounds. Duration of being sieged and complications had a significant association with wound infection with Acinetobacter baumanii. Drug sensitivity tests displayed that the isolated bacteria were highly resistant to common antibiotics. One strain of Acinetobacter baumanii-calcoaceticus complex and six strains of Acinetobacter baumanii were resistant to all common antibiotics including imipenem/cilastatin. Vancomycin-resistant Gram-positive bacteria were not identified. Conclusion Following the Wenchuan earthquake disaster, wound infection profiles of pediatric patients were significantly different, Acinetobacter baumanii was the main common organism isolated from wounds in contrast to the previous low isolation rate. The isolated bacteria were highly and multiple drug resistant and it was difficult to treat. Knowing the distribution and the drug resistance pattern of pathogen is of paramount importance in guiding the clinical treatment.

  9. Distribution and drug resistance of pathogens causing early wound infections in burn patients%烧伤患者早期创面感染病原菌分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    王进勇; 邹飞扬; 李莉莉; 徐向荣; 张承德; 朱志英; 龚海南

    2014-01-01

    OBJECTIVE To analyze the distribution and drug resistance of pathogens causing early wound infections in the burn patients so as to provide guidance for prevention and treatment of burn wound infections .METHODS A total of 2 981 burn patients who were treated in the hospital from Jan 2007 to Dec 2012 were enrolled in the study , among whom 310 patients with burn wound infections were chosen as the study objects ,then the pathogens isola-ted from the early wounds were detected ,and the drug resistance of the major species of pathogens was analyzed . RESULTS Of the 2 981 patients ,the wound infections occurred in 355 cases with the infection rate of 11 .9% , among whom 45 cases were complicated with other sites of infections .Totally 329 strains of pathogens have been isolated ,including 175 (53 .2% ) strains of gram-negative bacteria , 147 (44 .7% ) strains of gram-positive bacteria ,and the fungi (2 .1% );the Pseudomonas aeruginosa and Acinetobacter were the predominant species of gram-negative bacteria ;the Staphylococcus aureus was dominant among the gram-positive bacteria .The main gram-negative bacteria showed low drug resistance to imipenem but were highly resistant to ampicillin ,ceftriax-one ,and cefotaxime;the drug resistance rates of the S .aureus to penicillin ,ampicillin ,and clindamycin were high ,and the drug resistance rate to vancomycin was low ;the drug resistance rates of the fungi to penicillin and clindamycin were high , and the drug resistance rates to vancomycin and imipenem-cilastatin were low . CONCLUSION The incidence of early wound infections is high among the burn patients ,and the drug resistance rates of most of the pathogens are increased year by year ;it is necessary to prevent the infections according to the indications for use of antibiotics and perform corresponding supportive therapy so as to avoid cross drug resistance or mutations of the pathogens and ensure the curative effect as well as prevention of infections .%目的:分