scholarly journals Intravenous Fosfomycin: An Assessment of Its Potential for Use in the Treatment of Systemic Infections in Canada

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
George G. Zhanel ◽  
Michael A. Zhanel ◽  
James A. Karlowsky
Keyword(s):  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Second Line ◽  
Pharmacological Interactions ◽  
Term Administration ◽  
Excellent Safety Profile ◽  
Tract Infections ◽  
Systemic Infections

Fosfomycin is a bactericidal agent that inhibits cell wall synthesis using a mechanism of action distinct from β-lactams or other antimicrobial agents. It is a broad-spectrum agent that is frequently active against antimicrobial-resistant bacterial pathogens including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Enterobacteriaceae, and some isolates of MDR Pseudomonas aeruginosa. Intravenous fosfomycin has been prescribed for a wide variety of infections in many countries for >40 years. It is most frequently used in combination with other antimicrobial agents (e.g., β-lactams, carbapenems, and aminoglycosides) and has an excellent safety profile, including in neonates and children, even with long-term administration (weeks). Fosfomycin achieves extensive tissue distribution including difficult to reach compartments such as aqueous humor, vitreous humor, abscess fluid, and CSF. Available data, to date, suggest no clinically relevant pharmacological interactions between fosfomycin and other agents, including drugs, stimulants, or food. Intravenous fosfomycin’s role in therapy in Canada is likely as an agent used alone or in combination for complicated urinary tract infections in hospitalized patients as well as hospitalized patients with MDR infections who have not responded to first-, and potentially, second-line antimicrobials or in patients who cannot tolerate (due to adverse effects) first- and second-line antimicrobials.

Isolation and Identification of Multidrug-Resistant Isolates of Uropathogenic Klebsiella spp in Dogs

2021 ◽  
Vol 3 (1) ◽  
pp. 6-12
Author(s):  
M Mustapha ◽  
P Goel
Keyword(s):  
Antimicrobial Agents ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Urine Samples ◽  
Penicillin G ◽  
Isolation And Identification ◽  
Sensitivity Testing ◽  
Bacterial Organism ◽  
Tract Infections ◽  
Klebsiella Spp

The most widespread ailments in dogs are urinary tract infections (UTIs) caused by bacterial species. It is necessary to recognize the prevailing bacterial pathogens and their susceptibility to antimicrobial agents to effectively treat UTIs. The present study aimed to classify the bacterial organism that causes UTIs in dogs and their patterns of antimicrobial resistance. A total of 141 urine samples were collected from diseased dogs in Veterinary Clinical Complex LUVAS in Hisar, India. Culture, biochemical and sensitivity testing were performed for each of the urine samples based on standard method. Of the total 141 urine samples from dogs, 21 (14.9%) isolates were identified as Klebsiella spp. The isolates were found to be highly resistant to ampicillin (100%), penicillin G (100%), oxytetracycline (100%), enrofloxacin (85.7%), chloramphenicol (80.6%), ceftriaxone (76.2%) and cloxacillin (71.4%), while susceptibility was observed against gentamicin (100%), amikacin (100%) and neomycin (90.5%). In the current study, 19 out of 21 identified isolates were found to be multidrug-resistant. This study indicates that dogs in the study area are found to harbor highly resistant Klebsiella spp. Therefore, when deciding on the antibiotic regimen for UTIs cases, Vets should consider resistance profile of chosen antibacterial agents before usage in order to discourage dissemination of resistant organisms in the study area.

scholarly journals 1474. Epidemiology and Outcomes of Hospitalized Patients with Urinary Tract Infections (UTI) Due to Multidrug-Resistant Organisms (MDRO)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S537-S538
Author(s):  
Frances J Lahrman ◽  
Margaret A Olsen ◽  
Dustin Stwalley ◽  
Jason P Burnham ◽  
Jennie H Kwon
Keyword(s):  
Risk Factors ◽  
Foley Catheter ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Urinary System ◽  
Positive Urine Culture ◽  
Icu Stay ◽  
System Disease ◽  
Jewish Hospital ◽  
Tract Infections

