cefoxitin and Diarrhea

Enteroaggregative Escherichia coli (EAEC), a biofilm forming pathogen, causes acute and persistent diarrhea worldwide, requiring antimicrobial therapy in severe or persistent cases. To determine the susceptibility of EAEC biofilm to antimicrobials, as single-agent or combined therapy, biofilm formation was investigated using EAEC clinical strains via peg lid. Of the 78 initially analyzed strains, 35 could form biofilms, 15 (42.9%; 15/35) were resistant to at least 1 tested antimicrobial and 20 (57.1%) were susceptible to all of them in the planktonic form. The biofilms of these susceptible strains were challenged against chosen antimicrobials, and displayed resistance to tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, ampicillin, cefotaxime, ceftriaxone (85%-100%), tobramycin (25%), cefoxitin (20%), and ciprofloxacin (5%). Moreover, ciprofloxacin combined with ampicillin, and tobramycin eradicated the biofilm of 2 of the 4 tested strains. Ciprofloxacin, cefoxitin, and tobramycin maintained their activity well against EAEC biofilm, suggesting their possible effectiveness to treat diarrhea caused by biofilm-forming EAEC strains.

Topics: Ampicillin; Anti-Bacterial Agents; Biofilms; Cefoxitin; Ciprofloxacin; Diarrhea; Escherichia coli; Escherichia coli Infections; Humans; Tobramycin

A total of 690 pathogenic Escherichia (E.) coli isolates from weaned piglets were examined for antimicrobial resistance phenotypes, resistance genes, and virulence gene profiles. Also, 29 enterotoxigenic E. coli (ETEC) and 35 Shiga-toxin producing E. coli (STEC) isolates were analyzed using multi-locus sequence typing (MLST). Comparisons of the associations between antimicrobial resistance phenotypes, resistance genes, and virulence genes were performed separately by assessing odds ratio (OR). Although majorities of associations were not confirmed however, we found that associations between specific virulence factors-antimicrobial resistance. F18 encoding isolates showed association with resistance to cefazolin (OR = 3.08) and cefoxitin (OR = 3.65), and also with antimicrobial resistance gene mcr-3 (OR = 4.58). There was a high correlation between F4-STb (OR = 13.56), F4-LT (OR = 8.77), F4-EAST-I (OR = 4.97), and F18-Stx2e (OR = 3.83). Most of ETEC (21 of 29, 72.4%) isolates were assigned to ST100, and 20 of 35 STEC isolates (57.1%) were ST1. There were 5 clusters, and each cluster showed specific antimicrobial resistance patterns. Cluster I showed resistance to gentamicin, streptomycin, neomycin, nalidixic acid, ciprofloxacin, norfloxacin, trimethoprim / sulfamethoxazole, and tetracyclines whereas, cluster V showed resistance to ampicillin, amoxicillin / clavulanic acid, cephalothin, cefoxitin, cefazolin, norfloxacin, and colistin. Although there is need to do more experiments to clarify why certain virulence factors showed relationship with antimicrobial resistance, it is clear that there is a significant association between specific virulence genes and antimicrobial resistance in E. coli from weaned piglets with enteric colibacillosis in Korea.

Topics: Animals; Anti-Bacterial Agents; Cefazolin; Cefoxitin; Diarrhea; Drug Resistance, Bacterial; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Multilocus Sequence Typing; Norfloxacin; Swine; Swine Diseases; Virulence Factors

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Bacterial Proteins; beta-Lactam Resistance; beta-Lactamases; Catheter-Related Infections; Cefoxitin; Cross Infection; Diarrhea; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Enterococcus faecalis; Glycopeptides; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Pancreatic Neoplasms; Pneumonia, Bacterial; Postoperative Complications; Prostatitis; Substrate Specificity; Urinary Catheterization

Of 176 Salmonella isolates isolated from 2000 to 2003 in a Korean university hospital, 2 cefoxitin-resistant isolates of Salmonella enterica serovar Rissen were found in 2002. Both isolates were resistant to multiple beta-lactam antibiotics, including ampicillin, amoxicillin-clavulanate, cefoxitin, cefotaxime, and ceftazidime. Cell sonicates of the both clinical isolates and their transconjugants had beta-lactamase band of approximate isoelectric point of >8.6. The resistance to cefoxitin was transferred by conjugation to the recipient Escherichia coli J53. The resistance determinant was on conjugative plasmids that encoded a CMY-2, a plasmid-mediated AmpC beta-lactamase. To our knowledge, these are the first description of S. enterica serovar Rissen harboring CMY-2 in South Korea.

