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Meropenem

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https://www.readbyqxmd.com/read/28108390/fatal-sepsis-caused-by-multidrug-resistant-bacteroides-fragilis-harboring-a-cfia-gene-and-an-upstream-insertion-sequence-element-in-japan
#1
Itaru Nakamura, Kotaro Aoki, Yuri Miura, Tetsuo Yamaguchi, Tetsuya Matsumoto
Here, we report a case of fatal sepsis resulting from an intra-abdominal infection caused by a Bacteroides fragilis strain containing a CfiA4 metallo-β-lactamase and an upstream insertion sequence (IS) element. Meropenem was used as empiric therapy for septic shock as a result of the intra-abdominal infection, although two rounds of carbapenem treatment had been administered previously. B. fragilis was isolated from two anaerobic blood culture bottles 4 days after the onset of septic shock. Susceptibility testing revealed that the isolate was non-susceptible to all tested agents except metronidazole and tigecycline...
January 17, 2017: Anaerobe
https://www.readbyqxmd.com/read/28104513/a-multi-center-study-of-bacterial-blood-stream-infections-in-pediatric-allogeneic-hematopoietic-cell-transplantation-recipients-the-role-of-acute-gastrointestinal-graft-versus-host-disease
#2
Prakash Satwani, Jason L Freedman, Sonali Chaudhury, Zhezhen Jin, Anya Levinson, Marc D Foca, Jennifer Krajewski, Indira Sahdev, Mala Kiran Talekar, Aliza Gardenswartz, Justin Silverman, Meghan Hayes, Christopher C Dvorak
Blood stream infections (BSI) caused by enteric organisms are associated with a particularly high mortality rate in allogeneic hematopoietic cell transplantation (AlloHCT) recipients. We conducted a retrospective multicenter study aiming to analyze the risk factors associated with antibiotic resistance and impact of BSI on transplant related mortality (TRM) in children following alloHCT. During the study period from 2004 to 2014, 395 children (mean age 9.4 years) with at least one BSI were included. The incidences of resistant gram-negative rods (GNR) were 20...
January 16, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28101836/a-review-of-clinical-outcomes-associated-with-two-meropenem-dosing-strategies
#3
REVIEW
Kyle John Wilby, Ziad Ghantous Nasr, Shereen Elazzazy, Tim T Y Lau, Anas Hamad
Meropenem is a carbapenem antibiotic that exhibits time-dependent bactericidal activity, traditionally dosed intravenously at 1 g every 8 h. In order to maximize its pharmacodynamic activity and reduce costs, an alternative regimen employed by many institutions is 500 mg every 6 h. The objective of this review was to summarize and evaluate published literature comparing clinical outcomes associated with these two meropenem dosing regimens. The literature was searched up to October 2016 using the MEDLINE, EMBASE, and Google Scholar databases...
January 18, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28101656/off-label-use-of-antimicrobials-in-neonates-in-a-tertiary-children-s-hospital
#4
Niina Laine, Ann Marie Kaukonen, Kalle Hoppu, Marja Airaksinen, Harri Saxen
PURPOSE: Off-label (OL) use of drugs for hospitalized children is very common. OL use occurs especially in the youngest patients, neonates. This study focused on the OL use of antimicrobials in neonates. To our knowledge, only few studies have focused on the prevalence of OL use of antimicrobials in neonates. METHODS: We investigated the OL use of antimicrobials in neonates in a tertiary children's hospital. First, we investigated what were the most consumed OL antimicrobials in defined daily doses according to hospital's registry data from neonatal intensive care unit (NICU) during 2009-2014...
