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Journal of Infection and Chemotherapy :... May 2024Legionella pneumonia is one of the major causes of severe pneumonia, in which treatment delay might lead to a poor prognosis. Therefore, as far as possible, early...
Legionella pneumonia is one of the major causes of severe pneumonia, in which treatment delay might lead to a poor prognosis. Therefore, as far as possible, early diagnosis and treatment of Legionella pneumonia is essential. Regarding the antimicrobials for Legionella pneumonia, fluoroquinolones, such as levofloxacin, or macrolides, such as azithromycin (AZM), are recommended in Japan and other countries. Lascufloxacin (LSFX), the newest fluoroquinolone developed in Japan, has been in use in daily clinical practice since January 2020. However, there are only few reports of Legionella pneumonia cases treated with LSFX. Here, we report three cases of hospitalized Legionella pneumonia patients that were successfully treated using LSFX. All three patients were admitted to the medical ward on admission, although one patient was subsequently transferred to the ICU for mechanical ventilatory management due to worsening of the pneumonia on day 3. All patients improved and were discharged following LSFX treatment (the patient admitted to the ICU was treated using LSFX + AZM combination therapy) without any severe adverse events. LSFX might be considered to be the first antibiotic choice for Legionella pneumonia, similar to levofloxacin. However, further data regarding the treatment of Legionella pneumonia cases using LSFX are needed to evaluate its efficacy and safety.
PubMed: 38815654
DOI: 10.1016/j.jiac.2024.05.011 -
Alternative Therapies in Health and... May 2024This study aimed to evaluate the clinical efficacy of third-generation cephalosporins combined with Levofloxacin in treating community-acquired pneumonia (CAP) among...
OBJECTIVE
This study aimed to evaluate the clinical efficacy of third-generation cephalosporins combined with Levofloxacin in treating community-acquired pneumonia (CAP) among elderly patients.
METHODS
A retrospective analysis was conducted, and a total of 200 elderly patients with CAP were included in the study. We included elderly patients aged 55 and above diagnosed with CAP at our hospital between January 2019 and June 2021. Patients were categorized into two groups: a control group receiving Levofloxacin alone and an observation group receiving a combination of third-generation cephalosporins and Levofloxacin. Each group consisted of 100 patients. The control group received intravenous levofloxacin hydrochloride injection (0.5 g in 250 mL) once daily, while the observation group received the same dose of Levofloxacin along with intravenous ceftriaxone sodium (80 mg/kg/day) once daily. Outcome measures included levels of inflammatory markers, pulmonary function tests, clinical indices, adverse events, and overall clinical efficacy.
RESULTS
Baseline characteristics were similar between the two groups. After treatment, the observation group demonstrated significantly lower levels of procalcitonin (PCT) and C-reactive protein (CRP) compared to the control group (P < .01). Additionally, the combination therapy group exhibited reduced levels of inflammatory markers (P < .05), improved pulmonary function (P < .01), higher clinical efficacy (P < .01), and a lower incidence of adverse events (4.00%) compared to the levofloxacin-alone group (23.00%) (P < .01). Furthermore, the combination of third-generation cephalosporins with Levofloxacin enhanced clinical efficacy when compared to Levofloxacin alone (P < .05).
CONCLUSION
The combination of third-generation cephalosporins with Levofloxacin proved effective in reducing adverse events, improving lung function, and decreasing inflammatory markers in elderly patients with CAP. However, further clinical trials are warranted to validate these findings before widespread clinical implementation.
PubMed: 38814600
DOI: No ID Found -
Journal of Hazardous Materials Aug 2024The effects on the adsorption of fluoroquinolone antibiotics of long-term soil heterogeneity induced by land-use were investigated. Three different land use areas with...
The effects on the adsorption of fluoroquinolone antibiotics of long-term soil heterogeneity induced by land-use were investigated. Three different land use areas with their two organic matter (OM) pools were tested for the adsorption of three antibiotics widely detected in the environment (ciprofloxacin, norfloxacin, ofloxacin). The soils were separated into two size fractions, > 63 µm fraction and < 63 µm fractions for the fast and slow OM pools, respectively. Any effect of land use on adsorption was only observed in the slow pool in the increasing order: arable land, grassland, and forest. The composition of the soil organic matter (SOM) did influence adsorption in the slow pool, but not in the bulk soilsThis was, because: 1) the ratio of the slow pool was low, as in forest, 2) the ratio of the slow pool was high but its adsorption capacity was low due to its SOM composition, as in arable land and grassland. Soils containing a large slow SOM pool fraction with aliphatic dominance were found to be more likely to adsorb micropollutants. It is our contention that the release of contaminated water, sludge, manure or compost into the environment should only be undertaken after taking this into consideration.
