scholarly journals Antimicrobial Susceptibility, Minimum Inhibitory Concentrations, and Clinical Profiles of Stenotrophomonas maltophilia Endophthalmitis

2021 ◽  
Vol 9 (9) ◽  
pp. 1840
Author(s):  
Ming-Chih Ho ◽  
Ching-Hsi Hsiao ◽  
Ming-Hui Sun ◽  
Yih-Shiou Hwang ◽  
Chi-Chun Lai ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Vision Loss ◽  
First Line ◽  
Tertiary Referral Center ◽  
Preseptal Cellulitis ◽  
Minimum Inhibitory Concentrations ◽  
Ocular Infections ◽  
Common Etiology ◽  
Clinical Profiles ◽  
Third Generation Cephalosporins

Stenotrophomonas maltophilia has been reported in various ocular infections, including keratitis, conjunctivitis, preseptal cellulitis, and endophthalmitis, all of which may lead to vision loss. However, the S. maltophilia strain is resistant to a wide variety of antibiotics, including penicillins, third-generation cephalosporins, aminoglycosides, and imipenem. In this study, we retrospectively reviewed the clinical characteristics, antibiotic susceptibility, antimicrobial minimum inhibitory concentrations (MICs), and visual outcomes for S. maltophilia endophthalmitis. The data of 9 patients with positive S. maltophilia cultures in a tertiary referral center from 2010 to 2019 were reviewed. Cataract surgery (n  =  8, 89%) was the most common etiology, followed by intravitreal injection (n  =  1, 11%). S. maltophilia’s susceptibility to levofloxacin and moxifloxacin was observed in 6 cases (67%). Seven isolates were resistant to sulfamethoxazole-trimethoprim (78%). The MIC90 for S. maltophilia was 256, 256, 256, 8, 12, 12, 12, and 8 μg/mL for amikacin, cefuroxime, ceftazidime, tigecycline, sulfamethoxazole-trimethoprim, levofloxacin, galtifloxacin, and moxifloxacin, respectively. Final visual acuity was 20/200 or better in 5 patients (56%). Fluoroquinolones and tigecycline exhibited low antibiotic MIC90. Therefore, the results suggest that fluoroquinolones can be used as first-line antibiotics for S. maltophilia endophthalmitis.

Synthesis and antimicrobial activity of 4-trifluoromethylpyridine nucleosides

2017 ◽  
Vol 23 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Shaikha S. Alneyadi ◽  
Anas A. Abdulqader ◽  
Alaa A. Salem ◽  
Ibrahim M. Abdou
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Antimicrobial Activity ◽  
Stenotrophomonas Maltophilia ◽  
Antibacterial Agents ◽  
Antibacterial Activities ◽  
Nucleoside Analogues ◽  
Reference Drug ◽  
Minimum Inhibitory Concentrations

Abstract4-Trifluoromethylpyridine derivatives 4–8 represent good candidates for the discovery of new antibacterial agents. Fluorinated pyridine nucleosides 4–7 and non-nucleoside analogues 8a,b were synthesized and evaluated for their antibacterial activities against Staphylococcus aureus, Bacillus infantis, Escherichia coli and Stenotrophomonas maltophilia. The minimum inhibitory concentrations (MICs) of the new nucleosides 4–7 range from 1.3 to 4.9 μg/mL and MICs of fluoroaryl derivatives 8a,b are in the range of 1.8–5.5 μg/mL. Activity of amoxicillin, the reference drug, is 1.0–2.0 μg/mL under similar conditions.

scholarly journals Clinical profile and management of vitreous hemorrhage in tertiary eye care centre in Nepal

2020 ◽  
Vol 12 (1) ◽  
pp. 99-105
Author(s):  
Laxmi Devi Manandhar ◽  
Raba Thapa ◽  
Govinda Poudyal
Keyword(s):  
Emergency Department ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vision Loss ◽  
Vitreous Hemorrhage ◽  
Sudden Onset ◽  
Age Group ◽  
Care Centre ◽  
Vein Occlusion ◽  
Common Etiology

Introduction: Vitreous hemorrhage is one of the most common diseases presenting to emergency department and leading cause of painless vision loss. Objectives: To determine the profile of vitreous hemorrhage in patients presented to Outpatient Department (OPD) and emergency Department of Tilganga Institute of Ophthalmology (TIO). Materials and methods: This is a hospital based observational non interventional descriptive study. Total 198 patients were enrolled who visited OPD and Emergency department of TIO from August 1st 2012 to July 30th 2013. Result: Total 198 patients (201 eyes) were enrolled for the study, out of which 144 were male and 54 females. 195 were unilateral and 3 bilateral cases. Most common age group of presentation of vitreous hemorrhage was 51-60 years (24.75%). Most common presenting complaint was sudden onset of decreased vision (95%). Most common etiology of vitreous hemorrhage was branch retinal vein occlusion (22.38%). Among the total subjects, 57.7% of the patient were managed with medical therapy, 35.8% surgically and 6.47 % with combined medical and surgical treatment. Conclusion: Branch retinal vein occlusion (BRVO) is the most common cause of vitreous hemorrhage. Diabetes and hypertension are the most commonly associated systemic illnesses.

