scholarly journals Antimicrobial-Induced Cytopenia and Bone Marrow Hypocellularity in Patients with Cirrhosis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Anupama Patil ◽  
Vikas Khillan ◽  
Monika Thakur ◽  
Pratibha Kale ◽  
Chhagan Bihari
Keyword(s):  
Bone Marrow ◽  
Antimicrobial Agents ◽  
Bone Marrow Examination ◽  
Total Leucocyte Count ◽  
Severe Thrombocytopenia ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Drug Classes ◽  
Causative Factors ◽  
Cirrhotic Patients

There is great variation in cytopenias in cirrhotic patients with same severity and hypersplenism and their causative factors are not clear. Recent studies have highlighted the role of gut microbiome in regulation of constant and emergency hematopoiesis. Broad-spectrum antibiotics can disrupt the homeostatic or adaptive microbiota in cirrhosis, leading to impaired hematopoiesis and a higher susceptibility to infections. We studied all patients with cirrhosis with cytopenia (anemia, leucopenia, and/or thrombocytopenia), admitted in the Institute of Liver & Biliary Sciences, between January 2016 and July 2017, who underwent a bone marrow examination. The effect of the different antimicrobial agents on peripheral blood counts and bone marrow cellularity was assessed. A total of 196 patients’ data was analyzed for this study. Patients on antimicrobials (n=115) had significantly lower hemoglobin (p<0.001), total leucocyte count (p=0.048), and platelet count (p=0.043) compared to patients not on antimicrobials. On unadjusted analysis, significant association with thrombocytopenia existed in beta-lactams (OR = 1.56, 95% CI = 1.06–2.40), quinolones (OR = 1.66, 95% CI = 1.11–2.61), and antifungals (OR = 2.24, 95% CI = 1.96–4.34). Cephalosporins were found to be significantly associated with anemia (OR = 1.91, 95% CI = 1.07–3.41). Patients who received antimicrobials had hypocellular marrow (p<0.001) as compared to nonrecipients of antibiotics. The adjusted analysis showed that quinolones and beta-lactam antibiotics are the drug classes having significant association with thrombocytopenia and alternative class of drug should be explored in these patients to avoid severe thrombocytopenia.

scholarly journals DRUG UTILIZATION STUDY IN THE ORTHOPEDICS OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL IN MAHARASHTRA

2018 ◽  
Vol 11 (9) ◽  
pp. 224
Author(s):  
Madhuri Kulkarni ◽  
Anant Patil
Keyword(s):  
Retrospective Study ◽  
Drug Utilization ◽  
Antimicrobial Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Beta Lactam ◽  
Drug Utilization Study ◽  
Beta Lactam Antibiotics ◽  
Prescribed Medicines

Objective: The objective of this study was to analyze the pattern of drug utilization in outpatients of orthopedics department from a tertiary care hospital.Material and Methods: In this retrospective study, prescriptions of randomly selected patients attending orthopedics clinic were screened to analyze a number of medicines per prescription. Number and percentages of prescribed medicines were calculated.Results: In this study, 512 patients (male 260 [50.8%] and females 252 [49.2%]) were included in the study. The total number of prescribed medicines was 1562, accounting for 3.1 medicines per patient. A total number of oral, parenteral, and topical medicines were 1375 (88%), 176 (11.3%), and 11 (0.7%), respectively. Nonsteroidal anti-inflammatory agents (NSAIDs), antacid/anti-ulcerants, and antimicrobial agents were 641 (41%), 371 (23.8%), and 102 (6.5%), respectively. A total of 54 (52.9%), 29 (28.4%), 9 (8.8%), 6 (5.9%), 3 (2.9%), and 1 (1%) patients were prescribed fluoroquinolones, beta-lactam antibiotics, metronidazole, trimethoprim plus sulfamethoxazole, macrolides, and doxycycline, respectively. For 371 (23.8%) patients, anti-ulcerant and antiulcer were prescribed, among which ranitidine was the most common prescription [353 (95.1%)]Conclusion: Number of medicines prescribed per patient in orthopedic clinic was 3.1. NSAIDs and antacid/anti-ulcerants were the most commonly prescribed medicines.

