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OBJECTIVE To analyze the clinical manifestations and characteristics of adverse drug reactions （ADR） caused by cefotaxime sodium in Shandong province， and to explore the effects of skin test before medication of cefotaxime sodium on serious ADR， so as to provide reference for safe drug use in clinic. METHODS The relevant data of cefotaxime sodium-induced ADR reported by Shandong Province ADR Monitoring Center during December 2019 to December 2021 were collected from National ADR Monitoring System. The ADR classification， age， gender， ADR occurrence time， route of administration， history of allergy， primary diseases， ADR systems/organs involved， clinical manifestations， outcome， skin test or not before medication were statistically analyzed. RESULTS A total of 1 057 ADR reports caused by cefotaxime sodium were included. Among them， there were 867 patients （82.02%） with general ADR and 190 patients （17.98%） with serious ADR. The majority were ＜11 years old （40.30%）. The main route of administration was intravenous drip （96.69%）. A total of 1 033 patients （97.73%） developed ADR 30 min to 24 h after medication. A total of 814 patients （77.01%） had no history of allergy. The primary diseases were respiratory system infection （56.58%）. Main systems/organs involved in ADR were skin and its appendants， digestive system and respiratory system， and its clinical manifestations were rash， pruritus， nausea， vomiting， chest tightness， etc. After withdrawal or symptomatic treatment， 1 050 patients （99.34%） were cured or improved. Before the use of cefotaxime sodium， 850 patients underwent skin test （151 patients occurred serious ADR）； there was no statistical significance in the incidence of serious renzhen202102@163.com ADR， compared with the incidence of serious ADR in 207 patients without skin test （39 patients occurred serious ADR）（P＝0.718）. CONCLUSIONS ADR caused by cefotaxime sodium is mainly seen in patients ＜11 years old， mostly occurring 30 min to 24 h after intravenous drip； skin test before medication of cefotaxime sodium cannot reduce the risk of serious ADR. Before using cefotaxime sodium in clinical practice， patients should be asked about their allergy and medication history in detail. During use， it is important to focus on the patient’s condition within 24 h after medication to prevent serious ADR and ensure the safety of clinical medication.
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Background: Antimicrobials are routinely prescribed in several disease conditions in which infections are established or suspected to be the reason for the illness. Excessive and irrational use of antimicrobials leads to development of drug resistance in microorganisms, besides increasing health-care expenditure. Antimicrobial resistance (AMR) leads to increase in morbidity and mortality. The rational use of antimicrobials is a major health need in all countries. Hence, assessment of prescribing pattern of antimicrobials is essential for clinical, educational, and economic purposes. Aims and Objectives: The objectives of the study were to evaluate and compare the prescribing pattern of antimicrobials by assessing – (i) commonly used antimicrobials; and (ii) disease conditions for which they were prescribed. Materials and Methods: It was a prospective observational study done for a period of 1 month. All the prescriptions in which antimicrobials were prescribed in the outpatient departments (OPD) and in-patient wards (IP) were included in the study. Prescriptions were analyzed for demographic and antibiotic data. Results: 1092 prescriptions were collected and analyzed. Among them, 690 prescriptions were from OPD and 382 prescriptions from in patient wards. Out patient data: Cefixime (21.30%) was commonly prescribed followed by fixed dose combination of Amoxicillin + Clavulanic acid (14.64%) and Ciprofloxacin (8.84%). Cefixime was commonly prescribed for URTI (13.43%). Oral route (82.17%) was the preferred route of administration. IP data: Cefotaxime (26.45%) was commonly prescribed followed by fixed dose combination of Piperacillin + Tazobactum (15.29%) and Ceftriaxone (14.46%). Cefotaxime was commonly prescribed preoperatively for most of the surgeries (76.56%). Intravenous route (46.86%) was the preferred route of administration. Single antimicrobial therapy (81.41%) was preferred followed by double (17.80%) and triple (0.79%) antimicrobial therapy. Conclusion: Cefixime and cefotaxime were commonly used in OPD and in patient wards, respectively. Oral route and intravenous route were the preferred route in OPD and IP wards, respectively. Single antimicrobial therapy was commonly preferred in both IP and out-patient wards. Although double and triple antimicrobial therapy was prescribed in small number of patients, it should be cautiously used to prevent AMR.