scholarly journals Subacute Bacterial Endocarditis Caused byCardiobacterium hominis: A Case Report

2015 ◽  
Vol 26 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Davie Wong ◽  
Julie Carson ◽  
Andrew Johnson
Keyword(s):  
Susceptibility Testing ◽  
Medical Literature ◽  
Generation Cephalosporin ◽  
Bacterial Endocarditis ◽  
Clinical Microbiology Laboratory ◽  
Third Generation ◽  
First Line ◽  
Subacute Bacterial Endocarditis ◽  
First Line Therapy ◽  
Third Generation Cephalosporins

Cardiobacterium hominis, a member of the HACEK group of organisms, is an uncommon but important cause of subacute bacterial endocarditis. First-line therapy is a third-generation cephalosporin due to rare beta-lactamase production. The authors report a case involving endovascular infection due toC hoministhat initially tested resistant to third-generation cephalosporins using an antibiotic gradient strip susceptibility method (nitrocephin negative), but later proved to be susceptible using broth microdilution reference methods (a ‘major’ error). There are limited studies to guide susceptibility testing and interpretive breakpoints forC hominisin the medical literature, and the present case illustrates some of the issues that may arise when performing susceptibility testing for fastidious organisms in the clinical microbiology laboratory.

scholarly journals Genomics of Staphylococcus aureus ocular isolates

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250975
Author(s):  
William L. Johnson ◽  
Michael B. Sohn ◽  
Samantha Taffner ◽  
Payel Chatterjee ◽  
Paul M. Dunman ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Virulence Factors ◽  
Vision Loss ◽  
Genomic Analysis ◽  
Valuable Insight ◽  
Ocular Tissues ◽  
Ocular Infections ◽  
Specific Strain ◽  
Sequence Types ◽  
High Throughput Manner

Staphylococcus aureus is a major cause of ocular infections, often resulting in devastating vision loss. Despite the significant morbidity associated with these infections, little is yet known regarding the specific strain types that may have a predilection for ocular tissues nor the set of virulence factors that drive its pathogenicity in this specific biological niche. Whole genome sequencing (WGS) can provide valuable insight in this regard by providing a prospective, comprehensive assessment of the strain types and virulence factors driving disease among specific subsets of clinical isolates. As such, a set of 163-member S. aureus ocular clinical strains were sequenced and assessed for both common strain types (multilocus sequence type (MLST), spa, agr) associated with ocular infections as well as the presence/absence of 235 known virulence factors in a high throughput manner. This ocular strain set was then directly compared to a fully sequenced 116-member non-ocular S. aureus strain set curated from NCBI in order to identify key differences between ocular and non-ocular S. aureus isolates. The most common sequence types found among ocular S. aureus isolates were ST5, ST8 and ST30, generally reflecting circulating non-ocular pathogenic S. aureus strains. However, importantly, ocular isolates were found to be significantly enriched for a set of enterotoxins, suggesting a potential role for this class of virulence factors in promoting ocular disease. Further genomic analysis revealed that these enterotoxins are located on mobile pathogenicity islands, thus horizontal gene transfer may promote the acquisition of enterotoxins, potentially amplifying S. aureus virulence in ocular tissues.

scholarly journals Clinical profiles and trends in CD4+ counts to first-line antiretroviral therapy among HIV/AIDS patients in western part of Odisha state of India

2018 ◽  
Vol 6 (5) ◽  
pp. 1559
Author(s):  
Pradhan B. ◽  
Majhi C. ◽  
Murmu B.
Keyword(s):  
Body Weight ◽  
Antiretroviral Therapy ◽  
Adverse Drug Reactions ◽  
Cd4 Count ◽  
Drug Reactions ◽  
First Line ◽  
Cd4 Counts ◽  
Clinical Stages ◽  
Clinical Profiles ◽  
Hiv Aids

