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Continuous meropenem

Theodore Gouliouris, Ben Warne, Edward J P Cartwright, Luke Bedford, Chathika K Weerasuriya, Kathy E Raven, Nick M Brown, M Estée Török, Direk Limmathurotsakul, Sharon J Peacock
Background: VRE bacteraemia has a high mortality and continues to defy control. Antibiotic risk factors for VRE bacteraemia have not been adequately defined. We aimed to determine the risk factors for VRE bacteraemia focusing on duration of antibiotic exposure. Methods: A retrospective matched nested case-control study was conducted amongst hospitalized patients at Cambridge University Hospitals NHS Foundation Trust (CUH) from 1 January 2006 to 31 December 2012...
March 13, 2018: Journal of Antimicrobial Chemotherapy
Pelle Hanberg, Kristina Öbrink-Hansen, Anders Thorsted, Mats Bue, Mikkel Tøttrup, Lena E Friberg, Tore Forsingdal Hardlei, Kjeld Søballe, Jakob Gjedsted
The objectives of this study were to describe meropenem pharmacokinetics (PK) in plasma and/or subcutaneous adipose tissue (SCT) in critically ill patients receiving ECMO treatment, and to develop a population PK model to simulate alternative dosing regimens and modes of administration. We conducted a prospective observational study. Ten patients on ECMO treatment received meropenem (1 or 2 g) intravenously over 5 min every 8 hours. Serial SCT concentrations were determined using microdialysis and compared with plasma concentrations...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Juan Duan, Chuncai Hu, Jiafan Guo, Lianxian Guo, Jia Sun, Zuguo Zhao
The mechanism of substrate hydrolysis of New Delhi metallo-β-lactamase 1 (NDM-1) has been reported, but the process in which NDM-1 captures and transports the substrate into its active center remains unknown. In this study, we investigated the process of the substrate entry into the NDM-1 activity center through long unguided molecular dynamics simulations using meropenem as the substrate. A total of 550 individual simulations were performed, each of which for 200 ns, and 110 of them showed enzyme-substrate binding events...
February 14, 2018: Physical Chemistry Chemical Physics: PCCP
Iris K Minichmayr, Jason A Roberts, Otto R Frey, Anka C Roehr, Charlotte Kloft, Alexander Brinkmann
Background: Optimal antibiotic exposure is a vital but challenging prerequisite for achieving clinical success in ICU patients. Objectives: To develop and externally validate a population pharmacokinetic model for continuous-infusion meropenem in critically ill patients and to establish a nomogram based on a routinely available marker of renal function. Methods: A population pharmacokinetic model was developed in NONMEM® 7.3 based on steady-state meropenem concentrations (CSS) collected during therapeutic drug monitoring...
February 7, 2018: Journal of Antimicrobial Chemotherapy
Li Fu, Mei Huang, XinZhou Zhang, XiaoYing Yang, Yao Liu, LuHua Zhang, ZhiKun Zhang, GuangXi Wang, YingShun Zhou
The aim of this study is to determine the frequency of virulence genes in high biofilm formation blaKPC-2 producing Klebsiella pneumoniae strains collected over a period of two years. A total of 43 non-repetitive high biofilm blaKPC-2 producing isolates were screened from 429 strains. The MIC of carbapenems (imipenem and meropenem) ranged from 4 to 32 μg/ml. The OD595 value of the biofilm ranged from 0.56 to 2.56. The K1, K2, K5, K20, K54, K57 genotypes, MLST and virulence factors, including entB, ybtS, mrkD, fimH, rmpA, allS, iutA, kfu, wcaG, aerobaction, fecIRA, shiF, magA and pagO gene, were determined by PCR...
January 19, 2018: Microbial Pathogenesis
Kushal Patel, Jessica J Kram, Dennis J Baumgardner
INTRODUCTION: Pseudomonas aeruginosa infections resistant to carbapenem antimicrobials have increased. Traditional risk factors for non-carbapenem resistance include intensive care unit stay, mechanical ventilation, previous hospitalization, and major comorbidities. As microbes evolve, our understanding of their risk factors for resistance also should evolve. METHODS: We conducted a retrospective study of adult inpatients and outpatients with a positive Pseudomonas aeruginosa culture during 2014...
December 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
Carolyn M Bondarenka, John A Bosso
Background: Focus on antimicrobial use and infection prevention from accrediting or regulatory bodies such as the Joint Commission, as well as regulatory agencies such as the Centers for Medicare and Medicaid Services and the Centers for Disease Control, has highlighted the need for continuing development of antimicrobial stewardship programs at healthcare facilities across the country. Methods: Our institution utilized the 2007 Infectious Diseases Society of America and the Society for Healthcare Epidemiology guidelines to direct the evaluation of its antimicrobial use and develop a successful antimicrobial stewardship program...
