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[PMID]:29373935
[Au] Autor:Falcone M; Viale P; Tiseo G; Pai M
[Ad] Endereço:a Department of Public Health and Infectious Diseases , "Sapienza" University of Rome , Rome , Italy.
[Ti] Título:Pharmacokinetic drug evaluation of avibactam + ceftazidime for the treatment of hospital-acquired pneumonia.
[So] Source:Expert Opin Drug Metab Toxicol;14(3):331-340, 2018 Mar.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Ceftazidime-avibactam (CAZ-AVI) is a combination of a third-generation cephalosporin and a non-ß-lactam, ß-lactamase inhibitor, recently approved for urinary tract infections and complicated abdominal infections. Moreover, it represents a treatment option for patients with hospital acquired pneumonia (HAP), especially when caused by multidrug-resistant (MDR) bacteria. Areas covered: The review focuses on the pharmacokinetics (PK) of CAZ-AVI in HAP and on preclinical and clinical studies evaluating PK/pharmacodynamics (PD) in this field. Expert opinion: In vitro and in vivo data about PK/PD of CAZ-AVI confirm that penetration of CAZ-AVI in the epithelial lining fluid (ELF) represents approximately 30% of the plasma concentrations. Clinical studies documented that CAZ-AVI 2000 mg/500 mg every 8 h is the optimal dose regimen to achieve the PK/PD target attainment in patients with HAP. Thus, CAZ-AVI could represent an option both to treat HAP caused by Gram-negative bacilli (GNB) displaying resistance to most of the antibiotics and to reduce the use of carbapenems, limiting the onset of resistance profiles among GNB. Additional information about specific patients populations, such as critically-ill subjects or pediatric patients, are needed for a more individualized use of CAZ-AVI.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Compostos Azabicíclicos/administração & dosagem
Ceftazidima/administração & dosagem
Pneumonia Bacteriana/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Antibacterianos/farmacocinética
Compostos Azabicíclicos/farmacocinética
Ceftazidima/farmacocinética
Infecção Hospitalar/tratamento farmacológico
Infecção Hospitalar/microbiologia
Relação Dose-Resposta a Droga
Farmacorresistência Bacteriana Múltipla
Seres Humanos
Pneumonia Bacteriana/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Azabicyclo Compounds); 0 (avibactam, ceftazidime drug combination); 9M416Z9QNR (Ceftazidime)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180128
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2018.1434142


  2 / 3515 MEDLINE  
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[PMID]:28767588
[Au] Autor:Gugliandolo A; Caio C; Mezzatesta ML; Rifici C; Bramanti P; Stefani S; Mazzon E
[Ad] Endereço:aIRCCS Centro Neurolesi "Bonino-Pulejo", Via Provinciale Palermo, Messina bSection of Microbiology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
[Ti] Título:Successful ceftazidime-avibactam treatment of MDR-KPC-positive Klebsiella pneumoniae infection in a patient with traumatic brain injury: A case report.
[So] Source:Medicine (Baltimore);96(31):e7664, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Carbapenem-resistant Enterobacteriaceae infections are a serious health care problem, because of the high mortality. Carbapenem resistance is mainly caused by carbapenemases production, including Klebsiella pneumoniae carbapenemase (KPC). Ceftazidime-avibactam is a new cephalosporin/ß-lactamase inhibitor combination for the treatment of complicated urinary, intra-abdominal infections, and nosocomial pneumonia caused by gram negative, or other serious gram-negative infections. PATIENT CONCERNS: We showed the case of a 27-year-old patient, hospitalized for traumatic brain injury and chest trauma, with KPC-producing Klebsiella pneumoniae infection. DIAGNOSES: Blood and bronchial aspirate culture analysis detected an infection caused by MDR Klebsiella pneumoniae, resistant to meropenem, ertapenem, piperacillin/tazobactam, amoxicillin/clavulanic acid, aztreonam, ceftazidime, cefotaxime, cefepime, amikacin, ciprofloxacin, trimethoprim/sulfamethoxazole, colistin while it showed an intermediate sensitivity to gentamicin and was sensitive to ceftazidime-avibactam. Molecular analyses revealed that the isolate belonged to the epidemic clone sequence type 258 (ST258) carrying blaKPC-3, blaTEM-1, and blaSHV-11genes. INTERVENTIONS: After various combined antibiotic therapies without improvements, he was treated with ceftazidime-avibactam, on a compassionate-use basis. OUTCOMES: With ceftazidime-avibactam monotherapy clinical and microbiological clearance was obtained. A week after the end of the therapy microbiological analysis was repeated and a positive rectal swab for KPC-Klebsiella pneumoniae was found, becoming negative after 1 month. Moreover, the patient did not show any relapses for up to 18 weeks. LESSONS: This case indicates that ceftazidime-avibactam monotherapy could be efficacious against KPC positive Klebsiella pneumoniae infections.
