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PubMed1992

[Effectiveness of empirical antibiotic therapy in the control of infections in patients with acute leukemia during severe neutropenia].

The clinical efficacy of empiric antibiotic treatment regimen for infection in 38 neutropenic patients with acute leukemia during induction and intensification therapy was evaluated. The therapy, which was applied in 74 episodes of fever in patients with neutrophil count less then 0.5 G/l, consisted of three sets of antibiotics (gentamycin + carbenicillin or azlocillin, amikacin + cephradine++ or cefuroxime, netilmicin+cefotaxime or ceftazidime) used one after another in case of persistence of fever in spite of 72 hours of treatment: In addition, flucytosine was applied in case of stable fever after 72 hours of antibiotic therapy. Flucytosine was replaced by amphotericin after 72 hours of ineffective treatment. The response rate of 68% and 96% was observed for patients during induction and intensification chemotherapy respectively. Low clinical efficiency of gentamicin and carbenicillin/azlocillin during induction treatment indicates that the therapy with antibiotics of broader range of activity is needed for this group of patients.

Adolescent↗
PubMed1992

Molecular characterization of R-plasmids pST1 and pST2 from Salmonella typhimurium S24.

Salmonella typhimurium S24 was isolated in September 1986 at Kaohsiung Medical College Hospital, Kaohsiung, Taiwan, from a patient suffering from gastroenteritis during an outbreak of salmonellosis. Two conjugative R-plasmids have been isolated from Escherichia coli K-12 14R525, which was mated with S. typhimurium S24. The two R-plasmids found in S. typhimurium S24 belong to two different incompatibility (Inc) groups: the 130-kilobase IncFI plasmid pST1 and the 56-kb IncN plasmid pST2. These two R-plasmids of pST1 and pST2 together mediate resistance to multiple antibiotics in S. typhimurium S24. By DNA probes hybridization, plasmid pST1 was shown to carry an enteric type II chloramphenicol acetyltransferase (CAT) gene, a class C tetracycline resistance (TetR) gene and a type III dihydrofolate reductase (DHFR) gene, all of which confer resistance to chloramphenicol, tetracycline, and trimethoprim respectively. A Richmond's type III beta-lactamase gene was located on each plasmid of pST1 and pST2. beta-lactamases specified by both plasmids pST1 and pST2 conferred high level resistance to amoxicillin, carbenicillin, piperacillin, sulbenicillin, ticarcillin in addition to ampicillin. A novel aminoglycoside 6'-N-acetyltransferase [AAC(6')] was demonstrated on plasmid pST2. This AAC(6') enzyme modified kanamycin, amikacin, dibekacin, tobramycin, gentamicin, netilmicin, sisomicin, butirosin and ribostamycin.

Aminoglycosides↗
PubMed1992

Cross-resistance of clinical isolates of methicillin-resistant Staphylococcus aureus to aminoglycosides and fluoroquinolones.

Susceptibilities of 117 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) to aminoglycosides and fluoroquinolones were investigated during 1987 and 1990. Gentamicin, tobramycin, sisomicin, micronomicin, and astromicin showed the bimodal antimicrobial activity pattern against MRSA, revealing cross-resistance to these antibiotics. However, amikacin, netilmicin, isepamicin and arbekacin (ABK) exhibited the monomodal antimicrobial activity pattern, suggesting the presence of less resistant strains. All 117 MRSA strains were susceptible to ABK with MICs less than 3 micrograms/ml. MRSA also showed the bimodal antimicrobial susceptibility pattern to fluoroquinolones such as ofloxacin (OFLX), ciprofloxacin (CPFX) and tosufloxacin (TFLX). Frequencies of TFLX susceptible MRSA isolates decreased progressively from 1987 to 1989 when this drug was not even in general clinical use. The cross-resistance of MRSA between TFLX and OFLX or CPFX persisted. Cross-resistance between aminoglycosides and fluoroquinolones, however, was less frequently observed.

Aminoglycosides↗
PubMed1992

[Sensitivity of multiresistant bacterial strains to imipenem (Tienam)].

The susceptibility to imipenem of 213 clinical strains of Gram-negative rods resistant to six cephalosporins (cephradine, cefamandole, cefuroxime, cefotaxime, cefoperazone and ceftriaxone) has been studied. It was found that 93.9% of the strains were sensitive and 6.1% were resistant to imipenem. In the examined group 64 (30%) out of 213 strains were simultaneously resistant to four aminoglycosides (gentamycin, tobramycin, netilmicin and amikacin); among them 5 (7.8%) strains were resistant to imipenem. Sensitivity to imipenem 157 out of 213 examined strains as compared to that of ceftazidime was as follows: 29.3% of the strains were sensitive and 3.8% resistant to both of the antibiotics, whilst 64.3% were imipenem-sensitive and ceftazidime-resistant. In vitro imipenem proved to be very active antibiotic against over 90% of multiresistant Gram-negative rods.

