Treatment of tricuspid valve endocarditis with daptomycin and linezolid therapy

2019 ◽  
Vol 76 (14) ◽  
pp. 1033-1036 ◽  
Author(s):  
Kayla M Galanter ◽  
Jackie Ho
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Tricuspid Valve ◽  
Inhibitory Concentration ◽  
Synergistic Effects ◽  
Skilled Nursing Facility ◽  
Stable Condition ◽  
Multidrug Resistant ◽  
Replacement Procedure ◽  
Days Of Therapy ◽  
Tricuspid Valve Endocarditis

Abstract Purpose A case report of the use of linezolid and daptomycin for the treatment of multidrug-resistant right-sided infective endocarditis is presented. Summary A 36-year-old patient with a history of intravenous drug use was hospitalized for treatment of native tricuspid valve endocarditis resulting in persistent methicillin-resistant Staphylococcus aureus bacteremia. During the admission the patient was unsuccessfully treated with vancomycin monotherapy (final E-test minimum inhibitory concentration, 4 μg/mL). The patient’s treatment was switched to daptomycin and gentamicin, with no improvement in blood culture results over 4 days. Gentamicin was discontinued, and linezolid was administered in combination with daptomycin; bacteremia was cleared after 13 days of linezolid and daptomycin combination therapy. Due to daptomycin resistance (minimum inhibitory concentration, 4 μg/mL), gentamicin was substituted for daptomycin due to the former agent’s synergistic effects with linezolid. After 23 days of therapy the patient was transferred to another facility for a tricuspid valve replacement procedure, which was completed without complications. The patient was transferred in stable condition to a skilled nursing facility to continue antibiotic therapy lasting 6 weeks from the date of surgery. The patient’s blood cultures remained negative. Conclusion A 36-year-old woman with resistant tricuspid valve endocarditis was successfully treated with linezolid in combination with daptomycin.

Genotypic Resistance of Pyrazinamide but Not Minimum Inhibitory Concentration Is Associated With Longer Time to Sputum Culture Conversion in Patients With Multidrug-resistant Tuberculosis

2020 ◽  
Author(s):  
Johanna Kuhlin ◽  
Lina Davies Forsman ◽  
Mikael Mansjö ◽  
Michaela Jonsson Nordvall ◽  
Maria Wijkander ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Multidrug Resistant ◽  
Sputum Culture ◽  
Sputum Culture Conversion ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Culture Conversion

Abstract Background Pyrazinamide (PZA) resistance in multidrug-resistant tuberculosis (MDR-TB) is common; yet, it is not clear how it affects interim and treatment outcomes. Although rarely performed, phenotypic drug susceptibility testing (pDST) is used to define PZA resistance, but genotypic DST (gDST) and minimum inhibitory concentration (MIC) could be beneficial. We aimed to assess the impact of PZA gDST and MIC on time to sputum culture conversion (SCC) and treatment outcome in patients with MDR-TB. Methods Clinical, microbiological, and treatment data were collected in this cohort study for all patients diagnosed with MDR-TB in Sweden from 1992–2014. MIC, pDST, and whole-genome sequencing of the pncA, rpsA, and panD genes were used to define PZA resistance. A Cox regression model was used for statistical analyses. Results Of 157 patients with MDR-TB, 56.1% (n = 88) had PZA-resistant strains and 49.7% (n = 78) were treated with PZA. In crude and adjusted analysis (hazard ratio [HR], 0.49; 95% conficence interval [CI], .29-.82; P = .007), PZA gDST resistance was associated with a 29-day longer time to SCC. A 2-fold decrease in dilutions of PZA MIC for PZA-susceptible strains showed no association with SCC in crude or adjusted analyses (HR, 0.98; 95% CI, .73–1.31; P = .89). MIC and gDST for PZA were not associated with treatment outcome. Conclusions In patients with MDR-TB, gDST PZA resistance was associated with a longer time to SCC. Rapid PZA gDST is important to identify patients who may benefit from PZA treatment.

scholarly journals Isoalantolactone Enhances the Antimicrobial Activity of Penicillin G against Staphylococcus aureus by Inactivating β-Lactamase during Protein Translation

Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 161 ◽  
Author(s):  
Yonglin Zhou ◽  
Yan Guo ◽  
Zhongmei Wen ◽  
Xinxin Ci ◽  
Lining Xia ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Inhibitory Concentration ◽  
Synergistic Effects ◽  
Protein Translation ◽  
Multidrug Resistant ◽  
Cd Spectroscopy ◽  
Penicillin G ◽  
Pcr Assay ◽  
Mechanism Of Inhibition

β-Lactamase-positive Staphylococcus aureus is one of the most prevalent multidrug-resistant pathogens worldwide and is associated with increasing threats to clinical therapeutics and public health. Here, we showed that isoalantolactone (IAL), in combination with penicillin G, exhibited significant synergism against 21 β-lactamase-positive S. aureus strains (including methicillin resistant S. aureus). An enzyme inhibition assay, a checkerboard minimum inhibitory concentration (MIC) assay, a growth curve assay, a time-killing assay, a RT-PCR assay and Circular Dichroism (CD) spectroscopy were performed on different β-lactamases or β-lactamase-positive S. aureus strains, in vitro, to confirm the mechanism of inhibition of β-lactamase and the synergistic effects of the combination of penicillin G and IAL. All the fractional inhibitory concentration (FIC) indices of penicillin G, in combination with IAL, against β-lactamase-positive S. aureus, were less than 0.5, and ranged from 0.10 ± 0.02 to 0.38 ± 0.17. The survival rate of S. aureus-infected mice increased significantly from 35.29% to 88.24% within 144 h following multiple compound therapy approaches. Unlike sulbactam, IAL inactivated β-lactamase during protein translation, and the therapeutic effect of combination therapy with IAL and penicillin G was equivalent to that of sulbactam with penicillin G. Collectively, our results indicated that IAL is a promising and leading drug that can be used to restore the antibacterial effect of β-lactam antibiotics such as penicillin G and to address the inevitable infection caused by β-lactamase-positive S. aureus.

scholarly journals Minimum inhibitory concentration of carbapenems and tigecycline against Salmonella spp.

2009 ◽  
Vol 58 (3) ◽  
pp. 337-341 ◽  
Author(s):  
Malini R. Capoor ◽  
Deepthi Nair ◽  
Jitendra Posti ◽  
Smita Singhal ◽  
Monorama Deb ◽  
...  
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Antimicrobial Resistance ◽  
Final Stage ◽  
Inhibitory Concentration ◽  
Test Strip ◽  
Multidrug Resistant ◽  
Salmonella Spp ◽  
Extended Spectrum ◽  
Agar Dilution

Antimicrobial resistance in Salmonella spp. is of grave concern, more so in quinolone-resistant and extended-spectrum β-lactamase (ESBL)-producing isolates that cause complicated infections. The MIC of azithromycin, ciprofloxacin, cefixime, cefepime, ceftriaxone, gatifloxacin, imipenem, levofloxacin, meropenem and ofloxacin (E-test strip) and tigecycline and faropenem (agar dilution) against 210 Salmonella spp. was determined. MIC90 (defined as the antimicrobial concentration that inhibited growth of 90 % of the strains) of the carbapenems (imipenem and meropenem) for Salmonella Typhi and Salmonella Paratyphi A was 0.064 μg ml−1. MIC90 of faropenem was 0.25 μg ml−1 for S. Typhi, S. Paratyphi A and Salmonella Typhimurium. The MIC90 of azithromycin for all Salmonella spp. ranged from 8 to 16 μg ml−1. Tigecycline showed an MIC90 of 2 μg ml−1 for S. Typhi, 1 μg ml−1 for S. Paratyphi A and 4 μg ml−1 for S. Typhimurium. We concluded that tigecycline and the carbapenems are likely to have roles in the final stage of treatment of quinolone-resistant and ESBL-producing multidrug-resistant salmonellae.

scholarly journals Successful Treatment of Cryptococcal Meningitis and Cryptococcoma with Isavuconazole in a Patient Living with HIV

2021 ◽  
Vol 7 (6) ◽  
pp. 425
Author(s):  
Brendan O’Kelly ◽  
Aia Mohamed ◽  
Colm Bergin ◽  
Fiona Lyons ◽  
Thomas R. Rogers ◽  
...  
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Cryptococcal Meningitis ◽  
Inhibitory Concentration ◽  
Area Under The Curve ◽  
Hiv Positive ◽  
Days Of Therapy ◽  
Daily Dose ◽  
Living With Hiv ◽  
Inflammatory Syndrome ◽  
Modelling Data

