scholarly journals Increasing Chloramphenicol Resistance in Streptococcus pneumoniae Isolates from Papua New Guinean Children with Acute Bacterial Meningitis

2011 ◽  
Vol 55 (9) ◽  
pp. 4454-4456 ◽  
Author(s):  
Laurens Manning ◽  
Moses Laman ◽  
Andrew R. Greenhill ◽  
Audrey Michael ◽  
Peter Siba ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Acute Bacterial Meningitis ◽  
Time Curve ◽  
Chloramphenicol Resistance ◽  
Content Type ◽  
Concentration Time ◽  
Data Support ◽  
Papua New Guinean

ABSTRACTIn Papua New Guinean (PNG) children with acute bacterial meningitis (ABM), allHaemophilus influenzaeisolates were resistant to chloramphenicol. AlthoughStreptococcus pneumoniaeisolates had a median chloramphenicol MIC of 3 μg/ml, it was ≥4 μg/ml in 42.8%, and the likelihood of an area under the 24-hour concentration-time curve/MIC ratio of >100 h at a MIC of ≥4 μg/ml was approximately 50%. All isolates were ceftriaxone sensitive. These data support ceftriaxone rather than conventional chloramphenicol for all PNG children with suspected ABM.

scholarly journals Multicenter Hospital-Based Prospective Surveillance Study of Bacterial Agents Causing Meningitis and Seroprevalence of Different Serogroups of Neisseria meningitidis, Haemophilus influenzae Type b, and Streptococcus pneumoniae during 2015 to 2018 in Turkey

mSphere ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Mehmet Ceyhan ◽  
Yasemin Ozsurekci ◽  
Sevgen Tanır Basaranoglu ◽  
Nezahat Gurler ◽  
Enes Sali ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Neisseria Meningitidis ◽  
Surveillance Study ◽  
Haemophilus Influenzae Type ◽  
Acute Bacterial Meningitis ◽  
Close Monitoring ◽  
Type B ◽  
Content Type

ABSTRACT The etiology of bacterial meningitis in Turkey changed after the implementation of conjugated vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) in the Turkish National Immunization Program (NIP). Administration of Hib vaccine and PCV-7 (7-valent pneumococcal conjugate vaccine) was implemented in NIP in 2006 and 2009, respectively. In 2011, PCV-7 was replaced with PCV-13. Meningococcal vaccines have not yet been included in Turkish NIP. This prospective study comprised 27 hospitals located in seven regions of Turkey and represented 45% of the population. Children aged between 1 month and 18 years who were hospitalized with suspected meningitis were included. Cerebrospinal fluid (CSF) samples were collected, and bacterial identification was made according to the multiplex PCR assay results. During the study period, 994 children were hospitalized for suspected meningitis, and Hib (n = 3, 2.4%), S. pneumoniae (n = 33, 26.4%), and Neisseria meningitidis (n = 89, 71%) were detected in 125 samples. The most common meningococcal serogroup was MenB. Serogroup W comprised 13.9% (n = 5) and 7.5% (n = 4) of the meningococci in 2015 to 2016 and 2017 to 2018, respectively. Serogroup C was not detected. There were four deaths in the study; one was a pneumococcus case, and the others were serogroup B meningococcus cases. The epidemiology of meningococcal diseases has varied over time in Turkey. Differing from the previous surveillance periods, MenB was the most common serogroup in the 2015-to-2018 period. Meningococcal epidemiology is so dynamic that, for vaccination policies, close monitoring is crucial. IMPORTANCE Acute bacterial meningitis (ABM) is one of the most common life-threatening infections in children. The incidence and prevalence of ABM vary both geographically and temporally; therefore, surveillance systems are necessary to determine the accurate burden of ABM. The Turkish Meningitis Surveillance Group has been performing a hospital-based meningitis surveillance study since 2005 across several regions in Turkey. Meningococcus was the major ABM-causing agent during the 2015-to-2018 period, during which MenB was the dominant serogroup.

scholarly journals Detection of Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in Cerebrospinal Fluid by Multiplex PCR for Diagnosis of Acute Bacterial Meningitis in Paediatric Population

