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PubMed2004

Antimicrobial resistance rates and clonality results from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) programme: report of year five (2003).

The U.S. Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme in the fifth year continues to monitor the spectrum of activity and potency of meropenem within medical centers where carbapenems are used for the treatment of serious infections. The antimicrobial activity of 11 broad-spectrum agents (including initial comparisons for levofloxacin) was assessed against 2,848 isolates in 2003. The minimum inhibitory concentration (MIC) results demonstrate the continued high potency of meropenem against all monitored pathogens. Against all Gram-negative bacilli tested, the overall rank order of susceptibility was meropenem (96.3%) > imipenem (95.6%) > cefepime (93.7%) > tobramycin (91.9%) > piperacillin/tazobactam (90.2%) > ceftazidime (90.1%) > gentamicin (89.6%) > levofloxacin (82.8%) > ciprofloxacin (82.5%) > aztreonam (81.8%) > ceftriaxone (72.3%). Clonal-based resistances were observed that adversely influenced carbapenem resistance rates, particularly among Klebsiella spp. and Acinetobacter baumannii isolates. Continued surveillance of the carbapenem class and other broad-spectrum agents is warranted to monitor activity against pathogens causing serious infections in hospitalized patients.

Academic Medical Centers↗
PubMed2005

Sensed presence and mystical experiences are predicted by suggestibility, not by the application of transcranial weak complex magnetic fields.

Transcranial magnetic stimulation (TMS) with weak (micro Tesla) complex waveform fields have been claimed to evoke the sensed presence of a sentient being in up to 80% in the general population. These findings have had a questionable neurophysiological foundation as the fields are approximately six orders of magnitude weaker than ordinary TMS fields. Also, no independent replication has been reported. To replicate and extend previous findings, we performed a double-blind experiment (N=89), with a sham-field control group. Personality characteristics indicating suggestibility (absorption, signs of abnormal temporal lobe activity, and a "new age"-lifestyle orientation) were used as predictors. Sensed presence, mystical, and other somatosensory experiences previously reported from the magnetic field stimulation were outcome measures. We found no evidence for any effects of the magnetic fields, neither in the entire group, nor in individuals high in suggestibility. Because the personality characteristics significantly predicted outcomes, suggestibility may account for previously reported effects. Our results strongly question the earlier claims of experiential effects of weak magnetic fields.

Adolescent↗
PubMedDate not supplied

The biocultural paradigm: the neural connection between science and mysticism.

New discoveries in perceptual psychology, brain chemistry, brain evolution, brain development, ethology, cultural anthropology, the more recent work of MacLean on the structure of the brains and the discovery by Gazzaniga of the role of the, so-called, "interpreter module," are the foundations of a new paradigm on human cortical information processing, called by its discoverer, Dr. M. Colavito, the "biocultural paradigm." This paradigm shows that biology and culture act on one another as the conditioning parameters of neurocultural information. Through mutual interaction biology in humans becomes culture, and vice versa, culture opens and stimulates the neural passages of the brains, accounting thus for the varieties of brains in humans, and for cultural diversity. Culture conditions and stimulates biology, while biology conditions and makes culture possible. Cultures and brains may be distinguished from one another through identification with certain functions or combination of functions that are exercised habitually, or become neural hard-wire through repetition or habit. This new model has replaced older and simpler models of the nature/ nurture controversy, such as the unextended rational substance of Descartes, the tabula rasa of Locke, the associated-matrix of Hume, the passive, reinforcement-driven animal of Skinner, and the genetically hard-wired robot of the sociobiologists. However, elements of these earlier models are included in the new one, but the conversation about human experience has changed, and, therefore, the human images of ourselves. This change was forced on scientists by the importance of the conditionality of the experience of "I" and "not-I" as described by Alex Comfort in his book I and That, and was introduced in the conversations some of us already had with each other. This article focuses on the "I" and "not-I" experiences with a description of the "not-I" or "oceanic" or "mystical" experience to clarify the new paradigm of "biocultures."

