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[PMID]:28067989
[Au] Autor:Wungwattana M; Savic M
[Ad] Endereço:Department of Pharmacy, Maine Medical Center, Portland, ME, USA.
[Ti] Título:Tacrolimus interaction with nafcillin resulting in significant decreases in tacrolimus concentrations: A case report.
[So] Source:Transpl Infect Dis;19(2), 2017 Apr.
[Is] ISSN:1399-3062
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:Tacrolimus (TAC) is subject to many drug interactions as a result of its metabolism primarily via CYP450 isoenzyme 3A4. Numerous case reports of TAC and CYP3A4 inducers and inhibitors have been described including antimicrobials, calcium channel antagonists, and antiepileptic drugs. We present the case of a 13-year-old patient with cystic fibrosis and a history of liver transplantation, where subtherapeutic TAC concentrations were suspected to be a result of concomitant TAC and nafcillin (NAF) therapy. The observed drug interaction occurred on two separate hospital admissions, during both of which the patient exhibited therapeutic TAC concentrations prior to exposure to NAF, a CYP3A4 inducer. Upon discontinuation of NAF, TAC concentrations recovered in both instances. This case represents a drug-drug interaction between TAC and NAF that has not previously been reported to our knowledge. Despite the lack of existing reports of interaction between these two agents, this case highlights the importance of therapeutic drug monitoring and assessing for any potential drug-drug or drug-food interactions in patients receiving TAC therapy.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Rejeição de Enxerto/tratamento farmacológico
Imunossupressores/farmacologia
Transplante de Fígado/efeitos adversos
Nafcilina/farmacologia
Tacrolimo/farmacologia
[Mh] Termos MeSH secundário: Adolescente
Antibacterianos/uso terapêutico
Fibrose Cística/cirurgia
Citocromo P-450 CYP3A/metabolismo
Relação Dose-Resposta a Droga
Interações Medicamentosas
Monitoramento de Medicamentos
Seres Humanos
Imunossupressores/uso terapêutico
Masculino
Nafcilina/uso terapêutico
Infecções Respiratórias/tratamento farmacológico
Tacrolimo/uso terapêutico
Suspensão de Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Immunosuppressive Agents); 4CNZ27M7RV (Nafcillin); EC 1.14.13.67 (CYP3A4 protein, human); EC 1.14.14.1 (Cytochrome P-450 CYP3A); WM0HAQ4WNM (Tacrolimus)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE
[do] DOI:10.1111/tid.12662


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[PMID]:27485941
[Au] Autor:Benefield RJ; Barker BC; Gast CM; Alexander DP
[Ad] Endereço:Department of Pharmacy, University of Utah Health Care, Salt Lake City, Utah. Russell.Benefield@hsc.utah.edu.
[Ti] Título:Patient Variables Associated with Nafcillin Plasma Concentrations and Toxicity.
[So] Source:Pharmacotherapy;36(9):994-1002, 2016 Sep.
[Is] ISSN:1875-9114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PRIMARY OBJECTIVE: To retrospectively review nafcillin plasma concentrations (CNAF ) and determine nafcillin clearance (CLNAF ) in a diverse sample of patients treated with nafcillin administered as a continuous infusion. SECONDARY OBJECTIVE: To identify clinical variables associated with CLNAF and nafcillin-related adverse drug reactions (ADRs). METHODS: Retrospective chart review of patients receiving nafcillin via continuous infusion at University of Utah Health Care from 2006 to 2013 who had at least one steady-state CNAF measured. CLNAF was determined by dividing the nafcillin rate of infusion by CNAF . Adverse drug reactions (ADRs) were defined using the National Institutes of Health, Division of Microbiology and Infectious Diseases criteria and scored for probability of association with nafcillin by using Naranjo criteria. Multivariate models were constructed to identify independent variables associated with CLNAF and ADRs. MAIN RESULTS: Seventy-six CNAF from 54 patients were included. Median CLNAF was 13.9 L/hour (range ≤ 4.2 to 36.9 L/hr). Congestive heart failure (p=0.007), hyperbilirubinemia (p<0.0001), and serum creatinine (p<0.0001) were associated with reduced CLNAF , and Hispanic race (p=0.002) was associated with increased CLNAF by multivariate analysis. Twenty patients (37.0%) experienced an ADR. CNAF were significantly higher between patients that experienced an ADR and those that did not (66.0 vs 25.5 mg/L, p<0.001). Individual ADRs associated with CNAF included hepatotoxicity (62.8 vs 27.0 mg/L, p=0.001), nausea/vomiting (80.0 vs 28.5 mg/L, p=0.01), and diarrhea (66.5 vs 26.5 mg/L, p<0.001). Multivariate analysis identified CNAF as being independently associated with ADRs. A putative toxicity relationship between CNAF and predicted probability of ADR was established. CONCLUSIONS: Several patient variables were associated with impaired CLNAF , and elevated CNAF were associated with ADRs. Additional studies assessing the utility of nafcillin therapeutic drug monitoring to minimize toxicity are warranted.
