1
|
Liu L, Zhu L, Hu C, Zhu S, Ye S. Rare Cases of Pseudomonas aeruginosa Meningitis in Children: 10-Year Experience in a Single Center. J Child Neurol 2024; 39:113-121. [PMID: 38488459 DOI: 10.1177/08830738241239703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE The primary objective was to elucidate the epidemiologic characteristics, risk determinants, and clinical outcomes associated with Pseudomonas aeruginosa-induced meningitis. METHODS All cases of meningitis caused by Pseudomonas aeruginosa that were treated at the hospital between 2012 and 2022 were retrospectively analyzed and detailed. RESULTS During a 10-year period, only 10 patients satisfied the inclusion criteria. Three patients had previously undergone neurosurgical procedures and 4 patients had leukemia. CONCLUSIONS Although Pseudomonas aeruginosa meningitis possesses a low incidence rate, the rate of mortality is high. Patients with leukemia or those who have undergone neurosurgery are the most susceptible to diagnosis. Cases of severe neutropenia present only mild or no cerebrospinal fluid pleocytosis. In patients with sensitive Pseudomonas aeruginosa meningitis, the timely use of anti-Pseudomonas carbapenems for intravenous treatment is highly effective. For drug-resistant Pseudomonas aeruginosa meningitis, intrathecal polymyxins administration can be an effective treatment option.
Collapse
Affiliation(s)
- Lijun Liu
- Department of Pediatric Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lvchang Zhu
- Department of Pediatric Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Chanchan Hu
- Department of Pediatric Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shuzhen Zhu
- Department of Emergency, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Sheng Ye
- Department of Pediatric Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| |
Collapse
|
2
|
Scorza CA, Scorza FA, Finsterer J. Pseudomonas aeruginosa ventriculitis following pancytopenia due to myelodysplastic syndrome with an excess of blasts type 2. Clinics (Sao Paulo) 2023; 78:100250. [PMID: 37473625 PMCID: PMC10372161 DOI: 10.1016/j.clinsp.2023.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023] Open
Affiliation(s)
| | | | - Josef Finsterer
- Disciplina de Neurociência, Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, SP, Brazil.
| |
Collapse
|
3
|
Cotran-Lenrow A, Tefera LS, Douglas-Vail M, Ayebare A, Kpokpah LN, Davis BP. Community-Acquired Pseudomonas aeruginosa Meningitis in a Pediatric Patient. Cureus 2023; 15:e42376. [PMID: 37621787 PMCID: PMC10445549 DOI: 10.7759/cureus.42376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
This case report presents a rare and significant case of community-acquired Pseudomonas aeruginosa meningitis in a healthy 13-month-old male patient in rural Liberia. Pseudomonas aeruginosa meningitis, particularly in the absence of predisposing factors, is a rare occurrence with a high mortality rate. The challenges in diagnosing this condition, especially in resource-limited settings, are highlighted. The patient initially presented with fever, seizures, and altered consciousness, and lumbar puncture revealed turbid cerebrospinal fluid (CSF) with elevated white blood cell count. Subsequent CSF culture confirmed Pseudomonas aeruginosa infection. Prompt initiation of appropriate antibiotic therapy, including a push dose of meropenem, resulted in clinical improvement. However, the patient exhibited post-meningitis sequelae, including hearing and visual impairments. Comprehensive follow-up care and rehabilitation services are crucial for managing these long-term complications. By sharing this case, we aim to increase awareness and facilitate early recognition of Pseudomonas aeruginosa meningitis, leading to improved patient care and outcomes in similar clinical scenarios.
