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https://www.readbyqxmd.com/read/27921442/nebulized-antibiotics-in-mechanically-ventilated-patients-roadmap-and-challenges
#1
G Poulakou, G Siakallis, S Tsiodras, A Arfaras Melainis, G Dimopoulos
Nebulized antibiotics use has become common practice in the therapeutics of pneumonia in cystic fibrosis patients. There is an increasing interest in their use for respiratory infections in mechanically ventilated (MV) patients in order to a) overcome pharmacokinetic issues in the lung compartment with traditional systemic antibiotic use and b) prevent the emergence of multi-drug-resistant (MDR) pathogens. Areas covered: The beneficial effects of antibiotic nebulization in MV patients e.g. increasing efficacy, reduced toxicity and prevention of resistance are described...
December 6, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27921227/-nosocomial-pneumonia-from-a%C3%A2-radiological-perspective
#2
REVIEW
P Agarwal, A Wielandner
Due to the high morbidity and mortality, nosocomial pneumonia represents a serious risk in hospitalized patients. The increased risk of infections with multidrug-resistant (MDR) pathogens makes a timely diagnosis and prompt therapy indispensable. A newly occurring or progressive infiltrate in any patient who has been hospitalized for more than 48 h should be viewed with suspicion. In contrast to community acquired pneumonia (CAP), radiography plays a limited role in the diagnosis of hospital-acquired pneumonia (HAP)...
December 5, 2016: Der Radiologe
https://www.readbyqxmd.com/read/27917795/lytic-activity-of-various-phage-cocktails-on-multidrug-resistant-bacteria
#3
I Ozkan, E Akturk, N Yeshenkulov, S Atmaca, N Rahmanov, H I Atabay
PURPOSE: A bacteriophage is a virus that infects and replicates within a bacterium following the injection of phage genome into the bacterial cytoplasm. They are seen as a possible therapy for multi-drug-resistant strains of many bacteria. The aim of this study is to evaluate the lytic activity of the Pyo, Intesti and Fersisi bacteriophage cocktails on P. aeruginosa and S. aureus. METHODS: Ten different S. aureus and P. aeruginosa strains, which were isolated from hospitalized patients in Turkey, were used in the study...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27917692/once-daily-high-dose-tigecycline-pharmacokinetic-pharmacodynamic-based-dosing-for-optimal-clinical-effectiveness-dosing-matters-revisited
#4
Burke A Cunha, Jeffrey Baron, Cheston B Cunha
Tigecycline has emerged as first line therapy for serious systemic infections due to important pathogens (except P. aeruginosa and Proteus sp.), including multi-drug resistant (MDR) and Gram negative bacilli (GNB), including carbapenem resistant Enterobacteriae. Tigecycline has a "low resistance potential," is protective against C. difficile, and is often the only antibiotic effective against MDR GNB, e.g., Klebsiella sp. Areas covered: Standard dose tigecycline therapy has been used for intra-abdominal infections, complicated skin/skin structure infections (cSSSIs), and CAP...
December 3, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27916621/point-should-inhaled-antibiotic-therapy-be-routinely-used-for-the-treatment-of-bacterial-lower-respiratory-tract-infections-in-the-icu-setting-yes
#5
EDITORIAL
Richard G Wunderink
Routine use of aerosolized antibiotics is the most rational approach to the current treatment dilemmas for severe hospital-acquired pneumonia (HAP) requiring endotracheal intubation or ventilator-associated pneumonia (VAP). The two main issues for HAP/VAP are inappropriate initial therapy and ineffective therapy for multidrug resistant (MDR) pathogens, particularly gram negative bacilli such as Pseudomonas aeruginosa and Acinetobacter species. The emergence of extended spectrum beta-lactamases (ESBL) and carbapenem resistance in Enterobacteriaceae (CRE) have made even common pathogens such as Escherichia coli difficult to treat...
