Search PubMed⌕ Search

Biomedical subjects

V Krcmery

Publications and source records attributed to V Krcmery.

114 records · Page 7Linked to original sources
PubMedDate not supplied

Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens.

In conjugational crosses, three Klebsiella pneumoniae strains and one Serratia marcescens strain have been demonstrated to transfer resistance determinants to newer types of cephalosporins. While Klebsiella strains donated cefotaxime, cefamandole and cefuroxime resistance to Escherichia coli K-12 recipients, the genetic analysis of exconjugants after the transfer of plasmids from Serratia strains to Proteus or Salmonella recipients showed that the cefoxitin resistance determinant was also co-transferred. In subsequent transfer cycles of this plasmid, cefotaxime and cefoxitin resistance determinants segregated in contrast to the relative stability of plasmids derived from Klebsiella strains in subsequent transfer cycles. From results obtained in this study, it may be concluded that in some strains of nosocomial Enterobacteriaceae, resistance to newer cephalosporins could be transmissible and thus plasmid-located.

Cefamandole↗
PubMedDate not supplied

European Surveillance of Infections in Cancer Patients--ESIC.

Major advances in cancer therapy result from development of multidrug chemotherapy regimens. Besides death from tumor progression, infections are currently one of the major causes of mortality and morbidity. Because of the risk of complications and mortality, the treatment for febrile neutropenia is admission to hospital and administration of broad-spectrum antibiotics. Response rates of initial antimicrobial treatment vary considerably (40-92%). Due to the heterogeneity of populations in randomized studies, comparison of efficacy and identification of risk factors is limited. This is the main reason why the European Society of Biomodulation and Chemotherapy (ESBiC) is conducting a surveillance study that concentrates more on the evaluation of risk factors than on the therapeutic outcome of prospective randomized antimicrobial regimens: European Surveillance of Infections in Cancer Patients (ESIC). The present contribution is to determine which cancer patients are at low risk for fever, and can benefit from first-line treatment with treatment options such as monotherapy as well as on an outpatient basis.

Anti-Bacterial Agents↗
PubMedDate not supplied

Inappropriate antibiotic therapy in febrile cancer patients with bacteremia.

OBJECTIVE: The aim of the study was to assess the outcome of inappropriately treated cancer patients with documented bacteremia. DESIGN/SETTING: 95 cases of inappropriately treated bacteremias in febrile cancer patients in a tertiary-care center were analyzed and compared with a group of appropriately treated bacteremias to assess risk factors for inappropriate therapy and outcome. RESULTS: Among 285 bacteremias, 95 (33.3%) were not treated appropriately, with 42 receiving the wrong antibiotics and 17 having too short a therapeutic course of appropriate antibiotics. In 13, therapy was delayed for more than 48 hours after the onset of fever. Twenty-three patients did not receive antibiotic therapy at all despite bacteremia. A group of 95 inappropriately treated bacteremias was compared to 190 appropriately treated bacteremias occurring in the same period. Microbiological cure after the initial course of therapy was achieved more often (76.8% vs 38.9%, P < .001) in the group of appropriately treated bacteremias in all cases and also in the subgroup of leukemic patients (P < .01). Overall and attributable mortality were significantly lower in patients who were treated appropriately. There was no difference in the number of antibiotics administered in appropriately versus inappropriately treated bacteremias. Cost of therapy between both groups was similar. CONCLUSIONS: Inappropriately treated bacteremic cancer patients had outcomes that were significantly worse than patients who were treated appropriately. The reasons for inappropriate therapy were selection of the wrong antimicrobials, too short a duration of therapy, delayed onset of therapy, or absence of antimicrobial therapy.

Anti-Bacterial Agents↗