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meropenem use evaluation

Jeremiah Seni, Enock Sweya, Amri Mabewa, Stephen E Mshana, Japhet M Gilyoma
BACKGROUND: Secondary peritonitis is a common surgical emergence with deadly outcomes when not timely and promptly intervened. The emergence of Extended spectrum beta lactamase producing bacteria (ESBL) poses treatment challenge at Bugando Medical Centre (BMC); hence a need to evaluate the magnitude of ESBL so as to guide specific therapy. METHODS: This was a cross sectional study conducted at BMC from May 2014 to April 2015 involving patients with secondary peritonitis...
October 21, 2016: BMC Emergency Medicine
Charlotte A Huber, Hanna E Sidjabat, Hosam M Zowawi, David Kvaskoff, Sarah Reed, John F McNamara, Kate L McCarthy, Patrick Harris, Benjamin Toh, Alexander M Wailan, David L Paterson
It has been described that the sensitivity of the Carba NP test may be low in the case of OXA-48-like carbapenamases and mass spectrometry based methods as well as a colorimetry based method have been described as alternatives. We evaluated 84 Enterobacteriaceae isolates including 31 OXA-48-like producing isolates and 13 isolates that produced either an imipenemase (IMP; n=8), New Delhi metallo-β-lactamase (NDM; n=3), or Klebsiella pneumoniae carbapenemase (KPC; n=2), as well as 40 carbapenemase negative Enterobacteriaceae isolates...
October 11, 2016: Journal of Microbiological Methods
Manuel Kussmann, Linda Schuster, Sarah Wrenger, Petra Pichler, Gottfried Reznicek, Heinz Burgmann, Wolfgang Poeppl, Markus Zeitlinger, Martin Wiesholzer
♦ Background: Peritonitis is a major problem among patients on peritoneal dialysis (PD). The influence of diverse PD fluids on the activity of frequently used antibiotics has been insufficiently investigated. Thus, the present study set out to investigate the impact of different PD fluids on the activity of cefepime, ciprofloxacin, ertapenem, meropenem, and tobramycin against Escherichia coli. ♦ Methods: Time-kill curves in 4 different PD fluids (Dianeal PDG4, Extraneal, Nutrineal PD4 and Physioneal 40, all Baxter Healthcare Corp...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Sofia Maraki, Elpis Mantadakis, Viktoria Eirini Mavromanolaki, Diamantis P Kofteridis, George Samonis
BACKGROUND: Acinetobacter baumannii has emerged as a major cause of nosocomial outbreaks. It is particularly associated with nosocomial pneumonia and bloodstream infections in immunocompromised and debilitated patients with serious underlying pathologies. Over the last two decades, a remarkable rise in the rates of multidrug resistance to most antimicrobial agents that are active against A. baumannii has been noted worldwide. We evaluated the rates of antimicrobial resistance and changes in resistance over a 5-year period (2010-2014) in A...
September 2016: Infection & Chemotherapy
Diana Yap Fui Sing, Yang Liang Boo, Roshalina Mukhlis, Pek Woon Chin, Fan Kee Hoo
BACKGROUNDS & OBJECTIVE: Antimicrobial resistance is an alarming public health threat that requires urgent global solution. Implementation of antimicrobial stewardship program (ASP) is an essential practice element for healthcare institutions in gate-keeping judicious antimicrobial use. This study highlighted the development, first year experience, and result of the implementation of ASP utilizing persuasive and restrictive approaches in a Malaysian district hospital. METHODS: An observational study was conducted between January 2015 to December 2015 on implementation of ASP among hospitalized inpatients age 12 years old and above...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Sandra Liliana Valderrama, Pedro Felipe González, María Alejandra Caro, Natalia Ardila, Beatriz Ariza, Fabián Gil, Carlos Álvarez
INTRODUCTION: Bacteremia due to Pseudomonas aeruginosa resistant to carbapenems is a public health problem due to the limitations it places on therapeutic options, as well as the increased time patients must spend in hospital, costs and the risk of mortality.  OBJECTIVE: To evaluate the risk factors for presentation of bacteremia due to carbapenem-resistant P. aeruginosa acquired in the Hospital Universitario San Ignacio between January 2008 and June 2014.  MATERIALS AND METHODS: This was a case control study in which the case patients presented bacteremia due to P...