July 2017: Hospital Pharmacy
Viola C Y Chow, Thomas N Y Kwong, Erica W M So, Yolanda I I Ho, Sunny H Wong, Raymond W M Lai, Raphael C Y Chan
Incidence of Clostridium difficile infection (CDI) is rapidly increasing and it poses a major health burden globally. However, data regarding the epidemiology of CDI in Asia are limited. We aimed to characterize the antimicrobial susceptibility patterns of common ribotypes of toxigenic C. difficile in Hong Kong. Fifty-three PCR ribotypes were identified among 284 toxigenic C. difficile clinical isolates. The five most prevalent ribotypes were 002 (13%), 017 (12%), 014 (10%), 012 (9.2%), and 020 (9.5%). All tested C...
December 8, 2017: Scientific Reports
Manuela Aguilar-Guisado, Ildefonso Espigado, Almudena Martín-Peña, Carlota Gudiol, Cristina Royo-Cebrecos, José Falantes, Lourdes Vázquez-López, María Isabel Montero, Clara Rosso-Fernández, María de la Luz Martino, Rocío Parody, José González-Campos, Sebastián Garzón-López, Cristina Calderón-Cabrera, Pere Barba, Nancy Rodríguez, Montserrat Rovira, Enrique Montero-Mateos, Jordi Carratalá, José Antonio Pérez-Simón, José Miguel Cisneros
BACKGROUND: Continuation of empirical antimicrobial therapy (EAT) for febrile neutropenia in patients with haematological malignancies until neutrophil recovery could prolong the therapy unnecessarily. We aimed to establish whether EAT discontinuation driven by a clinical approach regardless of neutrophil recovery would optimise the duration of therapy. METHODS: We did an investigator-driven, superiority, open-label, randomised, controlled phase 4 clinical trial in six academic hospitals in Spain...
December 2017: Lancet Haematology
Eman Youssif, Mohammed Aseeri, Sahal Khoshhal
BACKGROUND: The appropriate use of broad-spectrum antibiotics, including appropriate de-escalation, is essential to reduce the emergence of antibiotic resistance. In surgical floors antibiotics are prescribed for prophylaxis (mostly, single dose), empirical treatment (started if infection is suspected till bacteria are identified with its sensitivity to antibiotics), or treatment of well-defined infection of previously isolated bacteria with its sensitivity to antibiotics. In this study, we aimed to evaluate the use of broad-spectrum antibiotics based on requests for cultures and de-escalation based on sensitivity results of culture tests at tertiary care hospital...
November 15, 2017: Journal of Infection and Public Health
Halit Kuş, Uğur Arslan, Hatice Türk Dağı, Duygu Fındık
Klebsiella pneumoniae is an opportunistic pathogen that commonly affects immunosuppressed patients and causes nosocomial infections. K.pneumoniae has a variety of virulence factors, especially capsule polysaccharide, hypermucoviscosity (HV), fimbriae, toxins and determinants for iron acquisition. The aim of this study was to detect the virulence factors in K.pneumoniae strains isolated from nosocomial infections in two years. Fifty three K.pneumoniae strains isolated from the samples of patients with nosocomial infections in the Medical Microbiology Laboratory of Selcuk University Faculty of Medicine Hospital between 2011 and 2013 were included in the study...
October 2017: Mikrobiyoloji Bülteni
Richelle Guerrero-Wooley, Ernesto Aranda-Aguirre, Wencheng Li, Aimee Wilkin, Elizabeth Palavecino
Strongyloides stercoralis is an intestinal nematode that can cause disseminated infection in an immunocompromised host. It is most commonly acquired in developing countries. It was previously a common infection in many parts of the United States, particularly in the Appalachian region, but is rarely identified currently. Here, we describe a patient born and raised in Appalachia, with no history of travel outside the United States, who presented with chronic lymphocytic leukemia and S. stercoralis hyperinfection characterized by acute respiratory failure, altered mental status, and extended-spectrum-beta-lactamase Klebsiella pneumoniae bacteremia...
November 2017: American Journal of Tropical Medicine and Hygiene
Srinu Rathlavath, Vandita Kohli, Asem Sanjit Singh, Manjusha Lekshmi, Gayatri Tripathi, Sanath Kumar, Binaya Bhusan Nayak
Arcobacter butzleri is an emerging pathogen isolated from animals, food and the environment. In this study, 147 A. butzleri isolated from seafood and the coastal environment were tested for the presence of ten putative virulence genes (cadF, cj1349, ciaB, mviN, pldA, tlyA, hecA, hecB, irgA, iroE) and antimicrobial susceptibilities. Majority of the isolates harbored mviN (100%), cj1349 (97.2%), ciaB (95.9%), tlyA (91.8%), pldA (91.1%) and cadF (89.7%). Lower detection rates were observed for hecA (10.8%), hecB (19%), iroE (12...
