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Wen SC, Best E, Nourse C. Non-typhoidal Salmonella infections in children: Review of literature and recommendations for management. J Paediatr Child Health 2017; 53:936-941. [PMID: 28556448 DOI: 10.1111/jpc.13585] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/23/2017] [Accepted: 03/21/2017] [Indexed: 12/24/2022]
Abstract
Non-typhoidal Salmonellae are a major cause of infectious diarrhoea worldwide and can cause invasive diseases, including bacteraemia, meningitis and osteomyelitis. Young or immunocompromised children and those with underlying conditions such as sickle cell disease are particularly vulnerable to invasive disease. There has been an increase in the rate of resistant non-typhoidal Salmonella, which is associated with invasive disease and hospitalisation. The intracellular nature of non-typhoidal Salmonella protects against extracellular antibiotics and can facilitate disease relapse, particularly meningitis. Effective antimicrobial agents with good intracellular penetration include azithromycin, fluoroquinolones and third-generation cephalosporins. Antibiotic treatment of non-typhoidal Salmonella gastroenteritis is only indicated if there are risk factors for invasive disease as it can prolong excretion and does not shorten the duration of gastrointestinal symptoms. Optimal choice and length of therapy for gastroenteritis and invasive disease in children is not clear. Here, we provide a review of the literature and treatment recommendations.
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Affiliation(s)
- Sophie Ch Wen
- Infection Management and Prevention Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Emma Best
- Department of Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand.,Department of Paediatrics, University of Auckland, Auckland, New Zealand
| | - Clare Nourse
- Infection Management and Prevention Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.,Department of Paediatrics, University of Queensland, Brisbane, Queensland, Australia
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Kamaruzzaman NF, Kendall S, Good L. Targeting the hard to reach: challenges and novel strategies in the treatment of intracellular bacterial infections. Br J Pharmacol 2017; 174:2225-2236. [PMID: 27925153 PMCID: PMC5481648 DOI: 10.1111/bph.13664] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/20/2016] [Accepted: 10/06/2016] [Indexed: 12/22/2022] Open
Abstract
Infectious diseases continue to threaten human and animal health and welfare globally, impacting millions of lives and causing substantial economic loss. The use of antibacterials has been only partially successful in reducing disease impact. Bacterial cells are inherently resilient, and the therapy challenge is increased by the development of antibacterial resistance, the formation of biofilms and the ability of certain clinically important pathogens to invade and localize within host cells. Invasion into host cells provides protection from both antibacterials and the host immune system. Poor delivery of antibacterials into host cells causes inadequate bacterial clearance, resulting in chronic and unresolved infections. In this review, we discuss the challenges associated with existing antibacterial therapies with a focus on intracellular pathogens. We consider the requirements for successful treatment of intracellular infections and novel platforms currently under development. Finally, we discuss novel strategies to improve drug penetration into host cells. As an example, we discuss our recent demonstration that the cell penetrating cationic polymer polyhexamethylene biguanide has antibacterial activity against intracellular Staphylococcus aureus. LINKED ARTICLES This article is part of a themed section on Drug Metabolism and Antibiotic Resistance in Micro-organisms. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.14/issuetoc.
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Affiliation(s)
- Nor Fadhilah Kamaruzzaman
- Department of Pathology and Pathogen BiologyRoyal Veterinary College, University of LondonNW10TUUK
- Faculty of Veterinary MedicineUniversiti Malaysia KelantanLocked Bag 36, Pengkalan Chepa16100Kota BharuKelantanMalaysia
| | - Sharon Kendall
- Department of Pathology and Pathogen BiologyRoyal Veterinary College, University of LondonNW10TUUK
| | - Liam Good
- Department of Pathology and Pathogen BiologyRoyal Veterinary College, University of LondonNW10TUUK
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Lee SM, Kwon HY, Im JH, Baek JH, Hwang SS, Kang JS, Chung MH, Lee JS. In Vitro Activity of Tigecycline Against Orientia tsutsugamushi. Yonsei Med J 2016; 57:1034-7. [PMID: 27189302 PMCID: PMC4951447 DOI: 10.3349/ymj.2016.57.4.1034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 11/27/2022] Open
Abstract
Scrub typhus is a zoonosis caused by Orientia tsutsugamushi (O. tsutsugamushi) occurring mainly in autumn in Korea. The need of new antibiotics has arisen with a report on strains resistant to antibiotics and chronic infection. This study aims to identify susceptibility of tigecycline in-vitro as a new therapeutic option for O. tsutsugamushi. Antibacterial activity of tigecycline against the O. tsutsugamushi was compared with doxycycline using flow cytometry assay. The inhibitory concentration 50 (IC₅₀) was 3.59×10⁻³ μg/mL in doxycycline-treated group. Whereas in 0.71×10⁻³ μg/mL tigecycline-treated group. These findings indicate that tigecycline may be a therapeutic option for the treatment of scrub typhus.
