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Microbial Pathogenesis Nov 2023Gram-negative bacteria are infectious and life-threatening agents after hematopoietic stem cell transplantation (HSCT). So, this study aimed to investigate the... (Review)
Review
Gram-negative bacteria are infectious and life-threatening agents after hematopoietic stem cell transplantation (HSCT). So, this study aimed to investigate the prevalence of Pseudomonas aeruginosa and its antibiotic resistance in patients who have received Hematopoietic Stem-Cell Transplantation through a systematic review. The systematic search was done with key words; Pseudomonas aeruginosa, hematopoietic stem cell transplantation from 2000 to the end of July 2023 in Google Scholar and PubMed/Medline, Scopus, and Web of Science. Twelve studies were able to include our study. Quality assessment of studies was done by Appraisal tool for Cross-Sectional Studies. The most of the included studies were conducted as allo-HSCT. Infections such as respiratory infection, urinary infection and bacteremia have occurred. The rate of prevalence with P. aeruginosa has varied between 3 and 100%. The average age of the participants was between 1 and 74 years. The rate of prevalence of P. aeruginosa resistant to several drugs has been reported to be variable, ranging from 20 to 100%. The highest antibiotic resistance was reported against cefotetan (100%), and the lowest was related to tobramycin (1.8%) followed by amikacin, levofloxacin and ciprofloxacin with the prevalence of 16.6%. Our findings showed a high prevalence and antibiotic resistance rate of P. aeruginosa in Hematopoietic stem cell transplantation. Therefore, more serious health measures should be taken in patients after transplantation.
Topics: Humans; Anti-Bacterial Agents; Cross-Sectional Studies; Drug Resistance, Multiple, Bacterial; Hematopoietic Stem Cell Transplantation; Prevalence; Pseudomonas aeruginosa; Pseudomonas Infections
PubMed: 37769854
DOI: 10.1016/j.micpath.2023.106368 -
Journal of Chemotherapy (Florence,... Oct 2019can cause serious infections in immunocompromised patients. The aim of this systematic review was to establish what invasive infections in humans are caused by and to...
can cause serious infections in immunocompromised patients. The aim of this systematic review was to establish what invasive infections in humans are caused by and to evaluate the optimal choice of antibiotics for their treatment. MEDLINE, EBSCO, SCOPUS, SCINDEKS and GOOGLE SCHOLAR were systematically searched for clinical trials, observational studies, case reports or case series describing invasive infections with in patients of any age. may cause invasive infections of various tissues in hospitalized patients. In the great majority of cases it was susceptible to co-trimoxazole, levofloxacin and ceftazidime. In about three fourths of the cases, the treatment was successful, while less than 20% of the patients died. is increasingly associated with serious invasive infections in hospitalized patients and due to growing trend of resistance to almost all antibiotics requires a careful approach to patients who is harboring this bacterium.
Topics: Anti-Bacterial Agents; Gram-Negative Bacterial Infections; Humans; Immunocompromised Host; Stenotrophomonas maltophilia
PubMed: 31130079
DOI: 10.1080/1120009X.2019.1620405 -
Hematology (Amsterdam, Netherlands) Dec 2019The incidence of febrile neutropenia (FN) in acute leukemia patients following induction or consolidation chemotherapy is high. Several clinical practice guidelines... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The incidence of febrile neutropenia (FN) in acute leukemia patients following induction or consolidation chemotherapy is high. Several clinical practice guidelines recommend the use of a fluoroquinolone prophylaxis to prevent bacterial infection in patients being prone to prolonged profound neutropenia.
METHODS
This systematic review and meta-analysis aimed to investigate the efficacy and complications of levofloxacin as a prophylaxis for FN patients following chemotherapy for acute leukemia. Two databases from MEDLINE and EMBASE were searched for published studies indexed before 10 July 2018.
RESULTS
A total of 862 acute leukemia patients were included, with 356 in the levofloxacin prophylaxis arm and 506 in the no-prophylaxis arm. Patients receiving levofloxacin had a significantly lower FN rate than patients who did not receive the antibiotic prophylaxis (odds ratio [OR]: 0.43, 95% confidence interval [CI]: 0.32-0.58, p < .00001, I = 0%). The rate of microbiologically documented infection in the no-prophylaxis group was higher than that for the levofloxacin prophylaxis group (OR: 0.45, 95% CI: 0.34-0.60, p < .00001, I = 0%). The bacteremia rate in the levofloxacin prophylaxis group was significantly lower than that for the no-prophylaxis group (OR: 0.45, 95% CI: 0.31-0.66, p < .00001, I = 0%). However, the mortality rates of the two groups were quite similar between the two groups (OR: 0.67, 95% CI: 0.34-1.33, p = .26, I = 0%).