Culture↗
PubMed2001

Antimicrobial resistance trends in medical centers using carbapenems: report of 1999 and 2000 results from the MYSTIC program (USA).

Trends in susceptibility to antimicrobials were assessed from United States participants using 4488 isolates in the MYSTIC Program, 1999 (10 centers) through 2000 (15 centers). Diverse types of hospitals (general service, university, cancer, federal, pediatric, cystic fibrosis) were enrolled from 13 states. In 2000, oxacillin-susceptible staphylococci were 100% susceptible to meropenem, imipenem, and cefepime; but only 88% of strains were susceptible to ceftazidime. Among Enterobacteriaceae, > or = 96% of Enterobacter spp., Citrobacter spp., and Serratia spp. were susceptible to meropenem, imipenem, and cefepime; but ceftazidime, ceftriaxone, and piperacillin/tazobactam had 5-20% resistance rates. Extended-spectrum beta-lactamase resistance rates in Klebsiella spp. and Escherichia coli (6-7% and 3-5%, respectively) were stable over 2 years. Acinetobacter spp. were 78-81% susceptible to carbapenems but only 63-72% susceptible to ciprofloxacin. Meropenem, tobramycin, and piperacillin/tazobactam were the most active against Pseudomonas aeruginosa, but ciprofloxacin inhibited only 74% in 2000. Overall, meropenem remained the most potent agent, especially against ceftazidime- or piperacillin/tazobactam-resistant strains.

Academic Medical Centers↗
PubMed2001

MYSTIC program: summary of European data from 1997 to 2000.

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program is a global study providing in-vitro surveillance data on microbial susceptibility in centers that prescribe meropenem. This paper summarizes data on the activity of meropenem and five comparator agents against 13,793 clinical isolates from 31 centers in 10 European countries, 1997-2000. Meropenem and imipenem demonstrated broad-spectrum activity against the tested organisms, including beta-lactamase-producing strains that were co-resistant to quinolones and aminoglycosides. The carbapenems were active against the most frequently isolated pathogens including staphylococci (98-100% susceptible), Pseudomonas aeruginosa (65-82% susceptible) and Klebsiella pneumoniae (98-100% susceptible). Resistance to penicillins and cephalosporins was observed, particularly among Enterobacter species in Southern and Eastern Europe. Eastern Europe showed a high prevalence of AmpC beta-lactamase and extended-spectrum beta-lactamase-producing strains in Russia (2000); 47% and 28% of Enterobacteriaceae isolates were AmpC or ESBL-producers, respectively. There was no significant decrease in susceptibility to the carbapenems throughout the four-year period. Meropenem and imipenem appear to remain reliable options for the treatment of serious nosocomial infections.

Enterobacter↗
PubMed2003

Antimicrobial spectrum of activity for meropenem and nine broad spectrum antimicrobials: report from the MYSTIC Program (2002) in North America.

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program provides susceptibility data for participating medical centers where carbapenems are utilized. The activity of meropenem and nine broad-spectrum antimicrobial agents were assessed against 3,047 bacterial isolates collected during 2002 from 16 North American sites. The overall rank order of susceptibility of the 10 antimicrobial agents tested against Gram-negative isolates was: meropenem (98%) > imipenem (97%) > cefepime (95%) > tobramycin (93%) > piperacillin/tazobactam = gentamicin (92%) > ceftazidime (91%) > ciprofloxacin (87%) > aztreonam (86%) > ceftriaxone (74%). These results and those from previous years, demonstrate the continued excellent potency and spectrum of activity for meropenem. The utility of meropenem against Pseudomonas aeruginosa isolates has increased steadily with a rise in percent susceptibility each year from 78.2% in 1999 to a present rate of 93.1% susceptible. Conversely, we showed the susceptibility for ciprofloxacin against these same P. aeruginosa isolates has decreased from 82.9 to 72.3% susceptible over four years. Many medical centers have observed a decreased activity of some aminoglycosides, cephalosporins and fluoroquinolones due to increases in rates of extended-spectrum beta-lactamases, Amp C and other resistance mechanisms. Carbapenem resistance remains rarely documented and these beta-lactamase-stable agents appear to be an alternative treatment option for serious community-acquired or nosocomial infections in high risk patient populations.

