Differences in characteristics, aetiologies, isolated pathogens, and the efficacy of antibiotics in adult patients with preseptal cellulitis and orbital cellulitis between 2000–2009 and 2010–2019

2021 ◽  
pp. bjophthalmol-2021-318986
Author(s):  
En-Jie Shih ◽  
Jui-Kuang Chen ◽  
Pei-Jhen Tsai ◽  
Youn-Shen Bee
Keyword(s):  
Orbital Cellulitis ◽  
Adult Patients ◽  
Coagulase Negative Staphylococci ◽  
Predisposing Factor ◽  
Methicillin Resistant ◽  
Preseptal Cellulitis ◽  
Gram Positive Bacteria ◽  
Hospitalised Patients ◽  
Susceptibility Tests ◽  
Antibiotic Efficacy

Background/aimsTo understand whether the epidemiology, aetiologies, common pathogens and the antibiotic efficacy against the identified bacteria of periorbital cellulitis in adults have changed recently (2010–2019) compared with the past decade (2000–2009).MethodsAdult patients (n=224) diagnosed with preseptal cellulitis and orbital cellulitis admitted to Kaohsiung Veterans General Hospital during 2000–2019 were retrospectively reviewed. Demographic and clinical characteristics, isolated pathogens and antibiotic susceptibility tests against the commonly cultured bacteria were analysed.ResultsPreseptal cellulitis showed a tendency of female predominance. Patients in their 60s showed an incidence peak; more cases were observed during winter. The most common predisposing factor was dacryocystitis (15.5%–30.5%), followed by hordeolum (15.5%–24.8%). Aetiology of sinusitis (p=0.001) decreased and that of conjunctivitis (p=0.007) increased significantly with time. Culture results of nasopharyngeal swabs and local abscess showed higher positivity rate than conjunctival swab. The most common isolates were methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, coagulase-negative staphylococci and Pseudomonas aeruginosa. Antibiotics including fluoroquinolones and vancomycin were effective; in contrast, ampicillin/sulbactam and oxacillin showed decreasing efficacy against gram-positive bacteria. For antibiotic treatment against P. aeruginosa, fluoroquinolones, ceftazidime, piperacillin and imipenem were ideal choices.ConclusionIn isolated pathogens, the increasing trend of methicillin-resistant S. aureus detection was compatible with reducing oxacillin efficacy against periorbital infection. In our study, the report of antibiotic efficacy against the most common identified bacteria offered empirical choices for hospitalised patients with periorbital infection before obtaining culture results.

scholarly journals In Vitro Activities of ME1036 (CP5609), a Novel Parenteral Carbapenem, against Methicillin-Resistant Staphylococci

2004 ◽  
Vol 48 (8) ◽  
pp. 2831-2837 ◽  
Author(s):  
Mizuyo Kurazono ◽  
Takashi Ida ◽  
Keiko Yamada ◽  
Yoko Hirai ◽  
Takahisa Maruyama ◽  
...  
Keyword(s):  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Multiple Drug Resistant ◽  
Time Kill

ABSTRACT ME1036, formerly CP5609, is a novel parenteral carbapenem with a 7-acylated imidazo[5,1-b]thiazole-2-yl group directly attached to the carbapenem moiety of the C-2 position. The present study evaluated the in vitro activities of ME1036 against clinical isolates of gram-positive and gram-negative bacteria. ME1036 displayed broad activity against aerobic gram-positive and gram-negative bacteria. Unlike other marketed β-lactam antibiotics, ME1036 maintained excellent activity against multiple-drug-resistant gram-positive bacteria, such as methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae (PRSP). The MICs of this compound at which 90% of isolates were inhibited were 2 μg/ml for methicillin-resistant Staphylococcus aureus (MRSA), 2 μg/ml for methicillin-resistant coagulase-negative staphylococci, and 0.031 μg/ml for PRSP. In time-kill studies with six strains of MRSA, ME1036 at four times the MIC caused a time-dependent decrease in the numbers of viable MRSA cells. The activity of ME1036 against MRSA is related to its high affinity for penicillin-binding protein 2a, for which the 50% inhibitory concentration of ME1036 was approximately 300-fold lower than that of imipenem. In conclusion, ME1036 demonstrated a broad antibacterial spectrum and high levels of activity in vitro against staphylococci, including β-lactam-resistant strains.

scholarly journals Pediatric Preseptal and Orbital Cellulitis: Analysis of Clinical, Laboratory and Imaging Findings of 123 Cases.

