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Vancomycin and neonate

Rajeev Soman, Umang Agrawal, Mitesh Suthar, Ketan Desai, Anjali Shetty
Elizabethkingia meningoseptica, formerly Chryseobacterium meningosepticum usually causes neonatal meningitis and is a rare cause of nosocomial meningitis in adults. E. meningoseptica is resistant to most antibiotics, and the use of inactive drugs as empirical therapy may contribute to poor outcome in many patients. Vancomycin, alone or in combination with rifampicin, has been successful in the treatment of meningitis in infants1. We present a case of E. meningoseptica meningitis in an adult who was treated initially with intravenous vancomycin and oral rifampicin, but did not respond to the treatment...
October 2016: Journal of the Association of Physicians of India
Constantin Hays, Mathilde Louis, Céline Plainvert, Nicolas Dmytruk, Gérald Touak, Patrick Trieu-Cuot, Claire Poyart, Asmaa Tazi
Group B Streptococcus (GBS) is the leading cause of neonatal invasive infections and an emerging pathogen in the elderly. Our objectives were to describe the evolution of GBS resistance to antibiotics in France and to investigate the emergence of fluoroquinolone (FQ) resistant isolates. A total of 8,757 unrelated GBS isolates were collected and tested for antibiotic susceptibility from 2007 and 2014 according to EUCAST recommendations. All isolates were susceptible to penicillin G, amoxicillin, and vancomycin...
October 10, 2016: Antimicrobial Agents and Chemotherapy
Satyendra Kaushal, Tuhina Banerjee, Shampa Anupurba, Ashok Kumar
The increasing reports of vancomycin-resistant enterococci (VRE) as a cause of neonatal septicemia are of recent interest. However, in majority of the cases, the source of VRE could not be located. As a consequence, the real importance of VRE and its control measures is undermined. Herein, we report a case of neonatal septicemia due to VRE (Enterococcus faecalis) of vanA genotype with VRE carriage in stool of the neonates as a possible source of sepsis. The report put forwards some lacunae in the infection control practices that are presently followed in the country...
October 2016: Indian Journal of Pathology & Microbiology
Chiara Matani, Michele Trezzi, Alice Matteini, Carlotta Catalani, Daniela Messeri, Corrado Catalani
Intrapartum antibiotic prophylaxis (IAP) reduces both the vertical transmission of Streptococcus agalactiae or Group B Streptococcus (GBS) and the early onset of neonatal sepsis. However, existing guidelines do not recommend that antimicrobial susceptibility testing (AST) be routinely performed. Penicillin or ampicillin are indicated as first-choice antibiotics, cefazolin being an alternative in the case of history of mild allergic reactions, and vancomycin or clindamycin an alternative in the event of severe reactions...
September 1, 2016: Le Infezioni in Medicina
Arun K Mishra, Pragya Yadav, Amrita Mishra
The symptoms of Staphylococcal scalded skin syndrome (SSSS) include blistering of skin on superficial layers due to the exfoliative toxins released from Staphylococcus aureus. After the acute exfoliation of skin surface, erythematous cellulitis occurs. The SSSS may be confined to few blisters localized to the infection site and spread to severe exfoliation affecting complete body. The specific antibodies to exotoxins and increased clearence of exotoxins decrease the frequency of SSSS in adults. Immediate medication with parenteral anti-staphylococcal antibiotics is mandatory...
2016: Open Microbiology Journal
Janko Samardzic, Anne Smits, Isabel Spriet, Ivan Soldatovic, Andrew Atkinson, Milica Bajcetic, John N Van Den Anker, Karel Allegaert
Substantial interassay variability (up to 20%) has been described for vancomycin immunoassays in adults, but the impact of neonatal matrix is difficult to quantify because of blood volume constraints in neonates. However, we provide circumstantial evidence for a similar extent of variability. Using the same vancomycin dosing regimens and confirming similarity in clinical characteristics, vancomycin trough concentrations measured by PETINIA (2011-2012, n = 400) were 20% lower and the mean difference was 1.93 mg/L compared to COBAS (2012-2014, n = 352) measurements...