Anti-Bacterial Agents↗
PubMed2002

Antimicrobial susceptibility of inducible AmpC beta-lactamase-producing Enterobacteriaceae from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme, Europe 1997-2000.

Among 11345 clinical isolates from 31 European centres in the MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) Programme (1997-2000), the potential AmpC-producing pathogens were Enterobacter spp. (904 cases), Citrobacter spp. (144) and Serratia marcescens (288). Resistance to ceftazidime or cefotaxime (11-34%) and piperacillin/tazobactam (12%) was observed, indicating stably derepressed expression of AmpC cephalosporinases. Meropenem (MIC(90), 0.25 mg/l; >99% susceptible) and imipenem (MIC(90), 2 mg/l; 98% susceptible) were active, even against these stably derepressed AmpC-producers: Enterobacter spp. (305 strains), Citrobacter spp. (29) and S. marcescens (35). The overall rank order of spectrum (% susceptible) versus the stably derepressed subset of isolates was: meropenem=imipenem (98%)>cefepime (89%)>gentamicin (73%)>ciprofloxacin (62%)>tobramycin (60%) >piperacillin/tazobactam (21%). We suggest increased attention in Europe to: (1) the recognition of these resistant phenotypes, (2) infection control practices, and (3) limiting the overuse of certain selecting extended-spectrum beta-lactam agents (e.g. ceftazidime).

Anti-Bacterial Agents↗
PubMed2002

Antimicrobial resistance in gram-negative isolates from European intensive care units: data from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) programme.

Susceptibility data were collected for 6243 gram-negative isolates from 29 European ICUs participating in the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme (1997-2000). The most commonly isolated bacteria were Pseudomonas aeruginosa (22.5%), Escherichia coli (19.8%), Klebsiella pneumoniae (10.4%), and Enterobacter cloacae (7.7%). The incidence of extended-spectrum beta-lactamase-producers was higher in Turkish, Russian and Italian ICUs (27.9-39.6%) than in other countries (2.5-10.8%). The frequency of AmpC-cephalosporin hyper-producers was 16.8-55.4%. Meropenem was more active against Proteus mirabilis than imipenem (99.0% versus 88.8% susceptibility, respectively). Against Acinetobacter baumannii, meropenem (79.6% susceptible) and imipenem (82.2%) were more active than comparators (34.3-51.6%). Meropenem and imipenem exhibited good activity against P. aeruginosa (76.1% and 68.2%, respectively; but with inter-country variation). Ciprofloxacin resistance in E. coli and K. pneumoniae increased and needs close monitoring. Meropenem (98.2-99.8% susceptibility) and imipenem (88.8-99.4%) remained potent against important species of gram-negative bacteria from European ICUs actively using meropenem.

Drug Resistance, Bacterial↗
PubMed2005

Antimicrobial susceptibility in intensive care units: MYSTIC Program Brazil 2002.