December 18, 2017: International Journal of Food Microbiology
A Wardhana, R Djan, Z Halim
Infection is a major cause of mortality and morbidity among burn patients. An effective measure to reduce infection is routine monitoring of bacterial infection and antimicrobial susceptibility patterns at the burn unit. This will help to create a burn centre-specific empirical antibiotic therapy protocol. A retrospective, descriptive study was conducted at the Cipto Mangunkusumo Hospital (RSCM) Burn Unit between September-November 2016. Data regarding bacterial culture isolates, antimicrobial susceptibility spectrum, and the number of burn patients diagnosed with sepsis were collected...
June 30, 2017: Annals of Burns and Fire Disasters
Chi-Jung Wu, Jui-Fen Lai, I-Wen Huang, Li-Yun Hsieh, Hui-Ying Wang, Yih-Ru Shiau, Tsai-Ling Lauderdale
Objectives: This study investigated the trend in antimicrobial resistance among group B Streptococcus (GBS) from a national surveillance programme in Taiwan and delineated characteristics of and factors associated with levofloxacin-resistant isolates. Methods: Clinical isolates of all sample types and patient groups were collected from multiple hospitals biennially between 2002 and 2012. Susceptibilities to different antibiotics were determined by broth microdilution...
December 1, 2017: Journal of Antimicrobial Chemotherapy
Fredrik Sjövall, Abdulaziz S Alobaid, Steven C Wallis, Anders Perner, Jeffrey Lipman, Jason A Roberts
Objectives: To use a population pharmacokinetic approach to define maximally effective meropenem dosing recommendations for treatment of Acinetobacter baumannii and Pseudomonas aeruginosa infections in a large cohort of patients with septic shock. Methods: Adult patients with septic shock and conserved renal function, treated with meropenem, were eligible for inclusion. Seven blood samples were collected during a single dosing interval and meropenem concentrations were measured by a validated HPLC-MS/MS method...
January 1, 2018: Journal of Antimicrobial Chemotherapy
Faizan Yasin, Salman Assad, Abdul Subhan Talpur, Mehr Zahid, Shuja A Malik
Hospital-acquired multidrug-resistant (MDR) Klebsiella infection is posing a significant challenge to physicians all around the world. The spread of multiple antibiotic resistance among various members of bacteria continues to be a significant clinical threat. Antibiotic susceptibility testing is the initial step in optimizing the appropriate antibiotic therapy for infections with MDR Klebsiella. We report a case of MDR Klebsiella urinary tract infection (UTI) in a patient following a trimalleolar fracture, which was appropriately treated with a combination of amikacin and meropenem...
July 22, 2017: Curēus
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVE: This study aims to describe the population pharmacokinetics and pharmacodynamic target attainment of meropenem in critically ill children. METHODS: The study involved a retrospective medical record review from a 189-bed, freestanding children's tertiary care teaching hospital of patients ages 1 to 9 years who received meropenem with concurrent therapeutic drug monitoring. RESULTS: There were 9 patients ages 1 to 9 years (mean age, 3...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Nathalie Abi Hatem, Sabrina Campbell, Edmundo Rubio, Anthony Lukas Loschner
Eosinophilic lung diseases are a diverse group of pulmonary disorders with an extensive list of differential diagnoses. Multiple drugs particularly antibiotics can cause pulmonary eosinophilia with variable pulmonary manifestations. Cutaneous drug reactions are common. Diagnosis is usually made on clinical history and blood eosinophilia with an accumulation of eosinophils in alveolar spaces on histologic analysis. Imaging findings are nonspecific. Stopping the offending agent is often enough while a short course of corticosteroids can hasten recovery...
September 2017: Lung India: Official Organ of Indian Chest Society
Demet Haciseyitoglu, Aysegul Dokutan, Ayham Abulaila, Fatma Erdem, Yasemin Cag, Serdar Ozer, Zerrin Aktas
BACKGROUND: The aim of this study was to investigate the occurrence of carbapenemase-producing Enterobacteriaceae. METHODS: A total of 54 carbapenem nonsusceptible Enterobacteriaceae (CRE) isolates were recovered from clinical samples sent to the Dr. Lutfi Kirdar Kartal Training and Research Hospital from the period 2011 through 2014. Forty-four isolates were Klebsiella pneumoniae (CRKP) and the other 10 were Enterobacter cloacae (CREC).The isolate identifications and antibiotic sensitivity tests were performed using a Vitek2 automatic system...
July 1, 2017: Clinical Laboratory
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