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Tomasz Wołkowicz, Jan Andrzej Patzer, Wanda Kamińska, Rafał Gierczyński, Danuta Dzierżanowska
This study aimed to analyse the distribution of carbapenem resistance mechanisms among Pseudomonas aeruginosa clinical isolates. Fifty-five P. aeruginosa isolates, resistant both to imipenem and meropenem, from children hospitalised in 2009-2010 were studied. All strains were genotyped by pulsed-field gel electrophoresis (PFGE). Mutations in the oprD gene and the occurrence of insertion sequences (ISs) were determined by DNA sequencing. Mex efflux systems were determined by analysis using the efflux pump inhibitor Phe-Arg β-naphthylamide...
October 8, 2016: Journal of Global Antimicrobial Resistance
A Guzek, Krzysztof Korzeniewski, D Tomaszewski, Z Rybicki, E Zwolińska
The article presents the results of 11-year study (2005-2015) of Gram-negative bacteria responsible for pneumonia in 2033 mechanically ventilated patients hospitalized in Intensive Care Unit. Of 8796 biological samples, consisting mainly of bronchial aspirate (97.9 %), 2056 bacterial strains were isolated and subjected to identification. VITEK 2 was used to determine drug susceptibility (classified according to the EUCAST criteria). ESBL, MBL and KPC-producing strains were identified by means of phenotypic methods using appropriate discs...
October 14, 2016: Advances in Experimental Medicine and Biology
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 10, 2016: Journal of Microbiological Methods
Thai-Hoang Le, Charmaine Ng, Hongjie Chen, Xin Zhu Yi, Tse Hsien Koh, Timothy Mark Sebastian Barkham, Zhi Zhou, Karina Yew-Hoong Gin
Wastewater discharged from clinical isolation and general wards at two hospitals in Singapore were examined to determine the emerging trends of antibiotic resistance (AR). We quantified the concentrations of 12 antibiotic compounds by LC-MS/MS, antibiotic resistant bacteria (ARB), class 1 integrase gene (int1), and 16 antibiotic resistant genes (ARGs) that confer resistance to 10 different clinically relevant antibiotics. A subset of 119 antibiotic resistant isolates were phylogenetically classified and tested for the presence of ARGs encoding resistance to β-lactam antibiotics (blaNDM, blaKPC, blaSHV, blaCTX-M), amikacin (aac(6')-Ib), co-trimoxazole (sul1, sul2, dfrA), ciprofloxacin (qnrA, qnrB), and the int1 Among these resistant isolates, 80...
October 10, 2016: Antimicrobial Agents and Chemotherapy
Giulia Landini, Tiziana Di Maggio, Francesco Sergio, Jean-Denis Docquier, Gian Maria Rossolini, Lucia Pallecchi
The effect of high NAC concentrations (10 and 50 mM) on antibiotic activity against 40 strains of respiratory pathogens was investigated. NAC compromised carbapenem activity (mostly imipenem and, to a lesser extent, meropenem and ertapenem) in a dose-dependent fashion. Chemical instability of carbapenems in the presence of NAC was demonstrated. With other antibiotics, 10 mM NAC had no major effects, while 50 mM NAC sporadically decreased (ceftriaxone and aminoglycosides) or increased (penicillins) antibiotic activity...
October 10, 2016: Antimicrobial Agents and Chemotherapy
Joseph S Van Tuyl, Aubrey N Jones, Peter N Johnson
Postmarketing surveillance has associated meropenem with the development of hematologic abnormalities, including agranulocytosis, neutropenia, and leukopenia, but the exact incidence in children is unknown. The case describes a full-term, 26-day-old neonate admitted for a sepsis workup. She was found to have a blood culture positive for Enterobacter cloacae and suspected meningitis and was initiated on meropenem 40 mg/kg/dose intravenously every 8 hours. On day 14 of antibiotic treatment, the patient developed an isolated neutropenia with an absolute neutrophil count of 288 cells/mm(3)...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Oyebola Fasugba, Brett G Mitchell, George Mnatzaganian, Anindita Das, Peter Collignon, Anne Gardner
This study describes the antimicrobial resistance temporal trends and seasonal variation of Escherichia coli (E. coli) urinary tract infections (UTIs) over five years, from 2009 to 2013, and compares prevalence of resistance in hospital- and community-acquired E. coli UTI. A cross sectional study of E. coli UTIs from patients attending a tertiary referral hospital in Canberra, Australia was undertaken. Time series analysis was performed to illustrate resistance trends. Only the first positive E. coli UTI per patient per year was included in the analysis...