[Mh] Termos MeSH primário: Nafcilina/efeitos adversos
Nafcilina/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Monitoramento de Medicamentos
Feminino
Seres Humanos
Masculino
Taxa de Depuração Metabólica
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
4CNZ27M7RV (Nafcillin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160804
[St] Status:MEDLINE
[do] DOI:10.1002/phar.1805


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[PMID]:27234592
[Au] Autor:Le J; Dam Q; Schweizer M; Thienphrapa W; Nizet V; Sakoulas G
[Ad] Endereço:Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, MC 0714, La Jolla, CA, 92093-0714, USA. jenle@ucsd.edu.
[Ti] Título:Effects of vancomycin versus nafcillin in enhancing killing of methicillin-susceptible Staphylococcus aureus causing bacteremia by human cathelicidin LL-37.
[So] Source:Eur J Clin Microbiol Infect Dis;35(9):1441-7, 2016 Sep.
[Is] ISSN:1435-4373
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Recent studies have demonstrated that anti-staphylococcal beta-lactam antibiotics, like nafcillin, render methicillin-resistant Staphylococcus aureus (MRSA) more susceptible to killing by innate host defense peptides (HDPs), such as cathelicidin LL-37. We compared the effects of growth in 1/4 minimum inhibitory concentration (MIC) of nafcillin or vancomycin on the LL-37 killing of 92 methicillin-susceptible S. aureus (MSSA) isolates. For three randomly selected strains among these, we examined the effects of nafcillin, vancomycin, daptomycin, or linezolid on LL-37 killing and autolysis. Growth in the presence of subinhibitory nafcillin significantly enhanced LL-37 killing of MSSA compared to vancomycin and antibiotic-free controls. Nafcillin also reduced MSSA production of the golden staphylococcal pigment staphyloxanthin in 39 % of pigmented strains vs. 14 % for vancomycin. Among the antibiotics tested, only nafcillin resulted in significantly increased MSSA autolysis. These studies point to additional mechanisms of anti-staphylococcal activity of nafcillin beyond direct bactericidal activity, properties that vancomycin and other antibiotic classes do not exhibit. The ability of nafcillin to enhance sensitivity to innate HDPs may contribute to its superior effectiveness against MSSA, as suggested by studies comparing clinical outcomes to vancomycin treatment.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Peptídeos Catiônicos Antimicrobianos/farmacologia
Bacteriemia/microbiologia
Viabilidade Microbiana/efeitos dos fármacos
Nafcilina/farmacologia
Staphylococcus aureus/efeitos dos fármacos
Vancomicina/farmacologia
[Mh] Termos MeSH secundário: Bacteriólise/efeitos dos fármacos
Interações Medicamentosas
Seres Humanos
Testes de Sensibilidade Microbiana
Infecções Estafilocócicas/microbiologia
Staphylococcus aureus/isolamento & purificação
Staphylococcus aureus/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Antimicrobial Cationic Peptides); 143108-26-3 (CAP18 lipopolysaccharide-binding protein); 4CNZ27M7RV (Nafcillin); 6Q205EH1VU (Vancomycin)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170902
[Lr] Data última revisão:
170902
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160529
[St] Status:MEDLINE
[do] DOI:10.1007/s10096-016-2682-0


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[PMID]:27216053
[Au] Autor:Pollett S; Baxi SM; Rutherford GW; Doernberg SB; Bacchetti P; Chambers HF
[Ad] Endereço:Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, NSW, Australia Simon.Pollett@ucsf.edu.