2016: BioMed Research International
Kathrine Mauchaza, Farai D Madzimbamuto, Seymour Waner
INTRODUCTION: The prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in Africa is sparsely documented. In Zimbabwe there is no routine patient or specimen screening for MRSA. The aim of this study was to document the presence and epidemiology of MRSA in Zimbabwe. METHOD: The study was done in one private sector laboratory with a national network that serves both public and private hospitals. The sample population included in-patients and outpatients, all ages, both genders, all races and only one positive specimen per patient was counted...
June 2016: Ghana Medical Journal
L Tang, J Fang, S N Wang, X H Weng, J J Li, E N Shang
OBJECTIVE: To evaluate the clinical efficacy and safety of vancomycin and linezolid for the treatment of gram-positive neonatal bacterial sepsis. METHOD: The data of neonates diagnosed as gram-positive bacterial sepsis in neonatology department of Suzhou Municipal Hospital from June 2009 to December 2015 were retrospectively collected. These neonates were divided into vancomycin group and linezolid group. Propensity score matching (PSM) on baseline variables was used to balance the two groups by identifying a comparable group of neonates who received vancomycin and linezolid therapy...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Mohammad Emaneini, Fereshteh Jabalameli, Akbar Mirsalehian, Amir Ghasemi, Reza Beigverdi
Between January and December 2013, swab samples were taken for the throat and external ear canals of 1037 newborns for screening of Group B Streptococcus (GBS or S. agalactiae). Isolates were analyzed form Multilocus sequence typing (MLST), capsular type, virulence genes and antibiotic susceptibility. The MLST analysis of 19 GBS isolates showed 8 sequence types (STs). Overall the most common STs were ST19 and ST28. Other STs were ST1, ST4, ST8, ST12, ST335 and ST734 (a new ST). The most common clonal complexes (CCs) were CC19 (68...
October 2016: Microbial Pathogenesis
Louise Whitticase, Gemma Holder, Matt Cawsey, Alison Bedford-Russell
AIM: To compare continuous intravenous infusions of vancomycin in achieving desired therapeutic plasma concentrations against an intermittent bolus regimen. METHOD: Data were collected for all babies who received a continuous infusion of vancomycin on our Neonatal Intensive Care Unit (NICU) between October 2014 and March 2015. The regimen is based on that of another hospital (Hospital A) and comprised of a loading dose of 15 mg/kg over 1 hour followed by a continuous infusion of 20-50 mg/kg/day according to creatinine and corrected gestational age (CGA)...
September 2016: Archives of Disease in Childhood
Anastasia Tsyben, Nigel Gooding, Wilf Kelsall
AIM: Prescribing audits have shown that the Women's and Children's Directorate reported higher number of prescription errors on the paediatric and neonatal wards compared to other areas in the Trust. Over the last three years a multidisciplinary prescribing team (PT), which included senior clinicians, pharmacists and trainees introduced a number of initiatives to improve the quality of prescribing. Strategies included structured departmental inductions, setting up of designated prescribing areas and reviewing errors with the prescriber...
September 2016: Archives of Disease in Childhood
Sarina Saimbi, Hannah Batchelor, Louise Whitticase, Gemma Holder, Alison Bedford Russell
AIM: Vancomycin is used as a second line antibiotic in the treatment of late onset neonatal infection for its activity against coagulase negative staphylococci. Vancomycin infusions are prepared within a ward setting for administration to neonates. Differences in preparation techniques on the ward have previously been recognised as a potential source of variation in vancomycin concentrations, as compared to concentrations in pre-made preparations. This study analyses a consecutive series of vancomycin syringes prepared in a ward for administration to neonates, to determine how accurate the concentration of each preparation was compared to the expected concentration...
September 2016: Archives of Disease in Childhood
Roberta Maia de Castro Romanelli, Lêni Márcia Anchieta, Juliana Chaves Abreu Fernandes, Mariana Antunes Faria Lima, Taís Marina de Souza, Viviane Rosado, Wanessa Trindade Clemente, Paulo Augusto Moreira Camargos
Coagulase-negative Staphylococcus has been identified as the main nosocomial agent of neonatal late-onset sepsis. However, based on the pharmacokinetics and erratic distribution of vancomycin, recommended empirical dose is not ideal, due to the inappropriate serum levels that have been measured in neonates. The aim of this study was to evaluate serum levels of vancomycin used in newborns and compare the prediction of adequate serum levels based on doses calculated according to mg/kg/day and m(2)/day. This is an observational reprospective cohort at a referral neonatal unit, from 2011 to 2013...