[Mh] Termos MeSH primário: Compostos Azabicíclicos/uso terapêutico
Lesões Encefálicas Traumáticas/complicações
Ceftazidima/uso terapêutico
Infecções por Klebsiella/tratamento farmacológico
Klebsiella pneumoniae
Inibidores de beta-Lactamases/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Lesões Encefálicas Traumáticas/microbiologia
Ensaios de Uso Compassivo
Estado Terminal
Farmacorresistência Bacteriana Múltipla
Seres Humanos
Infecções por Klebsiella/complicações
Klebsiella pneumoniae/efeitos dos fármacos
Klebsiella pneumoniae/genética
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Azabicyclo Compounds); 0 (avibactam, ceftazidime drug combination); 0 (beta-Lactamase Inhibitors); 9M416Z9QNR (Ceftazidime)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007664


  3 / 3515 MEDLINE  
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[PMID]:28764662
[Au] Autor:Kahandawaarachchi ICI; Premawansa GS; Warnasuriya W; Dassanayake M; Corea E
[Ad] Endereço:North Colombo Teaching Hospital, Ragama, Sri Lanka. isurucik@gmail.com.
[Ti] Título:A case report of co-infection of Melioidosis and cutaneous Leishmaniasis.
[So] Source:BMC Infect Dis;17(1):533, 2017 Aug 01.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Leishmaniasis and melioidosis are frequently reported from the North Central Province of Sri Lanka. However, only one case of co-infection of the two diseases has been reported to date over the world. This is a case report of a patient who had co-infection with cutaneous leishmaniasis and melioidosis and was successfully treated and recovered from the illness. CASE PRESENTATION: A 61 year old female patient with diabetes mellitus presented with fever for one month's duration and was found to have hepatosplenomegaly and an ulcer over the left arm. She had elevated inflammatory markers and blood culture grew Burkholderia pseudomallei and serum was highly positive for melioidosis antibodies. A slit skin smear of the ulcer showed Leishmania amastigotes. CONCLUSION: Melioidosis and leishmaniasis are emerging infectious diseases in endemic countries and can be severe. The high prevalence rates in Sri Lanka should keep the treating physicians' threshold for suspicion low for these two diseases.
[Mh] Termos MeSH primário: Leishmaniose Cutânea/etiologia
Melioidose/etiologia
[Mh] Termos MeSH secundário: Abscesso Abdominal/tratamento farmacológico
Burkholderia pseudomallei/isolamento & purificação
Ceftazidima/uso terapêutico
Coinfecção
Feminino
Seres Humanos
Leishmania/patogenicidade
Leishmaniose Cutânea/tratamento farmacológico
Melioidose/tratamento farmacológico
Meia-Idade
Sri Lanka
Tienamicinas/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Thienamycins); 9M416Z9QNR (Ceftazidime); FV9J3JU8B1 (meropenem)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2639-7


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[PMID]:28719324
[Au] Autor:Sengyee S; Saiprom N; Paksanont S; Limmathurotsakul D; Wuthiekanun V; Chantratita N
[Ad] Endereço:Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
[Ti] Título:Susceptibility of Clinical Isolates of to a Lipid A Biosynthesis Inhibitor.
