scholarly journals Antimicrobial Susceptibilities of Geographically Diverse Clinical Human Isolates of Leptospira

2008 ◽  
Vol 52 (8) ◽  
pp. 2750-2754 ◽  
Author(s):  
Roseanne A. Ressner ◽  
Matthew E. Griffith ◽  
Miriam L. Beckius ◽  
Guillermo Pimentel ◽  
R. Scott Miller ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Limit Of Detection ◽  
Medical Center ◽  
Penicillin G ◽  
Geographic Variability ◽  
Broth Microdilution ◽  
Randomized Controlled ◽  
The World ◽  
Susceptibility Patterns

ABSTRACT Although antimicrobial therapy of leptospirosis has been studied in a few randomized controlled clinical studies, those studies were limited to specific regions of the world and few have characterized infecting strains. A broth microdilution technique for the assessment of antibiotic susceptibility has been developed at Brooke Army Medical Center. In the present study, we assessed the susceptibilities of 13 Leptospira isolates (including recent clinical isolates) from Egypt, Thailand, Nicaragua, and Hawaii to 13 antimicrobial agents. Ampicillin, cefepime, azithromycin, and clarithromycin were found to have MICs below the lower limit of detection (0.016 μg/ml). Cefotaxime, ceftriaxone, imipenem-cilastatin, penicillin G, moxifloxacin, ciprofloxacin, and levofloxacin had MIC90s between 0.030 and 0.125 μg/ml. Doxycycline and tetracycline had the highest MIC90s: 2 and 4 μg/ml, respectively. Doxycycline and tetracycline were noted to have slightly higher MICs against isolates from Egypt than against strains from Thailand or Hawaii; otherwise, the susceptibility patterns were similar. There appears to be possible variability in susceptibility to some antimicrobial agents among strains, suggesting that more extensive testing to look for geographic variability should be pursued.

scholarly journals In Vitro Antimicrobial Susceptibility Testing of Bacterial Enteropathogens Causing Traveler's Diarrhea in Four Geographic Regions

2001 ◽  
Vol 45 (1) ◽  
pp. 212-216 ◽  
Author(s):  
Harumi Gomi ◽  
Zhi-Dong Jiang ◽  
Javier A. Adachi ◽  
David Ashley ◽  
Brett Lowe ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Moderate Activity ◽  
Traveler’S Diarrhea ◽  
The World ◽  
Traveler's Diarrhea ◽  
Susceptibility Patterns

ABSTRACT The emergence of resistant enteropathogens has been reported worldwide. Few data are available on the contemporary in vitro activities of commonly used antimicrobial agents against enteropathogens causing traveler's diarrhea (TD). The susceptibility patterns of antimicrobial agents currently available or under evaluation against pathogens causing TD in four different areas of the world were evaluated. Pathogens were identified in stool samples from U.S., Canadian, or European adults (18 years of age or older) with TD during 1997, visiting India, Mexico, Jamaica, or Kenya. MICs of 11different antimicrobials were determined against 284 bacterial enteropathogens by the agar dilution method. Ciprofloxacin, levofloxacin, ceftriaxone, and azithromycin were highly active in vitro against the enteropathogens, while traditional antimicrobials such as ampicillin, trimethoprim, and trimethoprim/sulfamethoxazole showed high levels and high frequencies of resistance. Rifaximin, a promising and poorly absorbable drug, had an MIC at which 90% of the strains tested were inhibited of 32 μg/ml, 250 times lower than the concentration of this drug in the stools. Amdinocillin, nalidixic acid, and doxycycline showed moderate activity. Fluoroquinolones are still the drugs of choice for TD in most regions of the world, although our study has a limitation due to the lack of Escherichia coli samples from Kenya and possible bias in selection of the patients for evaluation. Azithromycin and rifaximin should be considered as promising new agents. The widespread in vitro resistance of the traditional antimicrobial agents reported since the 1980s and the new finding of resistance to fluoroquinolones in Southeast Asia are the main reasons for monitoring carefully the antimicrobial susceptibility patterns worldwide and for developing and evaluating new antimicrobial agents for the treatment of TD.

scholarly journals Emergence of Antibiotic Resistance during Therapy for Infections Caused by Enterobacteriaceae Producing AmpC β-Lactamase: Implications for Antibiotic Use

2007 ◽  
Vol 52 (3) ◽  
pp. 995-1000 ◽  
Author(s):  
Sang-Ho Choi ◽  
Jung Eun Lee ◽  
Su Jin Park ◽  
Seong-Ho Choi ◽  
Sang-Oh Lee ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Medical Center ◽  
Antibiotic Use ◽  
Significance Level ◽  
Risk Of Mortality ◽  
Asan Medical ◽  
Bile Duct Invasion ◽  
Emergence Of Resistance

