Ticarcillin Therapy of Risk Patients with Infections Due to Pseudomonas Aeruginosa

The implication of nosocomial infection due to Pseudomonas aeruginosa is demonstrated by comparing the bacteriological findings with the clinical picture often patients in a surgical intensive care unit. The occurrence of this organism and its resistance to beta-lactam-antibiotics and aminoglycosides is demonstrated. Ticarcillin was administered to ten patients following bacteriological and clinical evidence of infections due to P. aeruginosa. The pathogenicity of P. aeruginosa as an organism complicating the course of severely injured patients is discussed. Therapeutic consequences in regard to possible combination with other antibiotics are suggested.

Download Full-text

Target site pharmacokinetics of meropenem: Measurement in human explanted lung tissue by bronchoalveolar lavage, microdialysis and homogenized lung tissue

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01564-21 ◽

2021 ◽

Author(s):

Michael Paal ◽

Christina Scharf ◽

Ann Katrin Denninger ◽

Luis Ilia ◽

Charlotte Kloft ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Lung Tissue ◽

Target Site ◽

Therapeutic Drug ◽

Beta Lactam ◽

Blood Concentrations ◽

Intensive Care Patients ◽

Beta Lactam Antibiotics ◽

Liquid Chromatography Tandem Mass ◽

Risk Patients

Objectives: Pneumonia is one of the most common infections in intensive care patients, and it is often treated with beta-lactam antibiotics. Even if therapeutic drug monitoring in blood is available, it is unclear whether sufficient concentrations are reached at the target site: the lung. The following study was initiated to fill this knowledge gap. Methods: Various compartments from ten patients` explanted lungs were subjected to laboratory analysis. Meropenem was quantified in serum, bronchoalveolar lavage (BAL), microdialysate and homogenized lung tissue with isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS). BAL represents diluted epithelial lining fluid (ELF), and microdialysate represents interstitial fluid (IF). Differences between target site and blood concentrations were investigated. Results: The median meropenem concentration in blood, ELF, IF and tissue were 26.8, 18.0, 12.1 and 9.1 mg/L, respectively. A total of 37.5% of the target site ELF and IF meropenem concentrations were below the clinical EUCAST breakpoint of 8 mg/L. The median ELF/serum quotient was 61.8% (IQR: 24.8%, 87.6%), the median IF/serum quotient was 35.4% (IQR: 23.8%, 54.3%), and the median tissue/serum quotient was 34.2% (IQR: 28.3%, 38.2%). We observed a substantial interindividual variability between the blood and the compartments (ELF, IF), whereas the intraindividual variability was relatively low. Conclusions: Target site measurement in different lung compartments was feasible and successfully applied in a clinical setting. A relevant amount of 37.5% of the target site concentrations fell under the clinical EUCAST breakpoint, indicating subtherapeutic dosing in high-risk patients receiving perioperative antibiotic prophylaxis in lung transplantation.

Download Full-text

Growing Menace of Antibacterial Resistance in Clinical Isolates ofPseudomonas aeruginosain Nepal: An Insight of Beta-Lactamase Production

BioMed Research International ◽

10.1155/2016/6437208 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Shamshul Ansari ◽

Rabindra Dhital ◽

Sony Shrestha ◽

Sangita Thapa ◽

Ram Puri ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Resistance ◽

Opportunistic Pathogen ◽

Resistance Rate ◽

Diffusion Method ◽

Beta Lactamase ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Microbiological Methods ◽

Immunosuppressed Patients

Introduction. Pseudomonas aeruginosais the most frequently isolated organism as it acts as the opportunistic pathogen and can cause infections in immunosuppressed patients. The production of different types of beta-lactamases renders this organism resistant to many commonly used antimicrobials. Therefore, the aim of this study was to document the antibiotic resistance rate inPseudomonas aeruginosaisolated from different clinical specimens.Methods. Pseudomonas aeruginosarecovered was identified by standard microbiological methods. Antibiotic susceptibility testing was performed by modified Kirby-Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines and all the suspected isolates were tested for the production of ESBLs, MBLs, and AmpC.Results.Out of total (178) isolates, 83.1% were recovered from the inpatient department (IPD). Majority of the isolates mediated resistance towards the beta-lactam antibiotics, while nearly half of the isolates were resistant to ciprofloxacin. Most of the aminoglycosides used showed resistance rate up to 75% but amikacin proved to be better option. No resistance to polymyxin was observed. ESBLs, MBLs, and AmpC mediated resistance was seen in 33.1%, 30.9%, and 15.7% isolates, respectively.Conclusions. Antibiotic resistance rate and beta-lactamase mediated resistance were high. Thus, regular surveillance of drug resistance is of utmost importance.

