trimethoprim--sulfamethoxazole-drug-combination and Gram-Positive-Bacterial-Infections

The management of some serious infections such as infective endocarditis (IE) and bone and joint infections (BJIs) caused by Gram-positive cocci (GPC) is complex and requires great responsiveness and effective antimicrobials with high bioavailability in heart valves or bone tissues. Treatment of these infections requires the use of a higher dosage that may result in increased toxicity or the use of new promising antimicrobials to control the infection. However, use of these new antimicrobials could still bring about new toxicity and resistance. Another approach may be the 'comeback' of old antimicrobials, which is evaluated in this review in the treatment of IE and BJIs caused by GPC.

Topics: Anti-Bacterial Agents; Bone and Bones; Communicable Diseases; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Joints; Osteomyelitis; Prosthesis-Related Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Antimicrobial resistance is a major and emerging threat worldwide. New antimicrobials have been unable to meet the resistance challenge, and treatment options are limited for a growing number of resistant pathogens. More and more clinicians are relying on older antimicrobials for the treatment of multidrug-resistant (MDR) bacteria. Some older antimicrobials have maintained excellent in vitro activity against highly resistant pathogens. In some instances, use of older agents is limited by unfavourable pharmacokinetic/pharmacodynamic characteristics and/or toxicities. In general, clinical data pertaining to the use of older agents for the treatment of MDR pathogens are scarce. Research efforts should be focused on the evaluation of older agents for the treatment of MDR pathogens as well as evaluating how these agents perform in complex patient populations with various and multiple co-morbid conditions.

Topics: Aminoglycosides; Anti-Bacterial Agents; Drug Combinations; Drug Resistance, Multiple, Bacterial; Fosfomycin; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Minocycline; Polymyxins; Sulfamethizole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Bacterial infections are a major cause of morbidity and mortality in patients who are neutropenic following chemotherapy for malignancy. Trials have shown the efficacy of antibiotic prophylaxis in reducing the incidence of bacterial infections but not in reducing mortality rates. Our systematic review from 2006 also showed a reduction in mortality.. This updated review aimed to evaluate whether there is still a benefit of reduction in mortality when compared to placebo or no intervention.. We searched the Cochrane Cancer Network Register of Trials (2011), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2011), MEDLINE (1966 to March 2011), EMBASE (1980 to March 2011), abstracts of conference proceedings and the references of identified studies.. Randomised controlled trials (RCTs) or quasi-RCTs comparing different types of antibiotic prophylaxis with placebo or no intervention, or another antibiotic, to prevent bacterial infections in afebrile neutropenic patients.. Two authors independently appraised the quality of each trial and extracted data from the included trials. Analyses were performed using RevMan 5.1 software.. One-hundred and nine trials (involving 13,579 patients) that were conducted between the years 1973 to 2010 met the inclusion criteria. When compared with placebo or no intervention, antibiotic prophylaxis significantly reduced the risk of death from all causes (46 trials, 5635 participants; risk ratio (RR) 0.66, 95% CI 0.55 to 0.79) and the risk of infection-related death (43 trials, 5777 participants; RR 0.61, 95% CI 0.48 to 0.77). The estimated number needed to treat (NNT) to prevent one death was 34 (all-cause mortality) and 48 (infection-related mortality).Prophylaxis also significantly reduced the occurrence of fever (54 trials, 6658 participants; RR 0.80, 95% CI 0.74 to 0.87), clinically documented infection (48 trials, 5758 participants; RR 0.65, 95% CI 0.56 to 0.76), microbiologically documented infection (53 trials, 6383 participants; RR 0.51, 95% CI 0.42 to 0.62) and other indicators of infection.There were no significant differences between quinolone prophylaxis and TMP-SMZ prophylaxis with regard to death from all causes or infection, however, quinolone prophylaxis was associated with fewer side effects leading to discontinuation (seven trials, 850 participants; RR 0.37, 95% CI 0.16 to 0.87) and less resistance to the drugs thereafter (six trials, 366 participants; RR 0.45, 95% CI 0.27 to 0.74).. Antibiotic prophylaxis in afebrile neutropenic patients significantly reduced all-cause mortality. In our review, the most significant reduction in mortality was observed in trials assessing prophylaxis with quinolones. The benefits of antibiotic prophylaxis outweighed the harm such as adverse effects and the development of resistance since all-cause mortality was reduced. As most trials in our review were of patients with haematologic cancer, we strongly recommend antibiotic prophylaxis for these patients, preferably with a quinolone. Prophylaxis may also be considered for patients with solid tumours or lymphoma.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteremia; Bacterial Infections; Cause of Death; Drug Resistance, Bacterial; Fever; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Neoplasms; Neutropenia; Quinolones; Randomized Controlled Trials as Topic; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Anti-Bacterial Agents; Catheter-Related Infections; Drug Therapy, Combination; Enterococcus; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Hypoglycemia; Immunocompromised Host; Kidney Failure, Chronic; Levofloxacin; Male; Ofloxacin; Renal Dialysis; Sepsis; Stenotrophomonas maltophilia; Trimethoprim, Sulfamethoxazole Drug Combination