Topics: Aged; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Cefoxitin; Cephalosporin Resistance; Conjugation, Genetic; Diarrhea; Female; Hospitals, University; Humans; Infant; Korea; Male; Microbial Sensitivity Tests; Plasmids; Retrospective Studies; Salmonella enterica; Salmonella Infections; Sequence Analysis, DNA

We reviewed hospital records of women on the obstetrics and gynecologic services with a diagnosis of antibiotic-associated diarrhea, pseudomembranous colitis, or Clostridium difficile infection to better characterize the incidence and course of women with C difficile infection. Cases were included if there was identification of C difficile by culture or toxin or endoscopic verification of pseudomembranous colitis. Between January 1985 and June 1995, there were 74,120 admissions to the obstetrics and gynecology services at two tertiary level hospitals. Eighteen women were found to have documented C difficile infection (0.02%)--3 from the obstetric services, 10 from the benign gynecologic services, and 5 from the gynecologic/oncology services. Diarrhea developed from 2 days to 30 days after antibiotics had been given (mean, 10 days). Nine patients had fever, six had nausea and vomiting, and five had abdominal pain. Antimicrobial agents given before infection included cephalexin, cefoxitin, imipenem, ciprofloxacin, trimethoprim/sulfamethoxazole, ampicillin, gentamicin, and clindamycin. All patients were treated successfully with inpatient antimicrobial agents-15 with metronidazole and 3 with vancomycin. There was one possible recurrence.

Topics: Abdominal Pain; Adult; Aged; Aged, 80 and over; Ampicillin; Anti-Bacterial Agents; Bacterial Toxins; Cefoxitin; Cephalexin; Cephalosporins; Cephamycins; Ciprofloxacin; Clindamycin; Clostridioides difficile; Colonoscopy; Diarrhea; Enterocolitis, Pseudomembranous; Female; Fever; Gentamicins; Humans; Imipenem; Incidence; Middle Aged; Nausea; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies; Thienamycins; Trimethoprim, Sulfamethoxazole Drug Combination; Vomiting

The effectiveness of cycloserine-cefoxitin-fructose agar (CCFA) and taurocholate-CCFA (TCCFA) in isolating Clostridium difficile from swabs of the rectum or stools from 184 hospitalized patients who were monitored weekly and when they had diarrhea was compared. The number of surveillance time points ranged from two to eight per patient over a period of 4 to 34 days per patient, totalling 621 comparisons of the media. C. difficile was isolated more frequently by TCCFA than CCFA at seven of eight surveillance points, a significant trend (O'Brien test, p = 0.002). This difference reached statistical significance at the second surveillance time point when the prevalence of C. difficile was sufficiently high. At the second surveillance point, C. difficle was isolated only by TCCFA in 7 of 184 comparisons of the media, only by CCFA in none of the comparisons, and by both media in 19 comparisons (p = 0.016). C. difficle was first isolated at an earlier surveillance time point on TCCFA in 11 of 36 patients and on CCFA first only once (p = 0.005). Use of TCCFA media increased the rapidity and sensitivity of culture for C. difficle when doing patient surveillance but did not increase sensitivity when diagnosing patients with diarrhea.

Topics: Antibiotics, Antitubercular; Cefoxitin; Cephamycins; Cholagogues and Choleretics; Clostridioides difficile; Cross Infection; Culture Media; Cycloserine; Diarrhea; Feces; Fructose; Humans; Prospective Studies; Rectum; Surgical Stomas; Taurocholic Acid

We have noted that prairie dogs given cefoxitin develop diarrhea and lose weight yet survive for periods of up to 4 weeks. Therefore, we tested the hypothesis that cefoxitin causes Clostridium difficile cecitis in prairie dogs. Six prairie dogs were given a single intramuscular dose of 100 mg of cefoxitin per kg of body weight, and six control animals received saline; both groups were sacrificed 1 week later. Controls had no diarrhea and lost 2% of their body weight, whereas cefoxitin-treated animals had diarrhea (P less than 0.001) and lost 16% of their body weight (P less than 0.001); one animals died 6 days after cefoxitin challenge. None of the controls yielded C. difficile or had cecal cytotoxin or pseudomembranes detected. Cecal contents from all cefoxitin-treated animals, however, yielded C. difficile (P less than 0.01) and had cecal cytotoxin present (P less than 0.01). Four of five surviving animals also had cecal pseudomembranes present (P less than 0.01). These results demonstrate that in prairie dogs cefoxitin induces C. difficile cecitis. We conclude that the prairie dog is another model for the study of antibiotic-induced diarrhea. The disease in prairie dogs may have a more chronic course than in other animal models of C. difficile-induced diarrhea and may be useful as a model for studying certain aspects of C. difficile-induced diarrhea.

Topics: Animals; Bacterial Toxins; Cecal Diseases; Cecum; Cefoxitin; Clostridium; Diarrhea; Disease Models, Animal; Inflammation; Sciuridae

Side effects of cefoxitin and cefuroxime were noted in 2 different studies during intravenous treatment for at least 14 days. In the cefoxitin group of 33 patients thrombophlebitis was observed in 3 cases and diarrhoea in 4 cases. In the cefuroxime group of 31 patients 1 case of thrombophlebitis was noted and 5 cases of diarrhoea occurred. Most patients with diarrhoea had decreased renal function or received higher dosage of the antibodies than the other patients.

Topics: Aged; Cefoxitin; Cefuroxime; Cephalosporins; Diarrhea; Glomerular Filtration Rate; Half-Life; Humans; Injections, Intravenous; Thrombophlebitis