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The joint application of traditional Chinese medicine injection containing chlorogenic acid (CA) and cefotaxime sodium (CS) is sometimes appeared in clinical practice, but the scientific basis of drug molecular compatibility is still weak. This study proposes a sequential analysis strategy based on isothermal titration calorimetry (ITC), cold-spray ionization mass spectrometry (CSI-MS) and antibacterial activity test to evaluate the molecular interactions between CA and CS. The results of ITC experiments showed that the Gibbs free energy ΔG < 0 and it was driven by enthalpy change when CA titrated CS, suggesting CA could spontaneously chemically react with CS. Subsequently, the parent ions (m/z 808.143 5) of binding molecular of CA and CS was detected by CSI-MS, indicating CA could chemically bond with CS. Furtherly, the antibacterial experiments found the antibacterial ability of CS against Klebsiella pneumonia was significantly reduced (P < 0.01) by CA in mixed solution. Finally, molecular docking technology showed CA and CS have a common target of penicillin binding protein 3 (PBP3), suggesting that the phenomenon of CA reduced the antibacterial ability of CS may be related to the competitive binding of two components with PBP3. Our studies have shown that CA could spontaneously chemically bond to CS and reduced its antibacterial ability, providing scientific data for molecular interaction evaluation of CA and CS.
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The aim of the study was to investigate the antimicrobial susceptibility pattern of Klebsiellaspecies from different clinical samples at Sree Balaji Medical College and Hospital, India. Overall 189 samples out of 980 non repetitive clinical samples obtained from wound/pus, urine, sputum swab and blood by disc diffusion method and identified as Klebsiellaand analysed. Out of total 189 Klebsiellaisolates, 76 out of 155 K. pneumoniae(49%)were resistant and none out of 34 Klebsiella oxytoca(0%) showed resistance to cefotaxime and ceftazidime by disc diffusion method. Antimicrobial susceptibility testing of Klebsiellaexhibited 100% resistance to Ampicillin. The present study highlights the need for the continued monitoring of antimicrobial susceptibility patterns of important bacterial pathogens, so that rational antibiotic policies can be formulated
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The present study evaluates the synergistic association between Cefotaxime and aqueous garlic (Allium sativum)extract (AGE) on extended spectrum beta-lactamase (ESBL) and Ambler Class C (AmpC) co-producing Escherichiacoli strains from skin and soft tissue infections (SSTIs). Ceftazidime-resistant E. coli strains were screened for betalactamase production by phenotypic confirmatory disc diffusion test (PCDDT) and E-test. Antibacterial activity ofAGE was examined by the disc diffusion method and the minimum inhibitory concentration (MIC) of Cefotaximeand AGE was determined. The synergistic association between Cefotaxime and AGE was evaluated by calculatingthe fractional inhibitory concentration (FIC) index, time-kill kinetics assay (TKA), and scanning electron microscopy(SEM). The zone of inhibition by AGE against the 27 E. coli co-producers of ESBL and AmpC ranged from 17 to 30mm. The average MIC of Cefotaxime and AGE was found to be 570 μg/ml and 0.86% (4.28 mg/ml), respectively. TheFIC index obtained by the checkerboard method established a synergistic association between Cefotaxime and AGEin 10 (37%) test strains, which was confirmed by TKA. The SEM analysis revealed complete cell degradation at 8hours on the treatment with Cefotaxime-AGE combination. It can be stated that the AGE may aid Cefotaxime in thetreatment of beta-lactamase producing E. coli strains from SSTIs.
