Background Infants in the first 90 days of life are more prone to develop serious bacterial infections(SBIs).Multi-drug-resistant organisms(MDROs)are emerging as important pathogens causing SBIs.We reviewed the epidem...Background Infants in the first 90 days of life are more prone to develop serious bacterial infections(SBIs).Multi-drug-resistant organisms(MDROs)are emerging as important pathogens causing SBIs.We reviewed the epidemiology of SBIs in infants 0-90 days old and compared the clinical features,laboratory values and final outcome for SBIs due to MDROs vs.non-MDROs.Methods Episodes of culture-proven SBIs(bacteremia,urinary tract infections,or meningitis)with age at onset of 0-90 days during a 7-year period were retrospectively reviewed.Health care-associated infections were excluded.We collected demo-graphics,clinical features,and laboratory and microbiology data.We compared clinical characteristics,laboratory data,microbiologic results and final outcome for SBIs due to MDROs vs.non-MDROs.Results Ninety-four episodes(88 patients)including bacteremia(42.6%),urinary tract infections(54.3%)and meningi-tis(3.1%)were caused by Gram-negative bacteria(67%),and Gram-positive bacteria(33%).Escherichia coli,Klebsiella pneumoniae and GBS were the most common causes.MDROs caused SBIs in 39 patients(44.3%).SBIs due to MDROs were associated with more delay in providing targeted antimicrobial therapy compared to non-MDROs(74.4%vs.0%,P≤0.001,but no difference in case-fatality rate(12.8%vs.12.2%,P=1.0).Clinical features or basic laboratory values were not statistically different between the two groups.Conclusions The bacteriology of SBIs in the first 90 days of life is changing to include more MDROs,which causes more delay in providing targeted antimicrobial therapy.Awareness of the local epidemiology is crucial to ensure appropriate antibiotics are provided in a timely manner.展开更多
Several related substances were detected at trace level in (2R)-2,3-dihydro-2-methyl-6-nitro-2-[[4-[4-[4-(trifluoromethoxy)phenoxy]-1-piperidinyl] phenoxy] methyl]imidazo[2, 1-b]oxazole drug substance by a newly devel...Several related substances were detected at trace level in (2R)-2,3-dihydro-2-methyl-6-nitro-2-[[4-[4-[4-(trifluoromethoxy)phenoxy]-1-piperidinyl] phenoxy] methyl]imidazo[2, 1-b]oxazole drug substance by a newly developed high-performance liquid chromatography method. All related substances were characterized rapidly but some impurities were found to be intermediates. Proposed structures were further confirmed by characterization using NMR, FT-IR, and HRMS techniques. Based on the spectroscopic data;unknown related sub-stances were characterized as 1-(Methylsulfonyl)-4-[4-(trifluoromethoxy) phenoxy]piperidine;4-{4-[4-(Tri-fluoromethoxy)-phenoxy]piperidin-1-yl}phenol and 4-{4-[4-(trifluoromethoxy)phenoxy]piperidin-1-yl}phenyl methane sulfonate;4-Bromophenyl methane sulfonate, Ethyl 3,6-dihydro-1(2H)-pyridine carboxylate, (2S)-3-(4-Bromophenoxy)-2-hydroxy-2-methylpropyl methane sulfonate, (2S)-3-(4-Bromophenoxy)-2-methylpropane-1,2-diyldimethane-sulfonate, (2S)-2-Methyl-3-(4-{4-[4-(trifluoromethoxy) phenoxy]-piperidin-1-yl} phenoxy)-propane-1,2-diyldimethane sulfonate, (S)-3-(4-Bromophenoxy)-2-methyl-propane-1,2-diol and corresponding Enantiomer, (2R)-2-[(4-Bromo-phenoxy)methyl]-2-methyloxirane and (2R)-2-[(4-bromophenoxy)methyl]-2-methyl-6-nitro-2,3-dihydroimidazo[2,1-b][1,3]oxazole. A possible mechanism for the formation of these related substances is also proposed.展开更多
文摘Background Infants in the first 90 days of life are more prone to develop serious bacterial infections(SBIs).Multi-drug-resistant organisms(MDROs)are emerging as important pathogens causing SBIs.We reviewed the epidemiology of SBIs in infants 0-90 days old and compared the clinical features,laboratory values and final outcome for SBIs due to MDROs vs.non-MDROs.Methods Episodes of culture-proven SBIs(bacteremia,urinary tract infections,or meningitis)with age at onset of 0-90 days during a 7-year period were retrospectively reviewed.Health care-associated infections were excluded.We collected demo-graphics,clinical features,and laboratory and microbiology data.We compared clinical characteristics,laboratory data,microbiologic results and final outcome for SBIs due to MDROs vs.non-MDROs.Results Ninety-four episodes(88 patients)including bacteremia(42.6%),urinary tract infections(54.3%)and meningi-tis(3.1%)were caused by Gram-negative bacteria(67%),and Gram-positive bacteria(33%).Escherichia coli,Klebsiella pneumoniae and GBS were the most common causes.MDROs caused SBIs in 39 patients(44.3%).SBIs due to MDROs were associated with more delay in providing targeted antimicrobial therapy compared to non-MDROs(74.4%vs.0%,P≤0.001,but no difference in case-fatality rate(12.8%vs.12.2%,P=1.0).Clinical features or basic laboratory values were not statistically different between the two groups.Conclusions The bacteriology of SBIs in the first 90 days of life is changing to include more MDROs,which causes more delay in providing targeted antimicrobial therapy.Awareness of the local epidemiology is crucial to ensure appropriate antibiotics are provided in a timely manner.
文摘Several related substances were detected at trace level in (2R)-2,3-dihydro-2-methyl-6-nitro-2-[[4-[4-[4-(trifluoromethoxy)phenoxy]-1-piperidinyl] phenoxy] methyl]imidazo[2, 1-b]oxazole drug substance by a newly developed high-performance liquid chromatography method. All related substances were characterized rapidly but some impurities were found to be intermediates. Proposed structures were further confirmed by characterization using NMR, FT-IR, and HRMS techniques. Based on the spectroscopic data;unknown related sub-stances were characterized as 1-(Methylsulfonyl)-4-[4-(trifluoromethoxy) phenoxy]piperidine;4-{4-[4-(Tri-fluoromethoxy)-phenoxy]piperidin-1-yl}phenol and 4-{4-[4-(trifluoromethoxy)phenoxy]piperidin-1-yl}phenyl methane sulfonate;4-Bromophenyl methane sulfonate, Ethyl 3,6-dihydro-1(2H)-pyridine carboxylate, (2S)-3-(4-Bromophenoxy)-2-hydroxy-2-methylpropyl methane sulfonate, (2S)-3-(4-Bromophenoxy)-2-methylpropane-1,2-diyldimethane-sulfonate, (2S)-2-Methyl-3-(4-{4-[4-(trifluoromethoxy) phenoxy]-piperidin-1-yl} phenoxy)-propane-1,2-diyldimethane sulfonate, (S)-3-(4-Bromophenoxy)-2-methyl-propane-1,2-diol and corresponding Enantiomer, (2R)-2-[(4-Bromo-phenoxy)methyl]-2-methyloxirane and (2R)-2-[(4-bromophenoxy)methyl]-2-methyl-6-nitro-2,3-dihydroimidazo[2,1-b][1,3]oxazole. A possible mechanism for the formation of these related substances is also proposed.