OBJECTIVE: Establish the susceptibility pattern of Gram-negative bacteria causing infections in ICU patients, MYSTIC Program Brazil 2002. MATERIAL AND METHODS: Gram-negative bacteria (n = 503) causing nosocomial infections were collected at seven Brazilian centers. The central laboratory confirmed the identification and performed the susceptibility tests by E-test methodology (AB Biodisk, Solna, Sweden) for meropenem, imipenem, ciprofloxacin, ceftazidime, cefepime, cefotaxime, piperacillin/tazobactam, gentamicin, and tobramycin. Interpretation criteria used were according to National Committee for Clinical Laboratory Standards (NCCLS). RESULTS: Pseudomonas aeruginosa (33%) was the most frequently isolated, followed by A. baumannii (17.1%), K. pneumoniae (12.1%), E. coli (10.5%), and E. cloacae (7.9%). Pseudomonas aeruginosa isolates had susceptibility rates of 67.5% to piperacillin/tazobactam, 59.8% to meropenem, 57.3% to imipenem. A. baumannii presented susceptibility rates to meropenem of 89.5%, 88.4% to imipenem, and 74.4% to tobramycin. E. coli and K. pneumoniae were fully susceptible to both carbapenems. CONCLUSIONS: Carbapenem resistance among Enterobacteriaceae is still rare in this region. A. baumannii and P. aeruginosa presented elevated resistance rates to all antimicrobials. Since these two bacterial species play an important role in nosocomial infections, the use of empirical combination therapy to treat these pathogens may be justified.

Anti-Bacterial Agents↗
PubMed2005

Antimicrobial susceptibility of Gram-negative bacteria in Brazilian hospitals: the MYSTIC Program Brazil 2003.

Establish the susceptibility pattern of Gram-negative bacteria causing infections in ICU patients, MYSTIC Program Brazil 2003. Gram-negative bacteria (n = 1,550) causing nosocomial infections were collected at 20 Brazilian centers. The central laboratory confirmed the identification and performed the susceptibility tests by Etest methodology (AB Biodisk, Solna, Sweden) for meropenem, imipenem, ciprofloxacin, ceftazidime, cefepime, cefotaxime, piperacillin/tazobactam, gentamicin, and tobramycin. Interpretation criteria used were according to National Committee for Clinical Laboratory Standards (NCCLS). Pseudomonas aeruginosa (30.3%) was the most frequent isolate, followed by E. coli (18.6%), Klebsiella pneumoniae (16.9%), Acitenobacter baumannii (8.8%), and Enterobacter cloacae (7.1%). Pseudomonas aeruginosa (n=470) isolates presented susceptibility rates of 64% to meropenem, 63.8% to piperacillin/tazobactam, 63.4% to amikacin, 58.7% to imipenem. Acitenobacter baumannii presented susceptibility rates to meropenem of 97.1%, and 73% to tobramycin. E. coli and K. pneumoniae were highly susceptible to both carbapenems. Carbapenem resistance among the Enterobacteriaceae is still rare in the region. Acitenobacter baumannii and P. aeruginosa presented elevated resistance rates to all antimicrobials. Since they play an important role in nosocomial infections in this environment, the use of empirical combination therapy to treat these pathogens may be justified.

Anti-Bacterial Agents↗
PubMed1983

Religious and mystical experiences as artifacts of temporal lobe function: a general hypothesis.

Mystical and religious experiences are hypothesized to be evoked by transient, electrical microseizures within deep structures of the temporal lobe. Although experiential details are affected by context and reinforcement history, basic themes reflect the inclusion of different amygdaloid-hippocampal structures and adjacent cortices. Whereas the unusual electrical coherence allows access to infantile memories of parents, a source of good expectations, specific stimulation evokes out-of-body experiences, space-time distortions, intense meaningfulness, and dreamy scenes. The species-specific similarities in temporal lobe properties enhance the homogeneity of cross-cultural experiences. They exist along a continuum that ranges from "early morning highs" to recurrent bouts of conversion and dominating religiosity. Predisposing factors include any biochemical or genetic factors that produce temporal lobe lability. A variety of precipitating stimuli provoke these experiences, but personal (life) crises and death bed conditions are optimal. These temporal lobe microseizures can be learned as responses to existential trauma because stimulation is of powerful intrinsic reward regions and reduction of death anxiety occurs. The implications of these transients as potent modifiers of human behavior are considered.

Culture↗
PubMed1993

Vectorial cerebral hemisphericity as differential sources for the sensed presence, mystical experiences and religious conversions.