November 22, 2016: Chest
https://www.readbyqxmd.com/read/27913093/genome-of-the-carbapenemase-producing-clinical-isolate-elizabethkingia-miricola-em_chuv-and-comparative-genomics-with-elizabethkingia-meningoseptica-and-elizabethkingia-anophelis-evidence-for-intrinsic-multidrug-resistance-trait-of-emerging-pathogens
#6
Onya Opota, Seydina M Diene, Claire Bertelli, Guy Prod'hom, Philippe Eckert, Gilbert Greub
Elizabethkingia miricola is a Gram-negative non-fermenting rod emerging as a life-threatening human pathogen. The multidrug-resistant (MDR) carbapenemase-producing clinical isolate E. miricola EM_CHUV was recovered in the setting of severe nosocomial pneumonia. In this study, the genome of E. miricola EM_CHUV was sequenced and a functional analysis was performed, including a comparative genomic study with Elizabethkingia meningoseptica and Elizabethkingia anophelis. The resistome of EM_CHUV revealed the presence of a high number of resistance genes, including the presence of the blaGOB-13 and blaB-9 carbapenemase-encoding genes...
November 15, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27902433/escherichia-coli-clonal-group-a-cga-among-uropathogenic-infections-in-mexico-city
#7
Angel Manjarrez-Hernandez, José Molina-López, Sandra Gavilanes-Parra, Rigoberto Hernandez-Castro
Escherichia coli clonal group A (CGA) causes urinary tract and other extraintestinal infections in humans. CGA is an important cause of trimethoprim/sulfamethoxazole (SXT)-resistance in extraintestinal pathogens. We examined the extent to which resistance in this area is related to CGA dissemination of E. coli from urinary tract infections (UTIs) in Mexico City. The virulence backgrounds of the isolates were also characterized. In this study, the frequency of resistance to SXT used for UTI treatment was high (56-65%) and CGA isolates accounted for 9 of the 78 SXT-resistant isolates (11...
November 7, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27902427/phenotypic-and-genetic-characterization-of-multi-drug-resistant-staphylococcus-aureus-in-the-tropics-of-southeast-asia
#8
Siti Norayuni Mohd Zulkeflle, Yus Amira Yusaimi, Norio Sugiura, Koji Iwamoto, Masafumi Goto, Motoo Utsumi, Nor'azizi Bin Othman, Zuriati Zakaria, Hirofumi Hara
Antibiotic resistance has become a major public health problem throughout the world. The presence of antibiotic resistant bacteria such as Staphylococcus aureus (S. aureus) and antibiotic resistance genes (ARGs) in hospital wastewater is cause for great concern today. In this study, 276 S. aureus isolates were recovered from hospital wastewater samples in Malaysia. All of the isolates were screened for susceptibility to nine different classes of antibiotics: ampicillin (AMP), ciprofloxacin (CFX), gentamicin (GMN), kanamycin (KMN), erythromycin (ERM), vancomycin (VAN), trimetoprim and sulfamethaxazole (TM-SMZ), chloramphenicol (CMP), tetracycline (TET), and nalidixic acid (NAL)...
November 3, 2016: Microbiology
https://www.readbyqxmd.com/read/27899074/antibiotic-resistance-and-clonal-diversity-of-invasive-staphylococcus-aureus-in-the-rural-ashanti-region-ghana
#9
Denise Dekker, Manuel Wolters, Eva Mertens, Kennedy Gyau Boahen, Ralf Krumkamp, Daniel Eibach, Norbert G Schwarz, Yaw Adu-Sarkodie, Holger Rohde, Martin Christner, Florian Marks, Nimako Sarpong, Jürgen May
BACKGROUND: Staphylococcus aureus is among the most common pathogens isolated from blood cultures in Ghana; yet the epidemiology of blood infections in rural settings is poorly described. This study aims to investigate antimicrobial susceptibility and clonal diversity of S. aureus causing bloodstream infections in two hospitals in the Ashanti Region, Ghana. METHODS: Blood cultures were performed for all febrile patients (≥37.5 °C) on hospital admission. Antibiotic susceptibility testing for S...
