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ESBL Piperacillin-Tazobactam

R Cantón, E Loza, J Aznar, R Barrón-Adúriz, J Calvo, F J Castillo, E Cercenado, R Cisterna, F González-Romo, J L López-Hontangas, A I Suárez-Barrenechea, F Tubau, B Molloy, D López-Mendoza
OBJECTIVE: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study monitors antimicrobial susceptibility and extended spectrum β-lactamases (ESBLs) in Gram-negative bacilli recovered from intra-abdominal infections (IAI). METHODS: Antimicrobial susceptibility of 5,343 isolates from IAI recovered in 11 centres during the 2011-2015 SMART-Spain program was analysed by standard microdilution (EUCAST criteria) and compared with that from 2002-2010...
March 12, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Juan Rojas De la Vega, Dona Benadof, Abigail Veas, Mirta Acuña
INTRODUCTION: Enterobacteriaceae are a group of gram-negative rods that can cause serious infections in humans. A susceptibility in Klebsiella pneumoniae of 79.4% to piperacillin/tazobactam (PIP/TAZO) is reported in pediatric hospitals in Chile. There is no published data published to date regarding PIP/TAZO susceptibility to other Enterobacteriaceae species in this population. AIM: To measure the in vitro PIP/TAZO susceptibility in Enterobacteriaceae isolates from patients in a pediatric hospital in Chile...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Flavio G Lipari, Abel H Zárate, Juan J García, Ana L Basquíera, Juan P Caeiro
BACKGROUND: Bloodstream infection is a common complication, which can be life-threatening for hematopoietic stem cells transplant recipients. OBJECTIVE: To analyze the characteristics of bloodstream infections in hematopoietic stem cell transplant recipients. MATERIALS AND METHODS: Observational, retrospective study. We reviewed the records of 451 patients (autologous and allogeneic transplants) from January 2009 to October 2015. RESULTS: 99 positive blood cultures in 73 patients with bloodstream infection (16%) were found...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Mathias W Pletz, Sebastian Weis, Christina Forstner, Florian Wagenlehner
Urosepsis is defined as a severe disease due to organ failure caused by a urinary tract infection. An empirical antibiotic therapy should be instigated within the first hour after diagnosis. Urine cultures and blood cultures should be performed before antibiotic treatment. Further diagnostics should be carried out at an early stage to enable an interventional focus control in the case of urinary tract obstruction or abscess formation, if necessary. Gram-negative pathogens are most frequently isolated. Extended spectrum beta-lactamase (ESBL) forming bacteria as a cause of urosepsis are increasing...
February 7, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Chau-Chyun Sheu, Shang-Yi Lin, Ya-Ting Chang, Chun-Yuan Lee, Yen-Hsu Chen, Po-Ren Hsueh
The spread of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a major public health threat worldwide. Area covered: A thorough systematic literature review describing the current evidence and future prospects of therapeutic options for infections caused by ESBL-producing Enterobacteriaceae. Expert commentary: The methods of detecting ESBLs have been evolving. The Clinical and Laboratory Standards Institute and the European Committee on Antimicrobial Susceptibility Testing lowered the MIC breakpoints of cephalosporins against ESBL-producing Enterobacteriaceae in 2010...
March 2018: Expert Review of Anti-infective Therapy
Chika Takano, Mitsuko Seki, Hiroaki Shiihara, Shihoko Komine-Aizawa, Kazumichi Kuroda, Shori Takahashi, Hiroshi Ushijima, Satoshi Hayakawa
Extended-spectrum beta-lactamase (ESBL) producing bacteria spread worldwide and became major concern for antibiotic treatment. Although surveillance reports in general hospitals and long-term care facilities are increasing, their frequencies in individuals with severe motor and intellectual disabilities (SMID) are so far unknown. In this study, we examined the frequency of ESBL in stool samples collected from 146 asymptomatic SMID subjects hospitalized in a single institution. With their clinical information, we evaluated possible risk factors for ESBL colonization...
February 2, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Allison Muller, Xavier Bertrand, Anne-Marie Rogues, Muriel Péfau, Serge Alfandari, Rémy Gauzit, Catherine Dumartin, Houssein Gbaguidi-Haore
Background: The ongoing extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) pandemic has led to an increasing carbapenem use, requiring release of guidelines for carbapenem usage in France in late 2010. We sought to determine factors associated with changes in carbapenem use in intensive care units (ICUs), medical and surgical wards between 2009 and 2013. Methods: This ward-level multicentre retrospective study was based on data from French antibiotic and multidrug-resistant bacteria surveillance networks in healthcare facilities...