[Ti] Título:Cefazolin versus Nafcillin for Methicillin-Sensitive Staphylococcus aureus Bloodstream Infection in a California Tertiary Medical Center.
[So] Source:Antimicrob Agents Chemother;60(8):4684-9, 2016 Aug.
[Is] ISSN:1098-6596
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent observational studies have suggested possible reductions in mortality in patients receiving cefazolin versus antistaphylococcal penicillins. We examined 90-day mortality in patients receiving cefazolin compared to nafcillin for methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infection (BSI). We identified persons with MSSA BSI admitted to San Francisco General Hospital from January 2008 to July 2013 through a hospital-wide infection surveillance system and confirmed 90-day mortality using U.S. national vital registries. We included persons receiving cefazolin or nafcillin as the predominant intravenous antimicrobial agent; all participants received inpatient Infectious Diseases service consultation. We estimated the association between receipt of cefazolin and 90-day risk of death by multivariate logistic regression, including a propensity score for receiving cefazolin as the second predictor. Of 230 MSSA BSI cases, 30 received nafcillin and 70 received cefazolin as the predominant antimicrobial; 10 died within 90 days, 5 from each group. Unadjusted analysis showed substantial but not statistically significant reduced odds of death in those receiving cefazolin (odds ratio, 0.38; 95% confidence interval [CI], 0.10 to 1.44). Multivariate analysis with propensity scores found a similar adjusted odds ratio (0.40; 95% CI, 0.09 to 1.74; P = 0.22). We found a large reduction in 90-day mortality in those receiving cefazolin compared to nafcillin for MSSA BSI, but this finding was not statistically significant. The magnitude of effect seen in this and other studies justifies further study.
[Mh] Termos MeSH primário: Bacteriemia/tratamento farmacológico
Cefazolina/uso terapêutico
Infecção Hospitalar/tratamento farmacológico
Meticilina/uso terapêutico
Nafcilina/uso terapêutico
Infecções Estafilocócicas/tratamento farmacológico
Staphylococcus aureus/efeitos dos fármacos
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Bacteriemia/microbiologia
California
Infecção Hospitalar/microbiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Penicilinas/uso terapêutico
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Penicillins); 4CNZ27M7RV (Nafcillin); IHS69L0Y4T (Cefazolin); Q91FH1328A (Methicillin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160525
[St] Status:MEDLINE
[do] DOI:10.1128/AAC.00243-16


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[PMID]:26976858
[Au] Autor:Viehman JA; Oleksiuk LM; Sheridan KR; Byers KE; He P; Falcione BA; Shields RK
[Ad] Endereço:University of Pittsburgh Medical Center, Division of Infectious Diseases, Pittsburgh, Pennsylvania, USA Outpatient Parenteral Antimicrobial Therapy Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
[Ti] Título:Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin.
[So] Source:Antimicrob Agents Chemother;60(5):3090-5, 2016 May.
[Is] ISSN:1098-6596
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nafcillin and oxacillin are used interchangeably in clinical practice, yet few studies have evaluated the safety of these two agents. Our objective was to compare the differential tolerabilities of nafcillin and oxacillin among hospitalized patients. We conducted a retrospective cohort study of all patients who received 12 g/day of nafcillin or oxacillin for at least 24 h. Two hundred twenty-four patients were included. Baseline characteristics and comorbidities were similar among patients receiving nafcillin (n = 160) and those receiving oxacillin (n = 64). Hypokalemia, defined as a potassium level of ≤3.3 mmol/liter or ≤2.9 mmol/liter or as a ≥0.5-mmol/liter decrease from the baseline level, occurred more frequently among patients who received nafcillin (51%, 20%, and 56%, respectively) than among those who received oxacillin (17%, 3%, and 34%, respectively; P < 0.0001, P = 0.0008, and P = 0.005, respectively). By multivariate logistic regression analysis, receipt of nafcillin was an independent predictor of severe hypokalemia (odds ratio [OR] = 6.74; 95% confidence interval [CI], 1.46 to 31.2; P = 0.02). Rates of hepatotoxicity did not differ between groups; however, acute kidney injury occurred more commonly with nafcillin than with oxacillin (18% versus 6%; P = 0.03). Overall, 18% of patients who received nafcillin discontinued therapy prematurely due to adverse events, compared to 2% of patients who received oxacillin (P = 0.0004). Nafcillin treatment is associated with higher rates of adverse events and treatment discontinuation than oxacillin among hospitalized adult patients. These findings have important implications for patients in both inpatient and outpatient settings, particularly patients who require long-term therapy and cannot be monitored routinely. Future randomized controlled studies evaluating the efficacy, costs, and tolerability of nafcillin versus oxacillin are warranted.