Collapse
Affiliation(s)
| | - Lidia S Tefera
- Department of Pediatrics, Partners in Health, Harper, LBR
| | - Matthew Douglas-Vail
- Department of Emergency Medicine, University of British Columbia, Vancouver, CAN
| | - Arnold Ayebare
- Department of Microbiology, Partners in Health, Harper, LBR
| | | | - Bill P Davis
- Department of Pediatrics, James Jenkins (JJ) Dossen Hospital, Ministry of Health, Harper, LBR
| |
Collapse
|
4
|
Off-Label Use of Ceftolozane/Tazobactam for the Successful Treatment of Healthcare-Associated Meningitis Caused by Extensively Drug-Resistant Pseudomonas aeruginosa in a Polytraumatized Patient—A Case Report. REPORTS 2022. [DOI: 10.3390/reports5030033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Hospital-acquired infections with extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have become a worrisome concern because of unfavorable outcomes and limited antimicrobial treatment options. Studies with new antimicrobial substances against XDR-PA show very promising results in different infection types, but the data for central nervous system (CNS) infections are scarce. Case presentation: Here, we report the case of a young patient with healthcare-associated meningitis caused by XDR-PA following severe craniocerebral injury. An off-label use of high-dose ceftolozane/tazobactam (C/T) monotherapy was administered for 10 days in parallel with source-controlling measures. Clinical and microbial recovery could be accomplished promptly. Conclusion: In patients with hospital-acquired CNS infections due to XDR-PA, C/T might be a new, safe and effective alternative with fewer adverse effects compared to older polymyxin- or aminoglycoside-based regimens.
Collapse
|
5
|
Evaluation of Blood-Brain-Barrier Permeability, Neurotoxicity, and Potential Cognitive Impairment by Pseudomonas aeruginosa’s Virulence Factor Pyocyanin. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3060579. [PMID: 35340215 PMCID: PMC8948603 DOI: 10.1155/2022/3060579] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/07/2021] [Accepted: 01/13/2022] [Indexed: 12/04/2022]
Abstract
Pyocyanin (PCN) is a redox-active secondary metabolite produced by Pseudomonas aeruginosa as its primary virulence factor. Several studies have reported the cytotoxic potential of PCN and its role during infection establishment and progression. Considering its ability to diffuse through biological membranes, it is hypothesized that PCN can gain entry into the brain and induce oxidative stress across the blood-brain barrier (BBB), ultimately contributing towards reactive oxygen species (ROS) mediated neurodegeneration. Potential roles of PCN in the central nervous system (CNS) have never been evaluated, hence the study aimed to evaluate PCN's probable penetration into CNS through blood-brain barrier (BBB) using both in silico and in vivo (Balb/c mice) approaches and the impact of ROS generation via commonly used tests: Morris water maze test, novel object recognition, elevated plus maze test, and tail suspension test. Furthermore, evidence for ROS generation in the brain was assessed using glutathione S-transferase assay. PCN demonstrated BBB permeability albeit in minute quantities. A significant hike was observed in ROS generation (P < 0.0001) along with changes in behavior indicating PCN permeability across BBB and potentially affecting cognitive functions. This is the first study exploring the potential role of PCN in influencing the cognitive functions of test animals.
Collapse
|
6
|
Lynch JP, Zhanel GG. Pseudomonas aeruginosa Pneumonia: Evolution of Antimicrobial Resistance and Implications for Therapy. Semin Respir Crit Care Med 2022; 43:191-218. [PMID: 35062038 DOI: 10.1055/s-0041-1740109] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pseudomonas aeruginosa (PA), a non-lactose-fermenting gram-negative bacillus, is a common cause of nosocomial infections in critically ill or debilitated patients, particularly ventilator-associated pneumonia (VAP), and infections of urinary tract, intra-abdominal, wounds, skin/soft tissue, and bloodstream. PA rarely affects healthy individuals, but may cause serious infections in patients with chronic structural lung disease, comorbidities, advanced age, impaired immune defenses, or with medical devices (e.g., urinary or intravascular catheters, foreign bodies). Treatment of pseudomonal infections is difficult, as PA is intrinsically resistant to multiple antimicrobials, and may acquire new resistance determinants even while on antimicrobial therapy. Mortality associated with pseudomonal VAP or bacteremias is high (> 35%) and optimal therapy is controversial. Over the past three decades, antimicrobial resistance (AMR) among PA has escalated globally, via dissemination of several international multidrug resistant "epidemic" clones. We discuss the importance of PA as a cause of pneumonia including health care-associated pneumonia, hospital-acquired pneumonia, VAP, the emergence of AMR to this pathogen, and approaches to therapy (both empirical and definitive).
