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1.
Chinese Journal of Biotechnology ; (12): 990-1003, 2022.
Article in Chinese | WPRIM | ID: wpr-927758

ABSTRACT

Antimicrobial resistance is one of the critical public health issues in the world. There is an urgent need to develop effective broad-spectrum antibiotics to treat the infection of multi-drug resistant Gram-negative bacilli. Cefiderocol, developed by the Shionogi Inc. in Japan, is a new type of iron carrier cephalosporin antibiotics, which overcomes the drug resistance of Gram-negative bacilli due to the down-regulation of outer membrane pore protein and the up-regulation of efflux pump, and has good stability to serine- and metallo-carbapenemases. This drug has a broad spectrum and strong antibacterial activity against carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. Cefiderocol can be used to treat complex urinary tract infections (including pyelonephritis), hospital-acquired pneumonia, and ventilator-associated pneumonia. By summarizing the chemical structure, antibacterial mechanism, in vitro antibacterial activity, pharmacokinetics, pharmacodynamics, and clinical treatment of cefiderocol, this review shows the application potential of cefiderocol as a new iron carrier cephalosporin in the treatment of multi-drug resistant Gram-negative bacilli infections.


Subject(s)
Cephalosporins/therapeutic use , Gram-Negative Bacteria , Microbial Sensitivity Tests , Siderophores/pharmacology
2.
Rev. cuba. med ; 60(1): e1350, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156564

ABSTRACT

Introducción: La endocarditis bacteriana es una enfermedad poco frecuente, ocasionada en la mayor parte de casos por organismos gram positivos, como estafilococos y estreptococos, seguido por organismos del grupo HACEK y raramente por gram negativos no HACEK. Su incidencia es baja, pero se relaciona con una alta mortalidad; existen diversos factores de riesgo asociados: edad avanzada, sexo femenino, antecedente de cirugías cardiacas, válvulas protésicas, uso de catéteres venosos centrales o urinarios. Objetivo: Describir la evidencia disponible sobre endocarditis bacteriana por Escherichia coli. Desarrollo: Se describe el caso de un paciente adulto mayor, sin antecedentes quirúrgicos cardíacos, que presenta cuadro de desorientación, astenia, adinamia, elevación de la temperatura corporal, asociados a infección urinaria, que luego de recibir piperacilina-tazobactam por 7 días, persiste con alzas térmicas. Hemocultivos confirman bacteriemia por Escherichia coli y en ecocardiograma transesofágico se logra la visualización de una vegetación a nivel de válvula aórtica nativa. El paciente recibió tratamiento antibiótico con cefalosporina de tercera generación por 30 días, con mejoría clínica, eco transesofágico de control sin vegetaciones, ni necesidad inmediata de tratamiento quirúrgico. Conclusiones: La sospecha clínica de endocarditis es importante en el momento de solicitar exámenes diagnósticos e interpretar sus resultados(AU)


Introduction: Bacterial endocarditis is a rare disease, caused in most cases by gram-positive organisms, such as staphylococci and streptococci, followed by HACEK group organisms and rarely by non-HACEK gram-negative organisms. Its incidence is low, but it is related to high mortality; there are several associated risk factors: advanced age, female sex, history of heart surgery, prosthetic valves, use of central venous or urinary catheters. Objective: To describe the available evidence on bacterial endocarditis due to Escherichia coli. Case report: We describe the case of an elderly patient, without a history of cardiac surgery, who showed disorientation, asthenia, adynamia, elevation of body temperature, associated with urinary infection, persisting after taken piperacillin-tazobactam for 7 days with temperature rises. Blood cultures confirm Escherichia coli bacteremia and transesophageal echocardiography exhibited vegetation at the native aortic valve level. The patient received antibiotic treatment with third-generation cephalosporin for 30 days, with clinical improvement, echo transesophageal control with no vegetations, and no immediate need for surgical treatment. Conclusions: The clinical suspicion of endocarditis is vital when requesting diagnostic tests and interpreting their results(AU)


Subject(s)
Humans , Cephalosporins/therapeutic use , Endocarditis, Bacterial/diagnosis , Escherichia coli Infections/drug therapy
3.
Biomédica (Bogotá) ; 41(1): 65-78, ene.-mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1249059

ABSTRACT

Abstract | Introduction: Shigellosis is endemic in low-and middle-income countries, causing approximately 125 million episodes of diarrhea and leading to approximately 160.000 deaths annually one-third of which is associated with children. Objective: To describe the characteristics and antimicrobial resistance profiles of Shigella species recovered in Colombia from 1997 to 2018. Materials and methods: We received isolates from laboratories in 29 Colombian departments. We serotyped with specific antiserum and determined antimicrobial resistance and minimal inhibitory concentrations for ten antibiotics with Kirby-Bauer tests following the Clinical and Laboratory Standards Institute recommendations. Results: We analyzed 5,251 isolates of Shigella spp., most of them obtained from stools (96.4%); 2,511 (47.8%) were from children under five years of age. The two most common species were S. sonnei (55.1%) and S. fbxneri (41.7%). The highest resistance rate was that of tetracycline (88.1%) followed by trimethoprim-sulfamethoxazole (79.3%) and ampicillin (65.5%); 50.8% of isolates were resistant to chloramphenicol, 43.6% to amoxicillin/clavulanic acid, and less than 1% to cefotaxime, ceftazidime, gentamicin, and ciprofloxacin. In S. sonnei, the most common resistance profile corresponded to trimethoprim-sulfamethoxazole (92%) whereas in S. fbxneri the most common antibiotic profiles were multidrug resistance. Conclusions. In Colombia, children under five years are affected by all Shigella species. These findings should guide funders and public health officials to make evidence-based decisions for protection and prevention measures. The antimicrobial resistance characteristics found in this study underline the importance of combating the dissemination of the most frequently isolated species, S. sonnei and S. ftexneri.


