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F Sörgel, R Höhl, R Glaser, C Stelzer, M Munz, M Vormittag, M Kinzig, J Bulitta, C Landersdorfer, A Junger, M Christ, M Wilhelm, U Holzgrabe
Optimized dosage regimens of antibiotics have remained obscure since their introduction. During the last two decades pharmacokinetic(PK)-pharmacodynamic(PD) relationships, originally established in animal experiments, have been increasingly used in patients. The action of betalactams is believed to be governed by the time the plasma concentration is above the minimum inhibitory concentration (MIC). Aminoglycosides act as planned when the peak concentration is a multiple of the MIC and vancomycin seems to work best when the area under the plasma vs...
October 24, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Alyshah Kaba, Andrea Baumann, Camille Kolotylo, Noori Akhtar-Danesh
Methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and Clostridium difficile have increased in health care facilities worldwide. The complexity of caring for patients with infectious comorbidities has impacted nurses' daily work. A mixed-methods study at 1 community hospital in Ontario, Canada, demonstrated the cumulative effect of additional time spent on infection prevention and control measures resulted in trade-offs, cutting corners, and raised concerns about the quality and continuity of care...
October 21, 2016: American Journal of Infection Control
Raquel Girardello, Marina Visconde, Rodrigo Cayô, Regina Célia Bressan Queiroz de Figueiredo, Marcelo Alves da Silva Mori, Nilton Lincopan, Ana Cristina Gales
Polymyxins have become drugs of last resort for treatment of multi-drug resistant (MDR) Gram-negative infections. However, the mechanisms of resistance to this compound have not been completely elucidated. In this study, we evaluated the mechanisms of resistance to this antimicrobial in two A. baumannii clinical isolates, respectively, susceptible (A027) and resistant (A009) to polymyxin B before and after polymyxin B exposure (A027(ind) and A009(ind)). The pmrAB and lpxACD were sequenced and their transcriptional levels were analyzed by qRT-PCR...
October 8, 2016: Diagnostic Microbiology and Infectious Disease
Jamal Chauhan, Steven Cardinale, Lei Fang, Jing Huang, Steven M Kwasny, M Ross Pennington, Kelly Basi, Robert diTargiani, Benedict R Capacio, Alexander D MacKerell, Timothy J Opperman, Steven Fletcher, Erik P H de Leeuw
Recently we described a novel di-benzene-pyrylium-indolene (BAS00127538) inhibitor of Lipid II. BAS00127538 (1-Methyl-2,4-diphenyl-6-((1E,3E)-3-(1,3,3-trimethylindolin-2-ylidene)prop-1-en-1-yl)pyryl-1-ium) tetrafluoroborate is the first small molecule Lipid II inhibitor and is structurally distinct from natural agents that bind Lipid II, such as vancomycin. Here, we describe the synthesis and biological evaluation of 50 new analogs of BAS00127538 designed to explore the structure-activity relationships of the scaffold...
2016: PloS One
Christen Ravn, Ulrika Furustrand Tafin, Bertrand Bétrisey, Søren Overgaard, Andrej Trampuz
Background and purpose - Antibiotic treatment of patients before specimen collection reduces the ability to detect organisms by culture. We investigated the suppressive effect of antibiotics on the growth of non-adherent, planktonic, and surface-related biofilm bacteria in vitro by using sonication and microcalorimetry methods. Patients and methods - Biofilms of Staphylococcus aureus, S. epidermidis, Escherichia coli, and Propionibacterium acnes were formed on porous glass beads and exposed for 24 h to antibiotic concentrations from 1 to 1,024 times the minimal inhibitory concentration (MIC) of vancomycin, daptomycin, rifampin, flucloxacillin, or ciprofloxacin...
October 24, 2016: Acta Orthopaedica
Yasuhiro Sasaki, Ayumi Kanamaru, Hisae Uchida, Masataka Yano, Hiroshi Tada
An 51-year-old man had undergone surgery for Rathke's cleft cyst by transsphenoidal approach on October 2015. After the surgery, cerebrospinal fluid (CSF) rhinorrhea arose. Surgical treatment of CSF rhinorrhea was performed by the same approach. Ten days after reoperation, he suffered from severe headache, high fever, and nuchal rigidity. CSF findings indicated bacterial meningitis. CSF culture showed methicillin-resistant Staphylococcus lugdunensis. He received vancomycin intravenously for 19 days and recovered from the bacterial meningitis with no serious complication...