Collapse
Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
| | - George G Zhanel
- Department of Medical Microbiology/Infectious Diseases, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada
| |
Collapse
|
7
|
Morin CD, Déziel E, Gauthier J, Levesque RC, Lau GW. An Organ System-Based Synopsis of Pseudomonas aeruginosa Virulence. Virulence 2021; 12:1469-1507. [PMID: 34180343 PMCID: PMC8237970 DOI: 10.1080/21505594.2021.1926408] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Driven in part by its metabolic versatility, high intrinsic antibiotic resistance, and a large repertoire of virulence factors, Pseudomonas aeruginosa is expertly adapted to thrive in a wide variety of environments, and in the process, making it a notorious opportunistic pathogen. Apart from the extensively studied chronic infection in the lungs of people with cystic fibrosis (CF), P. aeruginosa also causes multiple serious infections encompassing essentially all organs of the human body, among others, lung infection in patients with chronic obstructive pulmonary disease, primary ciliary dyskinesia and ventilator-associated pneumonia; bacteremia and sepsis; soft tissue infection in burns, open wounds and postsurgery patients; urinary tract infection; diabetic foot ulcers; chronic suppurative otitis media and otitis externa; and keratitis associated with extended contact lens use. Although well characterized in the context of CF, pathogenic processes mediated by various P. aeruginosa virulence factors in other organ systems remain poorly understood. In this review, we use an organ system-based approach to provide a synopsis of disease mechanisms exerted by P. aeruginosa virulence determinants that contribute to its success as a versatile pathogen.
Collapse
Affiliation(s)
- Charles D Morin
- Centre Armand-Frappier Santé Biotechnologie, Institut National De La Recherche Scientifique (INRS), Laval, Quebec, Canada
| | - Eric Déziel
- Centre Armand-Frappier Santé Biotechnologie, Institut National De La Recherche Scientifique (INRS), Laval, Quebec, Canada
| | - Jeff Gauthier
- Département De Microbiologie-infectiologie Et Immunologie, Institut De Biologie Intégrative Et Des Systèmes (IBIS), Université Laval, Québec City, Quebec, Canada
| | - Roger C Levesque
- Département De Microbiologie-infectiologie Et Immunologie, Institut De Biologie Intégrative Et Des Systèmes (IBIS), Université Laval, Québec City, Quebec, Canada
| | - Gee W Lau
- Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, IL, US
| |
Collapse
|
8
|
Tigabu A, Jember A, Nega T, Wubishet G, Misganaw H, Goshu T, Negash M. Bacterial Meningitis Among Adult Patients at University of Gondar Comprehensive Specialized Referral Hospital. Infect Drug Resist 2021; 14:565-574. [PMID: 33623397 PMCID: PMC7895910 DOI: 10.2147/idr.s296792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/28/2021] [Indexed: 12/17/2022] Open
Abstract
Background Bacterial meningitis is a bacterial infection that causes inflammation of the membranes that surround the brain and spinal cord. The most frequent causes of bacterial meningitis are Neisseria meningitidis, Streptococcus pneumoniae, Listeria monocytogenes, and Haemophilus influenzae. This study aimed to determine bacterial meningitis and their antibiotic susceptibility patterns among adult patients. Methods A retrospective cross-sectional study was conducted on records of 3,683 patients to determine bacterial meningitis and their antibiotic susceptibility patterns from 2011 to 2020. Cerebrospinal fluid samples were collected, inoculated on blood and chocolate agar plates, and then incubated at 37°c for 24 hours. Bacterial identification performed using morphological characters, Gram stain, and biochemical tests. And then antimicrobial susceptibility tests were done using modified Kirby–Bauer disk diffusion technique. Records of 3,683 culture results were collected and reviewed using a checklist from the registration book. Finally, data was entered, cleared, and checked using Epi-info version 7 and exported to SPSS version 20 for analysis. Results Of the 3,683 patients, the overall prevalence of culture-positive bacterial meningitis was 1.28% (47/3683). Of them, bacterial meningitis in males was 1.61% (33/2052). Streptococcus pneumoniae (32%, 15/47) was the commonest isolate followed by Staphylococcus aureus, (12.80%, 6/47), Escherichia coli, (12.80%, 6/47), and Neisseria meningitidis, (10.60%, 5/47). Out of 47 culture-positive isolates, 15 of them were MDR isolates. Ceftriaxone, chloramphenicol, ciprofloxacin, vancomycin, clindamycin, and erythromycin were the most effective antibiotics whereas penicillin, tetracycline, and cotrimoxazole were the least effective antibiotics for isolates. Gender (P = 0.047, AOR = 0.528, CI = 0.282–0.99) is significantly associated with bacterial meningitis. Conclusion The prevalence of bacterial meningitis among adult patients was 1.28%. Males are at high risk for bacterial meningitis compared to females. Therefore, infection preventive measures are required with a particular focus on adult patients. Further research is needed to explore the epidemiology and risk factors of bacterial meningitis.