[So] Source:Am J Trop Med Hyg;97(1):62-67, 2017 Jul.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:is the causative agent of melioidosis, a serious infection associated with high mortality and relapse. Current antimicrobial therapy using ceftazidime (CAZ) is often ineffective. Inhibitors of LpxC, the enzyme responsible for lipid A biosynthesis, have potential antimicrobial activity against several Gram-negative bacteria in vivo, but their activity against is unclear. Herein, we investigated the susceptibility of clinical isolates to LpxC-4, an LpxC inhibitor, and LpxC-4 in combination with CAZ. Time-kill assays for bactericidal activity were conducted for K96243, revealing growth inhibition and bactericidal effect at LpxC-4 concentrations of 2 µg/mL and 4 µg/mL, respectively. No significant synergistic effect was observed with the combination of LpxC-4 and CAZ. LpxC-4 susceptibility was tested on three groups of clinical isolates:1) CAZ- and trimethoprim-sulfamethoxazole (SXT)-susceptible ( = 71), 2) CAZ-resistant ( = 14), and 3) SXT-resistant ( = 23) isolates, by broth microdilution. The minimum concentration of LpxC-4 required to inhibit the growth of 90% of organisms was 2 µg/mL for all isolates. The median minimum inhibitory concentration of both the CAZ/SXT-susceptible and CAZ-resistant groups was 1 µg/mL (interquartile range [IQR] = 1-2 µg/mL), compared with 2 µg/mL (IQR = 2-4 µg/mL) for the SXT-resistant group. Cell morphology was observed after drug exposure by immunofluorescent staining, and a change from rod-shaped to cell wall-defective spherical cells was observed in surviving bacteria. LpxC-4 is a potent bactericidal agent against and warrants further testing as a new antibiotic to treat melioidosis.
[Mh] Termos MeSH primário: Aciltransferases/fisiologia
Antibacterianos/uso terapêutico
Proteínas de Bactérias/fisiologia
Burkholderia pseudomallei/efeitos dos fármacos
Ceftazidima/uso terapêutico
Farmacorresistência Bacteriana/efeitos dos fármacos
Melioidose/tratamento farmacológico
[Mh] Termos MeSH secundário: Inibidores Enzimáticos/uso terapêutico
Seres Humanos
Melioidose/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Enzyme Inhibitors); 9M416Z9QNR (Ceftazidime); EC 2.3.- (Acyltransferases)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171118
[Lr] Data última revisão:
171118
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.16-0858


  5 / 3515 MEDLINE  
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[PMID]:28633102
[Au] Autor:Liu Y; Wang Y; Zhang J; Sun L; Zhang A; Torres OL; Guo R; Chen J
[Ad] Endereço:School of Engineering, China Pharmaceutical University, Nanjing 211198, China.
[Ti] Título:An integrated assessment of ceftazidime and photoproducts on the feeding behavior of rotifers: From exposure to post-exposure.
[So] Source:Ecotoxicol Environ Saf;144:245-251, 2017 Oct.
[Is] ISSN:1090-2414
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Compared to traditional toxicological studies, which depict the dose-effect of contaminants themselves on organisms at the given time, the exposure and post-exposure impacts of antibiotic ceftazidime and its photoproducts are carried out to systematically evaluate the environmental risk fate of ceftazidime in aquatic environments. For the exposure process, the promotion effect of ceftazidime on the feeding behavior of the rotifers decreased when the target compound was irradiated by sunlight, and the promotion effect was converted into inhibition effect, which indicated that the highest toxicity of ceftazidime on the feeding behavior of the rotifers was found after UV-B irradiation. The overcompensation occurred in the post-exposure, indicating a short - term effect of the corresponding photoproducts on the rotifer. In order to better understand the mechanism of this change, the photodegradation pathways of the target compound was analyzed and compared. The degradation degree under the UV-B irradiation had intensified greatly than that under the nature light irradiation. The reactive oxygen species (ROS) of the rotifer in exposure and post-exposure was also detected. Ceftazidime and photoproducts induced generation of ROS, indicating that oxidative damage occurred, and the decreasing of ROS levels could be viewed as the recovery of the rotifers in the post-exposure.