2016: PloS One
Myra W Popejoy, David L Paterson, Daniel Cloutier, Jennifer A Huntington, Benjamin Miller, Caleb A Bliss, Judith N Steenbergen, Ellie Hershberger, Obiamiwe Umeh, Keith S Kaye
OBJECTIVES: The increase in infections caused by drug-resistant ESBL-producing Enterobacteriaceae (ESBL-ENT) is a global concern. The characteristics and outcomes of patients infected with ESBL-ENT were examined in a pooled analysis of Phase 3 clinical trials of ceftolozane/tazobactam in patients with complicated urinary tract infections (ASPECT-cUTI) and complicated intra-abdominal infections (ASPECT-cIAI). METHODS: Trials were randomized and double blind. The ASPECT-cUTI regimen was 7 days of either intravenous ceftolozane/tazobactam (1...
October 5, 2016: Journal of Antimicrobial Chemotherapy
Steven De Keukeleire, Daniëlle Borrey, Wim Decaluwe, Marijke Reynders
Necrotizing enterocolitis (NEC) continues to be a major cause of neonatal morbidity and mortality. We describe the added value of therapeutic drug monitoring by presenting the case of a preterm infant with severe NEC treated with meropenem. Dosing strategy will achieve adequate patient outcome when treating pathogens with elevated MIC. As safe as meropenem is, there are not enough data for 40 mg/kg, every 8 h infused over 4 h; accordingly, strict monitoring of blood levels is mandatory. Based on our findings, a 4 h prolonged infusion of 40 mg/kg meropenem, every 8 h, will achieve an adequate patient outcome...
2016: Case Reports in Infectious Diseases
Marion J Skalweit, Mei Li
Genetic screening of Pseudomonas aeruginosa (PSDA) and Acinetobacter baumannii (ACB) reveals genes that confer increased susceptibility to β-lactams when disrupted, suggesting novel drug targets. One such target is lytic transglycosylase. Bulgecin A (BlgA) is a natural product of Pseudomonas mesoacidophila and a lytic transglycosolase inhibitor that works synergistically with β-lactams targeting PBP3 for Enterobacteriaceae. BlgA also weakly inhibits di-Zn(2+) metallo-β-lactamases like L1 of Stenotrophomonas maltophilia...
2016: Drug Design, Development and Therapy
K Govind Babu, D Lokanatha, K C Lakshmaiah, M C Suresh Babu, Linu A Jacob, Gita R Bhat, Harsha Vardhana, Mahua Sinha, B R Vijaykumar, B G Sumati, R S Jayshree
INTRODUCTION: Febrile neutropenia (FN) is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. METHODS: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. OBJECTIVES: The objectives of this study were as follows: (1) To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies...
July 2016: Indian Journal of Medical and Paediatric Oncology
U Ni Riain, M Tierney, C Doyle, A Vellinga, C Fleming, M Cormican
OBJECTIVE: Use of meropenem in our hospital has doubled in recent years. An audit in 2013 showed that although initiation of therapy with meropenem was generally appropriate, therapy was rarely subsequently reviewed and de-escalated where appropriate. Therefore, a structured stewardship initiative focussed on meropenem de-escalation was developed. METHODS: A local guideline for review and de-escalation of meropenem was developed and approved by the Antimicrobial Stewardship Team...
September 29, 2016: Irish Journal of Medical Science
Mona Wassef, Mona Abdelhaleim, Doaa Ghaith, Yasmin El-Mahdy
New Delhi metallo-β-lactamase (NDM) compromises the efficacy of almost all β-lactam antibiotics, including carbapenems. This study aimed to screen for the blaNDM-1-type gene and NDM-1-type carbapenemase production among Gram-negative bacteria in Cairo University Pediatric Hospital (Cairo, Egypt). Among 382 Gram-negative clinical isolates collected over the period October 2013 to May 2014, 100 clinical isolates showing reduced carbapenem (imipenem and meropenem) susceptibility were included in this study. Initial phenotypic screening for NDM enzyme production was performed by Etest for metallo-β-lactamases (EMBL)...
