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https://www.readbyqxmd.com/read/27912842/the-rapid-spread-of-carbapenem-resistant-enterobacteriaceae
#1
REVIEW
Robert F Potter, Alaric W D'Souza, Gautam Dantas
Carbapenems, our one-time silver bullet for multidrug resistant bacterial infections, are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Successful expansion of Enterobacteriaceae clonal groups and frequent horizontal gene transfer of carbapenemase expressing plasmids are causing increasing carbapenem resistance. Recent advances in genetic and phenotypic detection facilitate global surveillance of CRE diversity and prevalence. In particular, whole genome sequencing enabled efficient tracking, annotation, and study of genetic elements colocalized with carbapenemase genes on chromosomes and on plasmids...
November 2016: Drug Resistance Updates: Reviews and Commentaries in Antimicrobial and Anticancer Chemotherapy
https://www.readbyqxmd.com/read/27895902/effect-of-%C3%AE-lactamase-inhibitors-on-in-vitro-activity-of-%C3%AE-lactam-antibiotics-against-burkholderia-cepacia-complex-species
#2
Annelien Everaert, Tom Coenye
BACKGROUND: Bacteria belonging to the Burkholderia cepacia complex (Bcc) are an important cause of chronic respiratory tract infections in cystic fibrosis patients. Intrinsic resistance to a wide range of antimicrobial agents, including a variety of β-lactam antibiotics, is frequently observed in Bcc strains. Resistance to β-lactams is most commonly mediated by efflux pumps, alterations in penicillin-binding proteins or the expression of β-lactamases. β-lactamase inhibitors are able to restore the in vitro activity of β-lactam molecules against a variety of Gram-negative species, but the effect of these inhibitors on the activity of β-lactam treatment against Bcc species is still poorly investigated...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27895014/ceftazidime-avibactam-as-salvage-therapy-for-infections-caused-by-carbapenem-resistant-organisms-a-case-series-from-the-compassionate-use-program
#3
Elizabeth Temkin, Julian Torre-Cisneros, Bojana Beovic, Natividad Benito, Maddalena Giannella, Raúl Gilarranz, Cameron Jeremiah, Belén Loeches, Isabel Machuca, María José Jiménez-Martín, José Antonio Martínez, Marta Mora-Rillo, Enrique Navas, Michael Osthoff, Juan Carlos Pozo, Juan Carlos Ramos Ramos, Marina Rodriguez, Miguel Sánchez García, Pierluigi Viale, Michel Wolff, Yehuda Carmeli
Ceftazidime-avibactam (CAZ-AVI) is a recently approved β-lactam β-lactamase inhibitor combination with the potential to treat serious infections caused by carbapenem-resistant organisms. Few patients with such infections were included in the CAZ-AVI clinical trials, and clinical experience is lacking. We present a case series of patients with infections caused by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (CRPa) who were treated with CAZ-AVI salvage therapy on a compassionate-use basis...
November 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27887765/activity-of-ceftazidime-avibactam-against-multidrug-resistance-enterobacteriaceae-expressing-combined-mechanisms-of-resistance
#4
Inmaculada López-Hernández, Noemí Alonso, Marta Fernández-Martínez, Laura Zamorano, Alba Rivera, Antonio Oliver, M Carmen Conejo, Luis Martínez-Martínez, Ferrán Navarro, Alvaro Pascual
INTRODUCTION: Antimicrobial resistance in Enterobacteriaceae is increasing worldwide and is making treating infections caused by multidrug-resistant Enterobacteriaceae a challenge. The use of β-lactam agents is compromised by microorganisms harboring extended-spectrum β-lactamases (ESBLs) and other mechanisms of resistance. Avibactam is a non β-lactam agent that inhibits clinically relevant β-lactamases, such as ESBL and AmpC. The ceftazidime-avibactam combination (CAZ-AVI) was recently approved for use in certain complicated infections, and may provide a therapeutic alternative for infections caused by these microorganisms...