October 21, 2016: Rinshō Shinkeigaku, Clinical Neurology
Pearlie P Chong, David van Duin, Ananta Bangdiwala, Anastasia Ivanova, William C Miller, David J Weber, Peter H Gilligan, Thomas C Shea
PURPOSE: Case reports of treatment failure with standard-dose daptomycin (6 mg/kg) have recently surfaced in vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI) episodes with daptomycin MICs of 3 to 4 mg/L. The clinical implications of daptomycin MICs of 3 to 4 mg/L in VRE BSIs have not been elucidated. METHODS: We performed a single institutional retrospective analysis of adult stem cell transplant recipients and patients with hematologic malignancies diagnosed with VRE BSI from 2006 to 2014 and compared outcomes between those with daptomycin MICs of 3 to 4 mg/L those with 2 mg/L, as determined by Etest...
October 19, 2016: Clinical Therapeutics
Christoph Lübbert, Lisa Zimmermann, Julia Borchert, Bernd Hörner, Reinier Mutters, Arne C Rodloff
INTRODUCTION: Clostridium difficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20-30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30-65%. Accurate data for Germany are not yet available. METHODS: Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed...
October 21, 2016: Infectious Diseases and Therapy
Mustafa Nakipoğlu, Fadime Yilmaz, Bulent Icgen
Untreated wastewaters and treated effluents even after final disinfection contain antibiotic resistant bacteria and resistance genes before they are released into surface waters. A correlation between resistant bacteria and antibiotics in surface waters has been found, as have antibiotic resistance genes. Of particular interest are vancomycin-resistant enterococci harboring vanA gene that confers high level of resistance to glycopeptide antibiotics including teicoplanin. Therefore, in this study, river water samples were analysed to investigate vancomycin- and teicoplanin-resistant bacterial isolates harboring vanA gene...
October 21, 2016: Bulletin of Environmental Contamination and Toxicology
Shanshan Wang, Yinjuan Guo, Jingnan Lv, Xiuqin Qi, Dan Li, Zengqiang Chen, Xueqing Zhang, Liangxing Wang, Fangyou Yu
BACKGROUND: Quinupristin/dalfopristin (Q/D) is a valuable alternative antibiotic to vancomycin for the treatment of multi-drug resistant Enterococcus faecium infections. However, resistance to Q/D in E. faecium clinical isolates and nosocomial dissemination of Q/D-resistant E. faecium have been reported in several countries and should be of concern. RESULTS: From January 2012 to December 2015, 911 E. faecium clinical isolates were isolated from various specimens of inpatients at the first Affiliated Hospital of Wenzhou Medical University located in Wenzhou, east China...
October 21, 2016: BMC Microbiology
Pierre Dehoux, Jean Christophe Marvaud, Amr Abouelleil, Ashlee M Earl, Thierry Lambert, Catherine Dauga
BACKGROUND: Clostridium bolteae and Clostridium clostridioforme, previously included in the complex C. clostridioforme in the group Clostridium XIVa, remain difficult to distinguish by phenotypic methods. These bacteria, prevailing in the human intestinal microbiota, are opportunistic pathogens with various drug susceptibility patterns. In order to better characterize the two species and to obtain information on their antibiotic resistance genes, we analyzed the genomes of six strains of C...
October 21, 2016: BMC Genomics
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
Lesley J Scott
Intravenous ceftaroline fosamil (Zinforo™), a prodrug that is rapidly converted to its active metabolite ceftaroline, is approved for use in adults and children (from 2 months of age) with complicated skin and soft tissue infections (cSSTIs) or community-acquired pneumonia (CAP). In several multinational trials, ceftaroline fosamil was an effective and generally well tolerated treatment in adult and paediatric patients with cSSTIs or CAP. In the phase 3 CANVAS trials, ceftaroline fosamil treatment was noninferior to vancomycin plus aztreonam in adults with cSSTIs...