[Mh] Termos MeSH primário: Nafcilina/efeitos adversos
Oxacilina/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antibacterianos/efeitos adversos
Feminino
Seres Humanos
Hipopotassemia/etiologia
Masculino
Meia-Idade
Análise Multivariada
Estudos Retrospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 4CNZ27M7RV (Nafcillin); UH95VD7V76 (Oxacillin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160316
[St] Status:MEDLINE
[do] DOI:10.1128/AAC.03122-15


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[PMID]:26842534
[Au] Autor:Hennigan K; Riley C
[Ti] Título:Staphylococcal Scalded Skin Syndrome: A Case Review.
[So] Source:Neonatal Netw;35(1):8-12, 2016.
[Is] ISSN:1539-2880
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Staphylococcal scalded skin syndrome (SSSS) is a rare yet well-known exfoliative skin syndrome. It involves extensive desquamated areas caused by an exfoliative toxin from Staphylococcus aureus. The typical presentation of SSSS allows for early diagnosis and treatment of the disease. Knowing and understanding the prevalence, pathophysiology, risk factors, and diagnosis of SSSS will ensure that infants being treated and cared for by neonatal nurses and neonatal nurse practitioners will receive appropriate, comprehensive, and multidisciplinary care while in the NICU. The purpose of this case review is to inform neonatal nurses and practitioners of the current literature that focuses on the diagnosis and management of SSSS.
[Mh] Termos MeSH primário: Doenças do Prematuro
Morfina/administração & dosagem
Nafcilina/administração & dosagem
Curativos Oclusivos
Síndrome da Pele Escaldada Estafilocócica
Staphylococcus aureus
[Mh] Termos MeSH secundário: Analgésicos Opioides/administração & dosagem
Antibacterianos/administração & dosagem
Emolientes/administração & dosagem
Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/diagnóstico
Doenças do Prematuro/tratamento farmacológico
Doenças do Prematuro/fisiopatologia
Síndrome da Pele Escaldada Estafilocócica/diagnóstico
Síndrome da Pele Escaldada Estafilocócica/tratamento farmacológico
Síndrome da Pele Escaldada Estafilocócica/fisiopatologia
Staphylococcus aureus/efeitos dos fármacos
Staphylococcus aureus/isolamento & purificação
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anti-Bacterial Agents); 0 (Emollients); 4CNZ27M7RV (Nafcillin); 76I7G6D29C (Morphine)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170130
[Lr] Data última revisão:
170130
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:160205
[St] Status:MEDLINE
[do] DOI:10.1891/0730-0832.35.1.8


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[PMID]:26833159
[Au] Autor:Smith JR; Yim J; Raut A; Rybak MJ
[Ad] Endereço:Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA.
[Ti] Título:Oritavancin Combinations with ß-Lactams against Multidrug-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci.
[So] Source:Antimicrob Agents Chemother;60(4):2352-8, 2016 Apr.