Resumen | Introducción. La shigelosis es endémica en los países de ingresos bajos y medios y ocasiona aproximadamente 125 millones de episodios de diarrea y 160.000 muertes al año, un tercio de los cuales se presenta en niños. Objetivo. Describir las características y los perfiles de resistencia antimicrobiana en aislamientos de Shigella spp. recuperados en Colombia entre 1997 y 2018. Materiales y métodos. Los aislamientos provenían de laboratorios en 29 departamentos de Colombia. La serotipificación se hizo con antisueros específicos de Shigella spp. y, la determinación de los perfiles de resistencia y la concentración inhibitoria mínima de diez antibióticos, por Kirby-Bauer. Resultados. Se estudiaron 5.251 aislamientos de Shigella spp. obtenidos de materia fecal (96,4 %); el 47,8 % de ellos correspondía a niños menores de cinco años. Las especies más frecuentes fueron S. sonnei (55,1 %) y S. ftexneri (41,7 %). Se presentó resistencia a tetraciclina (88,1 %), trimetoprim-sulfametoxasol (79,3 %), ampicilina (65,5 %), cloranfenicol (50,8 %) y amoxicilina-acido clavulánico (43,6 %). La resistencia no superó el 1 % contra cefotaxime, ceftazidima, gentamicina y ciprofloxacina. Para S. sonnei, el perfil de resistencia más frecuente correspondió a trimetoprim-sulfametoxasol, en contraste con S. ftexneri, cuyos perfiles fueron todos multirresistentes. Conclusiones. Los niños menores de cinco años se vieron afectados por todas las especies de Shigella spp., aspecto que los legisladores en salud pública deben considerar a la hora de tomar decisiones en torno a las medidas de prevención y protección frente a esta enfermedad. Las características de resistencia antimicrobiana de los aislamientos de Shigella spp. en Colombia ponen de manifiesto la importancia de combatir la diseminación de las dos especies más frecuentes en casos clínicos, S. sonnei y S. ftexneri.


Subject(s)
Dysentery, Bacillary , Drug Resistance, Microbial , Trimethoprim, Sulfamethoxazole Drug Combination , Cephalosporins , Chloramphenicol , Fluoroquinolones , Public Health Surveillance , Ampicillin
4.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(3): 430-440, dez 5, 2020. tab, fig
Article in English | LILACS | ID: biblio-1357939

ABSTRACT

Objective: evaluation of antibiotic resistance in Gram-negative microbiota from ready-to-eat cheese samples. Methodology: this research applied an adapted methodology to select from a food sample viable Gram-negative microbiota displaying antibiotic resistance. The selected food was a cheese that is commonly consumed without thermal processing, the Minas Frescal cheese. The evaluation was followed by a PCR screening in this resistant microbiota, for genes that provide resistance to antibiotics and also to the quaternary ammonium. Results: all cheese samples harbored a resistant microbiota. In 13.3% of the cheese samples analyzed, the resistance reached all ten different antibiotics tested and, in 80%, 8 to 10 different antibiotics. In antibiotics considered critics as the carbapenems: ertapenem presented resistant microbiota in 86.7% of the samples. In cephalosporins, the resistance reached 100% in the third generation (ceftazidime) and almost half of the samples (46.7%) in the fourth generation (cefepime). In genotypic research, seven different resistance genes were found in 69.2% of the bacterial pools, including the beta-lactamase-producing genes ctx, tem, shv, tetracycline-resistant genes, and a high rate of integrons class 1 and 2. Conclusion: the results indicate phenotypically and genotypically that the Minas Frescal cheese can harbor potential resistant microbiota. Therefore, the methodology used is a viable possibility and with a broader answer about the food microbiota role in resistance. This research corroborates the food area as an important sector to be managed to reduce the process of antibiotic resistance.


Objetivo: avaliação da resistência a antibióticos em microbiota Gram-negativa de amostras de queijo prontas para consumo. Metodologia: esta pesquisa aplicou uma metodologia adaptada para selecionar a microbiota Gram-negativa viável apresentando resistência a antibióticos em uma amostra de alimento. O alimento selecionado foi um queijo frequentemente consumido sem processamento térmico, o queijo Minas Frescal. A avaliação foi seguida de uma triagem por PCR, nesta microbiota resistente, para genes que fornecem resistência aos antibióticos e também ao quaternário de amônio. Resultados: todas as amostras de queijo apresentaram microbiota resistente. Em 13,3% dos queijos analisados essa resistência alcançou todos os 10 diferentes antibióticos testados e em 80% entre 8 e 10 antibióticos diferentes. Em antibióticos considerados críticos como os carbapenêmicos: ertapenem apresentou microbiota resistente em 86,7% das amostras. Nas cefalosporinas, a resistência atingiu 100% na terceira geração (ceftazidima) e quase a metade das amostras (46,7%) na quarta geração (cefepime). Na pesquisa genotípica, sete diferentes genes de resistência foram encontrados em 69,2% dos pools bacterianos, incluindo o genes produtores de beta-lactamase, genes de resistência à tetraciclina, ctx, tem, shv e uma alta taxa de integron classe 1 e 2. Conclusão: os resultados indicam fenotipicamente e genotipicamente que o queijo Minas Frescal pode apresentar uma potencial microbiota resistente. Portanto, a metodologia utilizada é uma possibilidade viável e com uma resposta mais ampla sobre o papel da microbiota na resistência. Esta pesquisa corrobora a área de alimentos como um setor importante a ser gerenciado para redução no processo de resistência a antibióticos.