Download Full-text

Serratia marcescans Contamination of Antiseptic Soap Containing Triclosan: Implications for Nosocomial Infection

Infection Control ◽

10.1017/s0195941700060690 ◽

1984 ◽

Vol 5 (9) ◽

pp. 427-430 ◽

Cited By ~ 29

Author(s):

M. Anita Barry ◽

Donald E. Craven ◽

Theresa A. Goularte ◽

Deborah A. Lichtenberg

Keyword(s):

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Nosocomial Infection ◽

Surgical Intensive Care Unit ◽

Minimal Bactericidal Concentration ◽

Surgical Intensive Care ◽

Time Kill ◽

The Impact

Abstract During a recent investigation in our surgical intensive care unit, we found that several bottles of the antiseptic handwashing soap, OR Scrub®, were contaminated with Serratia marcescens. OR Scrub® contains 1% triclosan, lanolin, and detergents. The antimicrobial efficacy of OR Scrub® was examined in vitro using serial two-fold dilutions of soap inoculated with various concentrations of different nosocomial pathogens. The minimal bactericidal concentration (MBC) of OR Scrub® against Pseudomonas aeruginosa and several strains of S. marcescens was ≤1:2 By comparison, a non-antiseptic soap from the same manufacturer (Wash®) and 4% chlorhexidine (Hibiclens®) had MBCs for all strains tested of at least 1:64. Time-kill curves confirmed the findings of the initial experiments.This is the first report of extrinsic contamination of antiseptic soap containing triclosan. No infections could be attributed to the contaminated soap, but sporadic outbreaks of Serratia have occurred in the intensive care unit with no identifiable source. Although there have been few studies on the impact of antiseptic soap in reducing nosocomial infection, we question whether a soap with the limitations of OR Scrub® should be used in intensive care units or operating rooms.

Download Full-text

Pseudomonas aeruginosa Resistance to beta-lactam antibiotics

Infectious Diseases Newsletter ◽

10.1016/0278-2316(91)90029-y ◽

1991 ◽

Vol 10 (12) ◽

pp. 97-101 ◽

Cited By ~ 1

Author(s):

B. Giwercman ◽

N. Høiby

Keyword(s):

Pseudomonas Aeruginosa ◽

Beta Lactam ◽

Beta Lactam Antibiotics

Download Full-text

A TEM-derived extended-spectrum beta-lactamase in Pseudomonas aeruginosa.

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.40.11.2488 ◽

1996 ◽

Vol 40 (11) ◽

pp. 2488-2493 ◽

Cited By ~ 47

Author(s):

P Mugnier ◽

P Dubrous ◽

I Casin ◽

G Arlet ◽

E Collatz

Keyword(s):

Pseudomonas Aeruginosa ◽

Clinical Strain ◽

Beta Lactamase ◽

Beta Lactam ◽

Aminoglycoside Resistance ◽

Double Mutation ◽

Extended Spectrum Beta Lactamase ◽

Beta Lactam Antibiotics ◽

Extended Spectrum ◽

High Level

A clinical strain of Pseudomonas aeruginosa, PAe1100, was found to be resistant to all antipseudomonal beta-lactam antibiotics and to aminoglycosides, including gentamicin, amikacin, and isepamicin. PAe1100 produced two beta-lactamases, TEM-2 (pI 5.6) and a novel, TEM-derived extended-spectrum beta-lactamase called TEM-42 (pI 5.8), susceptible to inhibition by clavulanate, sulbactam, and tazobactam. Both enzymes, as well as the aminoglycoside resistance which resulted from AAC(3)-IIa and AAC(6')-I production, were encoded by an 18-kb nonconjugative plasmid, pLRM1, that could be transferred to Escherichia coli by transformation. The gene coding for TEM-42 had four mutations that led to as many amino acid substitutions with respect to TEM-2: Val for Ala at position 42 (Ala42), Ser for Gly238, Lys for Glu240, and Met for Thr265 (Ambler numbering). The double mutation Ser for Gly238 and Lys for Glu240, which has so far only been described in SHV-type but not TEM-type enzymes, conferred concomitant high-level resistance to cefotaxime and ceftazidime. The novel, TEM-derived extended-spectrum beta-lactamase appears to be the first of its class to be described in P. aeruginosa.

Download Full-text