October 20, 2016: Drugs
R Fussen, S Lemmen
Multidrug resistant (MDR) bacteria present an increasing threat for intensive care patients. Whereas colonization of intensive care patients with methicillin-resistant staphylococcus aureus (MRSA) in German ICUs has remained at a constant level in recent years and therapeutic options have improved, colonization and infections with MDR gram-negative bacteria and vancomycin-resistant enterococci are increasing year by year. Only a few or even no therapeutic options remain for the treatment of these bacteria...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Michael G Ficklin, Michael P Kowaleski, Kevin A R Kunkel, Jonathan T Suber
A two-year-old, 44 kg dog with a right Helica cementless total hip replacement (THR) was radiographically diagnosed with implant loosening eight months after the index total hip replacement procedure. Subsequent synoviocentesis and synovial fluid culture revealed a methicillin-resistant coagulase-negative Staphylococcus spp infection of the right THR. A one-stage revision using a hybrid BFX cementless acetabular cup and CFX cemented femoral stem was performed. Vancomycin and micro-silver antimicrobial powder impregnated cement were used in the revision...
October 20, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
I Klimiene, M Virgailis, A Pavilonis, R Siugzdiniene, R Mockeliunas, M Ruzauskas
The objectives of this study were to determine the prevalence and antimicrobial resistance of coagulase-negative staphylococci (CNS) isolated from dairy cows with subclinical mastitis. Antimicrobial resistance in staphylococci were evaluated by breakpoint values specific to the species (EU-CAST). The presence of resistance-encoding genes was detected by multiplex PCR. A total of 191 CNS isolates were obtained. The CNS isolates were typically resistant to penicillin (67.4%), tetracyc-line (18.9%), and erythromycin (13...
September 1, 2016: Polish Journal of Veterinary Sciences
Luisa Z Moreno, Mauricio C Dutra, Marina Moreno, Thais Sp Ferreira, Givago Fr da Silva, Carlos Ec Matajira, Ana Paula S Silva, Andrea M Moreno
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) has been mainly related with pig farming, in Europe and North America, with the ST398 as the most commonly identified type of LA-MRSA. Here we present the draft genome of the first vancomycin-intermediate MRSA ST398/t9538 isolated from a swine presenting exudative epidermitis in Brazil.
October 2016: Memórias do Instituto Oswaldo Cruz
Jyothi Padiadpu, Priyanka Baloni, Kushi Anand, MohamedHusen Munshi, Chandrani Thakur, Abhilash Mohan, Amit Singh, Nagasuma Chandra
The global mechanisms and associated molecular alterations that occur in drug-resistant mycobacteria are poorly understood. To address this, we obtain genomics data and then construct a genome-scale response network in isoniazid-resistant Mycobacterium smegmatis and apply a network-mining algorithm. Through this, we decipher global alterations in an unbiased manner and identify emergent vulnerabilities in resistant bacilli, of which redox response was prominent. Using phenotypic profiling, we find that resistant bacilli exhibit collateral sensitivity to several compounds that block antioxidant responses...
September 9, 2016: ACS Infectious Diseases
Christian Geier, Jessica Davis, Marc Siegel
A previously healthy 66-year-old woman living in the Mid-Atlantic USA presented to the hospital with lethargy, ataxia and slurred speech. 2 weeks prior she had removed a tick from her right groin. She reported malaise, fevers, diarrhoea, cough and a rash. Physical examination revealed a maculopapular rash on her chest, and lung auscultation revealed bi-basilar rales. Laboratory tests were remarkable for hyponatraemia, leucopenia and thrombocytopenia. Chest X-ray demonstrated bilateral pleural effusions with pulmonary oedema...
October 6, 2016: BMJ Case Reports
N P Fewel
WHAT IS KNOWN AND OBJECTIVE: There are many methods for dosing vancomycin. The purpose of this commentary was to compare open-access vancomycin dosing websites with and describe how body weight can affect their pharmacokinetic (PK) calculations. COMMENT: A vancomycin dosing website,, was developed to improve the dosing practice at our health system. Nine other vancomycin dosing calculators were identified, including three open-access websites...
October 18, 2016: Journal of Clinical Pharmacy and Therapeutics
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