November 22, 2016: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27872067/in-vitro-activity-of-ceftazidime-avibactam-against-isolates-in-a-phase-3-open-label-clinical-trial-for-complicated-intra-abdominal-and-urinary-tract-infections-caused-by-ceftazidime-nonsusceptible-gram-negative-pathogens
#5
Gregory G Stone, Patricia A Bradford, Paul Newell, Angela Wardman
In vitro activity of ceftazidime-avibactam was evaluated against 341 Gram-negative isolates from 333 patients in a randomized, phase 3 clinical trial of patients with complicated urinary tract or intra-abdominal infections caused by ceftazidime nonsusceptible pathogens (NCT01644643). Ceftazidime-avibactam MIC90 values against Enterobacteriaceae and Pseudomonas aeruginosa (including several class B or D enzyme-producers that avibactam does not inhibit) were 1 and 64 μg/ml, respectively. Overall, ceftazidime-avibactam activity against ceftazidime-nonsusceptible isolates was comparable to the activity of ceftazidime-avibactam previously reported against ceftazidime-susceptible isolates...
November 21, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27850290/651-ceftolozane-tazobactam-and-ceftazidime-avibactam-against-meropenem-resistant-pseudomonas-aeruginosa
#6
Mordechai Grupper, Christina Sutherland, David Nicolau
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850289/650-ceftazidime-avibactam-activity-against-pseudomonas-aeruginosa-from-icu-and-non-icu-patients
#7
Helio Sader, Rodrigo Mendes, Mariana Castanheira, Robert Flamm
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27818808/persistent-bacteremia-from-pseudomonas-aeruginosa-with-in-vitro-resistance-to-the-novel-antibiotics-ceftolozane-tazobactam-and-ceftazidime-avibactam
#8
Louie Mar Gangcuangco, Patricia Clark, Cynthia Stewart, Goran Miljkovic, Zane K Saul
Ceftazidime-avibactam and ceftolozane-tazobactam are new antimicrobials with activity against multidrug-resistant Pseudomonas aeruginosa. We present the first case of persistent P. aeruginosa bacteremia with in vitro resistance to these novel antimicrobials. A 68-year-old man with newly diagnosed follicular lymphoma was admitted to the medical intensive care unit for sepsis and right lower extremity cellulitis. The patient was placed empirically on vancomycin and piperacillin-tazobactam. Blood cultures from Day 1 of hospitalization grew P...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27758148/ceftazidime-avibactam-for-the-treatment-of-complicated-intra-abdominal-infections
#9
Sara A Buckman, Tamara Krekel, Anouk E Muller, John E Mazuski
The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole...
October 31, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27743202/updates-in-the-management-of-cephalosporin-resistant-gram-negative-bacteria
#10
Andre Arizpe, Kelly R Reveles, Shrina D Patel, Samuel L Aitken
Resistance to cephalosporins is now common among Gram-negative bacterial infections, including those caused by the Enterobacteriaceae and Pseudomonas aeruginosa, posing a major threat to public health. As resistance to the traditional drugs of choice for these infections, carbapenems, has also become increasingly common, interest in cefepime and piperacillin-tazobactam as carbapenem-sparing alternatives has increased. Additionally, the availability of the novel β-lactam-β-lactamase inhibitor combinations ceftolozane-tazobactam and ceftazidime-avibactam has added to the antimicrobial armamentarium available to treat these multidrug-resistant infections...
December 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/27716983/pharmacokinetics-of-ceftazidime-avibactam-in-two-patients-with-kpc-producing-klebsiella-pneumoniae-bacteremia-and-renal-impairment
#11
John J Veillette, James Truong, Steven C Forland
Limited data exist regarding optimal dosing of ceftazidime/avibactam (C/A) in patients with unique physiology, who were excluded from published clinical trials. Data are also lacking regarding clinical efficacy of C/A in patients with infections due to multidrug-resistant gram-negative pathogens. To expand knowledge in these areas, we present pharmacokinetic data from two patients with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bloodstream infections, both of whom had renal impairment, and one of whom was morbidly obese...
September 26, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27716499/empowering-older-antibiotics
#12
Gerard D Wright
Avycaz combines an older cephalosporin antibiotic, ceftazidime, and the β-lactamase inhibitor avibactam. Ceftazidime targets penicillin-binding proteins (PBPs) in the bacterial periplasm that are required for cell wall synthesis. Avibactam blocks β-lactamases (β-L) in the periplasm, which would otherwise inactivate the antibiotics resulting in drug resistance.
October 6, 2016: Cell
https://www.readbyqxmd.com/read/27712848/-first-case-of-ceftazidime-avibactam-administration-in-home-care-esbl-producing-klebsiella-pneumoniae-bacteremia
#13
Elisa Torres-Del-Pliego, Elena Delgado-Mejía, Leire Gil-Alonso, Leonor Del Mar-Periáñez-Párraga
No abstract text is available yet for this article.