Bacterial infections are a major cause of morbidity and mortality in neutropenic patients following chemotherapy for malignancy. Trials have shown the efficacy of antibiotic prophylaxis in decreasing the incidence of bacterial infections, but not in reducing mortality rates.. This review aimed to evaluate whether antibiotic prophylaxis in afebrile neutropenic patients reduced mortality when compared to placebo or no intervention.. Electronic searches on The Cochrane Cancer Network Register of Trials (2004), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2004), MEDLINE (1966 to 2004) and EMBASE (1980 to 2004) and abstracts of conference proceedings; references of identified studies; the first author of each included trial was contacted.. RCTs or quasi-RCTs comparing different types of antibiotic prophylaxis with placebo or no intervention, or another antibiotic to prevent bacterial infections in afebrile neutropenic patients.. Two authors independently appraised the quality of each trial and extracted data from the included trials. Relative risks (RR) or average differences, with their 95% confidence intervals (CI) were estimated.. One hundred trials (10,274 patients) performed between the years 1973 to 2004 met inclusion criteria. Antibiotic prophylaxis significantly decreased the risk for death when compared with placebo or no intervention (RR, 0.66 [95% CI 0.54 to 0.81]). The authors estimated the number needed to treat (NNT) in order to prevent 1 death from all causes as 60 (95% CI 34 to 268). Prophylaxis resulted in a significant decrease in the risk of infection-related death, RR 0.58 (95% CI 0.45 to 0.74) and in the occurrence of fever, RR 0.78 (95% CI 0.75 to 0.82). A reduction in mortality was also evident when the more recently conducted quinolone trials were analysed separately. Quinolone prophylaxis reduced the risk for all-cause mortality, RR 0.52 (95% CI, 0.37 to 0.84).. Our review demonstrated that prophylaxis significantly reduced all-cause mortality. The most significant reduction in mortality was observed in trials assessing prophylaxis with quinolones. The benefit demonstrated in our review outweighs harm, such as adverse effects, and development of resistance, since all-cause mortality is reduced. Since most trials in our review were of patients with haematologic cancer, prophylaxis, preferably with a quinolone, should be considered for these patients.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Neoplasms; Neutropenia; Quinolones; Randomized Controlled Trials as Topic; Trimethoprim, Sulfamethoxazole Drug Combination

Infection are part of the natural course of lung cancer but overall they are poorly understood. The clinical studies on which is based our knowledge often lack sufficient clinical and microbiological documentation of the infection. Nevertheless, infection is frequently caused by Gram+ pathogens, among which pneumococci remain common. When lung cancer patients are treated with chemotherapy, the resulting neutropenia predisposes further to infection; its spectrum is similar to what has been observed in other granulocytopenic patients. The frequency and severity of the infection depends mainly on the severity and duration of neutropenia. Cotrimoxazole prophylaxis in neutropenic patients with lung cancer has been found effective in several studies. As far as therapy of fever and/or infection in neutropenic lung cancer is concerned, it does not appear that it should be handled differently from febrile neutropenia in other chemotherapy treated neutropenic patients.

