Epidemiology of patients with central nervous system infections, mainly neurosurgical patients: a retrospective study from 2012 to 2019 in a teaching hospital in China

Abstract Background Central nervous system (CNS) infections are relatively rare but are associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the survival of patients with CNS infections, and should be based on the knowledge of the pathogen distribution and antibiotic sensitivities. The aim of this study was to investigate the features of pathogens in patients with CNS infections in North China and evaluate the risk factors for mortality and multi-drug-resistant (MDR) bacterial infections. Methods A retrospective study was conducted with patients with positive cerebrospinal fluid (CSF) cultures in a teaching hospital from January 2012 to December 2019. The following data were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial sensitivity results. Data were analyzed with SPSS 16.0. Univariate analysis and binary logistic regression analyses were performed to identify the risk factors for mortality and MDR bacterial infections. Results A total of 72 patients were diagnosed with CNS infections, and 86 isolates were identified. The proportions of Gram-positive bacteria, Gram-negative bacteria and fungi were 59.3, 30.2 and 10.5%, respectively. The predominant Gram-positive bacteria was Coagulase-negative Staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella spp. were the predominant Gram-negative bacteria. Compared to 2012–2015 years, the proportion of Gram-negative bacteria increased markedly during 2016–2019 years. Coagulase-negative Staphylococci, Streptococcus pneumoniae and Enterococcus faecium had 100% sensitivity to vancomycin, teicoplanin and linezolid. Acinetobacter baumannii and Klebsiella pneumoniae were 100% sensitive to tigecycline. Escherichia coli had 100% sensitivity to amikacin, meropenem and imipenem. The overall mortality rate in the 72 patients was 30.6%. In multivariate analysis, age > 50 years, pulmonary infections and CSF glucose level < the normal value were associated with poor outcomes. CSF adenosine deaminase level > the normal value and the presence of external ventricular drainage/lumbar cistern drainage were associated with MDR bacterial infections. Conclusions The mortality rate due to CNS infections reached 30.6% in our study. The proportion of Gram-negative bacteria has increased markedly in recent years. We should give particular attention to patients with risk factors for mortality and MDR bacterial infections mentioned above.

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Epidemiology, Pathogens Distribution, Antibiotic Susceptibility and the Risk Factors for Mortality of Patients With Central Nervous System Infections: a Retrospective Study From 2012 to 2019 in a Teaching Hospital in China

10.21203/rs.3.rs-153262/v1 ◽

2021 ◽

Author(s):

Zheng Zhang ◽

Yan Song ◽

Jianbang Kang ◽

Surong Duan ◽

Qi Li ◽

...

Keyword(s):

Risk Factors ◽

Central Nervous System ◽

Nervous System ◽

Retrospective Study ◽

Pulmonary Infection ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Cns Infections

Abstract Background: Central nervous system (CNS) infections are relatively rare but associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the prognosis of patients with CNS infections, which should be based on the knowledge of pathogens distribution and antibiotic sensitivities. China is a vast country, and the pathogens distribution varies nationwide. The aim of this study is to investigate the features of pathogens in patients with CNS infections in north China and we tried to evaluate the risk factors for mortality.Methods: We retrospectively analyzed the patients with positive cerebrospinal fluid (CSF) culture in a teaching hospital between January 2012 and December 2019. The following information were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial susceptibility results. Univariate analysis and binary logistic regression analysis were performed to identify the risk factors for mortality.Results: In this eight-year retrospective study, a total of 72 patients were diagnosed with CNS infections and 86 isolates were identified. Among all the microorganisms detected, Gram-positive strains consisted of 59.3%, Gram-negative bacteria of 30.2% and fungi of 10.5%. The predominant Gram-positive isolate was coagulase-negative staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella were the common Gram-negative strains. Compared to 2012-2015 years, the proportion of Gram-negative bacteria increased markedly during 2016-2019 years. Vancomycin, teicoplanin and linezolid were still 100% sensitive to Gram-positive bacteria. For the multidrug-resistant Gram-negative bacteria, only tigecycline was the 100% sensitive antibiotics. The mortality of the 72 patients was 30.6%. In the multivariate analysis, age >50 years, combined pulmonary infection and CSF glucose < normal value were associated with poor prognosis. Conclusions: CNS infections cause high mortality worldwide. Although Gram-positive bacteria are still the primary pathogen of CNS infections, Gram-negative bacteria had increased in recent years and should be considered in the choice of empirical antibiotic treatment. Special attention should be given to older patients and those combined pulmonary infection and with low CSF glucose level.

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Epidemiology, pathogens distribution, antibiotic susceptibility and the risk factors for mortality of patients with central nervous system infections: a retrospective study from 2012 to 2019 in a teaching hospital in China

10.21203/rs.3.rs-153262/v2 ◽

2021 ◽

Author(s):

Zheng Zhang ◽

Yan Song ◽

Jianbang Kang ◽

Surong Duan ◽

Qi Li ◽

...