November 29, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27885285/emergence-of-aminoglycoside-resistance-due-to-arma-methylase-in-multi-drug-resistant-acinetobacter-baumannii-isolates-in-a-university-hospital-in-nepal
#10
S Shrestha, T Tada, B Shrestha, T Kirikae, H Ohara, B P Rijal, B M Pokhrel, J B Sherchand
BACKGROUND: The emergence of multidrug-resistant Acinetobacter baumannii associated with hospital-acquired infections has been increasingly reported worldwide. 16S rRNA methylase producing Gram-negative bacteria are highly resistant to all clinically important aminoglycosides. We analyzed A. baumannii clinical isolates resistant to aminoglycosides from hospitalized patients. The objective of this study was to investigate the emergence of armA in A.baumannii species associated with nosocomial infection in a university hospital in Nepal...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27879336/beyond-antimicrobial-resistance-evidence-for-a-distinct-role-of-the-acrd-efflux-pump-in-salmonella-biology
#11
Michelle M C Buckner, Jessica M A Blair, Roberto M La Ragione, Jane Newcombe, Daniel J Dwyer, Alasdair Ivens, Laura J V Piddock
: For over 20 years, bacterial multidrug resistance (MDR) efflux pumps have been studied because of their impact on resistance to antimicrobials. However, critical questions remain, including why produce efflux pumps under non-antimicrobial treatment conditions, and why have multiple pumps if their only purpose is antimicrobial efflux? Salmonella spp. possess five efflux pump families, including the resistance-nodulation-division (RND) efflux pumps. Notably, the RND efflux pump AcrD has a unique substrate profile, distinct from other Salmonella efflux pumps...
November 22, 2016: MBio
https://www.readbyqxmd.com/read/27874151/a-stepwise-introduction-of-a-successful-antimicrobial-stewardship-program-experience-from-a-tertiary-care-university-hospital-in-western-saudi-arabia
#12
Maha M Alawi, Bayan M Darwesh
OBJECTIVES: To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS: Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs)...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27865895/intensive-care-unit-acquired-pneumonia-due-to-pseudomonas-aeruginosa-with-and-without-multidrug-resistance
#13
Laia Fernández-Barat, Miquel Ferrer, Francesca De Rosa, Albert Gabarrús, Mariano Esperatti, Silvia Terraneo, Mariano Rinaudo, Gianluigi Li Bassi, Antoni Torres
OBJECTIVE: Pseudomonas aeruginosa often presents multi-drug resistance (MDR) in intensive care unit (ICU)-acquired pneumonia (ICUAP), possibly resulting in inappropriate empiric treatment and worse outcomes. We aimed to identify patients with ICUAP at risk for these pathogens in order to improve treatment selection and outcomes. METHODS: We prospectively assessed 222 consecutive immunocompetent ICUAP patients confirmed microbiologically. We determined the characteristics, risk factors, systemic inflammatory response and outcomes of P...
November 16, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27856730/multidrug-and-carbapenem-resistant-pseudomonas-aeruginosa-in-children-united-states-1999-2012
#14
Latania K Logan, Sumanth Gandra, Siddhartha Mandal, Eili Y Klein, Jordan Levinson, Robert A Weinstein, Ramanan Laxminarayan
BACKGROUND: Pseudomonas aeruginosa is a common cause of healthcare-associated infection. Multidrug-resistant (MDR) (>3 classes) and carbapenem-resistant (CR) P aeruginosa are significant threats globally. We used a large reference-laboratory database to study the epidemiology of P aeruginosa in children in the United States. METHODS: Antimicrobial susceptibility data from the Surveillance Network were used to phenotypically identify MDR and CR P aeruginosa isolates in children aged 1 to 17 years between January 1999 and July 2012...
November 16, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27855693/modelling-the-effect-of-short-course-multidrug-resistant-tuberculosis-treatment-in-karakalpakstan-uzbekistan
#15
James M Trauer, Jay Achar, Nargiza Parpieva, Atadjan Khamraev, Justin T Denholm, Dennis Falzon, Ernesto Jaramillo, Anita Mesic, Philipp du Cros, Emma S McBryde
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a major threat to global TB control. MDR-TB treatment regimens typically have a high pill burden, last 20 months or more and often lead to unsatisfactory outcomes. A 9-11 month regimen with seven antibiotics has shown high success rates among selected MDR-TB patients in different settings and is conditionally recommended by the World Health Organization. METHODS: We construct a transmission-dynamic model of TB to estimate the likely impact of a shorter MDR-TB regimen when applied in a low HIV prevalence region of Uzbekistan (Karakalpakstan) with high rates of drug resistance, good access to diagnostics and a well-established community-based MDR-TB treatment programme providing treatment to around 400 patients...
