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Id: biblio-1008023
Autor: Cruz Camino, Cristina; Paredes, Patricio; Patiño Gualichico, Luis.
Título: Staphylococcus aureus meticilino resistente comunitario, Hospital de Niños Baca Ortiz / Community methicilin-resistant Staphylococcus aureus; Baca Ortiz Children´s Hospital
Fonte: Cambios rev. méd;14(24):82-85, abr. 2015. ilus.
Idioma: es.
Resumo: Introducción: las infecciones debidas a Staphylococcus aureus adquiridos en la comunidad (MRSA-AC) están aumentando significativamente a nivel mundial. Su virulencia se caracteriza principalmente por la presencia de la leucocidina Panton- Valentine. Caso: en la siguiente revisión presentamos dos casos clínicos en niños ecuatorianos que tuvieron cuadros infecciosos con las características de MRSA-AC con el objetivo de analizar la importancia del estudio de sensibilidad de los antibióticos para S. aureus adquiridas en la comunidad, lo que determina un manejo adecuado y temprano en la terapéutica de estas infecciones.

Introduction: infections due to community-acquired Staphylococcus aureus (MRSA -AC) are increasing signifcantly worldwide. Its virulence is mainly characterized by the presence of Panton- Valentine Leukocidin. This study pretends to analyze the importance of studying antibiotic sensitivity of community- acquired S. aureus, which determines appropriate management and early treatment of these infections. Case study: we present two cases in Ecuadorian children who had the characteristics of MRSA-AC.
Descritores: Virulência
Criança
Staphylococcus aureus Resistente à Meticilina
Infecções
Leucocidinas
Antibacterianos
-Características de Residência
América Latina
Meticilina
Limites: Humanos
Masculino
Criança
Tipo de Publ: Relatos de Casos
Responsável: EC162.1


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Id: biblio-1008233
Autor: Granja Morán, Manuel; Orquera Carranco, Andrés.
Título: Utilidad de la Procalcitonina en la predicción de bacteriemia y utilización de antibióticos en pacientes neutropénicos febriles del servicio de Hematología del Hospital Carlos Andrade Marín en el período abril 2013 - abril 2014 / Procalcitonin helpfulness in predicting bacteriemia and usage of antibiotics in febrile neutropenic patients in Carlos Andrade Marin Hospital hematology department, April 2013 ­ April 2014
Fonte: Cambios rev. méd;14(25):17-19, jun.2015.
Idioma: es.
Resumo: Introducción: la neutropenia febril es una de las complicaciones más frecuentes y fatales del tratamiento de las neoplasias hematológicas. Es necesario el tratamiento antibiótico de amplio espectro de forma inmediata, sin embargo no se puede aislar el germen causal en la mayoría de casos. La utilización de biomarcadores de infección como la procalcitonina ha demostrado su utilidad en la predicción de bacteriemia en pacientes neutropénicos febriles que han recibido quimioterapia. Materiales y métodos: se tomaron 2 muestras de sangre periférica colocados en medio de hemocultivos y 3 cc para determinación de procalcitonina a pacientes con temperatura y un contaje menor de 500 neutróflos por ml después de haber concluido la administración de quimioterapia para neoplasias hematológicas. Resultado: se estudiaron 106 episodios de neutropenia febril en 66 pacientes, obteniéndose una sensibilidad de 84%, especifcidad de 55.1%, VPP 29%, VPN 94% de procalcitonina para diagnóstico de bacteriemia en comparación con el goldstantard hemocultivo. Conclusiones: la procalcitonina es un test de utilidad para predecir bacteriemia y riesgo alto de choque séptico en pacientes neutropénicos febriles.