Subject(s)
Drug Resistance, Microbial , Carbapenems , Cephalosporins , Cheese , Food , Gram-Negative Bacteria
5.
Gac. méd. Méx ; 156(6): 604-609, nov.-dic. 2020. tab
Article in Spanish | LILACS | ID: biblio-1249973

ABSTRACT

Resumen Introducción: Existe poca información acerca de la efectividad de las combinaciones ceftolozano/tazobactam y ceftazidima/avibactam en cepas clínicamente relevantes aisladas en México. Objetivo: Determinar el perfil antimicrobiano de ambos antibióticos en nuestra comunidad. Método: El presente estudio de investigación fue prospectivo, descriptivo y transversal. Se incluyeron cepas clínicamente relevantes aisladas a partir de cultivos de cepa pura durante el periodo de agosto de 2018 a enero de 2019 en Mexicali, Baja California, México. Resultados: Se analizaron 74 cepas de enterobacterias y 19 cepas de Pseudomonas aeruginosa; el porcentaje de sensibilidad de ceftazidima/avibactam fue de 100 % contra enterobacterias y de 72.7 % contra Pseudomonas aeruginosa; el porcentaje de sensibilidad de ceftolozano/tazobactam fue de 90.5 % para enterobacterias y de 72.7 % para Pseudomonas aeruginosa. Conclusiones: Las combinaciones ceftolozano/tazobactam y ceftazidima/avibactam ofrecen buena sensibilidad antimicrobiana in vitro, tanto contra enterobacterias productoras de betalactamasas de espectro extendido como contra Pseudomonas aeruginosa. Se requieren más datos para valorar la respuesta clínica en pacientes que reciben esas combinaciones de antibióticos.


Abstract Introduction: There is limited information on the effectiveness of ceftolozane/tazobactam and ceftazidime/avibactam combinations on clinically relevant strains isolated in Mexico. Objective: To determine the antimicrobial profile of both antibiotic combinations in our community. Method: The present research study was prospective, descriptive and cross-sectional. Clinically relevant strains isolated from pure-strain cultures were included during the period from August 2018 to January 2019 in Mexicali, Baja California, Mexico. Results: 74 enterobacteriaceae and 19 Pseudomonas aeruginosa strains were analyzed; the percentage of sensitivity of ceftazidime/avibactam was 100 % for enterobacteriaceae and 72.7 % for Pseudomonas aeruginosa; the percentage of sensitivity of ceftolozane/tazobactam for enterobacteriaceae was 90.5 % and 72.7 % for Pseudomonas aeruginosa. Conclusions: The ceftolozane/tazobactam and ceftazidime/avibactam combinations offer good antimicrobial sensitivity in vitro, both for ESBL-producing enterobacteriaceae and Pseudomonas aeruginosa. More data are required to assess clinical response in patients receiving these antibiotic combinations.


Subject(s)
Humans , Pseudomonas aeruginosa/drug effects , Ceftazidime/therapeutic use , Cephalosporins/therapeutic use , Enterobacteriaceae/drug effects , Azabicyclo Compounds/therapeutic use , Anti-Bacterial Agents/therapeutic use , Pseudomonas aeruginosa/isolation & purification , Microbial Sensitivity Tests , Cross-Sectional Studies , Prospective Studies , Drug Combinations , Enterobacteriaceae/isolation & purification , Tazobactam/therapeutic use , Mexico
6.
Más Vita ; 2(4): 74-79, dic. 2020. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1373005

ABSTRACT

La trombosis séptica del seno cavernoso se conoce como una complicación rara y potencialmente mortal de las infecciones en el área de la cabeza y el cuello. Aunque el uso de antibióticos ha mejorado el pronóstico, todavía es conocida por sus altas tasas de mortalidad y morbilidad. Objetivo: Analizar la presencia de la trombosis séptica de seno cavernoso mediante el estudio de un caso único. Metodología: De tipo observacional, cualitativa y de corte transversal, apoyado con sustento bibliográfico. Resultado: Caso de una paciente joven de sexo femenino que presenta una semana después de tener sintomatología de Covid, cefalea holocraneana, oftalmoplejía derecha, disminución de la agudeza visual, dolor, eritema, edema, tumefacción orbitaria, secreción ocular amarillenta supurativa derecha, se le realiza tomografía de cerebro evidenciándose de forma incidental trombosis del seno cavernoso. Conclusiones: Se determinó que la trombosis séptica de seno cavernoso es un diagnóstico de poca frecuencia y rara. Asimismo, la trombosis del seno cavernoso tiene la tasa más alta de mortalidad. En raras ocasiones, la infección del oído medio puede ser una causa de trombosis séptica del seno cavernoso y la respuesta al tratamiento es deficiente(AU)


Cavernous sinus septic thrombosis is a rare and life-threatening complication of infections in the head and neck area. Although the use of antibiotics has improved the prognosis, it still known for its high mortality and morbidity rates. Objective: To analyze the presence of cavernous sinus septic thrombosis by studying a single case. Methodology: Observational, qualitative and cross-sectional, supported by bibliographic support. Result: Case of a young female patient who presented one week after having symptoms of Covid, holocranial headache, right ophthalmoplegia, decreased visual acuity, pain, erythema, edema, orbital swelling, right suppurative yellowish eye discharge, was performed brain tomography, incidentally showing cavernous sinus thrombosis. Conclusions: It was determined that cavernous sinus septic thrombosis is an infrequent and rare diagnosis. In addition, cavernous sinus thrombosis has the highest mortality rate. In rare cases, middle ear infection can be a cause of cavernous sinus septic thrombosis and response to treatment is poor(AU)