January 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28100153/long-term-survival-after-coverage-with-prevertebral-fascia-for-abdominal-aortic-stump-closure
#5
Takehiro Inoue, Masato Imura, Toshio Kaneda, Toshihiko Saga
Abdominal aortic graft-enteric fistula is an uncommon but grave complication. Acceptable early results of its management have been reported in recent years, but aortic stump disruption remains a dreaded problem in the remote period. This report describes a case of a 71-year-old male with graft-enteric fistula following after a distant abdominal aortic aneurysm repair. The patient underwent 1-stage operation with extra-anatomic bypass preceding the complete removal of the infected aortic graft and intestinal repair...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28097722/antimicrobial-utilization-in-an-iraqi-province-a-comprehensive-evaluation-of-antibiotic-source-and-cost
#6
Ali A Al-Jumaili, Ahmed H Hussein, Mohammed D Al-Rekabi, Saba A Raheem, Erika J Ernst
PURPOSE: The aims were to calculate total systemic antibiotic consumption and cost in both public and private sectors in all care settings in Al-Najaf province, Iraq, during 2012, recognize the percentage of each pharmacological class for the dispensed antibiotics and identify oral and parenteral antibiotic percentages dispensed and the portions manufactured nationally and imported. METHODS: Cross-sectional study was conducted in Al-Najaf to calculate the total cost and quantities of antibiotics consumed during 2012 using World Health Organization Guidelines for Defined Daily Dose (DDD)...
February 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28097633/meropenem-dosing-based-on-a-population-pharmacokinetic-pharmacodynamic-model-in-elderly-patients-with-infection-of-the-lower-respiratory-tract
#7
Qing-Tao Zhou, Bei He, Ning Shen, Ying Liang, Li-Na Sun
BACKGROUND: Meropenem is used for the treatment of severe lower respiratory tract infections (LRTIs) caused by multidrug-resistant Gram-negative bacilli. OBJECTIVE: We evaluated the clinical benefits of a strategy of meropenem dosing based on a population pharmacokinetics/pharmacodynamics (PK/PD) model in elderly patients with an LRTI. METHODS: In this prospective single-center open-label randomized controlled trial, 79 elderly patients with an LRTI caused by Gram-negative bacilli were randomized to a study group (SG) or a control group (CG)...
January 17, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28096441/improved-outcome-of-enteric-peritonitis-in-peritoneal-dialysis-patients-aged-50-years-and-older-with-temporary-discontinuation-of-peritoneal-dialysis-and-intravenous-meropenem
#8
Alferso C Abrahams, Wim Rüger, Pieter M Ter Wee, Frans J van Ittersum, Walther H Boer
♦ Background: Peritonitis is a major cause of morbidity, mortality, and technique failure in peritoneal dialysis (PD) patients, especially when caused by enteric microorganisms (EM). We have implemented a treatment protocol specifically aimed at improving the outcome in EM peritonitis. The adapted protocol was applied in all PD patients 50 years and older presenting with peritonitis who were considered to be at risk of EM peritonitis and involves 3 interventions: 1) temporary discontinuation of PD without removing the catheter (peritoneal rest), 2) intravenous meropenem, and 3) meropenem intracatheter as lock (Mero-PerRest protocol)...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28096165/in-vitro-activity-of-ceftolozane-tazobactam-against-multidrug-resistant-non-fermenting-gram-negative-bacilli-isolated-from-patients-with-cystic-fibrosis
#9
Patrick Grohs, Gary Taieb, Philippe Morand, Iheb Kaibi, Isabelle Podglajen, Marie Lavollay, Jean-Luc Mainardi, Fabrice Compain
Ceftolozane-tazobactam was tested against 58 multidrug-resistant non-fermenting Gram-negative bacilli (35 Pseudomonas aeruginosa, 11 Achromobacter xylosoxydans and 12 Stenotrophomonas maltophilia) isolated from cystic fibrosis patients and compared to ceftolozane alone, ceftazidime, meropenem and piperacillin-tazobactam. Ceftolozane-tazobactam was the most active agent against P. aeruginosa but was inactive against A. xylosoxydans and S. maltophilia In time-kill experiments ceftolozane-tazobactam had complete bactericidal activity against 2/6 (33%) clinical isolates...