Collapse
Affiliation(s)
- Abiye Tigabu
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Abiyot Jember
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Nega
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Wubishet
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Hana Misganaw
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigist Goshu
- School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Markos Negash
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
9
|
Xu H, Cheng J, Yu Q, Li Q, Yi Q, Luo S, Li Y, Zhang G, Tian X, Cheng D, Luo Z. Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia. BMC Infect Dis 2020; 20:665. [PMID: 32907533 PMCID: PMC7488235 DOI: 10.1186/s12879-020-05257-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 07/14/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Pseudomonas aeruginosa (P. aeruginosa) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with P. aeruginosa bacteremia. METHODS From August 2014 to November 2018, we enrolled the inpatients with P. aeruginosa bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock. RESULTS Totally, 52 children with P. aeruginosa bacteremia were enrolled. The standard cut-off point of TTP was18 h. Early TTP (≤18 h) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%, P = 0.014), higher incidence of septic shock (52.4% vs12.9%, P = 0.06), higher Pitt bacteremia scores [3.00 (1.00-5.00) vs 1.00 (1.00-4.00), P = 0.046] and more intensive care unit admission (61.9% vs 22.6%, P = 0.008) when compared with late TTP (> 18 h) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21-21.96, P = 0.035; OR 4.95, 95%CI 1.26-27.50, P = 0.024; respectively). The independent risk factors for septic shock were as follows: TTP ≤18 h, Pitt bacteremia scores ≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18-33.77, P = 0.032; OR 8.15, 95%CI 1.15-42.43, P = 0.014; OR 6.46, 95% CI 1.19-33.19 P = 0.031; respectively). CONCLUSIONS Early TTP (≤18 hours) appeared to be associated with worse outcomes for P. aeruginosa bacteremia children.
Collapse
Affiliation(s)
- Huiting Xu
- Key Laboratory of Pediatrics in Chongqing, Chongqing, 400014, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Department of Children's Hospital of Chongqing Medical University of Education, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Jie Cheng
- Key Laboratory of Pediatrics in Chongqing, Chongqing, 400014, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Department of Children's Hospital of Chongqing Medical University of Education, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Qinghong Yu
- Key Laboratory of Pediatrics in Chongqing, Chongqing, 400014, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Department of Children's Hospital of Chongqing Medical University of Education, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Qingyuan Li
- Key Laboratory of Pediatrics in Chongqing, Chongqing, 400014, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Department of Children's Hospital of Chongqing Medical University of Education, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Qian Yi
- Key Laboratory of Pediatrics in Chongqing, Chongqing, 400014, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Department of Children's Hospital of Chongqing Medical University of Education, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Siying Luo
- Key Laboratory of Pediatrics in Chongqing, Chongqing, 400014, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Department of Children's Hospital of Chongqing Medical University of Education, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China
| | - Yuanyuan Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 401122, China
| | - Guangli Zhang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 401122, China
| | - Xiaoyin Tian
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 401122, China
| | - Dapeng Cheng
- Department of Clinical Laboratory center, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 401122, China.