[Is] ISSN:1098-6596
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Oritavancin possesses activity against vancomycin-resistant enterococci (VRE) and methicillin-resistantStaphylococcus aureus(MRSA).In vitrodata suggest synergy between beta-lactams (BLs) and vancomycin or daptomycin, agents similar to oritavancin. We evaluated the activities of BLs combined with oritavancin against MRSA and VRE. Oritavancin MICs were determined for 30 strains, 5 each of MRSA, daptomycin-nonsusceptible (DNS) MRSA, vancomycin-intermediate MRSA (VISA), heteroresistant VISA (hVISA), vancomycin-resistantEnterococcus faecalis, and vancomycin-resistantEnterococcus faecium Oritavancin MICs were determined in the presence of subinhibitory concentrations of BLs. Oritavancin combined with ceftaroline, cefazolin, or nafcillin was evaluated for lethal synergy against MRSA, and oritavancin combined with ceftaroline, ampicillin, or ertapenem was evaluated for lethal synergy against VRE in 24-h time-kill assays. Oritavancin at 0.5× the MIC was combined with BLs at 0.5× the MIC or the biological free peak concentration, whichever one was lower. Synergy was defined as a ≥2-log10-CFU/ml difference between the killing achieved with the combination and that achieved with the most active single agent at 24 h. Oritavancin MICs were ≤0.125 µg/ml for all MRSA isolates except three VISA isolates with MICs of 0.25 µg/ml. Oritavancin MICs for VRE ranged from 0.03 to 0.125 µg/ml. Oritavancin in combination with ceftaroline was synergistic against all MRSA phenotypes and statistically superior to all other combinations against DNS MRSA, hVISA, and MRSA isolates (P< 0.02). Oritavancin in combination with cefazolin and oritavancin in combination with nafcillin were also synergistic against all MRSA strains. Synergy between oritavancin and all BLs was revealed against VRE strain 8019, while synergy between oritavancin and ampicillin or ertapenem but not ceftaroline was demonstrated against VRE strain R7164. The data support the potential use of oritavancin in combination with BLs, especially oritavancin in combination with ceftaroline, for the treatment of infections caused by MRSA. The data from the present study are not as strong for oritavancin in combination with BLs for VRE. Further study of both MRSA and VRE in more complex models is warranted.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Glicopeptídeos/farmacologia
Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos
Enterococos Resistentes à Vancomicina/efeitos dos fármacos
beta-Lactamas/farmacologia
[Mh] Termos MeSH secundário: Cefazolina/farmacologia
Cefalosporinas/farmacologia
Daptomicina/farmacologia
Sinergismo Farmacológico
Infecções por Bactérias Gram-Positivas/microbiologia
Seres Humanos
Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento
Staphylococcus aureus Resistente à Meticilina/isolamento & purificação
Testes de Sensibilidade Microbiana
Nafcilina/farmacologia
Infecções Estafilocócicas/microbiologia
Vancomicina/farmacologia
Enterococos Resistentes à Vancomicina/crescimento & desenvolvimento
Enterococos Resistentes à Vancomicina/isolamento & purificação
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 0 (Glycopeptides); 0 (T 91825); 0 (beta-Lactams); 4CNZ27M7RV (Nafcillin); 6Q205EH1VU (Vancomycin); G32F6EID2H (ertapenem); IHS69L0Y4T (Cefazolin); NWQ5N31VKK (Daptomycin); PUG62FRZ2E (oritavancin)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160203
[St] Status:MEDLINE
[do] DOI:10.1128/AAC.03006-15


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[PMID]:26503983
[Au] Autor:Proulx MK; Palace SG; Gandra S; Torres B; Weir S; Stiles T; Ellison RT; Goguen JD
[Ad] Endereço:Department of Microbiology and Physiological Systems.
[Ti] Título:Reversion From Methicillin Susceptibility to Methicillin Resistance in Staphylococcus aureus During Treatment of Bacteremia.
[So] Source:J Infect Dis;213(6):1041-8, 2016 Mar 15.
[Is] ISSN:1537-6613
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Approximately 3% of Staphylococcus aureus strains that, according to results of conventional phenotypic methods, are highly susceptible to methicillin-like antibiotics also have polymerase chain reaction (PCR) results positive for mecA. The genetic nature of these mecA-positive methicillin-susceptible S. aureus (MSSA) strains has not been investigated. We report the first clearly defined case of reversion from methicillin susceptibility to methicillin resistance among mecA-positive MSSA within a patient during antibiotic therapy. We describe the mechanism of reversion for this strain and for a second clinical isolate that reverts at a similar frequency. The rates of reversion are of the same order of magnitude as spontaneous resistance to drugs like rifampicin. When mecA is detected by PCR in the clinical laboratory, current guidelines recommend that these strains be reported as resistant. Because combination therapy using both a ß-lactam and a second antibiotic suppressing the small revertant population may be superior to alternatives such as vancomycin, the benefits of distinguishing between mecA-positive MSSA and MRSA in clinical reports should be evaluated.