Aminoglycosides↗
PubMedDate not supplied

[Antibiotherapy in osteoarticular infections in children suffering from hemoglobinopathy in the University Teaching Hospital of Yopougon].

OBJECTIVE: The objective of this work was to evaluate antibiotherapy in osteo-articular infections found in children with henioglobinopathy, by identifying the antibiotics used and their mode of action. Their cost and efficacy were also assessed. MATERIALS AND METHOD: The study was retrospective and it took place in the haematology unit, the paediatric surgical department and the central pharmacy of the University Teaching Hospital of Yopougon from 1991 through 1998. Thirty-two medical records of children, carriers of osteo-articular infections (OAI), were selected. Amongst these patients, most of whom had sickle-cell anaemia (97%), 50% were homozygous. Osteomyelitis represented 78% of these infections (salmonella infections being the most frequent cause, amounting to 35%). RESULTS: Fifteen types of antibiotics amongst 57 from 5 families of drugs were used, with biotherapy (association of two drugs) being used in 69% of cases. The association of pefloxacine and netilmicine was the most frequently used and it was found to be the most expensive. The treatment was judged efficacious, with a satisfactory result in 75% of cases, based on the clinical criteria. DISCUSSION: Bitherapy is the type of treatment, which is often of concern to many authors and relies on the general consensus surrounding the most likely emergency treatment of osteo-articular infections. Certain particularities are worth mentioning regarding this utilisation: the multiplicity of the molecules due to frequent rupture of hospital stock; the use of fluoroquinolones exceptionally prescribed in children under 15. CONCLUSION: This antibiotherapy is justified owing to its efficacy on a sensitive issue concerning a pathology with grave sequellae, where long-term monitoring is necessary.

Adolescent↗
PubMed1992

[MRSA ocular infections].

Staphylococcus aureus and Staphylococcus epidermidis are organisms that frequently cause conjunctivitis, keratitis and endophthalmitis. MRSA comprised about 25% of the S. aureus isolated from ocular infections; most were from compromised host. MRSA was resistant to penicillins, cephems and macrolides but was sensitive to amikacin, netilmicin, minocycline and ofloxacin. Ofloxacin-resistant strains, however increased rapidly. Topical vancomycin, arbekacin and minocycline were used when commercially available antibiotics were inadequate.

Adolescent↗
PubMed1992

[Incidence and antimicrobial susceptibility of clinical isolates of MRSA from 1988 to 1990, from the results of 26 clinical laboratories in Tokyo and the surrounding area].

We made a survey to investigate the incidence of clinical isolation and the trend of antimicrobial susceptibility of Methicillin-resistant Staphylococcus aureus (MRSA), isolated in 26 clinical laboratories. Among the 26 institutions, the frequency of MRSA was 22 to 64% (average: 42.1%) in 1988, 22 to 69% (average: 55.3%) in 1989 and 29 to 76% (average: 56.9%) in 1990, and increasing year by year. MRSA showed poor sensitivity to beta-lactam antibiotics, gentamicin, toburamycin and clindamycin. There was a significant difference in frequency of the minocycline-resistant strains and the ofloxacin-resistant strains among the 26 institutions. Albekacin, netilmicin, and vancomycin were most active against MRSA with a MIC90 of 1, 8 and 1 microgram/ml, respectively.

Anti-Bacterial Agents↗
PubMed2004

Resistance rates to commonly used antimicrobials among pathogens of both bacteremic and non-bacteremic community-acquired urinary tract infection.