Subject(s)
Humans , Male , Adult , Cephalosporins/therapeutic use , Intracranial Thrombosis/complications , Intracranial Thrombosis/mortality , Cavernous Sinus Thrombosis , Anti-Bacterial Agents , Cavernous Sinus , Headache , Infections , Anti-Infective Agents
7.
In. Giachetto Larraz, Gustavo A; Pardo Casaretto, Lorena Victoria; Speranza Mourine, María Noelia. Prescripción de antimicrobianos para infecciones frecuentes en pediatría. Montevideo, Bibliomédica, 2020. p.91-118, tab.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1373295
8.
Article in English | WPRIM | ID: wpr-811269

ABSTRACT

OBJECTIVES: This study aimed to understand the nationwide patterns of antibiotic prescription after tooth extraction in adult patients.MATERIALS AND METHODS: This study analyzed dental records from the National Health Insurance Service–National Sample Cohort (NHIS–NSC) database on 503,725 tooth extractions performed in adults (≥19 years) during 2011–2015. Patient sex, age, household income, systemic disease (diabetes mellitus and hypertension), type of dental institution, region of dental institution, year of prescription, and type of tooth extraction procedure were considered. The antibiotic prescription rate and broad-spectrum antibiotic prescription frequency were analyzed using chi-squared tests. Factors affecting the prescription of broad-spectrum antibiotics were evaluated using multivariate logistic regression analysis.RESULTS: The rate of antibiotic prescription after tooth extraction was 81.85%. Penicillin was most commonly prescribed (45.25%), followed by penicillin with beta-lactamase inhibitors (18.76%), metronidazole (12.29%), and second- to fourth-generation cephalosporins (11.52%). The proportion of broad-spectrum antibiotics used among all prescribed antibiotics was 45.88%.CONCLUSION: The findings of this study demonstrate that the rate of antibiotic prescription after tooth extraction is higher in Korea than in other countries. Furthermore, broad-spectrum antibiotics are used more frequently, which may indicate unnecessary drug prescription, an important contributor to antibiotic resistance.


Subject(s)
Adult , Anti-Bacterial Agents , beta-Lactamase Inhibitors , Cephalosporins , Cohort Studies , Dental Records , Drug Prescriptions , Drug Resistance, Microbial , Family Characteristics , Humans , Korea , Logistic Models , Metronidazole , National Health Programs , Penicillins , Prescriptions , Tooth Extraction , Tooth
9.
Rev. chil. infectol ; 36(5): 551-555, oct. 2019. tab
Article in Spanish | LILACS | ID: biblio-1058080

ABSTRACT

Resumen Introducción: Pseudomonas aeruginosa es un patógeno oportunista asociado a alta morbi-mortalidad. Para cepas multi-resistentes (MDR), ceftolozano/tazobactam (CTZ) se ha autorizado por la Agencia Europea del Medicamento (EMA) para infecciones del tracto urinario complicadas, pielonefritis aguda e infecciones intra-abdominales complicadas. Objetivo: Determinar la sensibilidad a CTZ de P. aeruginosa MDR en muestras clínicas aisladas en el Hospital Universitario Puerto Real. Material y Métodos: Se estudió la sensibilidad según criterios EUCAST a CTZ de cepas de P. aeruginosa MDR, entre enero de 2015 y agosto de 2017. Los criterios de multi-resistencia fueron definidos por el Centers for Disease Control and Prevention. La sensibilidad antimicrobiana se obtuvo mediante sistema MicroScan® (Beckman Coulter). La sensibilidad a CTZ se determinó mediante tiras de gradiente (Liofilchem®, Werfen). Resultados: De 1253 cepas, 7% fueron MDR. Se estudió la sensibilidad de 78 cepas de P. aeruginosa MDR, de las cuales cinco (6,4%) resultaron resistentes a CTZ según criterios EUCAST. Conclusiones: En nuestro medio la resistencia in vitro a CTZ en cepas de P. aeruginosa MDR es aproximadamente 6%; CTZ es una opción de tratamiento de infecciones por cepas de P. aeruginosa MDR cuando no exista otra alternativa y se haya comprobado su sensibilidad in vitro.


Background: Pseudomonas aeruginosa is an opportunistic pathogen associated with high morbidity and mortality. For multidrug-resistant strains (MDR), ceftolozane/tazobactam (CTZ) has been authorized by the European Medicines Agency (EMA) for complicated urinary tract infections, acute pyelonephritis, and complicated intraabdominal infections. Aim: To determine the susceptibility to CTZ of P. aeruginosa MDR in isolated clinical samples at the University Hospital Puerto Real. Methods: The susceptibility according to the EUCAST to CTZ criteria of strains of P. aeruginosa MDR, between January 2015 and August 2017 has been studied. The multiresistance criteria were those defined by the Centers for Disease Control and Prevention. The antibiotic susceptibility was obtained by automated MicroScan® system (Beckman Coulter). Susceptibility to CTZ was determined using gradient strips (Liofilchem®, Werfen). Results: Of 1253 strains isolated, 7% presented MDR. We studied the susceptibility of a total of 78 strains of MDR P. aeruginosa, of which 5 (6.4%) were resistant to CTZ according to the EUCAST criteria. Conclusions: In our environment, the in vitro resistance to CTZ in MDR P. aeruginosa strains is approximately 6%. CTZ is an option for the treatment of infections by MDR P. aeruginosa when there is no other alternative and its in-vitro susceptibility has been proven.


