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Double carbapenem

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https://www.readbyqxmd.com/read/28216018/prospective-randomised-controlled-study-evaluating-early-modification-of-oral-microbiota-following-admission-to-the-intensive-care-unit-and-oral-hygiene-with-chlorhexidine
#1
Felipe Francisco Tuon, Oleg Gavrilko, Saulo de Almeida, Eigi Ricardo Sumi, Thiago Alberto, Jaime Luis Rocha, Edvaldo Antonio Rosa
OBJECTIVES: Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. METHODS: This was a prospective, randomised, controlled, double-blind study in patients (n=16) under MV who were mouth-rinsed with either CHX or placebo...
February 18, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28210888/double-carbapenem-combination-as-salvage-therapy-for-untreatable-infections-by-kpc-2-producing-klebsiella-pneumoniae
#2
M Souli, I Karaiskos, A Masgala, L Galani, E Barmpouti, H Giamarellou
We report our experience using the double-carbapenem combination as salvage therapy for patients with untreatable infections caused by KPC-2- producing Klebsiella pneumoniae. A total of 27 patients in two institutions in Athens, Greece suffering from complicated urinary tract infections (16) with or without secondary bacteraemia (four and 12 respectively), primary (six) or catheter-related bloodstream infections (two), HAP or VAP (two) and external ventricular drainage infection (one) were treated exclusively with ertapenem and high-dose prolonged infusion meropenem because in-vitro active antimicrobials were unavailable (19) or failed (four) or were contraindicated (six)...
February 16, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28182124/extended-spectrum-beta-lactamase-and-carbapenemase-producing-enterobacteriaceae-among-ethiopian-children
#3
Melese Hailu Legese, Gebru Mulugeta Weldearegay, Daniel Asrat
BACKGROUND: Infections by extended-spectrum beta-lactamase- (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in children nowadays. Hence, the aim of this study was to determine the prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae among children suspected of septicemia and urinary tract infections (UTIs). METHODS: A cross-sectional study was conducted from January to March 2014. A total of 322 study participants suspected of septicemia and UTIs were recruited...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28157141/icu-acquisition-rate-risk-factors-and-clinical-significance-of-digestive-tract-colonization-with-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-a-systematic-review-and-meta-analysis
#4
Marios Detsis, Styliani Karanika, Eleftherios Mylonakis
OBJECTIVE: To evaluate the acquisition rate, identify risk factors, and estimate the risk for subsequent infection, associated with the colonization of the digestive tract with extended-spectrum beta-lactamase-producing Enterobacteriaceae during ICU-hospitalization. DATA SOURCES: PubMed, EMBASE, and reference lists of all eligible articles. STUDY SELECTION: Included studies provided data on ICU-acquired colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae in previously noncolonized and noninfected patients and used the double disk synergy test for extended-spectrum beta-lactamase-producing Enterobacteriaceae phenotypic confirmation...
February 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28144604/evaluation-of-metallo-%C3%AE-lactamase-production-and-carriage-of-bla-vim-genes-in-pseudomonas-aeruginosa-isolated-from-burn-wound-infections-in-isfahan
#5
Mahmood Saffari, Farzaneh Firoozeh, Mohammad Pourbabaee, Mohammad Zibaei
BACKGROUND: Metallo-β-lactamase-production among Gram-negative bacteria, including Pseudomonas aeruginosa, has become a challenge for treatment of infections due to these resistant bacteria. OBJECTIVES: The aim of the current study was to evaluate the metallo-β-lactamase-production and carriage of bla-VIM genes among carbapenem-resistant P. aeruginosa isolated from burn wound infections. PATIENTS AND METHODS: A cross-sectional study was conducted from September 2014 to July 2015...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28108390/fatal-sepsis-caused-by-multidrug-resistant-bacteroides-fragilis-harboring-a-cfia-gene-and-an-upstream-insertion-sequence-element-in-japan
#6
Itaru Nakamura, Kotaro Aoki, Yuri Miura, Tetsuo Yamaguchi, Tetsuya Matsumoto
Here, we report a case of fatal sepsis resulting from an intra-abdominal infection caused by a Bacteroides fragilis strain containing a CfiA4 metallo-β-lactamase and an upstream insertion sequence (IS) element. Meropenem was used as empiric therapy for septic shock as a result of the intra-abdominal infection, although two rounds of carbapenem treatment had been administered previously. B. fragilis was isolated from two anaerobic blood culture bottles 4 days after the onset of septic shock. Susceptibility testing revealed that the isolate was non-susceptible to all tested agents except metronidazole and tigecycline...