We describe the successful use of isavuconazole for treatment of an HIV-positive patient with cryptococcal meningitis following induction therapy with liposomal amphotericin B and flucytosine. Because the Cryptococcus neoformans isolate from cerebrospinal fluid had a borderline minimum inhibitory concentration of 8 mg/L, initial consolidation therapy was given with a daily dose of fluconazole 1200 mg based on area under the curve to minimum inhibitory concentration modelling data. Toxicity, and the radiological emergence of a cryptococcoma in the setting of immune reconstitution inflammatory syndrome, prompted a therapeutic switch to isavuconazole. Subsequent imaging after 19 weeks of isavuconazole shows a significant reduction in cryptococcoma size from 11 mm to complete resolution. The patient remains well after 210 days of therapy with a view to completion of treatment after 1 year.

scholarly journals Activity of solvent extracts of Prosopis spicigera, Zingiber officinale and Trachyspermum ammi against multidrug resistant bacterial and fungal strains

2010 ◽  
Vol 4 (05) ◽  
pp. 292-300 ◽  
Author(s):  
Rosina Khan ◽  
Mohammad Zakir ◽  
Sadul H Afaq ◽  
Abdul Latif ◽  
Asad U Khan
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Antimicrobial Agents ◽  
Inhibitory Concentration ◽  
Zingiber Officinale ◽  
Multidrug Resistant ◽  
Dilution Method ◽  
Phytochemical Analysis ◽  
Trachyspermum Ammi ◽  
Soxhlet Apparatus ◽  
Study Results

Background: The emerging trends of multidrug resistance among several groups of microorganisms against different classes of antibiotics led different researchers to develop efficient drugs from plant sources to counter multidrug resistant strains. This study investigated different solvent extracts of Prosopis spicigera (P. Spicigera), Zingiber officinale, and Trachyspermum ammi (T. ammi) to determine their efficacy against multidrug resistant microbes. Methodology: Successive extractions of these plants were performed using a Soxhlet apparatus, using solvents with increasing polarities. Preliminary phytochemical analysis was also performed .Minimum inhibitory concentration was determined by a two-fold serial dilution method followed by determination of minimum bactericidal/fungicidal concentration. Multidrug resistant (MDR) strains of Candida albicans, Candida krusei, Candida tropicalis, Candida glabrata, Escherichia coli and reference strains of Streptococcus mutans and Streptococcus bovis were used in the study. Results: The ethanolic fraction of P. spicigera (least minimum inhibitory concentration [MIC] - 4.88 µg/ml) demonstrated a remarkable inhibition of the microorganisms while fractions obtained from those of Zingiber officinale (least MIC-78.125 µg/ml) exhibited little activity. The petroleum ether fraction of T. ammi (least MIC- 625 µg/ml) showed best activity when compared to its other fractions. Qualitative analysis of the phytoconstituents was also performed. Conclusions: The potency shown by these extracts recommends their use against multidrug resistant microorganisms. This study also showed that P. spicigera could be a potential source of new antimicrobial agents.

scholarly journals ANTIMICROBIAL ACTIVITY OF PINEAPPLE (ANANAS COMOSUS L. MERR) EXTRACT AGAINST MULTIDRUG-RESISTANT OF PSEUDOMONAS AERUGINOSA: AN IN VITRO STUDY

2017 ◽  
Vol 6 (5) ◽  
pp. 118 ◽  
Author(s):  
Rahmat Sayyid Zharfan ◽  
Priyo Budi Purwono ◽  
Arifa Mustika
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Minimum Bactericidal Concentration ◽  
Agar Plate ◽  
Multidrug Resistant ◽  
Ananas Comosus ◽  
Tract Infections

