scholarly journals Susceptibility to Imipenem/Relebactam of Pseudomonas Aeruginosa and Acinetobacter Baumannii Isolates From Chinese Intra-Abdominal, Respiratory and Urinary Tract Infections: SMART 2015 To 2018

2021 ◽  
Author(s):  
Hui Zhang ◽  
Peiyao Jia ◽  
Ying Zhu ◽  
Ge Zhang ◽  
Jingjia Zhang ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Urinary Tract ◽  
Acinetobacter Baumannii ◽  
Urinary Tract Infections ◽  
Surveillance Program ◽  
College Hospital ◽  
Medical College ◽  
Carbapenem Resistant ◽  
Tract Infections ◽  
Abdominal Infections

Abstract Background In recent years, less options are available for treating carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa. The present study investigatesthe susceptibility rates to imipenem/relebactamfor the treatment of intra-abdominal infections (IAIs), respiratory tract infections (RTIs) and urinary tract infections (UTIs) caused by A. baumannii and P. aeruginosain China. Methods 1,886 P. aeruginosa and 1,889 A.baumanniiisolates were collected in 21 centers (7 regions) as part of the global SMART surveillance program between 2015 and 2018. Antimicrobial susceptibility testing was performed according tothe Clinical and Laboratory Standards Institute (CLSI) recommendations using the broth microdilution methodology in the Peking Union Medical College Hospital. Results Rates of imipenem-non-susceptibilities of P. aeruginosa and A. baumanniiisolates were 44.3% and 79.0%, whereas the multidrug-resistance (MDR) rateswere 44.3% and 81.9%, respectively.For P. aeruginosa, susceptibility rates to imipenem/relebactamwere 84.2% at aCLSI breakpoint of ≤ 2 mg/L compared to 55.7% for imipenem. The MIC90 of imipenem/relebactam(8 mg/L) was one fourth of that of imipenem (32 mg/L).The susceptibilities of imipenem-non-susceptible and MDRP.aeruginosastrains were similarly restored by imipenem/relebactam in non-ICU and ICU wards.The susceptiblity rate of A. baumannii isolates to imipenem was 21.0% and to imipenem/relebactam 22.2%. Conclusions Imipenem/relebactam provides a therapy option for infections caused by MDRor imipenem-non-susceptible P. aeruginosa infections in China.

scholarly journals Ceftazidime/Avibactam: Who Says You Can’t Teach an Old Drug New Tricks?

2016 ◽  
Vol 19 (4) ◽  
pp. 448 ◽  
Author(s):  
Katie E. Barber ◽  
Jessica K. Ortwine ◽  
Ronda L Akins
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
The United States ◽  
Phase Iii ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
Tract Infections ◽  
Abdominal Infections

Purpose: Gram-negative resistance continues to rise with treatment options becoming more limited. Ceftazidime/avibactam was recently approved in the United States and Europe, which combines an established third-generation cephalosporin with a new, unique, non-β-lactam β-lactamase inhibitor. This review conducts a thorough examination of structure, pharmacology, spectrum of activity, pharmacokinetics/pharmacodynamics, in vitro and clinical efficacy and safety/tolerability of ceftazidime/avibactam, as well as detailed future directions for the agent. Methods: Pubmed and clinicaltrials.gov searches, as well as abstracts from the 2015 Interscience Conference on Antimicrobial Agents and Chemotherapy/International Society of Chemotherapy (ICAAC/ICC) and ID Week meetings and the 2016 American Society of Microbiology Microbe meeting, were conducted from January 2004 – September 2016. Relevant search terms included ceftazidime, ceftazidime/avibactam, avibactam, NXL104 and AVE1330A. The US package insert for ceftazidime/avibactam (02/2015) and European public assessment report (06/2016) were also reviewed. Results: In vitro susceptibility for ceftazidime/avibactam displayed potent activity against many Enterobacteriaceae including extended-spectrum-β-lactamase (ESBL) and carbapenemase-producing strains, as well as Pseudomonas aeruginosa. Phase II clinical trials utilized for approval demonstrated comparable safety and efficacy to imipenem/cilistatin for treatment of complicated urinary tract infections (70.4% vs. 71.4%) and combined with metronidazole compared to meropenem in complicated intra-abdominal infections (91.2% vs 93.4%). Phase III data displayed non-inferior efficacy of ceftazidime/avibactam compared to doripenem for complicated urinary tract infections (70.2% vs 66.2%) and combined with metronidazole compared to meropenem in complicated intra-abdominal infections (82.5% vs 84.9%), as well as comparable safety. Ceftazidime/avibactam was well-tolerated but does require renal adjustments. Additionally, 3 case series and a single case report have demonstrated the potential for ceftazidime/avibactam against multidrug resistant organisms for compassionate use or failure after previous therapy. Conclusion: By adding avibactam to ceftazidime, clinicians’ antimicrobial armamentarium is expanded, potentially increasing the ability to combat multi-drug resistant gram-negative pathogens, particularly ESBL and carbapenemase-producing organisms, as well as Pseudomonas aeruginosa. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

scholarly journals LANNEA BARTERI ENGL. (ANACARDIACEAE) PLANT USED IN THE TREATMENT OF URINARY TRACT INFECTIONS IN IVORY COAST: BIOLOGICAL AND CHEMICAL STUDIES OF THE AQUEOUS EXTRACT

