minocycline and Opportunistic-Infections

Topics: Animals; Anti-Bacterial Agents; Antitrichomonal Agents; Balantidiasis; Balantidium; Diagnosis, Differential; Drug Therapy, Combination; Humans; Metronidazole; Minocycline; Opportunistic Infections; Tinidazole

Invasive fungal infection (IFI) is a serious complication of chemotherapy for hematological malignancies and autologous/allogeneic hematopoietic stem cell transplantation in children and shows a high mortality rate. We performed a randomized trial comparing micafungin (MCFG), a new anti-fungal agent, with fosfluconazole, a prodrug of fluconazole (FF) conventionally used as a prophylactic agent, for prophylaxis against IFI. Cefpirome was administered as prophylaxis against bacterial infection, and meropenem+minocycline as an empiric window therapy for febrile neutropenia. MCFG 2 mg/kg/day (max 100 mg/day) and FF 10 mg/kg/day (max 400 mg/day) were both safe and effective (event free ratio of IFI, MCFG 94.4% vs FF 94.3%) without significant difference. Thus, MCFG is safe and can be used for prophylaxis against IFI in children.

Topics: Adolescent; Child; Child, Preschool; Drug Therapy, Combination; Echinocandins; Female; Fluconazole; Hematopoietic Stem Cell Transplantation; Humans; Infant; Lipopeptides; Male; Meropenem; Micafungin; Minocycline; Mycoses; Neutropenia; Opportunistic Infections; Organophosphates; Prodrugs; Thienamycins

Stenotrophomonas maltophilia (S. maltophilia) is an important opportunistic pathogen that can be isolated in hospitals. With the abuse of broad spectrum antibiotics and invasive surgical devices, the rate of S. maltophilia infection is increasing every year. This study was an epidemiological analysis of the clinical and molecular characteristics of S. maltophilia infection in a Chinese teaching hospital. The goal was to obtain a comprehensive understanding of the status of S. maltophilia infection to provide strong epidemiological data for the prevention and treatment of S. maltophilia infection.. A total of 93 isolates from Renji Hospital affiliated with the Shanghai Jiaotong University School of Medicine were included, in which 62 isolates were from male patients. In addition, 81 isolates were isolated from sputum samples. A total of 86 patients had underlying diseases. All patients received antibiotics. Multilocus sequence typing (MLST) analysis indicated that 61 different sequence types (STs) were found (including 45 novel STs), and MLST did not show significantly dominant STs. Pulsed field gel electrophoresis (PFGE) results showed that 93 isolates could be divided into 73 clusters, and they also showed weak genetic linkages between isolates. The resistant rates to trimethoprim/sulfamethoxazole (TMP/SMX) and levofloxacin were 9.7 and 4.3%, respectively, and all isolates were susceptible to minocycline. Four virulence gene's loci Stmpr1, Stmpr2, Smf-1, and Smlt3773 were positive in 79.6, 91.4, 94.6, and 52.7% of the isolates, respectively. Three biofilm genes rmlA, spgM, and rpfF were positive in 82.8, 92.5, and 64.5% of the isolates, respectively. Mean biofilm forming level of OD. Most of the patients had prior medical usage histories and baseline diseases. The positive rate of virulence genes was high, the drug resistance rate of S. maltophilia was low, and the biofilm formation ability was strong. The increased use of antibiotics was an independent risk factor for S. maltophilia infection, which should receive more attention. No obvious clonal transmissions were found in the same departments.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Typing Techniques; Biofilms; Case-Control Studies; China; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Female; Gene Expression; Genes, Bacterial; Gram-Negative Bacterial Infections; Hospitals, Teaching; Humans; Intensive Care Units; Levofloxacin; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Molecular Epidemiology; Multilocus Sequence Typing; Opportunistic Infections; Retrospective Studies; Risk Factors; Stenotrophomonas maltophilia; Trimethoprim, Sulfamethoxazole Drug Combination

A variety of medical conditions and medications can lead to cutaneous dyschromia. We report a case of minocycline dyschromia that had been mistakenly attributed to chronic actinic purpura.

Topics: Aged; Anti-Bacterial Agents; Coinfection; Diagnosis, Differential; Humans; Hyperpigmentation; Male; Minocycline; Opportunistic Infections; Time

Bacterial infections because of multidrug-resistant (MDR) bacteria are spreading worldwide. In patients with advanced liver cirrhosis, healthcare-acquired and hospital-acquired infections are common and are frequently sustained by MDR bacteria. In these settings, tigecycline, a new antibiotic, has been shown to be useful in the treatment of MDR bacteria, and it has been proposed for the treatment of hospital-acquired infections in patients with cirrhosis. Nevertheless, poor data exist on the safety profile of tigecycline in patients with cirrhosis. Here, an experience is reported in a female patient with advanced liver cirrhosis, who developed sepsis by an MDR Stenotrophomonas maltophilia and was treated with tigecycline. She experienced life-threatening side effects consisting of severe coagulopathy with hypofibrinogenaemia and subsequent gastrointestinal haemorrhage. The side effect disappeared after the withdrawal of tigecycline. Therefore, a strict monitoring of coagulation parameters in patients with cirrhosis treated with tigecycline is recommended.