[Mh] Termos MeSH primário: Ceftazidima/toxicidade
Monitoramento Ambiental/métodos
Comportamento Alimentar/efeitos dos fármacos
Luz
Rotíferos/efeitos dos fármacos
Poluentes Químicos da Água/toxicidade
[Mh] Termos MeSH secundário: Animais
Ceftazidima/efeitos da radiação
China
Fotólise
Espécies Reativas de Oxigênio/metabolismo
Luz Solar
Raios Ultravioleta
Poluentes Químicos da Água/efeitos da radiação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Reactive Oxygen Species); 0 (Water Pollutants, Chemical); 9M416Z9QNR (Ceftazidime)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE


  6 / 3515 MEDLINE  
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[PMID]:28619105
[Au] Autor:Tran GM; Ho-Le TP; Ha DT; Tran-Nguyen CH; Nguyen TSM; Pham TTN; Nguyen TA; Nguyen DA; Hoang HQ; Tran NV; Nguyen TV
[Ad] Endereço:ICU, Gia Dinh People's Hospital, 1 No Trang Long Street, Binh Thanh District, Ho Chi Minh City, Vietnam. giangbacsyicu@gmail.com.
[Ti] Título:Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam.
[So] Source:BMC Infect Dis;17(1):429, 2017 Jun 15.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Antimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia. METHODS: Between November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient. The Bauer-Kirby disk diffusion method was used to detect the antimicrobial susceptibility. RESULTS: Antimicrobial resistance was commonly found in ceftriaxone (88%), ceftazidime (80%), ciprofloxacin (77%), cefepime (75%), levofloxacin (72%). Overall, the rate of antimicrobial resistance to any drug was 93% (n = 153/164), with the majority (87%) being resistant to at least 2 drugs. The three commonly isolated microorganisms were Acinetobacter (n = 75), Klebsiella (n = 39), and Pseudomonas aeruginosa (n = 29). Acinetobacter baumannii were virtually resistant to ceftazidime, ceftriaxone, piperacilin, imipenem, meropenem, ertapenem, ciprofloxacin and levofloxacin. High rates (>70%) of ceftriaxone and ceftazidime-resistant Klebsiella were also observed. CONCLUSION: These data indicated that critically ill patients on ventilator in Vietnam were at disturbingly high risk of antimicrobial resistance. The data also imply that these Acinetobacter, Klebsiella, and Pseudomonas aeruginosa and multidrug resistance pose serious therapeutic problems in ICU patients. A concerted and systematic effort is required to rapidly identify high risk patients and to reduce the burden of antimicrobial resistance in developing countries.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Farmacorresistência Bacteriana/efeitos dos fármacos
Unidades de Terapia Intensiva
Pneumonia Associada à Ventilação Mecânica/microbiologia
[Mh] Termos MeSH secundário: Infecções por Acinetobacter/tratamento farmacológico
Infecções por Acinetobacter/microbiologia
Acinetobacter baumannii/efeitos dos fármacos
Acinetobacter baumannii/isolamento & purificação
Idoso
Antibacterianos/farmacologia
Ceftazidima/farmacologia
Ceftazidima/uso terapêutico
Ciprofloxacino/farmacologia
Ciprofloxacino/uso terapêutico
Feminino
Seres Humanos
Imipenem/farmacologia
Klebsiella/efeitos dos fármacos
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico
Pneumonia Associada à Ventilação Mecânica/mortalidade
Infecções por Pseudomonas/tratamento farmacológico
Infecções por Pseudomonas/microbiologia
Pseudomonas aeruginosa/efeitos dos fármacos
Pseudomonas aeruginosa/isolamento & purificação
Vietnã
beta-Lactamas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (beta-Lactams); 5E8K9I0O4U (Ciprofloxacin); 71OTZ9ZE0A (Imipenem); 9M416Z9QNR (Ceftazidime); G32F6EID2H (ertapenem)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2529-z


  7 / 3515 MEDLINE  
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[PMID]:28613873
[Au] Autor:Patel MP; Hu L; Stojanoski V; Sankaran B; Prasad BVV; Palzkill T
[Ti] Título:The Drug-Resistant Variant P167S Expands the Substrate Profile of CTX-M ß-Lactamases for Oxyimino-Cephalosporin Antibiotics by Enlarging the Active Site upon Acylation.
[So] Source:Biochemistry;56(27):3443-3453, 2017 Jul 11.
