Ampicillin Treatment Increases Placental Interleukin-1 Beta Concentration and Polymorphonuclear Infiltration in Group B Streptococcus-Induced Chorioamnionitis: A Preclinical Study

Neonatology ◽  
2020 ◽  
Vol 117 (3) ◽  
pp. 369-373
Author(s):  
Antoine Giraud ◽  
Marie-Julie Allard ◽  
Mariela Segura ◽  
Frédéric Roche ◽  
Hugues Patural ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Rat Model ◽  
Bacterial Infections ◽  
Interleukin 1 ◽  
Preclinical Study ◽  
Polymorphonuclear Cells ◽  
Increased Risk ◽  
Placental Inflammation ◽  
Intrapartum Antibiotic ◽  
Group B

<b><i>Background:</i></b> Antibiotic therapy during preterm labor with intact membranes has been associated with an increased risk of neonatal death. <b><i>Objectives:</i></b> Using an established rat model of group B <i>Streptococcus</i> (GBS)-induced chorioamnionitis, we hypothesized that ampicillin treatment increases placental inflammation, as shown in other bacterial infections. <b><i>Methods:</i></b> At gestational day 19, 19 Lewis dams were intraperitoneally (i.p.) inoculated by 10<sup>8</sup> CFU of β-hemolytic serotype Ia GBS (strain #16955 susceptible to ampicillin). Dams were treated i.p. with either 200 mg/kg of ampicillin (<i>n</i> = 9) or 0.9% saline (<i>n</i> = 10) at 48 and 60 h post-GBS inoculation. Cesarean sections were performed 72 h post-GBS inoculation. <b><i>Results:</i></b> Ampicillin treatment was associated with an increased number of polymorphonuclear cells (PMN) infiltrating the decidua (mean 1,536 vs. 532 PMN/mm<sup>2</sup>; <i>p</i> &#x3c; 0.001) and a higher placental concentration of IL-1β (mean 26.4 vs. 7.9 pg/mg; <i>p</i> &#x3c; 0.01) compared to saline-treated dams. These effects were observed in dams without GBS bacteremia. Conversely, ampicillin treatment was associated with a decreased placental concentration of proinflammatory cytokines in dams with GBS bacteremia. <b><i>Conclusions:</i></b> Ampicillin increases placental inflammation in a rat model of GBS-induced chorioamnionitis without bacteremia. This proinflammatory effect of ampicillin could be due to bacterial lysis. Our findings do not query the intrapartum antibiotic prophylaxis against GBS disease. They pave the way for future preclinical studies combining anti-inflammatory treatments and antibiotic therapy for GBS-induced chorioamnionitis.

scholarly journals Adolescents and primary herpetic gingivostomatitis: an Italian overview

2021 ◽  
Author(s):  
Elena Bardellini ◽  
Francesca Amadori ◽  
Federica Veneri ◽  
Giulio Conti ◽  
Alberto Paderno ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Antibiotic Therapy ◽  
Medical Records ◽  
Bacterial Infections ◽  
Group A ◽  
Acid Gel ◽  
Herpetic Gingivostomatitis ◽  
Group B ◽  
Italian Adolescents ◽  
Hyaluronic Acid Gel

Abstract Aim The aim of this study was to investigate the therapies administered to Italian adolescents with primary herpetic gingivostomatitis (PHGS) Methods The medical records of 74 adolescents with PHSG were reviewed. The following data were recorded: age, gender, day of onset, type of treatment, lesions’ severity, pain scoring, eating, and drinking ability. The oral examination was performed at the first evaluation (T0) and after one week (T1). Results All patients showed up at the first visit at least 48 h after the onset of symptoms. No patient was prescribed an antiviral therapy. An antibiotic therapy was prescribed in order to prevent secondary bacterial infections. Fifteen patients had been treated with non alcoholic chlorhexidine rinses (group A), 29 patients with non alcoholic chlorhexidine rinses plus hyaluronic acid gel (group B); 30 patients with non alcoholic chlorhexidine rinses plus Mucosyte® (group C). A significant improvement of the pain scoring and lesions’ severity was noted in group C. Conclusion In Italian adolescents, PHGS is diagnosed at least 48 h after onset and the antibiotic therapy is widely prescribed in order to prevent overinfections. Among topical therapies, an association of verbascoside and sodium hyaluronhate seems to favour a faster healing.