Topics: Anti-Infective Agents; Antineoplastic Agents; Gram-Positive Bacterial Infections; Humans; Lung Neoplasms; Neutropenia; Trimethoprim, Sulfamethoxazole Drug Combination

Bacterial resistance to antibiotics is an increasingly threatening consequence of antimicrobial exposure for many decades now. In urinary tract infections (UTIs), antibiotic prophylaxis (AP) increases bacterial resistance. We studied the resistance patterns of positive urinary cultures in spina bifida children on clean intermittent catheterization, both continuing and stopping AP.. In a cohort of 176 spina bifida patients, 88 continued and 88 stopped using AP. During 18 months, a fortnightly catheterized urine sample for bacterial pathogens was cultured. UTIs and significant bacteriuria (SBU) were defined as a positive culture with a single species of bacteria, respectively with and without clinical symptoms and leukocyturia. We compared the percentage of resistance to commonly used antibiotics in the isolated bacteria in both groups.. In a total of 4917 cultures, 713 (14.5%) had a positive monoculture, 54.3% of which were Escherichia coli. In the group stopping AP, the resistance percentage to antibiotics in UTI / SBU bacteria was lower than in the group remaining on AP, even when excluding the administered prophylaxis.. Stopping antibiotic prophylaxis for urinary tract infections is associated with reduced bacterial resistance to antibiotics in children with spina bifida.. ISRCTN ISRCTN56278131 . Registered 20 December 2005.

Topics: Adolescent; Aminoglycosides; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteriuria; Child; Deprescriptions; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Fluoroquinolones; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Male; Nitrofurantoin; Penicillins; Spinal Dysraphism; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

Both linezolid and cotrimoxazole are antibiotics that are well suited for oral therapy of bone and joint infections (BJI) caused by otherwise resistant Gram-positive cocci (GPC) (resistance to fluoroquinolones, maccolides, betalactamines). However, in this context, no data are currently available regarding the safety and tolerance of these antibiotics in combination with rifampicin. The objective of this study was to compare the efficacy and safety of a combination of rifampicin and linezolid (RLC) with those of a combination of rifampicin and cotrimoxazole (RCC) in the treatment of BJI. Between February 2002 and December 2006, 56 adult patients (RLC, n = 28; RCC, n = 28), including 36 with infected orthopaedic devices (RLC, n = 18; RCC, n = 18) and 20 with chronic osteomyelitis (RLC, n = 10; RCC, n = 10), were found to be eligible for inclusion in this study. Patients who discontinued antibiotic therapy within 4 weeks of commencing treatment were considered to represent cases of treatment failure and were excluded. Rates of occurrence of adverse effects were similar in the two groups, at 42.9% in the RLC group and 46.4% in the RCC group (p = 1.00), and led to treatment discontinuation in four (14.3%) RLC and six (21.4%) RCC patients. Cure rates were found to be similar in the two groups (RLC, 89.3%, RCC, 78.6%; p = 0.47). Prolonged oral RLC and RCC therapy were found to be equally effective in treating patients with BJI caused by resistant GPC, including patients with infected orthopaedic devices. However, the lower cost of cotrimoxazole compared with linezolid renders RCC an attractive treatment alternative to RLC. Further larger clinical studies are warranted to confirm these preliminary results.

Topics: Acetamides; Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Chronic Disease; Drug Therapy, Combination; Female; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Linezolid; Male; Middle Aged; Orthotic Devices; Osteomyelitis; Oxazolidinones; Prosthesis-Related Infections; Rifampin; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

One hundred and eighteen (118) episodes of bacteremia and fungemia in children with cancer were compared to 401 episodes of bacteremia and fungemia in adults with cancer to assess differences in etiology, risk factors and outcome. A retrospective univariate analysis was performed of all episodes of bacteremia in national pediatric and adult cancer institutions appearing in 1990-1996. A total of 519 episodes of bacteremia were assessed and compared. Both cancer centers differed in prophylactic antibiotic policies. About 50% of adults but less than 5% of children received quinolone prophylaxis during neutropenia, even though the empiric antibiotic therapeutic strategy was similar. There were differences in etiology between the groups: staphylococci and Stenotrophomonas maltophilia were more frequently observed in children (P<0.01), Pseudomonas aeruginosa and Acinetobacter spp. in adults (P<0.05). Gram-positive bacteremia was surprisingly more commonly observed in adults (65.7% vs 33.3%, P<0.01). Mixed polymicrobial bacteremia occurred more commonly in adults (31.8% vs 7.6%, P<0.001) than in children. Analysis of risk factors did not observe differences in risk factors except for underlying disease (acute leukemia was more frequently observed in children -48.3% vs adults 33.7%, P<0.05 and prophylaxis: (prior prophylaxis with quinolones was more common in adults (47.5%) than in children (2.5%) P<0.0001). Overall and attributable mortality in pediatric bacteremia was significantly lower than in adults (P<0.03).

