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Prevalence, Resistance Profile and Virulence Genes of Streptococcus agalactiae Colonizing Near-term Pregnant Women Attending Ain Shams University Hospital. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.3.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Group B streptococcus (GBS) is a common cause of infections in pregnant females and non-pregnant adults with chronic diseases (such as diabetes and cancer), also it is the main reason of septicaemia and meningitis in infants. The aim of this study was to figure out how common GBS is in pregnant women, the antimicrobial sensitivity pattern of the isolated GBS colonies and check the presence of scpB and rib virulence genes in these isolates. We screened 203 pregnant women attending the Maternity Hospital of Ain Shams University using vaginal sampling. Isolation was done on CHROMagarTM Strep B and sheep blood agar plates then identified via colony characters, Gram stain, test for catalase production, Christie–Atkins–Munch-Petersen (CAMP) test, test for hippurate hydrolysis and latex agglutination test. This was followed by an antibiotic susceptibility test. Finally, Detection of scpB and rib virulence genes by conventional PCR was done. Our study detected that the prevalence rate of GBS in involved pregnant women was 11.33%. A statistically significant association between colonization and history of spontaneous abortion and preterm labor was observed. CHROMagar™ StrepB showed the same sensitivity of sheep blood agar with extensive effort to isolate suspected GBS colonies from blood agar. GBS was 100% sensitive to levofloxacin, linezolid, cefepime, ceftaroline and ceftriaxone. Also, it was highly sensitive to vancomycin (91.3%). Sensitivity to clindamycin, azithromycin, penicillin and ampicillin was (21.70%, 21.70%,47.80%, 47.80%) respectively. The least sensitivity of GBS was to erythromycin ( 8.7%). All isolates possessed the scpB gene (100%) while only 18 isolates (78.26%) had the rib gene.
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Spaulding AB, Watson D, Dreyfus J, Heaton P, Koutsari C, Kharbanda AB. Associations of Antimicrobial-Resistant Gram-Negative Bloodstream Infections with Outcomes among Hospitalized Pediatric Patients in the United States. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1731643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Objective The aim of this study was to assess the impact of pediatric antimicrobial-resistant gram-negative bloodstream infections (GNBSIs).
Methods A retrospective cohort study (2009–2016) was conducted using the Premier Healthcare Database among pediatric admissions with GNBSIs at hospitals reporting microbiology data. Infections for neonates and nonneonates were classified as multidrug resistance (MDR), resistant to one or two antibiotic drug classes (1–2DR), or susceptible.
Results Among 1,276 GNBSIs, 266 (20.8%) infections were 1–2DR and 23 (1.8%) MDR. Compared with susceptible GNBSIs, MDR nonneonates had higher mortality and higher costs, whereas 1–2DR neonates had longer stays and higher costs.
Conclusions Antimicrobial-resistant GNBSIs were associated with worse outcomes among pediatric hospitalized patients.
