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Double carbapenem

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
Hyo Jin Lee, Jae Ki Choi, Sung Yeon Cho, Si Hyun Kim, Sun Hee Park, Su Mi Choi, Dong Gun Lee, Jung Hyun Choi, Jin Hong Yoo
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are Gram-negative bacteria with increasing prevalence of infection worldwide. In Korea, 25 cases of CPE isolates were reported by the Korea Centers for Disease Control and Prevention in 2011. Most CPE cases were detected mainly at tertiary referral hospitals. We analyzed the prevalence and risk factors for carbapenem-resistant Enterobacteriaceae (CRE) in a mid-sized community-based hospital in Korea. MATERIALS AND METHODS: We retrospectively analyzed all consecutive episodes of Enterobacteriaceae in a mid-sized community-based hospital from January 2013 to February 2014...
September 2016: Infection & Chemotherapy
Oren Zusman, Sergey Altunin, Fidi Koppel, Yael Dishon Benattar, Habip Gedik, Mical Paul
OBJECTIVES: The objective of this study was to summarize available data on polymyxin-based combination therapy or monotherapy for carbapenem-resistant Gram-negative bacteria. METHODS: This is a systematic review. We included observational studies and randomized controlled trials (RCTs) comparing polymyxin monotherapy versus polymyxin-based combination therapy in adult patients with infections caused by carbapenem-resistant or carbapenemase-producing Gram-negative bacteria...
September 13, 2016: Journal of Antimicrobial Chemotherapy
Saeed Shoja, Mojtaba Moosavian, Soodabeh Rostami, Fariba Abbasi, Mohammad Amin Tabatabaiefar, Amir Peymani
BACKGROUND: Carbapenem resistant Acinetobacter baumannii is an important nosocomial pathogen associated with a variety of infections. OBJECTIVES: The current study aimed to characterize the antimicrobial susceptibility, analyze the prevalence of oxacillinase and metallo-β-lactamase (MBL) genes and molecular typing of clinical isolates of A. baumannii. MATERIALS AND METHODS: A total of 124 non-repetitive isolates of A. baumannii were collected from various clinical specimens in two teaching hospitals in Ahvaz, south-west of Iran...
May 2016: Jundishapur Journal of Microbiology
Rachana Babu, Anil Kumar, Shamsul Karim, Sruthi Warrier, Suresh G Nair, Sanjeev K Singh, Raja Biswas
The prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in hospitalised and community patients is of significant public health concern. The aim of this study was to estimate the faecal carriage rate of ESBL-PE in hospitalised patients and healthy asymptomatic individuals coming for health check-up. Non-repetitive, consecutive stool samples from 480 adults (260 healthy individuals and 220 hospitalised patients) aged ≥18 years from November 2011 to July 2013 were screened using MacConkey agar supplemented with ceftazidime...
September 2016: Journal of Global Antimicrobial Resistance
David C Griffith, Jeffery S Loutit, Elizabeth E Morgan, Stephanie Durso, Michael N Dudley
Vaborbactam (formerly RPX7009) is a member of a new class of β-lactamase inhibitor with pharmacokinetic properties similar to those of many β-lactams, including carbapenems. The pharmacokinetics and safety of vaborbactam were evaluated in 80 healthy adult subjects in a first-in-human randomized, placebo-controlled, double-blind, sequential single- and multiple-ascending-dose study. A total of 10 dose cohorts were enrolled in the study, with 6 subjects randomized to receive 250 to 2,000 mg of vaborbactam and 2 subjects randomized to receive placebo in each cohort...
October 2016: Antimicrobial Agents and Chemotherapy
Christopher Lucasti, Liviu Vasile, Dorel Sandesc, Donatas Venskutonis, Patrick McLeroth, Mallika Lala, Matthew L Rizk, Michelle L Brown, Maria C Losada, Alison Pedley, Nicholas A Kartsonis, Amanda Paschke
Relebactam (REL [MK-7655]) is a novel class A/C β-lactamase inhibitor intended for use with imipenem for the treatment of Gram-negative bacterial infections. REL restores imipenem activity against some resistant strains of Klebsiella and Pseudomonas In this multicenter, double-blind, controlled trial (NCT01506271), subjects who were ≥18 years of age with complicated intra-abdominal infection were randomly assigned (1:1:1) to receive 250 mg REL, 125 mg REL, or placebo, each given intravenously (i.v.) with 500 mg imipenem-cilastatin (IMI) every 6 h (q6h) for 4 to 14 days...
