Treatment of severe infections caused by penicillin-resistant pneumococci. Role of third generation cephalosporins

Infection ◽  
1994 ◽  
Vol 22 (S3) ◽  
pp. S161-S166 ◽  
Author(s):  
E. Rubinstein ◽  
Bina Rubinovitch
Keyword(s):  
Third Generation ◽  
Severe Infections ◽  
Third Generation Cephalosporins

scholarly journals The role of prophylactic antibiotics in hepatitis B virus-related acute-on-chronic liver failure patients at risk of bacterial infection: a retrospective study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiao-Qin Liu ◽  
Xue-Yun Zhang ◽  
Yue Ying ◽  
Jian-Ming Zheng ◽  
Jian Sun ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Clinical Course ◽  
Prophylactic Antibiotics ◽  
Third Generation ◽  
Chronic Liver Failure ◽  
Free Survival ◽  
B Virus ◽  
Third Generation Cephalosporins

Abstract Background Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention. Methods A total of 140 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann-Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled. Results A total of 97 episodes of BIs occurred in patients during the course of HBV-ACLF. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P = 0.003) and the clinical course (P = 0.003). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those who did not (P = 0.046). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108). Conclusions BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.

Motile Aeromonas as agent of infections of the foot

1995 ◽  
Vol 85 (9) ◽  
pp. 505-508 ◽  
Author(s):  
M Wakabongo
Keyword(s):  
Second Generation ◽  
Antimicrobial Agents ◽  
Third Generation ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Taxonomic Uncertainty ◽  
Post Traumatic ◽  
Third Generation Cephalosporins

Motile Aeromonas infections of the foot are caused mostly by post-traumatic incidence, occurring mostly during summer months. Serious complications such as osteomyelitis and amputation can result if the infections go untreated or are inadequately treated. The role of each species of motile Aeromonas in pathogenesis and response to antimicrobial agents is not well understood because of taxonomic uncertainty. As a group, motile Aeromonas respond well to aminoglycosides, second-generation and third-generation cephalosporins, quinolones, and some beta-lactam antibiotics.

Epidemic Clostridium difficile-Associated Diarrhea: Role of Second- and Third-Generation Cephalosporins

1994 ◽  
Vol 15 (2) ◽  
pp. 88-94 ◽  
Author(s):  
David E. Nelson ◽  
Steven B. Auerbach ◽  
Aldona L. Baltch ◽  
Ethel Desjardin ◽  
Consuelo Beck-Sague ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Third Generation ◽  
Clostridium Difficile Associated Diarrhea ◽  
Third Generation Cephalosporins

scholarly journals The Role of Prophylactic Antibiotics In Hepatitis B Virus-Related Acute-On-Chronic Liver Failure Patients: A Retrospective Study

2020 ◽  
Author(s):  
Xiaoqin Liu ◽  
Xueyun Zhang ◽  
Yue Ying ◽  
Jianming Zheng ◽  
Jian Sun ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Clinical Course ◽  
Prophylactic Antibiotics ◽  
Third Generation ◽  
Chronic Liver Failure ◽  
Free Survival ◽  
B Virus ◽  
Third Generation Cephalosporins

Abstract Background: Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention.Methods: A total of 147 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann‐Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled.Results: A total of 104 episodes of BIs occurred in HBV-ACLF patients either at admission or during hospitalization. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P < 0.001) and the clinical course (P < 0.001). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those patients there were not administered prophylactic antibiotics (P = 0.038). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108).Conclusions: BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.

Epidemic Clostridium difficile-Associated Diarrhea: Role of Second- and Third-Generation Cephalosporins

1994 ◽  
Vol 15 (2) ◽  
pp. 88-94 ◽  
Author(s):  
David E. Nelson ◽  
Steven B. Auerbach ◽  
Aldona L. Baltch ◽  
Ethel Desjardin ◽  
Consuelo Beck-Sague ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Third Generation ◽  
Clostridium Difficile Associated Diarrhea ◽  
Third Generation Cephalosporins

scholarly journals Characterization of a P1-like bacteriophage carrying CTX-M-27 in Salmonella spp. resistant to third generation cephalosporins isolated from pork in China