Introduction: febrile neutropenia is one of the most common and fatal complications of hematologic malignancies treatment. Immediate treatment with broad-spectrum antibiotic is necessary; however the causal agent cannot be isolated in most cases. The use of infection biomarkers such as procalcitonin has proven useful in predicting bacteremia in febrile neutropenic patients receiving chemotherapy. Materials and methods: two peripheral blood samples were aken for blood culture and 3 cc for procalcitonin determination of patients with temperature and leucocyte count below 500, having received chemotherapy for hematological neoplasia. Results: 106 febrile episodes in 66 patients were studied obtaining 84% sensitivity, 55.1% specifcity, PPV 29%, 94% VPN procalcitonin for diagnosis of bacteremia compared to the Gold Standard blood culture. Conclusions: procalcinotin is a useful test to predict bacteremia and high risk septic shock in febrile neutropenic patients.
Descritores: Bacteriemia
Neutropenia Febril
Pró-Calcitonina
Hematologia
Antibacterianos
Neutropenia
-Biomarcadores
Neoplasias Hematológicas
Tratamento Farmacológico
Limites: Humanos
Adulto
Tipo de Publ: Estudo Observacional
Responsável: EC162.1


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Id: biblio-1145264
Autor: Routray, Samapika; Rath, Shakti; Mohanty, Neeta.
Título: Prevalence of methicillin resistant staphylococcus aureus isolated from saliva samples of patients with oral squamous cell carcinoma / revalencia de Staphylococcus aureus resistente a la meticilina en muestras de saliva de pacientes con carcinoma oral de células escamosas
Fonte: J. oral res. (Impresa);8(1):30-36, feb. 28, 2019. ilus, tab.
Idioma: en.
Resumo: Objectives: To study the prevalence of methicillin resistant Staphylococcus aureus (MRSA) in saliva samples of pre-surgical oral squamous cell carcinoma (OSCC) patients along with their resistance pattern to other antibiotics. Methods: Saliva samples of OSCC patients were collected and processed for isolation of MRSA. Staphylococcus aureus isolates were primarily identified using standard microbiological methods like biochemical assays, specialized media and latex agglutination test. Confirmation of MRSA strains was done by growing the isolates on MRSA agar and by using PCR to amplify two MRSA specific genes. All the isolated Staphylococcus aureus strains were subjected to antibiotic sensitivity tests. Results: A total of 17 Staphylococcus aureus strains were isolated from 50 saliva samples of pre-surgical OSCC patients of which 13 were confirmed to be MRSA. These MRSA strains were also found to be mostly resistant to other commonly used antibiotics. Univariate analysis revealed that most patients with MRSA infections had a prior history of hospitalization and surgery. Also, it was confirmed that patients with other comorbidities and infections were more prone to having MRSA present in the saliva. Conclusion: The majority of Staphylococcus aureus isolates from the saliva of OSCC patients were MRSA, and were resistant to several other commonly used antibiotics.

Objetivos: Estudiar la prevalencia de Staphylococcus aureus resistente a la meticilina (MRSA) en muestras de saliva prequirúrgicas de pacientes con carcinoma oral de células escamosas (COCE) junto con su patrón de resistencia a otros antibióticos. Métodos: Se recolectaron muestras de saliva de pacientes con COCE y se procesaron para el aislamiento de SARM. Los aislamientos de Staphylococcus aureus se identificaron principalmente mediante métodos microbiológicos estándar, como los análisis bioquímicos, los medios especializados y la prueba de aglutinación con látex. La confirmación de las cepas de SARM se realizó cultivando los aislados en agar SARM y utilizando PCR para amplificar dos genes específicos de SARM. Todas las cepas aisladas de Staphylococcus aureus se sometieron a pruebas de sensibilidad a los antibióticos. Resultados: Se aislaron un total de 17 cepas de Staphylococcus aureus a partir de 50 muestras de saliva de pacientes prequirúrgicos con COCE, de los cuales solo se confirmó que 13 eran SARM. También se encontró que estas cepas de SARM son resistentes a otros antibióticos de uso común. El análisis univariado reveló que la mayoría de los pacientes con infecciones por SARM tenían antecedentes previos de hospitalización y cirugía. Además, se confirmó que los pacientes con otras comorbilidades e infecciones eran más propensos a las infecciones por SARM. Conclusión: la mayoría de los aislamientos de Staphylococcus aureusde la saliva de los pacientes con OSCC fueron MRSA y fueron resistentes a varios otros antibióticos de uso común.
Descritores: Staphylococcus/isolamento & purificação
Resistência Microbiana a Medicamentos
Staphylococcus aureus Resistente à Meticilina/genética
Carcinoma de Células Escamosas de Cabeça e Pescoço
Boca/microbiologia
-Saliva
DNA Bacteriano/genética
Prevalência
Antibacterianos
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: CL30.1 - Biblioteca