October 2016: Antimicrobial Agents and Chemotherapy
J Gozdowska, M Czerwińska, Ł Chabros, G Młynarczyk, A Kwiatkowski, A Chmura, M Durlik
INTRODUCTION: The aim of this study was to investigate risk factors for urinary tract infections (UTI), the causative organisms of UTI and also their management and treatment. In addition, we evaluated the effects of UTI on renal graft function. METHODS: This analysis included 107 kidney transplant recipients (64% women) with a diagnosis of UTIs confirmed by positive results on urine culture. Type of pathogens, sensitivity to drugs, risk factors for infection, incidence of urosepsis, hospitalization period, treatment methods, and recurrence rates were analyzed...
June 2016: Transplantation Proceedings
P Lagerbäck, W W T Khine, C G Giske, T Tängdén
OBJECTIVES: To investigate the activity of colistin alone or in double and triple combination with rifampicin and meropenem against NDM-1-producing Klebsiella pneumoniae. METHODS: Eight isolates of NDM-1-producing K. pneumoniae were exposed to clinically relevant antibiotic concentrations in 24 h time-kill experiments. Three colistin concentrations were used for two of the strains. Resistance development was assessed with population analysis and sequencing of the mgrB and pmrB genes...
August 2016: Journal of Antimicrobial Chemotherapy
Monica Pavez, Camila Vieira, Maria Rita de Araujo, Alvaro Cerda, Lara Mendes de Almeida, Nilton Lincopan, Elsa Masae Mamizuka
Intrinsic mechanisms leading to carbapenem-induced membrane impermeability and multidrug resistance are poorly understood in clinical isolates of Enterobacteriaceae. In this study, molecular behaviours during the establishment of membrane impermeability in members of the Enterobacteriaceae family under imipenem selective pressure were investigated. Clinical isolates (n = 22) exhibiting susceptibility to multiple antibiotics or characterised as extended-spectrum β-lactamase (ESBL)- or AmpC-producers were submitted to progressive passages on Mueller-Hinton agar plates containing subclinical concentrations of imipenem [0...
July 2016: International Journal of Antimicrobial Agents
E A Reuland, G J B Sonder, I Stolte, N Al Naiemi, A Koek, G B Linde, T J W van de Laar, C M J E Vandenbroucke-Grauls, A P van Dam
Travel to (sub)tropical countries is a well-known risk factor for acquiring resistant bacterial strains, which is especially of significance for travellers from countries with low resistance rates. In this study we investigated the rate of and risk factors for travel-related acquisition of extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), ciprofloxacin-resistant Enterobacteriaceae (CIPR-E) and carbapenem-resistant Enterobacteriaceae. Data before and after travel were collected from 445 participants...
August 2016: Clinical Microbiology and Infection
Jongsoo Jeon, Choong-Min Ryu, Jun-Young Lee, Jong-Hwan Park, Dongeun Yong, Kyungwon Lee
UNLABELLED: The increasing prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) strains in intensive care units has caused major problems in public health worldwide. Our aim was to determine whether this phage could be used as an alternative therapeutic agent against multidrug-resistant bacterial strains, specifically CRAB clinical isolates, using a mouse model. Ten bacteriophages that caused lysis in CRAB strains, including blaOXA-66-like genes, were isolated. YMC13/01/C62 ABA BP (phage Bϕ-C62), which showed the strongest lysis activity, was chosen for further study by transmission electron microscopy (TEM), host range test, one-step growth and phage adsorption rate, thermal and pH stability, bacteriolytic activity test, genome sequencing and bioinformatics analysis, and therapeutic effect of phage using a mouse intranasal infection model...
July 15, 2016: Applied and Environmental Microbiology
Muneeza Anwar, Hassan Ejaz, Aizza Zafar, Hamdan Hamid
Multidrug resistant A. baumannii has emerged as an important and problematic human pathogen as it is the causative agent of several types of infections especially in neonates and immunocompromised patients because they have least capacity to fight against infections. Carbapenems are used as last resort antibiotics for treating these infections but currently resistance against carbapenems due to MBL production is on the rise. The objective of this study was to determine the frequency of antibiotic resistance in A...
2016: Journal of Pathogens
M Tato, P Ruiz-Garbajosa, M Traczewski, A Dodgson, A McEwan, R Humphries, J Hindler, J Veltman, H Wang, R Cantón
Rapid identification of patients who are colonized with carbapenemase-producing organisms (CPO) is included in multiple national guidelines for containment of these organisms. In a multisite study, we evaluated the performance of the Cepheid Xpert Carba-R assay, a qualitative diagnostic test that was designed for the rapid detection and differentiation of the blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP-1 genes from rectal swab specimens. A double rectal swab set was collected from 383 patients admitted at four institutions (2 in the United States, 1 in the United Kingdom, 1 in Spain)...