2021 ◽  
Author(s):  
Lida Bülbül ◽  
Neslihan Ozkul Saglam ◽  
Gizem Kara Elitok ◽  
Zahide Mine Yazıcı ◽  
Nevin Hatipoglu ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Orbital Cellulitis ◽  
Ocular Involvement ◽  
C Reactive Protein ◽  
Predisposing Factor ◽  
Preseptal Cellulitis ◽  
Orbital Involvement ◽  
Reactive Protein ◽  
Pediatric Age Group ◽  
The Right

Abstract Background: To compare the clinical and laboratory characteristics and imaging methods of patients diagnosed with preseptal cellulitis and orbital cellulitis in the pediatric age group. Methods: The study was designed retrospectively and the medical records of all patients who were hospitalized with the diagnosis of preseptal cellulitis and orbital cellulitis were reviewed. The findings of preseptal cellulitis and orbital cellulitis groups were compared. The risk factors for the development of orbital involvement were analyzed. Results: A total of 123 patients were included, 90.2% with preseptal cellulitis and 9.8% with cellulitis. The male gender ratio was 60.2% and the mean age was 72±43 months. While all patients had eyelid swelling and redness 20.3% had fever. Ocular involvement was 51.2% in the right eye and 4.9% in both eyes. The most common predisposing factor was rhinosinusitis (56.1%). Radiological imaging (Computed tomography/magnetic resonance imaging) was performed in 83.7% of the patients. Subperiostal abscess were detected in 7 cases (5.6%) which three of the cases were managed surgically and four were treated with medically. The levels of c-reactive protein were significantly higher in patients with orbital involvement (p:0.033) but there was no difference between the presence of fever, leukocyte and platelet values. Conclusions: Rhinosinusitis was the most common predisposing factor in the development of preseptal cellulitis and orbital cellulitis. Orbital involvement was present in 9.8% of the patients. It was determined that high c-reactive protein value could be used to predict orbital involvement. Keywords: Childhood, preseptal cellulit, rhinosinusit, orbital cellulit, subperiostal abscess.

scholarly journals Orbital cellulitis: early intervention saves vision

2019 ◽  
Vol 7 (1) ◽  
pp. 203
Author(s):  
N. Rajeshwari ◽  
A. Savitha
Keyword(s):  
Early Diagnosis ◽  
Soft Tissues ◽  
Orbital Cellulitis ◽  
Invasive Technique ◽  
Endoscopic Drainage ◽  
Predisposing Factor ◽  
Subperiosteal Abscess ◽  
Preseptal Cellulitis ◽  
Common Location ◽  
Life Threatening

Orbital cellulitis describes an infection involving the soft tissues posterior to the orbital septum including the fat and muscle within the bony orbit. This condition is associated with severe sight and life-threatening complications. Distinguishing it from preseptal cellulitis is difficult, but important. Acute sinusitis is the commonest predisposing factor. Clinical findings alone are not specific enough to distinguish between preseptal and post septal orbital cellulitis. Early diagnosis using CT orbit is important to rule out complications such as orbital cellulitis, subperiosteal abscess. The most common location of subperiosteal abscess is the medial wall of the orbit. Transnasal endoscopic drainage of the abscess is a functional and minimally invasive technique and is the treatment of choice at present. Early diagnosis and intervention are mandatory to prevent the visual loss and life-threatening complication.Here, the authors describe a 2 months old infant with orbital cellulitis and medial subperiosteal abscess and treated with transnasal endoscopic drainage of the subperiosteal abscess.

scholarly journals Use of Pristinamycin for Infections by Gram-Positive Bacteria: Clinical Experience at an Australian Hospital

2010 ◽  
Vol 54 (9) ◽  
pp. 3949-3952 ◽  
Author(s):  
A. B. Reid ◽  
J. R. Daffy ◽  
P. Stanley ◽  
K. L. Buising
Keyword(s):  
Staphylococcus Aureus ◽  
Side Effects ◽  
Epidural Abscess ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Prosthetic Joints ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Australian Hospital