scholarly journals A case of pneumonia and sepsis in cirrhosis as paradigm of the problems in the management of bacterial infections in cirrhosis and of the limitations of current knowledge

2013 ◽  
pp. 209-214
Author(s):  
Manuel Tufoni ◽  
Alessandra Tovoli ◽  
Caterina Maggioli ◽  
Lucia Napoli ◽  
Carmen Serena Ricci ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Hepatitis C ◽  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Clinical Presentation ◽  
Current Knowledge ◽  
Empirical Antibiotic Therapy ◽  
Increased Risk

Bacterial infections are a major problem in the management of liver cirrhosis. They represent the first precipitating cause of death since patients with cirrhosis carry an increased risk of sepsis, sepsis-induced organ failure and death. Although the clinical presentation is often misleading, the presence of bacterial infection should always be actively searched and ruled out with certainty whenever a cirrhotic patient is admitted to the hospital with an acute clinical deterioration. Major changes in the epidemiology of bacterial infections have also occurred in the last decade making the choice of empirical antibiotic therapy a challenge. We report a paradigmatic case of a 54-year old man with hepatitis C-related cirrhosis admitted to the hospital for worsening of his ascites and onset of hepatic encephalopathy, an excellent example for the difficulties of management of sepsis in cirrhosis and the limits of current knowledge.

Oxidation of Met1606 in von Willebrand factor is a risk factor for thrombotic and septic complications in chronic renal failure

2012 ◽  
Vol 442 (2) ◽  
pp. 423-432 ◽  
Author(s):  
Vincenzo De Filippis ◽  
Stefano Lancellotti ◽  
Fabio Maset ◽  
Barbara Spolaore ◽  
Nicola Pozzi ◽  
...  
Keyword(s):  
Von Willebrand Factor ◽  
Bacterial Infections ◽  
Vascular Endothelial Cells ◽  
Polymorphonuclear Cells ◽  
Septic Complications ◽  
Bacterial Adhesins ◽  
Increased Risk ◽  
Von Willebrand ◽  
Willebrand Factor

CKD (chronic kidney disease) is a life-threatening pathology, often requiring HD (haemodialysis) and characterized by high OS (oxidative stress), inflammation and perturbation of vascular endothelium. HD patients have increased levels of vWF (von Willebrand factor), a large protein (~240 kDa) released as UL-vWF (ultra large-vWF polymers, molecular mass ~20000–50000 kDa) from vascular endothelial cells and megakaryocytes, and responsible for the initiation of primary haemostasis. The pro-haemostatic potential of vWF increases with its length, which is proteolytically regulated by ADAMTS-13 (a disintegrin and metalloproteinase with thrombospondin motifs 13), a zinc-protease cleaving vWF at the single Tyr1605–Met1606 bond, and by LSPs (leucocyte serine proteases), released by activated PMNs (polymorphonuclear cells) during bacterial infections. Previous studies have shown that in vitro oxidation of Met1606 hinders vWF cleavage by ADAMTS-13, resulting in the accumulation of UL-vWF that are not only more pro-thrombotic than shorter vWF oligomers, but also more efficient in binding to bacterial adhesins during sepsis. Notably, HD patients have increased risk of developing dramatic cardiovascular and septic complications, whose underlying mechanisms are largely unknown. In the present study, we first purified vWF from HD patients and then chemically characterized its oxidative state. Interestingly, HD-vWF contains high carbonyl levels and increased proportion of UL-vWF polymers that are also more resistant to ADAMTS-13. Using TMS (targeted MS) techniques, we estimated that HD-vWF contains >10% of Met1606 in the sulfoxide form. We conclude that oxidation of Met1606, impairing ADAMTS-13 cleavage, results in the accumulation of UL-vWF polymers, which recruit and activate platelets more efficiently and bind more tightly to bacterial adhesins, thus contributing to the development of thrombotic and septic complications in CKD.

scholarly journals The effect of perinatal antibiotic prophylaxis on an early onset of symptomatic infections in newborns

