amoxicillin-potassium-clavulanate-combination and Cystic-Fibrosis

The use of central venous catheters (CVCs) in patients with cystic fibrosis is associated with an increased incidence of right atrial thrombosis. Practically, the management of CVC-related right atrial thrombosis presents a challenge as there are no clinical trials or systematic reviews in pediatric patients with cystic fibrosis. We describe a case of a 5-year-old child who presented with a CVC-related infection due to Candida parapsilosis. Echocardiogram revealed the presence of an incidental thrombus, measuring 1.4 cm × 0.4 cm, at the tip of the catheter, adherent to the right atrial wall and discrete from the tricuspid valve leaflets. Imaging was performed at monthly intervals and showed spontaneous resolution of the thrombus after six months. Follow-up blood cultures were negative, and the course of the patient was uneventful.

Topics: Amoxicillin-Potassium Clavulanate Combination; Asymptomatic Diseases; Candida parapsilosis; Catheters, Indwelling; Central Venous Catheters; Child; Cystic Fibrosis; Echocardiography; Female; Humans; Respiratory Tract Infections; Venous Thrombosis

The present study set out to detect and identify amoxicillin-clavulanic acid (AMC)-resistant Enterobacteriaceae in fecal samples of two patients with cystic fibrosis (CF) and their respective siblings.. Fecal Enterobacteriaceae were enumerated onto EMB agar containing amoxicillin (AMX). A total of 173 CF isolates and 41 sibling isolates were grouped into seven Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) clusters and identified through 16S rRNA and rpoB sequence analysis.. The fecal microbiota of patients with CF revealed a higher prevalence of AMX resistant Enterobacteriaceae compared to that of their healthy siblings. Whereas all selected isolates of healthy siblings were assigned to Escherichia coli, isolates of patients with CF belonged to Klebsiella oxytoca (58.4%), E. coli (28.3%), Klebsiella variicola (7.5%) or Citrobacter sp. (5.8%). All tested CF isolates showed a high resistance rate to AMX, and a lower level of resistance to the combination with clavulanic acid. In contrast, all tested sibling isolates were susceptible for both AMX and AMC.. The higher abundance of AMX resistance in the investigated patients with CF suggests that frequent AMC administration may be one of the major contributing factors in the proliferation of Enterobacteriaceae and the development of resistant strains in the gastrointestinal tract.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cystic Fibrosis; Drug Resistance, Bacterial; Enterobacteriaceae; Feces; Humans; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clavulanic Acid; Cystic Fibrosis; Diagnosis, Differential; Drug Eruptions; Female; Humans; Infant; Intradermal Tests; Patch Tests; Pneumonia

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; beta-Lactamases; Child; Clavulanic Acids; Cystic Fibrosis; Drug Combinations; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Sputum