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Gut Pathogens Apr 2021Helicobacter cinaedi are motile, gram-negative spiral rods with a natural reservoir in the intestinal tract of hamsters and rhesus monkeys. In humans, H. cinaedi has...
BACKGROUND
Helicobacter cinaedi are motile, gram-negative spiral rods with a natural reservoir in the intestinal tract of hamsters and rhesus monkeys. In humans, H. cinaedi has been reported in different human infections like fever, abdominal pain, gastroenteritis, proctitis, diarrhoea, erysipelas, cellulitis, arthritis, and neonatal meningitis typically diagnosed by positive blood cultures. Even though H. cinaedi has been detected from human blood and stool the entry of H. cinaedi into the blood stream was undocumented until quite recently. The use of pulse-field gel electrophoresis (PFGE) demonstrated that stool- and blood-derived H. cinaedi strains were consistent.
CASE PRESENTATION
Here, we describe a rare Danish case of H. cinaedi bacteraemia in an immunocompetent 44-year-old male with diarrhoea. We isolated H. cinaedi from a blood culture taken at admission, and from a FecalSwab taken at day six despite ongoing antibiotic therapy. Next, we made a genetic comparison of both isolates by use of Multi-locus sequence typing (MLST)- and Single nucleotide polymorphism (SNP)-analysis. The two isolates were identical with zero SNPs and by use of MLST the isolate was identified as a novel ST20, confirming previous data of the intestinal tract as a route of H. cinaedi bacteraemia. The results of our AST showed a resistance pattern with higher MICs for ciprofloxacin and clarithromycin than for ampicillin, amoxicillin, gentamicin, and imipenem. The patient was cured with targeted therapy with pivampicillin; however, the primary source of transmission was unknown.
CONCLUSIONS
In conclusion, this case of H. cinaedi bacteraemia secondary to enterocolitis in an immunocompetent patient provide clear evidence that one route of infection occurs through translocation from the intestinal tract to the bloodstream. Helicobacter cinaedi from blood and faeces were identical with a novel ST20, resistant to ciprofloxacin and clarithromycin however, the patient was cured with oral pivampicillin.
PubMed: 33888153
DOI: 10.1186/s13099-021-00422-8 -
Molecules (Basel, Switzerland) Feb 2019The problem of determining the formation of complexes of β-lactam antibiotics with cyclodextrins (CDs) and the interactions involved in this process were addressed by...
The problem of determining the formation of complexes of β-lactam antibiotics with cyclodextrins (CDs) and the interactions involved in this process were addressed by machine learning on multispectral images. Complexes of β-lactam antibiotics, including cefuroxime axetil, cefetamet pivoxil, and pivampicillin, as well as CDs, including αCD, βCD, γCD, hydroxypropyl-αCD, methyl-βCD, hydroxypropyl-βCD, and hydroxypropyl-γCD, were prepared in all combinations. Thermograms confirming the formation of cyclodextrin complexes were obtained using differential scanning calorimetry. Transmission Fourier-transform infrared (tFTIR) and complementary attenuated total reflectance FTIR (ATR) coupled with machine learning were techniques chosen as a nondestructive alternative. The machine learning algorithm was used to determine the formation of complexes in samples using solely their tFTIR and ATR spectra at the prediction stage. Parameterized method 7 (PM7) was used to support the analysis by molecular modeling of the complexes. The model developed through machine learning properly distinguished samples with formed complexes form noncomplexed samples with a cross-validation accuracy of 90.4%. Analysis of the contribution of spectral bands to the model indicated interactions of ester groups of β-lactam antibiotics with CDs, as well as some interactions of cephem ring in cefetamet pivoxil and penam moiety in pivampicillin. Molecular modeling with PM7 helped to explain experimental results and allowed to propose possible binding modes.
Topics: Cyclodextrins; Machine Learning; Models, Molecular; Molecular Conformation; Spectrum Analysis; Structure-Activity Relationship; beta-Lactams
PubMed: 30791432
DOI: 10.3390/molecules24040743 -
BMJ Case Reports Sep 2015Good's syndrome is a rare primary immunodeficiency associated with adult thymoma. Complications are mainly autoimmune manifestations and recurrent infections with...