| |
Collapse
|
10
|
Rodríguez-Lucas C, Fernández J, Martínez-Sela M, Álvarez-Vega M, Moran N, Garcia A, Menendez C, García-Prieto E, Rodríguez-Guardado A. Pseudomonas aeruginosa nosocomial meningitis in neurosurgical patients with intraventricular catheters: Therapeutic approach and review of the literature. Enferm Infecc Microbiol Clin 2020; 38:54-58. [DOI: 10.1016/j.eimc.2019.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 10/26/2022]
|
11
|
Marques BC, Santos MB, Anselmo DB, Monteiro DA, Gomes E, Saiki MFC, Rahal P, Rosalen PL, Sardi JCO, Regasini LO. Methoxychalcones: Effect of Methoxyl Group on the Antifungal, Antibacterial and Antiproliferative Activities. Med Chem 2019; 16:881-891. [PMID: 31339075 DOI: 10.2174/1573406415666190724145158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chalcones substituted by methoxyl groups have presented a broad spectrum of bioactivities, including antifungal, antibacterial and antiproliferative effects. However, a clear and unambiguous investigation about the relevance of this substituent on the chalcone framework has not been described. OBJECTIVE The purpose of this work is to assess the antibacterial, antifungal and antiproliferative activities of the two series of seventeen synthesized regioisomeric methoxychalcones. Series I and II were constituted by chalcones substituted by methoxyl groups on rings A (5-12) and B (13-21), respectively. In addition, the library of methoxychalcones was submitted to in silico drug-likeness and pharmacokinetics properties predictions. METHODS Methoxychalcones were synthesized and their structures were confirmed by NMR spectral data analyses. Evaluations of antimicrobial activity were performed against five species of Candida, two Gram-negative and five Gram-positive species. For antiproliferative activity, methoxychalcones were evaluated against four human tumorigenic cell lines, as well as human non-tumorigenic keratinocytes. Drug-likeness and pharmacokinetics properties were predicted using Molinspiration and PreADMET toolkits. RESULTS In general, chalcones of series I are the most potent antifungal, antibacterial and antiproliferative agents. 3', 4', 5'-Trimethoxychalcone (12) demonstrated potent antifungal activity against Candida krusei (MIC = 3.9 μg/mL), eight times more potent than fluconazole (reference antifungal drug). 3'-Methoxychalcone (6) displayed anti-Pseudomonas activity (MIC = 7.8 μg/mL). 2',5'-Dimethoxychalcone (9) displayed potent antiproliferative effect against C-33A (cervix), A-431 (skin) and MCF-7 (breast), with IC50 values ranging from 7.7 to 9.2 μM. Its potency was superior to curcumin (reference antiproliferative compound), which exhibited IC50 values ranging from 10.4 to 19.0 μM. CONCLUSION Our studies corroborated the relevance of methoxychalcones as antifungal, antibacterial and antiproliferative agents. In addition, we elucidated influence of the position and number of methoxyl groups toward bioactivity. In silico predictions indicated good drug-likeness and pharmacokinetics properties to the library of methoxychalcones.
Collapse
Affiliation(s)
- Beatriz C Marques
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto 15054-000, SP, Brazil
| | - Mariana B Santos
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto 15054-000, SP, Brazil
| | - Daiane B Anselmo
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto 15054-000, SP, Brazil
| | - Diego A Monteiro
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto15054-000, SP, Brazil
| | - Eleni Gomes
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto15054-000, SP, Brazil
| | - Marilia F C Saiki
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto15054-000, SP, Brazil
| | - Paula Rahal
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto15054-000, SP, Brazil
| | - Pedro L Rosalen
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas (Unicamp), Piracicaba 13083-970, SP, Brazil
| | - Janaina C O Sardi
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas (Unicamp), Piracicaba 13083-970, SP, Brazil
| | - Luis O Regasini
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, Sao Paulo State University (Unesp), Sao Jose do Rio Preto 15054-000, SP, Brazil
| |
Collapse
|
12
|
Frattari A, Savini V, Polilli E, Cibelli D, Talamazzi S, Bosco D, Consorte A, Fazii P, Parruti G. Ceftolozane-tazobactam and Fosfomycin for rescue treatment of otogenous meningitis caused by XDR Pseudomonas aeruginosa: Case report and review of the literature. IDCases 2018; 14:e00451. [PMID: 30263888 PMCID: PMC6156803 DOI: 10.1016/j.idcr.2018.e00451] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 11/18/2022] Open
Abstract
Infections due to XDR Pseudomonas are at increased risk of complications and death. CNS involvement may be due to poor CNS penetration of drugs with residual activity. XDR-PA meningitis ensued during treatment with colistin for pneumonia and bacteremia. CNS involvement by XDR-PA was timely suspected and quickly documented on CSF. High dose C-T and Fosfomycin provided rapid control of meningitis.