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The present study evaluates the synergistic association between Cefotaxime and aqueous garlic (Allium sativum)extract (AGE) on extended spectrum beta-lactamase (ESBL) and Ambler Class C (AmpC) co-producing Escherichiacoli strains from skin and soft tissue infections (SSTIs). Ceftazidime-resistant E. coli strains were screened for betalactamase production by phenotypic confirmatory disc diffusion test (PCDDT) and E-test. Antibacterial activity ofAGE was examined by the disc diffusion method and the minimum inhibitory concentration (MIC) of Cefotaximeand AGE was determined. The synergistic association between Cefotaxime and AGE was evaluated by calculatingthe fractional inhibitory concentration (FIC) index, time-kill kinetics assay (TKA), and scanning electron microscopy(SEM). The zone of inhibition by AGE against the 27 E. coli co-producers of ESBL and AmpC ranged from 17 to 30mm. The average MIC of Cefotaxime and AGE was found to be 570 μg/ml and 0.86% (4.28 mg/ml), respectively. TheFIC index obtained by the checkerboard method established a synergistic association between Cefotaxime and AGEin 10 (37%) test strains, which was confirmed by TKA. The SEM analysis revealed complete cell degradation at 8hours on the treatment with Cefotaxime-AGE combination. It can be stated that the AGE may aid Cefotaxime in thetreatment of beta-lactamase producing E. coli strains from SSTIs
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Background: Complicated UTIs (cUTIs) are leading causes of the gram negative bacteraemia. The objective of this study was to compare efficacy and safety Cefotaxime/ Sulbactam (CTS) and Piperacillin/ Tazobactam (PT) combinations in complicated Urinary Tract Infections.Methods: Total 80 patients admitted in the hospital due to cUTI were enrolled. 31 patients were given CTS while 49 patients were given PT. Clinical symptoms were registered and scored as mild (1) moderate (2) or severe (3). The follow-up of were done daily till the patient is discharged. Thereafter, one follow up visit was done within 4 to 9 days of after discharge, termed as test of cure (TOC), and, one late follow up visit after 6 to 8 weeks was done, known as late follow up visit (LFU). Clinical assessments and microbiological analysis were done at the time of TOC and LFU.Results: At TOC visit, in CTS and PT groups, clinical scores were 1.25�47 and 0.86�35, respectively (p<0.005). Rate of clinical improvement at TOC visit was 92.00% and 92.68% while microbiological clearance was 84.00% and 87.80% with CTS and PT groups respectively. At LFU visit, clinical scores CTS and PT in groups were 1.30�56 and 1.32�37, respectively, suggesting significant improvement from baseline (p<0.005). Clinical cure rate at LFU visit was 88.00% and 87.80% while microbiological cure rate at LFU visit was 76.00% and 82.91% in CTS and PT groups respectively.Conclusions: Results suggest that both regimens have no significant difference for the treatment of cUTI. CTS and PT both are equally efficacious in treatment of cUTI.
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Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients.
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OBJECTIVE: To establish a high performance size exclusion chromatography(HPSEC) method for the separation and analysis of polymers in cefotaxime sodium and cefotaxime sodium for injection, and determine the structures of the impurities by LCMS. METHODS: HPSEC was performed by using Sepax SRT SEC-150(7.8 mm × 300 mm, 5 μm) column. The mobile phase was 0.1 mol•L-1 disodium hydrogen phosphate and 0.1 mol•L-1 phosphate buffer solution. The flow rate was 0.8 mL•min-1, the detection wavelength was set at 235 nm, the injection volume was 10 μL, and the column temperature was maintained at 35 ℃. The concentration of polymers was quantified by external standard method. The LC-MS/MSn system conditions were as following: the mobile phase was 20 mmol•L-1 amonium acetate, the flow rate was 0.8 mL•min-1, ESI source with positive and negative ion scan was utilized, the scanning range was m/z 200 - 1 600, and the post-column diversion ratio was 1:4. RESULTS: Eight impurity peaks were obtained in total; the resolutions were all greater than 1. 5. The linear range of cefotaxime was 1 - 100 μg•mL-1 (r = 1.000 0). The RSD repeatability was 1.2%(n = 6). The limit of detection was 0.2 μg and the limit of quantitation was 0.4 μg. Three polymers were identified by LC-MS. CONCLUSION: The HPSEC method can be used for the quantitative and qualitative analyses of individual polymer impurities. It is also sensitive for the control of polymers in cefotaxime.