This study examined the distribution of organisms and their antimicrobial resistance in patients admitted due to acute bacteremic and non-bacteremic community-acquired urinary tract infection (UTI). During a period of 1 year and 1 month, a total of 201 patients and 253 bacterial isolates were studied. Fever higher than 38.5 degrees C was significantly more common in the bacteremic group than the non-bacteremic group (68% vs 48%; p<0.05). Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis were the most common organisms isolated. E. coli was the leading pathogen and it was significantly more predominant in bacteremic UTI than non-bacteremic UTI (73% vs 49%; p<0.01). Bacteria other than E. coli (i.e., K. pneumoniae, P. aeruginosa, Proteus spp., Morganella morganii, Enterobacter cloacae, Citrobacter spp., Acinetobacter baumannii, Serratia marcescens, and Providencia spp.) were more common in non-bacteremic UTI than bacteremic UTI (44% vs 22%; p<0.01). E. coli isolated from both bacteremic and non-bacteremic patients had a high rate of resistance to ampicillin (80%), cephalothin (59%), gentamicin (29%), piperacillin (61%), trimethoprim-sulfamethoxazole (56%), amoxicillin-clavulanic acid (34%), and ticarcillin-clavulanic acid (36%). Isolates of P. aeruginosa, K. pneumoniae, and Proteus spp. from the non-bacteremic group showed a higher proportion of resistance to extended-spectrum cephalosporins, aminoglycosides (netilmicin and amikacin) and ciprofloxacin. The emergence of a high rate of resistance to commonly used antimicrobials (ampicillin, cephalothin, gentamicin, trimethoprim-sulfamethoxazole, piperacillin, amoxicillin-clavulanic acid and ticarcillin-clavulanic acid) may have an impact on the antibiotic treatment of patients admitted due to acute community-acquired bacteremic or non-bacteremic UTI in Taiwan. Further studies are needed to clarify the impact of antimicrobial resistance on the outcome in these conditions.

Adult↗
PubMed2004

[Coryneform bacteria: their clinical significance and resistance patterns during a three-year study].

We report data concerning our experience during three years (1998-2001) about isolation, identification and susceptibility towards antimicrobial agents of coryneform bacteria in infections of hospitalized/at risk patients. We isolated 54 Corynebacterium spp., with prevalence of C. striatum (8 strains) and C. amycolatum (7 strains), and 1 strain of Oerskovia spp. and 1 strain of Actinomyces neuii. 31 strains were isolated from the "exit-site" and 6 from peritoneal fluid of CAPD patients. Vancomycin and teicoplanin were always "in vitro" efficacious. Resistance rates towards other antibiotics were the following: 11% for minocycline, 12.5% for tetracycline, 20% for gentamicin and netilmicin, 61% for erythromycin and chloramphenicol, 66% for penicillin.

Actinomycetales↗
PubMed2004

Incidence of extended-spectrum beta-lactamases in clinical isolates of the family Enterobacteriaceae in a pediatric hospital.

The incidence of extended-spectrum beta-lactamases (ESBLs) was analyzed in Enterobacteriaceae population circulating in the Upper Silesian Child and Mother Health Center in Katowice (USC&MHC). Altogether 1164 clinical specimens, collected from children hospitalized in 8 different hospital units of USC&MHC were investigated. Five hundred and eighty-five clinical isolates of the family Enterobacteriaceae were identified in specimens collected from 403 patients. Two hundred and twenty-nine Enterobacteriaceae strains (39%) isolated from 162 patients were found to be putative ESBL producers as revealed by double-disc synergy (DDS) test. ESBL activity was the most prevalent in the population of Klebsiella pneumoniae (77%), followed by Klebsiella oxytoca (50%), Serratia marcescens (43%), Escherichia coli (30%), Enterobacter spp. (18%) and Proteus mirabilis (12%). ESBL producers demonstrated also wide resistance to the non-beta-lactam antimicrobial co-trimoxazole (93%) and the aminoglycosides netilmicin (88%), gentamicin (84%) and amikacin (79%).

Child↗
PubMed2004

Antimicrobial susceptibility of isolates from neonatal septicemia.

A retrospective study of bacterial isolates from cases of neonatal septicemia was undertaken over a period of 5 years (July 1998 - June 2003) at the Government Medical College Hospital, Chandigarh, India. The study was carried out to determine the bacterial profile, the antimicrobial susceptibility of the isolates, and the change in trends over the study period. A total of 3,064 blood samples for blood culture were obtained, out of which 588 were positive for bacterial isolates. Most of the cases detected by blood culture occurred in the first week of life (64.4%). Gram-negative bacilli (58.5%) predominated over Gram-positive cocci (41.5%). Staphylococcus aureus was found to be the most common isolate (35.0%). The incidence of Gram-positive and Gram-negative organisms changed little over the 5 year span. However, a constant and significant rise in the incidence of Acinetobacter spp. was observed between the first to fifth year of the study period. Amikacin was found to be the most effective drug against Gram-negative bacteria. For S. aureus and Pseudomonas aeruginosa, overall resistance percentages of 5 years show that netilmicin and ciprofloxacin, respectively, were the most effective drugs.

Anti-Bacterial Agents↗
PubMed1992

[Intraventricular antibiotic therapy].