2017 ◽  
Vol 16 (3) ◽  
pp. 17-24
Author(s):  
Sławomir Szymański ◽  
Katarzyna Szczerba ◽  
Violetta Konstanty-Kurkiewicz
Keyword(s):  
Antibiotic Therapy ◽  
Statistical Significance ◽  
Group B Streptococcus ◽  
Clinical Signs ◽  
Intrauterine Infection ◽  
Arithmetic Means ◽  
E Coli ◽  
Negative Results ◽  
Intrapartum Antibiotic ◽  
Group B

Abstract Aim. The aim of the study was to evaluate the effectiveness of preventive perinatal antibiotic therapy on the occurrence of an earlysymptomatic infections in newborns. Material and Methods. The studied material consisted of data obtained from medical records of 1,328 born alive infants and their mothers. Advanced parameters were described with appropriate numbers, arithmetic means, standard deviation, median as well as minimum and maximum values. The level of statistical significance was p<0.05. Results. When it comes to 6.62% of newborns, they demonstrated the presence of early signs of infection. The Group B Streptococcus (GBS) infection was found in 14 cases, but only in 5 of them pure GBS strains were isolated. E. coli bacteria was reported in 33 neonates, while the other bacteria naming: Enterococcus faecalis, Enterobacteriaceae, taphylococcus epidermidis, Staphylococcus aureus were isolated from 42 newborns. Among 24 newborns showing clinical signs of infection and positive indicators of inflammation in laboratory tests, simultaneously negative results of bacteriological cultures were reported. Conclusions. In connection with the introduction of an obligation to perform tests for GBS, amount of used antibiotics is increasing. However, the effectiveness of intrapartum antibiotic therapy and its prevalence appear to be unsatisfactory. The color of amniotic fluid may have an impact on the occurrence of intrauterine infection, including early symptoms of the GBS infection.

scholarly journals Vaccine-Induced Opsonophagocytic Immunity to Neisseria meningitidis Group B

2008 ◽  
Vol 15 (5) ◽  
pp. 799-804 ◽  
Author(s):  
J. S. Plested ◽  
D. M. Granoff
Keyword(s):  
Bactericidal Activity ◽  
Membrane Vesicle ◽  
Polymorphonuclear Cells ◽  
Outer Membrane Vesicle ◽  
Complement Proteins ◽  
Increased Risk ◽  
Risk Of Disease ◽  
Group B ◽  
Terminal Complement

ABSTRACT The role of opsonophagocytosis (OP) in protection against meningococcal disease is controversial because patients with deficiencies in terminal complement proteins whose sera support OP but not bactericidal activity (BA) are at greatly increased risk of disease. We assayed complement-mediated BA and OP bactericidal activity in sera from 32 adults immunized with an outer membrane vesicle vaccine given alone or combined with an investigational recombinant protein, genome-derived neisserial antigen (GNA2132). The sera were heat inactivated to remove internal complement activity, and BA was measured with exogenous nonimmune human serum as a complement source. OP was measured with human polymorphonuclear cells (PMNs) and C6-depleted complement, which without PMNs did not support BA. Before immunization, 9 to 19% of sera from subjects in both vaccine groups combined had BA titers of ≥1:4, which increased to 41 to 72% after immunization (P < 0.01 against each of three test strains). The percentages of sera with OP titers of ≥1:5 were 3 to 16%, which increased to 55 to 72% (P < 0.001 for each strain). Most postimmunization BA-positive sera were OP positive, but 10 to 37% of BA-negative sera also were OP positive. Comparing the two vaccine groups, there were no significant differences in the percentages of sera with BA or OP activity except for a higher percentage of OP against one strain in postimmunization sera from subjects in the combination vaccine group (P ≤ 0.02). The data support independent roles for serum BA and OP bactericidal activity in protection against group B disease.

scholarly journals Outpatient Parenteral Antimicrobial Therapy in the Time of COVID-19: The Urgent Need for Better Insurance Coverage

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Omar Mansour ◽  
Sara Keller ◽  
Morgan Katz ◽  
Jennifer L Townsend
Keyword(s):  
Health Care ◽  
Antibiotic Therapy ◽  
Health Care System ◽  
Bacterial Infections ◽  
Care Home ◽  
Skilled Nursing Facility ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Relative Safety ◽  
Increased Risk ◽  
Care System

