scholarly journals A Narrative Review of Early Oral Stepdown Therapy for the Treatment of Uncomplicated Staphylococcus aureus Bacteremia: Yay or Nay?

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Michael Dagher ◽  
Vance G Fowler ◽  
Patty W Wright ◽  
Milner B Staub
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Readmission ◽  
Potential Role ◽  
Review Article ◽  
Narrative Review ◽  
Oral Antibiotics ◽  
Staphylococcus Aureus Bacteremia ◽  
Complete Treatment

Abstract Historically, intravenous (IV) antibiotics have been the cornerstone of treatment for uncomplicated Staphylococcus aureus bacteremia (SAB). However, IV antibiotics are expensive, increase the rates of hospital readmission, and can be associated with catheter-related complications. As a result, the potential role of oral antibiotics in the treatment of uncomplicated SAB has become a subject of interest. This narrative review article aims to summarize key arguments for and against the use of oral antibiotics to complete treatment of uncomplicated SAB and evaluates the available evidence for specific oral regimens. We conclude that evidence suggests that oral step-down therapy can be an alternative for select patients who meet the criteria for uncomplicated SAB and will comply with medical treatment and outpatient follow-up. Of the currently studied regimens discussed in this article, linezolid has the most support, followed by fluoroquinolone plus rifampin.

scholarly journals Top Questions in Uncomplicated, Non–Staphylococcus aureus Bacteremia

2018 ◽  
Vol 5 (5) ◽  
Author(s):  
Jesse D Sutton ◽  
Sena Sayood ◽  
Emily S Spivak
Keyword(s):  
Staphylococcus Aureus ◽  
Infectious Diseases ◽  
Blood Cultures ◽  
Oral Antibiotics ◽  
Beta Lactams ◽  
Duration Of Therapy ◽  
Staphylococcus Aureus Bacteremia

Abstract The Infectious Diseases Society of America infection-specific guidelines provide limited guidance on the management of focal infections complicated by secondary bacteremias. We address the following 3 commonly encountered questions and management considerations regarding uncomplicated bacteremia not due to Staphylococcus aureus: the role and choice of oral antibiotics focusing on oral beta-lactams, the shortest effective duration of therapy, and the role of repeat blood cultures.

scholarly journals Relative importance of the bacteria Brucella, Salmonella, Staphylococcus and other indicator bacteria in some mountain farm waters in West-Cameroon (Central Africa) and the potential role of some environmental factors

2020 ◽  
Vol 8 (2) ◽  
pp. 081-084
Author(s):  
Pierrette Ngo Bahebeck ◽  
Mireille Ebiane Nougang ◽  
Paul Alain Nana ◽  
Claire Stéphane Metsopkeng ◽  
Antoine Tamsa Arfao ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surface Waters ◽  
Brucella Abortus ◽  
Physicochemical Parameters ◽  
Potential Role ◽  
Abiotic Factors ◽  
Central Africa ◽  
Mountainous Regions ◽  
Brucella Suis

A bacteriological and physicochemical study was conducted in the waters of farms in mountainous regions of Cameroon. The different water samples were collected during two campaigns in December 2018 and February 2019. Ten stations representing the drinking water supply points in our study area were identified. The results showed that these waters contained both pathogenic and commensal fecal bacteria. The highest abundances reached 10x103 CFU/100mL for Salmonella sp., 72x103 CFU/100mL for Staphylococcus aureus, 102x103 CFU/100mL for Brucella suis and 40x103 CFU/100mL for Brucella abortus. These abundances were subject to space-time fluctuations. Water contamination by tweezers was not general and was present only in surface waters (rivers and ponds). The water in the ponds, rivers and wells analyzed were all basic, with low mineralization on average. The dissolved oxygen ranged from 37.5 to 70.6%, nitrate from 3.7 to 19.8 mg/L and iron from 0.01 to 3.5 mg/L. Most of the physicochemical parameters were relatively stable during the two campaigns. The degree of correlation between the physicochemical parameters and the abundance dynamics of the isolated bacteria was heterogeneous. This was clearly more pronounced with Salmonella sp. and Brucella suis. This would be due to the fraction of metabolically active cells present when the bacteria are exposed to unfavorable conditions. Correlations with the abiotic factors were less marked with Staphylococcus aureus and Brucella abortus; this would be due to their tolerance to environmental stresses.

scholarly journals Interleukin (IL)-1β and IL-10 Host Responses in Patients With Staphylococcus aureus Bacteremia Determined by Antimicrobial Therapy

2019 ◽  
Vol 70 (12) ◽  
pp. 2634-2640 ◽  
Author(s):  
Cecilia F Volk ◽  
Sarah Burgdorf ◽  
Graham Edwardson ◽  
Victor Nizet ◽  
George Sakoulas ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Therapy ◽  
Ex Vivo ◽  
Host Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Treatment Groups ◽  
Staphylococcus Aureus Bacteremia ◽  
Medical Centers ◽  
Persistent Bacteremia