Multiple variants of the sensed presence often precede mystical and religious experiences that are frequently followed by sudden, permanent changes in self-concept. The model of vectorial hemisphericity assumes that the relative metabolic activity of synaptic patterns between the cerebral hemispheres at the time of transient interhemispheric intercalation determines the affect, content, and type of experience. Depending upon the relative activity of the two hemispheres, intrusions of the right hemispheric equivalent of the left hemispheric (and linguistic) sense of self generate experimental phenomena that include "evil entities," gods, out-of-body experiences, and alterations in space-time. Conditions that facilitate interhemispheric intercalation and the generation of these experiences are discussed.

Anxiety↗
PubMed2000

Evaluation of the in vitro activity of 9 antimicrobials against bacterial strains isolated from patients in intensive care units in brazil: MYSTIC Antimicrobial Surveillance Program.

Multi-resistant bacterial strains are increasingly prevalent in hospital environments. Bacterial resistance is an important problem, especially for practitioners in intensive care units (ICUs) because of the selective pressure on the prevalent bacteria in these environments. The MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) study has been monitoring the performance of carbapenems and other antibiotics in different hospitals for at least 3 years. The in vitro activities of meropenem, imipenem, ceftazidime, cefepime, cefotaxime, ciprofloxacin, piperacilin/tazobactam, gentamicin, and tobramycin were compared against 452 recent clinical aerobic isolates. The isolates consisted of 19 species of Gram-negative bacteria (n=290) including K. pneumoniae (n=49), E. coli (n=48), A. baumannii (n=47), Enterobacter spp. (n=41), and P. aeruginosa (n=33) and 9 species of Gram-positive bacteria (n=162) including Staphylococcus aureus (n=63), Enterococcus faecalis (n=22), Streptococcus pneumoniae (n=22) and coagulase negative Staphylococci (n=21). All isolates were collected from ICU patients. Minimal inhibitory concentrations (MICs) were determined by Etest methodology, using standardized and controlled procedures. Meropenem and imipenem showed the lowest MIC(90) for all species tested. Gram-negative isolates showed the following overall resistance percentages to the other 7 drugs: tobramycin (43.1%), cefotaxime (38.6%), gentamicin (34.1%), ceftazidime (31.7%), ciprofloxacin (25.5%), piperacillin/tazobactam (26.9%), and cefepime (18.6%). Carbapenems were the most active drugs overall and only P. aeruginosa presented some degree of resistance (18.2%). We also evaluated the production of extended spectrum beta-lactamase (ESBL) among all Enterobacteriaceae members (n=176) by Etest/ESBL strip. ESBL production was detected in 51 strains (29.0%). Among them, Klebsiella pneumoniae was the most prevalent at 59.2%, followed by Enterobacter spp. (19.5%) and E. coli (14.6%). The high level of resistance against several antimicrobials and the alarming rate of ESBL production may restrict therapeutic choice to the carbapenems in this selected group of patients.

Anti-Bacterial Agents↗
PubMed1991

[Hildegard von Bingen: physician--mystic--poet].

Out of the multifaceted visionary writing of St. Hildegard from Bingen (1098-1179) three aspects are selected and commented on: 1. The cosmologically oriented art of healing showing man in its original state (constitutio) its actual condition (destitutio) and the expected healthy final state (restitutio); 2. An universal vision oriented on mystic enligthment proposing the individual as creation (opus Dei), as partner (opus alterum per alterium) and as worker on nature (opus cum creatura); 3. The esthetic dimension of universal and human perception as expressed by Hildegards songs (carmina) which culminate in hymns on the "celestrial Jerusalem". We should consider, that these aspects--beyond their historic roots--indicate ways for healing and salvation of the integral individual.

Germany↗
PubMed1990

[From virginity to mysticism].