September 19, 2016: Journal of Global Antimicrobial Resistance
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
Xiaofen Liu, Miao Zhao, Yuancheng Chen, Xingchen Bian, Yunfei Li, Jun Shi, Jing Zhang
Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important clinical threat. Combination therapy that exerts a synergistic effect has become a potential solution to combat CRAB. However, choosing an optimal combination regimen is challenging. A dynamic in vitro pharmacokinetic/pharmacodynamic (PK/PD) model that can simulate the pharmacokinetic profiles of antibiotics provides a powerful tool to compare antibacterial responses to different clinical dosage regimens. In this study, the synergistic effect of the combination of meropenem and colistin was tested in 12 clinical CRAB isolates from Chinese patients using the chequerboard technique...
September 8, 2016: International Journal of Antimicrobial Agents
Debarati Choudhury, Deepjyoti Paul, Anindya Sundar Ghosh, Anupam Das Talukdar, Manabendra Dutta Choudhury, Anand Prakash Maurya, Debadatta Dhar Chanda, Atanu Chakravarty, Amitabha Bhattacharjee
The therapeutic option of a carbapenem antibiotic is compromised in Pseudomonas aeruginosa owing both to acquired and intrinsic resistance mechanisms. In recent years, New Delhi metallo-β-lactamase has been the focus as a predominant carbapenem resistance determinant. However, it is unclear which of the mechanisms might be adopted by a P. aeruginosa strain possessing both blaNDM-1 and an overexpressed MexAB-OprM system during carbapenem therapy. This study investigated the interplay of both mechanisms in clinical isolates of P...
September 15, 2016: Journal of Global Antimicrobial Resistance
Narges Mazloomi Nobandegani, Shima Mahmoudi, Babak Pourakbari, Reihaneh Hosseinpour Sadeghi, Mehri Najafi Sani, Fateme Farahmand, Farzaneh Motamed, Raheleh Nabavizadeh Rafsanjani, Setareh Mamishi
INTRODUCTION: Infection is a major cause of morbidity and mortality in patients with cystic fibrosis (CF). Antimicrobial resistance of the bacterial spp. particularly methicillin resistance in Staphylococcus aureus has caused a lot of attention. The aim of this study was to describe the prevalence of S. aureus, Pseudomonas aeruginosa and Burkholderia cepacia-complex as well as their antimicrobial susceptibility patterns in CF patients in an Iranian referral pediatrics Hospital. MATERIAL AND METHODS: From March 2011 until February 2012, 172 samples were collected at the Children Medical Center (CMC), an Iranian referral hospital in Tehran, Iran...
September 22, 2016: Microbial Pathogenesis
Felicity K Abbott, Kathleen E N Milne, David A Stead, Ian M Gould
The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS)...
September 12, 2016: International Journal of Antimicrobial Agents
Baharak Babouee Flury, Matthew J Ellington, Katie L Hopkins, Jane F Turton, Michel Doumith, Neil Woodford
Mechanisms leading to carbapenem and cephalosporin resistance were sought in Enterobacter aerogenes isolates that were highly resistant to carbapenems but had no known carbapenemase. Results were compared with recent work examining carbapenem-resistant Enterobacter cloacae. Eighteen carbapenem-resistant E. aerogenes were screened for known β-lactamase and carbapenemase genes, and novel carbapenemases were sought in whole-genome sequencing (WGS) data of the three most resistant isolates. For all isolates, ampC, ampR, ampD and the porin genes omp35 and omp36 were investigated by Sanger sequencing or from available WGS data...
September 12, 2016: International Journal of Antimicrobial Agents
Aziz İnan Çelik, Ali Deniz, Mustafa Tangalay, Muhammet Buğra Karaaslan, Emine Bağır Kılıç
Eosinophilic myocarditis (EM) is a rare form of myocarditis that usually presents with heart failure due to eosinophilic infiltration. EM is often a component of hypereosinophilic syndrome (HES). HES is a rare disorder characterized by persistent, marked eosinophilia combined with organ system dysfunction. A 38-year-old man was admitted to emergency services with left inguinal pain and fever, and was hospitalized with diagnosis of nephrolithiasis and urinary tract infection. Intravenous antibiotic therapy of 3 grams meropenem per day and analgesic of 50 mg pethidine per day were administered...
September 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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