Topics: Adsorption; Soil Pollutants; Anti-Bacterial Agents; Fluoroquinolones; Soil; Ciprofloxacin; Norfloxacin
PubMed: 38810576
DOI: 10.1016/j.jhazmat.2024.134704 -
Antimicrobial Stewardship & Healthcare... 2024Levofloxacin prophylaxis reduces bloodstream infections in neutropenic patients with acute myeloid leukemia or relapsed acute lymphoblastic leukemia. A retrospective,...
Levofloxacin prophylaxis reduces bloodstream infections in neutropenic patients with acute myeloid leukemia or relapsed acute lymphoblastic leukemia. A retrospective, longitudinal cohort study compares incidence of bacteremia, multidrug-resistant organisms (MDRO), and (CDI) between time periods of levofloxacin prophylaxis implementation. Benefits were sustained without increasing MDRO or CDI.
PubMed: 38807931
DOI: 10.1017/ash.2024.81 -
PloS One 2024The examination of photocatalyst powders for the total removal of pollutants from aqueous solutions is a vital research subject within the realm of environmental...
The examination of photocatalyst powders for the total removal of pollutants from aqueous solutions is a vital research subject within the realm of environmental preservation. The objective of this study is to develop a photocatalyst heterojunction consisting of Zingiber/ZnO-H for the degradation of both the reactive red dye (RR 141) and ofloxacin antibiotic in wastewater. The current investigation outlines the process of synthesising a composite material by combining Zingiber montanum extract with zinc oxide (ZnO) by a hydrothermal method. The synthesis was conducted at a temperature of 180°C for a period of 4 hours. Consequently. The photocatalyst with a constructed heterojunction shown a notable enhancement in its photocatalytic activity as a result of the improved efficiency in charge separation at the interface. The application of economically viable solar energy facilitated the complete eradication of harmful pollutants through the process of detoxification. The removal of impurities occurs by a process that follows a first-order kinetics. Among the pollutants, RR141 demonstrates the greatest rate constant at 0.02 min-1, while ofloxacin has a rate constant of 0.01 min-1. The assessment of the stability of the produced photocatalyst was conducted after undergoing five cycles. This study additionally investigated the influence of sunshine on degradation, uncovering degradation rates of 97% for RR141 and 99% for ofloxacin when exposed to UV Lamp, and degradation rates of 97% for RR141 and 95% for ofloxacin when exposed to Solar Light.
Topics: Zinc Oxide; Ofloxacin; Anti-Bacterial Agents; Photolysis; Azo Compounds; Water Pollutants, Chemical; Catalysis; Kinetics
PubMed: 38805514
DOI: 10.1371/journal.pone.0300402 -
Frontiers in Pediatrics 2024infection of the bloodstream and intestine is a rare and severe opportunistic infection in immunocompromised people. In Southwest China, we first reported a case of...
infection of the bloodstream and intestine is a rare and severe opportunistic infection in immunocompromised people. In Southwest China, we first reported a case of bloodstream and intestinal infection with multidrug-resistant (MDR) in a 4-year-old child with T-cell acute lymphoblastic leukemia. Blood and stool cultures were used to identify the infection. The selection of antibiotics was based on clinical expertise and medication sensitivity tests. We used linezolid, levofloxacin, and polymyxin B to treat the patient aggressively. infection is uncommon in juvenile acute lymphoblastic leukemia. Doctors should be aware of the likelihood of opportunistic infection during the post-chemotherapy bone marrow suppression period. We further conducted a review of the literature and performed a detailed analysis of s infection in pediatric leukemia. It is becoming increasingly apparent that antibiotic is abused domestically and abroad, resulting in the sharp increase of MDR bacteria. In general, most of the isolates are susceptible to third- or fourth-generation cephalosporins, aminoglycosides, quinolones, and carbapenem, but drug-resistant strains are being reported increasingly. We summarized the drug resistance rate of s caviae and in China in the last 10 years. Early recognition and effective treatment will improve prognosis and reduce mortality.
PubMed: 38803640
DOI: 10.3389/fped.2024.1233600 -
JAC-antimicrobial Resistance Jun 2024Antimicrobial resistance (AMR) is a growing public health concern globally, and misuse of antibiotics is a major contributor.