2018 ◽  
Vol 10 (12) ◽  
pp. 64 ◽  
Author(s):  
Bredou Jean Brice ◽  
Boua Boua Benson ◽  
Konan Kouadio Fernique ◽  
Kabran Guy Roger Mida ◽  
Kouassi Kouadio Christian ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Urinary Tract ◽  
Acinetobacter Baumannii ◽  
Urinary Tract Infections ◽  
Aqueous Extract ◽  
Antibacterial Properties ◽  
Bacterial Strains ◽  
Mueller Hinton ◽  
Chemical Studies ◽  
Tract Infections

Objective: This research aims to evaluate the antibacterial activity and determine the chemical composition of the aqueous extract of the bark of Lannea barteri Engl. (DA) used in the traditional treatment of urinary tract infections in the Ivory Coast.Methods: The material is composed of DA, the bacterial strains of Pseudomonas aeruginosa and Acinetobacter baumannii, isolated from the urine of patients from different hospitals and subsequently stored. The qualitative analysis was performed using color-based detection tests and thin layer chromatography (TLC) reactions and the quantification of total phenols, flavonoids, flavone aglycones and anthocyanins using the method of Folin Ciocalteu. The method of diffusion on Mueller Hinton (MH) agar medium has been used for sensitivity tests. Results: The phytochemical screening of DA has revealed the presence of polyphenols, terpenes, and derivatives, coumarins, tannins, flavonoids, and alkaloids. Furthermore, the quantification of some polyphenols such as flavonoids, flavone aglycones, and anthocyanins was determined. The total polyphenols found was 0.757±0.003 mg/g MS representing respectively; 0.230±0.01 for flavonoids; 0.028±0.02 for flavone aglycones and 0.016±0.02 mg/g MS for anthocyanins. DA is bactericidal against Pseudomonas aeruginosa and Acinetobacter baumannii, which are mainly responsible for urinary tract infections.Conclusion: The bark of Lannea barteri Engl. (DA) is rich in flavonoids, flavone aglycones, and anthocyanins which are probably responsible for its antibacterial properties on Pseudomonas aeruginosa and Acinetobacter baumannii. This research thereby supports the use of this plant in the treatment of urinary tract infections.

scholarly journals 1358. In vitro Activity of Ceftazidime–Avibactam and Comparator Agents Against Pseudomonas aeruginosa Causing Intra-Abdominal, Lower Respiratory, and Urinary Tract Infections Collected in Latin America as Part of the INFORM Global Surveillance Program, 2012–2016

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S416-S416
Author(s):  
Mark Wise ◽  
Krystyna Kazmierczak ◽  
Gregory G Stone ◽  
Dan Sahm
Keyword(s):  
Latin America ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Vitro Activity ◽  
Surveillance Program ◽  
In Vitro Activity ◽  
Infection Types ◽  
Tract Infections ◽  
Abdominal Infections

Abstract Background The non-β-lactam β-lactamase inhibitor avibactam (AVI) is active against class A, C, and some class D β-lactamases, in combination with ceftazidime (CAZ) has been approved by the FDA and EMA for treatment of intra-abdominal infections (IAI), lower respiratory tract infections (LRTI), and urinary tract infections (UTI). This study reports on the in vitro activity of (CAZ-AVI) and comparators vs. P. aeruginosa collected from IAIs, LRTIs, and UTIs in Latin America as part of the INFORM surveillance study from 2012 to 2016. Methods For INFORM surveillance over 2012–2016 in Latin America, 1,595 nonduplicate P. aeruginosa isolates linked to IAIs, LRTIs, and UTIs were collected from 26 clinical sites in six countries. Susceptibility testing was done using broth microdilution according to CLSI guidelines and using CLSI 2018 breakpoints. CAZ was tested with AVI at a fixed concentration of 4 mg/mL. Meropenem (MEM) nonsusceptible organisms were screened for β-lactamase genes by PCR. Results Among the full collection of P. aeruginosa, CAZ-AVI showed consistently higher % susceptibilities than all comparators except for colistin (CST) for all infection sources. The addition of AVI to CAZ resulted in an increase in susceptibility ranging from 14.2% (IAI) to 19.5% (UTI). Against the non-metallo-β-lactamase (MBL) harboring subset, CAZ-AVI showed extremely potent activity (MIC90, 8 mg/mL) for all infection sources. In this subset, the activity of CAZ-AVI approached that of colistin for IAIs (susceptibility of 93.3% vs. 96.4%, respectively). Conclusion CAZ-AVI demonstrated very good in vitro activity against P. aeruginosa isolates, especially those without MBLs. More isolates were susceptible to CAZ-AVI than to MEM for all infection types. Disclosures M. Wise, Pfizer Inc.: Consultant, Consulting fee. IHMA, Inc.: Employee, Salary. K. Kazmierczak, Pfizer Inc.: Consultant, Consulting fee. IHMA, Inc.: Employee, Salary. G. G. Stone, Pfizer Inc.: Employee, Salary. AstraZeneca: Former Employee and Shareholder, Salary. D. Sahm, Pfizer Inc.: Consultant, Consulting fee. IHMA, Inc.: Employee, Salary.