2017 ◽  
Vol 11 (2) ◽  
pp. 9-16
Author(s):  
Nilufar Yeasmin Nili
Keyword(s):  
Streptococcus Pneumoniae ◽  
16S Rrna ◽  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Neisseria Meningitidis ◽  
Multiplex Pcr ◽  
Bacterial Culture ◽  
Acute Bacterial Meningitis ◽  
Pcr Assay ◽  
Etiologic Diagnosis

The present study was done to evaluate a multiplex PCR based method for simultaneous detection of Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in CSF. A cross sectional study was carried out with 140 children (2 months to 12 years of age) with clinical suspicion of acute meningitis during July 2010 to June 2011. Three species-specific primers were used along with universal primers of bacterial gene 16S rRNA, in a two-stage PCR assay for diagnosis of acute bacterial meningitis.Among 140 patients, 42 (30%) cases were diagnosed as bacterial meningitis and other 98 (70%) as viral meningitis by clinical and cytobiochemical criteria. Out of 42 bacterial meningitis cases, 9 (21.43%) were positive by Gram stain.These 9 cases were also positive by bacterial culture and PCR. Again, 15 (35.71%) were positive by bacterial culture which were also PCR positive. In 27 cases (out of 42), the etiologic diagnosis was not possible using routine bacteriological methods; in 11 of these patients, the etiologic agents were identified by PCR. In addition, PCR recognized 5 more cases whose etiologic diagnosis was not possible, as they were identified by universal primer of 16S rRNA. Hence, among 31 (73.81%) PCR positive cases, 12 (38.71%) were S. pneumoniae, 10 (32.26%) were H. influenzae, 4 (12.9%) were N. meningitidis and 5 (16.13%) were other bacteria.Among the antibiotic users, bacterial meningitis case detection by PCR was higher (65.52%) than that of culture (10.34%) and Gram staining (6.90%). The overall sensitivity and specificity of PCR assay was 100% and 66% respectively when bacterial culture was considered as gold standard. PCR can be used as a valuable supplementary diagnostic technique in routine clinical practice for diagnosis of acute bacterial meningitis in hospital setting. Bangladesh J Med Microbiol 2017; 11 (2): 9-16

scholarly journals Pharmacokinetic-Pharmacodynamic Characterization of Omadacycline against Haemophilus influenzae Using a One-Compartment In Vitro Infection Model

2020 ◽  
Vol 64 (6) ◽  
Author(s):  
Brian D. VanScoy ◽  
Elizabeth A. Lakota ◽  
Haley Conde ◽  
Jennifer McCauley ◽  
Lawrence Friedrich ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Antimicrobial Agents ◽  
Nonlinear Least Squares ◽  
Infection Model ◽  
Least Squares Regression ◽  
Total Drug ◽  
Time Curve ◽  
Content Type ◽  
Concentration Time

ABSTRACT Omadacycline is a novel aminomethylcycline with activity against Gram-positive and -negative organisms, including Haemophilus influenzae, which is one of the leading causes of community-acquired bacterial pneumonia (CABP). The evaluation of antimicrobial agents against H. influenzae using standard murine infection models is challenging due to the low pathogenicity of this species in mice. Therefore, 24-h dose-ranging studies using a one-compartment in vitro infection model were undertaken with the goal of characterizing the magnitude of the ratio of the area under the concentration-time curve (AUC) to the MIC (AUC/MIC ratio) associated with efficacy for a panel of five H. influenzae isolates. These five isolates, for which MIC values were 1 or 2 mg/liter, were exposed to omadacycline total-drug epithelial lining fluid (ELF) concentration-time profiles based on those observed in healthy volunteers following intravenous omadacycline administration. Relationships between change in log10 CFU/ml from baseline at 24 h and the total-drug ELF AUC/MIC ratios for each isolate and for the isolates pooled were evaluated using Hill-type models and nonlinear least-squares regression. As evidenced by the high coefficients of determination (r2) of 0.88 to 0.98, total-drug ELF AUC/MIC ratio described the data well for each isolate and the isolates pooled. The median total-drug ELF AUC/MIC ratios associated with net bacterial stasis and 1- and 2-log10 CFU/ml reductions from baseline at 24 h were 6.91, 8.91, and 11.1, respectively. These data were useful to support the omadacycline dosing regimens selected for the treatment of patients with CABP, as well as susceptibility breakpoints for H. influenzae.