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The aim of this work is to evaluate simple, sensitive, effective and validated procedures for the determination of cefotaxime, cefoperazone, ceftazidime and cefadroxil. In this study, the methods based on the ability of the cited drugs to reduce Ag+ ions to silver nanoparticles (Ag-NPs) in the presence of Polyvinyl Pyrrolidone (PVP) as a stabilizing agent producing very intense surface plasmon resonance peak of Ag-NPs (λmax. = 410-430 nm). The plasmon absorbance of the Ag-NPs allows the quantitative spectrophotometric determination of the cited drugs. The calibration curves are linear with concentration ranges of 0.4-3.2, 1-8, 0.5-4.0 and 1.5-9.0 µg/mL for cefotaxime, cefoperazone, ceftazidime and cefadroxil, respectively. Apparent molar absorptivity, detection and quantitative limits are calculated. Applications of the proposed methods to representative pharmaceutical formulations are successfully presented. The extracellular synthesis of nanoparticles is fast, and the method doesn't require various elaborate treatments and tedious extraction procedures.
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Cefadroxil/analysis , Cefoperazone/analysis , Cefotaxime/analysis , Ceftazidime/analysis , Metal Nanoparticles/statistics & numerical data , Surface Plasmon Resonance/methods , Validation StudyABSTRACT
Objective To investigate the clinical effect of Guilongkechuanning combined with cefotaxime in the treatment of elderly patients with acute exacerbation of chronic bronchitis .Methods 68 patients with acute exacerbation of chronic bronchitis were selected from April 2016 to March 2017 in the Third People's Hospital of Xiangshan County,and they were randomly divided into control group and observation groupaccording to the digital table,with 34 cases in each group .The two groups were given symptomatic treatment , the control group received cefotaxime treatment, while the observation group was given cefotaxime combined with Guilongkechuanning .The clinical effect , symptoms improve time , hospitalization time and lung function were observed in the two groups .Results The total effective rate of the observation group was 94.12％,which was significantly higher than 76.47％of the control group (χ2 =4.22,P<0.05).The recovery time of sputum,cough,wheezing and,hospitalization time in the observation group were (3.09 ±0.76)d,(4.28 ±0.83)d,(4.30 ±0.92)d,(7.02 ±0.66)d,respectively,which were significantly shorter than those in the control group [(5.93 ±0.60) d,(8.34 ±0.56) d,(9.19 ±1.05) d, (10.54 ±1.03)d](t=17.10,23.64,20.42,16.78,all P<0.05).After treatment,the forced vital capacity,forced expiratory volume in one second and forced vital capacity ratio in the observation group were (3937.48 ±18.99)mL, (64.28 ±3.45)％,respectively,which were better than those in the control group [(3038.42 ±20.31) mL, (57.88 ±2.89)％](t=188.54,8.29,all P<0.05).Conclusion Guilongkechuanning combined with cefotaxime in the treatment of elderly patients with acute exacerbation of chronic bronchitis has definite effect , which can effectively control the disease .
