cefotaxime and Hemolysis

ABO blood type incompatibility hemolytic disease of newborn (ABO-HDN) and drug-induced immune hemolytic anemia (DIIHA) due to non-immunologic protein adsorption (NIPA) mainly cause extravascular hemolysis. All the reported severe DIIHA were caused by drug-induced antibodies, and rare report of acute intravascular hemolysis was caused by the NIPA mechanism or ABO-HDN.. We report the first case of acute intravascular hemolysis induced by cefotaxime sodium - sulbactam sodium (CTX - SBT) in a case of ABO-HDN which resulted in death at 55 h after birth. The mother's blood type was O and RhD-positive, and the newborn's blood type was B and RhD-positive. No irregular red blood cell (RBC) antibodies or drug-dependent antibodies related to CTX or SBT was detected in the mother's plasma and the plasma or the RBC acid eluent of the newborn. Before the newborn received CTX - SBT treatment, the result of direct antiglobulin test (DAT) was negative while anti-B was positive (2 +) in both plasma and acid eluent. After the newborn received CTX - SBT treatment, the results of DAT for anti-IgG and anti-C3d were both positive, while anti-B was not detected in plasma, but stronger anti-B (3 +) was detected in acid eluent.. The NIPA effect of SBT promoted the specific binding of mother-derived IgG anti-B in newborn's plasma to the newborn's RBC B antigens and formed an immune complex, and then activated complement, which led to acute intravascular hemolysis. Drugs such as SBT with NIPA effect should not be used for newborns with HDN.

Topics: ABO Blood-Group System; Acute Disease; Adsorption; Anemia, Hemolytic; Antigen-Antibody Reactions; Blood Group Incompatibility; Cefotaxime; Complement Activation; Coombs Test; Erythroblastosis, Fetal; Erythrocyte Membrane; Fatal Outcome; Female; Hemolysis; Humans; Immunoglobulin G; Infant, Newborn; Isoantibodies; Male; Maternal-Fetal Exchange; Pregnancy; Sulbactam; Young Adult

Antimicrobial peptides (AMPs) are amphipathic molecules displaying broad-spectrum bactericidal activity, providing opportunities to develop a new generation of antibiotics. However, their use is limited either by poor metabolic stability or by high hemolytic activity. We herein addressed the potential of thiazole-based γ-peptide oligomers named ATCs as tunable scaffolds to design polycationic AMP mimetics. Knowing the side chain distribution along the backbone, we rationally designed facially amphiphilic sequences with bactericidal effect in the micromolar range. Since no hemolytic activity was detected up to 100 μM, this class of compounds has shown the potential for therapeutic development.

Topics: Anti-Bacterial Agents; Antimicrobial Cationic Peptides; Drug Design; Erythrocytes; Fungi; Gram-Negative Bacteria; Gram-Positive Bacteria; Hemolysis; Humans; Microbial Sensitivity Tests; Thiazoles

In recent years dendrimers have fascinated the investigators towards targeted drug delivery because of their versatile framework and exhibit immense potentiality in entrapping drug moieties through host-guest interactions and serve as a promising vector in biological applications. The current investigation is focused on developing pegylated citric acid cefotaxime dendrimers through the divergent method and its characterization through spectroscopic, microscopic, thermal and microscopic techniques. Among the spectroscopic techniques,

Topics: A549 Cells; Anti-Bacterial Agents; Cefotaxime; Cell Survival; Citric Acid; Dendrimers; Drug Carriers; Drug Liberation; Gram-Negative Bacteria; Gram-Positive Bacteria; Half-Life; Hemolysis; Humans; Microbial Sensitivity Tests; Nanostructures; Polyethylene Glycols

Red blood cell (RBC) Thomsen-Friedenreich antigen exposure (T activation) in infants with necrotizing enterocolitis (NEC) has occasionally been associated with posttransfusional intravascular hemolysis thought to be due to anti-T antibodies in the donor plasma.. We describe an infant with NEC and Clostridium perfringens infection complicated by severe hemolysis after plasma transfusion. After this case, infants with confirmed NEC were prospectively evaluated for T activation. We checked for hemolysis in patients with T activation receiving plasma-containing blood products.. The infant had received 80 mL of fresh-frozen plasma (FFP). His RBCs displayed strong T activation, and agglutination was observed with four of six ABO-compatible FFP units. A direct antiglobulin test was negative. IgM-class anti-T antibodies were present in small amounts (titer of 8) in the transfused FFP. Anti-T antibodies from the blood donor were not hemolytic in vitro. In the prospective study, T activation was observed in three of 28 infants with NEC (11%). One infant presented moderate T activation and two infants presented very strong T activation but only moderate decreases in sialic acid expression on the RBC membrane. These three infants presented no signs of hemolysis after transfusion with unwashed blood products or FFP.. Anti-T antibodies are unlikely to be the etiologic factor for the hemolytic reactions observed in infants with NEC and T activation. Massive RBC desialylation and the direct action of bacterial toxins are more probable causes. Strict avoidance of plasma-containing blood products does not seem justified in these infants.