[Mh] Termos MeSH primário: Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos
Infecções Estafilocócicas/microbiologia
[Mh] Termos MeSH secundário: Idoso
Sequência de Aminoácidos
Antibacterianos/uso terapêutico
Bacteriemia/microbiologia
Proteínas de Bactérias/genética
Proteínas de Bactérias/metabolismo
Sequência de Bases
DNA Bacteriano/genética
Mutação da Fase de Leitura
Regulação Bacteriana da Expressão Gênica
Seres Humanos
Masculino
Staphylococcus aureus Resistente à Meticilina/genética
Staphylococcus aureus Resistente à Meticilina/fisiologia
Nafcilina/administração & dosagem
Nafcilina/uso terapêutico
Proteínas de Ligação às Penicilinas/genética
Proteínas de Ligação às Penicilinas/metabolismo
Infecções Relacionadas à Prótese
Infecções Estafilocócicas/tratamento farmacológico
Vancomicina/administração & dosagem
Vancomicina/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (DNA, Bacterial); 0 (Penicillin-Binding Proteins); 0 (mecA protein, Staphylococcus aureus); 4CNZ27M7RV (Nafcillin); 6Q205EH1VU (Vancomycin)
[Em] Mês de entrada:1607
[Cu] Atualização por classe:170315
[Lr] Data última revisão:
170315
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151028
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jiv512


  9 / 560 MEDLINE  
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[PMID]:26708708
[Au] Autor:Khan K; Wozniak SE; Mehrabi E; Giannone AL; Dave M
[Ad] Endereço:Division of General Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USA.
[Ti] Título:Sternoclavicular Osteomyelitis in an Immunosuppressed Patient: A Case Report and Review of the Literature.
[So] Source:Am J Case Rep;16:908-11, 2015 Dec 28.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Sternoclavicular osteomyelitis is a rare disease, with less than 250 cases identified in the past 50 years. We present a rare case of sternoclavicular osteomyelitis in an immunosuppressed patient that developed from a conservatively treated dislocation. CASE REPORT A 62-year-old white man with a history of metastatic renal cell carcinoma presented to the emergency department (ED) with a dislocated left sternoclavicular joint. He was managed conservatively and subsequently discharged. However, over subsequent days he began to experience pain, fever, chills, and night sweats. He presented to the ED again and imaging revealed osteomyelitis. In the operating room, the wound was aggressively debrided and a wound vac (vacuum-assisted closure) was placed. He was diagnosed with sternoclavicular osteomyelitis and placed on a 6-week course of intravenous Nafcillin. CONCLUSIONS Chemotherapy patients who sustain joint trauma normally associated with a low risk of infection should be monitored thoroughly, and the option to discontinue immunosuppressive therapy should be considered if signs of infection develop.
[Mh] Termos MeSH primário: Hospedeiro Imunocomprometido
Osteomielite/diagnóstico
Infecções Estafilocócicas/diagnóstico
Staphylococcus aureus/isolamento & purificação
Articulação Esternoclavicular
Tomografia Computadorizada Espiral/métodos
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Seres Humanos
Injeções Intravenosas
Masculino
Meia-Idade
Nafcilina/administração & dosagem
Osteomielite/tratamento farmacológico
Osteomielite/microbiologia
Infecções Estafilocócicas/tratamento farmacológico
Infecções Estafilocócicas/microbiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 4CNZ27M7RV (Nafcillin)
[Em] Mês de entrada:1609
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151229
[St] Status:MEDLINE


  10 / 560 MEDLINE  
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[PMID]:26525797
[Au] Autor:Berti AD; Theisen E; Sauer JD; Nonejuie P; Olson J; Pogliano J; Sakoulas G; Nizet V; Proctor RA; Rose WE
[Ad] Endereço:Pharmacy Practice Division, University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin, USA.