ABSTRACT Thirty-six patients were treated with pristinamycin for 46 different microbiological isolates between April 2007 and July 2009. Pathogens included 9 methicillin-resistant Staphylococcus aureus isolates, 13 methicillin-resistant coagulase negative staphylococci, and 9 vancomycin-resistant enterococci. Sites of infections included 12 osteomyelitis cases, 10 prosthetic joints, 4 other prostheses, and 1 epidural abscess. Five patients ceased treatment due to side effects. Ten patients were cured of their infections, and 21 patients had infections successfully suppressed.

scholarly journals Susceptibility of clinical methicillin-resistant Staphylococci isolates to new antibiotics

2013 ◽  
Vol 7 (11) ◽  
pp. 825-831 ◽  
Author(s):  
Lutfiye Oksuz ◽  
Nezahat Gurler
Keyword(s):  
Methicillin Resistance ◽  
Good Choice ◽  
Coagulase Negative Staphylococci ◽  
In Vitro Susceptibility ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Staphylococcal Infections ◽  
New Antibiotics ◽  
Susceptibility Tests

Background: The treatment of methicillin-resistant staphylococcal infections has been a growing problem both in and out of hospitals for the past 30 years. Therefore, there is a need for other antibiotics as an alternative to glycopeptides in the treatment of methicillin-resistant staphylococcal infections. This study investigated the in vitro susceptibility of 49 methicillin-resistant Staphylococcus aureus (MRSA) and 59 methicillin-resistant coagulase negative staphylococci (MRCNS) clinical isolates to daptomiycin, telithromycin, tigecyclin, quinupristin/dalfopristin, and linezolid. Methodology: The identification of the strains was made by conventional methods. Antibiotic susceptibility tests were performed according to CLSI. Methicillin resistance was determined by cefoxitin disk. Susceptibilities of the strains to daptomycin, quinupristin/dalfopristin, tigecycline, and vancomycin were performed using the E-test according to the recommendations of CLSI 2011 and the manufacturer. Results: Two strains of MRCNS were resistant, and one was teicoplanin intermediate. It was found that one (2%) strain of MRSA and two (3%) strains of MRCNS were resistant to tigecyclin. Telithromycin resistance was detected in 33% of MRSA strains and 37% of MRCNS strains. Inducible clindamycin resistance was found in nine (18.4%) strains of MRSA and eighteen (30.5%) strains of MRCNS. All strains were susceptible to daptomiycin, quinupristin/dalfopristin, and linezolid. Conclusions:Although it has recently been used, telithromycin has a high percentage of resistance; its use for methicillin-resistant staphylococcal strains, therefore, should be limited. Daptomycin and quinupristin/dalfopristin were found to be effective against MRSA and MRCNS strains and were concluded to be a good choice in the treatment of methicillin-resistant staphylococci.

scholarly journals Antimicrobial Properties of MX-2401, an Expanded-Spectrum Lipopeptide Active in the Presence of Lung Surfactant

2011 ◽  
Vol 55 (8) ◽  
pp. 3720-3728 ◽  
Author(s):  
Dominique Dugourd ◽  
Haiyan Yang ◽  
Melissa Elliott ◽  
Raymond Siu ◽  
Jacob J. Clement ◽  
...  
Keyword(s):  
Lung Surfactant ◽  
Antimicrobial Properties ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Lipopeptide Antibiotic ◽  
Hospital Acquired