scholarly journals Efficacy of Solithromycin (CEM-101) for Experimental Otitis Media Caused by Nontypeable Haemophilus influenzae and Streptococcus pneumoniae

2016 ◽  
Vol 60 (9) ◽  
pp. 5533-5538 ◽  
Author(s):  
M. Figueira ◽  
P. Fernandes ◽  
S. I. Pelton
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Middle Ear ◽  
Fourth Generation ◽  
Minimal Bactericidal Concentration ◽  
Nontypeable Haemophilus Influenzae ◽  
Time Curve ◽  
Content Type ◽  
Middle Ear Fluid

ABSTRACTSolithromycin (CEM-101) is a “fourth-generation” macrolide, as it has three binding site and is acid stable. The three binding sites confer activity against bacteria resistant to the older macrolides and ketolides, including multidrug-resistantStreptococcus pneumoniaeand nontypeableHaemophilus influenzae(NTHi). The objective of this study was to evaluate solithromycin pharmacokinetics (PK), middle ear fluid (MEF) concentrations, and microbiologic efficacy in a chinchilla model of experimental otitis media (EOM) due to strains ofS. pneumoniaeor NTHi. Plasma PK (maximum concentration of drug in serum [Cmax] and area under the concentration-time curve from 0 to 24 h [AUC0–24]) and middle ear fluid (MEF) concentrations were determined. Isolates with specified antimicrobial susceptibility patterns were inoculated directly into the middle ear (ME). Plasma and MEF were collected for PK and MEF cultures performed to determine efficacy. Solithromycin administered at 150 mg/kg of body weight/day resulted inCmaxand AUC0–24values of 2.2 μg/ml and 27.4 μg · h/ml in plasma and 1.7 μg/ml and 28.2 μg · h/ml in extracellular MEF on day 1. By day 3,Cmaxand AUC0–24values had increased to 4.5 μg/ml and 54 μg · h/ml in plasma and 4.8 μg/ml and 98.6 μg · h/ml in extracellular MEF. For NTHi EOM, three isolates with MIC/minimal bactericidal concentration (MBC) ratios of 0.5/1 μg/ml (isolate BCH1), 2/2 μg/ml (isolate BMC1247C), and 4/4 μg/ml (isolate BMC1213C) were selected. The MEF of >85% of animals infected with BCH1 and BMC1247C was sterilized. For NTHi BMC1213, >85% of MEF cultures remained positive. ForS. pneumoniaeEOM, 3 isolates with MIC/MBC ratios of 0.06/0.125 μg/ml (S. pneumoniae331), 0.125/1 μg/ml (S. pneumoniaeCP-645 [MLSBphenotype]), and 0.5/2 μg/ml (CP-712 [mefAsubclassmefAresistance]) were selected. Solithromycin sterilized MEF in 100% of animals infected withS. pneumoniae331 andS. pneumoniaeCP-645. ME infection persisted in 60% of animals infected with CP-712. In a model of EOM, solithromycin sterilized MEF in >85% of animals challenged with NTHi with an MIC of ≤2 μg/ml and 100% of ME infected withS. pneumoniaewith an MIC of ≤0.125 μg/ml.

scholarly journals Pharmacokinetics/Pharmacodynamics of Peptide Deformylase Inhibitor GSK1322322 against Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in Rodent Models of Infection

2015 ◽  
Vol 60 (1) ◽  
pp. 180-189 ◽  
Author(s):  
Jennifer Hoover ◽  
Thomas Lewandowski ◽  
Robert J. Straub ◽  
Steven J. Novick ◽  
Peter DeMarsh ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Lung Model ◽  
Peptide Deformylase ◽  
Dose Fractionation ◽  
Mouse Lung ◽  
Time Curve ◽  
Content Type