2016: Biomédica: Revista del Instituto Nacional de Salud
Katie E Barber, Allison M Bell, Samuel Travis King, Jason J Parham, Kayla R Stover
Drug shortages pose a clear detriment to antimicrobial stewardship (AS) efforts. Our objective was to evaluate the effect of a piperacillin-tazobactam shortage on meropenem use, related costs, and associated changes in AS activity. A quasi-experimental quality improvement review compared adult patients receiving meropenem ≥72h three months pre-shortage and three months during the shortage. 320 patients were included (pre-shortage: 103; shortage: 217). Baseline characteristics were similar, but the length of stay was slightly longer in pre-shortage [19 (11-32) days] versus shortage [16 (11-32) days] (p=0...
September 5, 2016: Brazilian Journal of Infectious Diseases
Changsheng Kong, Jun Chen, Xiaoyan Zou, Yi Zhang, Lingna Zhu
OBJECTIVE: To determine the drug resistance of Comamonas testosteroni (C. testosteroni) by the Kirby-Bauer (K-B) method without Clinical and Laboratory Standards Institute (CLSI) explanation or the minimum inhibitory concentration (MIC) method with the standard CLSI explanation to evaluate the sensitivity of K-B method in detection of C. testosteroni.
 METHODS: K-B method and MIC method was used to determine the sensitivity of C. testosteroni to Piperacillin, Cefepime, Piperacillin/tazobactam, Imipenem, Meropenem, Amikacin, Gentamicin, Tobramycin, Ceftazidime and Ciprofloxacin...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Cidália Pina-Vaz, Ana P Silva, Isabel Faria-Ramos, Rita Teixeira-Santos, Daniel Moura, Tatiana F Vieira, Sérgio F Sousa, Sofia Costa-de-Oliveira, Rafael Cantón, Acácio G Rodrigues
The synergy of carbapenem combinations regarding Enterobacteriaceae producing different types of carbapenemases was study through different approaches: flow cytometry and computational analysis. Ten well characterized Enterobacteriaceae (KPC, verona integron-encoded metallo-β-lactamases -VIM and OXA-48-like enzymes) were selected for the study. The cells were incubated with a combination of ertapenem with imipenem, meropenem, or doripenem and killing kinetic curves performed with and without reinforcements of the drugs...
2016: Frontiers in Microbiology
Capan Konca, Mehmet Tekin, Fatih Uckardes, Sadik Akgun, Habip Almis, Ibrahim Hakan Bucak, Yeliz Genc, Mehmet Turgut
BACKGROUND: Urinary tract infections (UTIs) are common infections affecting children. In this study, in order to determine a guide for the empirical antibiotic treatment of community-acquired UTIs, we aimed to investigate the etiology and antimicrobial resistance patterns of uropathogens and to evaluate epidemiological and clinical characteristics of patients. METHODS: A total of 158 children with a positive urine culture were included in the study. Antibiotic susceptibility testing was performed by Vitek 2 Compact for twenty eight commonly used antimicrobials...
August 20, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Elif Gülsüm Ümit, Figen Kuloğlu, Ahmet Muzaffer Demir
BACKGROUND: Vancomycin resistant enterococci (VRE) are common pathogens of hospital-acquired infection. Long hospitalization periods, use of broad-spectrum antibiotics and immunosuppression are major risks for VRE colonization. AIMS: We aimed to evaluate patients' characteristics and factors which may contribute to VRE colonization. METHODS: Data of 66 patients with colonization and 112 patients without colonization who have been hospitalized in the Hematology clinic were collected...