ABSTRACTMX-2401 is an expanded-spectrum lipopeptide antibiotic selective for Gram-positive bacteria that is a semisynthetic analog of the naturally occurring lipopeptide amphomycin. It was active againstEnterococcusspp., including vancomycin-sensitiveEnterococcus(VSE),vanA-,vanB-, andvanC-positive vancomycin-resistantEnterococcus(VRE), linezolid- and quinupristin-dalfopristin-resistant isolates (MIC90of 4 μg/ml), methicillin-resistantStaphylococcus aureus(MRSA) and methicillin-sensitiveS. aureus(MSSA) (MIC90of 2 μg/ml), coagulase-negative staphylococci, including methicillin-sensitiveStaphylococcus epidermidis(MSSE) and methicillin-resistantS. epidermidis(MRSE) (MIC90of 2 μg/ml), andStreptococcusspp. including viridans group streptococci, and penicillin-resistant, penicillin-sensitive, penicillin-intermediate and macrolide-resistant isolates ofStreptococcus pneumoniae(MIC90of 2 μg/ml). MX-2401 demonstrated a dose-dependent postantibiotic effect varying from 1.5 to 2.4 h. Furthermore, MX-2401 was rapidly bactericidal at 4 times the MIC againstS. aureusandEnterococcus faecalis, with more than 99.9% reduction in viable bacterial attained at 4 and 24 h, respectively. The MICs of MX-2401 against MRSA, MSSA, VSE, and VRE strains serially exposed for 15 passages to sub- to supra-MICs of MX-2401 remained within three dilutions of the original MIC. In contrast to that of the lipopeptide daptomycin, the antibacterial activity of MX-2401 was not affectedin vitroby the presence of lung surfactant, and MX-2401 was activein vivoin the bronchial-alveolar pneumonia mouse model, in which daptomycin failed to show any activity. Moreover, the activity of MX-2401 was not as strongly dependent on the Ca2+concentration as is the activity of daptomycin. In conclusion, MX-2401 is a promising new-generation lipopeptide for the treatment of serious infections with Gram-positive bacteria, including hospital-acquired pneumonia.

scholarly journals Linezolid Induced Thrombocytopenia: A Case Report

2021 ◽  
Vol 11 (05) ◽  
pp. 1702-1704
Author(s):  
Harsh H. Patel ◽  
Harsha D. Makwana ◽  
Supriya D. Malhotra
Keyword(s):  
Platelet Count ◽  
Common Adverse Effect ◽  
Prolonged Treatment ◽  
Coagulase Negative Staphylococci ◽  
Baseline Platelet Count ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Vancomycin Resistant Enterococci ◽  
Lower Body Weight ◽  
Vancomycin Resistant

Linezolid (LZD) is an antimicrobial agent with a broad spectrum of activity against virtually all clinically important Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRCoNS) and vancomycin-resistant enterococci (VRE). Thrombocytopenia (TP) is a common adverse effect of Linezolid (LZD). Prolonged treatment duration, renal insufficiency, chronic liver disease, malignancy, previous vancomycin use, baseline platelet count, and lower body weight have been reported as possible risk factors for LZD-associated TP. Here, we illustrate a case of a 51-year-old male patient diagnosed with pancreatitis and urinary tract infection and was prescribed several antibiotics including Linezolid. In this case, platelets count which were initially normal started declining from day 7 of initiating Linezolid. Linezolid was withdrawn from treatment from day 9. Platelet count gradually came back to normal on day 16. This suggests reversible type of thrombocytopenia by Linezolid. This case illustrates need for careful observation of platelet count during the treatment with Linezolid. Keywords: Linezolid, Thrombocytopenia, Dechallenge

scholarly journals Non-susceptibility trends among methicillin-resistant coagulase-negative staphylococci isolated from blood cultures

2014 ◽  
Vol 66 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Anika Povazan ◽  
Anka Vukelic ◽  
Tatjana Kurucin ◽  
Mirjana Hadnadjev ◽  
Vesna Milosevic ◽  
...  
Keyword(s):  
Diffusion Method ◽  
Resistance Pattern ◽  
Multiple Resistance ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Resistant Strains ◽  
Susceptibility Tests ◽  
Hospital Acquired

Coagulase-negative staphylococci are a significant cause of hospital-acquired bacteremias. There is an increase of infections induced by methicillin-resistant strains, with growing resistance to other antibiotics. The aim of the study was to analyze the resistance of methicillin-resistant coagulase-negative staphylococci isolated from hemocultures in a five-year period. The study was carried out in the microbiology laboratory of the Institute for Pulmonary Diseases of Vojvodina, from 2008 to 2013. Coagulase-negative staphylococci were isolated from 196 hemocultures. Susceptibility tests were performed using the disc diffusion method. Of 196 coagulase-negative staphylococci, 122 (62.2%) were resistant to methicillin, of which 112 (91.8%), 105 (86.1%), 103 (84.4%), 88 (72.1%) were resistant to erythromycin, gentamicin, ciprofloxacin and clindamycin, respectively. All strains were susceptible to vancomycin and linezolid. Multiple resistance was registered in 100 (82%) strains. The most common resistance pattern was gentamicin-erythromycin-clindamycinciprofloxacin. Multiple resistance was established in a significant percentage of methicillin-resistant strains.

