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Biomedical subjects

M Venditti

Publications and source records attributed to M Venditti.

At least 109 records · Page 6Linked to original sources
PubMed1988

Efficacy of teicoplanin as antimicrobial treatment of severe nosocomial infections caused by gram-positive bacteria: a preliminary study.

We used single daily intravenous teicoplanin as therapy for 12 severe nosocomial infections caused by gram-positive bacteria. A daily dosage of 3-6 mg/kg was usually adopted; however, in selected cases the dosage was increased to 8-9.5 mg/day on the basis of serum bactericidal monitoring. Most of these infections were life-threatening and included ventriculitis/meningitis (3 cases), sepsis (3 cases), mediastinitis (1 case) and extensive burn wound infection (1 case). Staphylococcus aureus was by far the most frequent pathogen and methicillin-resistant strains were isolated in 7 out of 9 infections caused by this organism. The remaining isolates were Staphylococcus epidermidis, JK Corynebacterium, Streptococcus agalactiae and Propionilbacterium acnes. Additional antibiotics were used in 5 cases for concomitant gram-negative bacillus etiology (2 cases), granulocytopenia (2 cases), superinfection (1 case). Overall a clinical success and microbial eradication were documented in 100% and 91% of 12 cases, respectively. Except one case of fever, no other major adverse effect was observed and no patient required trial therapy discontinuation. In conclusion, our preliminary data seem to suggest a satisfactory activity of teicoplanin against nosocomial gram-positive infections.

Adolescent↗
PubMed1985

Superinfections during antimicrobial treatment with betalactam-aminoglycoside combinations in neutropenic patients with hematologic malignancies.

The frequency, etiology and risk factors of superinfections during and/or within one week after antibiotic therapy with betalactam-aminoglycoside combinations were evaluated in 631 patients with hematologic malignancies admitted to the Institute of Hematology of Rome from January 1982 to December 1984. 356 patients (56%) developed 402 episodes of proven or presumed infection. Of these patients, 78 developed 102 superinfections. Overall, superinfections responded less satisfactorily to antibiotic therapy than the primary febrile episodes (63% vs. 85%). The distribution of etiologic agents of superinfections differed from those responsible for primary infections, since fungi and anaerobes (especially Clostridium difficile) were mostly isolated after antibiotic therapy had begun. Moreover, among aerobic bacteria, frequently antibiotic-resistant species, such as Pseudomonas aeruginosa, Streptococcus faecalis and Staphylococcus epidermidis were the leading etiologic agents of superinfection. The risk of superinfection appeared to increase with the depth and persistence of granulocytopenia. On the other hand, the length of hospitalization, length of previous antibiotic therapy, previous chemoprophylaxis and presence of indwelling venous catheter did not affect the risk of superinfection.

Adolescent↗
PubMed1985

Clostridium difficile colitis in leukemia patients.

Leukemia patients with diarrhea or other abdominal symptoms have been investigated for the presence of Clostridium difficile and its cytotoxin in stools. Of the patients studied 19% had C. difficile, in most cases together with cytotoxin. All patients but one had received antibiotics, while one had been treated with cytotoxic agents only. Symptoms of colitis were most often abdominal pain and distension rather than diarrhea. Owing to the not infrequent fatal evolution, it is recommended that routine search for C. difficile in leukemia patients with abdominal symptoms be performed and appropriate therapy started immediately.

Adolescent↗
PubMed1985

Serum bactericidal activity as a therapeutic guide in severely granulocytopenic patients with gram-negative septicemia.

The peak and trough levels of bactericidal activity of the serum of 74 severely granulocytopenic patients (less than or equal to 500 polymorphonucleates per microliter) with hematologic malignancies and Gram-negative septicemia were measured using the patient's infectious organism and serum containing the given antibiotics. When the peak titer of bactericidal activity in the serum was greater than 1:8 the septicemia was cured in more than 90% of the cases. However, in order to achieve a satisfactory rate of cure, patients with less than 100 polymorphonucleates/microliter required higher peak levels than patients with 100-500 polymorphonucleates/microliter. Serum bactericidal activity was influenced by the in vitro susceptibility of the offending pathogen and by the presence of in vitro synergism between the given antibiotics. These two variables showed a correlation with the clinical outcome that proved to be increasing with the degree of granulocytopenia. Furthermore, synergistic combination of the antibiotics appeared essential when the in vitro susceptibility shown by the offending pathogen was moderate. These data suggest (i) that determination of the bactericidal activity of the serum may prove to be a useful method to predict the clinical outcome in severely granulocytopenic patients with Gram-negative septicemia; and (ii) under the same conditions, antibiotic combinations that have demonstrable in vitro synergy against the offending pathogen should be given the utmost consideration.

Agranulocytosis↗
PubMed1985

Water supply as a source of Pseudomonas aeruginosa in a hospital for hematological malignancies.

This report details of an investigation on a significant increase in nosocomial bacteremias due to multiply-resistant Pseudomonas aeruginosa strains which occurred in a hematological ward. Serotyping according to Habs method showed a high frequence of the serotype 12. Control cultures identified in the hospital building water reservoirs the presence of the organism. After disinfection of these water reservoirs, the frequence of nosocomial septicemias caused by serotype 12 Pseudomonas aeruginosa strains on the overall bacteremic episodes declined immediately and showed a declining trend in the following 13 months period. To conclude serotyping of Pseudomonas aeruginosa is a useful epidemiological marker and allows to discover from where the diffusion of the organism responsible of outbreaks starts.