ABSTRACT Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii are characterized by chromosomally encoded AmpC β-lactamases and possess the ability to develop resistance upon exposure to broad-spectrum cephalosporins. To determine the incidences of the emergence of resistance during antimicrobial therapy for infections caused by these organisms and the effect of the emergence of resistance on patient outcomes, all patients who were admitted to the Asan Medical Center (Seoul, Republic of Korea) from January 2005 to June 2006 and whose clinical specimens yielded Enterobacter spp., S. marcescens, C. freundii, or M. morganii were monitored prospectively. The main end point was the emergence of resistance during antimicrobial therapy. A total of 732 patients with infections were included for analysis. The overall incidence of the emergence of antimicrobial resistance during antimicrobial therapy was 1.9% (14/732). Resistance to broad-spectrum cephalosporins, cefepime, extended-spectrum penicillin, carbapenem, fluoroquinolones, and aminoglycosides emerged during treatment in 5.0% (11/218), 0% (0/20), 2.0% (2/100), 0% (0/226), 0% (0/153), and 1.1% (1/89) of patients, respectively. The emergence of resistance to broad-spectrum cephalosporins occurred more often in Enterobacter spp. (8.3%, 10/121) than in C. freundii (2.6%, 1/39), S. marcescens (0%, 0/37), or M. morganii (0%, 0/21). Biliary tract infection associated with malignant bile duct invasion was significantly associated with the emergence of resistance to broad-spectrum cephalosporins (P = 0.024 at a significance level of 0.042, by use of the Bonferroni correction). Only 1 of the 14 patients whose isolates developed resistance during antimicrobial therapy died. The emergence of resistance was more frequently associated with broad-spectrum cephalosporins than with the other antimicrobial agents tested, especially in Enterobacter spp. However, the emergence of resistance was associated with a low risk of mortality.

scholarly journals The effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe atopic dermatitis (ABC trial): study protocol for a pragmatic randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Aviël Ragamin ◽  
Karin B. Fieten ◽  
Ron A. Tupker ◽  
Jill de Wit ◽  
Minke M. F. van Mierlo ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Cost Effectiveness ◽  
Antimicrobial Agents ◽  
Medical Center ◽  
Safety Data ◽  
Severe Atopic Dermatitis ◽  
Randomized Controlled ◽  
Functional Textiles ◽  
Patient Reported ◽  
Skin Colonization

Abstract Background Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10 to 20% of children and between 2 and 15% of the adults in Western Europe. Since 2000, therapeutic clothing or functional textiles based on silver or chitosan as antibacterial agents were introduced for AD. These agents aim to reduce skin colonization with Staphylococcus (S.) aureus. Increased colonization with S. aureus is correlated with increased AD severity. The antimicrobial effects of silver and chitosan have been demonstrated before. At this point, there is insufficient evidence for the effectiveness of antibacterial therapeutic clothing in patients with AD. Methods This is a pragmatic randomized controlled double-blind multi-center trial comparing the effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe AD. A total of 165 participants, aged 0 to 80, diagnosed with moderate to severe AD are included. The study is performed in the Erasmus MC University Medical Center, University Medical Center Groningen, University Medical Center Utrecht, Amsterdam University Medical Centers, and St. Antonius Hospital Nieuwegein. Patients will be randomized 1:1:1 into one of the three intervention groups: group A will receive therapeutic clothing without antimicrobial agents, group B will receive microbial growth reducing therapeutic clothing based on chitosan, and group C will receive antimicrobial clothing based on silver. All therapeutic clothing is to be worn at night during the 12-month intervention period. Usual care is continued. The primary objective is to assess the effectiveness of antibacterial clothing (silver and chitosan group) as compared to non-antibacterial clothing assessed with the Eczema Area and Severity Index at 12 months compared to baseline. Secondary outcomes include between-group differences in physician- and patient-reported outcome measures, topical therapy use, S. aureus skin colonization, and safety. Data will be collected at baseline and after 1 month, 3 months, 6 months, and 12 months. A cost-effectiveness analysis will be performed. Discussion This trial will provide data on the effectiveness, cost-effectiveness, and safety of antibacterial therapeutic clothing for patients with AD. Trial registration ClinicalTrials.gov NCT04297215. Registered on 5 March 2020

The Effectiveness Of Antibacterial Therapeutic Clothing Based On Silver Or Chitosan As Compared With Non-Antibacterial Therapeutic Clothing In Patients With Moderate To Severe Atopic Dermatitis (ABC Trial): Study Protocol For A Pragmatic Randomized Controlled Trial

