ro13-9904 and Bacteroides-Infections

The aim of this report was to describe the occurrence of a bacterial brain abscess in a healthy individual, without any predisposing condition.. A thirteen-year old boy was admitted to the Department of Neurosurgery after the onset of vomiting, headache and dizziness. A neurological deficit was detected during the physical examination so urgent magnetic resonance imaging of the brain was performed, revealing an intrahemispheric, right positioned solitary expansive mass with ring enhancement. Purulent material was obtained during osteoplastic craniotomy with total extirpation of the brain abscess. Aggregatibacter aphrophilus and Bacteroides uniformis were isolated. The patient's general condition improved and the neurological deficit subsided as a result of the prompt recognition and treatment of this life threatening condition.. To achieve a favourable clinical outcome, prompt recognition and surgical treatment of a brain abscess are of primary importance,followed by administration of appropriate antimicrobial therapy. To our best knowledge, this is the first report of this combination of microorganisms as the cause of a brain abscess.

Topics: Adolescent; Aggregatibacter aphrophilus; Anti-Bacterial Agents; Bacteroides; Bacteroides Infections; Brain Abscess; Cefixime; Ceftriaxone; Coinfection; Craniotomy; Drainage; Humans; Magnetic Resonance Imaging; Male; Metronidazole; Pasteurellaceae Infections

Septic thrombophlebitis of the portal vein is an unusual and serious complication of abdominal infection. We present a patient with thrombophlebitis of the portal vein of unknown origin, suffering from fever, abdominal pain, jaundice, abnormal liver test function and bacteremia related to Bacteroides fragilis. Ultrasonography, with doppler of the portal vein, was performed which showed thrombosis of the portal vein together with signs of portal hypertension. The patient underwent six weeks of antibiotic treatment. The evolution was favourable, the infection was overcome and the portal vein was de-obstructed as a consequence of which the signs of portal hypertension disappeared.

Topics: Aged; Bacterial Infections; Bacteroides fragilis; Bacteroides Infections; Ceftriaxone; Cephalosporins; Humans; Hypertension, Portal; Male; Ornidazole; Portal Vein; Thrombophlebitis; Ultrasonography

Intra-abdominal abscess is seldom adequately treated by systemic antibiotics alone and often requires surgical or computed tomography-guided drainage for resolution. Abscess penetration of six currently used antibiotics was examined in a murine intra-abdominal abscess model. Ampicillin/sulbactam, cefmetazole, clindamycin, and trospectomycin penetrated intra-abdominal abscesses to a greater degree than cefoxitin and ceftriaxone. Abscess pus antibiotic levels were not significantly higher after multiple doses than after a single dose. Pus antibiotic levels below the MIC90 for Bacteroides and E. coli within intra-abdominal abscess were observed for most antibiotics with the doses used in this study. Selection of antibiotics with a greater ability to penetrate abscess may be important in optimally treating patients with abdominal infection.

Topics: Abdominal Abscess; Ampicillin; Animals; Anti-Bacterial Agents; Bacteroides fragilis; Bacteroides Infections; Cefmetazole; Cefoxitin; Ceftriaxone; Clindamycin; Drug Evaluation, Preclinical; Drug Therapy, Combination; Escherichia coli Infections; Hydrogen-Ion Concentration; Male; Mice; Microbial Sensitivity Tests; Spectinomycin; Sulbactam

Using a rat model of intraperitoneal abscess due to Bacteroides fragilis, we evaluated therapy with the combination of ceftriaxone plus the beta-lactamase inhibitor tazobactam in comparison with ceftriaxone or cefotaxime alone. When treatment was begun five hours after bacterial challenge, final bacterial counts within abscesses at 3.5 days of treatment were as follows (mean +/- S.D., log10 cfu/g): ceftriaxone plus tazobactam, 4.15 +/- 1.25; cefotaxime, 4.77 +/- 1.80; ceftriaxone alone, 5.68 +/- 1.04; untreated controls, 9.14 +/- 1.13. In spite of pharmacokinetic differences between the two drugs, coadministration of tazobactam significantly enhanced activity of ceftriaxone in this model.

Topics: Abdomen; Abscess; Animals; Bacteroides fragilis; Bacteroides Infections; Ceftriaxone; Disease Models, Animal; Drug Therapy, Combination; Male; Penicillanic Acid; Peritoneal Diseases; Rats; Rats, Sprague-Dawley; Tazobactam