Topics: Adult; Analysis of Variance; Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Antifungal Agents; Antineoplastic Agents; Bacteremia; Child; Colistin; Fluconazole; Fungemia; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Neoplasms; Neutropenia; Ofloxacin; Penicillin V; Penicillins; Retrospective Studies; Risk Factors; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Nasal tip abscesses in children are uncommon. We report on 7 children/teenagers who presented with an advanced nasal tip abscess that required intravenous antibiotics and surgical drainage, despite adequate pre-admission antibiotic therapy with amoxicillin/clavulanic acid or cephalosporins. Cultures were positive for Staphylococcus aureus, that was clindamycin-resistant but TMP/SMX sensitive.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Child; Drainage; Drug Resistance, Bacterial; Female; Gram-Positive Bacterial Infections; Humans; Male; Nose Diseases; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus pyogenes; Trimethoprim, Sulfamethoxazole Drug Combination

Finegoldia magna (formerly called Peptostreptococcus magnus) is a Gram-positive anaerobic coccus which is increasingly recognized as an opportunistic pathogen. We present a case of F. magna associated non-valvular cardiovascular device-related infection in an 83 year-old male who received a permanent pacemaker for sick sinus syndrome seven weeks prior to his presentation. Five weeks after the implantation, the pacemaker and leads were explanted because of clinical evidence of pacemaker pocket infection. He was initially treated with sulfamethoxazole-trimethoprim based on the Gram stain results from the removed pacemaker. However, two weeks later, he was readmitted with sepsis and was successfully treated with ampicillin-sulbactam. Culture results from the pacemaker and pocket as well as blood cultures grew F. magna. Clinicians should be aware of the possibility of F. magna infection when initial gram stain results show "gram positive cocci".

Topics: Aged, 80 and over; Ampicillin; Animals; Anti-Bacterial Agents; Firmicutes; Gram-Positive Bacterial Infections; Humans; Male; Pacemaker, Artificial; Prosthesis-Related Infections; Sulbactam; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Anti-Bacterial Agents; Drug Therapy, Combination; Eyelid Diseases; Gram-Positive Bacterial Infections; Humans; Immunocompetence; Male; Middle Aged; Rifampin; Skin Diseases, Bacterial; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Academic Medical Centers; Administration, Oral; Anti-Infective Agents, Urinary; Clinical Decision-Making; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Humans; Japan; Microbial Sensitivity Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

A 29-year-old man was admitted with fevers, cough, left-sided chest pain and lethargy for 1 week. He had a cardiac transplant 10 years prior and was on immunosuppressive drugs. He was found to have a pulmonary lesion and went on to develop a lung abscess. Propionibacterium acnes was identified on matrix-assisted laser desorption ionisation mass spectrometry-time of flight and 16s rRNA gene sequencing after drainage. He was curatively treated with co-trimoxazole and co-amoxiclav. He divulged a longstanding history of seborrhoeic dermatitis with frequent flares leading to large volumes of squames collecting on his bed sheets. We hypothesise this was a possible route of entry: inhalation of the Propionibacterium. This case highlights how a common commensal bacterium, P. acnes, was able to cause pathology in an immunosuppressed patient. This is the only case of a patient with transplantation developing a P. acnes pulmonary infection and the only case of P. acnes causing these clinical features to be reported in the literature.

Topics: Adult; Anti-Bacterial Agents; Diagnosis, Differential; Gram-Positive Bacterial Infections; Heart Transplantation; Humans; Immunocompromised Host; Lung Abscess; Male; Propionibacterium acnes; RNA, Ribosomal, 16S; RNA, Viral; Sequence Analysis, RNA; Trimethoprim, Sulfamethoxazole Drug Combination