[Is] ISSN:1520-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CTX-M ß-lactamases provide resistance against the ß-lactam antibiotic, cefotaxime, but not a related antibiotic, ceftazidime. ß-Lactamases that carry the P167S substitution, however, provide ceftazidime resistance. In this study, CTX-M-14 was used as a model to study the structural changes caused by the P167S mutation that accelerate ceftazidime turnover. X-ray crystallography was used to determine the structures of the P167S apoenzyme along with the structures of the S70G/P167S, E166A/P167S, and E166A mutant enzymes complexed with ceftazidime as well as the E166A/P167S apoenzyme. The S70G and E166A mutations allow capture of the enzyme-substrate complex and the acylated form of ceftazidime, respectively. The results showed a large conformational change in the Ω-loop of the ceftazidime acyl-enzyme complex of the P167S mutant but not in the enzyme-substrate complex, suggesting the change occurs upon acylation. The change results in a larger active site that prevents steric clash between the aminothiazole ring of ceftazidime and the Asn170 residue in the Ω-loop, allowing accommodation of ceftazidime for hydrolysis. In addition, the conformational change was not observed in the E166A/P167S apoenzyme, suggesting the presence of acylated ceftazidime influences the conformational change. Finally, the E166A acyl-enzyme structure with ceftazidime did not exhibit the altered conformation, indicating the P167S substitution is required for the change. Taken together, the results reveal that the P167S substitution and the presence of acylated ceftazidime both drive the structure toward a conformational change in the Ω-loop and that in CTX-M P167S enzymes found in drug-resistant bacteria this will lead to an increased level of ceftazidime hydrolysis.
[Mh] Termos MeSH primário: Antibacterianos/metabolismo
Ceftazidima/metabolismo
Proteínas de Escherichia coli/metabolismo
Escherichia coli/enzimologia
Modelos Moleculares
beta-Lactamases/metabolismo
[Mh] Termos MeSH secundário: Acilação
Substituição de Aminoácidos
Antibacterianos/química
Antibacterianos/farmacologia
Apoenzimas/química
Apoenzimas/genética
Apoenzimas/metabolismo
Domínio Catalítico
Ceftazidima/química
Ceftazidima/farmacologia
Cefalosporinas/química
Cefalosporinas/metabolismo
Cefalosporinas/farmacologia
Cristalografia por Raios X
Farmacorresistência Bacteriana Múltipla
Estabilidade Enzimática
Escherichia coli/efeitos dos fármacos
Proteínas de Escherichia coli/química
Proteínas de Escherichia coli/genética
Hidrólise
Ligantes
Mutagênese Sítio-Dirigida
Oximas/química
Oximas/metabolismo
Oximas/farmacologia
Mutação Puntual
Conformação Proteica
Proteínas Recombinantes/química
Proteínas Recombinantes/metabolismo
Especificidade por Substrato
beta-Lactamases/química
beta-Lactamases/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Apoenzymes); 0 (Cephalosporins); 0 (Escherichia coli Proteins); 0 (Ligands); 0 (Oximes); 0 (Recombinant Proteins); 9M416Z9QNR (Ceftazidime); EC 3.5.2.- (beta-lactamase CTX-M-14); EC 3.5.2.- (beta-lactamase CTX-M-14, E coli); EC 3.5.2.6 (beta-Lactamases)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1021/acs.biochem.7b00176


  8 / 3515 MEDLINE  
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[PMID]:28392315
[Au] Autor:Castón JJ; Lacort-Peralta I; Martín-Dávila P; Loeches B; Tabares S; Temkin L; Torre-Cisneros J; Paño-Pardo JR
[Ad] Endereço:Infectious Diseases Unit Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
[Ti] Título:Clinical efficacy of ceftazidime/avibactam versus other active agents for the treatment of bacteremia due to carbapenemase-producing Enterobacteriaceae in hematologic patients.
[So] Source:Int J Infect Dis;59:118-123, 2017 Jun.