ABSTRACTGSK1322322 is a novel inhibitor of peptide deformylase (PDF) with goodin vitroactivity against bacteria associated with community-acquired pneumonia and skin infections. We have characterized thein vivopharmacodynamics (PD) of GSK1322322 in immunocompetent animal models of infection withStreptococcus pneumoniaeandHaemophilus influenzae(mouse lung model) and withStaphylococcus aureus(rat abscess model) and determined the pharmacokinetic (PK)/PD index that best correlates with efficacy and its magnitude. Oral PK studies with both models showed slightly higher-than-dose-proportional exposure, with 3-fold increases in area under the concentration-time curve (AUC) with doubling doses. GSK1322322 exhibited dose-dependentin vivoefficacy against multiple isolates ofS. pneumoniae,H. influenzae, andS. aureus. Dose fractionation studies with twoS. pneumoniaeandS. aureusisolates showed that therapeutic outcome correlated best with the free AUC/MIC (fAUC/MIC) index inS. pneumoniae(R2, 0.83), whereasfAUC/MIC and free maximum drug concentration (fCmax)/MIC were the best efficacy predictors forS. aureus(R2, 0.9 and 0.91, respectively). Median dailyfAUC/MIC values required for stasis and for a 1-log10reduction in bacterial burden were 8.1 and 14.4 for 11S. pneumoniaeisolates (R2, 0.62) and 7.2 and 13.0 for fiveH. influenzaeisolates (R2, 0.93). The data showed that for eightS. aureusisolates,fAUC correlated better with efficacy thanfAUC/MIC (R2, 0.91 and 0.76, respectively), as efficacious AUCs were similar for all isolates, independent of their GSK1322322 MIC (range, 0.5 to 4 μg/ml). MedianfAUCs of 2.1 and 6.3 μg · h/ml were associated with stasis and 1-log10reductions, respectively, forS. aureus.

scholarly journals In Vivo Pharmacodynamic Target Assessment of Antofloxacin against Streptococcus pneumoniae and Staphylococcus aureus in a Neutropenic Murine Pneumonia Model

2020 ◽  
Vol 64 (12) ◽  
Author(s):  
Yu-Feng Zhou ◽  
Ping Liu ◽  
Shu-He Dai ◽  
Jian Sun ◽  
Ya-Hong Liu ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Streptococcus Pneumoniae ◽  
Free Drug ◽  
Time Curve ◽  
Content Type ◽  
Concentration Time ◽  
Lung Epithelial ◽  
The Mean ◽  
And Staphylococcus Aureus

ABSTRACT We determined in vivo efficacy and target PK/PD exposures of antofloxacin against Streptococcus pneumoniae and Staphylococcus aureus in the murine pneumonia model. The mean plasma free drug area under the concentration-time curve/MIC (fAUC/MIC) targets associated with stasis and 1-log10 and 2-log10 kill effects were 8.93, 19.2, and 48.1, respectively, for S. pneumoniae, whereas they were 30.5, 55.4, and 115.8, respectively, for S. aureus. The fAUC/MIC targets in murine lung epithelial lining fluids (ELF) for the same endpoints were nearly 2-fold higher than those in plasma.

scholarly journals In Vitro Pharmacokinetic and Pharmacodynamic Evaluation of S-013420 against Haemophilus influenzae and Streptococcus pneumoniae

2010 ◽  
Vol 54 (10) ◽  
pp. 4300-4305 ◽  
Author(s):  
Tomoyuki Homma ◽  
Toshihiko Hori ◽  
Merime Ohshiro ◽  
Hideki Maki ◽  
Yoshinori Yamano ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Viable Cell ◽  
Time Curve ◽  
Concentration Time ◽  
Auc Value ◽  
Two Parameters ◽  
Concentration Curves