Motile Aeromonas as agent of infections of the foot

1995 ◽  
Vol 85 (9) ◽  
pp. 505-508 ◽  
Author(s):  
M Wakabongo
Keyword(s):  
Second Generation ◽  
Antimicrobial Agents ◽  
Third Generation ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Taxonomic Uncertainty ◽  
Post Traumatic ◽  
Third Generation Cephalosporins

Motile Aeromonas infections of the foot are caused mostly by post-traumatic incidence, occurring mostly during summer months. Serious complications such as osteomyelitis and amputation can result if the infections go untreated or are inadequately treated. The role of each species of motile Aeromonas in pathogenesis and response to antimicrobial agents is not well understood because of taxonomic uncertainty. As a group, motile Aeromonas respond well to aminoglycosides, second-generation and third-generation cephalosporins, quinolones, and some beta-lactam antibiotics.

Beta-Lactam Hypersensitivity and Cross-Reactivity

2014 ◽  
Vol 27 (6) ◽  
pp. 530-544 ◽  
Author(s):  
Adrienne T. Terico ◽  
Jason C. Gallagher
Keyword(s):  
Retrospective Studies ◽  
Immunoglobulin E ◽  
Cross Reactivity ◽  
Side Chains ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Medline Search ◽  
Beta Lactam Antibiotics ◽  
Drug Classes

Penicillin is the most frequently reported cause of drug allergy, and cross-reactivity of penicillins with other beta-lactam antibiotics is an area of debate. This review evaluates the available data on immunoglobulin E-mediated penicillin hypersensitivity and cross-reactivity with cephalosporin, carbapenem, and monobactam antibiotics. A MEDLINE search was conducted from 1950 to October 2013, and selected references from review articles were also evaluated. There is a wide variety in reported incidences of cross-reactivity between penicillins and cephalosporins or carbapenems, with early retrospective studies suggesting up to 41.7% and 47.4% cross-reactivity, respectively. Conversely, the use of monobactam antibiotics is frequently employed in the case of a penicillin allergy, as prescribers believe that there is no cross-reactivity between the 2 drug classes. More recent prospective studies suggest that the rates of cross-reactivity with cephalosporins and carbapenems are <5% and <1%, respectively. Similarities in penicillin and cephalosporin side chains may play a role in cross-reactivity between these classes. Cross-reactivity with monobactams is essentially negligible; however, there are some clinical data to support an interaction between ceftazidime and aztreonam, due to the similarity of their side chains. The data reviewed suggest that avoidance of other beta-lactams in patients with type 1 hypersensitivity to penicillins should be reconsidered.

scholarly journals Prevalence of Plasmid-Mediated Quinolone Resistance Determinants and OqxAB Efflux Pumps among Extended-Spectrumβ-Lactamase ProducingKlebsiella pneumoniaeIsolated from Patients with Nosocomial Urinary Tract Infection in Tehran, Iran

Scientifica ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mehdi Goudarzi ◽  
Mehdi Azad ◽  
Sima Sadat Seyedjavadi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Agents ◽  
Quinolone Resistance ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Nosocomial Urinary Tract Infection ◽  
Clinical Resistance ◽  
Synergy Test

Objective. Plasmid-mediated quinolone resistance (PMQR) plays an important role in the development of clinical resistance to quinolone. The aim of this study was to investigate PMQR determinants among extended-spectrumβ-lactamases- (ESBL-) producingKlebsiella pneumoniaerecovered from patients with nosocomial urinary tract infection (UTI).Methods. A total of 247 ESBL-producingK. pneumoniaeisolates were collected from 750 patients with UTI. ESBL production was confirmed by double disc synergy test and combined disc diffusion test. The prevalence of PMQR determinants among ESBL-producingK. pneumoniaewas assessed using PCR method.Results. The rates of resistance to antimicrobial agents in present study varied from 14.2% to 98.8%. In comparison with other PMQR genotypes, the frequency ofaac(6′)-Ib(68.8%) was strikingly high. Of the 247 isolates tested,qnrA, qnrB, qnrS,andqepAgenes were present in 3.6%, 1.6%, 1.2, and 2%, respectively.oqxAandoqxBwere detected in 56.7% and 54.6% of isolates. The predominant coexisting ESBL and PMQR profile among our isolates includedblaCTX-Mandaac(6′)-Ib, oqxA, oqxB(28.3%) andblaTEM,blaSHVandaac(6′)-Ib, oqxA,andoqxB(19.4%) profile.  Conclusion. Given the linkage observed between resistance to quinolones and beta lactam antibiotics, therapeutic protocol with fluoroquinolones and beta lactam antibiotics should be seriously revised in Tehran hospitals.

scholarly journals Frequency and antimicrobial resistance of bacteria isolated from oral and topical medicaments from Hilla, Iraq