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Affiliation(s)
| | - David Watson
- Children's Minnesota Research Institute, Minneapolis, Minnesota, United States
| | | | - Phillip Heaton
- Children's Minnesota Research Institute, Minneapolis, Minnesota, United States
| | - Christina Koutsari
- Antimicrobial Stewardship Program, Children's Minnesota, Minneapolis, Minnesota, United States
| | - Anupam B. Kharbanda
- Pediatric Emergency Medicine, Chief of Critical Care Services, Children's Minnesota, Minneapolis, Minnesota, United States
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Rao C, Dhawan B, Vishnubhatla S, Kapil A, Das B, Sood S. Emergence of high-risk multidrug-resistant Enterococcus faecalis CC2 (ST181) and CC87 (ST28) causing healthcare-associated infections in India. INFECTION GENETICS AND EVOLUTION 2020; 85:104519. [PMID: 32877660 DOI: 10.1016/j.meegid.2020.104519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/14/2020] [Accepted: 08/25/2020] [Indexed: 12/13/2022]
Abstract
High-risk hospital-associated multidrug-resistant (MDR) Enterococcus faecalis clonal complexes (CCs) such as CC2 and CC87 are enriched with virulence determinants that help to accumulate, colonize, and cause serious nosocomial infections. The aim of this study was to establish the epidemiology and clonal composition of 134 clinical E. faecalis isolates and to link molecular typing data with antimicrobial resistance and virulence determinants. All isolates were identified by conventional methods and confirmed by polymerase chain reaction (PCR) (16srRNA gene and ddl genes of E. faecalis/ E. faecium) in 5-years. Disc diffusion test was performed on all strains. We screened all E. faecalis for aac(6')-aph(2″), vanA, and vanB resistance genes, and aggregation substance-asa1, cytolysin-cylA, collagen-binding protein-ace, enterococcal surface protein-esp, gelatinase-gelE, and hyaluronidase-hyl virulence genes by PCR. Representative isolates of E. faecalis were characterized by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). Out of 539 patients with enterococcal infections, 134 (24.9%) had E. faecalis infections, 366 (67.9%) had E. faecium infections, and 39 (7.2%) had infections due to other enterococcal species. Of the 134 isolates, 79.1% and 61.9% isolates were high-level gentamicin resistant (HLGR) and MDR. In multivariate analysis, independent predictor for infection due to MDR E. faecalis strains was a surgical intervention (OR 2.41, 95% CI 1.17-4.96, P = 0·017). Overall, the observed rate of in-hospital mortality was 11.9%. The gelE, asa1, ace, cylA, esp and hyl genes were detected in 87.3%, 78.4%, 54.5%, 53.7%, 36.6% and 3.0%, respectively in E. faecalis isolates. The asaI, cylA, and gelE genes were significantly correlated with MDR E. faecalis. The PFGE analysis showed 28 clones with four major clones. MLST analysis revealed two sequence types-ST28 (CC87) and ST181 (CC2). This is the first Indian report on the emergence of the high-risk hospital-associated worldwide-disseminated ST28 (CC87) and ST181 (CC2), which have enriched with multiple virulence determinants and resistance to antibiotics, paticularly ampicillin. This report indicates serious health concern and calls for on-going surveillance, close monitoring, and improved infection control procedures to stop further spread of these isolates.
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Affiliation(s)
- Chandrabhan Rao
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Sreenivas Vishnubhatla
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Bimal Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Seema Sood
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India
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Molecular Characterization of Streptococcus agalactiae Isolates from Pregnant Women in Kathmandu City. J Trop Med 2020; 2020:4046703. [PMID: 32908547 PMCID: PMC7474781 DOI: 10.1155/2020/4046703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Group B streptococci (GBS) are globally recognized as one of the leading causes of neonatal sepsis and meningitis and is also known to cause adverse pregnancy outcomes such as stillbirths and miscarriages. Thus, detailed investigation of GBS in pregnant women has special significance in public health related researches. Objectives The present study is aimed at evaluating the prevalence of GBS colonization among pregnant women in Kathmandu city. Methods The study was carried out among 125 pregnant women at their trimester (35-37 weeks) (during the time period between January and June in 2018). The prevalence was determined by the culture method in HiCrome Strep B Selective Agar Base and then by using the PCR technique. The serotypes were evaluated by multiplex PCR analysis, while the antibiotics susceptibility tests were performed using the disk diffusion method. Results Among 125 samples studied, GBS were recorded in 24 samples (implying a prevalence of 19.2%). Furthermore, using the multiplex PCR, among 24 GBS-positive samples, 13 (54.17%) were found to be typeable while 11 (45.83%) were nontypeable. The most abundant serotype recorded in this study was type III (33.33) while the serotypes IV, V, VI, VII, and VIII were not found. Conclusion The isolates were sensitive towards some antibiotics such as linezolid and ceftriaxone 100%, whereas penicillin 50% and vancomycin 75% but were resistant to tetracycline and ertapenem. Serotype III was found to be predominant in the samples collected during the study period. The observed prevalence was significantly associated with the gestational period, whereas no relationship was found for other risk factors.