Good's syndrome is a rare primary immunodeficiency associated with adult thymoma. Complications are mainly autoimmune manifestations and recurrent infections with encapsulated bacteria. Only one possible case of combined granulomatous-lymphocytic interstitial lung disease (GL-ILD) and Good's syndrome have been described earlier, but the patient died at the time of diagnosis. This is the first case of GL-ILD in Good's syndrome with a successful outcome. We present a case of a 43-year-old man with GL-ILD, who suffered from recurrent infections of Haemophilus influenzae and Pneumocystis jirovecii, with 8-year follow-up. After a thymectomy, he was diagnosed with Good's syndrome and GL-ILD. He was treated with prophylactic pivampicillin, quinolones and cephalosporins for his recurrent P. jirovecii and H. influenzae infections, an approach that proved unsuccessful due to resistance, with relapse after cessation. He was stabilised with oral diaminodiphenyl-sulfone for P. jirovecii and colistimethate-sodium inhalations for H. influenzae, which is a new approach to prophylactic treatment.
Topics: Adult; Agammaglobulinemia; Anti-Bacterial Agents; Cephalosporins; Granuloma; Haemophilus Infections; Haemophilus influenzae; Humans; Immunologic Deficiency Syndromes; Lung Diseases, Interstitial; Male; Neoplasms, Glandular and Epithelial; Pivampicillin; Pneumocystis Infections; Pneumocystis carinii; Quinolones; Rare Diseases; Thymoma; Thymus Neoplasms
PubMed: 26424818
DOI: 10.1136/bcr-2014-205635 -
BMJ Case Reports Jul 2015We present a case report of a 65-year-old man admitted to the department of infectious diseases on suspicion of meningitis with headache, fever and double vision. A...
We present a case report of a 65-year-old man admitted to the department of infectious diseases on suspicion of meningitis with headache, fever and double vision. A cerebral MRI revealed a 17×30 mm pontine abscess with surrounding oedema. The patient had, 2 months prior to admission, been treated for Streptococcus salivarius aortic valve endocarditis. The abscess was not suitable for surgery, and the patient received multidrug antibiotic treatment for 4 weeks. The patient initially responded well clinically, but was readmitted 4 weeks after discontinuation of treatment, with headache and dizziness. A new cerebral MRI showed progression of the abscess. He received an additional 8 weeks of broad spectrum antibiotic treatment, followed by 12 weeks of oral treatment with pivampicillin. His symptoms resolved and a cerebral MRI at discontinuation of treatment showed regression of the abscess to 7.5 mm.
Topics: Aged; Anti-Bacterial Agents; Aortic Valve; Bicuspid Aortic Valve Disease; Brain Abscess; Drug Therapy, Combination; Endocarditis, Bacterial; Heart Defects, Congenital; Heart Valve Diseases; Humans; Magnetic Resonance Imaging; Male; Multimodal Imaging; Positron-Emission Tomography; Streptococcal Infections; Treatment Outcome
PubMed: 26139646
DOI: 10.1136/bcr-2014-205949 -
Przeglad Epidemiologiczny 2014The Polish results of the international Happy Audit 2 project are reported which objective was to present therapeutic decisions made by general practitioners (especially... (Comparative Study)
Comparative Study
OBJECTIVE
The Polish results of the international Happy Audit 2 project are reported which objective was to present therapeutic decisions made by general practitioners (especially antibiotics prescribed) and diagnostic methods applied to patients with respiratory tract infections (RTI).
MATERIAL AND METHODS
[corrected] Following each visit of patient with respiratory tract infection, general practitioners participating in the study completed the questionnaire. The questionnaire included patient's data (age, gender), the duration of disease, clinical symptoms, diagnosis, prescribed antibiotics, additional testing as well as the influence of various factors on therapeutic decision.
RESULTS
Having considered the results of HappyAudit in Poland, a total of 5,137 office visits of patients reporting symptoms of RTIs were analyzed. The average duration of symptoms before visiting GP was 4.8 days (compared to average 4.4 in other countries). Worth noting is that additional testing in diagnosis of RTIs was performed less frequently in Poland: rapid streptococcal test was conducted in 0.4% of cases (European average: 4.45%), CRP--in 2.2% of patients (average from other countries: 14.2%) and chest X-ray in 2.3% of cases compared to 14% in other project's participants. In Poland, the most frequently applied antibiotic was amoxicillin, which was used in 28.9% of cases ended with antibiotic prescribing (amoxicillin/pivampicillin were also predominant in other countries, excluding Sweden). In Poland, macrolides (22.4% of all prescriptions for antibiotic) and cephalosporins (12.1%) were frequently used. The results indicate that narrow-spectrum antibiotics are prescribed in Poland less frequently, with the example being penicillin V which was prescribed in 6.7% of patients with RTIs who were given antibiotic.
