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Sexually Transmitted Diseases Nov 2019
Topics: Anti-Bacterial Agents; Female; Humans; Metronidazole; Trichomonas Infections; Trichomonas Vaginitis
PubMed: 31644503
DOI: 10.1097/OLQ.0000000000001059 -
HPB Surgery : a World Journal of... 2010A 25-year-old caucasian lady presented to the Accident & Emergency department complaining of acute onset severe epigastric pain radiating through to the back with...
CASE SUMMARY
A 25-year-old caucasian lady presented to the Accident & Emergency department complaining of acute onset severe epigastric pain radiating through to the back with associated nausea and vomiting. A diagnosis of acute pancreatitis was made. Symptoms commenced after the third dose of Metronidazole therapy prescribed for a recurrent periodontal abscess. The patient described a similar episode 10 months previously. On neither occasion were any other medications being taken, there was no history of alcohol abuse and no other gastro-intestinal aetiology could be identified on imaging. Symptoms resolved quickly upon discontinuation of the antibiotic agent. We conclude therefore that Metronidazole can reasonably be identified as the only potential causative agent.
DISCUSSION
The proportion of cases of pancreatitis caused by drugs is estimated to be around 2% in the general population. The exact mechanism of action of Metronidazole induced pancreatitis is unclear but a trigger role for the drug seems likely.
CONCLUSION
This case provides the eighth report of Metronidazole induced pancreatitis. All of the cases were reported in females and ran a benign course. Early diagnosis, discontinuation of the drug and supportive care will lead to a successful recovery in the majority of cases.
Topics: Adult; Anti-Infective Agents; Female; Humans; Metronidazole; Pancreatitis; Treatment Outcome
PubMed: 20862338
DOI: 10.1155/2010/523468 -
The Indian Journal of Medical Research May 2021Bacteroides fragilis is a Gram-negative anaerobic opportunistic pathogen which is managed by empirical anaerobic coverage as a hospital norm. However, with rising... (Observational Study)
Observational Study
BACKGROUND & OBJECTIVE
Bacteroides fragilis is a Gram-negative anaerobic opportunistic pathogen which is managed by empirical anaerobic coverage as a hospital norm. However, with rising reports of resistance among B. fragilis strains, antibiotic susceptibility testing for this pathogen may be the only way to understand the magnitude of the problem. This study aimed to characterize resistance patterns among clinical isolates and identify resistance genes.
METHODS
A prospective observational study was conducted which included all samples requesting anaerobic cultures within the study period. Minimum inhibitory concentration (MIC) was detected for metronidazole, clindamycin and chloramphenicol by agar dilution. E-test strips were used for imipenem and piperacillin, followed by polymerase chain reaction to detect nim and cfiA genes.
RESULTS
Among a total of 50 isolates, 94 per cent (47/50) were susceptible and six per cent (3/50) showed intermediate resistance to metronidazole. Susceptibility to clindamycin and piperacillin was noted in 70 and 50 per cent of strains; intermediate resistance in 14 and 2 per cent and resistance in 16 and 48 per cent, respectively. No resistance was observed for chloramphenicol and imipenem. Nim gene was found in 26 per cent (13/50) and cfiA gene was found in 52 per cent (26/50) of isolates. Isolates with high metronidazole MIC of 8-16 μg/ml were found to carry nim gene (χ test, P<0.001).
INTERPRETATION & CONCLUSIONS
Rising resistance among B. fragilis is evident and there is a significant association between nim gene and metronidazole resistance. Improving awareness among clinicians is paramount in tackling AMR among these pathogens, as empirical anaerobic coverage may not be effective in all cases.
Topics: Anti-Bacterial Agents; Bacterial Infections; Bacteroides fragilis; Chloramphenicol; Clindamycin; Drug Resistance, Bacterial; Humans; Imipenem; Metronidazole; Microbial Sensitivity Tests; Piperacillin
PubMed: 35532593
DOI: 10.4103/ijmr.IJMR_2568_19 -
Journal of Wound, Ostomy, and... 2016The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted inflammation, delayed reepithelization, and... (Review)
Review
The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted inflammation, delayed reepithelization, and production of pungent odors. The malodor produced by these wounds may lower health-related quality of life and produce psychological discomfort and social isolation. Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases. For example, charcoal-based materials have been incorporated into dressing for direct adsorption of the responsible gases. In addition, multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection. This review describes options for controlling malodor in chronic wounds, the benefits and drawbacks of each topical agent, and their mode of action. We also discuss the use of subjective odor evaluation techniques to assess the efficacy of odor-controlling therapies. The perspectives of employing novel biomaterials and technologies for wound odor management are also presented.