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Id: biblio-1099651
Autor: Morales Urresta, Erika Estefanía; Velasco Polo, Verónica Alexandra; Cárdenas Martínez, Ana Gabriela; Oñate Araque, Ximena Lucia; Núñez Freile, Byron Fabián; Guerrero Toapanta, Fausto Marcos; Reyes Chacón, Jorge Aníbal.
Título: Carbapenemasas y sensibilidad a los antibióticos no ß-lactámicos en Klebsiella pneumoniae resistente a los carbapenémicos en un hospital de tercer nivel de complejidad. Quito ­ Ecuador / Carbapenemases and sensitivity to non-ß-lactam antibiotics in Klebsiella pneumoniae resistant to carbapenems in a third level hospital. Quito - Ecuador
Fonte: Cambios rev. méd;18(2):52-57, 2019/12/27. tabs..
Idioma: es.
Resumo: INTRODUCCIÓN. La resistencia de Klebsiella pneumoniae a carbapenémicos ha aumentado con los años, reduciendo opciones terapéuticas. Puede deberse a dos mecanismos principales, como: la producción de carbapenemasas y alteración de la permeabilidad de la membrana. OBJETIVO. Analizar la frecuencia de Klebsiella pneumoniae resistente a carbapenémicos, junto al mecanismo de resistencia informado por el Laboratorio Nacional de Referencia y la sensibilidad a antibióticos usados para uso terapéutico. MATERIA-LES Y MÉTODOS. Estudio retrospectivo, de población y muestra conocida. Se determinó la sensibilidad/resistencia de Klebsiella pneumoniae: todos los datos aislados de Klebsiella pneumoniae. Se reportaron 11 809 bacilos gram negativos pertenecientes a la familia Enterobacteriaceae. Se utilizó el sistema Whonet 5.6 2017 y BacLink2, así como la revisión de los resultados enviados al Centro Nacional de Referencia para la Resistencia a los Antimicrobianos del Instituto Nacional de Investigación de Salud Pública Izquieta Pérez para investigación de carbapenemasas en el Hospital de Especialidades Carlos Andrade Marín,en el período abril 2016 a mayo 2018. RESULTADOS. El 20,5% (2 421; 11 809) correspondieron a Klebsiella pneumoniae y de estos, 32,9% (797; 2 421) mostraron resistencia a Meropenem. Existió mayor frecuencia en muestra de orina, secreción, sangre y aspirado traqueal. Predominó en varones de más de 61 años. Se clasificó en 15 grupos fenotípicos según los perfiles de resistencia a los antibióticos utilizados como alternativa terapéutica. CONCLUSIÓN. La presencia de Klebsiella pneumoniae produjo una carbapenemasa resistente a los medi-camentos utilizados como tratamiento, llevó a pensar en el uso de otros medicamentos como: fosfomicina o ceftazidima/viabactam; sin embargo, se desarrolló medidas de control y prevención de infecciones, así como programas para el uso de antibióticos.