Pseudomonas aeruginosa is the main cause of nosocomial infection which is responsible for 10% of hospital-acquired infection. Pseudomonas aeruginosa tends to mutate and displays potential for development of antibiotic resistance. Approximately, 10% of global bacterial isolates are found as Multidrug-resistant Pseudomonas aeruginosa. Pseudomonas aeruginosa have a quite tremendous severity index, especially on pneumonia and urinary tract infections, even sepsis, which 50% mortality rate. Pineapple (Ananas comosus L. Merr) has antimicrobial properties. The active antimicrobial compounds in Ananas comosus L. Merr include saponin and bromelain. This research aims to find the potency of antimicrobial effect of pineapple (Ananas comosus L. Merr) extract towards Multidrug-resistant Pseudomonas aeruginosa. Multidrug-resistant Pseudomonas aeruginosa specimen is obtained from patient’s pus in orthopaedic department, Dr Soetomo Public Hospital, Surabaya. Multidrug-resistant Pseudomonas aeruginosa specimen is resistant to all antibiotic agents except cefoperazone-sulbactam. This research is conducted by measuring the Minimum Inhibitory Concentration (MIC) through dilution test with Mueller-Hinton broth medium. Pineapple extract (Ananas comosus L. Merr.) is dissolved in aquadest, then poured into test tube at varying concentrations (6 g/ml; 3 g/ml; 1.5 g/ml; 0.75 g/ml, 0.375 g/ml; and 0.1875 g/ml). After 24 hours’ incubation, samples are plated onto nutrient agar plate, to determine the Minimum Bactericidal Concentration (MBC). The extract of pineapple (Ananas comosus L. Merr) has antimicrobial activities against Multidrug-resistant Pseudomonas aeruginosa. Minimum Inhibitory Concentration (MIC) could not be determined, because turbidity changes were not seen. The Minimum Bactericidal Concentration (MBC) of pineapple extract (Ananas comosus L. Merr) to Multidrug-resistant Pseudomonas aeruginosa is 0.75 g/ml. Further study of in vivo is needed.

scholarly journals Generating Ampicillin-Level Antimicrobial Peptides with Activity-Aware Generative Adversarial Networks

2020 ◽  
Author(s):  
Andrejs Tucs ◽  
Duy Phuoc Tran ◽  
Akiko Yumoto ◽  
Yoshihiro Ito ◽  
Takanori Uzawa ◽  
...  
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Antimicrobial Peptides ◽  
Inhibitory Concentration ◽  
Multidrug Resistant ◽  
Generative Models ◽  
Generative Adversarial Networks ◽  
Potential Solution ◽  
Active Peptides ◽  
Adversarial Networks ◽  
Physicochemical Descriptors

<p>Antimicrobial peptides are a potential solution to the threat of multidrug-resistant bacterial pathogens. Recently, deep generative models including generative adversarial networks (GANs) have been shown to be capable of designing new antimicrobial peptides. Intuitively, a GAN controls the probability distribution of generated sequences to cover active peptides as much as possible. This paper presents a peptide-specialized model called PepGAN that takes the balance between covering active peptides and</p><p>dodging non-active peptides. As a result, PepGAN has superior statistical fidelity with respect to physicochemical descriptors including charge, hydrophobicity and weight. Top six peptides were synthesized and one of them was confirmed to be highly antimicrobial. The minimum inhibitory concentration was 3.1μg/mL, indicating that the peptide is twice as strong as ampicillin.</p>

Surveillance of antimicrobial resistance of Salmonella enterica serotype Typhi in seven Asian countries

2008 ◽  
Vol 137 (2) ◽  
pp. 266-269 ◽  
Author(s):  
C.-H. CHUANG ◽  
L.-H. SU ◽  
J. PERERA ◽  
C. CARLOS ◽  
B. H. TAN ◽  
...  
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Antimicrobial Resistance ◽  
Salmonella Enterica ◽  
Inhibitory Concentration ◽  
Multidrug Resistant ◽  
Asian Countries

SUMMARYTwo hundred and four Salmonella enterica serotype Typhi (S. Typhi) isolates were collected from seven Asian countries during 2002–2004. Multidrug-resistant S. Typhi (resistant to ⩾3 antibiotics) was detected in 84 (41·2%) isolates and 142 (69·6%) showed reduced susceptibility to ciprofloxacin (minimum inhibitory concentration=0·125–1·0 mg/l). This study highlights the worsening situation of antimicrobial resistance of S. Typhi in Asia.

Sign in / Sign up

Export Citation Format

Share Document