Cancer Care Facilities↗
PubMed1985

N-formimidoyl-thienamycin and norfloxacin against multiple-resistant Pseudomonas aeruginosa strains. Combined in vitro activity and comparison with 14 other antibiotics.

The in vitro susceptibility of 54 multiple-resistant strains of Pseudomonas aeruginosa to 16 antipseudomonal agents were determined. The majority of these organisms were also beta-lactamase-producing strains. Norfloxacin, N-formimidoyl-thienamycin and aztreonam showed the best antipseudomonal activity, with minimum inhibitory concentrations for 90% of isolates (MIC90) of 2, 8, and 8 mg/l respectively. Of the aminoglycosides, only amikacin (MIC90 = 32 mg/l) showed satisfactory activity, whereas among beta-lactam antibiotics, cefotaxime, ceftriaxone and moxalactam (MIC90 = 32 mg/l) were more active than cefoperazone (MIC90 = 128 mg/l), cefsulodin (MIC90 = 128 mg/l), piperacillin (MIC90 = 512 mg/l) and azlocillin (MIC90 = 1024 mg/l). A synergistic or partially synergistic interaction (fractional inhibitory concentration index less than 1) was demonstrated in vitro against 37% of the strains when N-formimidoyl-thienamycin was combined with norfloxacin.

Amikacin↗
PubMed1984

Comparative in vitro activity of aztreonam, other beta-lactam antibiotics and aminoglycosides against Pseudomonas aeruginosa.

Aztreonam, ceftriaxone, moxalactam, cefotaxime, cefsulodin, cefoperazone, piperacillin, azlocillin, carbenicillin, amikacin, gentamicin, tobramycin, sisomicin and dibekacin were tested by broth dilution against 161 isolates of Pseudomonas aeruginosa. Seventy-one of these strains were selected for their resistance to carbenicillin and aminoglycosides and classified as "multiply resistant" strains. Over all, aztreonam showed the greatest antipseudomonal activity by far, followed by ceftriaxone, moxalactam, cefotaxime and amikacin. Piperacillin, azlocillin, cefsulodin, and cefoperazone were highly active against carbenicillin and/or aminoglycoside-susceptible P. aeruginosa strains, but were also poorly inhibitory against multiply resistant isolates.

Aminoglycosides↗
PubMedDate not supplied

Cefotaxime plus amikacin as empiric therapy in the treatment of febrile episodes in neutropenic patients with hematologic malignancies.

Between October 1980 and October 1981, cefotaxime plus amikacin were used in the treatment of 131 febrile episodes that occurred in 108 neutropenic patients with hematologic malignancies. The overall clinical response was 86.2%. Fevers of unknown origin and clinically or microbiologically documented infections responded in 88.8 and 84.4% of the cases, respectively. Renal toxicity occurred in 3.8% of the cases. In vitro studies showed that cefotaxime and amikacin were active against 78.7 and 94.7% of the pathogens, respectively, despite the high frequency (31%) of multiply resistant strains of Pseudomonas aeruginosa (defined as in vitro simultaneously resistant to carbenicillin, gentamicin, tobramycin and sisomicin) isolated from blood and infected sites. Synergy studies performed against 35 gram-negative bacilli isolated from blood revealed the presence of synergism between cefotaxime and amikacin in 54% of the cases. The peak levels of bactericidal activity in the serum of patients receiving cefotaxime plus amikacin showed median values of 1:128 and 1:8 against Escherichia coli and P. aeruginosa septicemias, respectively.

Adolescent↗
PubMedDate not supplied

Murine interferon-alpha1 gene-transduced ESb tumor cells are rejected by host-mediated mechanisms despite resistance of the parental tumor to interferon-alpha/beta therapy.

The highly metastatic ESb tumor is totally resistant to murine interferon-alpha/beta (IFN-alpha/beta) therapy, regardless of the number of cells injected or the route of inoculation. In contrast, as we show herein, mouse IFN-alpha1-transduced ESb tumor cells were inhibited markedly when injected subcutaneously into immunocompetent mice. IFN-producing ESb tumor rejection was mediated by the immune system, because these tumor cells grew normally in immunosuppressed mice. Tumor regression was accompanied by extensive necrosis and cellular infiltrates in the tumor area. These results further support the use of IFN-alpha in cytokine gene therapy of cancer and suggest the advantage of using gene transfer rather than cytokine administration to enhance an antitumor immune response.

Animals↗
PubMedDate not supplied

Invasive Fusarium solani infections in patients with acute leukemia.

Two cases of disseminated hyalohyphomycosis due to Fusarium solani in patients with acute nonlymphocytic leukemia were studied. The clinical features in both patients included fever, fungemia, severe myalgias, disseminated ecthyma gangrenosum-like skin lesions, ocular symptoms, and a fatal outcome despite systemic administration of amphotericin B in the setting of profound, persistent granulocytopenia. In vitro studies showed the resistance of both F. solani isolates to amphotericin B, 5-fluorocytosine, and imidazoles. This investigation confirmed the emergence of F. solani infection in immunosuppressed hosts.

Adolescent↗