Topics: Adult; Afibrinogenemia; Anti-Bacterial Agents; Blood Coagulation Disorders; Cross Infection; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacterial Infections; Humans; Liver Cirrhosis; Minocycline; Opportunistic Infections; Stenotrophomonas maltophilia; Tigecycline

Solid organ transplantation (SOT) is a risk factor for the acquisition of carbapenem-resistant Klebsiella pneumoniae. This infection is associated with a high mortality rate given the limited armamentarium of antibiotics for multidrug-resistant organisms along with continued immunosuppression to prevent graft rejection. We report a case of carbapenem-resistant K. pneumoniae pneumonia, bacteraemia and intra-abdominal infection in a newly transplanted liver recipient. The patient was successfully treated with a long course of high-dose tigecycline and colistin, along with surgical drainage. We discuss SOT-relevant epidemiology, therapeutic options and the rationale for our treatment choice.

Topics: Anti-Bacterial Agents; Colistin; Dose-Response Relationship, Drug; Drug Therapy, Combination; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver Transplantation; Male; Middle Aged; Minocycline; Opportunistic Infections; Tigecycline

Topics: Adult; Aged; Anti-Bacterial Agents; Carrier State; Clinical Trials as Topic; Cross Infection; Female; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Minocycline; Off-Label Use; Opportunistic Infections; Practice Guidelines as Topic; Salvage Therapy; Soft Tissue Infections; Stenotrophomonas maltophilia; Tigecycline

Dentists generally recognize the importance of periodontal treatment in patients with leukemia, with the most attention paid to preventing the development of odontogenic infection. For physicians, the worst type of infection is one caused by multidrug-resistant bacteria. Here, we report a patient with an abnormal increase in multidrug-resistant opportunistic bacteria in the gingiva during hematopoietic cell transplantation (HCT).. A 53-year-old woman receiving HCT for leukemia had an insufficient blood cell count for invasive periodontal treatment before HCT. Even brushing caused difficulties with hemostasis. Therefore, frequent pocket irrigation and local minocycline administration were performed.. The multidrug-resistant opportunistic bacterium Stenotrophomonas maltophilia was detected first in phlegm 2 days before HCT, and it was detected in a gingival smear and a blood sample 7 and 11 days after HCT, respectively. The patient developed sepsis on day 11 and died 14 days after HCT. Frequent irrigation and local antibiotic application were ineffective against S. maltophilia on the gingiva. Inflammatory gingiva without scaling and root planing showed bleeding tendency, and this interfered with the eradication of this bacterium.. The gingiva in patients undergoing leukemia treatment acts as sites of proliferation and reservoirs for multidrug-resistant opportunistic bacteria. Severe systemic infection by multidrug-resistant bacteria in such patients with leukemia also may involve the gingiva. To prevent abnormal increases in such bacteria on the gingiva, scaling and/or root planing before chemotherapy, which reduces bleeding on brushing during the neutropenic period caused by chemotherapy, may contribute to infection control in such patients, although it was impossible in this case.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Drug Resistance, Multiple, Bacterial; Fatal Outcome; Female; Gingival Diseases; Gingivitis; Gram-Negative Bacterial Infections; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Middle Aged; Minocycline; Opportunistic Infections; Periodontitis; Povidone-Iodine; Sepsis; Stenotrophomonas maltophilia; Transplantation Conditioning; Whole-Body Irradiation

Mycobacterium mucogenicum is a recently characterized organism that rarely may cause human infections. This rapidly growing mycobacterium is commonly identified in tap water. Both immunosuppressed and immunocompetent patients may develop infections from Mycobacterium mucogenicum. Some patients have experienced lethal disease, including sepsis. Infections occurring in the skin and soft tissues have been described only after a preceding injury. We present the first case of infection with Mycobacterium mucogenicum occurring in a patient on the TNF-alpha antagonist etanercept and without any prior soft tissue injury.

Topics: Anti-Bacterial Agents; Arthritis, Rheumatoid; Clarithromycin; Etanercept; Female; Humans; Immunoglobulin G; Immunosuppressive Agents; Middle Aged; Minocycline; Mycobacterium Infections; Opportunistic Infections; Receptors, Tumor Necrosis Factor; Skin Diseases, Bacterial; Tumor Necrosis Factor-alpha