Subject(s)
Pseudomonas aeruginosa/drug effects , Cephalosporins/pharmacology , Drug Resistance, Multiple, Bacterial/drug effects , Tazobactam/pharmacology , Anti-Bacterial Agents/pharmacology , Pseudomonas aeruginosa/isolation & purification , Reference Values , Mass Spectrometry , Microbial Sensitivity Tests , Reproducibility of Results , Real-Time Polymerase Chain Reaction
10.
Arch. argent. pediatr ; 117(3): 205-210, jun. 2019. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1001190

ABSTRACT

Introducción. La resistencia a los antibióticos plantea un problema de salud mundial cada vez mayor, por lo que la búsqueda de nuevos y más efectivos antibióticos es prioritaria. La ceftarolina tiene un amplio espectro de actividad contra cepas Gram-positivas clínicamente relevantes, que incluyen el Staphylococcus aureus meticilino resistente y cepas de Streptococcus pneumoniae resistentes, así como algunos patógenos Gram-negativos implicados en infecciones de piel y tejidos blandos o en la neumonía adquirida en la comunidad; es una potencial opción terapéutica. Se realizó una revisión sistemática que evaluó si la ceftarolina era más efectiva y segura que los comparadores. Material y métodos. Se realizó una búsqueda bibliográfica exhaustiva para identificar estudios clínicos experimentales que compararan la seguridad y eficacia de la ceftarolina con un comparador en la población pediátrica. El criterio de evaluación de eficacia fue la tasa de fracaso terapéutico y, para seguridad, la presencia de cualquier efecto adverso. Resultados. Se identificaron tres estudios, 2 de neumonía adquirida en la comunidad y uno de infecciones de piel y tejidos blandos. En ninguno, se detectó diferencia en el riesgo de fracaso terapéutico, RR 0,97 (0,54-1,73), ni en el criterio de seguridad, RR 0,79 (0,51-1,23). Conclusiones. La evidencia disponible sugiere que la ceftarolina podría ser una opción terapéutica válida en el tratamiento de las infecciones de piel y tejidos blandos o neumonía adquirida en la comunidad en pacientes pediátricos. No se encontraron trabajos de alta calidad de evidencia en otro tipo de infecciones o en pacientes admitidos en la Unidad de Cuidados Críticos.


Introduction. Antibiotic resistance is an increasingly growing health problem worldwide, so it is imperative to look for new, more effective antibiotics. Ceftaroline has a broad spectrum of activity against clinically relevant Grampositive strains, including methicillin-resistant Staphylococcus aureus and resistant Streptococcus pneumoniae strains, as well as Gram-negative pathogens implicated in skin and soft tissue infections or community-acquired pneumonia; it is therefore a potential therapeutic option. We conducted a systematic review to assess whether ceftaroline was safer and more effective than comparators. Material and methods. A comprehensive bibliographic search was done to identify experimental clinical trials that compared the safety and effectiveness of ceftaroline to a comparator in the pediatric population. The rate of therapeutic failure was used to determine the effectiveness, while the presence of any adverse event was considered for safety. Results. Three studies were identified: two in community-acquired pneumonia and one in skin and soft tissue infections. No study showed a difference in the risk for therapeutic failure, relative risk (RR): 0.97 (0.54-1.73), or safety criterion, RR: 0.79 (0.51-1.23). Conclusions. The available evidence suggests that ceftaroline may be a valid therapeutic option for the management of skin and soft tissue infections or community-acquired pneumonia in pediatric patients. No studies with a high-quality of evidence were observed in other types of infections or in patients admitted to the critical care unit.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Safety , Efficacy , Cephalosporins
12.
Rev. cuba. obstet. ginecol ; 45(1): 1-13, ene.-mar. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093618

ABSTRACT

Introducción: El mecanismo más común de actividad antibiótica es la interferencia en la síntesis de la pared celular bacteriana. Las cefalosporinas tienen el mismo mecanismo de acción que las penicilinas; sin embargo, tienen un espectro antibacteriano más amplio, son resistentes a muchas b-lactamasas y tienen propiedades farmacocinéticas mejoradas. Objetivos: Identificar por servicios los gérmenes aislados y determinar la resistencia del Staphylococcus aureus a las cefalosporinas. Método: Se realizó un estudio retrospectivo, transversal y descriptivo en hospital Ginecobstétrico de Guanabacoa desde enero de 2014 hasta diciembre de 2016. Se seleccionaron como variables los gérmenes aislados y el patrón de resistencia del germen que predominó frente a todas las generaciones de cefalosporinas. Resultados: En el servicio de neonatología el mayor aislamiento fue en el hemocultivo seguido del catéter venoso (19 pacientes) y tubo endotraqueal. En el servicio de Obstetricia, los loquios y el sitio quirúrgico fue donde se aisló mayor número (69 y 31 pacientes, respectivamente). Conclusiones: El germen más frecuente aislado en ambos servicios fue el Staphylococcus aureus y la resistencia a las cefalosporinas fue muy elevado(AU)


Introduction: The synthesis interference of bacterial cell wall is the most common antibiotic mechanism. Cephalosporins have the same mechanism of action as penicillin. However, they have wider antibacterial spectrum, they are more resistant to B-lactamases and better pharmacokinetics properties. Additionally, cephalosporins have higher activity in front of gram-negative bacteria than penicillin. Objective: To identify isolated germs in these services and to determine the Staphylococcus aureus resistance to cephalosporins. Method: A retrospective, transversal and descriptive study was conducted in Guanabacoa Gynecobstetric hospital from January 2014 to December 2016. selected variables as isolated microorganism, and resistance pattern in front of cephalosporin generations. The isolated germs and the resistance pattern of the germ that prevailed against all generations of cephalosporins were selected as variables. In the Obstetrics Service, the largest number of germs was isolated in the lochia and surgical sites. (69 and 31, respectively). Results: In neonatology service, the most frequent isolation occurred in blood culture (35), venous catheter (19) and endotracheal tube (10). In Obstetric service, the most frequent isolation occurred in liquors (69) and the surgical site isolated (31). Conclusions: Staphylococcus Aureus was the main microorganism isolated in hospital and its cephalosporin resistance was very high(AU)