ABSTRACT The pharmacokinetic (PK)/pharmacodynamic (PD) parameters and the antibacterial activity of S-013420, a novel bicyclolide, against Haemophilus influenzae and Streptococcus pneumoniae, including macrolide-resistant isolates, were investigated using an in vitro PD model. Various time-concentration curves were artificially constructed by modifying the PK data obtained in phase I studies. The activity against H. influenzae was evaluated using two parameters, that is, the area above the killing curve (AAC) and the viable cell reduction at 24 h. The relationships between the antibacterial activity of S-013420 and the three PK/PD parameters were investigated by fitting the data to the sigmoid maximum effective concentration model. The square of the correlation coefficient (R 2) values for AAC versus the area under the concentration-time curve from 0 to 24 h (AUC0-24)/MIC, the peak concentration (C max)/MIC, and the cumulative percentage of a 24-h period that the drug concentration exceeded the MIC under steady-state PK conditions (%T MIC) were 0.92, 0.87, and 0.49, respectively. The R 2 values for viable cell reduction at 24 h versus AUC0-24/MIC, C max/MIC, and %T MIC were 0.93, 0.61, and 0.56, respectively. These results demonstrated that AUC0-24/MIC is the most significant parameter for evaluation of the antibacterial activity of S-013420. The values of AUC0-24/MIC required for maximum and static efficacy were 10.8 and 9.63, respectively, for H. influenzae and 16.3 to 22.3 and 4.66 to 9.01, respectively, for S. pneumoniae. This analysis is considered useful for determining the AUC value at the infection site, which would be required for efficacy in clinical use.

Meningitis (II) – acute bacterial meningitis

1999 ◽  
Vol 56 (11) ◽  
pp. 640-646 ◽  
Author(s):  
Leib ◽  
Täuber
Keyword(s):  
Listeria Monocytogenes ◽  
Streptococcus Pneumoniae ◽  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Streptococcus Agalactiae ◽  
Acute Bacterial Meningitis ◽  
Antibiotische Therapie ◽  
Bakterielle Meningitis ◽  
Medizinischer Notfall

Die akute bakterielle Meningitis ist ein medizinischer Notfall, insbesondere bei Patienten mit rasch progredientem Krankheitsbild und Bewußtseinstrübung. Die Liquoruntersuchung zeigt bei der bakteriellen Meningitis eine entzündliche Reaktion mit vorwiegend polymorphonukleären Zellen. Die häufigsten bakteriellen Meningitis-Erreger sind Streptococcus pneumoniae, Neisseria meningitis, Listeria monocytogenes, Gruppe B Streptokokken (Streptococcus agalactiae), Haemophilus influenzae und Enterobacteriaceae. Infektion mit spezifischen Meningitis-Erregern ist abhängig vom Alter und von prädisponierenden Faktoren. Die Behandlung hat zwei Hauptziele: Die Eradikation des Infektionserregers und die Behandlung der zentralnervösen und systemischen Komplikationen. Die empirische («blinde») antibiotische Therapie muß unverzüglich begonnen werden, da die Prognose der Erkrankung maßgeblich vom Zeitpunkt des Therapiebeginns bestimmt ist. Blutkulturen sollten stets vor Beginn der Antibiotikatherapie abgenommen werden. Die Wahl der empirisch verabreichten Antibiotika ist primär vom Alter des Patienten abhängig und wird anhand der Resultate der Gram-Färbung des Liquors und dem Vorhandensein von spezifischen Risikofaktoren angepaßt. Zu Beginn wählt man eine Antibiotikatherapie, welche alle wahrscheinlichen Erreger abdeckt und engt anschließend das Wirkungsspektrum wenn möglich ein.

scholarly journals Pharmacodynamics of Daptomycin against Enterococcus faecium and Enterococcus faecalis in the Murine Thigh Infection Model

2018 ◽  
Vol 62 (10) ◽  
Author(s):  
James M. Kidd ◽  
Kamilia Abdelraouf ◽  
Tomefa E. Asempa ◽  
Romney M. Humphries ◽  
David P. Nicolau
Keyword(s):  
Enterococcus Faecalis ◽  
Enterococcus Faecium ◽  
Hill Equation ◽  
Infection Model ◽  
Free Drug Concentration ◽  
Time Curve ◽  
Content Type ◽  
Concentration Time ◽  
The Hill ◽  
Susceptibility Breakpoint

