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https://www.readbyqxmd.com/read/28320724/piperacillin-tazobactam-versus-other-antibacterial-agents-for-treatment-of-bloodstream-infections-due-to-ampc-beta-lactamase-producing-enterobacteriaceae
#1
Lucy Cheng, Brian C Nelson, Monica Mehta, Nikhil Seval, Sarah Park, Marla J Giddins, Qiuhu Shi, Susan Whittier, Angela Gomez-Simmonds, Anne-Catrin Uhlemann
In vivo induction of AmpC beta-lactamases produces high-level resistance to many beta-lactam antibiotics in Enterobacteriaceae, often resulting in the use of carbapenems or cefepime (FEP). The clinical effectiveness of piperacillin-tazobactam (TZP), a weak inducer of AmpC beta-lactamases, is poorly understood. Here we conducted a case-control study of adult inpatients with bloodstream infections (BSIs) due to Enterobacter, Serratia, or Citrobacter spp. from 2009 to 2015 to assess outcomes following treatment with TZP compared to FEP or meropenem (MEM)...
March 20, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28302661/severe-co-trimoxazole-induced-hypoglycaemia-in-a-patient-with-microscopic-polyangiitis
#2
Thomas Edward Conley, Atif Mohiuddin, Noshaba Naz
A 69-year-old man presented to the emergency department with lower respiratory tract infection and febrile neutropaenia. He was recently discharged following a 50-day hospital stay with newly diagnosed microscopic polyangiitis, complicated by pulmonary haemorrhage and severe renal dysfunction requiring renal replacement therapy, plasma exchange and immunosuppression (cyclophosphamide and methylprednisolone). High risk of pneumocystis pneumonia (PCP) led to an escalation in treatment from prophylactic to therapeutic oral co-trimoxazole, alongside broad-spectrum antibiotics...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#3
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28271469/lactobacillus-plantarum-and-its-probiotic-and-food-potentialities
#4
Hamza Ait Seddik, Farida Bendali, Frédérique Gancel, Ismail Fliss, Giuseppe Spano, Djamel Drider
The number of studies claiming probiotic health effects of Lactobacillus plantarum is escalating. Lb. plantarum is a lactic acid bacterium found in diverse ecological niches, highlighting its particular capabilities of adaptation and genome plasticity. Another function that needs to be underlined is the capabilities of Lb. plantarum to produce diverse and potent bacteriocins, which are antimicrobial peptides with possible applications as food preservative or antibiotic complementary agents. Taken together, all these characteristics design Lb...
March 7, 2017: Probiotics and Antimicrobial Proteins
https://www.readbyqxmd.com/read/28260599/peritonsillar-abscess-clinical-aspects-of-microbiology-risk-factors-and-the-association-with-parapharyngeal-abscess
#5
REVIEW
Tejs Ehlers Klug
PTA is a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is considered a complication of acute tonsillitis and is the most prevalent deep neck infection (approximately 2000 cases annually in Denmark) and cause of acute admission to Danish ENT departments. Teenagers and young adults are most commonly affected and males may predominate over females. However, no studies of age- and gender-stratified incidence rates have previously been published. Furthermore, smoking may be associated with increased risk of peritonsillar abscess (PTA) development, although the magnitude of the association has not been estimated...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#6
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
March 2, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28254405/early-appendectomy-shortens-antibiotic-course-and-hospital-stay-in-children-with-early-perforated-appendicitis
#7
Hsin-Yu Tsai, Hsun-Chin Chao, Wan-Ju Yu
BACKGROUND: The optimal management of perforated appendicitis in the pediatric population has been controversial. This study aimed to compare the therapeutic efficacy between conservative treatment (CS) and early appendectomy (EA) in pediatric perforated appendicitis, and to determine whether surgical intervention is an optimal treatment modality for early perforated appendicitis in children. METHODS: Patients treated between January 2012 and April 2014, aged 0-18 years, with an imaging-based diagnosis of perforated appendicitis were retrospectively reviewed...
February 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28249572/efficacy-and-safety-of-de-escalation-therapy-to-ertapenem-for-treatment-of-infections-caused-by-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-an-open-label-randomized-controlled-trial
#8
Pinyo Rattanaumpawan, Peerawong Werarak, Anupop Jitmuang, Pattarachai Kiratisin, Visanu Thamlikitkul
BACKGROUND: Carbapenem antibiotics are considered the treatment of choice for serious extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria (GNB) infections. The study objectives were to evaluate efficacy and safety of de-escalation therapy to ertapenem for treatment of infections caused by extended-spectrum-β-lactamase-producing Enterobacteriaceae. METHODS: We conducted a randomized controlled trial of adult patients with documented ESBL-producing Enterobacteriaceae infections who had received any group 2 carbapenem for less than 96 h...
March 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28230084/highly-potent-antimicrobial-peptides-from-n-terminal-membrane-binding-region-of-e-coli-mreb
#9
Karabi Saikia, Yalavarthi Durga Sravani, Vibin Ramakrishnan, Nitin Chaudhary
Microbial pathogenesis is a serious health concern. The threat escalates as the existing conventional antimicrobials are losing their efficacy against the evolving pathogens. Peptides hold promise to be developed into next-generation antibiotics. Antimicrobial peptides adopt amphipathic structures that could selectively bind to and disrupt the microbial membranes. Interaction of proteins with membranes is central to all living systems and we reasoned that the membrane-binding domains in microbial proteins could be developed into efficient antimicrobials...