INTRODUCTION. The resistance of Klebsiella pneumoniae to carbapenems has increased over the years, reducing therapeutic options. It can be due to two main mechanisms, such as: the production of carbapene-mases and alteration of membrane permeability. OBJECTIVE. Analyse the frequency of carbapenem-resistant Klebsiella pneumoniae, along with the resistance mechanism reported by the National Reference Laboratory and sensitivity to antibiotics used for therapeutic use. MATERIALS AND METHODS. Retrospective study, po-pulation and known sample. The sensitivity / resistance of Klebsiella pneumoniae was determined: all isolated were Klebsiella pneumoniae. 11 809 gram negative bacillus belonging to the Enterobacteriaceae family were reported. The Whonet 5.6 2017 and BacLink2 system was used, as well as the review of the results sent to the National Reference Center for the Antimicrobial Resistance of the National Institute of Public Health Research Izquieta Pérez for carbapenemases research at the Carlos Andrade Marín Speciality Hospital, in the period april 2016 to may 2018. RESULTS. 20,5% (2 421; 11 809) were Klebsiella pneumoniae and of these, 32,9% (797; 2 421) showed resistance to Meropenem. There was a higher frequency in urine sample, secretion, blood and tracheal aspiration. Predominance in males over 61 years old. It was classified into 15 phenotypic groups according to antibiotic resistance profiles used as a therapeutic alternative. CONCLUSION. The pre-sence of Klebsiella pneumoniae produced a carbapenemase drug-resistance used as treatment, leading to thought on the use of other medicines such as phosphomycin or ceftazidima/avibactam; however, infection control and prevention measures were developed, as well as programs for the use of antibiotics.
Descritores: Fenótipo
Carbapenêmicos
beta-Lactamas
Enterobacteriaceae
Klebsiella pneumoniae
Antibacterianos
-Terapêutica
Fatores R
Testes de Sensibilidade Microbiana
Gestão de Antimicrobianos
Unidades de Terapia Intensiva
Microbiologia
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Estudo de Validação
Responsável: EC162.1


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Id: biblio-1130108
Autor: Tomaseto, Alex Augusto; Alpiste, Marcel Costa; Nassar, Alessandra Figueiredo de Castro; Destéfano, Suzete Aparecida Lanza.
Título: Antibacterial activity of phytopathogenic Streptomyces strains against bacteria associated to clinical diseases / Atividade antimicrobiana de Streptomyces fitopatogênicas contra bactérias associadas a doenças de importância clínica
Fonte: Arq. Inst. Biol;87:e0142020, 2020. tab.
Idioma: en.
Projeto: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil; . Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
Resumo: The genus Streptomyces is associated with the ability to produce and excrete a variety of bioactive compounds, such as antibiotic, antifungal and antiviral. Biological active polyketide and peptide compounds with applications in medicine, agriculture and biochemical research are synthesized by PKS-I and NRPS genes. The evaluation of the presence of these genes associated with the biosynthesis of secondary metabolites in different phytopathogenic Streptomyces strains were performed using degenerated primers. The positive signal was observed in 58/63 Streptomyces strains for NRPS gene, 43/63 for PKS-I, and for PKS-II all the 63 strains showed positive signal of amplification. These strains also were tested with double layer agar-well technique against bacterial with clinical importance, and it was possible to observe the Streptomyces spp. strains were able to inhibit the growth of 14, 20, 13 and 3 isolates Gram-positive and Gram-negative bacteria, Staphylococcus aureus (ATCC 25923), Bacillus cereus (ATCC 14579), Pseudomonas aeruginosa (ATCC 27853) and Escherichia coli (ATCC 11775) respectively. The Streptomyces sp. strains IBSBF 2019 and IBSBF 2397 showed antibacterial activity against all four bacteria-target tested.(AU)

O gênero Streptomyces apresenta alta capacidade de produzir e excretar uma grande variedade de compostos biologicamente ativos, como antibióticos, antifúngicos e antivirais. Compostos biologicamente ativos de policetídeos e peptídeos com aplicações na medicina, agricultura e pesquisas bioquímicas são sintetizados pelos genes PKS-I e NRPS. A avaliação da presença desses genes associados à biossíntese de metabólitos secundários em diferentes linhagens de Streptomyces fitopatogênicas foi realizada através do uso de primers degenerados. O sinal positivo foi observado em 58/63 linhagens de Streptomyces para o gene NRPS, 43/63 para o gene PKS-I e, para o gene PKS-II, todas as 63 linhagens apesentaram o sinal positivo de amplificação. Essas linhagens também foram testadas através da técnica de dupla camada contra bactérias de importância clínica e foi possível observar que as linhagens de Streptomyces spp. foram capazes de inibir o crescimento de 14, 20, 13 e 3 isolados de bactérias Gram-positivas e Gram-negativas, Staphylococcus aureus (ATCC 25923), Bacillus cereus (ATCC 14579), Pseudomonas aeruginosa (ATCC 27853) e Escherichia coli (ATCC 11775), respectivamente. As linhagens de Streptomyces sp. ISBSF 2019 e 2397 apresentaram atividade antibacteriana contra todas as bactérias-alvo testadas.(AU)
Descritores: Streptomyces
Bactérias Gram-Negativas
Bactérias Gram-Positivas
-Peptídeos
Pseudomonas aeruginosa
Staphylococcus aureus
Bacillus cereus
Escherichia coli
Policetídeos
Antibacterianos
Antifúngicos
Responsável: BR1942.1 - NID - Biblioteca - Núcleo de Informação e Documentação