2018: Antimicrobial Resistance and Infection Control
Mathias W Pletz, Sebastian Weis, Christina Forstner, Florian Wagenlehner
Urosepsis is defined as a severe disease due to organ failure caused by a urinary tract infection. An empirical antibiotic therapy should be instigated within the first hour after diagnosis. Urine cultures and blood cultures should be performed before antibiotic treatment. Further diagnostics should be carried out at an early stage to enable an interventional focus control in the case of urinary tract obstruction or abscess formation, if necessary. Gram-negative pathogens are most frequently isolated. Extended spectrum beta-lactamase (ESBL) forming bacteria as a cause of urosepsis are increasing...
January 10, 2018: Der Urologe. Ausg. A
Christina Le, Frank Chu, Ronald Dunlay, Julian Villar, Peter Fedullo, Gabriel Wardi
STUDY OBJECTIVE: To determine the frequency and cause of inadequate initial antibiotic therapy with vancomycin and piperacillin-tazobactam in patients with severe sepsis and septic shock in the emergency department (ED), characterize its impact on patient outcomes, and identify patients who would benefit from an alternative initial empiric regimen. METHODS: Retrospective cohort study conducted between 2012 and 2015 in which 342 patients with culture-positive severe sepsis or septic shock who received initial vancomycin and piperacillin-tazobactam were reviewed to determine appropriateness of antimicrobial therapy, risk factors for inappropriate use, and outcome data...
December 29, 2017: American Journal of Emergency Medicine
María Díez-Aguilar, María-Carmen Conejo, María-Isabel Morosini, Núria Tormo Palop, Concepción Gimeno, Rafael Cantón, Álvaro Pascual
A nationwide study was developed to evaluate the ability of 60 Spanish clinical microbiology laboratories to predict the underlying β-lactam resistance mechanisms of 12 Enterobacteriaceae strains (CCS01-CCS12). Results obtained by two reference laboratories were compared with those reported by the participants that used their own routine susceptibility testing methodology. CLSI interpretive criteria were used in 53.3% of the centres, while 46.7% used EUCAST. The overall categorical agreement (CA) was 85.5%...
December 21, 2017: International Journal of Antimicrobial Agents
Daniel B Chastain, Bryan P White, David A Cretella, Christopher M Bland
OBJECTIVE: To present systematic recommendations for carbapenem-sparing therapy against extended-spectrum β-lactamases (ESBLs) Enterobacteriaceae bloodstream infections (BSIs) derived from a critical review of clinical data. DATA SOURCES: A systematic literature search using PubMed and MEDLINE databases (January 1, 2012, to June 30, 2017) was performed using key MESH terms: ESBL or extended-spectrum β-lactamases and bacteremia or bloodstream infection with piperacillin/tazobactam, ciprofloxacin, levofloxacin, cefepime, cephamycins, carbapenem, doripenem, meropenem, and ertapenem...
December 1, 2017: Annals of Pharmacotherapy
Audrey N Schuetz, Sergio Reyes, Pranita D Tamma
INTRODUCTIONBeta-lactam/beta-lactamase inhibitor combination antimicrobials (BLBLIs) are among the most controversial classes of antibiotic agents available for the treatment of infections caused by extended-spectrum-beta-lactamase (ESBL)-producing Gram-negative bacteria (ESBL-GNR). Piperacillin-tazobactam (PTZ) is one of the most frequently utilized antibiotic agents for empirical Gram-negative bacterial coverage and remains active against a large proportion of ESBL-GNR strains. Furthermore, good antimicrobial stewardship practices encourage the use of carbapenem-sparing treatment regimens for infections due to ESBL-GNR...
March 2018: Journal of Clinical Microbiology
George G Zhanel, Courtney K Lawrence, Heather Adam, Frank Schweizer, Sheryl Zelenitsky, Michael Zhanel, Philippe R S Lagacé-Wiens, Andrew Walkty, Andrew Denisuik, Alyssa Golden, Alfred S Gin, Daryl J Hoban, Joseph P Lynch, James A Karlowsky
Relebactam (formerly known as MK-7655) is a non-β-lactam, bicyclic diazabicyclooctane, β-lactamase inhibitor that is structurally related to avibactam, differing by the addition of a piperidine ring to the 2-position carbonyl group. Vaborbactam (formerly known as RPX7009) is a non-β-lactam, cyclic, boronic acid-based, β-lactamase inhibitor. The structure of vaborbactam is unlike any other currently marketed β-lactamase inhibitor. Both inhibitors display activity against Ambler class A [including extended-spectrum β-lactamases (ESBLs), Klebsiella pneumoniae carbapenemases (KPCs)] and class C β-lactamases (AmpC)...