August 16, 2016: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Eun Kyoung Chung, S Christian Cheatham, Megan R Fleming, Daniel P Healy, Michael B Kays
The study objective was to evaluate meropenem population pharmacokinetics and pharmacodynamics in non-obese, obese, and morbidly obese patients. Forty adult patients [11 non-obese (body mass index [BMI] <30 kg/m(2) ), 9 obese (30 kg/m(2) ≤ BMI < 40 kg/m(2) ), 20 morbidly obese (BMI ≥40 kg/m(2) )] received meropenem 500 mg q6h, q8h, or q12h or 1 g q6h or q8h, infused over 0.5 hours. Population pharmacokinetic modeling was performed using NONMEM, and 5,000-patient Monte-Carlo simulations were performed to calculate probability of target attainment (PTA) for 5 dosing regimens, infused over 0...
August 17, 2016: Journal of Clinical Pharmacology
Gülçin Bayramoğlu, Gülşen Uluçam, Çiğdem Gençoğlu Özgür
The rapid and accurate identification of carbapenemases is of crucial importance in terms of infection control. Methods employed in the determination of carbapenemases should be constantly updated in the light of technical advances and newly emerging carbapenemase variants. The aim of this study was to evaluate the performance of the newly developed carbapenem inactivation method (CIM) for the identification of carbapenemases defined in the members of the family Enterobacteriaceae. Enterobacteriaceae isolates with resistance to at least one of the carbapenems (ertapenem, imipenem or meropenem) were included in the study...
July 2016: Mikrobiyoloji Bülteni
Muneyoshi Kimura, Hideki Araoka, Atsushi Yoshida, Hisashi Yamamoto, Masahiro Abe, Yuki Okamoto, Mitsuhiro Yuasa, Daisuke Kaji, Kosei Kageyama, Aya Nishida, Kazuya Ishiwata, Shinsuke Takagi, Go Yamamoto, Yuki Asano-Mori, Naoyuki Uchida, Akira Hishinuma, Koji Izutsu, Atsushi Wake, Shuichi Taniguchi, Akiko Yoneyama
BACKGROUND: Breakthrough viridans streptococcal bacteremia (VSB) in patients with hematological malignancy receiving levofloxacin prophylaxis is a major blood stream infection (BSI) occurring during febrile neutropenia. However, clinical data focused on VSB in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are lacking. METHODS: The medical records of allo-HSCT recipients who received oral levofloxacin prophylaxis between January 2011 and August 2013 at Toranomon Hospital were reviewed to evaluate breakthrough VSB...
2016: BMC Infectious Diseases
Duck Jin Hong, Jung Ok Kim, Hyukmin Lee, Eun-Jeong Yoon, Seok Hoon Jeong, Dongeun Yong, Kyungwon Lee
Increased use of colistin in a clinical setting had resulted in the emergence of colistin-resistant (CoR) Acinetobacter baumannii. Combination therapy has been studied as a new approach to treat infections caused by A. baumannii. Here, we investigated the in vitro antimicrobial synergistic activities of several antimicrobial agent combinations against CoR A. baumannii. A total of 41 non-duplicate clinical isolates of CoR A. baumannii from a tertiary care hospital in Korea were prospectively collected from April 2012 to December 2014...