Keyword(s):

Risk Factors ◽

Central Nervous System ◽

Nervous System ◽

Retrospective Study ◽

Pulmonary Infection ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Cns Infections

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Pyelonephritis in Pediatric Uropathic Patients: Differences from Community-Acquired Ones and Therapeutic Protocol Considerations. A 10-Year Single-Center Retrospective Study

Children ◽

10.3390/children8060436 ◽

2021 ◽

Vol 8 (6) ◽

pp. 436

Author(s):

Giovanni Parente ◽

Tommaso Gargano ◽

Stefania Pavia ◽

Chiara Cordola ◽

Marzia Vastano ◽

...

Keyword(s):

Escherichia Coli ◽

Retrospective Study ◽

Success Rate ◽

Pediatric Population ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Significant Difference ◽

Klebsiella Spp

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; moreover, to identify a proper empiric therapeutic strategy. A retrospective study was conducted on antibiograms on urine cultures from PNs in vesicoureteral reflux (VUR) patients admitted to pediatric surgery department and from PNs in not VUR patients admitted to Pediatric Emergency Unit between 2010 and 2020. We recorded 58 PNs in 33 patients affected by VUR and 112 PNs in the not VUR group. The mean age of not VUR patients at the PN episode was 1.3 ± 2.6 years (range: 20 days of life–3 years), and almost all the urine cultures, 111 (99.1%), isolated Gram-negative bacteria and rarely, 1 (0.9%), Gram-positive bacteria. The Gram-negative uropathogens isolated were Escherichia coli (97%), Proteus mirabilis (2%), and Klebsiella spp. (1%). The only Gram-positive bacteria isolated was an Enterococcus faecalis. As regards the antibiograms, 96% of not VUR PNs responded to beta-lactams, 99% to aminoglycosides, and 80% to sulfonamides. For the VUR group, mean age was 3.0 years ± 3.0 years (range: 9 days of life–11 years) and mean number of episodes per patient was 2.0 ± 1.0 (range: 1–5); 83% of PNs were by Gram-negatives bacteria vs. 17% by Gram-positive: the most important Gram-negative bacteria were Pseudomonas aeruginosa (44%), Escherichia coli (27%), and Klebsiella spp. (12%), while Enterococcus spp. determined 90% of Gram-positive UTIs. Regimen ampicillin/ceftazidime (success rate: 72.0%) was compared to ampicillin/amikacin (success rate of 83.0%): no statistically significant difference was found (p = 0.09). The pathogens of PNs in uropathic patients are different from those of community-acquired PNs, and clinicians should be aware of their peculiar antibiotic susceptibility. An empiric therapy based on the association ampicillin + ceftazidime is therefore suggested.

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Risk Factors for Early Mortality in Patients with Primary Central Nervous System Lymphoma: A Large-Cohort Retrospective Study

World Neurosurgery ◽

10.1016/j.wneu.2020.03.150 ◽

2020 ◽

Vol 138 ◽

pp. e905-e912

Author(s):

Xingwang Zhou ◽

Xiaodong Niu ◽

Junhong Li ◽

Shuxin Zhang ◽

Wanchun Yang ◽

...

Keyword(s):

Risk Factors ◽

Central Nervous System ◽

Nervous System ◽

Retrospective Study ◽

Central Nervous System Lymphoma ◽

Early Mortality ◽

Large Cohort

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Visualizing the Potential Impairment of Polymyxin B to Central Nervous System Through MR Susceptibility-Weighted Imaging

Frontiers in Pharmacology ◽

10.3389/fphar.2021.784864 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ni Zhang ◽

Lichong Zhu ◽

Qiuhong Ouyang ◽

Saisai Yue ◽

Yichun Huang ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Polymyxin B ◽

Susceptibility Weighted Imaging ◽

Gram Negative Bacteria ◽

Severe Toxicity ◽

Gram Negative ◽

The Impact

Polymyxin B (PMB) exert bactericidal effects on the cell wall of Gram-negative bacteria, leading to changes in the permeability of the cytoplasmic membrane and resulting in cell death, which is sensitive to the multi-resistant Gram-negative bacteria. However, the severe toxicity and adverse side effects largely hamper the clinical application of PMB. Although the molecular pathology of PMB neurotoxicity has been adequately studied at the cellular and molecular level. However, the impact of PMB on the physiological states of central nervous system in vivo may be quite different from that in vitro, which need to be further studied. Therefore, in the current study, the biocompatible ultra-uniform Fe3O4 nanoparticles were employed for noninvasively in vivo visualizing the potential impairment of PMB to the central nervous system. Systematic studies clearly reveal that the prepared Fe3O4 nanoparticles can serve as an appropriate magnetic resonance contrast agent with high transverse relaxivity and outstanding biosafety, which thus enables the following in vivo susceptibility-weighted imaging (SWI) studies on the PMB-treated mice models. As a result, it is first found that the blood-brain barrier (BBB) of mice may be impaired by successive PMB administration, displaying by the discrete punctate SWI signals distributed asymmetrically across brain regions in brain parenchyma. This result may pave a noninvasive approach for in-depth studies of PMB medication strategy, monitoring the BBB changes during PMB treatment, and even assessing the risk after PMB successive medication in multidrug-resistant Gram-negative bacterial infected patients from the perspective of medical imaging.