While shunt infections are regularly treated with intraventricular antibiotics, the validity of such an application in bacterial meningitis of other origin is controversial. We report two cases of partly successful treatment with intraventricular Ceftazidime (10-20 mg twice per week). One patient with pseudomonas aeruginosa meningitis who was treated as an out-patient for nearly two years died after an attempted withdrawal of the intraventricular treatment. In our experience, intraventricular application of antibiotics can be a part of the therapeutic regimen in all cases of chronic meningitis with problematic bacteria. Depending on the bacillus, Ceftazidime, Vancomycin or Netilmicin can be recommended for intrathecal application.

Aged↗
PubMed2004

[Electrospray ion trap mass spectrometry of eight aminoglycoside antibiotics].

AIM: To study the dissociation pathways of aminoglycoside antibiotics. METHODS: In positive mode, eight aminoglycoside antibiotics were elucidated by use of electrospray ion trap mass spectrometry in the multi-stage MS full scan mode. RESULTS: It was demonstrated that the eight aminoglycoside antibiotics gave abundant product ions at m/z 322 (gentamicin, micronomicin and sisomicin), m/z 350 (etimicin, netilmicin and vetilmicin) and m/z 324 (kanamycin and tobramycin) by loss of the C-ring (amino-alpha-D-glucopyranose) in MS2 full scan mode. In MS3 full scan mode, the prominent fragmentation ions at m/z 163 as well as m/z 191 were formed from the fragmentation ions at m/z 322, m/z 350 and m/z 324 by loss of the A-ring (amino-alpha-D-glucopyranose), separately, while the characteristic fragmentation ions at m/z 160 as well as m/z 162 were formed from m/z 322, m/z 350 and m/z 324 by loss of the B-ring (2-deoxy-D-streptamine), separately. CONCLUSION: The structural information was obtained via collision-activated dissociation and these characteristics are applicable to the structural elucidation and quantitative analysis of aminoglycoside compounds.

Aminoglycosides↗
PubMed2005

Unregulated use of antibiotics in Siliguri city vis-a-vis occurrence of MAR bacteria in community waste water and river Mahananda, and their potential for resistance gene transfer.

The unregulated use of antibiotics, including therapeutic and prophylactic prescribing, in the fastest growing city of West Bengal, Siliguri, was studied indirectly from a random survey conducted on retail medicine sellers at their counters. Ciprofloxacin, ampicillin, norfioxacin and amoxycillin were the highest retailed antibiotics and 58% of the city pharmacies sold antibiotics even without prescriptions. To understand the influence of the extent of antibiotic use by the community on the collective bacterial flora in the aquatic environment, we have determined the fraction(s) of Standard Plate Count (SPC) bacteria resistant to different antibiotics and multiple antibiotic resistance (MAR) profile of resistant SPC isolates from two municipal open drains and Mahananda river water samples of Siliguri. Within the MAR groups of Drain I and Drain II samples, 37.44% and 77.43% respectively were resistant to all seven antibiotics (ampicillin, chloramphenicol, ciprofloxacin, kanamycin, netilmicin, streptomycin and tetracycline) used in the study. Twenty Gram-negative SPC MAR isolates were examined for the presence of plasmids. Antibiotic resistance was shown to be associated with a carriage of a 47 kb (D1QN - 9), 48 kb (D2QN - 14) and 49.4 and 3.6 kb (MR - 1) plasmids, which were transmissible to the Escherichia coli DH5alpha recipient. The rapid spread of antibiotic resistance genes in bacterial population as a consequence of indiscriminate use of antibiotics, which can be partly attributed to plasmid-mediated horizontal transfer was discussed.

Anti-Bacterial Agents↗
PubMed2004

Significance and characterisation of pseudomonads from urinary tract specimens.

Pseudomonads are commonly encountered in clinical samples. Usually ignored as contaminants, these organisms are known to cause nosocomial opportunistic infections like urinary tract infections (UTI). One hundred and two pseudomonads obtained in pure culture and significant numbers from 8400 consecutive urinary tract (UT) specimens were biochemically characterised upto species level by a battery of biochemical tests. Modified Stoke's disk diffusion method was followed for testing antibiotic susceptibility. Beta-lactamase production was checked by nitrocefin disk method. Minimum Inhibitory Concentration for some of these strains against imipenem was done by agar dilution method of NCCLS. Etiological significance of isolating these organisms from UT specimens was also assessed. P. aeruginosa was the commonest (76) followed by B. pickettii (10), P. putida (6), P.fluorescence (2), P. stutzeri (20) P. vesicularis (2), S. putrefaciens (2) and Stenotrophomonas maltophilia (2). Seventy six per cent of P. aeruginosa produced beta-lactamases as compared to 45% of other pseudomonads. The frequency of antibiotic resistance was gentamicin and ciprofloxacin (68.6%) followed by netilmicin (60.7%), ceftazidime (58.8%), amikacin (43.1%) and piperacillin (39.2%). In 42 patients (51.2%) the etiological significance of isolating a pseudomonad could be confirmed. Risk factors for development of UTI were present in 62(75%). Obstructive uropathy (20) followed by post operative period and surgery on urinary tract were the commonest risk factors involved. A high level of resistance was observed for imipenem (P. aeruginosa 43.7% and other pseudomonads 25%).

