meropenem and Respiratory-Distress-Syndrome

The coronavirus disease 2019 causes a wide degree of organ dysfunction and is associated with bacterial secondary infections. We reported lung microbiota dynamics in a critically ill patient with coronavirus disease 2019, who developed severe Hafnia alvei ventilator-associated pneumonia and required extracorporeal membrane oxygenation support.

Topics: Bronchoalveolar Lavage; COVID-19; Dysbiosis; Enterobacteriaceae Infections; Hafnia alvei; Humans; Lung; Male; Meropenem; Microbiota; Middle Aged; Pneumonia, Ventilator-Associated; Respiration, Artificial; Respiratory Distress Syndrome; SARS-CoV-2

The use of antibiotics is mandatory in patients during extracorporeal membrane oxygenation (ECMO) support. Clinical studies have shown high variability in the antibiotic concentrations, as well as sequestration of them by the ECMO circuit, suggesting that the doses and/or interval administration used during ECMO may not be adequate. Thus, a fast response sensor to estimate antibiotic concentrations in this setting would contribute to improve dose adjustments. The biosensor PenP has been shown to have a dynamic range, sensitivity and specificity useful for pharmacokinetic (PK) tests in healthy subjects. However, the use of this biosensor in the context of a complex critical condition, such as ECMO during acute respiratory distress syndrome (ARDS), has not been tested.. To describe, by using PenP Biosensor, the pharmacokinetic of meropenem in a 24-h animal ARDS/ECMO model.. The PK of meropenem was evaluated in a swine model before and during ECMO.. The PK parameters such as maximum concentration (Cmax), elimination rate constant (Ke), and cleareance (Cl), were not significantly altered during ECMO support.. (a) ECMO does not affect the PK of meropenem, at least during the first 24 h; and (b) PenP has the potential to become an effective tool for making medical decisions associated with the dose model of antibiotics in a critical patient context.

Topics: Animals; Anti-Bacterial Agents; Area Under Curve; beta-Lactamases; Biosensing Techniques; Disease Models, Animal; Extracorporeal Membrane Oxygenation; Half-Life; Meropenem; Respiratory Distress Syndrome; ROC Curve; Swine; Thienamycins

The spectrum of disease with pandemic novel H1N1 influenza A (2009) virus ranges from non-febrile, mild upper respiratory tract infection to severe or fatal pneumonia. We report the bronchoscopic findings associated with a fatal case of H1N1 influenza A associated with co-infection with methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy child, which were more severe than those previously described as associated with seasonal influenza infection alone. The severity of the airway pathology seen on bronchoscopy in this patient may be due to a unique effect of the H1N1 influenza A virus or may be as a result of a destructive synergism between this virus and bacteria such as MRSA.

Topics: Anti-Bacterial Agents; Bronchoscopy; Child; Fatal Outcome; Female; Fibrinolytic Agents; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Lung; Meropenem; Methicillin-Resistant Staphylococcus aureus; Oseltamivir; Respiratory Distress Syndrome; Respiratory Insufficiency; Staphylococcal Infections; Thienamycins; Tissue Plasminogen Activator; Vancomycin

Melioidosis is an endemic disease in southeast Asia and northern Australia, caused by Burkholderia pseudomallei. A typhoon-related outbreak occurred in southern Taiwan in July 2005. High mortality in melioidosis associated with bacteremic pneumonia and septic shock. We report a patient with life-threatening melioidosis who developed rapid progression of bacteremic pneumonia with acute respiratory distress syndrome, septic shock and multiple organ dysfunction and was successfully treated with recombinant human activated protein C (rhAPC) and meropenem. Although rhAPC has been reported to reduce the mortality of severe septic shock caused by various pathogens, to our best knowledge, this is the first reported case of rhAPC application in life-threatening melioidosis.

Topics: Anti-Bacterial Agents; Burkholderia pseudomallei; Drug Therapy, Combination; Fibrinolytic Agents; Humans; Male; Melioidosis; Meropenem; Middle Aged; Multiple Organ Failure; Pneumonia, Bacterial; Protein C; Recombinant Proteins; Respiratory Distress Syndrome; Shock, Septic; Thienamycins