CONCLUSIONS
Comparing the results of Happy Audit 2 in Poland and other project's participants, the major differences consist in rare use of phenoxymethylpenicillin in favour of amoxicillin and macrolides as well as infrequent use of additional testing in diagnosis of RTIs in Poland.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Clinical Audit; Female; General Practitioners; Humans; Infant; Latvia; Lithuania; Male; Middle Aged; Poland; Practice Patterns, Physicians'; Primary Health Care; Respiratory Tract Infections; Russia; Sweden; Treatment Outcome; Young Adult
PubMed: 25004629
DOI: No ID Found -
The Cochrane Database of Systematic... Sep 2010Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications. (Review)
Review
BACKGROUND
Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications.
OBJECTIVES
To assess which antibiotic is most effective and least harmful as initial treatment for asymptomatic bacteriuria in pregnancy.
SEARCH STRATEGY
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010) and reference lists of retrieved studies.
SELECTION CRITERIA
Randomized controlled trials comparing two antibiotic regimens for treating asymptomatic bacteriuria.
DATA COLLECTION AND ANALYSIS
Review authors independently screened the studies for inclusion and extracted data.
MAIN RESULTS
We included five studies involving 1140 women with asymptomatic bacteriuria. We did not perform meta-analysis; each trial examined different antibiotic regimens and so we were not able to pool results. In a study comparing a single dose of fosfomycin trometamol 3 g with a five-day course of cefuroxime, there was no significant difference in persistent infection (risk ratio (RR) 1.36, 95% confidence interval (CI) 0.24 to 7.75), shift to other antibiotics (RR 0.08, 95% CI 0.00 to 1.45), or in allergy or pruritus (RR 2.73, 95% CI 0.11 to 65.24). A comparison of seven-day courses of 400 mg pivmecillinam versus 500 mg ampicillin, both given four times daily, showed no significant difference in persistent infection at two weeks or recurrent infection, but there was an increase in vomiting (RR 4.57, 95% CI 1.40 to 14.90) and women were more likely to stop treatment early with pivmecillinam (RR 8.82, 95% CI 1.16 to 66.95). When cephalexin 1 g versus Miraxid(R) (pivmecillinam 200 mg and pivampicillin 250 mg) were given twice-daily for three days, there was no significant difference in persistent or recurrent infection. A one- versus seven-day course of nitrofurantoin resulted in more persistent infection with the shorter course (RR 1.76, 95% CI 1.29 to 2.40), but no significant difference in symptomatic infection at two weeks, nausea, or preterm birth. Comparing cycloserine with sulphadimidine, no significant differences in symptomatic, persistent, or recurrent infections were noted.
AUTHORS' CONCLUSIONS
We cannot draw any definite conclusion on the most effective and safest antibiotic regimen for the initial treatment of asymptomatic bacteriuria in pregnancy. One study showed advantages with a longer course of nitrofurantoin, and another showed better tolerability with ampicillin compared with pivmecillinam; otherwise, there was no significant difference demonstrated between groups treated with different antibiotics. Given this lack of conclusive evidence, it may be useful for clinicians to consider factors such as cost, local availability and side effects in the selection of the best treatment option.
Topics: Anti-Bacterial Agents; Bacteriuria; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Randomized Controlled Trials as Topic
PubMed: 20824868
DOI: 10.1002/14651858.CD007855.pub2 -
Journal of the American Geriatrics... Mar 2010The syndrome of chronic obstructive pulmonary disease (COPD) consists of chronic bronchitis (CB), bronchiectasis, emphysema, and reversible airway disease that combine... (Review)
Review
The syndrome of chronic obstructive pulmonary disease (COPD) consists of chronic bronchitis (CB), bronchiectasis, emphysema, and reversible airway disease that combine uniquely in an individual patient. Older patients are at risk for COPD and its components--emphysema, CB, and bronchiectasis. Bacterial and viral infections play a role in acute exacerbations of COPD (AECOPD) and in acute exacerbations of CB (AECB) without features of COPD. Older patients are at risk for resistant bacterial organisms during their episodes of AECOPD and AECB. Organisms include the more-common bacteria implicated in AECOPD/AECB such as Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae. Less-common nonenteric, gram-negative organisms including Pseudomonas aeruginosa, gram-positive organisms including Staphylococcus aureus, and strains of nontuberculosis Mycobacteria are more often seen in AECOPD/AECB episodes involving elderly patients with frequent episodes of CB or those with bronchiectasis. Risk-stratified antibiotic treatment guidelines appear useful for purulent episodes of AECOPD and episodes of AECB. These guidelines have not been prospectively validated for the general population and especially not for the elderly population. Using a risk-stratification approach for elderly patients, first-line antibiotics (e.g., amoxicillin, ampicillin, pivampicillin, trimethoprim/sulfamethoxazole, and doxycycline), with a more-limited spectrum of antibacterial coverage, are used in patients who are likely to have a low probability of resistant organisms during AECOPD/AECB. Second-line antibiotics (e.g., amoxicillin/clavulanic acid, second- or third-generation cephalosporins, and respiratory fluoroquinolones) with a broader spectrum of coverage are reserved for patients with significant risk factors for resistant organisms and those who have failed initial antibiotic treatment.