Antibiotic utilization patterns in Tanzania: a retrospective longitudinal study comparing pre- and intra-COVID-19 pandemic era using Tanzania Medicines and Medical Devices Authority data.
BACKGROUND
Antimicrobial resistance (AMR) is a growing public health concern globally, and misuse of antibiotics is a major contributor.
OBJECTIVE
This study investigated antibiotic utilization patterns before and during the COVID-19 pandemic in Tanzania using data from the Tanzania Medicines and Medical Devices Authority (TMDA).
METHODS
This retrospective longitudinal study analysed secondary data. The study compared antibiotics consumption in defined daily doses per 1000 inhabitants per day (DID) in two distinct eras: 2018-2019 as the pre-COVID-19 era and 2020-2021 as the intra-COVID-19 era. A sample -test was conducted using Statistical Package for the Social Sciences.
RESULTS
The study analysed 10 614 records and found an overall increase in antibiotics consumption from 2018 to 2021. We found that the consumption was 61.24 DID in the intra-COVID-19 era and 50.32 DID in the pre-COVID-19 era. Levofloxacin had the highest percentage increase in use, with a 700% increase in DID during the intra-COVID-19 era. Azithromycin had a 163.79% increase, while cefotaxime had a 600% increase. By contrast, some antibiotics exhibited a decrease in usage during the intra-COVID-19 era, such as nalidixic acid, which had a 100% decrease, and cefpodoxime, which had a 66.67% decrease.
CONCLUSIONS
Increased antibiotic consumption during the COVID-19 pandemic highlights the importance of implementing effective antimicrobial stewardship strategies to prevent AMR, especially during pandemics.
PubMed: 38803386
DOI: 10.1093/jacamr/dlae081 -
Zhongguo Dang Dai Er Ke Za Zhi =... May 2024To investigate the risk factors for (HP) infection in children with primary duodenogastric reflux (DGR) and its impact on gastritis and antibioticresistance.
OBJECTIVES
To investigate the risk factors for (HP) infection in children with primary duodenogastric reflux (DGR) and its impact on gastritis and antibioticresistance.
METHODS
A retrospective analysis was performed on the clinical data of 2 190 children who underwent upper gastrointestinal endoscopy in Wuxi Children's Hospital from January 2019 to February 2022, among whom 308 children were diagnosed with primary DGR. According to the presence or absence of HP infection, the children were classified to HP infection group (53 children) and non-HP infection group (255 children). The risk factors for HP infection and its impact on the incidence rate and severity of gastritis were analyzed. According to the presence or absence of primary DGR, 331 children with HP infection were classified to primary DGR group (29 children) and non-primary DGR group (302 children), and then the impact of primary DGR with HP infection on antibiotic resistance was analyzed.
RESULTS
The HP infection group had a significantly higher age than the non-HP infection group (<0.05), and there was a significant difference in the age distribution between the two groups (<0.05), while there were no significant differences in the incidence rate and severity of gastritis between the two groups (>0.05). The multivariate logistic regression analysis showed that older age was a risk factor for HP infection in children with DGR (<0.05). Drug sensitivity test showed that there were no significant differences in the single and combined resistance rates of metronidazole, clarithromycin, and levofloxacin between the primary DGR group and the non-primary DGR group (>0.05).
CONCLUSIONS
Older age is closely associated with HP infection in children with DGR. Primary DGR with HP infection has no significant impact on gastritis and antibiotic resistance in children.
Topics: Humans; Helicobacter Infections; Gastritis; Helicobacter pylori; Male; Female; Child; Retrospective Studies; Child, Preschool; Drug Resistance, Bacterial; Duodenogastric Reflux; Anti-Bacterial Agents; Risk Factors; Adolescent; Infant; Logistic Models
PubMed: 38802910
DOI: 10.7499/j.issn.1008-8830.2311086 -
BMC Microbiology May 2024Pseudomonas aeruginosa is an opportunistic pathogen responsible for complicated UTIs and exhibits high antibiotic resistance, leading to increased mortality rates,...
BACKGROUND
Pseudomonas aeruginosa is an opportunistic pathogen responsible for complicated UTIs and exhibits high antibiotic resistance, leading to increased mortality rates, especially in cases of multidrug-resistant strains. This study aimed to investigate the antibiotic susceptibility patterns and genomic characterization of XDR strains identified in end-stage liver disease patients who underwent liver transplants.