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Affiliation(s)
- Sun Myoung Lee
- Translation Research Center, Inha University School of Medicine, Incheon, Korea
| | - Hae Yoon Kwon
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jae Hyoung Im
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Ji Hyeon Baek
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seung Sik Hwang
- Department of Social & Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jae Seung Kang
- Department of Microbiology, Inha University School of Medicine, Incheon, Korea
| | - Moon Hyun Chung
- Department of Internal Medicine, Hanmaeum Hospital, Jeju, Korea
| | - Jin Soo Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
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Tang HJ, Chen CC, Lai CC, Zhang CC, Weng TC, Chiu YH, Toh HS, Chiang SR, Yu WL, Ko WC, Chuang YC. In vitro and in vivo antibacterial activity of tigecycline against Vibrio vulnificus. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 51:76-81. [PMID: 27260781 DOI: 10.1016/j.jmii.2016.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/12/2016] [Accepted: 04/25/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND/PURPOSE The aim of this study is to investigate the role of tigecycline in Vibrio vulnificus infection. METHODS Eight randomly selected clinical V. vulnificus isolates were studied to obtain the minimal inhibitory concentrations (MICs) of minocycline, cefotaxime, and tigecycline, and the time-kill curves of tigecycline alone or in combination with other drugs. A peritonitis mouse model was used for the evaluation of the therapeutic efficacy of tigecycline alone or cefotaxime in combination with minocycline or tigecycline. RESULTS The MIC of minocycline, cefotaxime, and tigecycline for eight clinical V. vulnificus isolates was 0.06-0.12 μg/mL, 0.03-0.06 μg/mL, and 0.03-0.06 μg/mL, respectively. In time-killing studies, at the concentration of 1 × MIC, the inhibitory effect of tigecycline persisted for 24 hours in five of eight isolates. With 2 × MIC and trough level, the inhibitory effect was noted in all isolates for 24 hours. With the combination of minocycline plus cefotaxime and tigecycline plus cefotaxime at 1/2 × MIC, the bactericidal effect was noted in 25% and 62.5% of eight isolates and synergism in 50% and 75% of isolates. With a low (1.25 × 105 CFU/mL) inoculum, all infected mice survived with tigecycline alone, tigecycline plus cefotaxime, or minocycline plus cefotaxime on the 14th day. At the inoculum of 1.25 × 106 CFU, the survival rate was 33.3% on the 14th day in the tigecycline plus cefotaxime-treated group, but none of the mice treated by tigecycline alone or minocycline plus cefotaxime survived (33.3% vs. 0%, p = 0.01 by Fisher's exact test). CONCLUSION Our in vitro combination and animal studies indicate that tigecycline could be an option for the treatment of invasive V. vulnificus infections.
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Affiliation(s)
- Hung-Jen Tang
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
| | - Chi-Chung Chen
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liou Ying, Tainan, Taiwan
| | | | - Tzu-Chieh Weng
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Hsin Chiu
- Department of Medicine, Chi Mei Medical Center, Liou Ying, Tainan, Taiwan
| | - Han-Siong Toh
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Shyh-Ren Chiang
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Wen-Liang Yu
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
| | - Yin-Ching Chuang
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan; Department of Medicine, Chi Mei Medical Center, Liou Ying, Tainan, Taiwan.
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Tang HJ, Chen CC, Ko WC. Tigecycline therapy for bacteremia and aortitis caused by Salmonella enterica serotype Choleraesuis: A case report. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 49:131-3. [DOI: 10.1016/j.jmii.2012.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 11/11/2011] [Accepted: 01/16/2012] [Indexed: 10/28/2022]
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Bassis CM, Theriot CM, Young VB. Alteration of the murine gastrointestinal microbiota by tigecycline leads to increased susceptibility to Clostridium difficile infection. Antimicrob Agents Chemother 2014; 58:2767-74. [PMID: 24590475 PMCID: PMC3993203 DOI: 10.1128/aac.02262-13] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 02/23/2014] [Indexed: 12/29/2022] Open
Abstract
Antibiotics can play dual roles in Clostridium difficile infection (CDI); antibiotic treatment increases the risk of CDI, and antibiotics are used to treat CDI. The glycylcycline antibiotic tigecycline has broad antimicrobial activity, yet it is rarely associated with the development of CDI, presumably due to its activity against C. difficile. In this study, we investigated how tigecycline treatment affects the structure of the gut microbiota and susceptibility to CDI by treating mice with tigecycline (n = 20) or saline (n = 8) for 10 days. A sequence analysis of the bacterial 16S rRNA gene amplicons was used to monitor changes in the fecal microbiota. A subset of the mice was followed for 5 weeks after the end of treatment. The remaining mice were challenged with C. difficile strain VPI 10463 spores 2 days after the tigecycline treatment ended. Tigecycline treatment resulted in major shifts in the gut microbiota, including large decreases in Bacteroidetes levels and large increases in Proteobacteria levels. Mice with tigecycline-altered microbial communities were susceptible to challenge with C. difficile spores and developed clinical signs of severe CDI. Five weeks after the cessation of tigecycline treatment, the recovery of the bacterial community was incomplete and diversity was lower than in the untreated controls. Antibiotics with intrinsic activity against C. difficile can still alter the microbiota in a way that leads to susceptibility to CDI after discontinuation of the drug. These results indicate that microbiotic dynamics are key in the development of CDI, and a better understanding of these dynamics may lead to better strategies to prevent and treat this disease.