November 18, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27854165/antimicrobial-resistance-mechanisms-and-genetic-diversity-of-multidrug-resistant-acinetobacter-baumannii-isolated-from-a-teaching-hospital-in-malaysia
#16
Shirin Biglari, Alfizah Hanafiah, Shaliawani Mohd Puzi, Ramliza Ramli, Mostafizur Rahman, Bruno Silvester Lopes
Multidrug-resistant (MDR) Acinetobacter baumannii has increasingly emerged as an important nosocomial pathogen. The aim of this study was to determine the resistance profiles and genetic diversity in A. baumannii clinical isolates in a tertiary medical center in Malaysia. The minimum inhibitory concentrations of carbapenems (imipenem and meropenem), cephalosporins (ceftazidime and cefepime), and ciprofloxacin were determined by E-test. PCR and sequencing were carried out for the detection of antibiotic resistance genes and mutations...
November 17, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/27842757/in-vitro-reduction-of-antibacterial-activity-of-tigecycline-against-multidrug-resistant-acinetobacter-baumannii-with-host-stress-hormone-norepinephrine
#17
Masato Inaba, Naoyuki Matsuda, Hirotsugu Banno, Wanchun Jin, Jun-Ichi Wachino, Keiko Yamada, Kouji Kimura, Yoshichika Arakawa
The host stress hormone norepinephrine (NE), also called noradrenaline, is reported to augment bacterial growth and pathogenicity, but few studies have focused on the effect of NE on the activity of antimicrobials. The aim of this study was to clarify whether NE affects antimicrobial activity against multidrug-resistant Acinetobacter baumannii (MDR-AB). Time-kill studies of tigecycline (TIG) and colistin (COL) against MDR-AB as well as assays for factors contributing to antibiotic resistance were performed using MDR-AB clinical strains both in the presence and absence of 10 µM NE...
November 4, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27842536/antibacterial-and-cytotoxic-cytochalasins-from-the-endophytic-fungus-phomopsis-sp-harbored-in-garcinia-kola-heckel-nut
#18
Jean-Bosco Jouda, Jean-de-Dieu Tamokou, Céline Djama Mbazoa, Clovis Douala-Meli, Prodipta Sarkar, Prasanta Kumar Bag, Jean Wandji
BACKGROUND: The continuous emergence of multidrug-resistant (MDR) bacteria drastically reduced the efficacy of our antibiotic armory and consequently, increased the frequency of therapeutic failure. The search for bioactive constituents from endophytic fungi against MDR bacteria became a necessity for alternative and promising strategies, and for the development of novel therapeutic solutions. We report here the isolation and structure elucidation of antibacterial and cytotoxic compounds from Phomopsis sp...
November 14, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27834203/predatory-bacteria-attenuate-klebsiella-pneumoniae-burden-in-rat-lungs
#19
Kenneth Shatzkes, Eric Singleton, Chi Tang, Michael Zuena, Sean Shukla, Shilpi Gupta, Sonal Dharani, Onoyom Onyile, Joseph Rinaggio, Nancy D Connell, Daniel E Kadouri
: Bdellovibrio bacteriovorus and Micavibrio aeruginosavorus are predatory bacteria that naturally-and obligately-prey on other Gram-negative bacteria, and their use has been proposed as a potential new approach to control microbial infection. The ability of predatory bacteria to prey on Gram-negative human pathogens in vitro is well documented; however, the in vivo safety and efficacy of predatory bacteria have yet to be fully assessed. In this study, we examined whether predatory bacteria can reduce bacterial burden in the lungs in an in vivo mammalian system...
November 8, 2016: MBio
https://www.readbyqxmd.com/read/27826141/rapid-antimicrobial-susceptibility-test-for-identification-of-new-therapeutics-and-drug-combinations-against-multidrug-resistant-bacteria
#20
Wei Sun, Rebecca A Weingarten, Miao Xu, Noel Southall, Sheng Dai, Paul Shinn, Philip E Sanderson, Peter R Williamson, Karen M Frank, Wei Zheng
Current antimicrobial susceptibility testing has limited screening capability for identifying empirical antibiotic combinations to treat severe bacterial infections with multidrug-resistant (MDR) organisms. We developed a new antimicrobial susceptibility assay using automated ultra-high-throughput screen technology in combination with a simple bacterial growth assay. A rapid screening of 5170 approved drugs and other compounds identified 25 compounds with activities against MDR Klebsiella pneumoniae. To further improve the efficacy and reduce the effective drug concentrations, we applied a targeted drug combination approach that integrates drugs' clinical antimicrobial susceptibility breakpoints, achievable plasma concentrations, clinical toxicities and mechanisms of action to identify optimal drug combinations...
November 9, 2016: Emerging Microbes & Infections
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