[Ti] Título:Penicillin Binding Protein 1 Is Important in the Compensatory Response of Staphylococcus aureus to Daptomycin-Induced Membrane Damage and Is a Potential Target for ß-Lactam-Daptomycin Synergy.
[So] Source:Antimicrob Agents Chemother;60(1):451-8, 2015 Nov 02.
[Is] ISSN:1098-6596
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The activity of daptomycin (DAP) against methicillin-resistant Staphylococcus aureus (MRSA) is enhanced in the presence of ß-lactam antibiotics. This effect is more pronounced with ß-lactam antibiotics that exhibit avid binding to penicillin binding protein 1 (PBP1). Here, we present evidence that PBP1 has a significant role in responding to DAP-induced stress on the cell. Expression of the pbpA transcript, encoding PBP1, was specifically induced by DAP exposure whereas expression of pbpB, pbpC, and pbpD, encoding PBP2, PBP3, and PBP4, respectively, remained unchanged. Using a MRSA COL strain with pbpA under an inducible promoter, increased pbpA transcription was accompanied by reduced susceptibility to, and killing by, DAP in vitro. Exposure to ß-lactams that preferentially inactivate PBP1 was not associated with increased DAP binding, suggesting that synergy in the setting of anti-PBP1 pharmacotherapy results from increased DAP potency on a per-molecule basis. Combination exposure in an in vitro pharmacokinetic/pharmacodynamic model system with ß-lactams that preferentially inactivate PBP1 (DAP-meropenem [MEM] or DAP-imipenem [IPM]) resulted in more-rapid killing than did combination exposure with DAP-nafcillin (NAF) (nonselective), DAP-ceftriaxone (CRO) or DAP-cefotaxime (CTX) (PBP2 selective), DAP-cefaclor (CEC) (PBP3 selective), or DAP-cefoxitin (FOX) (PBP4 selective). Compared to ß-lactams with poor PBP1 binding specificity, exposure of S. aureus to DAP plus PBP1-selective ß-lactams resulted in an increased frequency of septation and cell wall abnormalities. These data suggest that PBP1 activity may contribute to survival during DAP-induced metabolic stress. Therefore, targeted inactivation of PBP1 may enhance the antimicrobial efficiency of DAP, supporting the use of DAP-ß-lactam combination therapy for serious MRSA infections, particularly when the ß-lactam undermines the PBP1-mediated compensatory response.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Daptomicina/farmacologia
Imipenem/farmacologia
Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos
Modelos Estatísticos
Proteínas de Ligação às Penicilinas/genética
Tienamicinas/farmacologia
[Mh] Termos MeSH secundário: Antibacterianos/farmacocinética
Cefaclor/farmacologia
Cefotaxima/farmacologia
Cefoxitina/farmacologia
Ceftriaxona/farmacologia
Membrana Celular/efeitos dos fármacos
Membrana Celular/metabolismo
Daptomicina/farmacocinética
Sinergismo Farmacológico
Quimioterapia Combinada
Regulação Bacteriana da Expressão Gênica
Imipenem/farmacocinética
Staphylococcus aureus Resistente à Meticilina/genética
Staphylococcus aureus Resistente à Meticilina/metabolismo
Nafcilina/farmacologia
Proteínas de Ligação às Penicilinas/metabolismo
Regiões Promotoras Genéticas
Isoformas de Proteínas/genética
Isoformas de Proteínas/metabolismo
Tienamicinas/farmacocinética
Transcrição Genética/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Penicillin-Binding Proteins); 0 (Protein Isoforms); 0 (Thienamycins); 4CNZ27M7RV (Nafcillin); 69K7K19H4L (Cefaclor); 6OEV9DX57Y (Cefoxitin); 71OTZ9ZE0A (Imipenem); 75J73V1629 (Ceftriaxone); FV9J3JU8B1 (meropenem); N2GI8B1GK7 (Cefotaxime); NWQ5N31VKK (Daptomycin)
[Em] Mês de entrada:1610
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151104
[St] Status:MEDLINE
[do] DOI:10.1128/AAC.02071-15



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