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Ling Yang ◽  
Wan Li ◽  
Gui-Ze Jiang ◽  
Wen-Hui Zhang ◽  
Huan-Zhong Ding ◽  
...  
Keyword(s):  
Potential Role ◽  
Generation Cephalosporin ◽  
Complete Sequence ◽  
Third Generation ◽  
Salmonella Spp ◽  
Incp Plasmids ◽  
Horizontal Spread ◽  
Third Generation Cephalosporins

Abstract The aim of this study was to elucidate the epidemiology of third generation cephalosporin resistant Samonella isolates from pork of a slaughterhouse in China and the features of transferable elements carrying bla CTX-M genes. One hundred and twenty-six (7.3%) Salmonella isolates were identified; S. Derby and S. Rissen were the most two prevalent serotypes. Among these isolates 20 (15.8%) were resistant to third generation cephalosporins and nine of them carried bla CTX-M-27. S1-PFGE and replicon typing of bla CTX-M-27-carrying plasmids showed that seven were untypeable plasmids of about 104 Kb and two were IncP plasmids of about 300 Kb. Complete sequence analysis of one PBRT-untypeable plasmid showed it was a P1-like bateriophage, named SJ46, which contained a non-phage-associated region with several mobile elements, including Tn1721, ISEcp1B and IS903D. The other six 104 Kb PBRT-untypeable bla CTX-M-27-carrying plasmids also harboured the same phage-insertion region of SJ46 suggesting that they were the same P1-like bacteriophage. PFGE profiles of the parental strains revealed both potential vertical and horizontal spread of this P1-like bla CTX-M-27-containing element. Additionally, the representative gene of the P1 family bacteriophage, repL, was detected in 19.0% (24/126) of the isolates. This study indicated a potential role of P1-family bacteriophage in capture and spread of antimicrobial resistance in pathogens.

scholarly journals Multiple substitutions at position 104 of β-lactamase TEM-1: assessing the role of this residue in substrate specificity

1995 ◽  
Vol 305 (1) ◽  
pp. 33-40 ◽  
Author(s):  
A Petit ◽  
L Maveyraud ◽  
F Lenfant ◽  
J P Samama ◽  
R Labia ◽  
...  
Keyword(s):  
Substrate Specificity ◽  
Active Site ◽  
Kinetic Properties ◽  
Third Generation ◽  
Wild Type Enzyme ◽  
Beta Lactamases ◽  
Class A ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins

Residue 104 is frequently mutated from a glutamic acid to a lysine in the extended-spectrum TEM beta-lactamases responsible for the resistance to third-generation cephalosporins in clinical Gram negative strains. Among class A beta-lactamases, it is the most variable residue within a highly conserved loop which delineates one side of the active site of the enzymes. To investigate the role of this residue in the extended-spectrum phenotype, it has been replaced by serine, threonine, lysine, arginine, tyrosine and proline. All these substitutions yield active enzymes, with no drastic changes in kinetic properties compared with the wild-type enzyme, except with cefaclor, but an overall improved affinity for second- and third-generation cephalosporins. Only mutant E104K exhibits a significant ability to hydrolyse cefotaxime. Molecular modelling shows that the substitutions have generally no impact on the conformation of the 101-111 loop as the side chains of residues at position 104 are all turned towards the solvent. Unexpectedly, the E104P mutant turns out to be the most efficient enzyme. All our results argue in favour of an indirect role for this residue 104 in the substrate specificity of the class A beta-lactamases. This residue contributes to the precise positioning of residues 130-132 which are involved in substrate binding and catalysis. Changing residue 104 could also modify slightly the local electrostatic potential in this part of the active site. The limited kinetic impact of the mutations at this position have to be analysed in the context of the microbiological problem of resistance to third-generation cephalosporins. Although mutation E104K improves the ability of the enzyme to hydrolyse these compounds, it is not sufficient to confer true resistance, and is always found in clinical isolates associated with at least one mutation at another part of the active site. It is the combined effect of the two mutations that synergistically enhances the hydrolytic capability of the enzyme towards third-generation cephalosporins.

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