Increase in resistance pattern of urinary tract pathogens to conventional antimicrobial agents used for urinary tract infections (UTIs) is gaining the attention of many microbiologists worldwide in respect to treatment of UTIs. The aim of the present study was to obtain data on resistance patterns of pathogens responsible for UTIs to currently used antimicrobial agents in Sher-I-Kashmir Institute of Medical Sciences (tertiary healthcare hospital).. A total of 2842 samples were collected from both outpatient and inpatient departments. The majority of samples in this study were midstream urine specimens, others included catheterized urine samples. Standard parameters were followed for isolation and identification of clinical isolates and further antimicrobial susceptibility test was done by Kirby Bauer disk diffusion method.. Out of 2842 samples, 1980 (67%) were culture positive. Escherichia coli (E coli) was the most prevalent isolate (OP 63%, IP 45.5%) followed by Klebsiella pneumonia (K pneumonia) as the second commonest UTI-causing agent (OP 15.9%, IP 21.7%). High percentage of isolates showed resistance to sulfa drugs such as cotrimoxazole. First generation cephalosporins were ineffective, while aminoglycosides and third generation cephalosporins were effective against E coli, K pneumoniae, Pseudomonas aeruginosa (P aeruginosa), Enterococcus faecalis and Staphyococcus aureus (Staph aureus). Furthermore, this study noticed that glycopeptide drugs such as vancomycin are highly effective against E faecalis and Staph aureus UTIs.. This study reveals the increased trend in resistance pattern of uropathogens in the valley region. These data may aid health professionals in choosing the appropriate treatment for patients with UTI in the region and hopefully will prevent the misuse of antibiotics.

Topics: Aminoglycosides; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Cephalosporins; Drug Resistance, Bacterial; Female; Gram-Positive Bacterial Infections; Humans; India; Male; Microbial Sensitivity Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections; Vancomycin

Actinobaculum schaalii was first described as a causative agent for human infection in 1997. Since then it has mainly been reported causing urinary tract infections (UTI) in elderly individuals with underlying urological diseases. Isolation and identification is challenging and often needs molecular techniques. A. schaalii is increasingly reported as a cause of infection in humans, however data in children is very limited.. We present the case of an 8-month-old Caucasian boy suffering from myelomeningocele and neurogenic bladder who presented with a UTI. An ultrasound of the urinary tract was unremarkable. Urinalysis and microscopy showed an elevated leukocyte esterase test, pyuria and a high number of bacteria. Empiric treatment with oral co-trimoxazole was started.Growth of small colonies of Gram-positive rods was observed after 48 h. Sequencing of the 16S rRNA gene confirmed an A. schaalii infection 9 days later. Treatment was changed to oral amoxicillin for 14 days. On follow-up urinalysis was normal and urine cultures were negative.. A.schaalii is an emerging pathogen in adults and children. Colonization and subsequent infection seem to be influenced by the age of the patient. In young children with high suspicion of UTI who use diapers or in children who have known abnormalities of their urogenital tract, infection with A. schaalii should be considered and empiric antimicrobial therapy chosen accordingly.

Topics: Actinomycetaceae; Amoxicillin; Anti-Bacterial Agents; Communicable Diseases, Emerging; DNA, Bacterial; DNA, Ribosomal; Gram-Positive Bacterial Infections; Humans; Infant; Male; Meningomyelocele; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Bladder, Neurogenic; Urinary Tract Infections; Urine; White People

Aerococcus urinae has been described as resistant to trimethoprim-sulfamethoxazole (SXT), but the test medium may affect this observation. Twenty-seven clinical isolates of A. urinae tested susceptible to SXT in cation-adjusted Mueller-Hinton broth (CAMHB) plus lysed horse blood and resistant in CAMHB plus lysed sheep blood.

Topics: Aerococcus; Animals; Anti-Bacterial Agents; Culture Media; Drug Combinations; Gram-Positive Bacterial Infections; Hemolysis; Horses; Humans; Microbial Sensitivity Tests; Sheep; Trimethoprim, Sulfamethoxazole Drug Combination

Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen in the debilitated host. S maltophilia is not an inherently virulent pathogen, but its ability to colonise respiratory-tract epithelial cells and surfaces of medical devices makes it a ready coloniser of hospitalised patients. S maltophilia can cause blood-stream infections and pneumonia with considerable morbidity in immunosuppressed patients. Management of infection is hampered by high-level intrinsic resistance to many antibiotic classes and the increasing occurrence of acquired resistance to the first-line drug co-trimoxazole. Prevention of acquisition and infection depends upon the application of modern infection-control practices, with emphasis on the control of antibiotic use and environmental reservoirs.