February 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#10
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28222277/antibiotic-prophylaxis-in-blepharoplasty-review-of-the-current-literature
#11
REVIEW
Elie M Ferneini, Steven Halepas, Steven I Aronin
The purpose of this study was to provide an evidence-based overview of antibiotic prophylaxis in blepharoplasty. We performed a literature search that evaluated the risk of infection associated with blepharoplasty, as well as the risks and benefits of antibiotic prophylaxis. The overall infection rate associated with eyelid surgery is extremely low. However, the use of antibiotic prophylaxis has increased over the past 25 years in esthetic facial procedures. There is no standard of care for or against antibiotic prophylaxis, and routine practices vary widely...
February 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28209400/multidrug-resistant-enterococcal-infections-new-compounds-novel-antimicrobial-therapies
#12
REVIEW
Roel M van Harten, Rob J L Willems, Nathaniel I Martin, Antoni P A Hendrickx
Over the past two decades infections due to antibiotic-resistant bacteria have escalated world-wide, affecting patient morbidity, mortality, and health care costs. Among these bacteria, Enterococcus faecium and Enterococcus faecalis represent opportunistic nosocomial pathogens that cause difficult-to-treat infections because of intrinsic and acquired resistance to a plethora of antibiotics. In recent years, a number of novel antimicrobial compound classes have been discovered and developed that target Gram-positive bacteria, including E...
February 13, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#13
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#14
REVIEW
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28178130/de-escalation-empirical-antibiotic-therapy-improved-survival-for-patients-with-severe-aplastic-anemia-treated-with-antithymocyte-globulin
#15
COMPARATIVE STUDY
Rong Fu, Tong Chen, Jia Song, Guojin Wang, Lijuan Li, Erbao Ruan, Hui Liu, Yihao Wang, Huaquan Wang, Limin Xing, Yuhong Wu, Hong Liu, Wen Qu, Zonghong Shao
We aimed to investigate the efficacy and safety of de-escalation empirical therapy for controlling infection in patients with severe aplastic anaemia (SAA) treated with antithymocyte globulin (ATG). Eighty-seven ATG-treated SAA patients who had microbiological culture-confirmed infections from 2006 to 2015 in our center were retrospectively analyzed. The efficacy of de-escalation and non-de-escalation therapy was compared. Among all 87 patients, 63 patients were treated with de-escalation therapy and 24 patients with non-de-escalation therapy...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28115354/characterization-of-class-iia-bacteriocin-resistance-in-enterococcus-faecium
#16
Kathryn Geldart, Yiannis N Kaznessis
Vancomycin-resistant enterococci, particularly resistant E. faecium, pose an escalating threat in nosocomial environments because of their innate resistance to many antibiotics, including vancomycin, a treatment of last resort. Many class IIa bacteriocins strongly target these enterococci and may offer a potential alternative for the management of this pathogen. However, E. faecium's resistance to these peptides remains relatively uncharacterized. Herein, we explore the development of resistance of E. faecium to a cocktail of three class IIa bacteriocins; Enterocin A, Enterocin P, and Hiracin JM79...
January 23, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28108091/implementation-of-a-simple-innovative-system-for-postprescription-antibiotic-review-based-on-computerized-tools-with-shared-access
#17
F Bouchand, A Dinh, A L Roux, B Davido, H Michelon, M Lepainteur, B Legendre, F El Sayed, I Pierre, J Salomon, C Lawrence, C Perronne, M Villart, A-C Crémieux
BACKGROUND: Controlling antibiotic use in healthcare establishments limits their consumption and the emergence of bacterial resistance. AIM: To evaluate the efficiency of an innovative antibiotic stewardship strategy implemented over three years in a university hospital. METHODS: An antimicrobial multi-disciplinary team (AMT) [pharmacist, microbiologist and infectious disease specialist (IDS)] conducted a postprescription review. Specific coding of targeted antibiotics (including broad-spectrum β-lactams, glycopeptides, lipopeptides, fluoroquinolones and carbapenems) in the computerized physician order entry allowed recording of all new prescriptions...
March 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28093134/management-of-clostridium-difficile-infection-in-inflammatory-bowel-disease-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#18
REVIEW
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#19
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
May 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28077586/redeploying-%C3%AE-lactam-antibiotics-as-a-novel-antivirulence-strategy-for-the-treatment-of-methicillin-resistant-staphylococcus-aureus-infections
#20
Elaine M Waters, Justine K Rudkin, Simone Coughlan, Geremy C Clair, Joshua N Adkins, Suzanna Gore, Guoqing Xia, Nikki S Black, Tim Downing, Eoghan O'Neill, Aras Kadioglu, James P O'Gara
Innovative approaches to the use of existing antibiotics is an important strategy in efforts to address the escalating antimicrobial resistance crisis. We report a new approach to the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections by demonstrating that oxacillin can be used to significantly attenuate the virulence of MRSA despite the pathogen being resistant to this drug. Using mechanistic in vitro assays and in vivo models of invasive pneumonia and sepsis, we show that oxacillin-treated MRSA strains are significantly attenuated in virulence...
January 1, 2017: Journal of Infectious Diseases
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