2012 ◽  
Vol 6 (06) ◽  
pp. 489-494 ◽  
Author(s):  
Alaa Hani Al-Charrakh
Keyword(s):  
High Resistance ◽  
Antimicrobial Agents ◽  
Pharmaceutical Products ◽  
High Rate ◽  
Diffusion Method ◽  
Bacterial Isolates ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
Beta Lactam Antibiotics

Introduction: The presence of microorganisms in pharmaceuticals is undesirable because they may cause spoilage of the product and may present an infection hazard to the consumers or patients.  Methodology: A total of 102 samples of oral and topical non-sterile pharmaceutical products were collected at random from different drug houses and pharmacies in Iraq, to investigate the microbial contamination of these products. Bacterial isolates recovered from these medicaments were subjected to susceptibility testing against various antibiotics by disk diffusion method according to Clinical and Laboratory Standards (CLSI) guidelines. Results: The results revealed that the occurrence of Gram-positive bacteria was in oral and topical medicaments while Gram-negative bacteria were only detected in topical medicaments. More than 58% of Bacillus isolates were resistant to lincomycin and Bacillus mycoides isolates were resistant to beta-lactam antibiotics and trimethoprim-sulfamethoxazole. Staphylococcus spp. showed a relatively high resistance to ampicillin, amoxicillin, penicillin, tetracycline, and trimethoprim-sulfamethoxazole. S. epidermidis had the highest number of multi-resistant isolates. Furthermore, 87.5% of isolated Gram-negative rods showed high resistance to beta-lactam antibiotics and 75% of them were highly resistant to erythromycin. One isolate of Pseudomonas aeruginosa was the most resistant among all Gram-negative rod isolates. Conclusion: The high rate of resistance to antimicrobial agents of bacterial isolates recovered from oral and topical medicaments in this study may indicate a widespread antibiotic resistance among bacteria isolated from different sources, including those of anthropological and environmental origin. 

scholarly journals Myelodysplastic Syndrome with t(1;7) Associated with Marked Dysmegakarypoiesis & Severe Thrombocytopenia: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Michael Gilbertson ◽  
Annabel Tuckfield ◽  
Surender Juneja
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Myelodysplastic Syndrome ◽  
Diagnostic Criteria ◽  
Bone Marrow Examination ◽  
Recent History ◽  
Severe Thrombocytopenia ◽  
Review Of The Literature ◽  
Multilineage Dysplasia ◽  
History Of

We present the case of a 70-year-old woman who had a bone marrow examination performed to investigate marked thrombocytopenia in the context of a recent history of metastatic glucagonoma. Surprisingly this identified marked dysmegakaryopoiesis and fulfilled diagnostic criteria for refractory cytopenia with multilineage dysplasia, with a relatively uncommon associated cytogenetic lesion t(1;7). We present the case and review the literature of this cytogenetic lesion.

scholarly journals In Vitro Activity of Antimicrobial Agents against Streptococcus Pyogenes Isolates from Patients with Acute Tonsillopharyngitis in Dakar, Senegal

2009 ◽  
Vol 2 ◽  
pp. MBI.S2319
Author(s):  
A. Gueye Ndiaye ◽  
ND.C. Sarr ◽  
K. Thiam ◽  
C.S. Boye
Keyword(s):  
High Activity ◽  
Streptococcus Pyogenes ◽  
Antibacterial Agents ◽  
Antimicrobial Agents ◽  
Inhibitory Concentration ◽  
Capital City ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
First Choice

Streptococcus pyogenes ( S. pyogenes) is the most important causative agent of tonsillopharyngitis. Beta-lactam antibiotics, particularly penicillin, are the drug of first choice and macrolides are recommended for patients who are allergic to penicillin. However, other antibiotics are also used for the treatment of streptococcal tonsillopharyngitis. In recent years, the increase in the incidence of respiratory tract pathogens that are resistant to current antibacterial agents highlights the need to monitor the evolution of the resistance of these pathogens to antibiotics. In this study, we assess the susceptibility of 98 isolates of S. pyogenes to 16 antibiotics. The pathogens were recovered from patients with acute tonsillopharyngitis in Dakar, the Senegalese capital city, who were recruited from May 2005 to August 2006. All strains were susceptible to penicillin with low Minimum Inhibitory Concentration (MIC = 0,016 mg/L). Amoxicillin had high activity (100%) showing its importance in treatment of streptococcal infections. Cephalosporins had MIC90 values ranging from 0.016 to 0.094 mg/L. Macrolides have shown high activity. All strains were resistant to tetracyclin. Other molecules such as teicoplanin, levofloxacin and chloramphenicol were also active and would represent alternatives to treatment of tonsillopharyngitis due to this pathogen. These results indicate that no significant resistance to antibiotics was found among patients with tonsillopharyngitis studied in Dakar. Limitations of this study were that the number of isolates tested was small and all isolates were collected from one hospital in Dakar. Hence, results may not be representative of the isolates found, in the wider community or other regions of Senegal. Further studies are needed in other parts of Dakar and other geographic regions of Senegal, in order to better clarify the antibiotic susceptibility profile of S. pyogenes isolates recovered from patients with tonsillopharyngitis.

