scholarly journals Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China

2019 ◽  
Vol 12 (5) ◽  
pp. 630-633 ◽  
Author(s):  
Ding-Yun Feng ◽  
Yu-Qi Zhou ◽  
Xiao-Ling Zou ◽  
Mi Zhou ◽  
Wen-Bin Wu ◽  
...  
Keyword(s):  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Factors Influencing ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

scholarly journals Resistance of gram negative bacteria in hospital acquired pneumonia: a prospective study

2016 ◽  
Vol 20 (1) ◽  
pp. 113-114 ◽  
Author(s):  
Farzaneh Dehghan ◽  
Nader Zolghadri ◽  
Vahid Boostani ◽  
Afsaneh Shafii ◽  
Tasnim Eghbal Eftekhaari
Keyword(s):  
Prospective Study ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
A Prospective Study ◽  
Hospital Acquired

scholarly journals Inhalation with intravenous loading dose of colistin in critically ill patients with pneumonia caused by carbapenem-resistant gram-negative bacteria

2019 ◽  
Vol 13 ◽  
pp. 175346661988552 ◽  
Author(s):  
Junsu Choe ◽  
You Min Sohn ◽  
Suk Hyeon Jeong ◽  
Hyo Jung Park ◽  
Soo Jin Na ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Loading Dose ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Optimal Dosing ◽  
Microbiological Outcome ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Background: Despite the increasing use of colistin in clinical practice, the optimal dosing, and administration route have not been established. This study aimed to evaluate the clinical outcome and safety of intravenous (IV) colistin with a loading dose (LD) and adjunctive aerosolized (AS) colistin administration in critically ill patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria (CRGNB). Methods: We retrospectively reviewed 191 critically ill patients who received colistin for the treatment of HAP or VAP caused by CRGNB. Patients were divided into three groups: non-LD IV (patients received only IV colistin without LD), LD IV (patients received only IV colistin with LD), and AS–LD (patients received IV colistin with LD and adjunctive AS colistin). Results: There was no difference in clinical response between the three groups. However, the rate of microbiological eradication was significantly higher in the AS–LD group (60%) than in the non-LD IV (31%), and LD IV (33%) groups ( p = 0.010). Patients treated with adjunctive AS colistin in combination with LD IV had significantly lower 30-day mortality rates than patients treated with IV colistin alone ( p = 0.027). After adjusting for potential confounding factors, adjunctive AS colistin was still significantly associated with lower mortality (adjusted OR 0.338, CI 95% 0.132–0.864, p = 0.024). However, nephrotoxicity did not change according to the use of LD regimen and AS colistin administration ( p = 0.100). Conclusions: Adjunctive AS colistin in combination with IV colistin with LD was related to an improved 30-day mortality and microbiological outcome without an increase in nephrotoxicity in critically ill patients with HAP and VAP caused by CRGNB. The reviews of this paper are available via the supplemental material section.

scholarly journals Ceftazidimeavibactam use in children and adolescents

2021 ◽  
Vol 23 (2) ◽  
pp. 173-183
Author(s):  
Оlga U. Stetsiouk ◽  
Irina V. Andreeva ◽  
А.U. Lekmanov ◽  
Еlena V. Haykina
Keyword(s):  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Pediatric Practice ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
Tract Infections ◽  
Hospital Acquired ◽  
Limited Choice ◽  
Intraabdominal Infections

Abstract The increasing number of infections caused by multidrug-resistant gram-negative bacteria in children is a serious problem all over the world. Ceftazidim-avibactam is a promising antimicrobial drug recently approved in Russia for use in pediatric practice. This review provides information on the possible use of ceftazidime-avibactam in children with complicated intraabdominal infections (in combination with metronidazole); complicated urinary tract infections, including pyelonephritis; hospital-acquired pneumonia, including ventilator-associated pneumonia; infections caused by aerobic gram-negative microorganisms in patients with limited choice of antibacterial therapy. Based on the data on the in vitro activity of the drug, the results of clinical studies of pharmacokinetics, safety and efficacy of ceftazidimeavibactam for the treatment of infections in children the main clinical cases in which the use of ceftazidimeavibactam in pediatric practice is most justified and appropriate are identified.

scholarly journals POLYMIXIN IN ONCOLOGY CLINICAL PRACTICE

2018 ◽  
Vol 17 (3) ◽  
pp. 88-93 ◽  
Author(s):  
N. V. Dmitrieva ◽  
I. N. Petukhova ◽  
Z. V. Grigorievskaya ◽  
N. S. Bagirova ◽  
I. V. Тereshchenko ◽  
...  
Keyword(s):  
Polymyxin B ◽  
Multidrug Resistant ◽  
Infectious Complications ◽  
Cochrane Library ◽  
Clinical Response Rate ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