Abstract The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes, coronavirus disease 2019 (COVID-19), are placing unprecedented pressure on every health care system. Patients who require weeks of intravenous antibiotic therapy after hospital discharge due to severe bacterial infections, generally referred to as outpatient parenteral antibiotic therapy (OPAT), are at increased risk for contracting and/or transmitting COVID-19 due to extensive contact with the health care system. To reduce the risk of COVID-19 among this vulnerable patient population, providers overseeing OPAT care need to consider the relative safety of the different OPAT sites of care. Home-based OPAT should be emphasized to minimize hospital stays and prevent skilled nursing facility admissions. Medicare reimbursement policies need to urgently change to provide comprehensive coverage of home infusion services.

Procalcitonin Testingreduce Unnecessary Antibiotic Use in Bacterial Infection

2019 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Attabak Toofani Milani ◽  
Mahshid Mohammadian ◽  
Sadegh Rostaminasab ◽  
Roghayeh Paribananaem ◽  
Zohre Ahmadi ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Diagnostic Test ◽  
Bacterial Infections ◽  
Intervention Studies ◽  
Antibiotic Use ◽  
Clinical Suspicion ◽  
Diagnostic Biomarker ◽  
Clinical Routine ◽  
Initial Rise

Conventional diagnostic test have limitations to deferential diagnosis in clinical suspicion ofbacterial infection cases, that in some cases lead to inappropriate antibiotic therapy and increases antibiotic resistance. A new diagnostic insight is procalcitonin (PCT) test to improve diagnosis of bacterial infections and to guide antibiotic therapy. Serum PCT levels are of useful test as a biomarker in patients with bacterial infections for several reasons. Initial rise of PCT levels due to bacterial infection, subsequent sequential PCT levels can be used to assess the effectiveness and duration of antibiotic therapy. Based on clinical researches results, in bacterial infections, promising good results obtained when use of PCT used as differential diagnostic test. But further intervention studies are needed before use of PCT in clinical routine tests. The goal of this review is to study the PCT reliability as infections diagnostic biomarker.

The influence of intrapartum antibiotic therapy on the diagnosis of early-onset neonatal sepsis

1997 ◽  
Vol 73 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Rita de Cássia S. Vieira ◽  
Renato S. Procianoy ◽  
Lisiane Dalle Mulle ◽  
Cristina H. A. Prado
Keyword(s):  
Antibiotic Therapy ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Intrapartum Antibiotic

scholarly journals Kidney Injury Caused by Preeclamptic Pregnancy Recovers Postpartum in a Transgenic Rat Model

2021 ◽  
Vol 22 (7) ◽  
pp. 3762
Author(s):  
Sarah M. Kedziora ◽  
Kristin Kräker ◽  
Lajos Markó ◽  
Julia Binder ◽  
Meryam Sugulle ◽  
...  
Keyword(s):  
Rat Model ◽  
Renal Damage ◽  
Kidney Injury ◽  
Tissue Growth ◽  
Female Rats ◽  
Male Rats ◽  
Renal Diseases ◽  
Transgenic Rat ◽  
Increased Risk ◽  
Before And After

Preeclampsia (PE) is characterized by the onset of hypertension (≥140/90 mmHg) and presence of proteinuria (>300 mg/L/24 h urine) or other maternal organ dysfunctions. During human PE, renal injuries have been observed. Some studies suggest that women with PE diagnosis have an increased risk to develop renal diseases later in life. However, in human studies PE as a single cause of this development cannot be investigated. Here, we aimed to investigate the effect of PE on postpartum renal damage in an established transgenic PE rat model. Female rats harboring the human-angiotensinogen gene develop a preeclamptic phenotype after mating with male rats harboring the human-renin gene, but are normotensive before and after pregnancy. During pregnancy PE rats developed mild tubular and glomerular changes assessed by histologic analysis, increased gene expression of renal damage markers such as kidney injury marker 1 and connective-tissue growth factor, and albuminuria compared to female wild-type rats (WT). However, four weeks postpartum, most PE-related renal pathologies were absent, including albuminuria and elevated biomarker expression. Only mild enlargement of the glomerular tuft could be detected. Overall, the glomerular and tubular function were affected during pregnancy in the transgenic PE rat. However, almost all these pathologies observed during PE recovered postpartum.

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