January 2018: Drugs
S Z Chen, K N Lin, M Xiao, X F Luo, Q Li, J H Ren, R Y Huang, M M Chen, Z Z Ally, T Chen, J D Yang, Jianda Hu
Objective: To investigate the distribution and resistance of pathogens isolated from blood cultures in patients with hematological malignancies after chemotherapy in Union Hospital of Fujian Medical University so as to understand the real situation of blood stream infection (BSI) and provide the basis for rational use of antibiotics in clinic. Methods: The data of 657 strains isolated from blood culture specimens of patients with hematological malignancies from January 2013 to December 2016 were collected analyzed...
November 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
Helio S Sader, Michael D Huband, Leonard R Duncan, Robert K Flamm
BACKGROUND: Ceftazidime-avibactam was approved by the US Food and Drug Administration in 2015 to treat complicated intra-abdominal and urinary tract infections in adults, and is under clinical development for treating pediatric patients. METHODS: Among 53,381 gram-negative organisms (1 per patient) collected in 2011-2015, 8,461 (15.9%) were from pediatric (≤17 years-old [yo]) patients. The isolates were collected from 82 US medical centers and susceptibility tested against ceftazidime-avibactam (avibactam at fixed 4 µg/mL) and comparators by reference broth microdilution methods...
December 4, 2017: Pediatric Infectious Disease Journal
E Ruppé, A Cherkaoui, N Wagner, G C La Scala, J-Y Beaulieu, M Girard, J Frey, V Lazarevic, J Schrenzel
We report the selection in a 15-year-old boy of a multidrug-resistant, extended-spectrum β-lactamase (ESBL)-producing Aeromonas salmonicida after medicinal leech therapy that required an antibiotic prophylaxis based on piperacillin/tazobactam and cotrimoxazole. Whole genome sequencing of the strain indeed revealed 13 antibiotic resistance genes, including the ESBL CTX-M-3 and the unusual β-lactamase SCO-1.
January 2018: New Microbes and New Infections
J-H Ko, N R Lee, E-J Joo, S-Y Moon, J-K Choi, D A Park, K R Peck
The efficacy of empirical non-carbapenem antibiotics for extended-spectrum beta-lactamase-producing Enterobacteriaceae bacteremia (ESBL-B) is still inconclusive. We conducted a multicenter retrospective cohort study to evaluate the efficacy of empirical non-carbapenem antibiotics for treating ESBL-B. Electronic medical records of individuals who were diagnosed with ESBL-B were reviewed between January 2010 and December 2014 at four university hospitals in Korea. Patients were classified into non-carbapenem and carbapenem groups according to the empirical antibiotic regimen...
February 2018: European Journal of Clinical Microbiology & Infectious Diseases
Mariasofia Caltagirone, Elisabetta Nucleo, Melissa Spalla, Francesca Zara, Federica Novazzi, Vittoria M Marchetti, Aurora Piazza, Ibrahim Bitar, Marica De Cicco, Stefania Paolucci, Giorgio Pilla, Roberta Migliavacca, Laura Pagani
To evaluate the water compartment antibiotic-resistance contamination rates, 11 wells, five streams, and four treatment plants located in the Oltrepò Pavese area were screened for the presence of third generation cephalosporins resistant Gram-negative bacteria. Enterobacteriaceae were also characterized for the Extended-Spectrum-β-Lactamases (ESBLs), carbapenemases, and mcr-1 genes presence. From December 2014 to November 2015, 246 water samples were filtered, plated on Plate Count Agar, MacConkey Agar, and MacConkey Agar with cefotaxime...
2017: Frontiers in Microbiology
Abhishek Mandal, Abhishek Sengupta, Ajay Kumar, Utpal K Singh, Anil K Jaiswal, Pradeep Das, Sushmita Das
Background: Childhood diarrheal diseases remain highly endemic in India, but the emergence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli among children with diarrhea in Bihar remains elusive. In this study, we determine and characterize ESBL-producing E coli pathotypes among hospitalized diarrheal preschool children living in low socioeconomic level communities in Bihar, India. Materials and methods: The stool samples were collected everyday throughout the year for 2 consecutive years...
2017: Infectious Diseases
Benoit Pilmis, Vincent Jullien, Alexis Tabah, Jean-Ralph Zahar, Christian Brun-Buisson
Several studies suggest that alternatives to carbapenems, and particulary beta-lactam/beta-lactamase inhibitor combinations, can be used for therapy of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE)-related infections in non-ICU patients. Little is known concerning ICU patients in whom achieving the desired plasmatic pharmacokinetic/pharmacodynamic (PK/PD) target may be difficult. Also, in vitro susceptibility to beta-lactamase inhibitors might not translate into clinical efficacy. We reviewed the recent clinical studies examining the use of BL/BLI as alternatives to carbapenems for therapy of bloodstream infection, PK/PD data and discuss potential ecological benefit from avoiding the use of carbapenems...
November 10, 2017: Annals of Intensive Care
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