Background: HIV infection is globally pandemic and about 36.7 million people living with HIV/ AIDS (PLHA) in 2016. At present CD4+ count is the gold standard of immunological marker of disease severity. Highly active antiretroviral therapy (HAART) is the first line of treatment to improve CD4 count. AIMS AND OBJECTIVES of study was to observe the clinical profiles and response in CD4+ counts to first-line HAART in PLHA and their adverse reactions.Methods: Total 153 PLHA with CD4+ counts <250/µl was consecutively taken in the study and detail clinical examinations, baseline CD4+ counts and body weights were noted. HAART was started in 26 (16.99%), 37 (24.18%), 78 (50.98%) and 12 (7.84%) cases in WHO clinical stages of I, II, III, and V respectively and CD4+ counts, body weight and any adverse drug reactions were noted at 15 days, 3, 6, 18 and 24 months intervals and data were collected and analyzed.Results: Out of 153 cases 89 were male and 64 were female. Mean age was 35.4±9.08 years for male and 30.2±5.75 years for female. Mean baseline CD4+ count was 202±75/µl and mean body weight was 47.44kg. Mean CD4+ count was increased to 314.22±166.53, 343±194.02, 378±221.30 and 299.6±146.55/µl at 6, 12, 18 and 24 months respectively. Commonest adverse drug reaction was headache and GIT side effects.Conclusions: HAART improves clinical and immunological parameter CD4+ count in PLHA, irrespective of their clinical stages. Headache and GIT manifestations are commonest adverse drug reactions.

scholarly journals Piperacillin-tazobactam should be preferred to third-generation cephalosporins to treat wild-type inducible AmpC-producing Enterobacteriaceae in critically ill patients with hospital or ventilator-acquired pneumonia. A propensity score-matched analysis

2019 ◽  
Author(s):  
Cédric Carrié ◽  
Guillaume Bardonneau ◽  
Laurent Petit ◽  
Alexandre Ouattara ◽  
Didier Gruson ◽  
...  
Keyword(s):  
Propensity Score ◽  
Antibiotic Therapy ◽  
Pulmonary Infection ◽  
Therapeutic Failure ◽  
Third Generation ◽  
Pulmonary Infections ◽  
Wild Type ◽  
First Line ◽  
Emergence Of Resistance ◽  
Third Generation Cephalosporins

Abstract BACKGROUND The aim of this study was to compare the rate of therapeutic failure and emergence of resistance in critically ill patients treated by third-generation cephalosporins (3GCs) or piperacillin-tazobactam (PTZ) for wild-type AmpC-producing Enterobacteriaceae pulmonary infections. METHODS In a multicenter retrospective cohort study over a 4-year period, all patients treated for a pulmonary infection related to wild-type AmpC-producing Enterobacteriaceae who received documented antibiotic therapy with 3GCs or PTZ after less than 48 hours of empirical antibiotic therapy were eligible. The main outcome was the rate of therapeutic failure, defined by an impaired clinical response under treatment and/or a relapse of pulmonary infection related to the same pathogen. The secondary outcome was a secondary acquisition of derepressed cephalosporinase-producing Enterobacteriaceae. RESULTS Over the study period, 244 patients were included; 56 (23%) experienced therapeutic failure and 19 (8%) experienced secondary acquisition of resistance. In the non-adjusted cohort, the rate of therapeutic failure and emergence of resistance were significantly higher in the 3GCs group (32 vs. 18%, p = 0.011 and 13 vs. 5%, p = 0.035, respectively). In the propensity score-matched population, the 3GCs group was associated with higher rates of therapeutic failure (HR = 1.61 [1.27 – 2.07]). The secondary de-escalation to 3GCs after 48h of PTZ as a first-line antibiotic therapy was not associated with increased rate of emergence of resistance. CONCLUSION Our study confirms that third-generation cephalosporins should be avoided as first-line antibiotic therapy in wild-type AmpC-producing Enterobacteriaceae pulmonary infections.

scholarly journals Teprotumumab Treatment for Thyroid-Associated Ophthalmopathy

2020 ◽  
Vol 9 (Suppl. 1) ◽  
pp. 31-39
Author(s):  
Terry J. Smith
Keyword(s):  
Paradigm Shift ◽  
Vision Loss ◽  
Standard Of Care ◽  
Autoimmune Process ◽  
First Line ◽  
Thyroid Associated Ophthalmopathy ◽  
The Us ◽  
Fundamental Research ◽  
Line Standard

<b><i>Background:</i></b> Thyroid-associated ophthalmopathy (TAO), an autoimmune process affecting the tissues surrounding the eye, most commonly develops in individuals with Graves’ disease. It is disfiguring, can cause vision loss, and dramatically lessens the quality of life in patients. There has been an absence of approved medical therapies for TAO with proven effectiveness and safety in multicenter, placebo-controlled, and adequately powered clinical trials. <b><i>Summary:</i></b> The following is a brief overview of the rationale for developing a monoclonal antibody inhibitor of the insulin-like growth factor-I receptor into a treatment for TAO. This area of fundamental research has yielded an effective and safe medication, namely teprotumumab, based on two multicenter, placebo-controlled trials. Teprotumumab, marketed as Tepezza, has been approved recently by the US Food and Drug Administration for the treatment of TAO. Given its remarkable effectiveness, Tepezza is poised to become the first-line standard of care for TAO. <b><i>Key Messages:</i></b> Introduction of Tepezza into our armamentarium of therapeutic strategies for TAO represents a paradigm shift in the management of the disease. I proffer that the drug will replace glucocorticoids as a first-line treatment for TAO.

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