October 3, 2016: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27712137/an-update-on-the-management-of-urinary-tract-infections-in-the-era-of-antimicrobial-resistance
#14
Mazen S Bader, Mark Loeb, Annie A Brooks
Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Gram-negative bacteria, specifically Enterobacteriaceae, are common causes of both community-acquired and hospital acquired UTIs. These organisms can acquire genes that encode for multiple antibiotic resistance mechanisms, including extended-spectrum-lactamases (ESBLs), AmpC- β -lactamase, and carbapenemases. The assessment of suspected UTI includes identification of characteristic symptoms or signs, urinalysis, dipstick or microscopic tests, and urine culture if indicated...
October 7, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27624958/clinical-outcomes-drug-toxicity-and-emergence-of-ceftazidime-avibactam-resistance-among-patients-treated-for-carbapenem-resistant-enterobacteriaceae-infections
#15
Ryan K Shields, Brian A Potoski, Ghady Haidar, Binghua Hao, Yohei Doi, Liang Chen, Ellen G Press, Barry N Kreiswirth, Cornelius J Clancy, M Hong Nguyen
Thirty-seven carbapenem-resistant Enterobacteriaceae (CRE)-infected patients were treated with ceftazidime-avibactam. Clinical success and survival rates at 30-days were 59% (22/37) and 76% (28/37), respectively. In 23% (5/22) of clinical successes, CRE infections recurred within 90-days. Microbiologic failure rate was 27% (10/37). Ceftazidime-avibactam resistance was detected in 30% (3/10) of microbiologic failures.
September 13, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27624957/ceftazidime-avibactam-and-carbapenem-resistant-enterobacteriaceae-we-re-gonna-need-a-bigger-boat
#16
Brad Spellberg, Robert A Bonomo
No abstract text is available yet for this article.
September 13, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27608309/-resistant-gram-negative-bacteria-therapeutic-approach-and-risk-factors
#17
REVIEW
P Salgado, F Gilsanz, E Maseda
The rapid spread of multidrug-resistant bacteria has become a serious threat, especially in critical care units, thereby prolonging the hospital stay. Enterobacteriaceae have a high capacity to adapt to any environment. Plasmids are the reason behind their expansion. The choice of empiric therapy for intra-abdominal or urinary infections requires knowledge of the intrinsic microbiological variability of each hospital or critical care unit, as well as the source of infection, safety or antibiotic toxicity, interaction with other drugs, the dosage regimen and the presence of risk factors...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27599088/what-is-the-role-of-the-new-%C3%AE-lactam-%C3%AE-lactamase-inhibitors-ceftolozane-tazobactam-and-ceftazidime-avibactam
#18
Ivan Gentile, Alberto Enrico Maraolo, Guglielmo Borgia
No abstract text is available yet for this article.
October 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27589330/pharmacodynamic-and-pharmacokinetic-considerations-in-the-treatment-of-critically-ill-patients-infected-with-carbapenem-resistant-enterobacteriaceae
#19
Elizabeth A Neuner, Jason C Gallagher
Carbapenem-Resistant Enterobacteriaceae (CRE) are an emerging healthcare crisis. Infections due to CRE are associated with high morbidity and mortality, especially in critically ill patients. Due to the multi-drug resistant nature of these infections only limited treatment options are available. Antimicrobials that have been described for the treatment of CRE infections include carbapenems, polymyxins, fosfomycin, tigecycline, aminoglycosides, and ceftazidime-avibactam. Given the limited treatment options it is imperative the pharmacokinetic and pharmacodynamics (PK-PD) characteristics of these agents are considered to optimize treatment regimens...
August 9, 2016: Virulence
https://www.readbyqxmd.com/read/27584588/reducing-the-impact-of-carbapenem-resistant-enterobacteriaceae-on-vulnerable-patient-groups-what-can-be-done
#20
Gökhan Metan, Murat Akova
PURPOSE OF REVIEW: Carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide challenge and associated with a high mortality rate in critically ill patients. This review focused on rapid diagnosis, optimization of antimicrobial therapy, and implication of effective infection control precautions to reduce impact of CRE on vulnerable patients. RECENT FINDINGS: Several new diagnostic assays have recently been described for the early diagnosis of CRE. Retrospective studies are supportive for colistin plus meropenem combination for the treatment of CRE infections; however, solid evidence is still lacking...
December 2016: Current Opinion in Infectious Diseases
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