METHODS
In this study, a number of 30 individuals who underwent liver transplants were registered. Ninety urine and 60 wound site swab samples were collected and processed for culturing, identification, and antimicrobial sensitivity. Extensively drug-resistant strain EMARA01 was confirmed through Sanger sequencing and was then processed for whole genome sequencing to characterize the genomic pattern. Sequencing data were processed for de novo assembly using various tools and databases, including genome annotation, serotype identification, virulence factor genes, and antimicrobial resistance gene. Pangenome analysis of randomly selected 147 reference strains and EMAR01 sequenced strain was performed using the Bacterial Pan Genome Analysis (BPGA) software.
RESULTS
Of these total examined samples, nosocomial infection due to P. aeruginosa was detected in twelve patients' samples. AST analysis showed that P. aeruginosa strains exhibit resistance to tobramycin, erythromycin, and gentamicin, followed by piperacillin and ofloxacin, and no strains exhibit resistance to meropenem and imipenem. The CARD database identified 59 AMR genes similar to the EMAR01 strain genome and mostly belong to the family involved in the resistance-nodulation-cell division (RND) antibiotic efflux pump. Five genes; nalC, nalD, MexR, MexA, and MexB, exhibit resistance to 14 classes of antibiotics, while two AMR; CpxR, and OprM, exhibit resistance to 15 classes of drugs. Pangenome analysis revealed that the pan-genome remained open, suggesting the potential for acquiring accessory and unique genes. Notably, the genes predominantly involved in amino acid transport metabolism were identified using the KEGG database.
CONCLUSIONS
This study provides valuable insights into the antimicrobial resistance profile, genetic features, and genomic evolution of P. aeruginosa strains causing UTIs in liver transplant patients. The findings emphasize the significance of comprehending AMR mechanisms and genetic diversity in P. aeruginosa for developing effective treatment strategies and infection control measures.
Topics: Humans; Drug Resistance, Multiple, Bacterial; Pseudomonas aeruginosa; Liver Transplantation; Egypt; Urinary Tract Infections; Pseudomonas Infections; Anti-Bacterial Agents; Microbial Sensitivity Tests; Whole Genome Sequencing; Male; Female; Genome, Bacterial; Adult; Cross Infection; Middle Aged; Virulence Factors
PubMed: 38802754
DOI: 10.1186/s12866-024-03318-0 -
RSC Advances May 2024An advanced form of magnesium-rich hydroxyapatite (Mg·HAP) was modified with two types of biopolymers, namely chitosan (CH/Mg·HAP) and β-cyclodextrin (CD/Mg·HAP),...
Characterization of chitosan- and β-cyclodextrin-modified forms of magnesium-doped hydroxyapatites as enhanced carriers for levofloxacin: loading, release, and anti-inflammatory properties.
An advanced form of magnesium-rich hydroxyapatite (Mg·HAP) was modified with two types of biopolymers, namely chitosan (CH/Mg·HAP) and β-cyclodextrin (CD/Mg·HAP), producing two types of bio-composites. The synthesized materials were developed as enhanced carriers for levofloxacin to control its loading, release, and anti-inflammatory properties. The polymeric modification significantly improved the loading efficiency to 281.4 mg g for CH/Mg·HAP and 332.4 mg g for CD/Mg·HAP compared with 218.3 mg g for Mg·HAP. The loading behaviors were determined using conventional kinetic and isotherm models and mathematical parameters of new equilibrium models (the monolayer model of one energy). The estimated density of effective loading sites ( = 88.03 mg g (Mg·HAP), 115.8 mg g (CH/Mg·HAP), and 138.5 mg g (CD/Mg·HAP)) illustrates the markedly higher loading performance of the modified forms of Mg·HAP. Moreover, the loading energies (<40 kJ mol) in conjunction with the capacity of each loading site ( > 1) and Gaussian energies (<8 kJ mol) signify the physical trapping of LVX molecules in vertical orientation. The addressed materials validate prolonged and continuous release behaviors. These behaviors accelerated after the modification procedures, as the complete release was identified after 160 h (CH/Mg·HAP) and 200 h (CD/Mg·HAP). The releasing behaviors are regulated by both diffusion and erosion mechanisms, according to the kinetic investigations and diffusion exponent analysis (>0.45). The entrapping of LVX into Mg·HAP induces its anti-inflammatory properties against the generation of cytokines (IL-6 and IL-8) in human bronchial epithelia cells (NL20), and this effect displays further enhancement after the integration of chitosan and β-cyclodextrin.
PubMed: 38799215
DOI: 10.1039/d4ra02144d