Subject(s)
Humans , Female , Pregnancy , Puerperal Infection/drug therapy , Staphylococcal Infections/drug therapy , Cephalosporins/therapeutic use , Cephalosporin Resistance/drug effects , Neonatal Sepsis/drug therapy
13.
Infectio ; 23(1): 45-51, Jan.-Mar. 2019. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-975562

ABSTRACT

Resumen Introducción: La infección de vías urinarias (IVU) es una de las enfermedades más prevalentes en la práctica clínica Objetivo: Identificar los principales agentes etiológicos y la frecuencia de resistencia a antibióticos por parte de microorganismos aislados por urocultivos en pa cientes con IVU en un hospital de primer nivel de atención. Materiales y Métodos: Estudio descriptivo de corte transversal, a partir de una muestra aleatoria de pacientes con IVU en La Virginia, Risaralda, entre el 1 de abril de 2014 a 31 de marzo de 2015. Se evaluaron las bacterias aisladas en la totalidad de urocultivos procesados y los resultados de los antibiogramas. Se establecieron frecuencias y proporciones. Para el análisis de datos, se utilizó SPSS Statistics 22. Se hizo análisis multivariado. Resultados: Se realizaron 1563 urocultivos en el periodo de estudio, de los cuales 329 (21,0%) mostraron crecimiento mayor a 100.000 UFC. Las frecuencias más altas de resistencia para E. coli se observaron para cefalotina (75,8%), ampicilina (72,6%) y trimetoprim/sulfametoxazol (55,3%). De 296 pacientes seleccionados aleatoriamente se halló que la cistitis era la IVU más frecuente (70,3%) y al 50,7% no se les prescribió ningún antimicrobiano. El uso de antiulcerosos se asoció con mayor probabilidad de uso inadecuado del antibiótico (OR:4,28; IC95%:1,070-17,153; p=0,04). Conclusiones: Existe una elevada resistencia bacteriana a los antibióticos de primera línea para el tratamiento de las IVUs, lo que sugiere la importancia de identi ficar los microorganismos y sus perfiles de sensibilidad a antimicrobianos para seleccionar con mejor criterio cual emplear.


Abstract Introduction: Urinary tract infection (UTI) is one of the most prevalent diseases in clinical practice. Objective: To identify the main etiologic agents and the frequency of antibiotic resistance by microorganisms isolated from urine culture and sensitivity in patients with IVU in a hospital primary care. Materials and Methods. Descriptive cross-sectional study, from a random sample of patients with UTI in La Virginia, Risaralda, from April 1, 2014 to March 31, 2015. Bacteria isolated from all processed urine cultures and the results of susceptibility were evaluated. Frequencies and proportions were established. For data analysis was used SPSS Statistics 22. Results: A total of 1563 urine cultures were performed in the study period, of which 329 (21.0%) showed further growth to 100,000 UFC. Higher frequencies of resis tance were observed for E. coli to cephalothin (75.8%), ampicillin (72.6%) and trimethoprim/sulfamethoxazole (55.3%). In the 296 randomized patients it was found that the most common UTI was cystitis (70.3%) and 50.7% were not prescribed any antimicrobial. The use of anti-ulcer is associated with increased probability of inappropriate use of antibiotics (OR:4.28; 95% CI:1.070-17.153; p=0.04). Conclusions: There is a high bacterial resistance to first-line antibiotics for treatment of UTIs, suggesting the importance of identifying microorganisms and their antimicrobial susceptibility profiles to select which use better approach.


Subject(s)
Humans , Female , Adult , Middle Aged , Urinary Tract , Urinary Tract Infections , Drug Resistance, Microbial , Cephalosporins , Cystitis , Anti-Bacterial Agents , Sulfamethoxazole , Bacteria , Trimethoprim , Cephalothin , Cross-Sectional Studies , Multivariate Analysis , Selectins , Escherichia coli , Ampicillin , Anti-Infective Agents , Anti-Ulcer Agents
15.
Article in English | WPRIM | ID: wpr-764967

ABSTRACT

BACKGROUND: Although guidelines to prevent surgical site infections (SSIs) were published more than a decade ago, prophylactic antibiotics are still used subjectively in clinical practice. In this study, we evaluated the safety of single-dose preoperative intravenous antibiotics without postoperative antibiotics in the field of clean wound surgery performed under local anesthesia. We also surveyed the present clinical conditions for prophylactic antibiotic use in the plastic surgery departments of training hospitals in Korea. METHODS: A total of 360 consecutive patients who underwent clean wound surgery under local anesthesia in an outpatient clinic from March 2018 to October 2018 were reviewed. In the study group, a single surgeon administered first-generation cephalosporins intravenously within 1 hour of skin incision and did not prescribe additional antibiotics. In the control group, 2 other surgeons prescribed oral first-generation cephalosporins postoperatively for 2 to 3 days without preoperative antibiotics. A telephone survey about perioperative antibiotic regimens was conducted at the departments of plastic surgery in training hospitals. RESULTS: There were 128 patients in the study group and 232 patients in the control group. There were no significant differences between the 2 groups regarding SSIs and other surgical complications. A total of 41 training hospitals answered the survey and every hospital had protocols of prescribing postoperative oral antibiotics routinely at the time of discharge with a mean duration of 3.9 days. Only 11 hospitals (26.8%) prescribed parenteral antibiotics before surgery as well as postoperative oral antibiotics. CONCLUSION: Intravenous injection of single-dose first-generation cephalosporins 1 hour before surgery without postoperative antibiotics did not increase the incidence of SSIs compared with the usual practice of giving only postoperative antibiotics prescription for 2 to 3 days in cases of clean wound surgery performed under local anesthesia. Proper antibiotic prophylaxis should be performed by surgeons in training hospitals without hesitation.