Abstract Background Patient interleukin (IL)-1β and IL-10 responses early in Staphylococcus aureus bacteremia (SaB) are associated with bacteremia duration and mortality. We hypothesized that these responses vary depending on antimicrobial therapy, with particular interest in whether the superiority of β-lactams links to key cytokine pathways. Methods Three medical centers included 59 patients with SaB (47 methicillin-resistant S. aureus [MRSA], 12 methicillin-sensitive S. aureus [MSSA]) from 2015–2017. In the first 48 hours, patients were treated with either a β-lactam (n = 24), including oxacillin, cefazolin, or ceftaroline, or a glyco-/lipopeptide (n = 35), that is, vancomycin or daptomycin. Patient sera from days 1, 3, and 7 were assayed for IL-1β and IL-10 by enzyme-linked immunosorbent assay and compared using the Mann-Whitney U test. Results On presentation, IL-10 was elevated in mortality (P = .008) and persistent bacteremia (P = .034), while no difference occurred in IL-1β. Regarding treatment groups, IL-1β and IL-10 were similar prior to receiving antibiotic. Patients treated with β-lactam had higher IL-1β on days 3 (median +5.6 pg/mL; P = .007) and 7 (+10.9 pg/mL; P = .016). Ex vivo, addition of the IL-1 receptor antagonist anakinra to whole blood reduced staphylococcal killing, supporting an IL-1β functional significance in SaB clearance. β-lactam–treated patients had sharper declines in IL-10 than vancomycin or daptomycin –treated patients over 7 days. Conclusions These data underscore the importance of β-lactams for SaB, including consideration that the adjunctive role of β-lactams for MRSA in select patients helps elicit favorable host cytokine responses.

Intraperitoneal recombinant alpha-2-interferon alternating with cisplatin as salvage therapy for minimal residual-disease ovarian cancer: a phase II study.

1990 ◽  
Vol 8 (6) ◽  
pp. 1036-1041 ◽  
Author(s):  
M Nardi ◽  
F Cognetti ◽  
C F Pollera ◽  
M D Giulia ◽  
A Lombardi ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Phase Ii ◽  
Salvage Therapy ◽  
Potential Role ◽  
Residual Disease ◽  
Phase Ii Study ◽  
Positive Cytology ◽  
Chemical Peritonitis

A phase II study was initiated in March 1987 at the Regina Elena National Cancer Institute of Rome to evaluate the efficacy of alternating intraperitoneal (IP) recombinant alpha-2-interferon (r-alpha 2-IFN) and cisplatin (DDP) as salvage therapy for less than or equal to 5 mm residual-disease (RD) ovarian carcinoma. Fourteen assessable patients entered the study. All had received prior chemotherapy (11 with DDP-based regimens); five patients had macroscopic RD (less than or equal to 5 mm), and nine had microscopic RD (histologically positive random biopsies and/or positive cytology and immunocytochemical tests). The response to IP immunochemotherapy was evaluated by laparotomy. Pathologic complete remissions (PCRs) were achieved in seven patients (50%) who have remained free of disease with a median follow-up of 22+ months (range, 11+ to 30+ months). Six patients achieved a stable disease and one presented disease progression. With the exception of chemical peritonitis-induced adhesions, no limiting toxicity was observed. The results obtained in this small, highly selected series demonstrate that a high PCR rate may be obtained with IP immunochemotherapy with DDP and r-alpha 2-IFN as salvage therapy in residual ovarian carcinoma less than or equal to 5 mm after first-line chemotherapy also including intravenous (IV) DDP. Larger comparative studies must be conducted to establish the potential role of IP DDP and r-alpha 2-IFN as compared with either of the single treatments.

scholarly journals Propranolol as an effective therapy for infantile haemangioma of the urinary bladder

2019 ◽  
Vol 12 (2) ◽  
pp. e226929
Author(s):  
Taha Anwar ◽  
Elizabeth Malm-Buatsi
Keyword(s):  
Surgical Treatment ◽  
Urinary Bladder ◽  
Medical Therapy ◽  
Potential Role ◽  
Marked Decrease ◽  
Surgical Techniques ◽  
Cutaneous Lesions ◽  
Infantile Haemangiomas

Infantile haemangiomas are one of the most common tumours in infancy, but typically present as cutaneous lesions; haemangiomas of the urinary bladder are incredibly rare. Although benign, these can sometimes ulcerate and bleed, causing haematuria in the case of bladder lesions. Propranolol is a well-documented medical therapy for cutaneous lesions, but surgical treatment dominates the literature on bladder haemangiomas. We present the case of a child with infantile haemangiomas of the urinary bladder, as well as internal and cutaneous lesions, treated with propranolol. At 6-week follow-up cystoscopy and MRI, there was a significant improvement in both bladder and internal lesions, respectively. Follow-up with dermatology 9 months after initiation of propranolol demonstrated excellent regression of the cutaneous lesions with a marked decrease in both size and prominence. This case demonstrates the potential role of propranolol in the treatment of bladder haemangiomas in lieu of more invasive surgical techniques.