Topics: Administration, Topical; Anti-Infective Agents; Charcoal; Deodorants; Honey; Humans; Iodine; Metronidazole; Odorants; Silver Compounds; Wound Healing
PubMed: 27684356
DOI: 10.1097/WON.0000000000000273 -
British Medical Journal Sep 1977
Topics: Adult; Animals; Crohn Disease; Humans; Male; Metronidazole; Peripheral Nervous System Diseases; Rats
PubMed: 198056
DOI: 10.1136/bmj.2.6087.610 -
Acta Dermato-venereologica 2004
Topics: Adult; Biopsy, Needle; Drug Eruptions; Drug Interactions; Female; Follow-Up Studies; Humans; Immunohistochemistry; Metronidazole; Nicotine; Risk Assessment; Severity of Illness Index; Skin Diseases, Vesiculobullous
PubMed: 15339081
DOI: 10.1080/00015550410025282 -
Folia Biologica 2019Autoimmune uveitis is a serious sightthreatening disease that in many cases fails to respond to conventional immunosuppressive or biological therapy. Experimental models...
Autoimmune uveitis is a serious sightthreatening disease that in many cases fails to respond to conventional immunosuppressive or biological therapy. Experimental models used in research allow more detailed study of pathogenesis of the autoimmune process and testing new therapeutic strategies. Recent results show that infection can trigger autoimmune diseases, and some commensal microorganisms are essential in causing disease activity. The aim of this work was to assess the effect of broadspectrum antibiotics - combination of metronidazole and ciprofloxacin or metronidazole alone - on the intensity of intraocular inflammation in experimental autoimmune uveitis (EAU). EAU was induced in mouse strain C57BL/6J by interphotoreceptor retinoid- binding protein in complete Freund's adjuvant and pertussis toxin. The grade of uveitis was assessed clinically and histologically in haematoxylin and eosin- stained tissues. Lymphocytes and macrophages were detected in cryosections using the immunoperoxidase method with antibodies. The therapy was commenced one week before EAU induction and continued throughout the experiment. In addition, metronidazole treatment was also started two weeks before EAU induction. Antibiotics significantly reduced the intensity of uveitis compared to the control group (P < 0.05). The effects of combination of ciprofloxacin and metronidazole and of metronidazole alone were similar when the therapy started one week before EAU induction (P < 0.05). Metronidazole commenced two weeks before EAU induction and throughout the experiment suppressed the intensity of EAU with even higher statistical significance (P < 0.0001). It can be assumed that the high protective effect of metronidazole on EAU intensity may be due not only to its antimicrobial effect, but also to its immunomodulatory activity.
Topics: Animals; Ciprofloxacin; Female; Inflammation; Metronidazole; Mice, Inbred C57BL; Severity of Illness Index; Uveitis
PubMed: 32362310
DOI: No ID Found -
Parasites & Vectors Sep 2023The emergence and spread of drug resistance in Trichomonas vaginalis parasites has become an important concern in trichomoniasis treatment. Fast and reliable growth...
BACKGROUND
The emergence and spread of drug resistance in Trichomonas vaginalis parasites has become an important concern in trichomoniasis treatment. Fast and reliable growth assessment is critical for validating in vitro drug susceptibility and high-throughput screening of newly developed drugs.
METHODS
Modified media without yeast extract were evaluated for their ability to support the growth of T. vaginalis parasites. The potential of the nucleic acid-binding dye SYBR Green I for detecting T. vaginalis drug resistance was characterized, and seeding parasite concentration and incubation time were optimized. The fluorescence assay based on SYBR Green I was further validated in four T. vaginalis isolates with different susceptibilities to the antibiotics metronidazole, tinidazole, ornidazole and secnidazole, and compared with the traditional method that detects minimum lethal concentrations (MLCs).
RESULTS
A modified medium consisting of RPMI 1640 and Tryptone Plus as replacements for yeast extract and tryptone, respectively, in traditional trypticase-yeast extract-maltose (TYM) medium exhibited similar performance as TYM medium in maintaining T. vaginalis growth, while it showed much lower background fluorescent signals. The T. vaginalis SYBR Green I-based fluorescence (TSF) drug assay was found to have to satisfy one of two conditions to demonstrate the 50% inhibitory concentration of metronidazole for the sensitive isolate TV-334: (i) a seeding density of 3 × 10 parasites/ml and an incubation time of 48 h; or (ii) a seeding density of 1 × 10 parasites/ml and an incubation time of 72 h. Subsequent validation experiments revealed that the 48-h incubation/3 × 10 parasites/ml seeding density condition had a greater sensitivity to detect drug resistance than the 72-h condition. The TSF assay also exhibited high efficiency in identifying parasite drug resistance, as evidenced by its strong correlation with the standard MLC assay results (P = 0.003).
CONCLUSIONS
This study presents a robust TSF assay that has the potential to facilitate high-throughput, automated in vitro anti-trichomoniasis susceptibility testing for drug resistance monitoring and drug development. In comparison to the standard MLC method, this assay offers the advantages of reduced labor and elimination of subjective examination.