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Buurman ET, Timofeyeva Y, Gu J, Kim JH, Kodali S, Liu Y, Mininni T, Moghazeh S, Pavliakova D, Singer C, Singh S, Handke LD, Lotvin J, Prasad AK, Scully IL, Donald RGK, Jansen KU, Anderson AS. A Novel Hexavalent Capsular Polysaccharide Conjugate Vaccine (GBS6) for the Prevention of Neonatal Group B Streptococcal Infections by Maternal Immunization. J Infect Dis 2020; 220:105-115. [PMID: 30778554 PMCID: PMC6548902 DOI: 10.1093/infdis/jiz062] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/14/2019] [Indexed: 12/20/2022] Open
Abstract
Background Group B streptococcus (GBS) causes serious diseases in newborn infants, often resulting in lifelong neurologic impairments or death. Prophylactic vaccination of pregnant women prior to delivery could provide comprehensive protection, as early onset and late-onset disease and maternal complications potentially could be addressed. Methods Capsular polysaccharide conjugate vaccine GBS6 was designed using surveillance data yielded by whole-genome sequencing of a global collection of recently recovered GBS isolates responsible for invasive neonatal GBS disease. Capsular polysaccharides were isolated, oxidized using sodium periodate, and conjugated to CRM197 by reductive amination in dimethyl sulfoxide. Immune responses in mice and rhesus macaques were measured in a multiplex Luminex immunoglobulin G (IgG) assay and opsonophagocytic activity assays. Results The optimized conjugates were immunogenic, alone and in combination, in mice and rhesus macaques, inducing IgG antibodies that mediated opsonophagocytic killing. Active immunization of murine dams with GBS6 prior to mating resulted in serotype-specific protection of pups from a lethal challenge with GBS. Protection following passive administration of serotype-specific IgG monoclonal antibodies to dams demonstrated conclusively that anticapsular polysaccharide IgG alone is sufficient for protection. Conclusions The findings support the ongoing clinical evaluation of maternal GBS6 vaccination as a potential alternative method to prevent GBS disease in infants.
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Affiliation(s)
- Ed T Buurman
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | | | - Jianxin Gu
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Jin-Hwan Kim
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Srinivas Kodali
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Yongdong Liu
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Terri Mininni
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Soraya Moghazeh
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | | | | | - Suddham Singh
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Luke D Handke
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Jason Lotvin
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | | | - Ingrid L Scully
- Vaccine Research and Development, Pfizer, Pearl River, New York
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Huttner A, Bielicki J, Clements MN, Frimodt-Møller N, Muller AE, Paccaud JP, Mouton JW. Oral amoxicillin and amoxicillin-clavulanic acid: properties, indications and usage. Clin Microbiol Infect 2019; 26:871-879. [PMID: 31811919 DOI: 10.1016/j.cmi.2019.11.028] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Amoxicillin has been in use since the 1970s; it is the most widely used penicillin both alone and in combination with the β-lactamase clavulanic acid. OBJECTIVES In this narrative review, we re-examine the properties of oral amoxicillin and clavulanic acid and provide guidance on their use, with emphasis on the preferred use of amoxicillin alone. SOURCES Published medical literature (MEDLINE database via Pubmed). CONTENT While amoxicillin and clavulanic acid have similar half-lives, clavulanic acid is more protein bound and even less heat stable than amoxicillin, with primarily hepatic metabolism. It is also more strongly associated with gastrointestinal side effects, including Clostridium difficile infection, and, thus, in oral combination formulations, limits the maximum daily dose of amoxicillin that can be given. The first ratio for an amoxicillin-clavulanic acid combination was set at 4:1 due to clavulanic acid's high affinity for β-lactamases; ratios of 2:1, 7:1, 14:1 and 16:1 are currently available in various regions. Comparative effectiveness data for the different ratios are scarce. Amoxicillin-clavulanic acid is often used as empiric therapy for many of the World Health Organization's Priority Infectious Syndromes in adults and children, leading to extensive consumption, when some of these syndromes could be handled with a delayed antibiotic prescription approach or amoxicillin alone. IMPLICATIONS Using available epidemiological and pharmacokinetic data, we provide guidance on indications for amoxicillin versus amoxicillin-clavulanic acid and on optimal oral administration, including choice of combination ratio. More data are needed, particularly on heat stability, pharmacodynamic effects and emergence of resistance in 'real-world' clinical settings.