Extensively drug resistant Pseudomonas aeruginosa (XDR-PA) strains with limited or absent residual antimicrobial susceptibility cause a growing burden of difficult-to treat infections. Treatment options are even more limited for patients with central nervous system (CNS) involvement, as colistin-based regimens are hampered by poor blood brain barrier penetration, being often associated with insufficient clinical and microbiological success. New treatment options are awaited, but evidence from prospective evidence-based evaluations is still lacking. Here we report a case of breakthrough otogenous meningitis caused by XDR-PA in a young patient treated with meropenem and colistin for XDR-PA bloodstream infection and pneumonia after a car-crash polytrauma. The patient was treated with off-label, high-dose ceftolozane-tazobactam and high-dose fosfomycin after characterization of CNS XDR-PA isolates, with rapid clinical and microbiological resolution of meningitis. Our experience, although based on a single case, lands preliminary support to the concept that rescue regimens including ceftolozane-tazobactam and fosfomycin may be considered for XDR-PA CNS infections in patients without alternative therapeutic options.
Collapse
Affiliation(s)
| | - Vincenzo Savini
- Clinical Microbiology Unit, Pescara General Hospital, Pescara, Italy
| | - Ennio Polilli
- Clinical Pathology Laboratory, Pescara General Hospital, Pescara, Italy
| | | | | | - Donatella Bosco
- Intensive Care Unit, Pescara General Hospital, Pescara, Italy
| | - Augusta Consorte
- Infectious Disease Unit, Pescara General Hospital, Pescara, Italy
| | - Paolo Fazii
- Clinical Microbiology Unit, Pescara General Hospital, Pescara, Italy
| | - Giustino Parruti
- Infectious Disease Unit, Pescara General Hospital, Pescara, Italy
- Corresponding author at: Unit of Infectious Diseases, Pescara General Hospital, Via Fonte Romana 8, Pescara, Italy.
| |
Collapse
|
13
|
Gallaher C, Norman J, Singh A, Sanderson F. Community-acquired Pseudomonas aeruginosa meningitis. BMJ Case Rep 2017; 2017:bcr-2017-221839. [PMID: 29054951 DOI: 10.1136/bcr-2017-221839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gram-negative bacilli such as Pseudomonas aeruginosa are a rare cause of meningitis. Patients developing P. aeruginosa meningitis most commonly have a history of neurosurgical procedures. We report a patient who presented with community-acquired chronic meningitis secondary to P. aeruginosa, related to surgery for otosclerosis 5 years previously.
Collapse
Affiliation(s)
- Charles Gallaher
- Emergency Department, Chelsea and Westminster Hospital, London, UK
| | - James Norman
- Infectious Diseases, Chelsea and Westminster Hospital, London, UK
| | - Abhinav Singh
- Department of Radiology, Charing Cross Hospital, London, UK
| | | |
Collapse
|
14
|
Huang CR, Lien CY, Tsai WC, Lai WA, Hsu CW, Tsai NW, Chang CC, Lu CH, Chien CC, Chang WN. The clinical characteristics of adult bacterial meningitis caused by non-Pseudomonas (Ps.) aeruginosa Pseudomonas species: A clinical comparison with Ps. aeruginosa meningitis. Kaohsiung J Med Sci 2017; 34:49-55. [PMID: 29310816 DOI: 10.1016/j.kjms.2017.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/29/2017] [Accepted: 08/22/2017] [Indexed: 11/27/2022] Open
Abstract
Adult bacterial meningitis (ABM) caused by non-Pseudomonas (Ps.) aeruginosa Pseudomonas (NPAP) species infection has rarely been reported. The clinical characteristics of 52 cases of Pseudomonas ABM (11 NPAP- and 41 Ps. aeruginosa-related meningitis) collected during a 30-year study period (1986-2015) were included. Eleven cases of NPAP ABM were identified in the literature, and their clinical data were also collected. Therefore, a total of 22 NPAP ABM cases were enrolled. The clinical characteristics of the NPAP ABM and Ps. aeruginosa ABM groups were compared. Of the implicated NPAP strains, Ps. putida and Ps. stutzeri were the most common (7 cases each), followed by Ps. mendocina in 4, Ps. fluorescens in 1, Ps. fulva in 1, Ps. alcaligenes in 1, and Ps. mosselii in 1. Of the 22 cases, 50% (11/22) had an underlying postneurosurgical state. Fever (77.3%, 17/22) and altered consciousness (45.5%, 10/22) were the most common clinical presentations. Antibiotic non-susceptibility was found in 3 strains of Ps. putida and 1 Ps. mosselii strain. Compared to the patients with Ps. aeruginosa ABM, those with NPAP ABM had a higher incidence of spontaneous infections and a better survival rate. In conclusion, although Ps. putida, Ps. stutzeri and Ps. mendocina were the major implicated strains of NPAP ABM, the clinical characteristics of this specific group of ABM demonstrated marked heterogeneity. Even though the cases with NPAP ABM had better therapeutic results than those with Ps. aeruginosa ABM, further large-scale studies are needed to better delineate this specific group of ABM.