ABSTRACT The Clinical and Laboratory Standards Institute (CLSI) daptomycin MIC susceptibility breakpoint for the treatment of enterococcal infections is ≤4 μg/ml. However, patients receiving daptomycin for the treatment of infections caused by enterococci with MICs of ≤4 μg/ml may experience treatment failures. We assessed the pharmacodynamics of daptomycin against enterococci in a neutropenic murine thigh infection model and determined the exposures necessary for bacteriostasis and a 1-log10-CFU reduction of Enterococcus faecalis and Enterococcus faecium. We further characterized daptomycin efficacy at clinically achievable exposures. Six E. faecium and 6 E. faecalis isolates (daptomycin MICs, 0.5 to 32 μg/ml) were studied. Daptomycin was administered at various doses over 24 h to achieve area under the free drug concentration-time curve-to-MIC ratios (fAUC0–24/MIC) ranging from 1 to 148. Daptomycin regimens that simulate mean human exposures following doses of 6, 8, and 10 mg/kg of body weight/day were also studied. Efficacy was assessed by the differences in the number of log10 CFU per thigh at 24 h. The Hill equation was used to estimate the fAUC0–24/MIC required to achieve bacteriostasis and a 1-log10-CFU reduction. For E. faecium, a 1-log10-CFU reduction required an fAUC0–24/MIC of 12.9 (R2 = 0.71). For E. faecalis, a 1-log10-CFU reduction was not achieved, while the fAUC0–24/MIC required for stasis was 7.2 (R2 = 0.8). With a human-simulated regimen of 6 mg/kg/day, a 1-log10-CFU reduction was observed in 3/3 E. faecium isolates with MICs of <4 μg/ml and 0/3 E. faecium isolates with MICs of ≥4 μg/ml; however, a 1-log10-CFU reduction was not achieved for any of the 6 E. faecalis isolates. These results, alongside clinical data, prompt a reevaluation of the current breakpoint.

scholarly journals Pharmacological Basis of CD101 Efficacy: Exposure Shape Matters

2017 ◽  
Vol 61 (11) ◽  
Author(s):  
Elizabeth A. Lakota ◽  
Justin C. Bader ◽  
Voon Ong ◽  
Ken Bartizal ◽  
Lynn Miesel ◽  
...  
Keyword(s):  
Time Course ◽  
Fungicidal Activity ◽  
Control Group ◽  
Time Curve ◽  
Content Type ◽  
Treatment Groups ◽  
Concentration Time ◽  
Treatment Control Group ◽  
Pharmacological Basis

ABSTRACT CD101 is a novel echinocandin with concentration-dependent fungicidal activity in vitro and a long half-life (∼133 h in humans, ∼70 to 80 h in mice). Given these characteristics, it is likely that the shape of the CD101 exposure (i.e., the time course of CD101 concentrations) influences efficacy. To test this hypothesis, doses which produce the same total area under the concentration-time curve (AUC) were administered to groups of neutropenic ICR mice infected with Candida albicans R303 using three different schedules. A total CD101 dose of 2 mg/kg was administered as a single intravenous (i.v.) dose or in equal divided doses of either 1 mg/kg twice weekly or 0.29 mg/kg/day over 7 days. The studies were performed using a murine disseminated candidiasis model. Animals were euthanized at 168 h following the start of treatment. Fungi grew well in the no-treatment control group and showed variable changes in fungal density in the treatment groups. When the CD101 AUC from 0 to 168 h (AUC0–168) was administered as a single dose, a >2 log10 CFU reduction from the baseline at 168 h was observed. When twice-weekly and daily regimens with similar AUC values were administered, net fungal stasis and a >1 log10 CFU increase from the baseline were observed, respectively. These data support the hypothesis that the shape of the CD101 AUC influences efficacy. Thus, CD101 administered once per week demonstrated a greater degree of fungal killing than the same dose divided into twice-weekly or daily regimens.

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