September 2016: Brazilian Journal of Infectious Diseases
Benjamin M Hammer, Allison B Lardieri, Jill A Morgan
OBJECTIVES: Because of increases in antimicrobial resistance, the use of vancomycin in late-onset sepsis has come under scrutiny. The primary outcome of this study was to determine if vancomycin for the treatment of late-onset sepsis in the neonatal intensive care unit (NICU) was being discontinued within 72 hours according to the existing protocol. Secondary outcomes included the appropriateness of therapeutic drug monitoring associated with vancomycin, and renal dysfunction associated with the use of vancomycin in the NICU outside of the 72-hour policy...
May 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Abeba Mengist, Hemalatha Kannan, Alemseged Abdissa
BACKGROUND: Streptococcus agalactiae (group B Streptococcus, GBS) is the most frequent pathogen isolated from neonates with invasive bacterial disease and responsible for serious infections in newborns such as pneumonia, septicemia and meningitis. Infection is primarily acquired vertically from mothers colonized with GBS. However, the prevalence and antimicrobial susceptibility pattern of GBS among pregnant women in Ethiopia are less studied. METHODS: This cross-sectional study involved 126 pregnant women at 35-37 weeks of gestation attending the antenatal clinic at Jimma University Hospital...
2016: BMC Research Notes
Jasmine Chong, Caroline Quach, Ana C Blanchard, Philippe Guillaume Poliquin, George R Golding, Céline Laferrière, Simon Lévesque
Coagulase-negative staphylococci (CoNS) have become the leading cause of bloodstream infections (BSIs) in intensive care units (ICUs), particularly in premature neonates. Vancomycin-intermediate heteroresistant CoNS (hVICoNS) have been identified as sources of BSIs worldwide, and their potential to emerge as significant pathogens in the neonatal ICU (NICU) remains uncertain. This study describes the molecular epidemiology of an outbreak of vancomycin-heteroresistant (hV) Staphylococcus epidermidis central-line-associated BSI (CLABSI) in a single tertiary care NICU and compares it to a second tertiary care NICU that had not been associated with an outbreak...
October 2016: Antimicrobial Agents and Chemotherapy
Giancarlo Alvarado-Gamarra, Katherine M Alcalá-Marcos, Diego M Abarca-Alfaro, Victoria Bao-Castro
OBJECTIVES: To describe the microbiological and therapeutic characteristics of confirmed neonatal sepsis, and determineits incidence and mortality, at the National Hospital Arzobispo Loayza (HNAL) from 2011 to 2012, Lima, Peru. MATERIALS AND METHODS: Retrospective longitudinal study. It was performed a monitoring to newborns with probable sepsis, and assessed the results from positive blood cultures. The newborns' characteristics were obtained from medical records...
March 2016: Revista Peruana de Medicina Experimental y Salud Pública
Pablo J Sánchez, Mohannad Moallem, Joseph B Cantey, Avante Milton, Ian C Michelow
No abstract text is available yet for this article.
September 2016: Jornal de Pediatria
Despoina Gkentzi, Soultana Kolyva, Iris Spiliopoulou, Markos Marangos, Gabriel Dimitriou
BACKGROUND: Coagulase-negative staphylococci (CoNS) are the leading cause of late-onset sepsis in neonatal intensive-care units (NICUs). Despite adequate therapeutic levels and in vivo susceptibility, vancomycin is not always adequate in clearing CoNS bacteremias and other theurapeutic regimens are warranted especially when dealing with persistent CoNS bacteremias. METHODS: Retrospective analysis of neonates with persistent CoNS bacteremias in a tertiary NICU in two study periods (January 2006 to December 2007 and January 2011 to December 2012)...
June 3, 2016: Current Pediatric Reviews
David M Lister, Kenneth Tan, Elizabeth Carse, Rhonda L Stuart
A follow-up cohort study was undertaken to document clearance of fecal vancomycin-resistant Enterococcus faecium carriage in 19 infants colonized during a hospital outbreak. By the conclusion of the 14-month study period, all participants had returned terminal negative fecal specimens, supporting the hypothesis that carriage is transient in this population.
May 18, 2016: American Journal of Infection Control
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