January 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28095794/development-of-an-algorithm-for-phenotypic-screening-of-carbapenemase-producing-enterobacteriaceae-in-the-routine-laboratory
#10
Jérôme Robert, Alix Pantel, Audrey Merens, Elodie Meiller, Jean-Philippe Lavigne, Marie-Hélène Nicolas-Chanoine
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are difficult to identify among carbapenem non-susceptible Enterobacteriaceae (NSE). We designed phenotypic strategies giving priority to high sensitivity for screening putative CPE before further testing. METHODS: Presence of carbapenemase-encoding genes in ertapenem NSE (MIC > 0.5 mg/l) consecutively isolated in 80 French laboratories between November 2011 and April 2012 was determined by the Check-MDR-CT103 array method...
January 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28095290/study-of-the-microbiological-quality-of-bulgarian-bottled-water-in-terms-of-its-contamination-with-pseudomonas-aeruginosa
#11
Vesela Georgieva, Yulia Dimitrova
BACKGROUND: Due to the widespread use of bottled water, it is important from a hygienic point of view to ensure that these products have good quality and meet the requirements set out in regulations. METHODS: In the period 2000-2013, a large-scale study (2,500 samples) was carried out on the quality of Bulgarian bottled water as per the microbiological parameters laid down in the European and Bulgarian legislation. Standard microbiological methods were applied. RESULTS: There is strong evidence that the most frequently isolated contaminant in these products was Pseudomonas aeruginosa...
December 2016: Central European Journal of Public Health
https://www.readbyqxmd.com/read/28093651/infections-in-intensive-care-unit-adult-patients-harboring-multidrug-resistant-pseudomonas-aeruginosa-implications-for-prevention-and-therapy
#12
B Borgatta, L Lagunes, A T Imbiscuso, M N Larrosa, M Lujàn, J Rello
The purpose of this paper was to report the burden and characteristics of infection by multidrug-resistant Pseudomonas aeruginosa (MDR-PA) in clinical samples from intensive care unit (ICU) adults, and to identify predictors. This was a retrospective observational study at four medical-surgical ICUs. The case cohort comprised adults with documented isolation of an MDR-PA strain from a clinical specimen during ICU stay. Multivariate analysis was performed to identify predictors for MDR-PA infection. During the study period, 5667 patients were admitted to the ICU and P...
January 16, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28093482/dissemination-of-blaoxa-58-in-proteus-mirabilis-isolates-from-germany
#13
Felix Lange, Niels Pfennigwerth, Sonja Gerigk, Frank Gohlke, Klaus Oberdorfer, Ingvill Purr, Nikolaus Wohanka, Andreas Roggenkamp, Sören G Gatermann, Martin Kaase
OBJECTIVES: Characterization of Proteus mirabilis isolates harbouring blaOXA-58 with emphasis on the genetic environment of this resistance determinant. METHODS: Strains of P. mirabilis (n = 37) isolated from different patients were tested for the presence of blaOXA-58 The genetic context of blaOXA-58 was determined by WGS of two strains and Sanger sequencing. Clonality of the strains was assessed by PFGE. Susceptibility testing was performed by microdilution according to EUCAST...
January 15, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#14
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
BACKGROUND: Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents, including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacill-tazobactam, tobramycin, vancomycin, and voriconazole, are presented...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28077672/potentiation-of-ceftazidime-by-avibactam-against-%C3%AE-lactam-resistant-pseudomonas-aeruginosa-in-an-in-vitro-infection-model
#15
Sherwin K B Sy, Luning Zhuang, Marie-Eve Beaudoin, Philipp Kircher, Maria A M Tabosa, Noely C T Cavalcanti, Christian Grunwitz, Sebastian Pieper, Virna J Schuck, Wright W Nichols, Hartmut Derendorf
OBJECTIVES: This study evaluated the in vitro pharmacodynamics of combinations of ceftazidime and the non-β-lactam β-lactamase inhibitor, avibactam, against ceftazidime-, piperacillin/tazobactam- and meropenem-multiresistant Pseudomonas aeruginosa by a quantitative time-kill method. METHODS: MICs of ceftazidime plus 0-16 mg/L avibactam were determined against eight isolates of P. aeruginosa Single-compartment, 24 h time-kill kinetics were investigated for three isolates at 0-16 mg/L avibactam with ceftazidime at 0...