scholarly journals Quinupristin-Dalfopristin Resistance among Gram-Positive Bacteria in Taiwan

2000 ◽  
Vol 44 (12) ◽  
pp. 3374-3380 ◽  
Author(s):  
Kwen-Tay Luh ◽  
Po-Ren Hsueh ◽  
Lee-Jene Teng ◽  
Hui-Ju Pan ◽  
Yu-Chi Chen ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Animal Husbandry ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
In Vitro Susceptibility ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Vancomycin Resistant ◽  
Viridans Group Streptococci

ABSTRACT To understand quinupristin-dalfopristin resistance among clinical isolates of gram-positive bacteria in Taiwan, where this agent is not yet available for clinical use, we evaluated 1,287 nonduplicate isolates recovered from January 1996 to December 1999 for in vitro susceptibility to quinupristin-dalfopristin and other newer antimicrobial agents. All methicillin-susceptible Staphylococcus aureus (MSSA) isolates were susceptible to quinupristin-dalfopristin. High rates of nonsusceptibility to quinupristin-dalfopristin (MICs, ≥2 μg/ml) were demonstrated for the following organisms: methicillin-resistant S. aureus (MRSA) (31%), coagulase-negative staphylococci (CoNS) (16%),Streptococcus pneumoniae (8%), viridans group streptococci (51%), vancomycin-susceptible enterococci (85%), vancomycin-resistantEnterococcus faecalis (100%), vancomycin-resistantEnterococcus faecium (66%), Leuconostoc spp. (100%), Lactobacillus spp. (50%), andPediococcus spp. (87%). All isolates of MSSA, MRSA,S. pneumoniae, and viridans group streptococci were susceptible to vancomycin and teicoplanin. The rates of nonsusceptibility to vancomycin and teicoplanin were 5 and 7%, respectively, for CoNS, ranging from 12 and 18% for S. simulans to 0 and 0% for S. cohnii and S. auricularis. Moxifloxacin and trovafloxacin had good activities against these isolates except for ciprofloxacin-resistant vancomycin-resistant enterococci and methicillin-resistant staphylococci. In Taiwan, virginiamycin has been used in animal husbandry for more than 20 years, which may contribute to the high rates of quinupristin-dalfopristin resistance.

IncreasingStaphylococcusSpecies Resistance in Peritoneal Dialysis-Related Peritonitis Over a 10-Year Period in a Single Taiwanese Center

2018 ◽  
Vol 38 (4) ◽  
pp. 266-270 ◽  
Author(s):  
Ho-Ching Chen ◽  
Chi-Chang Shieh ◽  
Junne-Ming Sung
Keyword(s):  
Peritoneal Dialysis ◽  
Methicillin Resistance ◽  
Removal Rate ◽  
Staphylococcal Infection ◽  
Resistance Rate ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Southern Taiwan

BackgroundPeritonitis is a major complication of peritoneal dialysis (PD). Staphylococcus species are gram-positive bacteria that are most commonly associated with peritoneal peritonitis. The increasing antimicrobial resistance rate is a severe burden when considering the initial choice of antibiotics. This investigation examined the trends of staphylococcal infection as well as the resistance rate and clinical outcomes from 2006 to 2015 in southern Taiwan.MethodsWe retrospectively investigated all PD-related peritonitis episodes in southern Taiwan between January 2006 and December 2015 and evaluated the clinical characteristics of peritonitis, microbiological prevalence and resistance of Staphylococcus species, and outcomes in patients.ResultsAmong 244 episodes of peritonitis, Staphylococcus species accounted for approximately 65% of the gram-positive bacteria that caused the infection. The methicillin resistance rate among Staphylococcus species substantially increased to 64% by 2015 in both Staphylococcus aureus and coagulase-negative staphylococci in southern Taiwan. Notably, patients with methicillin-resistant staphylococcal infection exhibited a significantly higher hospitalization rate than those with methicillin-sensitive staphylococcal infection. However, the catheter removal rate and transfer to hemodialysis exhibited no differences between the 2 groups.ConclusionPeritonitis is the most serious complication in patients on PD, and microbiological trends have changed over the past 10 years at a single center in southern Taiwan. The number of methicillin-resistant Staphylococcus species has substantially increased. Empirical initial antibiotic therapy should be adapted on the basis of the growing microbiological resistance.

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