CONCLUSIONS
Although the levofloxacin prophylaxis for the acute leukemia patients receiving intensive chemotherapy showed advantages for infectious complications, it did not affect mortality.
Topics: Acute Disease; Bacteremia; Febrile Neutropenia; Female; Humans; Leukemia; Levofloxacin; Male
PubMed: 30880638
DOI: 10.1080/16078454.2019.1589706 -
Cardiology in Review Apr 2024Fluoroquinolones (FQs) are routinely administered antibiotics that have demonstrated an increased propensity to cause major adverse cardiovascular events (MACE). We...
Fluoroquinolones (FQs) are routinely administered antibiotics that have demonstrated an increased propensity to cause major adverse cardiovascular events (MACE). We conducted a systematic review aimed to investigate the association between FQ usage and the risk of MACE. A comprehensive literature search was conducted using PubMed, Scopus, and the Cochrane Library from inception to September 2023 to retrieve studies comparing FQ administration with placebo and reporting the occurrence of MACE. Relevant studies that explored the occurrence of MACE, defined as "acute myocardial infarction, stroke, cardiovascular mortality, arrhythmia, or heart failure" with FQ usage were eligible for inclusion. Four studies with a total of 42,808 patients were included. Levofloxacin, moxifloxacin, and gatifloxacin were observed to have an increased propensity to cause MACE, particularly arrhythmias, whereas ciprofloxacin was associated with the lowest risk of causing MACE. Despite the methodological diversity in the included studies, this systematic review uncovered a consistent trend of heightened likelihood of MACE with FQ administration across studies, suggesting that elevated serum concentrations of some FQs may correlate with higher risks of MACE development. This systematic review emphasizes the need for cautious administration of FQs, particularly in patients with a preexisting cardiovascular condition. Routine cardiac monitoring using electrocardiograms is warranted for patients on high doses of FQs to preemptively detect the development of MACE, particularly arrhythmias.
PubMed: 38687013
DOI: 10.1097/CRD.0000000000000710 -
Frontiers in Pharmacology 2020To study the prescribing pattern of antibiotics in outpatients and emergency departments in the Gulf region. To compare the appropriateness of prescriptions and...
To study the prescribing pattern of antibiotics in outpatients and emergency departments in the Gulf region. To compare the appropriateness of prescriptions and antibiotics commonly prescribed for respiratory tract infection. The search was limited to the years 2008-2020, and articles had to be in English. Articles were searched from various resources and evaluated using PRISMA. Forty-one articles were selected and screened, and in the end, 17 articles were included in the study. All articles were selected from the gulf region of six countries: UAE, Saudi Arabia, Qatar, Oman, Yemen, and Bahrain. Only primary literature were included. Inpatient and literature from other countries outside the gulf region were excluded. Penicillins, cephalosporins, and macrolides are highly useful antibiotics for respiratory tract infections. Ceftriaxone IV is recommended in acute respiratory tract infection if therapy with penicillin fails. Most of the antibiotic prescriptions in Gulf countries are inappropriate. Inappropriate antibiotic prescribing in the gulf region varies from place to place and reaches a maximum of 80%. Antibiotics may be prescribed with the wrong dosage or frequency and inappropriate guidelines. Penicillins are prescribed at about 50-60%; the most common penicillins prescribed are amoxicillin and co-amoxiclave. Cephalosporins are prescribed at about 30%, and the most common are third-generation. Macrolides are prescribed at about 17-20%, and the most common macrolides are azithromycin and clarithromycin. Fluoroquinolones are prescribed at about 10-12%, of which levofloxacin and ciprofloxacin are more commonly prescribed with metronidazole at 10%. It is suggested that the antibiotic-prescribing pattern in outpatient and emergency departments in the Gulf region are highly inappropriate and need improvement through education, following guidelines, annual vaccination, and stewardship programs; the most prescribed antibiotic is amoxicillin/co-amoxiclave, and the most often encountered infection in outpatients is acute respiratory tract infection.
PubMed: 33424594
DOI: 10.3389/fphar.2020.585051 -
Emergency Medicine International 2023[This retracts the article DOI: 10.1155/2022/8788365.].
Retracted: Clinical Efficacy and Safety Analysis of Levofloxacin for the Prevention of Infection after Traumatic Osteoarthrosis and Internal Fixation: Systematic Review and Meta-Analysis.
[This retracts the article DOI: 10.1155/2022/8788365.].