Subject(s)
Ambulatory Care Facilities , Anesthesia, Local , Anti-Bacterial Agents , Antibiotic Prophylaxis , Cephalosporins , Humans , Incidence , Injections, Intravenous , Korea , Prescriptions , Skin , Surgeons , Surgery, Plastic , Surgical Wound Infection , Telephone , Wounds and Injuries
16.
S. Afr. fam. pract. (2004, Online) ; 62(2): 40-44, 2019. tab
Article in English | AIM | ID: biblio-1270131

ABSTRACT

Purpose: In everyday practice clinicians are overwhelmed by claims from the pharmaceutical industry and, due to marketing efforts, they often view generic multisource products with scepticism despite proof and registration by regulatory authorities of bioequivalence. The primary aim of this study was exploratory and aimed to compare the acceptability of generic cefpodoxime (Cepodem®) versus the innovator brand product (Orelox®) in terms of effectiveness, safety and tolerability in a general private setting in South Africa in the treatment of upper and lower respiratory tract infections.Methods and patients: Ninety patients were recruited and randomised to receive either product for 10 days after clinical diagnoses of either tonsillo-pharyngitis or rhino-sinusitis or pneumonia.Results: It was demonstrated that both products resulted in similar clinical and bacteriological cure rates with also no difference in tolerability profiles. Conclusion: These findings support the bioequivalence data as submitted for regulatory approval, of the generic Cepodem® translating into clinical effectiveness and argues against the need for a clinical non-inferiority study to demonstrate sameness


Subject(s)
Cephalosporins , Therapeutic Equivalency
17.
Article in English | WPRIM | ID: wpr-719662

ABSTRACT

PURPOSE: A task force appointed by the Korean Society of Acute Care Surgery reviewed previously published guidelines on antibiotic use in patients with abdominal injuries and adapted guidelines for Korea. METHODS: Four guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Five topics were considered: indication for antibiotics, time until first antibiotic use, antibiotic therapy duration, appropriate antibiotics, and antibiotic use in abdominal trauma patients with hemorrhagic shock. RESULTS: Patients requiring surgery need preoperative prophylactic antibiotics. Patients who do not require surgery do not need antibiotics. Antibiotics should be administered as soon as possible after injury. In the absence of hollow viscus injury, no additional antibiotic doses are needed. If hollow viscus injury is repaired within 12 hours, antibiotics should be continued for ≤ 24 hours. If hollow viscus injury is repaired after 12 hours, antibiotics should be limited to 7 days. Antibiotics can be administered for ≥7 days if hollow viscus injury is incompletely repaired or clinical signs persist. Broad-spectrum aerobic and anaerobic coverage antibiotics are preferred as the initial antibiotics. Second-generation cephalosporins are the recommended initial antibiotics. Third-generation cephalosporins are alternative choices. For hemorrhagic shock, the antibiotic dose may be increased twofold or threefold and repeated after transfusion of every 10 units of blood until there is no further blood loss. CONCLUSION: Although this guideline was drafted through adaptation of other guidelines, it may be meaningful in that it provides a consensus on the use of antibiotics in abdominal trauma patients in Korea.


Subject(s)
Abdominal Injuries , Advisory Committees , Anti-Bacterial Agents , Antibiotic Prophylaxis , Cephalosporins , Consensus , Humans , Korea , Shock, Hemorrhagic
18.
Article in English | WPRIM | ID: wpr-739013

ABSTRACT

BACKGROUND: Escherichia coli and Klebsiella pneumoniae clinical isolates producing CTX-M extendedspectrum β-lactamases (ESBLs) were assessed for antimicrobial resistance phenotypes varied by group of enzymes. METHODS: A total of 1,338 blood isolates, including 959 E. coli and 379 K. pneumoniae, were studied. All the strains were collected between January and July 2017 from eight general hospitals in South Korea. The species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibilities were determined by disk diffusion methods and ESBL phenotypes by double-disk synergy tests using disks containing cefotaxime, ceftazidime, cefepime, aztreonam, and clavulanic acid (CA). The genes for β-lactamases were identified by PCR and sequencing. RESULTS: Of total microbes, 31.6% (303/959) E. coli and 24.0% (91/379) K. pneumoniae were resistant to cefotaxime and 28.1% (269/959) E. coli and 20.1% (76/379) K. pneumoniae were CTX-M-type ESBL producers. Among the detected CTX-M ESBLs, 58.0% (156/269) in E. coli and 86.8% (66/76) in K. pneumoniae belonged to group 1, 46.8% (126/269) in E. coli and 14.5% (11/76) in K. pneumoniae were group 9. Ten E. coli and one K. pneumoniae isolates co-produced both groups of CTX-M ESBL. The group 1 CTX-M producers had a higher level of resistance to cefotaxime, ceftazidime, cefepime, and aztreonam and exhibited stronger synergistic activities when combined with CA compared to group 9. CONCLUSION: ESBL phenotypes differ by CTX-M ESBL group and phenotype testing with drugs including 4th generation cephalosporins and monobactams is critical for screening CTX-M-producers with better sensitivity.