The purpose of the study was to present data on polymixin-based antibiotics with activity against infections caused by multidrug- resistant Gram-negative bacteria, such as Acinetobacter baumannii,  Klebsiella pneumoniae, and Pseudomonas aeruginosa.Material and methods. The review includes data from clinical as well as in vitro studies for the period 1998–2017. The search for  relevant sources was carried out in the Medline, Cochrane Library, Elibrary and other databases.Results. The analysis of the data showed the presence of synergism and additive activity of polymyxin in combination with  carbapenems, rifampicin and azithromycin. However, experimental  data showed no direct positive correlation between combination of  polymyxim and azithromycin/ rifampicin. In clinical studies, in  hospital-acquired pneumonia, including ventilator-associated  pneumonia, the clinical response rate of polymyxin B combined with  other antibiotics ranged from 38 % to 88 %. High nephro-and  neurotoxicity of polymyxin observed in previous studies can be  explained by a lack of understanding of its toxicodynamics or the use of an incorrect dose.Conclusion. Polymyxin B in combination with other antibiotics is a promising treatment against infectious complications caused by multidrug resistant Gram-negative bacteria.

scholarly journals In Vitro Activity of Doripenem, a Carbapenem for the Treatment of Challenging Infections Caused by Gram-Negative Bacteria, against Recent Clinical Isolates from the United States

2008 ◽  
Vol 52 (12) ◽  
pp. 4388-4399 ◽  
Author(s):  
Chris M. Pillar ◽  
Mohana K. Torres ◽  
Nina P. Brown ◽  
Dineshchandra Shah ◽  
Daniel F. Sahm
Keyword(s):  
The United States ◽  
Clinical Isolates ◽  
Gram Negative Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Coagulase Negative Staphylococci ◽  
Hospital Acquired Pneumonia ◽  
Abdominal Infections ◽  
Hospital Acquired ◽  
Gram Positive Cocci

ABSTRACT Doripenem, a 1β-methylcarbapenem, is a broad-spectrum antibiotic approved for the treatment of complicated urinary tract and complicated intra-abdominal infections. An indication for hospital-acquired pneumonia including ventilator-associated pneumonia is pending. The current study examined the activity of doripenem against recent clinical isolates for the purposes of its ongoing clinical development and future longitudinal analysis. Doripenem and comparators were tested against 12,581 U.S. clinical isolates collected between 2005 and 2006 including isolates of Staphylococcus aureus, coagulase-negative staphylococci, Streptococcus pneumoniae, Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. MICs (μg/ml) were established by broth microdilution. By MIC90, doripenem was comparable to imipenem and meropenem in activity against S. aureus (methicillin susceptible, 0.06; resistant, 8) and S. pneumoniae (penicillin susceptible, ≤0.015; resistant, 1). Against ceftazidime-susceptible Enterobacteriaceae, the MIC90 of doripenem (0.12) was comparable to that of meropenem (0.12) and superior to that of imipenem (2), though susceptibility of isolates exceeded 99% for all evaluated carbapenems. The activity of doripenem was not notably altered against ceftazidime-nonsusceptible or extended-spectrum β-lactamase screen-positive Enterobacteriaceae. Doripenem was the most potent carbapenem tested against P. aeruginosa (MIC90/% susceptibility [%S]: ceftazidime susceptible = 2/92%S, nonsusceptible = 16/61%S; imipenem susceptible = 1/98.5%S, nonsusceptible = 8/56%S). Against imipenem-susceptible Acinetobacter spp., doripenem (MIC90 = 2, 89.1%S) was twice as active by MIC90 as were imipenem and meropenem. Overall, doripenem potency was comparable to those of meropenem and imipenem against gram-positive cocci and doripenem was equal or superior in activity to meropenem and imipenem against Enterobacteriaceae, including β-lactam-nonsusceptible isolates. Doripenem was the most active carbapenem tested against P. aeruginosa regardless of β-lactam resistance.

How fluoroquinolone preauthorization affects third- and fourth-generation cephalosporin use and resistance in a large academic hospital

2021 ◽  
pp. 1-12
Author(s):  
Adeniyi J. Idigo ◽  
Matthew L. Brown ◽  
Howard W. Wiener ◽  
Russell L. Griffin ◽  
Yuanfan Ye ◽  
...  
Keyword(s):  
Regression Models ◽  
Interrupted Time Series ◽  
Generation Cephalosporin ◽  
Fourth Generation ◽  
Gram Negative Bacteria ◽  
Academic Hospital ◽  
Gram Negative ◽  
Hospital Acquired Infections ◽  
Quasi Experimental ◽  
Hospital Acquired