Abstract Background MDROs are a threat to public health, and UTIs are the most common type of MDRO infection. The objective of this study was to describe risk factors and outcomes associated with MDRO UTIs. Methods A retrospective cohort study with IRB approval from Barnes-Jewish Hospital, January 1, 2006–November 8, 2017. Demographics, comorbidities, procedures, outcomes, and culture data were collected from the BJC Healthcare Informatics database for hospitalized patients with MDRO UTIs. MDROs were defined according to European and US CDC standards. Results A total of 7,945 hospitalized patients with MDRO UTI were identified. Demographics and comorbidities are described in Table 1. Notably, 69% of patients were female, 23% had underlying urinary system disease, and at least 20% had a foley catheter in place. Of these patients, 18% required an intensive care unit (ICU) stay within 48 hours before/after the positive urine culture, and 7% died during their hospitalization (Table 2). The most frequent cause of UTIs was MDR Enterobacteriaceae (Table 3). Conclusion Patients who are hospitalized with MDRO UTIs frequently have underlying urinary system disease and/or foley catheter. MDRO UTIs are a significant cause of morbidity and mortality in hospitalized patients, with 18% requiring an ICU stay, and death in 7% during the hospitalization. Further research is needed regarding risk factors and interventions to prevent, detect, and treat MDRO UTIs. Disclosures All authors: No reported disclosures.

scholarly journals High Prevalence of Oxacillin-Resistant Staphylococcus aureus Isolates from Hospitalized Patients in Asia-Pacific and South Africa: Results from SENTRY Antimicrobial Surveillance Program, 1998-1999

2002 ◽  
Vol 46 (3) ◽  
pp. 879-881 ◽  
Author(s):  
Jan M. Bell ◽  
John D. Turnidge
Keyword(s):  
South Africa ◽  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Asia Pacific ◽  
Surveillance Program ◽  
Antimicrobial Surveillance ◽  
Resistance Patterns ◽  
Tract Infections

ABSTRACT As part of the SENTRY antimicrobial surveillance program, we examined the prevalence rates, types, and antibiograms of oxacillin-resistant Staphylococcus aureus from hospitalized patients from 17 institutions in eight countries in Asia-Pacific and South Africa (APAC). From April 1998 to December 1999, a total of 1,711 isolates of S. aureus (814 from blood, 392 from the respiratory tract, 467 from skin and skin structures, and 38 from urine) were collected from hospitalized patients within the APAC region. Multidrug-resistant oxacillin-resistant S. aureus (MORSA) isolates, defined as strains with three or more resistances to drug classes other than β-lactams, were the most common type of oxacillin-resistant S. aureus (ORSA). They were the most frequently identified pathogen in wound infections and were common in bloodstream and lower respiratory tract infections. In all contributing institutions combined, more than 45% (range, 4 to 74%) of S. aureus isolates were oxacillin resistant, and in six institutions, this rate exceeded 60%. MORSA accounted for 91.2% of all oxacillin-resistant isolates. Distinct resistance patterns predominated at various sites within the APAC region, suggesting the local evolution of resistant clones. Non-multidrug-resistant strains were frequent in one part of Australia. No vancomycin-intermediate strains were detected, and no strains were resistant to linezolid or quinupristin-dalfopristin. MORSA strains are a very common cause of infection in hospitalized patients in the APAC region.

scholarly journals A Study of Isolation and Identification of Multidrug Resistant Pseudomonas aeruginosa from Wound Specimen

2020 ◽  
pp. 26-31
Author(s):  
Maria Muddassir ◽  
Sadaf Munir ◽  
Almas Raza ◽  
Adeel Iqbal ◽  
Muddassir Ahmed ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Antimicrobial Agents ◽  
Morphological Characteristics ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Clinical Samples ◽  
Isolation And Identification ◽  
Antimicrobial Drugs ◽  
Antibiotic Resistant

Background: Pseudomonas aeruginosa is a clinically important pathogenic microbe in hospitalized patients. It is a major cause of mortality and morbidity having a number of mechanisms that make it antibiotic resistant. Considering the dearth of antimicrobial drugs to treat infection with this pathogen, it has become a necessity to open up new arena for treatment with this organism. Recently, there has been an up rise in the number of multidrug resistant pathogenic strains of Pseudomonas aeruginosa. Objective: Isolation and identification of multidrug resistant Pseudomonas aeruginosa from wound specimens and to evaluate the antibiotic resistant strains of this microbe. Methodology: One hundred and fifty clinical samples of wound were taken from hospitalized patients at Jinnah hospital Lahore during the period of October 2019 to April 2020. In total, twenty (20) isolates of Pseudomonas aeruginosa were identified using the cultural features, morphological characteristics and various biochemical tests plus the Vitek 2 system. Blue/green, brown /blue and yellow/green pigment production showed the presence and growth of Pseudomonas aeruginosa. Results: Percentage of Pseudomonas aeruginosa in females came out to be 15% as compared to 11.42% in males. This was followed by testing susceptibility of isolates of Pseudomonas aeruginosa to various antimicrobial drugs. Piperacillin/tazobactam and meropenem showed the highest efficacy against Pseudomonas aeruginosa. Highest resistance was exhibited against trimethoprim/sulfamethoxazole which was 75%. Conclusion: Most isolates showed multidrug resistance to four or more drugs. Development of multidrug resistance has emerged as a global problem with pathogens commonly causing infections becoming increasingly resistant to antimicrobial agents.