Topics: Acute Disease; Age Factors; Aged; Anti-Bacterial Agents; Bacterial Infections; Bronchiectasis; Bronchitis, Chronic; Humans; Pulmonary Disease, Chronic Obstructive; Respiratory Tract Infections
PubMed: 20398122
DOI: 10.1111/j.1532-5415.2010.02741.x -
BMJ Clinical Evidence Apr 2010Genital chlamydia is the most commonly reported bacterial sexually transmitted infection (STI) in developed countries. In women, infection occurs most commonly between... (Review)
Review
INTRODUCTION
Genital chlamydia is the most commonly reported bacterial sexually transmitted infection (STI) in developed countries. In women, infection occurs most commonly between the ages of 16 and 19 years.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antibiotic treatment for men and non-pregnant women with uncomplicated genital chlamydial infection?What are the effects of antibiotic treatment for pregnant women with uncomplicated genital chlamydial infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: amoxicillin, ampicillin, azithromycin, ciprofloxacin, clarithromycin, clindamycin, doxycycline, erythromycin, lymecycline, minocycline, ofloxacin, pivampicillin, rifampicin, roxithromycin, sparfloxacin, tetracycline, and trovafloxacin.
Topics: Amoxicillin; Azithromycin; Chlamydia; Chlamydia Infections; Chlamydia trachomatis; Erythromycin; Humans
PubMed: 21718568
DOI: No ID Found -
Canadian Family Physician Medecin de... Jan 2009To compare the effectiveness and toxicity of semisynthetic penicillins (SSPs) (amoxicillin, ampicillin, pivampicillin) and trimethoprim-based regimens (trimethoprim,... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
To compare the effectiveness and toxicity of semisynthetic penicillins (SSPs) (amoxicillin, ampicillin, pivampicillin) and trimethoprim-based regimens (trimethoprim, trimethoprim-sulfamethoxazole, trimethoprim-sulfadiazine) in treating acute bacterial exacerbations of chronic bronchitis (ABECB).
DATA SOURCES
We searched MEDLINE, EMBASE, Current Contents, and the Cochrane Central Register of Controlled Trials to identify and extract data from relevant randomized controlled trials (RCTs).
STUDY SELECTION
Only RCTs comparing penicillins with trimethoprim-based regimens for the treatment of patients with ABECB that reported data on effectiveness, toxicity, or mortality were considered eligible for this meta-analysis.
SYNTHESIS
Out of 134 RCTs identified in the search, 5 RCTs involving 287 patients were included in the analysis. There were no differences between patients with ABECB treated with SSPs and those treated with trimethoprim, alone or in combination with a sulfonamide, in treatment success (intention-to-treat patients: n = 262, odds ratio [OR] 1.68, 95% confidence interval [CI] 0.91-3.09; clinically evaluable patients: n = 246, OR 1.59, 95% CI 0.79-3.20) or number of drug-related adverse events in general (n = 186 patients, OR 0.37, 95% CI 0.11-1.24), frequency of diarrhea or skin rashes, or number of withdrawals due to adverse events (n = 179 patients, OR 0.27, 95% CI 0.07-1.03).
CONCLUSION
Based on limited evidence leading to wide CIs of the estimated treatment effects, SSPs and trimethoprim-based regimens seem to be equivalent in terms of effectiveness and toxicity for ABECB.
Topics: Acute Disease; Amoxicillin; Anti-Infective Agents; Bronchitis, Chronic; Drug Therapy, Combination; Humans; Pivampicillin; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 19155372
DOI: No ID Found -
BMJ Clinical Evidence Jun 2008Genital chlamydia is the most commonly reported bacterial sexually transmitted disease (STD) in resource-rich countries. In women, infection occurs most commonly between... (Review)
Review
INTRODUCTION
Genital chlamydia is the most commonly reported bacterial sexually transmitted disease (STD) in resource-rich countries. In women, infection occurs most commonly between the ages of 16 and 19 years.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antibiotic treatment in men, non-pregnant women, and pregnant women with uncomplicated genital chlamydia infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: amoxicillin, ampicillin, azithromycin, ciprofloxacin, clarithromycin, clindamycin, doxycycline, erythromycin, lymecycline, minocycline, ofloxacin, pivampicillin, rifampicin, roxithromycin, sparfloxacin, tetracycline, and trovafloxacin.
Topics: Amoxicillin; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Erythromycin; Humans
PubMed: 19450291
DOI: No ID Found