Topics: Communicable Diseases, Emerging; Drug Resistance, Multiple, Bacterial; Environmental Exposure; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Opportunistic Infections; Stenotrophomonas maltophilia; Trimethoprim, Sulfamethoxazole Drug Combination; Water Microbiology

To investigate the microbial etiology of suppurative chronic otitis media (SCOM) in patients with complete cleft lip and palate and isolated cleft palate and to determine the sensitivity of isolated microorganisms to antibiotics by drug diffusion from impregnated discs in agar and the minimum inhibitory concentration of each drug to these microorganisms by drug dilution in agar.. Effusion samples of SCOM obtained from 40 patients with cleft lip and palate registered at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, at Bauru, Brazil, were bacteriologically analyzed by cultures. The isolated bacteria were submitted to an in vitro susceptibility test to clinically used drugs.. Positive cultures were obtained in 100% of studied cases. Among the 57 strains observed, the most frequent were Pseudomonas aeruginosa (35%), Staphylococcus aureus (15.5%), Enterococcus faecalis (14%), and Proteus mirabilis (12%). The frequency of Gram-negative bacilli (enterobacteriaceae and nonfermentative bacilli) was 67%. Pseudomonas aeruginosa presented the highest sensitivity to ciprofloxacin, and enterobacteriaceae exhibited the highest sensitivity to gentamicin. The strains of S. aureus and E. faecalis presented the highest sensitivity to imipenem and sulfamethoxazole/trimethoprim, respectively.. Patients with cleft lip and palate presenting with SCOM exhibited 100% positive cultures, with the highest frequency of Pseudomonas and enterobacteriaceae. With regard to the action of antibiotics, imipenem was effective against the four species of isolated microorganisms, followed by ciprofloxacin, which was effective against 75% of isolated species.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Bacteria; Child; Child, Preschool; Chronic Disease; Ciprofloxacin; Cleft Lip; Cleft Palate; Drug Resistance, Bacterial; Enterococcus faecalis; Female; Gentamicins; Gram-Positive Bacterial Infections; Humans; Imipenem; Infant; Male; Middle Aged; Otitis Media, Suppurative; Proteus Infections; Proteus mirabilis; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Staphylococcus aureus; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Anaerobic organisms are a rare cause of spondylodiscitis. Eggerthella lenta is an organism that is not commonly associated with spondylodiscitis. We describe a case of spondylodiscitis due to Eggerthella lenta in an 82-year-old Chinese woman presenting with back pain. The organism was isolated from tissue cultures obtained via radiology-guided biopsy.

Topics: Actinobacteria; Aged, 80 and over; Anti-Bacterial Agents; Back Pain; Discitis; Drug Therapy, Combination; Female; Fractures, Compression; Gram-Positive Bacterial Infections; Humans; Lumbar Vertebrae; Metronidazole; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Administration, Oral; Aged; Enterococcus faecium; Female; Gram-Positive Bacterial Infections; Humans; Liver Abscess; Trimethoprim, Sulfamethoxazole Drug Combination

Aortic stent graft infection is rare and there are no reported cases of seeded peripheral mycotic aneurysms complicating this condition. We describe the case of a 54 year old man who developed a late stent graft infection at three years, resulting in the peripheral seeding of three mycotic aneurysms with two incidents of rupture. He was successfully treated with extra-anatomic bypass of the aorta and both surgical and endovascular repair of his peripherally seeded mycotic aneurysms.

Topics: Aneurysm, Infected; Aneurysm, Ruptured; Anti-Infective Agents; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis Implantation; Enterococcus faecalis; Follow-Up Studies; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Prosthesis-Related Infections; Radiography; Reoperation; Rupture, Spontaneous; Stents; Tibial Arteries; Time Factors; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Chronic Disease; Combined Modality Therapy; Enterococcus; Folic Acid; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Prostatectomy; Prostatitis; Trimethoprim, Sulfamethoxazole Drug Combination

In this investigation, the urine samples obtained in a single oral-dose pharmacokinetic study were examined for their bactericidal activity against a range of relevant urinary tract pathogens.. Six healthy volunteers received a single oral dose of ten oral antibiotics available in Croatia. Urine samples were taken every 2 h during the whole dosing interval of the particular antibiotic. The urinary bactericidal activity was tested by determination of urinary bactericidal titers.. All antibiotics showed a significant urinary bactericidal activity against non-extended spectrum beta-lactamase Escherichia coli and Proteus mirabilis. Fluoroquinolones displayed high and persisting levels of urinary bactericidal activity against all gram-negative bacteria and Staphylococcus saprophyticus.. Average urinary bactericidal activity can be predicted from in vitro susceptibility testing, but we expect that there will be patients with a low level of urinary bactericidal activity.