October 2016: Diagnostic Microbiology and Infectious Disease
Marion Smith, Bram Diederen, Jelle Scharringa, Maurine Leversteijn-van Hall, Ad C Fluit, James Cohen Stuart
Rapid and accurate detection of carbapenemase-producing Enterobacteriaceae is pivotal for adequate antibiotic therapy and infection control. The Cepheid Xpert Carba-R assay detects and identifies the most prevalent carbapenemases (KPC, VIM, IMP, NDM and OXA-48), using automated real-time PCR. The test performance of the Xpert Carba-R was evaluated with 129 well-characterized non-repeat Enterobacteriaceae isolates, suspected for carbapenemase production, i.e. with meropenem MICs >0.25 mg l-1. The isolate collection contained 100 carbapenemase-producing isolates (36 KPC-2 or KPC-3, 20 VIM-1, 4 KPC-2 plus VIM-1, 5 NDM-1, 2 IMP-1, 1 IMP-28, 1 IMP-1 plus VIM-1 and 31 OXA-48 like) and 29 negative control isolates producing extended-spectrum β-lactamase and/or AmpC β-lactamases...
September 2016: Journal of Medical Microbiology
Hossein Maspi, Hamideh Mahmoodzadeh Hosseini, Mohsen Amin, Abbas Ali Imani Fooladi
Acinetobacter species particularly Acinetobacter baumannii (A. baumannii) have been widely reported as broad-spectrum antibiotic resistant pathogens. Expression of various types of metallo beta-lactamases (MBL), classified as Ambler class B, has been associated with carbapenem resistance. Here, we attempted to assess the frequency of extensively drug-resistant (XDR) and MBL-producing A. baumannii among clinical isolates. 86 clinical A. baumannii strains were collected from 2014 to 2015 and their susceptibility to meropenem (10 μg), imipenem (10 μg), azteronem (30 μg), pipracillin (100 μg) tazobactam (110 μg), tobramycin (10 μg), fosfomycin (200 μg), rifampicin (5 μg), colistin (10 μg), tigecycline (15 μg), sulbactam/ampicillin (10 μg + 10 μg) and polymixin B (300 U) was evaluated using disk diffusion method...
September 2016: Microbial Pathogenesis
Mariana Castanheira, Paul R Rhomberg, Robert K Flamm, Ronald N Jones
Klebsiella pneumoniae carbapenemase (KPC)-producing isolates have become increasingly prevalent worldwide, and these organisms are often multidrug resistant, limiting the therapeutic options available for treating infections. We evaluated the activity of meropenem combined with the serine β-lactamase inhibitor vaborbactam (formerly RPX7009) against 315 serine carbapenemase-producing Enterobacteriaceae (CPE) isolates by use of checkerboard-designed panels to assess the optimal inhibitor concentration (range tested, 0...
September 2016: Antimicrobial Agents and Chemotherapy
Rasha Elsherif, Dalia Ismail, Sanaa Elawady, Samyah Jastaniah, Saad Al-Masaudi, Steve Harakeh, Gamal Karrouf
BACKGROUND: The Middle East is regarded as a secondary reservoir for OXA-48 and New Delhi metallo-β-lactamase (NDM) carbapenemases. One of the main challenges in clinical microbiology diagnostics is the detection of carbapenemases. For this reason simple screening methods have been sought to detect carbapenemase producers to determine appropriate therapeutic measures and implement infection control interventions. The present study aimed to evaluate the efficacy of the modified Hodge test (MHT) and a boronic acid-based combined disk test using carbapenems as substrates for the phenotypic determination of OXA-48 and NDM type carbapenemases in 45 epidemiologically unrelated carbapenem-resistant clinical isolates of Klebsiella pneumoniae (13 isolates), Acinetobacter baumanii (20 isolates), and Pseudomonas aeruginosa (12 isolates)...
2016: BMC Microbiology
Maria Tärnberg, Lennart E Nilsson, Michael J Dowzicky
BACKGROUND: As part of the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) we report antimicrobial resistance among Gram-positive and Gram-negative isolates collected globally from integumentary sources between 2010 and 2014. METHODS: Minimum inhibitory concentrations and antimicrobial resistance were determined according to Clinical and Laboratory Standards Institute guidelines (US Food and Drug Administration breakpoints against tigecycline). The Cochran-Armitage trend test was used to identify statistically significant changes in resistance...
August 2016: International Journal of Infectious Diseases: IJID
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