scholarly journals Imaging in polymyalgia rheumatica

Reumatismo ◽  
2018 ◽  
Vol 70 (1) ◽  
pp. 51 ◽  
Author(s):  
N. Possemato ◽  
C. Salvarani ◽  
N. Pipitone
Keyword(s):  
Polymyalgia Rheumatica ◽  
Morning Stiffness ◽  
Imaging Techniques ◽  
Review Article ◽  
Inflammatory Disorder ◽  
Chronic Inflammatory Disorder ◽  
Pet Ct ◽  
Ct And Mri

Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause clinically characterized by pain and prolonged morning stiffness affecting the shoulders and often the pelvic girdle and neck. Imaging has substantially contributed to defining PMR as a disease mainly involving extra-articular structures. This review article analyses the role of the different imaging techniques in the diagnosis and follow-up of patients with PMR with particular emphasis on the role of ultrasound, PET/CT and MRI.

scholarly journals Potential role of post‑treatment follow‑up FDG‑PET CT to detect mandibular osteoradionecrosis: A case report

2017 ◽  
Author(s):  
Masaya Akashi ◽  
Satoshi Wanifuchi ◽  
Junya Kusumoto ◽  
Megumi Kishimoto ◽  
Yasumasa Kakei ◽  
...  
Keyword(s):  
Case Report ◽  
Fdg Pet ◽  
Potential Role ◽  
Post Treatment ◽  
Pet Ct ◽  
Fdg Pet Ct

Investigating and critically appraising the expression and potential role of androgen receptor in breast carcinoma

2011 ◽  
Vol 7 (1) ◽  
Author(s):  
Mark B. Peter ◽  
Abeer M. Shaaban ◽  
Sree Sundara Rajan ◽  
Loaie Maraqa ◽  
Kieran Horgan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Androgen Receptor ◽  
Potential Role ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Continuous Variable ◽  
Endocrine Treatment ◽  
Breast Cancer Death

AbstractThe potential role of the androgen receptor (AR) as a predictive or prognostic factor in breast cancer remains unclear. We aimed to determine the prognostic significance of AR in a cohort of breast carcinomas with long-term follow-up and to critically appraise this in the context of existing literature. Four hundred and eight cases of invasive breast cancer were incorporated into tissue microarrays (TMAs). All received tamoxifen and comprised 108 cases which relapsed and 300 cases which did not. Mean follow-up time for the former was 84 months (range 1–142, SD 38.8) and for the latter was 77 months (range 11–229, SD 49.7). TMAs were immunohistochemically stained with AR and scored as a continuous variable and using the Allred score. AR expression was significantly associated with grade, recurrence on tamoxifen, non-breast cancer death estrogen receptor alpha (ERα) and progesterone receptor (PR). AR correlated significantly with better overall survival (OS) and disease-free survival (DFS) using an Allred cut-off of 4 (log rank=0.0053 and 0.0044, respectively), and 20% positive tumor cells (log rank=0.0027 and 0.0059, respectively). AR expression was additionally associated with a reduced risk of recurrence following endocrine therapy. In summary, AR positive breast tumors have better OS and DFS and are less likely to recur following endocrine treatment.

scholarly journals Jumping the Barrier to β-Lactam Resistance in Staphylococcus aureus

2003 ◽  
Vol 185 (18) ◽  
pp. 5465-5472 ◽  
Author(s):  
Yuki Katayama ◽  
Hong-Zhong Zhang ◽  
Dong Hong ◽  
Henry F. Chambers
Keyword(s):  
Staphylococcus Aureus ◽  
Potential Role ◽  
Methicillin Resistance ◽  
Population Analysis ◽  
Regulatory Genes ◽  
Resistance Determinant ◽  
Host Chromosome ◽  
Resistance Phenotype ◽  
Mrsa Strains

ABSTRACT Although the staphylococcal methicillin resistance determinant, mecA, resides on a mobile genetic element, staphylococcus cassette chromosome mec (SCCmec), its distribution in nature is limited to as few as five clusters of related methicillin-resistant Staphylococcus aureus (MRSA) clones. To investigate the potential role of the host chromosome in clonal restriction of the methicillin resistance determinant, we constructed plasmid pYK20, carrying intact mecA, and introduced it into several methicillin-susceptible Staphylococcus aureus strains, five of which were naive hosts (i.e., mecA not previously resident on the host chromosome) and five of which were experienced hosts (i.e., methicillin-susceptible variants of MRSA strains from which SCCmec was excised). We next assessed the effect of the recipient background on the methicillin resistance phenotype by population analysis, by assaying the mecA expression of PBP2a by Western blot analysis, and by screening for mutations affecting mecA. Each experienced host transformed with pYK20 had a resistance phenotype and expressed PBP2a similar to that of the parent with chromosomal SCCmec, but naive hosts transformed with pYK20 selected against its expression, indicative of a host barrier. Either inducible β-lactamase regulatory genes blaR1-blaI or homologous regulatory genes mecR1-mecI, which control mecA expression, acted as compensatory elements, permitting the maintenance and expression of plasmid-carried mecA.

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