Subject(s)
Aztreonam , Cefotaxime , Ceftazidime , Cephalosporins , Clavulanic Acid , Diffusion , Escherichia coli , Hospitals, General , Klebsiella pneumoniae , Korea , Mass Screening , Mass Spectrometry , Monobactams , Phenotype , Pneumonia , Polymerase Chain Reaction
19.
Rev. chil. infectol ; 35(5): 465-475, 2018. tab
Article in Spanish | LILACS | ID: biblio-978059

ABSTRACT

Resumen La resistencia bacteriana se ha incrementado en América Latina y el mundo, por lo que se requiere investigación y creación de nuevos antimicrobianos capaces de erradicar a los microorganismos resistentes. Se realizó una revisión acerca de nuevas cefalosporinas y sus combinaciones con un inhibidor de β-lactamasas, recopilando información de espectro, farmacocinética, farmacodinamia y estudios clínicos de las indicaciones actuales para ceftarolina, ceftazidima/avibactam y ceftolozano/tazobactam. La primera, con actividad frente a Staphylococcus aureus y Staphylococcus coagulasa negativa sensibles y resistentes a meticilina, y contra Streptococcus pneumoniae resistente a penicilina; por lo tanto, aprobada para uso en neumonía bacteriana adquirida en comunidad e infecciones bacterianas de piel y tejidos blandos. Entre las nuevas combinaciones, ceftazidima, una cefalosporina de tercera generación con actividad anti-pseudomonas, asociada a avibactam, un inhibidor de β-lactamasas, ha demostrado efectividad en el tratamiento de infecciones abdominales e infecciones urinarias complicadas. Por último, la combinación ceftolozano y el conocido tazobactam presenta acción comparable a la combinación de ceftazidima y avibactam por su actividad contra bacilos gramnegativos y, en combinación con metronidazol no presenta inferioridad a meropenem en infecciones intra-abdominales. Se presentan los estudios clínicos y las potenciales indicaciones y escenarios de uso de estas cefalosporinas.


Bacterial resistance has increased in Latin America and the world, making research and creation of new antimicrobials capable of eradicating resistant microorganisms essential. A review of new cephalosporins and their combinations with a beta-lactamase inhibitor was conducted, collecting data on the spectrum, pharmacokinetic and pharmacodynamic profile and clinical studies of the current indications for ceftaroline, and the combinations ceftazidime with avibactam and ceftolozane with tazobactam. The first one has activity against methicillin-resistant Staphylococcus aureus and coagulase negative Staphylococcus (SCoN) and against penicillin-resistant Streptococcus pneumoniae, therefore approved for use in community-acquired pneumonia and acute bacterial skin and skin structure infections. Among the new combinations, ceftazidime, a third generation cephalosporin with antipseudomonal activity, associated with avibactam, a betalactamase inhibitor, has been shown to be effective in the treatment of abdominal infections and complicated urinary infections. Finally, the combination of ceftolozane with tazobactam has comparable action to ceftazidime with avibactam due to its activity against Gram negative rods, and in combination with metronidazole they do not present inferiority to meropenem in intra-abdominal infections. The clinical studies are presented, as well as the potential indications and clinical scenarios for their use of this cephalosporins.


Subject(s)
Humans , Cephalosporins/therapeutic use , Cephalosporins/pharmacology , Gram-Positive Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Aerobic Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology , Microbial Sensitivity Tests , Ceftazidime/therapeutic use , Ceftazidime/pharmacology , Drug Combinations , Azabicyclo Compounds/therapeutic use , Azabicyclo Compounds/pharmacology , Tazobactam/therapeutic use , Tazobactam/pharmacology
20.
Rev. chil. infectol ; 35(3): 329-331, 2018. tab
Article in Spanish | LILACS | ID: biblio-1042647

ABSTRACT

Resumen Actualmente se recomienda el uso de cefazolina para determinar la susceptibilidad a cefalosporinas orales de primera generación en cepas de enterobacterias en ITU no complicada. Nuestro objetivo fue establecer la susceptibilidad a cefalosporinas orales en cepas urinarias según puntos de corte para cefalotina o cefazolina y la correlación de susceptibilidad entre cefazolina y cefadroxilo. Se estudió la concordancia entre cefalotina y cefazolina en 52 cepas por método de Kirby-Bauer y Vitek XL. En Escherichia coli fue de 0% para VitekXL y 50% para Kirby-Bauer. La concordancia entre cefazolina y cefadroxilo fue 95,6%. En el laboratorio debiera usarse cefazolina para determinar susceptibilidad a cefalosporinas orales de primera generación. La concordancia entre cefazolina y cefadroxilo sugiere que cefazolina podría predecir susceptibilidad para cefadroxilo.


Currently, the use of cefazolin is recommended to determine the susceptibility to first-generation oral cephalosporins in strains of enterobacteria in uncomplicated UTI. We determined susceptibility differences to oral cephalosporins in urinary strains according to cefazolin or cefalotin breakpoints and the correlation of susceptibility between cefazolin and cefadroxil. We studied 52 strains with cefalotin and cefazolin by disk-diffusion and MIC (Kirby-Bauer and Vitek XL) and a subgroup by disk-diffusion for cefadroxil. Agreement among different methods was 100% for K. pneumoniae and Proteus spp. In Escherichia coli, agreement for Vitek and disk-diffusion were 0 and 50% respectively. Susceptibility to first generation cephalosporins in E. coli should be determined with cefazolin. Agreement between cefazolin and cefadroxil suggests that cefazolin could also predict the susceptibility of cefadroxil.


Subject(s)
Humans , Cephalosporins/pharmacology , Enterobacteriaceae/drug effects , Anti-Bacterial Agents/pharmacology , Proteus/drug effects , Urinary Tract Infections/microbiology , Microbial Sensitivity Tests/methods , Cefadroxil/pharmacology , Cefazolin/pharmacology , Cephalosporins/classification , Cephalothin/pharmacology , Enterobacteriaceae/classification , Enterobacteriaceae Infections/microbiology , Escherichia coli/drug effects , Klebsiella pneumoniae/drug effects
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