PubMed: 38077108
DOI: 10.1155/2023/9864247 -
The Journal of Spinal Cord Medicine Jul 2023Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that. (Meta-Analysis)
Meta-Analysis
Epidemiology of pathogens and antimicrobial resistance of nosocomial urinary tract infections in patients with spinal cord injuries in China: A systematic review and meta-analysis.
CONTEXT
Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that.
OBJECTIVE
The purpose of our article was to characterize the distribution of pathogens of UTI patients with spinal cord injuries (SCI) and the resistance profile of pathogens.
METHODS
A literature search of six electronic databases was carried out to identify the incidence, pathogen distribution, and drug resistance of UTI after SCI based on our inclusion and exclusion criteria. Meta-analysis was carried out using R 4.0.2 software; a subgroup analysis was performed by the year 2012.
RESULTS
We screened 1110 eligible studies, 33 were included in our final review. A total of 7271 bacterial species were included in our studies; 6092 were gram-negative (81.13% [76.83-85.11]) and 1003 were gram-positive (14.89% [11.70-18.38]). Before 2012, (45.43%) was the predominant isolated pathogen, followed by Klebsiella (7.49%) and Enterococcus (6.01%). After 2012, (50.23%) was the main pathogen, followed by Klebsiella (12.47%) and Proteus (6.88%). was more likely to be resistant to Levofloxacin, Amikacin, sulfonamides, 4th-generation cephalosporins and Nitrofurantoin before 2012 (81.8% vs. 62.9%, 32.0% vs. 7.6%, 81.3% vs. 61.6%, 81.8% vs. 24.1%, 33.5% vs. 5.1%), whereas was more frequently resistant to Inhibitor-resistant β-lactamas after 2012 (56.3% vs. 34.0%). was more likely to be resistant to Aztreonam, Amikacin before 2012 (80.0% vs. 39.8%, 48.1% vs. 19.0%). presented a high resistance to Levofloxacin, Inhibitor-resistant β-lactamas after 2012 (61.8% vs. 35.6%, 59.1% vs. 5.7%).
CONCLUSIONS
UTI in patients with SCI in China were mainly caused by gram-negative bacteria. We observed a remarkable modification in resistance profiles of pathogen distribution before 2012 and after 2012, which suggests reasonable control of the use of antibiotics has a positive effectiveness on resistance profiles.
Topics: Humans; Anti-Bacterial Agents; Amikacin; Levofloxacin; Cross Infection; Escherichia coli; Drug Resistance, Bacterial; Spinal Cord Injuries; Urinary Tract Infections
PubMed: 36622339
DOI: 10.1080/10790268.2022.2129154 -
Gastroenterology Research Dec 2020(HP) is the most common cause of gastritis worldwide. Clarithromycin-based triple therapy or bismuth-based quadruple therapy is usually considered the first-line...
BACKGROUND
(HP) is the most common cause of gastritis worldwide. Clarithromycin-based triple therapy or bismuth-based quadruple therapy is usually considered the first-line treatment, however with around 30% failure rate for both regimens. Drug resistance of clarithromycin and metronidazole is a growing concern in some parts of the world. Therefore, there is a need for effective eradication regimen for HP. Nitazoxanide, a bactericidal thiazolide antibiotic, has been shown to be effective in HP infection. We conducted a systematic review and meta-analysis to evaluate the efficacy of nitazoxanide-based regimen for the eradication of HP.
METHODS
We have searched PubMed, Embase, Ovid Medline and Cochrane library database from inception to December 9, 2020 to identify studies that utilized nitazoxanide in the treatment regimen for HP eradication. Our primary outcome was pooled eradication rate of HP.
RESULTS
Thirteen studies including 1,028 patients met our inclusion criteria and were analyzed in a meta-analysis. HP eradication was successful in 867 patients with a pooled eradication rate of 86% (95% confidence interval (CI): 79-90%) with 84% heterogeneity. A subgroup analysis that included 230 patients who failed other prior eradication regimens revealed a pooled eradication rate of 85% (95% CI: 69-94%) without heterogeneity. In a subgroup analysis, highest eradication rates were achieved with levofloxacin, doxycycline, nitazoxanide and proton pump inhibitor with a pooled eradication rate of 92% (88-95%).
CONCLUSION
Nitazoxanide-based regimen is safe and effective in the eradication of HP infection. It is also successful as a salvage therapy in patients who have failed prior treatments.
PubMed: 33447305
DOI: 10.14740/gr1342 -
Thorax Oct 2021The main aim of this network meta-analysis is to identify the empiric antibiotic (Em-ATB) with the highest probability of being the best (HPBB) in terms of (1) cure rate... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The main aim of this network meta-analysis is to identify the empiric antibiotic (Em-ATB) with the highest probability of being the best (HPBB) in terms of (1) cure rate and (2) mortality rate in hospitalised patients with community acquired pneumonia (CAP) .