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Objective To investigate the clinical efficacy of piperacillin/tazobactam in the treatment of community acquired pneumonia (CAP).Methods 100 cases of CAP in Songyang People's Hospital from March 2016 to March 2017 were collected and randomly divided into two groups according to the digital table , with 50 cases in each group .The piperacillin/tazobactam group was treated with piperacillin/tazobactam , and the cefotaxime sodium group was given cefotaxime sodium .The clinical indicators ,symptoms and imaging effects ,blood indicators ,blood gas analysis and inflammatory indicators were compared between the two groups .Results The clinical symptoms disap-peared time,hospitalization time and hospitalization expenses in the piperacillin /tazobactam group were (3.77 ± 1.12)d,(8.44 ±2.47) d,(1780 ±489) CNY,respectively,which were significantly lower than those in the cefotaxime sodium group [(5.36 ±1.70)d,(11.37 ±3.68)d,(2136 ±470)CNY,t=5.523,4.675,3.711,all P<0.01].The effective rate of the piperacillin/tazobactam group was 90％,which was significantly higher than 70％ of the cefotaxime sodium group (χ2 =6.25,P <0.05).The effective rate of imaging treatment in the piperacillin /tazobactam group was 94％,which was significantly higher than 68％in the cefotaxime sodium group (χ2 =10.981, P<0.01).After treatment,the WBC and neutrophil percentage of the piperacillin/tazobactam group were (7.30 ± 1.08) ×109/L,(0.65 ±0.04),respectively,which were significantly lower than those of the cefotaxime sodium group [(8.66 ±1.25) ×109/L,(0.71 ±0.04),t=5.821,7.405,all P<0.01].The PaO2 level of the piperacillin/tazobactam group was significantly higher than that of the cefotaxime sodium group [(81.90 ±6.83)％vs.(74.20 ± 6.27)％,t=5.873,P<0.01].The levels of CRP,PCT,IL-1 and TNF-αin the piperacillin/tazobactam group
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OBJECTIVE: To establish an HPLC-MS method for the analysis of the impurity profile of cefotaxime sodium. METHODS: Shimadzu-LCMS-IT-TOF was used with Waters XBridge Shield (RP18, 4.6 mm×250 mm, 5 μm) column. Mobile phase A was 20 mmol·L-1 ammonium acetate (pH adjusted to 6.25)-methanol (92: 8), and mobile phase B was set at 20 mmol·L-1 ammonium acetate-methanol (60: 40) (pH adjusted to 6.25).Gradient elution was performed at a flow rate of 1.0 mL·min-1. ESI source was used.Positive and negative ion scanning was conducted in the range of m/z 150-900.The heating temperature was 200℃, CDL temperature was maintained at 200℃, atomization gas flow rate was 1.5 L·min-1, dry gas pressure was 94.0 kPa, and the post-column diversion ratio was 1: 4.Some related substances in cefotaxime sodium were identified by comparing the retention time in chromatography, [M+H]+ spectrum and MS2 spectrum with those of reference substances, the others which haven't reference substances were deduced or speculated by analyzing the MS2 or MSn fragmentation with the help of a rule summarized from the MS2 fragmentation of cefotaxime sodium and the reference substances of system suitability impurities. RESULTS: Twenty-six related substances were separated and detected in the sample, all of which were identified or deduced. They were cefotaxime sodium isomeric compounds and homologs generated during the production process or degradation products. CONCLUSION: The method can be applied in the identification and qualitative analysis of the related substances of cefotaxime sodium and the quality control and optimization of the synthesis of cefotaxime sodium.
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An efficient method for the analysis of cefotaxime and its metabolite desacetylcefotaxime residues in eggs was developed based on high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).The samples were homogenized and extracted with acetonitrile/water (9∶1, V/V) solution.The fat was removed by hexane, and the other impurities were removed with C18 sorbent.The separation of cefotaxime and desacetylcefotaxime was performed on an Agilent Eclipse Plus C18 column (100 mm × 2.1 mm, 3.5 μm) using a mobile phase of 0.2% formic acid(A)-acetonitrile(B) by gradient elution.The analytes were detected by MS/MS in positive electrospray ionization mode (ESI+) and multiple reaction monitoring (MRM), quantitated by matrix-matched extemal standard method.Results showed that the calibration curves had a good linearity in the range of 1.0-143 μg/L (cefotaxime) and 1.0-120 μg/L (desacetylcefotaxime), respectively, with correlation coefficient R.2>0.999.Limits of detection (LOD, S/N=3) for cefotaxime and desacetylcefotaxime were 0.07 and 0.14 μg/kg, and limits of quantitation (LOQ, S/N=10) for cefotaxime and desacetylcefotaxime were 0.23 and 0.99 μg/kg, respectively.At three spiked concentration levels, the recoveries of cefotaxime and desacetylcefotaxime ranged from 83.1% to 103.0% and 88.2% to 101.0%, respectively, both with RSDs (n=6) less than 6.2%.The results demonstrated that the method was simple, quick, sensitive and reliable, and suitable for determination of cefotaxime and desacetylcefotaxime residues in eggs.