[Is] ISSN:1878-3511
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The primary objective was to describe clinical features, treatment and outcomes in patients with carbapenemase-producing Enterobacteriaceae (CPE) bacteremia. Additionally, patients treated with ceftazidime/avibactam (study group) were compared to the rest of the patients (comparator group) to determine the influence of the treatment in both crude mortality and clinical cure. METHODS: Multicenter and retrospective study that included patients with hematologic malignancies who had CPE bacteremia. A bivariate analysis was performed to compare the clinical variables between the study group and the control group. RESULTS: 31 patients were included. Bacteremia was considered primary in 14 (45%) patients. Overall crude mortality at 30days was 45.2% (n=14). Mortality was more frequent when septic shock (78.6% vs 11.8%; p>0.001) and higher Pitt score (6+14 vs 1.5+4; p<0.01) were present. 8 patients (25.8%) received treatment with ceftazidime/avibactam. No significant differences in crude mortality were found between study and comparator groups (p=0.19). In contrast, patients in study group had higher clinical cure rates than the comparator group within 14days of initiating treatment (85.7% vs. 34.8%, respectively, p=0.031). CONCLUSIONS: CPE bacteremia is associated with high mortality in patients with hematologic malignancies. Ceftazidime/avibactam may be an effective alternative for treating these patients.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Compostos Azabicíclicos/uso terapêutico
Bacteriemia/tratamento farmacológico
Ceftazidima/uso terapêutico
Infecções por Enterobacteriaceae/tratamento farmacológico
Neoplasias Hematológicas/complicações
[Mh] Termos MeSH secundário: Bacteriemia/complicações
Bacteriemia/microbiologia
Proteínas de Bactérias/biossíntese
Estudos de Coortes
Quimioterapia Combinada
Enterobacteriaceae/enzimologia
Feminino
Seres Humanos
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
beta-Lactamases/biossíntese
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Azabicyclo Compounds); 0 (Bacterial Proteins); 7352665165 (avibactam); 9M416Z9QNR (Ceftazidime); EC 3.5.2.6 (beta-Lactamases); EC 3.5.2.6 (carbapenemase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE


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[PMID]:28369471
[Au] Autor:Falagas ME; Skalidis T; Vardakas KZ; Legakis NJ; Hellenic Cefiderocol Study Group
[Ad] Endereço:Research Center of Infectious Diseases, Iaso Group Hospitals, Athens, Greece.
[Ti] Título:Activity of cefiderocol (S-649266) against carbapenem-resistant Gram-negative bacteria collected from inpatients in Greek hospitals.
[So] Source:J Antimicrob Chemother;72(6):1704-1708, 2017 Jun 01.
[Is] ISSN:1460-2091
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Cefiderocol (S-649266), a siderophore cephalosporin, utilizes a novel mechanism of entry into the periplasmic space of Gram-negative bacteria and is broadly stable to ESBLs and carbapenemases. Methods: A collection of carbapenem-resistant Gram-negative bacteria isolated from clinical specimens in 18 Greek hospitals was tested for susceptibility to cefiderocol, meropenem, ceftazidime, cefepime, ceftazidime/avibactam, ceftolozane/tazobactam, aztreonam, amikacin, ciprofloxacin, colistin and tigecycline. Broth microdilution plates were used to determine MICs. Results: In total 189 non-fermentative Gram-negative bacteria (107 Acinetobacter baumannii and 82 Pseudomonas aeruginosa ) and 282 Enterobacteriaceae (including 244 Klebsiella pneumoniae , 14 Enterobacter cloacae and 11 Providencia stuartii ) were studied. For both A. baumannii and P. aeruginosa the MIC 90 of cefiderocol was 0.5 mg/L. For K. pneumoniae , E. cloacae and P. stuartii the MIC 90 of cefiderocol was 1, 1 and 0.5 mg/L, respectively. Tigecycline was the second most active antibiotic, followed by colistin. Conclusions: Cefiderocol exhibited greater antimicrobial activity in vitro against carbapenem-resistant Gram-negative bacteria than comparator antibiotics.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Carbapenêmicos/farmacologia
Cefalosporinas/farmacologia
Bactérias Gram-Negativas/efeitos dos fármacos
Infecções por Bactérias Gram-Negativas/microbiologia
Resistência beta-Lactâmica
[Mh] Termos MeSH secundário: Acinetobacter baumannii/efeitos dos fármacos
Acinetobacter baumannii/enzimologia
Acinetobacter baumannii/isolamento & purificação
Proteínas de Bactérias/metabolismo
Ceftazidima/farmacologia
Colistina/farmacologia
Farmacorresistência Bacteriana Múltipla
Bactérias Gram-Negativas/enzimologia
Bactérias Gram-Negativas/isolamento & purificação
Infecções por Bactérias Gram-Negativas/epidemiologia
Grécia/epidemiologia
Seres Humanos
Pacientes Internados
Klebsiella pneumoniae/efeitos dos fármacos
Klebsiella pneumoniae/enzimologia
Klebsiella pneumoniae/isolamento & purificação
Testes de Sensibilidade Microbiana
Minociclina/análogos & derivados
Minociclina/farmacologia
Pseudomonas aeruginosa/efeitos dos fármacos
Pseudomonas aeruginosa/enzimologia
Pseudomonas aeruginosa/isolamento & purificação
Tienamicinas/farmacologia
beta-Lactamases/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Carbapenems); 0 (Cephalosporins); 0 (Thienamycins); 0 (cefiderocol); 70JE2N95KR (tigecycline); 807PW4VQE3 (cefepime); 9M416Z9QNR (Ceftazidime); EC 3.5.2.6 (beta-Lactamases); EC 3.5.2.6 (carbapenemase); FV9J3JU8B1 (meropenem); FYY3R43WGO (Minocycline); Z67X93HJG1 (Colistin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1093/jac/dkx049


  10 / 3515 MEDLINE  
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[PMID]:28365324
[Au] Autor:Xie J; Peters BM; Li B; Li L; Yu G; Xu Z; Shirtliff ME
[Ad] Endereço:School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China.