2021 ◽  
Author(s):  
Aviël Ragamin ◽  
Karin B. Fieten ◽  
Ron A. Tupker ◽  
Jill de Wit ◽  
Minke M.F. van Mierlo ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Cost Effectiveness ◽  
Antimicrobial Agents ◽  
Medical Center ◽  
Safety Data ◽  
Severe Atopic Dermatitis ◽  
Randomized Controlled ◽  
Functional Textiles ◽  
Patient Reported ◽  
Skin Colonization

Abstract Background:Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 10% to 20% of children and between 2% and 15% of the adults in Western Europe. Since 2000 therapeutic clothing or functional textiles based on silver or chitosan as antibacterial agents were introduced for AD. These agents aim to reduce skin colonization with Staphylococcus (S.) aureus. Increased colonization with S. aureus is correlated with increased AD severity. The antimicrobial effects of silver and chitosan have been demonstrated before. At this point there is insufficient evidence for the effectiveness of antibacterial therapeutic clothing in patients with AD.Methods: This is a pragmatic randomized controlled double-blind multi-center trial comparing the effectiveness of antibacterial therapeutic clothing based on silver or chitosan as compared with non-antibacterial therapeutic clothing in patients with moderate to severe AD. A total of 165 participants, aged 0 to 80, diagnosed with moderate to severe AD are included. The study is performed in the Erasmus MC University Medical Center, University Medical Center Groningen, University Medical Center Utrecht, Amsterdam University Medical Centers and St. Antonius Hospital Nieuwegein. Patients will be randomized 1:1:1 into one of the three intervention groups: Group A will receive therapeutic clothing without antimicrobial agents, group B will receive microbial growth reducing therapeutic clothing based on chitosan, and group C will receive antimicrobial clothing based on silver. All therapeutic clothing is to be worn at night during the 12-month intervention period. Usual care is continued. The primary objective is to assess the effectiveness of antibacterial clothing (silver and chitosan group) as compared to non-antibacterial clothing assessed with the Eczema Area and Severity Index at 12 months compared to baseline. Secondary outcomes include between-group differences in physician and patient-reported outcome measures, topical therapy use, S. aureus skin colonization, and safety. Data will be collected at baseline, after 1 month, 3 months, 6 months an at 12 months. A cost-effectiveness analysis will be performed.Discussion:This trial will provide data on the effectiveness, cost-effectiveness, and safety of antibacterial therapeutic clothing for patients with AD. Trial registration Clinicaltrials.gov, NCT04297215. Registered on 5 March 2020

scholarly journals Determination of Susceptibilities of 26 Leptospira sp. Serovars to 24 Antimicrobial Agents by a Broth Microdilution Technique

2004 ◽  
Vol 48 (10) ◽  
pp. 4002-4005 ◽  
Author(s):  
Clinton K. Murray ◽  
Duane R. Hospenthal
Keyword(s):  
Antimicrobial Agents ◽  
Vitro Activity ◽  
Penicillin G ◽  
In Vitro Activity ◽  
Broth Microdilution

ABSTRACT The MICs of 24 antimicrobials for 26 Leptospira spp. serovars were determined using a broth microdilution technique. The MICs at which 90% of isolates tested were inhibited (MIC90s) of cefepime, imipenem-cilastatin, erythromycin, clarithromycin, and telithromycin were all ≤0.01 μg/ml. The MIC90s of amoxicillin, aztreonam, cefdinir, chloramphenicol, and penicillin G were ≥3.13 μg/ml. Many antimicrobials have excellent in vitro activity against Leptospira.

scholarly journals Antimicrobial Therapy for Bacillus anthracis-Induced Polymicrobial Infection in 60Co γ-Irradiated Mice

2002 ◽  
Vol 46 (11) ◽  
pp. 3463-3471 ◽  
Author(s):  
Thomas B. Elliott ◽  
Itzhak Brook ◽  
Rita A. Harding ◽  
S. Samy Bouhaouala ◽  
Michael O. Shoemaker ◽  
...  
Keyword(s):  
Survival Rate ◽  
Bacillus Anthracis ◽  
Antimicrobial Therapy ◽  
Mixed Infection ◽  
Nuclear Weapons ◽  
Antimicrobial Agents ◽  
Polymicrobial Infection ◽  
Biological Weapons ◽  
Penicillin G ◽  
Γ Irradiation