Adolescent↗
PubMed2005

The virulence factors and antibiotic sensitivities of Escherichia coli isolated from recurrent urinary tract infections.

OBJECTIVE: We determined the antibiotic sensitivities of uropathogenic Escherichia coli (UPEC) strains isolated from the urine of patients who have recurrent urinary tract infections (UTIs). METHODS: Our study was carried out between November 2000 and January 2002 at the Infectious Diseases Clinic, Istanbul Haydarpasa Numune Hospital, Istanbul, Turkey. We compared the virulence factors (fimbrial adhesion, hemolysin production, motility property) of 50 strains of Escherichia coli (E. coli) isolated from urine with the same properties of 25 strains of E. coli isolated from stool specimens of healthy individuals. In addition, we detected the virulence factors of UPEC strains using a microbiological and biochemical methods and by using disk diffusion method, we were able to investigate the sensitivity of the strains to the antimicrobials. RESULTS: We found the level of mannose-resistant (MR) fimbriae bearing in the UPEC strains to be significantly higher than that in the controls (odds ratio=10.27, p<0.001). The difference in mannose-resistant hemoagglutination (MRHA) and mannose sensitive hemoagglutination (MSHA) bearing levels in UPEC strains were rather high. This difference was regarded as significant in terms of showing the virulence of fimbriae bearing strains (odds ratio=29.03, p<0.001). CONCLUSION: Our study demonstrates that strains with MR fimbriae have a rather high virulence (p<0.001), and that a combination of MR+MS fimbriae increased that virulence (p<0.001). As MR strains have a greater adhesive property, the determination of MR fimbriae bearing as high shows that fimbriae bearing plays an important role in widespread and resistant strains, especially in recurrent UTIs such as in our study. In addition, hemolysin capability was also a virulence factor in recurrent UTIs (p<0.01). In addition, the sensitivity of the strains to the antimicrobials appeared in the following order; imipenem 93%, norfloxacin 89%, ciprofloxacin 85%, netilmicin 80%, amikacin 78%, ceftriaxone 74%, gentamicin 72%, nitrofurantoin 71%, ampicillin-sulbactam 60%, amoxicillin-clavulanate 58%, Trimethoprim/sulfamethoxazole 45%, ampicillin 35%.

Adult↗
PubMed1991

[Antibiotic sensitivity tests of methicillin-resistant staphylococci].

In this study, 231 Methicillin-Resistant Staphylococcus (MRS) and 76 Methicillin-Susceptible Staphylococcus (MSS) strains were investigated. 23 antibiotics were tested by using Modified Kirby-Bauer Technique. The highest resistance ration in MRS strains were found for lincomycin, clindamycin and ampicillin with the ratios of 61.0%, 59.3%, and 56.2% respectively. And the lowest resistance ratios were measured for vancomycin, ciprofloxacin and ofloxacin 0.5%, 8.2%, 10.8% respectively. It was found that, resistance of MRS strains to 17 antibiotics were significantly higher than resistance of MSS strains, but not for sulbactam-ampicillin, cefoperazone, ceftriaxone, vancomycin, ciprofloxacin, ofloxacin and netilmicin.

Anti-Bacterial Agents↗
PubMed1991

Antimicrobial resistance among gram-negative bacilli to newer aminoglycosides and beta-lactams.

Two hundred and fifty nine i.e. 30.72% of 843 strains of gram negative bacilli were resistant to gentamicin. When tested against newer aminoglycosides, 48.9% were resistant to tobramycin, 4.1% to amikacin and 20.5% to netilmicin. Marked cross-resistance between gentamicin and tobramycin was seen. All these strains were resistant to ampicillin, amoxycillin and co- trimoxazole. However, a high level of antimicrobial activity was seen with third generation cephalosporins, cefotaxime and ceftriaxone. Minimum inhibitory concentrations of gentamicin and tobramycin were of significant level. Gentamicin resistance could be transferred directly in 20 of 45 strains of S. typhimurium where conjugation experiments were done.

Aminoglycosides↗