January 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28069785/postoperative-mycoplasma-hominis-brain-abscess-keep-it-in-mind
#16
Sarah Maria Bergin, Shehara M Mendis, Barnaby Young, Ezlyn Binti Izharuddin
A temporal lobe abscess was diagnosed in a 57-year-old man. A urethral catheter had been inserted 12 days earlier, just prior to clot evacuation of a subacute haematoma secondary to an arterio-venous malformation. Fever persisted despite debridement and treatment with meropenem and vancomycin. Gram stains of operative samples showed no bacteria. Extended cultures grew pinpoint colonies after 5 days. Meanwhile, sequencing of bacterial 16S rDNA from operative specimens had identified Mycoplasma hominis; the bacterial colonies were subsequently similarly identified...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28069655/mutation-in-an-unannotated-protein-confers-carbapenem-resistance-in-mycobacterium-tuberculosis
#17
Pankaj Kumar, Amit Kaushik, Drew Bell, Varsha Chauhan, Fangfang Xia, Rick L Stevens, Gyanu Lamichhane
β-lactams are the most widely used antibacterials. Among β-lactams, carbapenems are considered the last line of defense against recalcitrant infections. As recent developments have prompted consideration of carbapenems for treatment of drug-resistant tuberculosis, it is only a matter of time before Mycobacterium tuberculosis (Mtb) strains resistant to these drugs will emerge. Here, we investigated the genetic basis that confers such resistance. To our surprise, instead of mutations in the known β-lactam targets, a single nucleotide polymorphism in the Rv2421c-Rv2422 intergenic region was common among Mtb mutants selected with meropenem or biapenem...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28069652/antimicrobial-susceptibility-of-pseudomonas-aeruginosa-results-from-four-years-2012-2015-of-the-international-network-for-optimal-resistance-monitoring-inform-program-in-the-united-states
#18
Helio S Sader, Michael D Huband, Mariana Castanheira, Robert K Flamm
Pseudomonas aeruginosa represents a major cause of health-care associated infections, and inappropriate initial antimicrobial therapy is associated with increased morbidity and mortality. The International Network for Optimal Resistance Monitoring (INFORM) program monitors the in vitro activity of ceftazidime-avibactam and many comparators agents. We evaluated the antimicrobial susceptibility of 7,452 P. aeruginosa isolates collected from 79 USA medical centers in 2012-2015. The isolates were collected and tested consecutively for susceptibility by broth microdilution method...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28069649/antimicrobial-activity-of-ceftazidime-avibactam-when-tested-against-gram-negative-bacteria-isolated-from-patients-hospitalized-with-pneumonia-in-united-states-medical-centers-2011-2015
#19
Helio S Sader, Mariana Castanheira, Robert K Flamm
Bacterial isolates were collected from patients hospitalized with pneumonia (PHP), including ventilator-associated (VAP), from 76 USA medical centers in 2011-2015. The Gram-negative organisms (n=11,185; including 1,097 from VAP) were tested for susceptibility against ceftazidime-avibactam and comparators by broth microdilution method. β-lactamase-encoding genes were screened using a microarray based assay on selected isolates. Pseudomonas aeruginosa and Klebsiella spp. were the most common Gram-negatives isolated from PHP and VAP...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28069648/the-acinetobacter-outer-membrane-contains-multiple-specific-channels-for-carbapenem-%C3%AE-lactams-as-revealed-by-kinetic-characterization-analyses-of-imipenem-permeation-into-acinetobacter-baylyi-cells
#20
Jorgelina Morán-Barrio, María M Cameranesi, Verónica Relling, Adriana S Limansky, Luciano Brambilla, Alejandro M Viale
The number and type of outer membrane (OM) channels responsible of carbapenem uptake in Acinetobacter are still not well defined. Here, we addressed these questions using Acinetobacter baylyi as a model species and a combination of methodologies aimed to characterize OM channels in their original membrane environment. Kinetic and competition analyses of imipenem (IPM) uptake by A. baylyi whole cells allowed us to identify different carbapenem-specific OM uptake sites. Comparative analyses of IPM uptake by A...
January 9, 2017: Antimicrobial Agents and Chemotherapy
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