netilmicin and Klebsiella-Infections

Topics: Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Child, Preschool; Drug Therapy, Combination; Female; Humans; Klebsiella Infections; Klebsiella oxytoca; Meropenem; Netilmicin; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Proctitis; Thienamycins; Tomography, X-Ray Computed; Typhlitis; Vancomycin

The first outbreak of carbapenem-resistant Klebsiella pneumoniae isolates producing the plasmid-encoded carbapenem-hydrolyzing oxacillinase OXA-48 is reported. The 39 isolates belonged to two different clones and were collected at the University Hospital of Istanbul, Turkey, from May 2006 to February 2007, and they coproduced various beta-lactamases (SHV-12, OXA-9, and TEM-1 for clone A and CTX-M-15, TEM-1, and OXA-1 for clone B).

Topics: Bacterial Proteins; beta-Lactamases; Carbapenems; Cross Infection; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Models, Genetic; Turkey

The effects of subinhibitory concentrations (sub-MICs) of gentamicin, netilmicin and amikacin on the serum sensitivity and the cell surface hydrophobicity of Klebsiella pneumoniae were investigated. At concentrations 1/16 or 1/8 of the MICs, in all antibiotics significantly enhanced the sensitivity of K. pneumoniae to human serum as compared to nontreated bacteria. The higher concentration of the antibiotics tested was more efficient. Survival of bacteria under these conditions ranged from 24.1% to 36.7% after incubation with 10% serum for 180 min when compared with the viability of the control bacteria. Bacteria grown with the test antibiotics at sub-MICs (1/8 or 1/4 of the MICs) manifested an effective decrease of the surface hydrophobicity. The aminoglycosides which were more effective at a concentration of 1/4 of the MICs reduced bacterial hydrophobicity to 28.5% (gentamicin), 14.8% (netilmicin) and 12.7% (amikacin) of the nontreated bacteria.

Topics: Amikacin; Anti-Bacterial Agents; Bacterial Adhesion; Blood Bactericidal Activity; Gentamicins; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Netilmicin; Respiratory System; Surface Properties

An outbreak of amikacin-resistant Enterobacteriaceae (KES) occurred in the Intensive Care Nursery (ICN) of the Louisville General Hospital from January 1978 through March 1978. Epidemic disease and an increased colonization rate in newborn infants due to amikacin-resistant microorganisms has not been documented previously. Three of the 11 neonates died. The organisms isolated were resistant to amikacin and two experimental aminoglycosides, sissomicin and netilmicin. The outbreak was contained following institution of several control measures, including pharyngeal inoculation of an experimental strain of alpha streptococcus in four infants.

Topics: Amikacin; Cross Infection; Disease Outbreaks; Drug Resistance, Microbial; Enterobacter; Enterobacteriaceae Infections; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units; Kanamycin; Klebsiella Infections; Klebsiella pneumoniae; Male; Netilmicin; Nurseries, Hospital; Serratia marcescens; Sisomicin

49 newborns and infants were treated with netilmicin for verified or suspected infections. Infection was verified in 23 patients (mean gestational age 32 weeks and mean body weight 2100 g) and clinical cure or marked improvement occurred in 20 of these. Of the remaining 3 patients, 2 died, partly due to reasons unassociated with infection. 25 causative organisms were isolated and bacteriological elimination was achieved in 73% of the cases. At an average dose of 2.6 mg/kg twice a day, peak serum concentrations (30 min following injection) were 7.4 +/- 3.4 micrograms/ml. Serum half life was approximately 4.5 hours for infants born at term, and longer at shorter gestational age. Netilmicin is considered a safe and efficient aminoglycoside with a low rate of adverse effects.

Topics: Bacterial Infections; Drug Evaluation; Escherichia coli Infections; Female; Gentamicins; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Klebsiella Infections; Male; Netilmicin; Sepsis; Staphylococcal Infections; Streptococcal Infections

Ninety-two patients with cancer with 100 infectious episodes were treated with netilmicin sulfate, a new aminoglycoside. Netilmicin was administered intravenously, either intermittently or by continuous infusion. The overall cure rate was 60%. Gram-negative bacilli were the most common causative organisms and the response rate for these infections was 32/53 (60%). The most common pathogens were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Pneumonia, urinary tract infection, and septicemia were the most common types of infection treated and the response rates were 23/47 (49%), 19/21 (90%), and 9/17 (53%), respectively. Nephrotoxicity occurred in ten patients (6%) who had normal renal function initially. Netilmicin is an effective aminoglycoside with a spectrum of antibacterial activity similar to that of gentamicin sulfate and it appears to be less nephrotoxic.

Topics: Bacterial Infections; Escherichia coli Infections; Gentamicins; Humans; Injections, Intravenous; Klebsiella Infections; Neoplasms; Netilmicin; Pseudomonas Infections

Netilmicin, a new aminoglycoside antibiotic, was used to treat 19 patients with urinary tract infection and 5 with systemic infection. The causal organisms were Escherichia coli (in 2), Klebsiella pneumoniae (in 4), Serratia marcescens (in 12) and Pseudomonas aeruginosa (in 7); 1 patient was infected with two of these organisms. All the isolates of causal organisms except one of Serratia were initially sensitive to netilmicin but many were resistant to other aminoglycosides. Sixteen of the urinary tract infections responded to netilmicin therapy, although relapse occurred in three patients. Two of the three patients with musculoskeletal infection responded to combined therapy with surgery and netilmicin; the other patient responded to the same regimen but with carbenicillin added. Netilmicin cured pneumonia in one patient but failed in the other patient with pneumonia, who had leukemia. Superinfection occurred in five patients with urinary tract infection. Adverse reactions to netilmicin were minor. Netilmicin may prove to be a useful agent, particularly for infections due to multiresistant Klebsiella or Serratia, or when prolonged aminoglycoside therapy is required.

Topics: Adolescent; Adult; Aged; Amputation, Surgical; Aorta, Abdominal; Aortic Aneurysm; Drug Evaluation; Enterobacteriaceae Infections; Escherichia coli Infections; Female; Gentamicins; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Middle Aged; Netilmicin; Pneumonia; Pseudomonas aeruginosa; Pseudomonas Infections; Serratia marcescens; Surgical Wound Infection; Urinary Tract Infections