ro13-9904 and Diabetes-Mellitus

Diabetic foot ulcer (DFU) represented the most feared diabetic complication that caused the hospitalization of the diabetic patient. DFU was usually characterized with delayed healing as the diabetic neuropathy, angiopathy, and ulcer concomitant infections, among them, are multidrug-resistant (MDR) bacteria that emphasized the clinical importance for developing new therapeutic strategy with safe and effective alternatives for the antibiotics to overcome DFU-MDR bacterial infection. Bacteriophage therapy was considered a novel approach to eradicate the MDR, but its role in the polymicrobial infection of the DFU remains elusive. Thus, the current work was designed to investigate the effect of the topical application of the phage cocktail on the healing of the diabetic wound infected with clinical isolates of Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella variicola, Escherichia coli, and Proteus mirabilis. Bacterial isolation was performed from clinical hospitalized and non-hospitalized cases of DFU, identified morphologically, biochemically, molecularly via 16 s rRNA sequencing, and typed for the antibiotic resistance pattern. Moreover, phages were isolated from the aforementioned clinical isolates and identified with electron microscope. Forty-five adult male Sprague-Dawley rats were assigned in 3 groups (15 rats each), namely, the diabetic infected wound group, diabetic infected wound ceftriaxone-treated group, and the diabetic infected wound phage cocktail-treated group. The results revealed that phage cocktail had a superior effect over the ceftriaxone in wound healing parameters (wound size, wound index, wound bacterial load, and mRNA expression); wound healing markers (Cola1a, Fn1, MMP9, PCNA, and TGF-β); inflammatory markers (TNF-α, NF-κβ, IL-1β, IL-8, and MCP-1); anti-inflammatory markers (IL-10 and IL-4); and diabetic wound collagen deposition; and also the histomorphic picture of the diabetic infected wound. Based on the current findings, it could be speculated that phage therapy could be considered a novel antibiotic substitute in the DFU with MDR-polymicrobial infection therapeutic strategies.

Topics: Animals; Anti-Bacterial Agents; Ceftriaxone; Coinfection; Diabetes Mellitus; Diabetic Foot; Male; Phage Therapy; Rats; Rats, Sprague-Dawley

Topics: Alcoholism; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftriaxone; Diabetes Mellitus; Drainage; Drug Therapy, Combination; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess, Pyogenic; Male; Metronidazole; Middle Aged

Topics: Aged; Anti-Bacterial Agents; Cefotaxime; Ceftriaxone; Diabetes Mellitus; Fermentation; Glucose; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver; Liver Abscess; Male; Taiwan; Tomography, X-Ray Computed

Topics: Aged; Anti-Bacterial Agents; Bile; Ceftriaxone; Chemical Precipitation; Cholecystitis; Diabetes Mellitus; Humans; Male; Pneumococcal Infections

The United States labeling for gatifloxacin has been updated to include contradictions related to its reported association with dysglycemia. However, adequately controlled studies in acute care settings assessing the magnitude and clinical determinants of dysglycemia are lacking.. To compare the hypoglycemic and hyperglycemic effects of gatifloxacin with ceftriaxone in hospitalized patients.. A retrospective cohort study of hospitalized adult (> or =18 years) patients admitted with Community Acquired Pneumonia (CAP) or Acute Exacerbation of Chronic Bronchitis (AECB) in a US tertiary care hospital between 7/1/01 and 12/31/04 treated with gatifloxacin or ceftriaxone during hospital admission. Outcomes of interests were incidence of hypoglycemia (blood glucose levels <46 mg/dL) or hyperglycemia (>200 mg/dL) during up to 5 days of drug exposure. Risks for gatifloxacin and ceftriaxone were compared adjusting for variables previously reported to be independent predictors of hypoglycemia or hyperglycemia.. 1504 patients met the study inclusion criteria. Compared to ceftriaxone, gatifloxacin was associated with an increased risk of hypoglycemia: (adjusted odds ratio (OR) 2.34, 95% confidence interval (CI) 1.4-4.0). The increased risk of hypoglycemia during exposure to gatifloxacin was similar in patients with and without a diagnosis of diabetes mellitus. Gatifloxacin was not associated with an increased risk for hyperglycemia (adjusted OR: 1.06 95% CI 0.8-1.4) considering the whole study cohort. However, stratification by diagnosis of diabetes, gatifloxacin treated patients appeared to have a reduced risk of hyperglycemia (adjusted OR: 0.4 95% CI 0.2-0.4) while non-diabetic gatifloxacin treated patients appeared to have an increased risk of hyperglycemia (adjusted OR: 1.64 95% CI 1.1-2.4).. The risk of dysglycemia with gatifloxacin in this population of hospitalized patients was not as high as previously reported in ambulatory patients. Although these results suggest gatifloxacin use is safer in acute care settings, we recommend that clinicians monitor blood glucose levels carefully or consider alternatives to gatifloxacin therapy whenever possible.

Topics: Adult; Aged; Anti-Bacterial Agents; Blood Glucose; Bronchitis; Ceftriaxone; Cohort Studies; Community-Acquired Infections; Diabetes Mellitus; Female; Fluoroquinolones; Gatifloxacin; Homeostasis; Hospitalization; Humans; Hyperglycemia; Hypoglycemia; Male; Middle Aged; Pneumonia; Retrospective Studies; Risk Factors; United States

Salmonella mycotic aneurysms of the descending thoracic aorta are exceedingly rare. There are few case reports and even fewer reports of long term survival. The case of a 68-year-old female presenting with a mycotic aneurysm of the descending thoracic aorta caused by Salmonella species is described, which involved successful surgical intervention.

Topics: Aged; Aneurysm, Infected; Aorta, Thoracic; Aortic Aneurysm, Thoracic; Aortography; Blood Vessel Prosthesis Implantation; Ceftriaxone; Cephalosporins; Diabetes Complications; Diabetes Mellitus; Female; Hemoptysis; Humans; Salmonella Infections; Tomography, X-Ray Computed

Topics: Anti-Bacterial Agents; Cefazolin; Ceftriaxone; Diabetes Mellitus; Duplicate Publications as Topic; Humans; Osteomyelitis; Penicillins; Peripheral Vascular Diseases; Staphylococcal Infections