Topics: Adult; Antibodies; Antigens, Tumor-Associated, Carbohydrate; Bacterial Proteins; Blood Donors; Cefotaxime; Clostridium Infections; Clostridium perfringens; Enterocolitis, Necrotizing; Erythrocytes; Female; Hemolysis; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Male; Middle Aged; Plasma Exchange; Prospective Studies

We aimed to document the risk of Aeromonas spp. in marine shrimp species cultured in inland low salinity ponds in Thailand. In 14 of 18 shrimp samples retrieved from inland grow-up ponds, Aeromonas spp. were detected at ranges from 4667 to 1,500,000 CFU/g body weight. The phylogenetic tree constructed with the gyrB and cpn60 concatenated sequences indicated that the 87 isolates consisted of Aeromonas veronii (70%), Aeromonas aquariorum (18%), Aeromonas caviae (7%), Aeromonas jandaei (2%), and Aeromonas schubertii (2%). The potential virulence of the isolates was examined by phenotypic and PCR assays. Hemolytic activity and the extracellular activity of lipase, DNase, and gelatinase were observed in most isolates (94-99%). PCR revealed the presence of 9 genes related to virulence in the 87 isolates: act (75%), aer (74%), alt (30%), ast (1%), ascV (34%), aexT (24%), fla (92%), ela (34%), and lip (24%). The susceptibility profiles to 14 antimicrobial agents of isolates were typical for the genus, but resistance to cefotaxime, a third-generation cephalosporin, and imipenem were found in two A. aquariorum and in three A. veronii isolates, respectively. These resistances were confirmed by determining minimum inhibitory concentrations. Our results indicate that the microbiological risk posed by Aeromonas should be considered for marine shrimp species that are cultured in low-salinity ponds. These shrimps may also be a vehicle for the transfer of different genotypes of Aeromonas and antibiotic-resistant determinants to regions worldwide through trade.

Topics: Aeromonas; Animals; Anti-Bacterial Agents; Cefotaxime; Deoxyribonucleases; Drug Resistance, Microbial; Gelatinases; Hemolysis; Imipenem; Microbial Sensitivity Tests; Penaeidae; Penicillin Amidase; Phenotype; Phylogeny; Polymerase Chain Reaction; Salinity; Shellfish; Thailand; Virulence

The pace of resistance against antibiotics almost exceeds that of the development of new drugs. As many bacteria have become resistant to conventional antibiotics, new drugs or drug resources are badly needed to combat antibiotic-resistant pathogens, like methicillin-resistant Staphylococcus aureus (MRSA). Antimicrobial peptides, rich sources existing in nature, are able to effectively kill multidrug-resistant pathogens. Here, imcroporin, a new antimicrobial peptide, was screened and isolated from the cDNA library of the venomous gland of Isometrus maculates. The MIC of imcroporin against MRSA was 50 microg/ml, 8-fold lower than that of cefotaxime and 40-fold lower than that of penicillin. Imcroporin killed bacteria rapidly in vitro, inhibited bacterial growth, and cured infected mice. These results revealed that imcroporin could be considered a potential anti-infective drug or lead compound, especially for treating antibiotic-resistant pathogens.

Topics: Amino Acid Sequence; Animals; Anti-Bacterial Agents; Antimicrobial Cationic Peptides; Cefotaxime; Female; Hemolysis; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Mice; Microbial Sensitivity Tests; Molecular Sequence Data; Penicillins; Scorpion Venoms; Scorpions; Sequence Homology, Amino Acid; Staphylococcal Infections; Vancomycin

The metabolism of cefotaxime (CTX) by hemolyzed blood at different concentrations, time intervals, and temperatures was studied. Cefotaxime and desacetylcefotaxime (DES) levels were quantitated by reverse phase high pressure liquid chromatography. When CTX was added to tubes with 10% hemolysis, CTX/DES levels (micrograms per milliliter) were 123/134, 161/114, and 202/60 at 37 degrees C, room temperature, and 4 degrees C, respectively, after a 1 hr incubation. No reduction in CTX was observed in control experiments (10% blood, no hemolysis) at these temperatures after 1 hr; 200 +/- 23 micrograms/ml CTX; 5 +/- 2 micrograms/ml DES. The disappearance half-life of CTX in 10% hemolyzed blood at 37 degrees C was 45.7 min and at room temperature 84.3 min (p less than 0.001). The addition of the enzyme inhibitors ethylenediaminetetraacetic acid and p-hydroxymercuibenzoate reduced the metabolism of CTX in the presence of 10% hemolysis after 1 hr at 37 degrees C from 41% to 19% with ethylenediaminetetraacetic acid (0.45 mM) and to 0% with p-hydroxymercuibenzoate (10 mM). Our results suggest that for accurate determinations of CTX serum levels, which often have some degree of hemolysis, such specimens should be collected in tubes with ethylenediaminetetraacetic acid or p-hydroxymercuibenzoate and transported at 4 degrees C.

Topics: Adult; Cefotaxime; Chromatography, High Pressure Liquid; Edetic Acid; Half-Life; Hemolysis; Humans; Hydroxymercuribenzoates; Temperature; Time Factors

Cefotaxime was given to neonates as treatment of infection in a dose of 25 mg/kg 12 hourly by intravenous injection. Blood samples taken by heel-prick were specially treated to minimize any effect of haemolysis on the hydrolysis of cefotaxime. The mean peak plasma concentrations of cefotaxime on the first, second and third days of therapy were 43, 40 and 52 mg/l, respectively, with mean plasma half lives of 4.0, 2.7 and 3.2 h. The mean peak concentrations of desacetyl-cefotaxime were about a quarter of those of cefotaxime, which is in good agreement with adult studies, but much lower than those previously published in studies with neonates. These results emphasize the care that is necessary in the assay of body fluids and tissues for cefotaxime and desacetyl-cefotaxime if accurate results are to be obtained.

Topics: Cefotaxime; Half-Life; Hemolysis; Humans; Infant, Newborn; Kinetics