scholarly journals Antimicrobial Action and Reversal of Resistance in MRSA by Difluorobenzamide Derivatives Targeted at FtsZ

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 873
Author(s):  
Wern Chern Chai ◽  
Jonathan J. Whittall ◽  
Di Song ◽  
Steven W. Polyak ◽  
Abiodun D. Ogunniyi ◽  
...  
Keyword(s):  
Cell Division ◽  
Antimicrobial Agents ◽  
Efflux Pump ◽  
Coli Strain ◽  
Haemolytic Activity ◽  
Bacterial Cell Division ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Mrsa Strains ◽  
Ftsz Inhibitors

The bacterial cell division protein, FtsZ, has been identified as a target for antimicrobial development. Derivatives of 3-methoxybenzamide have shown promising activities as FtsZ inhibitors in Gram-positive bacteria. We sought to characterise the activity of five difluorobenzamide derivatives with non-heterocyclic substituents attached through the 3-oxygen. These compounds exhibited antimicrobial activity against methicillin resistant Staphylococcus aureus (MRSA), with an isopentyloxy-substituted compound showing modest activity against vancomycin resistant Enterococcus faecium (VRE). The compounds were able to reverse resistance to oxacillin in highly resistant clinical MRSA strains at concentrations far below their MICs. Three of the compounds inhibited an Escherichia coli strain lacking the AcrAB components of a drug efflux pump, which suggests the lack of Gram-negative activity can partly be attributed to efflux. The compounds inhibited cell division by targeting S. aureus FtsZ, producing a dose-dependent increase in GTPase rate which increased the rate of FtsZ polymerization and stabilized the FtsZ polymers. These compounds did not affect the polymerization of mammalian tubulin and did not display haemolytic activity or cytotoxicity. These derivatives are therefore promising compounds for further development as antimicrobial agents or as resistance breakers to re-sensitive MRSA to beta-lactam antibiotics.

scholarly journals Mechanisms of Resistance to Quinolones and Epidemiological Significance of Salmonella spp.

2016 ◽  
Vol 66 (2) ◽  
pp. 147-159 ◽  
Author(s):  
Maja Velhner
Keyword(s):  
Antimicrobial Agents ◽  
Efflux Pump ◽  
Resistance Mechanism ◽  
Quinolone Resistance ◽  
Beta Lactam ◽  
Foodborne Illnesses ◽  
Salmonella Spp ◽  
Over Expression ◽  
Beta Lactam Antibiotics ◽  
Chromosomal Mutations

Abstract Bacteria develop resistance to antimicrobial agents by a number of different mechanisms. The resistance to (fluoro)quinolones in Salmonella is of particular importance especially if therapy in humans is required. For decades there has been a significant interest in studying the biology of Salmonella because these bacteria are among the leading causes of foodborne illnesses around the globe. To this date, two main mechanisms of quinolone resistance have been established: alteration in the targets for quinolones, decreased accumulation inside bacteria due to impermeability of the membrane and/or an over expression of the efflux pump systems. Both of these mechanisms are chromosomally mediated. Furthermore, mobile elements have been described carrying the qnr gene which confers resistance to quinolones. The plasmid encoded QNR proteins belong to the pentapeptide repeat family of proteins. The plasmid mediated quinolone resistance (PMQR) is often associated with the resistance to beta lactam antibiotics. It was noticed that PMQR is backing up chromosomal mutations for quinolone resistance, hence becoming an important resistance mechanism worldwide. Even with our knowledge expanding over the years, it is not possible to predict how bacteria will respond in the future, if they are exposed to new external challenges. The possibility that they will find a way to survive by introducing new mutations or by exchanging mobile genetic elements and subsequently developing resistance to survive in the environment should not be underestimated.

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