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Objective To evaluate the clinical efficacy of cefotaxime combined with gamma globulin on neonatal septicemia. Methods The subjects of this study were selected from 88 cases of neonatal septicemia admitted in Jiangyou No.903 hospital from April 2014 to April 2017. They were randomly divided into two groups, each with 44 cases. The control group was given symptomatic treatment and cefotaxime, while the observation group symptomatic treatment, cefotaxime and gamma globulin as well. After 7days of treatment, the overall effective rates, case fatality rates, clinical symptoms (body temperature, resistance to milk, neurological symptoms), time for improvement and hospital stay were compared between the two groups. Results The overall effective rate of the observation group was 95.45％, much higher than 72.73％ of the control group (P<0.01). The observation group had much lower case fatality rate than the control group did (2.27％ vs 18.19％) (P<0.05). The time the observation group took for improvement in the condition of body temperature, resistance to milk, neurological symptoms, and hospital stay was (3.25±1.07) days, (4.93±1.96) days, (5.92±1.58) days, and (6.80±1.94) days respectively, all significantly shorter than the time the control group took (P<0.01). Conclusion The combination of cefotaxime and gamma globulin is effective in the treatment of neonatal septicemia. It can significantly reduce case fatality rate and shorten the time for clinical symptoms and hospital stay.
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OBJECTIVE:To optimize the solution preparation in related substance test of cefotaxime sodium.METHODS:HPLC method was adopted to determine the total amount of impurities in cefotaxime sodium.Using phosphoric acid buffer solution pH,placing temperature,standing time and illumination as factor,the total amount of impurities as indexes,the preparation condition of solution was optimized by L9(34) orthogonal test.The validation test was carried out.RESULTS:The optimal preparation method was as follows as the sample was dissolved with a solvent containing pH 6.50 phosphate buffer protected from light.The test temperature and the sample temperature were set at 5 ℃,and the sample was injected within 5 min after the preparation of the solution.CONCLUSIONS:The optimized method is reproducible and reliable.
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Objective To investigate the efficacy of amoxicillin,clavulanate potassium and cefotaxime in the treatment of neonatal pneumonia and its influence on intestinal microflora.Methods 310 cases of neonatal pneumonia diagnosed in the hospital from June 2014 to June 2016 were selected as the subjects.They were divided into three groups according to random number table.The group A (100 cases) was treated with amoxicillin and clavulanate potassium,group B(105 cases) was treated with cefotaxime,group C(105 cases) was treated with amoxicillin,clavulanate potassium and cefotaxime.The effect and the difference of intestinal microecology were compared among the three groups.Results There were no statistically significant differences among the three groups in effect and the cure time [(5.2 ± 1.3) d vs.(5.4 ± 1.5) d vs.(5.3 ± 1.4) d] (P ＞ 0.05).There were statistically significant differences in intestinal microecology among the group A,group B,group C and control group (x2 =11.741,7.066,6.163,8.752,22.851,all P ＜ 0.05).The lactobacillus,Bifidobacterium,Enterococcus and true Bacillus of group A,group B,group C were less than those of the control group,which in group C were significantly less than group A and group B,there were statistically significant differences (t =10.453,6.843,5.974,17.654,all P ＜ 0.05).The Enterobacteriaceae of group A,group B and group C was significantly more than that of the control group,and the Enterobacteriaceae of group C was significantly more than that in group A and group B,there were statistically significant differences (t =6.574,4.634,3.968,9.893,all P ＜ 0.05).Conclusion Amoxicillin,clavulanate potassium and cefotaxime are effective in the treatment of neonatal pneumonia,the combined use of drugs has great influence on intestinal microflora.
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En este trabajo se evalúa una prueba rápida in house para la detección de enterobacterias sensibles a cefotaxima, basada en el cambio de pH del rojo fenol debido a la hidrólisis de este antibiótico. Las cepas de enterobacterias procedentes de 1.947 urocultivos se evaluaron mediante los paneles MicroScan y esta prueba in house. Mediante los paneles de MicroScan se estudiaron 499 aislados de enterobacterias, entre los cuales había 27 aislados de Escherichia coli productora de β-lactamasa de espectro extendido (BLEE), 16 de Klebsiella pneumoniae BLEE y una de Klebsiella oxytoca BLEE. La prueba in house mostró una sensibilidad del 98% y una especificidad del 97%, con un valor predictivo negativo del 100% y un valor predictivo positivo del 78%. La prueba in house basada en el cambio de pH es útil en nuestro medio para detectar presuntivamente de forma rápida cepas de enterobacterias con cierta resistencia a cefotaxima.