To evaluate the impact of using central venous catheters (CVCs) impregnated with the combination of minocycline and rifampin on nosocomial bloodstream infections (BSIs), morbidity, and mortality in cancer patients in the ICU.. Prospective surveillance study consisting of the following two time periods: September 1997 through August 1998 (ie, fiscal year [FY] 1998); and from September 1998 through August 1999 (ie, FY 1999).. ICUs of a tertiary care hospital in Houston, TX.. Cancer patients in the medical ICU (MICU) and surgical ICU (SICU).. ICUs started using CVCs impregnated with the minocycline-rifampin combination at the beginning of FY 1999.. The rates of nosocomial BSIs and other patients' characteristics were compared for the two study periods to determine the impact of using the impregnated catheters in the ICU. Patients' characteristics, including antibiotic use, were comparable for the two study periods in both the MICU and the SICU. The rate of nosocomial BSIs in the MICU unit decreased from 8.3 to 3.5 per 1,000 patient-days (p < 0.01), and decreased in the SICU from 4.8 to 1.3 per 1,000 patient-days (p < 0.01) in FY 1999. Nosocomial vancomycin-resistant enterococcus (VRE) bacteremia also decreased significantly (p = 0.004). Length of stay in the MICU and SICU significantly decreased in FY 1999 (p < 0.01 and p = 0.03, respectively). The duration of hospitalization decreased for MICU and SICU patients (p = 0.06 and p < 0.01, respectively). The rate of catheter-related infections decreased from 3.1 to 0.7 per 1,000 patient-days in FY 1999 (p = 0.02). The decrease in infections resulted in net savings of at least $1,450,000 for FY 1999.. The use of antibiotic-impregnated CVCs in the MICU and SICU was associated with a significant decrease in nosocomial BSIs, including VRE bacteremia, catheter-related infections, and lengths of hospital and ICU stays.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacteremia; Catheterization, Central Venous; Catheters, Indwelling; Cause of Death; Child; Child, Preschool; Coated Materials, Biocompatible; Critical Care; Cross Infection; Drug Resistance, Multiple; Drug Therapy, Combination; Enterococcus; Female; Hospital Mortality; Humans; Male; Middle Aged; Minocycline; Neoplasms; Opportunistic Infections; Prospective Studies; Rifampin; Survival Rate; Texas; Vancomycin Resistance

Actinomycosis is an uncommon infectious disease caused predominantly by Actinomyces israelii. The cutaneous disseminated form is usually caused by hematogenous dissemination from a primary extra-cutaneous lesion. We report here cutaneous disseminated actinomycosis without any detectable extra-cutaneous lesions in a 42-year-old Japanese woman with acute lymphocytic leukemia. Multiple soft nodules developed on her upper and lower extremities. Histopathological examination revealed "sulfur granules", which are a specific finding for actinomycosis. Cultures from biopsy specimens were not successful. There were no cervicofacial, thoracic, nor abdominal lesions. These findings suggest that cutaneous disseminated actinomycosis in our patient developed primarily in the skin. Although the patient was immunocompromised, antibiotic treatment with minocycline was effective.

Topics: Actinobacillus; Actinomycosis; Adult; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Arm; Bacteremia; Biopsy; Cytoplasmic Granules; Female; Humans; Immunocompromised Host; Leg Dermatoses; Minocycline; Opportunistic Infections; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Skin Diseases, Bacterial

We report a case of pulmonary Nocardia (N.) otitidiscaviarum infection in a 76-year-old man with chronic respiratory infection. The patient responded poorly to intravenous imipenem and oral minocycline, but later improved after treatment with trimethoprim-sulfamethoxazole. Pulmonary infection with N. otitidiscaviarum should be considered in the differential diagnosis of chronic respiratory infections. Further studies are needed to evaluate the correlation between species and drug susceptibility.

Topics: Aged; Agricultural Workers' Diseases; Bronchoalveolar Lavage Fluid; Chronic Disease; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Imipenem; Male; Microbial Sensitivity Tests; Minocycline; Nocardia; Nocardia Infections; Opportunistic Infections; Pneumonia, Bacterial; Species Specificity; Trimethoprim, Sulfamethoxazole Drug Combination

A 76-year-old man who was admitted to the hospital because of chronic renal insufficiency and chronic hepatitis died of Corynebacterium group JK pneumonia, after showing a slight improvement by treatment of Staphylococcus aureus with sulbactam/cefoperazone and minocycline. Transtracheal aspiration (TTA) just before his death revealed numerous gram-positive bacilli phagocytized by many neutrophils and more than 10(8) colony forming units (CFU)/ml of Corynebacterium group JK. A drug susceptibility test showed Corynebacterium group JK was resistant to many antibiotics, with the exception of vancomycin and amikacin.

Topics: Aged; Cefoperazone; Corynebacterium; Corynebacterium Infections; Disease Susceptibility; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Immunocompromised Host; Kidney Failure, Chronic; Male; Minocycline; Opportunistic Infections; Pneumonia; Pneumonia, Staphylococcal; Sulbactam

Mycobacterium haemophilum is a fastidious species that has been isolated from skin and subcutaneous nodules. The authors describe a case of Mycobacterium haemophilum osteomyelitis and skin infection in an AIDS patient and successful treatment with minocycline.

Topics: Acquired Immunodeficiency Syndrome; Adult; Diagnosis, Differential; Didanosine; Drug Therapy, Combination; Female; Humans; Minocycline; Mycobacterium Infections, Nontuberculous; Opportunistic Infections; Osteomyelitis; Tuberculosis, Osteoarticular; Zidovudine