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Id: biblio-881350
Autor: Maluf Junior, Ivan; Zahdi, Mariana Ribas; Bonalumi Filho, Aguinaldo; Cruz, Cristina Rodrigues.
Título: Doença de Lyme: diagnóstico e tratamento / Lyme Disease: diagnosis and treatment
Fonte: Rev. bras. med. fam. comunidade;3(10):76-81, nov. 2007. ilus..
Idioma: en; pt.
Resumo: A doença de Lyme é uma infecção bacteriana sistêmica causada pela espiroqueta Borrelia burgdoferi e transmitida por carrapatos do gênero Ixodes e Amblyomma. Ela é doença endêmica em áreas de animais silvestres, carrapatos e florestas, sendo pouco relatada no Brasil. É a patologia mais comum transmitida por carrapatos. As manifestações clínicas iniciam-se com aparecimento de eritema migratório no local da picada, seguido de sintomas semelhantes ao da gripe. Com a evolução da doença, pode ocorrer acometimento dos sistemas nervoso central, cardiovascular, ocular e articulações.Odiagnóstico é feito pelas características clínicas, dados epidemiológicos e exames laboratoriais; já o tratamento é realizado com administração de antibióticos conforme o estágio da doença.

Lyme disease is a multisystem bacterial infection caused by the spirochete Borrelia burgdorferi. It is transmitted by the bite of infected ticks of the genus Ixodes and Amblyomma. The disease is endemic in wooded, brushy areas, which are habitats for wild animals and ticks. It is the disease most commonly transmitted by ticks, but rarely reported in Brazil. Early local Lyme Disease often starts with erythema migrans at the site of the tick bite, followed by flu-like symptoms. In advanced stage the disease may cause symptoms in the joints, eyes, heart and nervous system. Diagnosis is based on clinical symptoms, epidemiology and laboratory tests. Lyme disease is treated with antibiotics according to the stage of the disease.
Descritores: Doença de Lyme
-Carrapatos
Doença de Lyme/diagnóstico
Doença de Lyme/terapia
Antibacterianos
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM


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Id: lil-780802
Autor: Akturk, Hacer; Sutcu, Murat; Somer, Ayper; Aydın, Derya; Cihan, Rukiye; Ozdemir, Aslı; Coban, Asuman; Ince, Zeynep; Citak, Agop; Salman, Nuran.
Título: Carbapenem-resistant Klebsiella pneumoniae colonization in pediatric and neonatal intensive care units: risk factors for progression to infection
Fonte: Braz. j. infect. dis;20(2):134-140, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: Abstract Background Little is known about factors associated with carbapenem-resistant Klebsiella pneumoniae infections in pediatric patients, who are initally colonized with carbapenem-resistant Klebsiella pneumoniae. Materials and methods A retrospective case–control study was conducted involving pediatric and neonatal intensive care units throughout a five-year period (January 2010–December 2014). Clinical and microbiological data were extracted from Hospital Infection Control Committee reports and patients’ medical records. Risk factors were assessed in carbapenem-resistant Klebsiella pneumoniae colonized patients who developed subsequent systemic infection (cases) and compared to carbapenem-resistant Klebsiella pneumoniae colonized patients who did not develop infection (controls). Results Throughout the study period, 2.6% of patients admitted to neonatal intensive care units and 3.6% of patients admitted to pediatric intensive care units had become colonized with carbapenem-resistant Klebsiella pneumoniae. After a mean of 10.6 ± 1.9 days (median: 7 days, range: 2–38 days) following detection of colonization, 39.0% of the carbapenem-resistant Klebsiella pneumoniae colonized patients in pediatric intensive care units and 18.1% of carbapenem-resistant Klebsiella pneumoniae colonized patients in neonatal intensive care units developed systemic carbapenem-resistant Klebsiella pneumoniae infection. Types of systemic carbapenem-resistant Klebsiella pneumoniae infections included bacteremia (n = 15, 62.5%), ventilator-associated pneumonia (n = 4, 16.6%), ventriculitis (n = 2, 8.3%), intraabdominal infections (n = 2, 8.3%), and urinary tract infection (n = 1, 4.1%). A logistic regression model including parameters found significant in univariate analysis of carbapenem resistant Klebsiella pneumoniae colonization and carbapenem resistant Klebsiella pneumoniae infection groups revealed underlying metabolic disease (OR: 10.1; 95% CI: 2.7–37.2), previous carbapenem use (OR: 10.1; 95% CI: 2.2–40.1), neutropenia (OR: 13.8; 95% CI: 3.1–61.0) and previous surgical procedure (OR: 7.4; 95% CI: 1.9–28.5) as independent risk factors for carbapenem-resistant Klebsiella pneumoniae infection in patients colonized with carbapenem-resistant Klebsiella pneumoniae. Out of 24 patients with carbapenem resistant Klebsiella pneumoniae infection, 4 (16.6%) died of carbapenem-resistant Klebsiella pneumoniae sepsis. Conclusion Asymptomatic colonization with carbapenem-resistant Klebsiella pneumoniae in intensive care units of pediatric departments should alert health care providers about forthcoming carbapenem-resistant Klebsiella pneumoniae infection. Those carbapenem-resistant Klebsiella pneumoniae colonized patients at risk of developing infection due to carbapenem-resistant Klebsiella pneumoniae may be targeted for interventions to reduce subsequent infection occurence and also for timely initiation of empirical carbapenem-resistant Klebsiella pneumoniae active treatment, when necessary.
Descritores: Infecções por Klebsiella/microbiologia
Carbapenêmicos/farmacologia
Infecção Hospitalar/microbiologia
Farmacorresistência Bacteriana
Klebsiella pneumoniae/efeitos dos fármacos
Antibacterianos/farmacologia
-Reto/microbiologia
Infecções por Klebsiella/epidemiologia
Unidades de Terapia Intensiva Neonatal
Infecção Hospitalar/epidemiologia
Métodos Epidemiológicos
Progressão da Doença
Resistência beta-Lactâmica
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão
Klebsiella pneumoniae/isolamento & purificação
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Pré-Escolar
Criança
Adolescente
Responsável: BR1.1 - BIREME


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Id: lil-780805
Autor: Berber, Ismet; Avsar, Cumhur; Yegin, Zeynep; Tekerci, Melike; Civek, Seyhan.
Título: Molecular epidemiology of Pseudomonas aeruginosa clinical isolates
Fonte: Braz. j. infect. dis;20(2):224-225, Mar.-Apr. 2016. graf.
Idioma: en.
Descritores: Pseudomonas aeruginosa/genética
Fatores de Virulência/genética
Antibacterianos/farmacologia
-Pseudomonas aeruginosa/efeitos dos fármacos
Turquia
DNA Bacteriano/análise
Epidemiologia Molecular
Genes Bacterianos/genética
Limites: Humanos
Tipo de Publ: Carta
Responsável: BR1.1 - BIREME