scholarly journals Characterization of auto-agglutinating and non-typeable uropathogenic Escherichia coli strains

2019 ◽  
Vol 13 (06) ◽  
pp. 465-472
Author(s):  
Ulises Hernández-Chiñas ◽  
Alejandro Pérez-Ramos ◽  
Laura Belmont-Monroy ◽  
María E Chávez-Berrocal ◽  
Edgar González-Villalobos ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Genes ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Uropathogenic Escherichia Coli ◽  
E Coli ◽  
Resistant Strains ◽  
Tract Infections ◽  
Disk Method

Introduction: Uropathogenic Escherichia coli (UPEC) are the main etiological agent of urinary tract infections (UTIs). Association between different serotypes and UTIs is known, however, some strains are incapable to be serotyped. The aim of this work was to study bthe phenotypical and genotypical characteristics of 113 non-typeable (NT) and auto-agglutinating (AA) E. coli strains, isolated from UTIs in children and adults. Methodology: The 113 UPEC strains were analyzed by PCR assays using specific primers to determine their serogroups, fimH, papC, iutA, sat, hlyCA and cnf1, virulence associated genes, and chuA, yjaA and TSPE4.C2 for phylogroup determination. Additionally, the diffusion disk method was performed to evaluate the antimicrobial resistance to 18 antimicrobial agents. Results: Using the PCR assay, 63% (71) of the strains were genotyped showing O25 and O75 as the most common serogroups. The virulence genes fimH (86%) and iutA (74%) were the most prevalent, in relation to the phylogroups the commensal (A and B1) and virulent (B2 and D) showed similar frequencies (P > 0.05). The antimicrobial susceptibility test showed a high percentage (73%) of multidrug-resistant strains. Conclusions: The genotyping allowed identifying the serogroup in many of the strains that could not be typed by traditional serology. The strains carried virulence genes and were multidrug-resistant in both, commensal and virulent phylogroups. Our findings revealed that, in addition to the classical UPEC serogroups, there are pathogenic serogroups not reported yet.

scholarly journals Antimicrobial Susceptibility and Characterization of Resistance Mechanisms of Corynebacterium urealyticum Clinical Isolates

Antibiotics ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 404
Author(s):  
Itziar Chapartegui-González ◽  
Marta Fernández-Martínez ◽  
Ana Rodríguez-Fernández ◽  
Danilo J. P. Rocha ◽  
Eric R. G. R. Aguiar ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Point Mutations ◽  
Tetracycline Resistance ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Resistance Rate ◽  
Clinical Isolates ◽  
Tract Infections ◽  
Corynebacterium Urealyticum

Corynebacterium urealyticum is a non-diphtherial urease-producing clinically relevant corynebacterial, most frequently involved in urinary tract infections. Most of the C. urealyticum clinical isolates are frequently resistant to several antibiotics. We investigated the susceptibility of 40 C. urealyticum isolated in our institution during the period 2005–2017 to eight compounds representative of the main clinically relevant classes of antimicrobial agents. Antimicrobial susceptibility was determined by the Epsilometer test. Resistance genes were searched by PCR. All strains were susceptible to vancomycin whereas linezolid and rifampicin also showed good activity (MICs90 = 1 and 0.4 mg/L, respectively). Almost all isolates (39/40, 97.5%) were multidrug resistant. The highest resistance rate was observed for ampicillin (100%), followed by erythromycin (95%) and levofloxacin (95%). Ampicillin resistance was associated with the presence of the blaA gene, encoding a class A β-lactamase. The two rifampicin-resistant strains showed point mutations driving amino acid replacements in conserved residues of RNA polymerase subunit β (RpoB). Tetracycline resistance was due to an efflux-mediated mechanism. Thirty-nine PFGE patterns were identified among the 40 C. urealyticum, indicating that they were not clonally related, but producing sporadic infections. These findings raise the need of maintaining surveillance strategies among this multidrug resistant pathogen.