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Affiliation(s)
- Christine M. Bassis
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, Michigan, USA
| | - Casey M. Theriot
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, Michigan, USA
| | - Vincent B. Young
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, Michigan, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
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Akkoyunlu Y, Ceylan B, Iraz M, Elmadag NM, Aslan T. Muscle Abscess due to Salmonella Enterica. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:605-607. [PMID: 24396582 PMCID: PMC3871750 DOI: 10.5812/ircmj.6852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 01/26/2013] [Accepted: 05/21/2013] [Indexed: 06/03/2023]
Abstract
Non typhoidal Salmonellae spp. causes clinical symptoms especially in neonates, infants, aged and immunocompromised patients. Hematogenous dissemination may occur in complicated cases whereas the formation of abscess is rare. A 61-year old woman presented to our hospital with pain and a mass in her left arm, without fever and leukocytosis. She was using methotrexate, corticosteroids and quinine for rheumatoid arthritis. She had a history of cervix cancer and was given radiotherapy and chemotherapy 3 years ago. Upon physical examination and magnetic resonance imaging, the mass was considered as an abscess and was surgically drained. Salmonella enterica spp. enterica was yielded in the culture of the drainage material. Ceftriaxon 2g/day was started intramuscularly and continued for 4 weeks. Salmonellosis is usually a self-limited disease, generally restricted to gastrointestinal tract and acquired following food poisoning. Management of Salmonella abscess requires a combination of antibiotherapy, surgical drainage and eradication of primary foci.
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Affiliation(s)
- Yasemin Akkoyunlu
- Bezmialem Vakif University, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Bahadir Ceylan
- Bezmialem Vakif University, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Meryem Iraz
- Bezmialem Vakif University, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Nuh Mehmet Elmadag
- Bezmialem Vakif University, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Turan Aslan
- Bezmialem Vakif University, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Use of Carbapenems against clinical, nontyphoid Salmonella isolates: results from in vitro and in vivo animal studies. Antimicrob Agents Chemother 2012; 56:2916-22. [PMID: 22470122 DOI: 10.1128/aac.00110-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The emergence of multidrug-resistant Salmonella isolates has created the need for new therapeutic agents. We evaluated the intracellular activity of four carbapenem compounds against clinical nontyphoid Salmonella (NTS) isolates in vitro and ex vivo. Subsequently, the efficacy of carbapenem treatment against selected Salmonella isolates in vivo was assessed using a murine peritonitis model. The MIC(50) and MIC(90) for doripenem, ertapenem, imipenem, and meropenem against 126 NTS isolates were found to be 0.062 and 0.062, 0.015 and 0.015, 0.5 and 1, and 0.031 and 0.031 μg/ml, respectively. The intracellular killing effect of ertapenem was sustained for 24 h and was superior to that of imipenem, meropenem, and doripenem; its effect was comparable to that of ceftriaxone. Ertapenem demonstrated an excellent pharmacokinetic profile with a percent time above the MIC of 75.5% and an area under the concentration-time curve/MIC ratio of 20,733. When peritoneal exudate cells were examined directly ex vivo from mice with Salmonella-induced peritonitis, cells from mice treated with ertapenem and ceftriaxone had intracellular and extracellular bacterial counts reduced 10(2)- to 10(4)-fold and exhibited killing effects similar to each other. The survival rates of mice inoculated with 1 × 10(5) and 10(6) CFU of a ceftriaxone-susceptible Salmonella isolate that were subsequently treated with ertapenem or ceftriaxone were 100% and 90%, respectively. When mice were inoculated with 5 × 10(4) and 10(5) CFU of a ceftriaxone-resistant and ciprofloxacin-resistant Salmonella isolate, mice treated with ertapenem had a higher survival rate than mice treated with ceftriaxone (70% versus 0% and 50% versus 0%, respectively; P < 0.001). Our results suggest that ertapenem is at least as effective as ceftriaxone in treating murine Salmonella infections and show that further clinical investigations on the potential use of ertapenem in treatment of human Salmonella infections are warranted.
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