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Affiliation(s)
- A Huttner
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | - J Bielicki
- University of Basel Children's Hospital, Paediatric Infectious Diseases, Basel, Switzerland; Paediatric Infectious Diseases Research Group, St. George's University of London, London, UK
| | - M N Clements
- MRC Clinical Trials Unit at UCL, UCL, London, UK
| | - N Frimodt-Møller
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - A E Muller
- Department of Medical Microbiology, Haaglanden Medical Centre, The Hague, the Netherlands; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - J-P Paccaud
- Global Antibiotic Research and Development Partnership, Geneva, Switzerland
| | - J W Mouton
- Department of Medical Microbiology, Haaglanden Medical Centre, The Hague, the Netherlands
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Changing antibiotic resistance profile of Staphylococcus aureus isolated from HIV patients (2012-2017) in Southern India. J Infect Public Health 2019; 13:75-79. [PMID: 31402312 DOI: 10.1016/j.jiph.2019.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 05/20/2019] [Accepted: 06/16/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Emergence of multidrug-resistant and methicillin-resistant Staphylococcus aureus (MRSA) infections in HIV patients limit the treatment options and challenge the clinical management of infections. The periodic monitoring of S. aureus infections and its drug resistance profile in HIV patients are of paramount importance in clinical management. MATERIALS AND METHODS A total of 7204 clinical specimens from HIV patients from 2012 to 2017 were processed for the isolation of S. aureus strains using conventional culture techniques and cultures were identified using standard biochemical test. Antibiotic susceptibility of S. aureus strains was tested by Kirby-Bauer disk diffusion method. RESULTS A total of 380 (5.3%) S. aureus strains were isolated from HIV patients in the study period. High percentage of S. aureus strains were isolates from urine (69.5%) specimen and 58.4% of S. aureus infections were noted among hospitalized patients. Antibiotic susceptibility profile reveals S. aureus was highly resistant to penicillin (95.2%) followed by cephalexin (84.6%). Methicillin resistance was highly observed in the year 2017 (86%) and the rate of MRSA steadily increasing from 51.8% in 2012 to 86% in 2017. Significant increase of S. aureus infections (35%; p<0.001) and MRSA (76%; p=0.0007) were observed in the year 2016. CONCLUSIONS This study reports the increasing trends of S. aureus infections and MRSA among HIV patients from Southern India. Multidrug-resistance profile of S. aureus could complicate the selection of proper antibiotic regimens and time cure of HIV patients.
