BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,c...BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,creating a new burden on medical care in hospitals,particularly for patients admitted to the intensive care unit(ICU).AIM To describe risk factors for ventilator-acquired pneumonia(VAP)in patients with cancer and to evaluate the impact of MDRB.METHODS A retrospective study was performed from January 2016 to December 2018 at a cancer referral center in Mexico City,which included all patients who were admitted to the ICU and required MV≥48 h.They were classified as those who developed VAP versus those who did not;pathogens isolated,including MDRB.Clinical evolution at 60-d was assessed.Descriptive analysis was carried out;comparison was performed between VAP vs non-VAP and MDRB vs non-MDRB.RESULTS Two hundred sixty-three patients were included in the study;mean age was 51.9 years;52.1%were male;68.4%had solid tumors.There were 32 episodes of VAP with a rate of 12.2%;11.5 episodes/1000 ventilation-days.The most frequent bacteria isolated were the following:Klebsiella spp.[n=9,four were Extended-Spectrum Beta-Lactamase(ESBL)producers,one was Carbapenem-resistant(CR)];Escherichia coli(n=5,one was ESBL),and Pseudomonas aeruginosa(n=8,two were CR).One Methicillin-susceptible Staphylococcus aureus was identified.In multivariate analysis,the sole risk factor associated for VAP was length of ICU stay(OR=1.1;95%CI:1.03-1.17;P=0.003).Sixty-day mortality was 53%in VAP and 43%without VAP(P=0.342).There was not higher mortality in those patients with MDRB.CONCLUSION This study highlights the high percentage of Gram-negative bacteria,which allows the initiation of empiric antibiotic coverage for these pathogens.In this retrospective,single center,observational study,MDRB VAP was not directly linked to increased mortality at 60 days.展开更多
To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODSA literature search was performed on...To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODSA literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15<sup>th</sup> of November 2016, using the following search strategy: “spontaneous” AND “peritonitis”. RESULTSThe initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies. CONCLUSIONN-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity.展开更多
Pneumonia is the single largest infectious cause of death in children worldwide and also a form of an acute respiratory infection that affects the lung. The purpose of the study was to develop a new approach to treat ...Pneumonia is the single largest infectious cause of death in children worldwide and also a form of an acute respiratory infection that affects the lung. The purpose of the study was to develop a new approach to treat antibiotic-resistant <i>K. pneumoniae</i> infection. This study aimed in quest of a drug to combine with ciprofloxacin, a broad spectrum antibiotic frequently used to treat lung infections. Methodology: A total of 23 lung infection bacterial samples were collected and studied against 14 antibiotics of different classes. The disk diffusion method was performed to determine synergy screening, MIC value, and qualitative toxicity analysis of ciprofloxacin and chloramphenicol combination. Results: After primary screening of antibiotic susceptibility, they were categorized into multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan drug-resistant (PDR) pathogens where 9 isolates were MDR, 5 were XDR and 3 isolates were PDR. Furthermore, they were trialed in combination ciprofloxacin along with other 7 drugs in disk diffusion to explore the synergistic effect. The combination of ciprofloxacin and moxifloxacin, ciprofloxacin and chloramphenicol were found to be synergic. Then the MIC test was done for the combination ciprofloxacin and chloramphenicol. When the MIC result was generated, the MIC of the respective combination was analyzed. Furthermore, the fractional inhibitory concentration (FIC) was calculated and in accordance with the results of the FIC index, ciprofloxacin-chloramphenicol combination has shown value 0.4510 which revealed a synergistic effect against multi-drug resistant <i>Klebsiella pneumoniae</i>. Conclusion: Given these points, if the efficiency of this antibiotic can be accelerated from combination with other drugs, it might be lifesaving and cost effective as well.展开更多
Objective： To evaluate the in vitro antibacterial properties and the ability to potentiate some common antibiotics effects of the methanol extracts of 11 Cameroonian food plants on 29 Gram-negative bacteria expressin...Objective： To evaluate the in vitro antibacterial properties and the ability to potentiate some common antibiotics effects of the methanol extracts of 11 Cameroonian food plants on 29 Gram-negative bacteria expressing multidrug resistant （MDR） phenotypes. Methods： The antimicrobial activity of the extracts was performed using the broth microdilution method. The phytochemical screening of these extracts was also performed using standard methods. Resalts： Ocimum basilicum, Gnetum africanum and Eucalyptus robusta extracts possessed an antibacterial activity against all the 29 studied bacteria. The extracts from G. africanum and E. robusta were the most active with the lowest minimal inhibitory concentration of 64 p, g/mL on Escherichia coil AG100A for both extracts and also against Klebsiella pneumoniae K24 for G. africanum. When tested in the presence of phenylalanine-arginine 13 -Naphtylamide （PA 13 N）, an efflux pump inhibitor, the extract of Thymus vulgafis and E. Robusta showed the best activities on most tested strains. E. Robusta extract showed good synergistic effects, improving the activity of commonly used antibiotics in about 85% of cases. Coaclasion： The overall results obtained provide the baseline information for the use of the tested plants in the treatment of bacterial infections.展开更多