scholarly journals Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing

Antibiotics ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 153 ◽  
Author(s):  
Márió Gajdács
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Phenotypic Characterization ◽  
Care Hospital ◽  
Disk Diffusion Test ◽  
Carbapenem Resistant ◽  
Tract Infections

This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) Pseudomonas aeruginosa isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic characterization of the possible resistance mechanisms in these isolates. Isolates and data were collected regarding P. aeruginosa UTIs corresponding to the period between 2008 and 2017. Susceptibility testing was performed using the Kirby–Bauer disk diffusion method; minimum inhibitory concentrations (MICs) of the isolates were determined using E-tests. The phenotypic detection of ampicillin C-type (AmpC) β-lactamases, efflux pump overexpression and carbapenemase production was also performed. P. aeruginosa represented n = 575 (2.72% ± 0.64%) from outpatient, and n = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, n = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, n = (64.34%) were also resistant to ciprofloxacin; n = (60.17%) to gentamicin/tobramycin; n = (58.51%) to levofloxacin; and n = (27.57%) to amikacin. From among the carbapenem-resistant isolates, n = 56 (15.59%) isolates were multidrug-resistant, while n = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (n = 57), overexpression of AmpC was observed in n = 7 cases (12.28%); carbapenemase production in n = 4 (7.02%); while overexpression of efflux pumps was present in n = 31 (54.39%) isolates. To spare last-resort agents, e.g., colistin, the use of broad-spectrum cephalosporins or safe, alternative agents should be considered in these infections.

scholarly journals Catheter-Related Urinary Tract Infection in Patients Suffering from Spinal Cord Injuries

2009 ◽  
Vol 9 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Amela Dedeić-Ljubović ◽  
Mirsada Hukić
Keyword(s):  
Spinal Cord ◽  
Pseudomonas Aeruginosa ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acinetobacter Baumannii ◽  
Urinary Tract Infections ◽  
Spinal Cord Injuries ◽  
Providencia Rettgeri ◽  
Tract Infections

Urinary tract infection is commoner in patients with spinal cord injuries because of incomplete bladder emptying and the use of catheters that can result in the introduction of bacteria into the bladder. 145 patients suffering from spinal cord injuries, admitted to the Institute for physical medicine and rehabilitation, Centre for paraplegia of the Clinical Centre of the University of Sarajevo, were included. The patients were divided in three groups according to the method of bladder drainage: Group A (n=61) consisted of patients on clean intermittent catheterization; Group B (n=54) consisted of patients with indwelling catheters; Group C (n=30) consisted of patients who had performed self-catheterization. From a total of 4539 urine samples, 3963 (87,3%) were positive and 576 (12,7%) were sterile. More than 90% of the infected patients were asymptomatic.The overall rate of urinary infection amounted to about 2,1 episodes, and bacteriuria to 8,1 episodes per patient. 77% of infections (113/145) were acquired within seven days from catheterization.Infection was usually polymicrobial; the greatest number of urine samples 1770/3943 (44,9%) included more than one bacterium.The vast majority of cases of urinary tract infection and bacteriuria are caused by Gram-negative bacilli and enterococci, commensal organisms of the bowel and perineum, representative of those from the hospital environment. Providencia stuarti (18,9%) being the most common, followed by Proteus mirabilis (16,3%), Escherichia coli (11,8%), Pseudomonas aeruginosa (10,2%), Klebsiella pneumoniae (8,1%), Morganella morgani (5,4%), Acinetobacter baumannii (4,6%), Providencia rettgeri (3,5%). 15,7% of isolates were Gram-positive with Enterococcus faecalis (8,6%) as the most common. 55,3% of isolates were multidrug-resistant, and the highest rates of resistance were found among Acinetobacter baumannii (87,8%), Providencia rettgeri (86,7%), Pseudomonas aeruginosa (85,4%), Providencia stuarti (84,3%) and Morganella morgani (81,0%). Lower rates of resistance were found in Group C, i.e. patients on intermittent self- catheterisation. Eradication of organisms was achieved in only 53 (10,05%) of patients; hence, antibiotic therapy had no or very low effect.Significant correlations were found between the method of catheterization and the frequency of bacteriuria and urinary tract infections. The analysis of Group C showed a rate of lower urinary tract infection and bacteriuria than the other two Groups of patients. The objective of this study is the update of etiology and antimicrobial susceptibility in urinary tract infections in this group of patients. In addition, possible correlations between UTI and the type of bladder management were examined.

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