Collapse
Affiliation(s)
- Chi-Ren Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia-Yi Lien
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wan-Chen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-An Lai
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Che-Wei Hsu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Chih Chien
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Neng Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| |
Collapse
|
15
|
Sankar Ganesh P, Ravishankar Rai V. Attenuation of quorum-sensing-dependent virulence factors and biofilm formation by medicinal plants against antibiotic resistant Pseudomonas aeruginosa. J Tradit Complement Med 2017; 8:170-177. [PMID: 29322006 PMCID: PMC5755981 DOI: 10.1016/j.jtcme.2017.05.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/14/2017] [Accepted: 05/15/2017] [Indexed: 11/26/2022] Open
Abstract
Pseudomonas aeruginosa use small signaling molecules such as acyl homoserine lactones (AHLs), which play an important role in release virulence factors and toxin for further establishment of host infection. Thus, involving with the QS system would provide alternative ways of preventing the pathogenicity. In the present study, totally six medicinal plants (Terminalia bellerica, Celastrus paniculatus, Kingiodendron pinnatum, Schleichera oleosa, Melastoma malabathricum, Garcinia gummi-gutta) were screened for anti-QS activity using biomonitor strain of Chromobacterium violaceum CV12472. The primary screening of antimicrobial activity of all the plant extracts have inhibited the growth of tested bacterial species. Of these at the sub-minimum inhibitory concentration the methanol extract of T. bellerica (0.0625–0.5 mg/ml) has significantly inhibited violacein production (20.07–66.22%) in C. violaceum (CV12472). Consequently, the extract of T. bellerica has reduced the production of pyocyanin, exopolysaccharide and biofilm formation in P. aeruginosa strains. Fluorescence and scanning electron microscopy analysis confirmed the reduction of biofilm formation in P. aeruginosa strains when treated with T. bellerica. GC–MS analysis showed the active compounds inhibited the production of virulence factors of P. aeruginosa. The results suggest the possible use of this T. bellerica as an anti-QS and anti-biofilm agent to control Pseudomonas infection. Interference of QS provides an important means for the inhibition of bacterial virulence and thus aids in treatment strategies.
Collapse
Affiliation(s)
- P Sankar Ganesh
- Department of Studies in Microbiology, University of Mysore, Mysore 570006, Karnataka, India
| | - V Ravishankar Rai
- Department of Studies in Microbiology, University of Mysore, Mysore 570006, Karnataka, India
| |
Collapse
|
16
|
Ganesh PS, Rai RV. Inhibition of quorum-sensing-controlled virulence factors of Pseudomonas aeruginosa by Murraya koenigii essential oil: a study in a Caenorhabditis elegans infectious model. J Med Microbiol 2016; 65:1528-1535. [DOI: 10.1099/jmm.0.000385] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- P. Sankar Ganesh
- Department of Studies in Microbiology, University of Mysore, Manasagangotri, Mysore 570006, Karnataka, India
| | - Ravishankar Vittal Rai
- Department of Studies in Microbiology, University of Mysore, Manasagangotri, Mysore 570006, Karnataka, India
| |
Collapse
|