METHOD
Inclusion criteria: (1) adult patients (>16 years old) diagnosed with CAP that required hospitalisation; (2) randomised to at least two different Em-ATBs, (3) that report cure rate and (4) are written in English or Spanish.
EXCLUSION CRITERIA
(1) ambiguous antibiotics protocol and (2) published exclusively in abstract or letter format.
DATA SOURCES
Medline, Embase, Cochrane and citation reviews from 1 January 2000 to 31 December 2018. Risk of bias: Cochrane's tool. Quality of the systematic review (SR): A MeaSurement Tool to Assess systematic Reviews-2. Certainity of the evidence: Grading of Recommendations Assessment, Development and Evaluation.
STATISTICAL ANALYSES
frequentist method performed with the 'netmeta' library, R package.
RESULTS
27 randomised controlled trials (RCTs) from the initial 41 307 screened citations were included. Regarding the risk of bias, more than one quarter of the studies presented low risk and no study presented high risk in all domains. The SR quality is moderate. two networks were constructed. Thus, two Em-ATBs have the HPBB: cetaroline 600 mg (two times a day) and piperacillin 2000 mg (two times a day). three networks were constructed. Thus, three Em-ATBs have the HPBB: ceftriaxone 2000 mg (once a day) plus levofloxacin 500 (two times a day), ertapenem 1000 mg (two times a day) and amikacin 250 mg (two times a day) plus clarithromycin 500 mg (two times a day). The certainity of evidence for each results is moderate.
CONCLUSION
For cure rate, ceftaroline and piperaciline are the options with the HPBB. However, for mortality rate, the options are ceftriaxone plus levofloxacin, ertapenem and amikacin plus clarithromycin. It seems necessary to conduct an RCT that compares treatments with the HPBB for each event (cure or mortality) (CRD42017060692).
Topics: Adolescent; Adult; Anti-Bacterial Agents; Community-Acquired Infections; Humans; Network Meta-Analysis; Pneumonia
PubMed: 33723019
DOI: 10.1136/thoraxjnl-2019-214054 -
Helicobacter 2024Helicobacter pylori antibiotic resistance has undergone vast changes in the last two decades. No systematic review has been done on the prevalence of antibiotic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Helicobacter pylori antibiotic resistance has undergone vast changes in the last two decades. No systematic review has been done on the prevalence of antibiotic resistant H. pylori in India in the last two decades. We evaluated the pattern of resistance rates across various regions of India.
MATERIALS AND METHODS
A systematic review of the geographical variations in antibiotic resistance pattern of H. pylori was conducted using PubMed, Google Scholar, Web of Science, Science Direct, etc. for articles published between January 1, 2000 and May 30, 2023. Random effects-model-based Cochran's Q test, I statistics, and chi-squared tests were used to measure heterogeneity.
RESULTS
The overall resistance was highest against metronidazole (77.65%) followed by amoxicillin (37.78%), levofloxacin (32.8%), clarithromycin (35.64%), furazolidone (12.03%), and tetracycline (11.63%). 14.7% of the H. pylori isolates were multi-drug resistant. Under meta-analysis of each antibiotic, high heterogeneity levels were observed having I ranges from 86.53% to 97.70% at p < 0.0001. In sub-group analysis, Metronidazole has a stable rate of resistance as compared to other antibiotics. Other antibiotics have had a downtrend in the last 5 years except for levofloxacin, which has had an uptrend in the resistance rate for the past 5 years. Hence, one should avoid using metronidazole for any kind of first-line treatment.
CONCLUSIONS
Metronidazole resistance is high in most regions of India except Assam and Mumbai while clarithromycin is found to be ineffective in South India, Gujarat, and Kashmir. As compared to other antibiotics, resistance to amoxicillin is generally low except in certain regions (Hyderabad, Chennai, and the Gangetic belt of North India). Tetracycline and Furazolidone have the least resistance rates and should be part of anti- H. pylori regimens. The resurgence of high single and multidrug resistance to the commonly used drugs suggests the need for newer antibiotics and regular resistance surveillance studies.
Topics: Humans; Metronidazole; Clarithromycin; Helicobacter pylori; Levofloxacin; Furazolidone; India; Helicobacter Infections; Anti-Bacterial Agents; Amoxicillin; Tetracycline; Antibodies; Drug Resistance, Microbial
PubMed: 38415810
DOI: 10.1111/hel.13057