In this work an "in house" rapid test based on the change in pH that is due to hydrolysis for detecting Enterobacteriaceae susceptible to cefotaxime is evaluated. The strains of Enterobacteriaceae from 1947 urine cultures were assessed using MicroScan panels and the "in house" test. This rapid test includes red phenol solution and cefotaxime. Using MicroScan panels, 499 Enterobacteriaceae isolates were evaluated, which included 27 isolates of Escherichia coli producing extended-spectrum beta-lactamases (ESBL), 16 isolates of Klebsiella pneumoniae ESBL and 1 isolate of Klebsiella oxytoca ESBL. The "in house" test offers the following values: sensitivity 98% and specificity 97%, with negative predictive value 100% and positive predictive value 78%. The "in house" test based on the change of pH is useful in our area for detecting presumptively cefotaxime-resistant Enterobacteriaceae strains.
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Humans , Male , Female , Microbial Sensitivity Tests/methods , Cefotaxime/therapeutic use , Enterobacteriaceae/drug effects , Phenolsulfonphthalein/analysis , beta-Lactamases/analysis , Cefotaxime/pharmacology , Enterobacteriaceae/isolation & purificationABSTRACT
Objective To investigate the in vitro interference of cefotaxime at subinhibitory concentrations [sub-minimal inhibitory concentrations (MIC)] on biofilm formation by nontypeable Haemophilus influenzae (NTHi). Methods The interference of subinhibitory concentrations of cefotaxime on biofilm formation of the clinical strong-biofilm forming isolates of NTHi was evaluated by a microtiter plate biofilm formation assay. The effect of sub-MIC cefotaxime on bacterial cell-surface hydrophobicity was determined using a standard microbial adhesion to n-hexadecane test. Additionally, the effects on bacterial adherence to human fibronectin and expression of bacterial adhesins were also investigated. Results Subinhibitory concentrations of cefotaxime, both at 0.1× and 0.5× MIC levels, efficiently reduced the NTHi biofilm formation, and this effect was independent of decreasing bacterial viability. Sub-MIC cefotaxime also decreased bacterial cell-surface hydrophobicity and reduced adherence to human fibronectin. Inhibition in the P2 and P6 gene expressions upon exposure to sub-MIC cefotaxime was also noted. Conclusions Taken together, our results indicate that sub-MIC cefotaxime interferes with the formation of NTHi biofilm, and this effect is feasibly related to the interference with cell-surface hydrophobicity, fibronectin-binding activity as well as alteration of the P2 and P6 gene expression. The findings of the present study therefore provide a rationale for the use of subinhibitory concentrations of cefotaxime for treatment of NTHi-related diseases.
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Objective To investigate the clinical application significance of flow cytofluroometric(FCM ) antibiotic susceptibility test for A .baumannii in vitro .Methods The sensitivity to Ampicillin/Sulbactam ,Levofloxacin ,Meropenem ,Cefotaxime of an Esch‐erichia coli standard strain and 66 isolates of A .baumannii were tested with FCM by using propidium iodide as a fluorescent probe . The survival rates of the bacteria in the culture after treatment with different dosages of the antibiotics were determined according to the fluorescence strength .The MIC value of the antibiotics against the 66 strains were judged with FCM ,compared with microdi‐lution and VITEK methods .Results The antibiotic resistant strains number of sultamicillin ,levofloxacin ,meropenem and cefo‐taxime sodium were 35 ,30 ,13 and 38 respectively in flow cytofluorometric antibiotic sensitivity test(FCST) of 66 strains of A .bau‐mannii .There was no significant difference(P>0 .05) compared with the antibiotic susceptibility results by the methods of VITEK instrument and microdilution by measuring with χ2 test respectively .Conclusion The established method of FCST for A .baumannii is suitable for dectecting bacterial drug‐sensitivity ,which is more rapid ,accurate and objective .