[Ti] Título:Clinical features and antimicrobial resistance profiles of important Enterobacteriaceae pathogens in Guangzhou representative of Southern China, 2001-2015.
[So] Source:Microb Pathog;107:206-211, 2017 Jun.
[Is] ISSN:1096-1208
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECT: This surveillance aimed to investigate the antimicrobial resistance profiles of Enterobacteriaceae pathogens in Southern China during 2001-2015. METHODS: A total of 6858 Enterobacteriaceae isolates were collected, including 4276 E. coli, 1992 K. pneumoniae and 590 Enterobacter spp. Disk diffusion method and minimum inhibitory concentrations method were used for susceptibility testing, with results interpreted by the CLSI (2015). RESULTS: Urinary tract remained the dominant isolated site among E. coli (49.88%), whereas 53.26% K. pneumoniae and 45.25% Enterobacter spp. were from Sputum. The carbapenems maintained the highest antimicrobial activity (resistance rates <15%), followed by piperacillin-tazobactam and amikacin. Gentle increases were obtained in carbapenems-resistant K. pneumoniae and Enterobacter spp. (eg. from 4.5% to 11.2% and 3.2% to 14.5% in imipenem, repestively). The third-generation cephalosporins showed high and stable resistance among Enterobacteriaceae pathogens during the studied period, with ceftazidime as the most active third-generation cephalosporin against Enterobacteriaceae. Isolates from ICU department showed higher or similar resistance rates among Enterobacteriaceae pathogens compared to other wards. CONCLUSION: Carbapenems are the most potent antibiotic agents against Enterobacteriaceae pathogens. Due to the complicated susceptibility profiles, prescribing guidelines should be based on the knowledge of antibiogram of pathogens.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Farmacorresistência Bacteriana
Enterobacteriaceae/efeitos dos fármacos
Enterobacteriaceae/isolamento & purificação
Enterobacteriaceae/patogenicidade
[Mh] Termos MeSH secundário: Amicacina/farmacologia
Sangue/microbiologia
Carbapenêmicos/farmacologia
Ceftazidima/farmacologia
Cefalosporinas/farmacologia
China
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão/métodos
Enterobacter/efeitos dos fármacos
Enterobacter/isolamento & purificação
Enterobacter/patogenicidade
Escherichia coli/efeitos dos fármacos
Escherichia coli/isolamento & purificação
Escherichia coli/patogenicidade
Seres Humanos
Klebsiella pneumoniae/efeitos dos fármacos
Klebsiella pneumoniae/isolamento & purificação
Klebsiella pneumoniae/patogenicidade
Testes de Sensibilidade Microbiana/métodos
Ácido Penicilânico/análogos & derivados
Ácido Penicilânico/farmacologia
Piperacilina/farmacologia
Escarro/microbiologia
Sistema Urinário/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Carbapenems); 0 (Cephalosporins); 157044-21-8 (piperacillin, tazobactam drug combination); 84319SGC3C (Amikacin); 87-53-6 (Penicillanic Acid); 9M416Z9QNR (Ceftazidime); X00B0D5O0E (Piperacillin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170403
[St] Status:MEDLINE



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