January 17, 2017: Anaerobe
https://www.readbyqxmd.com/read/28031201/emergence-of-ceftazidime-avibactam-resistance-due-to-plasmid-borne-blakpc-3-mutations-during-treatment-of-carbapenem-resistant-klebsiella-pneumoniae-infections
#7
Ryan K Shields, Liang Chen, Shaoji Cheng, Kalyan D Chavda, Ellen G Press, Avin Snyder, Ruchi Pandey, Yohei Doi, Barry N Kreiswirth, M Hong Nguyen, Cornelius J Clancy
Ceftazidime-avibactam is a novel β-lactam/β-lactamase inhibitor with activity against carbapenem-resistant Enterobacteriaceae (CRE) that produce Klebsiella pneumoniae carbapenemase (KPC). We report the first cases of ceftazidime-avibactam resistance to develop during treatment of CRE infections, and identify resistance mechanisms. Ceftazidime-avibactam resistant K. pneumoniae emerged in three patients after ceftazidime-avibactam treatment for 10-19 days. Whole genome sequencing (WGS) of longitudinal ceftazidime-avibactam susceptible and resistant K...
December 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27956216/distribution-of-ctx-m-group-i-and-group-iii-%C3%AE-lactamases-produced-by-escherichia-coli-and-klebsiella-pneumoniae-in-lahore-pakistan
#8
Samyyia Abrar, Ayesha Vajeeha, Noor Ul-Ain, Saba Riaz
Extended-spectrum-lactamases (ESBLs) of the CTX-M type is worrisome issue in many countries of the world from past decade. But little is known about CTX-M beta-lactamase producing bacteria in Pakistan. Therefore, this study was carried out to investigate the distribution of CTX-M beta-lactamase producing E. coli and Klebsiella pneumoniae using phenotypic and molecular techniques. A total of 638 E. coli and 338 Klebsiella pneumoniae were isolated from patients attending two hospitals and one diagnostic Centre in Pakistan during 2013-2015...
December 9, 2016: Microbial Pathogenesis
https://www.readbyqxmd.com/read/27942358/ndm-1-and-rmtc-producing-klebsiella-pneumoniae-isolates-in-turkey
#9
Tulin Guven Gokmen, Togrul Nagiyev, Melda Meral, Cansu Onlen, Farzad Heydari, Fatih Koksal
BACKGROUND: The resistance of aminoglycosides in strains that produce beta-lactamase can be developed through the multidrug resistant encoding genes carried by common plasmids. Recently, the association between 16S rRNA methyltransferase resistance and beta-lactamase enzymes carried by the same plasmids has drawn increased attention from researchers, particularly the association in aminoglycoside-resistant strains with a minimum inhibitory concentration (MIC) of ≥ 256 µg/mL. OBJECTIVES: We aimed to investigate the co-existence of 16S rRNA methyltransferase and beta-lactamase genes in multidrug resistant (MDR) Klebsiella pneumoniae strains isolated from clinical samples...
October 2016: Jundishapur Journal of Microbiology
https://www.readbyqxmd.com/read/27933276/acinetobacter-baumannii-isolated-from-lebanese-patients-phenotypes-and-genotypes-of-resistance-clonality-and-determinants-of-pathogenicity
#10
Elias Dahdouh, Micheline Hajjar, Monica Suarez, Ziad Daoud
Introduction:Acinetobacter baumannii is a nosocomial pathogen that usually affects critically ill patients. High mortality rates have been associated with MDR A. baumannii infections. Carbapenem resistance among these isolates is increasing worldwide and is associated with certain International Clones (ICs) and oxacillinases (OXAs). Moreover, this organism possesses a wide range of virulence factors, whose expression is not yet fully understood. In this study, clinical A. baumannii isolates are characterized in terms of antibiotic resistance, mechanisms of carbapenem resistance, clonality, and virulence...