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Jamal W, Abdulkareem H, Rotimi VO. Comparative in vitro activity of ceftaroline and comparator agents against nosocomial Gram-negative and Gram-positive clinically significant bacterial isolates from patients in a teaching hospital in Kuwait. J Chemother 2018; 30:213-223. [PMID: 29466931 DOI: 10.1080/1120009x.2018.1438768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective was to test the in vitro activities of ceftaroline and comparator agents against clinical isolates of Gram-negative and Gram-positive bacteria. Isolates were identified with VITEK II. Susceptibility testing was with E test. A total of 1264 isolates were tested. Compared to other cephalosporins, ceftaroline demonstrated excellent in vitro activities (MIC90, ≤0.5 mg/L) against Escherichia coli, Salmonella spp. and Haemophilus influenzae. When matched with the comparator cephalosporins, ceftaroline demonstrated the greatest activity against methicillin-susceptible Staphylococcus aureus (MSSA), with MIC90 of 0.25 mg/L. Ceftaroline's MIC90s against both community-associated methicillin-resistant S. aureus (MRSA) and hospital-acquired MRSA were 0.5 and 1 mg/L, respectively. Major discrepancies were noted between E test and disc diffusion tests for ceftaroline only against 16 Gram-negative and 16 Gram-positive isolates. Ceftaroline demonstrated an excellent in vitro activity against the majority of clinically significant Gram-negative and Gram-positive isolates obtained from proven cases of bacterial infections.
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Affiliation(s)
- Wafaa Jamal
- a Faculty of Medicine, Department of Microbiology , Kuwait University , Jabriya , Kuwait
- b Microbiology Unit, Mubarak Al Kabir Hospital , Jabriya , Kuwait
| | | | - Vincent O Rotimi
- a Faculty of Medicine, Department of Microbiology , Kuwait University , Jabriya , Kuwait
- b Microbiology Unit, Mubarak Al Kabir Hospital , Jabriya , Kuwait
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Clinical and Bacterial Risk Factors for Mortality in Children With Carbapenem-resistant Enterobacteriaceae Bloodstream Infections in India. Pediatr Infect Dis J 2017; 36:e161-e166. [PMID: 28005691 DOI: 10.1097/inf.0000000000001499] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carbapenem-resistant Enterobacteriaceae (CRE) are an increasing cause of nosocomial infection in hospitalized children worldwide. Few studies have investigated risk factors for mortality in children with CRE bloodstream infection (BSI). Data are particularly scarce in areas where NDM and OXA carbapenemases predominate. Here, we investigate mortality rates, clinical and microbiologic risk factors for mortality in 50 pediatric patients with CRE BSI in India. METHODS Children younger than 17 years old with meropenem-resistant Klebsiella pneumoniae or Escherichia coli isolated from blood culture in 2014 and 2015 were identified from laboratory records. Clinical records were systematically reviewed for each child to establish mortality at 30 days and clinical details. Bacterial isolates were subjected to meropenem E test and multiplex polymerase chain reaction to determine carbapenemase gene. Data were analyzed to establish clinical and bacterial risk factors for mortality. RESULTS All CRE BSI were hospital-acquired or associated with healthcare. A total of 84% of children had an underlying comorbidity and 46% had a malignancy. K. pneumoniae was the most common bacteria isolated; NDM was the most common carbapenemase gene detected. The mortality rate was 52%. Significant risk factors for mortality included intensive care admission, intubation, inotropic support and respiratory source. Failure to clear bacteremia and a minimum inhibitory concentration > 8 mg/L for the isolate was associated with a statistically significant increase in mortality. Mortality rates were significantly lower when two or more effective drugs were used in combination. CONCLUSIONS CRE BSI affects children with multiple comorbidities and repeated admissions to hospital. The mortality rate is high; combination therapy may be beneficial.
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Mastrolia MV, Galli L, De Martino M, Chiappini E. Use of tigecycline in pediatric clinical practice. Expert Rev Anti Infect Ther 2017; 15:605-612. [PMID: 28395551 DOI: 10.1080/14787210.2017.1318064] [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] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Tigecycline, a derivative of minocycline, is an extended-spectrum antimicrobial agent. It has a restricted approval field in children and the experience of its adoption in clinical practice is reserved for cases of challenging infections. The aim of this review was to summarize evidence regarding the use of tigecycline in infants and children, focusing on the drug's clinical efficacy data and tolerability profile. Areas covered: We have conducted a literature search of the Cochrane Library, EMBASE, and MEDLINE databases, from their inception through 5 January 2017, using the following terms: tigecycline, newborn, infant, child, pediatrics, adolescent, human, clinical trial, and case report. Articles were excluded if they were redundant or not pertinent. Bibliographies of all relevant articles were also evaluated. Seventeen publications were included: 1 pharmacokinetic study, 16 case reports. In the selected publications, the patients' mean age was 4.45 years, 38.7% of children was <3 years old and favorable clinical response was achieved in 74.2% of cases. Expert commentary: Tigecycline may be a considerable option in life-threatening infections in pediatric patients. Its administration is well tolerated and has demonstrated a good clinical response in nonbacteremic patients. However, the available clinical records are limited and more studies are needed.