ABSTRACT Challenge with both nonlethal ionizing radiation and toxigenic Bacillus anthracis spores increases the rate of mortality from a mixed bacterial infection. If biological weapons, such as B. anthracis spores, and nuclear weapons were used together, casualties could be more severe than they would be from the use of either weapon alone. We previously discovered that a polymicrobial infection developed in B6D2F1/J mice after nonlethal (7-Gy) 60Co γ irradiation and intratracheal challenge with B. anthracis Sterne spores 4 days after irradiation. In this present study, we investigated the survival of mice and the response of the polymicrobial infection during the course of antimicrobial therapy with penicillin G procaine, ofloxacin, trovafloxacin, or gatifloxacin. Survival was prolonged, but not ensured, when the mice were treated with either broad-spectrum ofloxacin or narrow-spectrum penicillin G for 7 days beginning 6 or 24 h after challenge. Survival was not prolonged when therapy was delayed more than 24 h after challenge. When these two antimicrobial agents were given for 21 days, the survival rate was increased from 0% for the controls to 38 to 63% after therapy. Therapy with trovafloxacin or gatifloxacin reduced the incidence of mixed infection and improved the rate of survival to 95% (trovafloxacin) or 79% (gatifloxacin), whereas the rate of survival for the controls was 5%. We conclude that the mixed infection induced by B. anthracis in irradiated mice complicates effective therapy with a single antimicrobial agent. To limit mortality following nonlethal irradiation and challenge with B. anthracis spores, antimicrobial therapy needs to be initiated within a few hours after challenge and continued for up to 21 days.

scholarly journals Broth Microdilution Susceptibility Testing for Leptospira spp

2004 ◽  
Vol 48 (5) ◽  
pp. 1548-1552 ◽  
Author(s):  
Clinton K. Murray ◽  
Duane R. Hospenthal
Keyword(s):  
Antimicrobial Agents ◽  
Internal Validity ◽  
Penicillin G ◽  
Broth Microdilution ◽  
Microdilution Method ◽  
Wide Range ◽  
Broth Macrodilution ◽  
Patient Presentation ◽  
Choice Of Therapy

ABSTRACT Leptospirosis in humans has traditionally been treated with penicillin or doxycycline. The choice of therapy offered at the time of initial patient presentation is often empirical, as definitive diagnosis can take weeks. Determining the activity of numerous antimicrobial agents against a wide range of Leptospira serovars may broaden empirical therapeutic options. Various antimicrobials have been shown to be active against a limited number of serovars in in vitro studies, chiefly by the use of broth macrodilution techniques. We developed a broth microdilution technique using the commercially available growth indicator alamarBlue. MICs produced by this technique were compared to MICs and minimal bactericidal concentrations produced by the traditional broth macrodilution technique. The internal validity of our methods was assessed with 11 runs over numerous days with a single isolate of Leptospira interrogans serovar Icterohaemorrhagiae. By either method, the MICs for these internal-validity runs fell within 2 dilutions of each other for more than 90% of antimicrobials. A broader application of these two techniques included 12 serovars (including seven species) of Leptospira and six antimicrobials (penicillin G, doxycycline, chloramphenicol, erythromycin, cefotaxime, and ciprofloxacin). Observed reproducibility fell within 2 dilutions for 99% of the duplicate result sets for the MIC microdilution method, compared to 89% for the MIC macrodilution method. The macrodilution method tended to have a higher MIC at which 90% of the isolates were inhibited (MIC90) than did the microdilution method, but the MIC90s of both methods were within 2 dilutions of each other for all six drugs. The macrodilution and microdilution techniques produced similar results, with microdilution allowing a faster, more streamlined method of producing MIC results.

scholarly journals Hormone Replacement Therapy: Lebanese Women’s Awareness, Perception, and Acceptance

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
A. Anastasia Salame ◽  
Mohammad J. Jaffal ◽  
Fatin Khalifeh ◽  
Dalia Khalife ◽  
Ghina Ghazeeri
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Positive Attitude ◽  
Medical Center ◽  
Hormone Replacement ◽  
Menopausal Symptoms ◽  
World Health ◽  
Knowledge And Attitudes ◽  
The World ◽  
Whi Study

Objectives. Hormone replacement therapy (HRT) had been the gold standard for the treatment of menopausal symptoms until the publication of the World Health Initiative (WHI) study. After the WHI study, the use of HRT changed among the physicians and patients all over the world despite newer more reassuring data. This study aimed to investigate the knowledge and attitudes of women towards HRT and the factors affecting it for better counseling. Study design. A clinic-based cross-sectional study using a survey was offered to women aged 40 years and above coming to the women’s health center at the American University of Beirut Medical Center (AUBMC) from October 1st, 2017, till March 31st, 2018. The questionnaire included questions about demographics and menopausal symptoms in addition to knowledge and attitudes towards menopause and HRT. Main outcome measures. Our main hypothesis was that women would be aware of HRT as a treatment modality; however, the majority would have a negative attitude towards its usage. Results. The response rate was 87.8%. Seventy-three percent of the respondents had already heard about HRT with 57.9% supporting the use of HRT; however, 47.9% did not know when to use it. The significant predictor for having heard about HRT and a positive attitude towards HRT were having HRT prescribed as a part of treatment and employment status, respectively. Conclusions. Lebanese women are aware of HRT as a treatment option; however, a lack of both proper information and positive attitude towards HRT use was noted.

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