Through a clinical observation illustrated with a borderline state described by Bergeret and in a variety of nervous breakdown, the problem of narcissism is set through the quest for an ultimate and an idealization. With the arrival of a late and disorganizing traumatism, is realized an exchange between a narcissic ideal (pureness/virginity) and a megalomaniac one (mysticity). It is the punctual established fact of a cure of a narcissic loss (loss of virginity) by a narcissic recival (God). Virginity represents the main concept of an original ideal by with are established the different axes of a narcissic problem: sexuality-death-religion, where every word seems to have several meanings through these three values.

Adult↗
PubMed2004

Susceptibility of meropenem and comparators tested against 30,634 Enterobacteriaceae isolated in the MYSTIC Programme (1997-2003).

A total of 30,634 global Enterobacteriaceae isolates collected from the MYSTIC (Meropenem Yearly Surveillance Test Information Collection) Programme were tested using a reference methodology against meropenem and seven other broad-spectrum agents commonly used in the hospital setting (1997-2003). The most active compound was meropenem (99.6% susceptible), followed by imipenem (98.4%), cefepime (94.0%), gentamicin (86.8%), piperacillin/tazobactam (85.8%), ceftazidime (85.0%), ciprofloxacin (84.6%), and tobramycin (84.5%). Continued surveillance of antimicrobial compounds' in vitro activity is necessary to recommend regimens that are likely to be effective in clinical practice.

Anti-Bacterial Agents↗
PubMed2005

Trends in antimicrobial susceptibilities among bacterial pathogens isolated from patients hospitalized in European medical centers: 6-year report of the MYSTIC Surveillance Study (1997-2002).

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program provides antimicrobial susceptibility data. The activity of meropenem and 7 broad-spectrum antimicrobials have been examined against 12645 bacterial isolates from 14 European centers between 1997 and 2002. Cumulative susceptibility rates against all species of Enterobacteriaceae combined were ranked as follows: meropenem (99.9%) > imipenem (97.7%) > ciprofloxacin (86.0%) > piperacillin-tazobactam (85.6%) > ceftazidime (85.4%) > gentamicin (85.4%) > tobramycin (85.0%) > cefotaxime (83.8%). The carbapenems were also found to be the most active of the classes tested against nonfermentative Gram-negative bacilli. Against methicillin-susceptible Staphylococcus aureus and coagulase-negative staphylococci, all beta-lactams tested (except ceftazidime) had susceptibility rates of > or = 99.0% and > or = 94.3%, respectively. Over the 6-year period, there was no loss of activity or increase in resistance rate for either carbapenem against any of the species tested. These data confirm the continued potency and broad-spectrum activity of meropenem in units where it is actively being prescribed.

Academic Medical Centers↗
PubMed2005

Prevalence and antimicrobial susceptibility data for extended-spectrum beta-lactamase- and AmpC-producing Enterobacteriaceae from the MYSTIC Program in Europe and the United States (1997-2004).

This article presents prevalence and susceptibility data from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program in Europe (1997-2004) and the United States (1999-2004) for Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBL) and/or AmpC beta-lactamases. For ESBL-producing isolates, the prevalence of Escherichia coli and Klebsiella spp. in Europe and Enterobacter spp. in the United States increased over time. For AmpC-producing isolates, the prevalence of Enterobacter spp. and Citrobacter spp. decreased over time in Europe and the United States, respectively. Compared with other antimicrobial agents, meropenem and imipenem had greatest activity against ESBL-producing E. coli and Klebsiella spp. in both Europe (96.9-100.0%) and the United States (100.0%). Such activity was also found for AmpC-producing Enterobacteriaceae in Europe (50.0-100.0%), and Enterobacter spp. and Citrobacter spp. from the United States (100.0% for both). The continued efficacy of carbapenems such as meropenem confirms that these remain first-line agents for treatment of nosocomial infections caused by Enterobacteriaceae-producing ESBL or AmpC beta-lactamases.

Anti-Bacterial Agents↗