2016: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/27851857/assessing-the-efficacy-and-safety-of-eravacycline-vs-ertapenem-in-complicated-intra-abdominal-infections-in-the-investigating-gram-negative-infections-treated-with-eravacycline-ignite-1-trial-a-randomized-clinical-trial
#11
Joseph Solomkin, David Evans, Algirdas Slepavicius, Patrick Lee, Andrew Marsh, Larry Tsai, Joyce A Sutcliffe, Patrick Horn
Importance: Eravacycline is a novel, fully synthetic fluorocycline antibiotic of the tetracycline class with in vitro activity against clinically important gram-negative, gram-positive aerobic, and facultative bacteria including most of those resistant to cephalosporins, fluoroquinolones, β-lactam/β-lactamase inhibitors, multidrug resistant strains and carbapenem-resistant Enterobacteriaceae, and most anaerobic pathogens. Objective: To evaluate the efficacy and safety of eravacycline compared with ertapenem in adult hospitalized patients with complicated intra-abdominal infections (cIAIs)...
November 16, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27842873/in-vitro-activities-of-colistin-tigecycline-and-tobramycin-alone-or-in-combination-against-carbapenem-resistant-enterobacteriaceae-strains
#12
Berna Ozbek, Emel Mataracı-Kara, Sevda Er, Melda Ozdamar, Mesut Yilmaz
The aim of this study was to investigate the activities of various antibiotics, alone or in combination, against carbapenem-resistant Enterobacteriaceae (CRE). Minimum inhibitory concentrations (MICs) of meropenem, colistin, tigecycline and tobramycin were determined by microbroth dilution against 40 clinical strains. Carbapenemase-encoding genes were detected by PCR using specific primers. The in vitro synergistic activities of tigecycline, colistin and tobramycin in double antibiotic combinations were determined by the microbroth chequerboard technique, and results were interpreted using the fractional inhibitory concentration index (FICI)...
December 2015: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27821448/optimization-of-synergistic-combination-regimens-against-carbapenem-and-aminoglycoside-resistant-clinical-pseudomonas-aeruginosa-isolates-via-mechanism-based-pharmacokinetic-pharmacodynamic-modeling
#13
Rajbharan Yadav, Jürgen B Bulitta, Roger L Nation, Cornelia B Landersdorfer
Optimizing antibiotic combinations is promising to combat multidrug-resistant Pseudomonas aeruginosa This study aimed to systematically evaluate synergistic bacterial killing and prevention of resistance by carbapenem and aminoglycoside combinations and to rationally optimize combination dosage regimens via a mechanism-based mathematical model (MBM). We studied monotherapies and combinations of imipenem with tobramycin or amikacin against three difficult-to-treat double-resistant clinical P. aeruginosa isolates...
January 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27777535/open-conversion-after-aortic-endograft-infection-caused-by-colistin-resistant-carbapenemase-producing-klebsiella-pneumoniae
#14
Nunzio Montelione, Danilo Menna, Pasqualino Sirignano, Laura Capoccia, Wassim Mansour, Francesco Speziale
A 62-year-old man presented with fever, abdominal pain, and malaise 13 months after emergency endovascular aortic repair. Computed tomographic angiograms showed a periprosthetic fluid and gas collection, so infection was diagnosed. Open conversion was performed, involving endograft explantation and in situ aortic reconstruction. Cultures and the explanted prosthesis were positive for carbapenemase-producing Klebsiella pneumoniae, resistant to colistin. Because of the sparse data on endograft infections caused by this pathogen, we placed the patient on an empiric double-carbapenem regimen for 4 weeks...
October 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27686471/targeted-de-escalation-rounds-may-effectively-and-safely-reduce-meropenem-use
#15
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
https://www.readbyqxmd.com/read/27659436/carbapenem-resistant-enterobacteriaceae-prevalence-and-risk-factors-in-a-single-community-based-hospital-in-korea
#16
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
https://www.readbyqxmd.com/read/27624572/polymyxin-monotherapy-or-in-combination-against-carbapenem-resistant-bacteria-systematic-review-and-meta-analysis
#17
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...
January 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27540456/characterization-of-oxacillinase-and-metallo-%C3%AE-lactamas-genes-and-molecular-typing-of-clinical-isolates-of-acinetobacter-baumannii-in-ahvaz-south-west-of-iran
#18
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
https://www.readbyqxmd.com/read/27530858/faecal-carriage-rate-of-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-hospitalised-patients-and-healthy-asymptomatic-individuals-coming-for-health-check-up
#19
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
https://www.readbyqxmd.com/read/27527080/phase-1-study-of-the-safety-tolerability-and-pharmacokinetics-of-the-%C3%AE-lactamase-inhibitor-vaborbactam-rpx7009-in-healthy-adult-subjects
#20
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
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