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Id: lil-780812
Autor: Ortiz-Covarrubias, Alejandro; Fang, Edward; Prokocimer, Philippe G; Flanagan, Shawn D; Zhu, Xu; Cabré-Márquez, Jose Francisco; Tanaka, Toshiaki; Passarell, Julie; Fiedler-Kelly, Jill; Nannini, Esteban C.
Título: Efficacy, safety, tolerability and population pharmacokinetics of tedizolid, a novel antibiotic, in Latino patients with acute bacterial skin and skin structure infections
Fonte: Braz. j. infect. dis;20(2):184-192, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: Abstract Acute bacterial skin and skin structure infections are caused mainly by Gram-positive bacteria which are often treated with intravenous vancomycin, daptomycin, or linezolid, with potential step down to oral linezolid for outpatients. Tedizolid phosphate 200 mg once daily treatment for six days demonstrated non-inferior efficacy, with a favourable safety profile, compared with linezolid 600 mg twice daily treatment for 10 days in the Phase 3 ESTABLISH-1 and -2 trials. The objective of the current post-hoc analysis of the integrated dataset of ESTABLISH-1 and -2 was to evaluate the efficacy and safety of tedizolid (N = 182) vs linezolid (N = 171) in patients of Latino origin enrolled into these trials. The baseline demographic characteristics of Latino patients were similar between the two treatment groups. Tedizolid demonstrated comparable efficacy to linezolid at 48–72 h in the intent-to-treat population (tedizolid: 80.2% vs linezolid: 81.9%). Sustained clinical success rates were comparable between tedizolid- and linezolid-treated Latino patients at end-of-therapy (tedizolid: 86.8% vs linezolid: 88.9%). Tedizolid phosphate treatment was well tolerated by Latino patients in the safety population with lower abnormal platelet counts at end-of-therapy (tedizolid: 3.4% vs linezolid: 11.3%, p = 0.0120) and lower incidence of gastrointestinal adverse events (tedizolid: 16.5% vs linezolid: 23.5%). Population pharmacokinetic analysis suggested that estimated tedizolid exposure measures in Latino patients vs non-Latino patients were similar. These findings demonstrate that tedizolid phosphate 200 mg, once daily treatment for six days was efficacious and well tolerated by patients of Latino origin, without warranting dose adjustment.
Descritores: Organofosfatos/efeitos adversos
Organofosfatos/uso terapêutico
Organofosfatos/farmacocinética
Antibacterianos/efeitos adversos
Antibacterianos/uso terapêutico
Antibacterianos/farmacocinética
-Oxazóis/efeitos adversos
Oxazóis/uso terapêutico
Oxazóis/farmacocinética
Método Duplo-Cego
Doença Aguda
Resultado do Tratamento
Dermatopatias Bacterianas/metabolismo
Dermatopatias Bacterianas/tratamento farmacológico
Linezolida/efeitos adversos
Linezolida/uso terapêutico
Linezolida/farmacocinética
América Latina
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Tipo de Publ: Research Support, Non-U.S. Gov't
Estudo Multicêntrico
Ensaio Clínico Controlado Aleatório
Ensaio Clínico Fase III
Responsável: BR1.1 - BIREME


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Id: lil-789475
Autor: Oliveira, Priscila Rosalba; Felix, Cassia da Silva; Carvalho, Vladimir Cordeiro de; Giovani, Arlete Mazzini; Reis, Rosangela Suarti dos; Beraldo, Marisa; Albuquerque, Edmir Peralta; Ferreira Junior, Walter Cintra; Silva, Jorge dos Santos; Lima, Ana Lucia Lei.
Título: Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil
Fonte: Braz. j. infect. dis;20(3):272-275, May.-June 2016. tab.
Idioma: en.
Resumo: Abstract Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions of Brazil and Latin America.
Descritores: Osteomielite/terapia
beta-Lactamas/uso terapêutico
Infusões Parenterais/métodos
Minociclina/análogos & derivados
Antibacterianos/administração & dosagem
-Pacientes Ambulatoriais
Doenças Ósseas Infecciosas/classificação
Doenças Ósseas Infecciosas/tratamento farmacológico
Brasil
Ertapenem
Tigeciclina
Anti-Infecciosos
Minociclina/uso terapêutico
Antibacterianos/classificação
Limites: Humanos
Masculino
Feminino
Criança
Adolescente
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME



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