Topics: Animals; Trichomonas vaginalis; Drug Evaluation, Preclinical; Metronidazole; Trichomonas Infections
PubMed: 37723582
DOI: 10.1186/s13071-023-05919-6 -
Antimicrobial Agents and Chemotherapy Sep 1976Twelve 4- and 5-nitroimidazole derivatives, including metronidazole and two of its metabolites, tinidazole, dimetridazole, and nimorazole, were tested for... (Comparative Study)
Comparative Study
Twelve 4- and 5-nitroimidazole derivatives, including metronidazole and two of its metabolites, tinidazole, dimetridazole, and nimorazole, were tested for antitrichomonad action on Tritrichomonas foetus (KV(1)) and Trichomonas vaginalis (ATCC 30001) for mutagenicity on a nitroreductase-positive (TA 100) and a nitroreductase-deficient (TA 100-FR(1)) strain of Salmonella typhimurium, as well as for the reducibility of the nitro group by T. foetus homogenates. Compounds with activity <1% of that of metronidazole are regarded as inactive. All antitrichomonad compounds induce mutations and can be reduced. S. typhimurium TA 100 gave mutations under both aerobiosis and anaerobiosis; TA 100-FR(1), however, gave mutations only under anaerobiosis. Certain compounds that are reducible, and the nonreducible derivatives, were inactive. Metronidazole and its inactive 4-nitro analogue were reduced in a four-electron process in ferredoxin- or methyl viologen-mediated reactions with the same velocity. The results underscore the role of the reduction of the nitro group in the antitrichomonad and in the mutagenic activity of nitroimidazoles.
Topics: Aerobiosis; Anaerobiosis; Antitrichomonal Agents; Electron Transport; Metronidazole; Mutagens; Nitroimidazoles; Oxidation-Reduction; Salmonella typhimurium; Trichomonas vaginalis; Tritrichomonas
PubMed: 791102
DOI: 10.1128/AAC.10.3.476 -
Microbiology Spectrum Aug 2022Clostridioides difficile is one of the most important human pathogens. The identification of its possible sources is important for the understanding of C. difficile...
Clostridioides difficile is one of the most important human pathogens. The identification of its possible sources is important for the understanding of C. difficile infection (CDI) epidemiology. A total of 16 water samples from wastewater and surface water in South Moravia in the Czech Republic and 82 samples of fish and gulls were collected between May and July 2019. C. difficile isolates were cultured by direct plating and after enrichment on chromogenic media. Susceptibility testing to eight antimicrobials was performed by Etest. C. difficile isolates were characterized by ribotyping, multilocus sequence typing, multilocus tandem repeats analysis, and toxin gene detection. Samples from fish and gulls were C. difficile negative; a total of 15 C. difficile isolates from 8 out of 16 water samples were cultured (6 out of 14 surface water samples yielded 6 isolates, and 2 out of 2 wastewater samples yielded 9 isolates). Direct plating was culture positive in 6 out of 16 samples (12 isolates), and enrichment culture was positive in an additional 2 out of 16 samples (3 isolates). Twelve different ribotyping profiles and 14 sequence types of clades 1, 4, and 5 were identified. Five isolates did not carry genes for toxins, and eight isolates carried genes for toxins A and B; the remaining two isolates (RT078) carried the genes for toxins A, B, and binary. All C. difficile isolates were susceptible to amoxicillin, moxifloxacin, tetracycline, and vancomycin and resistant to ciprofloxacin. A high level of erythromycin resistance (>256 mg/L) was detected in eight isolates. Clindamycin resistance was found in 14 isolates, 6 of which showed a high level of resistance (>256 mg/L) and carried . Surprisingly, one isolate (RT010, ST15) showed resistance to metronidazole (12 mg/L) with the presence of the plasmid pCD-METRO. In conclusion, a diverse spectrum of C. difficile strains was found in wastewater and surface water. A recently discovered plasmid-bound resistance to metronidazole was detected in C. difficile from the surface water sample. The combination of direct plating and culture after enrichment was used in order to gain a spectrum of C. difficile ribotypes present in the water samples. Toxigenic C. difficile ribotypes detected in surface water and in wastewater treatment plants overlapped with those derived from patients with CDI and/or animals. Importantly, a recently discovered plasmid-mediated resistance to metronidazole, a drug used for the treatment of CDI, was detected in C. difficile from river water.
Topics: Animals; Anti-Bacterial Agents; Clostridioides; Clostridioides difficile; Clostridium Infections; Drug Resistance, Bacterial; Humans; Metronidazole; Microbial Sensitivity Tests; Plasmids; Rivers; Wastewater; Water
PubMed: 35950844
DOI: 10.1128/spectrum.00806-22