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Affiliation(s)
- Maria Vincenza Mastrolia
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
| | - Luisa Galli
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
| | - Maurizio De Martino
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
| | - Elena Chiappini
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
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Rubinstein E, Lagacé-Wiens P. Quinolones. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00144-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kacou-Ndouba A, Revathi G, Mwathi P, Seck A, Diop A, Kabedi-Bajani MJ, Mwiti W, Anguibi-Pokou MJ, Morrissey I, Torumkuney D. Results from the Survey of Antibiotic Resistance (SOAR) 2011-14 in the Democratic Republic of Congo, Ivory Coast, Republic of Senegal and Kenya. J Antimicrob Chemother 2016; 71 Suppl 1:i21-31. [PMID: 27048579 DOI: 10.1093/jac/dkw070] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011-14. METHODS Bacterial isolates were collected and MICs determined using Etest(®) for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2. RESULTS Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (∼65%) but 87%-100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with β-lactamase prevalence of 39% and 4%, respectively. Furthermore, β-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries. CONCLUSIONS There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility.
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Affiliation(s)
| | - G Revathi
- Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya, PO Box 30270, 00100
| | - P Mwathi
- Kenyatta National Hospital, Microbiology Department, P.O. Box 20723, Nairobi, Kenya 00200
| | - A Seck
- Institute Pasteur Dakar, Dakar Faculty of Medicine, 36 Avenue Pasteur, B.P. 220, Dakar, Senegal
| | - A Diop
- University of Dakar, Faculty of Medicine, BP 45515, Dakar-Fann, Senegal
| | - M J Kabedi-Bajani
- University of Kinshasa, National Institute Biomedical Research (INRB), Kinshasa, Democratic Republic of Congo
| | - W Mwiti
- GlaxoSmithKline Kenya, 23 Likoni Road, P.O. Box 78392, Nairobi, Kenya 00507
| | - M J Anguibi-Pokou
- GlaxoSmithKline West and Central Africa, 7 Rue des Bougainvilliers Cocody, 01 BP 8111 Abidjan 01, Cote d'Ivoire
| | - I Morrissey
- IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland
| | - D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
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Basireddy S, Singh M, Ali S, Kabra V. Tigecycline-resistant staphylococcal isolates in a tertiary care centre. Indian J Med Microbiol 2016; 33:461-2. [PMID: 26068365 DOI: 10.4103/0255-0857.158608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - M Singh
- Department of Microbiology, Sri Venkata Sai Medical College, Mahabubnagar - 509 001, Andhra Pradesh, India
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Induced tigecycline resistance inStreptococcus pneumoniaemutants reveals mutations in ribosomal proteins and rRNA. J Antimicrob Chemother 2015; 70:2973-80. [DOI: 10.1093/jac/dkv211] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/21/2015] [Indexed: 11/12/2022] Open
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Antimicrobial susceptibilities of group B streptococcus isolates from prenatal screening samples. J Clin Microbiol 2014; 52:3499-500. [PMID: 25031448 DOI: 10.1128/jcm.01781-14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Doi A, Iwata K, Takegawa H, Miki K, Sono Y, Nishioka H, Takeshita J, Tomii K, Haruta T. Community-acquired pneumonia caused by carbapenem-resistant Streptococcus pneumoniae: re-examining its prevention and treatment. Int J Gen Med 2014; 7:253-7. [PMID: 24899822 PMCID: PMC4038523 DOI: 10.2147/ijgm.s63744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 73-year-old man with no significant past medical history or any history of health care visits was hospitalized for pneumonia. Sputum culture revealed multidrug-resistant Streptococcus pneumoniae, even to carbapenems. The patient was later treated successfully with levofloxacin. Throat cultures from his two grandchildren revealed S. pneumoniae with the same susceptibility pattern. Analysis for resistant genes revealed gPRSP (pbp1a + pbp2x + pbp2b gene variants) in both the patient and his grandchildren, none of whom had received pneumococcal vaccines of any kind. This case illustrates the importance of the emergence of carbapenem-resistant S. pneumoniae. Non-rational use of carbapenems for community-acquired infections may be counterproductive. This case also highlights the importance of pneumococcal vaccinations in children and the elderly.