scholarly journals 1534. Polymyxin Antimicrobial Susceptibility (AST) Testing and Breakpoints for P. aeruginosa, A. baumannii, and Enterobacteriaceae: Recommendations from the United States Committee on Antimicrobial Susceptibility Testing (USCAST)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S559-S559
Author(s):  
Jason M Pogue ◽  
Ronald N Jones ◽  
John S Bradley ◽  
David Andes ◽  
Sujata M Bhavnani ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Package Insert ◽  
Polymyxin B ◽  
The United States ◽  
Multidrug Resistant ◽  
Outcome Data ◽  
Published Data ◽  
Tract Infections

Abstract Background Polymyxins are important antimicrobial agents for the treatment of infections due to carbapenem-resistant and other multidrug-resistant organisms. Recently, the CLSI and EUCAST have set breakpoints for colistin (EUCAST and CLSI) and polymyxin B (CLSI) with slight differences in recommendations. However, there are issues unique to the polymyxin class that warrant additional guidances. Herein, we assess data related to breakpoint setting and make additional recommendations for polymyxin AST interpretive criteria. Methods Data sources included longitudinal (2011–2017) US surveillance reference broth microdilution (BMD) MIC distributions (128,573 isolates) for colistin and polymyxin B (PB), published data on accuracy of various AST methodologies, in vivo pharmacokinetic/pharmacodynamic (PK-PD) models, prior polymyxin guidelines and agency package insert dosing recommendations, and population PK-PD and toxicodynamic (TD) data. Epidemiological cut-off, PK-PD (and TD), and clinical data were all considered for susceptible (S) breakpoint determinations. Results Data demonstrate that the most commonly utilized AST methodologies (disk diffusion, Etest, and automated MIC susceptibility panels), as well as agar dilution testing cannot reliably detect resistance; and BMD is the preferred AST. Importantly, colistin S is a reliable surrogate for PB S with cross-S accuracy at > 99% of isolates in each pathogen group. Breakpoint recommendations can be found in the Table with emphasis on applying combination therapy. Key recommendations include an S breakpoint of ≤2 mg/L for each pathogen (both colistin and PB). However, based on a lack of preclinical efficacy in murine pneumonia models, PK/PD concerns, and poor clinical outcome data, we strongly suggest that no breakpoints are applied for pneumonia and that alternative therapies should be used where available. Additionally, due to a lack of significant renal excretion, PB will also have no S breakpoint recommendation for lower urinary tract infections. Conclusion The polymyxins have compromising characteristics that make them suboptimal antimicrobials when used alone, and additional caveats are required for AST breakpoint interpretive criteria and stewardship programs. Disclosures All authors: No reported disclosures.

scholarly journals Biochemical and Molecular Analysis ofStaphylococcus aureusClinical Isolates from Hospitalized Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Amit Karmakar ◽  
Parimal Dua ◽  
Chandradipa Ghosh
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Biochemical Tests ◽  
Species Specific ◽  
High Level ◽  
Gelatin Hydrolysis

Staphylococcus aureusis opportunistic human as well as animal pathogen that causes a variety of diseases. A total of 100Staphylococcus aureusisolates were obtained from clinical samples derived from hospitalized patients. The presumptiveStaphylococcus aureusclinical isolates were identified phenotypically by different biochemical tests. Molecular identification was done by PCR using species specific 16S rRNA primer pairs and finally 100 isolates were found to be positive asStaphylococcus aureus. Screened isolates were further analyzed by several microbiological diagnostics tests including gelatin hydrolysis, protease, and lipase tests. It was found that 78%, 81%, and 51% isolates were positive for gelatin hydrolysis, protease, and lipase activities, respectively. Antibiogram analysis of isolatedStaphylococcus aureusstrains with respect to different antimicrobial agents revealed resistance pattern ranging from 57 to 96%. Our study also shows 70% strains to be MRSA, 54.3% as VRSA, and 54.3% as both MRSA and VRSA. All the identified isolates were subjected to detection ofmecA,nuc, andhlbgenes and 70%, 84%, and 40% were found to harbourmecA,nuc, andhlbgenes, respectively. The current investigation is highly important and informative for the high level multidrug resistantStaphylococcus aureusinfections inclusive also of methicillin and vancomycin.

scholarly journals Long-Term Administration of Second-Line Chemotherapy with S-1 and Gemcitabine for Platinum-Resistant Non-small Cell Lung Cancer: A Phase II Study

2011 ◽  
Vol 6 (1) ◽  
pp. 156-160 ◽  
Author(s):  
Yuichi Takiguchi ◽  
Takashi Seto ◽  
Yukito Ichinose ◽  
Naoyuki Nogami ◽  
Tetsu Shinkai ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
Term Administration ◽  
Line Chemotherapy
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