Topics: Acetamides; Administration, Oral; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; beta-Lactamases; Biomarkers; Cefadroxil; Ceftibuten; Cefuroxime; Cephalexin; Cephalosporins; Ciprofloxacin; Disk Diffusion Antimicrobial Tests; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Humans; Linezolid; Middle Aged; Norfloxacin; Oxazolidinones; Time Factors; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

We wanted to investigate the antimicrobial susceptibility of urinary tract pathogens in uncomplicated lower urinary tract infections in adult women in Norway.. Urine samples from 312 adult women with symptoms of uncomplicated urinary tract infections from eight general practices were included.. Significant bacteriuria was found in 187 samples (60%). E coli was isolated from 153 (82%) of these samples. Other isolated uropathogens were S saprophyticus 18 (10%), Proteus spp 6 (3%), Klebsiella spp 4 (2%), Enterobacter spp 2 (1%), enterococci 1 (0.5%) and other Gram-positive bacteria 3 (1,5%). No fungi were isolated. Of the E coli isolates, 1 %, 1 % and 9 % were resistant to nitrofurantoin, mecillinam and trimetoprim respectively. All S saprophyticus isolates were sensitive to nitrofurantoin and trimetoprim.. Antibiotic resistance of urinary tract pathogens causing uncomplicated urinary tract infections in adult women in general practice is still low in Norway.

Topics: Adult; Aged; Amdinocillin; Ampicillin; Ampicillin Resistance; Anti-Infective Agents, Urinary; Bacteriuria; Ciprofloxacin; Drug Resistance, Bacterial; Female; Gram-Positive Bacterial Infections; Humans; Middle Aged; Nitrofurantoin; Penicillins; Trimethoprim Resistance; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

Topics: Aged; Biofilms; Combined Modality Therapy; Enterococcus faecalis; Escherichia coli Infections; Gram-Positive Bacterial Infections; Humans; Kidney Calculi; Male; Microbial Sensitivity Tests; Nephrostomy, Percutaneous; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

Bacteremia may occur after disruption of the oral mucous membrane, particularly after dental treatment. 18 mentally handicapped patients who underwent dental treatment with general anesthesia were included in our study. None of the patients had general illnesses or received antibiotic protection. From each patient several blood samples were drawn aseptically during dental treatment and cultured. The majority of aerobic bacteria recovered belonged to Streptococcus sp and Gemella sp., anaerobic bacteria mainly belonged to Porphyromonas gingivalis and Peptostreptococcus sp. Resistance of the isolated bacteria to penicillin as well as to oxacillin, erythromycin and Co-trimoxazole was substantial. The highest resistance rate could be shown against fucidic acid.

Topics: Adolescent; Adult; Anesthesia, Dental; Anesthesia, General; Anti-Bacterial Agents; Bacteremia; Bacteroidaceae Infections; Dental Care; Drug Resistance, Microbial; Erythromycin; Fusidic Acid; Gram-Positive Bacterial Infections; Humans; Intellectual Disability; Oxacillin; Penicillin Resistance; Penicillins; Peptostreptococcus; Porphyromonas gingivalis; Streptococcal Infections; Streptococcus; Trimethoprim, Sulfamethoxazole Drug Combination

We studied fecal colonization with vancomycin-resistant enterococci (VRE) in 89 HIV-infected nonhospitalized patients ages 24 to 62 years, including 70 (79%) men (including 41 homosexual and 5 bisexual men) and 19 (21%) women. Of the 89 patients, 61 (69%) were black, 25 (28%) Hispanic, and 3 (3%) white; 53 (60%) had history of ongoing or recent antibacterial therapy with trimethoprim/sulfamethoxazole (29), clarithromycin (18), amoxicillin (7), ofloxacin (3), and metronidazole, doxycycline, dicloxacillin, and cephalexin (1 each). VRE were not isolated from any of the patients studied.

Topics: Adult; AIDS-Related Opportunistic Infections; Amoxicillin; Anti-Bacterial Agents; Bisexuality; Black People; Cephalexin; Cephalosporins; Clarithromycin; Dicloxacillin; Doxycycline; Drug Resistance, Microbial; Enterococcus; Feces; Female; Gram-Positive Bacterial Infections; Homosexuality, Male; Humans; Male; Metronidazole; Middle Aged; Ofloxacin; Penicillins; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin; White People

Topics: Adult; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteremia; Bone Marrow Transplantation; Drug Resistance, Microbial; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Pneumonia, Pneumocystis; Trimethoprim, Sulfamethoxazole Drug Combination