Abstract Objective: We observed an overall increase in the use of third- and fourth-generation cephalosporins after fluoroquinolone preauthorization was implemented. We examined the change in specific third- and fourth-generation cephalosporin use, and we sought to determine whether there was a consequent change in non-susceptibility of select Gram-negative bacterial isolates to these antibiotics. Design: Retrospective quasi-experimental study. Setting: Academic hospital. Intervention: Fluoroquinolone preauthorization was implemented in the hospital in October 2005. We used interrupted time series (ITS) Poisson regression models to examine trends in monthly rates of ceftriaxone, ceftazidime, and cefepime use and trends in yearly rates of nonsusceptible isolates (NSIs) of select Gram-negative bacteria before (1998–2004) and after (2006–2016) fluoroquinolone preauthorization was implemented. Results: Rates of use of ceftriaxone and cefepime increased after fluoroquinolone preauthorization was implemented (ceftriaxone RR, 1.002; 95% CI, 1.002–1.003; P < .0001; cefepime RR, 1.003; 95% CI, 1.001–1.004; P = .0006), but ceftazidime use continued to decline (RR, 0.991, 95% CI, 0.990–0.992; P < .0001). Rates of ceftazidime and cefepime NSIs of Pseudomonas aeruginosa (ceftazidime RR, 0.937; 95% CI, 0.910–0.965, P < .0001; cefepime RR, 0.937; 95% CI, 0.912–0.963; P < .0001) declined after fluoroquinolone preauthorization was implemented. Rates of ceftazidime and cefepime NSIs of Enterobacter cloacae (ceftazidime RR, 1.116; 95% CI, 1.078–1.154; P < .0001; cefepime RR, 1.198; 95% CI, 1.112–1.291; P < .0001) and cefepime NSI of Acinetobacter baumannii (RR, 1.169; 95% CI, 1.081–1.263; P < .0001) were increasing before fluoroquinolone preauthorization was implemented but became stable thereafter: E. cloacae (ceftazidime RR, 0.987; 95% CI, 0.948–1.028; P = .531; cefepime RR, 0.990; 95% CI, 0.962–1.018; P = .461) and A. baumannii (cefepime RR, 0.972; 95% CI, 0.939–1.006; P = .100). Conclusions: Fluoroquinolone preauthorization may increase use of unrestricted third- and fourth-generation cephalosporins; however, we did not observe increased antimicrobial resistance to these agents, especially among clinically important Gram-negative bacteria known for hospital-acquired infections.

Ultra-fast and universal detection of Gram-negative bacteria in complex samples based on colistin derivatives

2020 ◽  
Vol 8 (8) ◽  
pp. 2111-2119 ◽  
Author(s):  
Jea Sung Ryu ◽  
San Hae Im ◽  
Yoo Kyung Kang ◽  
Yang Soo Kim ◽  
Hyun Jung Chung
Keyword(s):  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Complex Samples ◽  
Hospital Acquired Infections ◽  
Universal Detection ◽  
Hospital Acquired ◽  
Fluorescent Derivative

A rapid and universal assay for detection of Gram-negative bacteria was developed using a fluorescent derivative of colistin. Labeling is achieved within 10 min in various bacteria relevant to hospital-acquired infections in complex samples.

Microbiology of Ventilator–Associated Pneumonia Compared With That of Hospital-Acquired Pneumonia

2007 ◽  
Vol 28 (7) ◽  
pp. 825-831 ◽  
Author(s):  
David J. Weber ◽  
William A. Rutala ◽  
Emily E. Sickbert-Bennett ◽  
Gregory P. Samsa ◽  
Vickie Brown ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Empirical Therapy ◽  
Ventilator Associated Pneumonia ◽  
Gram Positive ◽  
Similar Frequency ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Gram Positive Cocci ◽  
Ventilated Patients

Objective.Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumonia in non-ventilated patients (HAP). This evaluation assessed whether the currently recommended empirical therapy is appropriate for both ventilator-associated pneumonia (VAP) and HAP by evaluating the infecting flora.Design.Prospectively collected hospitalwide surveillance data was obtained by infection control professionals using standard Centers for Disease Control and Prevention definitions.Setting.A tertiary care academic hospital.Patients.All patients admitted from 2000 through 2003.Results.A total of 588 episodes of pneumonia were reported in 556 patients: 327 episodes of VAP in 309 patients, and 261 episodes of HAP in 247 Patients. The infecting flora in ventilated patients included gram-positive cocci (32.0% [oxacillin-susceptible Staphylococcus aureus {OSSA}, 9.25%; oxacillin-resistant Staphylococcus aureus {ORSA}, 17.75%]), gram-negative bacilli (59.0% {Pseudomonas aeruginosa, 17.50%; Stenotrophomonas maltophilia, 6.75%; Acinetobacter species, 7.75%), and miscellaneous pathogens (9.0%). The infecting flora in nonventilated patients included gram-positive cocci (42.59% [OSSA, 13.33%; ORSA, 20.37%]), gram-negative bacilli (39.63% [P. aeruginosa, 9.26%; S. maltophilia, 1.11%; Acinetobacter species, 3.33%), and miscellaneous pathogens (17.78%).Conclusions.Our data demonstrated that patients with HAP, compared with those with VAP, had a similar frequency of infection with ORSA but less commonly had infections due to P. aeruginosa, Acinetobacter species, and S. maltophilia. However, the overall frequency of infection with these pathogens was sufficiently high to warrant the use of empirical therapy likely to be active against them. Our data supports using the currently recommended empirical therapy for both HAP and VAP.

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