文摘BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,creating a new burden on medical care in hospitals,particularly for patients admitted to the intensive care unit(ICU).AIM To describe risk factors for ventilator-acquired pneumonia(VAP)in patients with cancer and to evaluate the impact of MDRB.METHODS A retrospective study was performed from January 2016 to December 2018 at a cancer referral center in Mexico City,which included all patients who were admitted to the ICU and required MV≥48 h.They were classified as those who developed VAP versus those who did not;pathogens isolated,including MDRB.Clinical evolution at 60-d was assessed.Descriptive analysis was carried out;comparison was performed between VAP vs non-VAP and MDRB vs non-MDRB.RESULTS Two hundred sixty-three patients were included in the study;mean age was 51.9 years;52.1%were male;68.4%had solid tumors.There were 32 episodes of VAP with a rate of 12.2%;11.5 episodes/1000 ventilation-days.The most frequent bacteria isolated were the following:Klebsiella spp.[n=9,four were Extended-Spectrum Beta-Lactamase(ESBL)producers,one was Carbapenem-resistant(CR)];Escherichia coli(n=5,one was ESBL),and Pseudomonas aeruginosa(n=8,two were CR).One Methicillin-susceptible Staphylococcus aureus was identified.In multivariate analysis,the sole risk factor associated for VAP was length of ICU stay(OR=1.1;95%CI:1.03-1.17;P=0.003).Sixty-day mortality was 53%in VAP and 43%without VAP(P=0.342).There was not higher mortality in those patients with MDRB.CONCLUSION This study highlights the high percentage of Gram-negative bacteria,which allows the initiation of empiric antibiotic coverage for these pathogens.In this retrospective,single center,observational study,MDRB VAP was not directly linked to increased mortality at 60 days.
文摘To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODSA literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15<sup>th</sup> of November 2016, using the following search strategy: “spontaneous” AND “peritonitis”. RESULTSThe initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies. CONCLUSIONN-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity.
文摘Pneumonia is the single largest infectious cause of death in children worldwide and also a form of an acute respiratory infection that affects the lung. The purpose of the study was to develop a new approach to treat antibiotic-resistant <i>K. pneumoniae</i> infection. This study aimed in quest of a drug to combine with ciprofloxacin, a broad spectrum antibiotic frequently used to treat lung infections. Methodology: A total of 23 lung infection bacterial samples were collected and studied against 14 antibiotics of different classes. The disk diffusion method was performed to determine synergy screening, MIC value, and qualitative toxicity analysis of ciprofloxacin and chloramphenicol combination. Results: After primary screening of antibiotic susceptibility, they were categorized into multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan drug-resistant (PDR) pathogens where 9 isolates were MDR, 5 were XDR and 3 isolates were PDR. Furthermore, they were trialed in combination ciprofloxacin along with other 7 drugs in disk diffusion to explore the synergistic effect. The combination of ciprofloxacin and moxifloxacin, ciprofloxacin and chloramphenicol were found to be synergic. Then the MIC test was done for the combination ciprofloxacin and chloramphenicol. When the MIC result was generated, the MIC of the respective combination was analyzed. Furthermore, the fractional inhibitory concentration (FIC) was calculated and in accordance with the results of the FIC index, ciprofloxacin-chloramphenicol combination has shown value 0.4510 which revealed a synergistic effect against multi-drug resistant <i>Klebsiella pneumoniae</i>. Conclusion: Given these points, if the efficiency of this antibiotic can be accelerated from combination with other drugs, it might be lifesaving and cost effective as well.
文摘Objective： To evaluate the in vitro antibacterial properties and the ability to potentiate some common antibiotics effects of the methanol extracts of 11 Cameroonian food plants on 29 Gram-negative bacteria expressing multidrug resistant （MDR） phenotypes. Methods： The antimicrobial activity of the extracts was performed using the broth microdilution method. The phytochemical screening of these extracts was also performed using standard methods. Resalts： Ocimum basilicum, Gnetum africanum and Eucalyptus robusta extracts possessed an antibacterial activity against all the 29 studied bacteria. The extracts from G. africanum and E. robusta were the most active with the lowest minimal inhibitory concentration of 64 p, g/mL on Escherichia coil AG100A for both extracts and also against Klebsiella pneumoniae K24 for G. africanum. When tested in the presence of phenylalanine-arginine 13 -Naphtylamide （PA 13 N）, an efflux pump inhibitor, the extract of Thymus vulgafis and E. Robusta showed the best activities on most tested strains. E. Robusta extract showed good synergistic effects, improving the activity of commonly used antibiotics in about 85% of cases. Coaclasion： The overall results obtained provide the baseline information for the use of the tested plants in the treatment of bacterial infections.