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Affiliation(s)
- Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
| | - Kentaro Iwata
- Division of Infectious Diseases, Kobe University Hospital, Japan
| | - Hiroshi Takegawa
- Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Japan
| | - Kanji Miki
- Hyogo Health Service Association, Hyogo, Japan
| | - Yumi Sono
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
| | - Hiroaki Nishioka
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
| | | | - Keisuke Tomii
- Department of Pulmonary Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Tsunekazu Haruta
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan
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Rincón S, Panesso D, Díaz L, Carvajal LP, Reyes J, Munita JM, Arias CA. [Resistance to "last resort" antibiotics in Gram-positive cocci: The post-vancomycin era]. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2014; 34 Suppl 1:191-208. [PMID: 24968051 PMCID: PMC4435674 DOI: 10.1590/s0120-41572014000500022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/31/2014] [Indexed: 06/03/2023]
Abstract
New therapeutic alternatives have been developed in the last years for the treatment of multidrug-resistant Gram-positive infections. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are considered a therapeutic challenge due to failures and lack of reliable antimicrobial options. Despite concerns related to the use of vancomycin in the treatment of severe MRSA infections in specific clinical scenarios, there is a paucity of solid clinical evidence that support the use of alternative agents (when compared to vancomycin). Linezolid, daptomycin and tigecycline are antibiotics approved in the last decade and newer cephalosporins (such as ceftaroline and ceftobiprole) and novel glycopeptides (dalvavancin, telavancin and oritavancin) have reached clinical approval or are in the late stages of clinical development. This review focuses on discussing these newer antibiotics used in the "post-vancomycin" era with emphasis on relevant chemical characteristics, spectrum of antimicrobial activity, mechanisms of action and resistance, as well as their clinical utility.
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Affiliation(s)
- Sandra Rincón
- Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C., Colombia
| | - Diana Panesso
- Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C., Colombia
- University of Texas Medical School at Houston, Houston, TX, USA
| | - Lorena Díaz
- Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C., Colombia
| | - Lina P. Carvajal
- Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C., Colombia
| | - Jinnethe Reyes
- Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C., Colombia
- University of Texas Medical School at Houston, Houston, TX, USA
| | - José M. Munita
- University of Texas Medical School at Houston, Houston, TX, USA
- Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago de Chile, Chile
| | - César A. Arias
- Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C., Colombia
- University of Texas Medical School at Houston, Houston, TX, USA
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Mortality indicators in pneumococcal meningitis: therapeutic implications. Int J Infect Dis 2014; 19:13-9. [DOI: 10.1016/j.ijid.2013.09.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 09/16/2013] [Accepted: 09/20/2013] [Indexed: 11/22/2022] Open
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Cattoir V, Giard JC. Antibiotic resistance inEnterococcus faeciumclinical isolates. Expert Rev Anti Infect Ther 2014; 12:239-48. [DOI: 10.1586/14787210.2014.870886] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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