July 2016: Journal of Clinical Microbiology
Samira Aghamiri, Nour Amirmozafari, Jalil Fallah Mehrabadi, Babak Fouladtan, Mojtaba Hanafi Abdar
BACKGROUND: Metallo-β-lactamases (MBLs) producing strains of Acinetobacter baumannii are serious etiological agents of hospital infections worldwide. Among the β- lactams, carbapenems are the most effective antibiotics used against A. baumannii. However, resistance to these drugs among clinical strains of A. baumannii has been increasing in recent years. In this study, the antimicrobial sensitivity patterns of A. baumannii strains isolated from eleven different hospitals in Tehran, Iran, and the prevalence of MBL genes (bla-VIM and bla-IMP) were determined...
2016: Chemotherapy
Julie Toubiana, Sandra Timsit, Agnès Ferroni, Marie Grasseau, Xavier Nassif, Olivier Lortholary, Jean-Ralph Zahar, Martin Chalumeau
Limited data is available on pediatric community-onset infections with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE), but such infections may affect both the efficacy of empiric antibiotic therapy and the rational use of antibiotics.We retrospectively analyzed data from 2007 to 2012 for all children ≤16 years old with a positive ESBL-PE strain from usually sterile sites within 48 hours of admission in a tertiary hospital in France. We analyzed healthcare- and community-associated infections among community-onset infections...
March 2016: Medicine (Baltimore)
Richa Gupta, Abida Malik, Meher Rizvi, S Moied Ahmed
BACKGROUND: Multidrug-resistant (MDR) Pseudomonas spp. have been reported to be the important cause of ICU infections. The appearance of ESBL, AmpC and MBL genes and their spread among bacterial pathogens is a matter of great concern. Biofilm production also attributes to antimicrobial resistance due to close cell to cell contact that permits bacteria to more effectively transfer plasmids to one another. This study aimed at determining the incidence of ESBL, AmpC, MBL and biofilm producing Pseudomonas spp...
January 2016: Journal of Global Infectious Diseases
Giovanna Pulcrano, Salvatore Pignanelli, Adriana Vollaro, Matilde Esposito, Vita Dora Iula, Emanuela Roscetto, Amata Amy Soriano, Maria Rosaria Catania
Enterobacter aerogenes has recently emerged as an important hospital pathogen. In this study, we showed the emergence of E. aerogenes isolates carrying the blaKPC gene in patients colonized by carbapenem-resistant Klebsiella pneumoniae strains. Two multiresistant E. aerogenes isolates were recovered from bronchial aspirates of two patients hospitalized in the Intensive Care Unit at the "Santa Maria della Scaletta" Hospital, Imola. The antimicrobial susceptibility test showed the high resistance to carbapenems and double-disk synergy test confirmed the phenotype of KPC and AmpC production...
June 2016: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
J Jeon, R D'Souza, N Pinto, C-M Ryu, J Park, D Yong, K Lee
AIMS: The aim of this study was to characterize phenotypical properties, to analyse whole genomes of novel Acinetobacter baumannii phages infecting carbapenem-resistant Ac. baumannii (CRAB) and to evaluate their potential as antimicrobial alternatives to control Ac. baumannii in clinical settings. METHODS AND RESULTS: The Ac. baumannii phages, Βϕ-R1215 and Βϕ-R2315, were isolated from sewage samples. These phages were characterized by transmission electron microscopy, host spectrum, the thermal/pH stability test, the bacterial lysis assay and the whole genome analysis...
July 2016: Journal of Applied Microbiology
John E Mazuski, Leanne B Gasink, Jon Armstrong, Helen Broadhurst, Greg G Stone, Douglas Rank, Lily Llorens, Paul Newell, Jan Pachl
BACKGROUND: When combined with ceftazidime, the novel non-β-lactam β-lactamase inhibitor avibactam provides a carbapenem alternative against multidrug-resistant infections. Efficacy and safety of ceftazidime-avibactam plus metronidazole were compared with meropenem in 1066 men and women with complicated intra-abdominal infections from 2 identical, randomized, double-blind phase 3 studies (NCT01499290 and NCT01500239). METHODS: The primary end point was clinical cure at test-of-cure visit 28-35 days after randomization, assessed by noninferiority of ceftazidime-avibactam plus metronidazole to meropenem in the microbiologically modified intention-to-treat (mMITT) population (in accordance with US Food and Drug Administration guidance), and the modified intention-to-treat and clinically evaluable populations (European Medicines Agency guidance)...
June 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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