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Survival of some non-starter bacteria in naturally ripened and enzyme-accelerated Cheddar cheese

Journal of Dairy Research ◽

10.1017/s0022029900033380 ◽

1988 ◽

Vol 55 (4) ◽

pp. 597-602 ◽

Cited By ~ 5

Author(s):

Lydia Bautista ◽

Rohan G. Kroll

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Enterococcus Faecalis ◽

Enzyme System ◽

Cheddar Cheese ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Ripening Period ◽

Gram Positive Bacteria

SummaryEffects of the addition of a proteinase (Neutrase 1–5S) and a peptidase (aminopeptidase DP-102) as agents for accelerating the ripening of Cheddar cheese on the survival of some non-starter bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coliand aSalmonellasp.) were studied throughout a 4-month ripening period. The enzymes were found to have no significant effect on the survival of the Gram-positive bacteria but some significant effects were observed, at some stages of the ripening period, with the Gram-negative bacteria in that lower levels were recovered from cheeses treated with the enzyme system.

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Moxalactam Therapy of Serious; Pediatric Infections

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002808401800910 ◽

1984 ◽

Vol 18 (9) ◽

pp. 723-726 ◽

Cited By ~ 1

Author(s):

Michael D. Reed ◽

Stephen C. Aronoff ◽

Jeffrey L. Blumer

Keyword(s):

Central Nervous System ◽

Staphylococcus Aureus ◽

Nervous System ◽

Drug Therapy ◽

Bacterial Infections ◽

Multiple Sources ◽

Cns Infections ◽

The Central Nervous System ◽

Pediatric Infections ◽

In Infants And Children

Forty children with documented or suspected bacterial infections arising outside the central nervous system (CNS) were studied. Fifteen different pathogens for a total of 30 isolates were obtained from multiple sources. Staphylococcus aureus (minimum inhibitory concentrations 4–8 μg/ml) was the most common pathogen isolated, involving seven patients. Each patient received moxalactam 50 mg/kg iv over 15 minutes q8h and responded favorably to therapy, exhibiting bacteriologic and/or clinical cures. Toxicity associated with moxalactam occurred in only two patients and necessitated discontinuation of drug therapy. Moxalactam 50 mg/kg iv q8h is effective therapy for non-CNS infections occurring in infants and children.

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Different Modes of Action of Naphthyridones in Gram-Positive and Gram-Negative Bacteria

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.50.1.385-387.2006 ◽

2006 ◽

Vol 50 (1) ◽

pp. 385-387 ◽

Cited By ~ 16

Author(s):

Ed T. Buurman ◽

Kenneth D. Johnson ◽

Roxanne K. Kelly ◽

Kathy MacCormack

Keyword(s):

Escherichia Coli ◽

Haemophilus Influenzae ◽

Mode Of Action ◽

Bacterial Pathogens ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Modes Of Action

ABSTRACT Naphthyridones that were recently described as a class of translation inhibitors in gram-positive bacteria mediate their mode of action via GyrA in Haemophilus influenzae and Escherichia coli. These are the first examples of compounds in which modes of action in different bacterial pathogens are mediated through widely different targets.

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Synthesis of cyclotetrapeptide analogues of c-PLAI and evaluation of their antimicrobial properties

Royal Society Open Science ◽

10.1098/rsos.201822 ◽

2021 ◽

Vol 8 (3) ◽

Author(s):

Rani Maharani ◽

Orin Inggriani Napitupulu ◽

Jelang M. Dirgantara ◽

Ace Tatang Hidayat ◽

Dadan Sumiarsa ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Properties ◽

Trichophyton Mentagrophytes ◽

Solution Phase ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Aromatic Residues ◽

Gram Positive Bacteria ◽

Lysine Residues ◽

Bacteria And Fungi

Antimicrobial peptides (AMPs) are interesting compounds owing to their ability to kill several pathogens. In order to identify new AMPs, c-PLAI analogues were synthesized and evaluated together with their linear precursors for their antimicrobial properties against two Gram-positive bacteria ( Staphylococcus aureus and Bacillus cereus ), two Gram-negative bacteria ( Escherichia coli and Klebsiella pneumoniae ), and two fungal strains ( Candida albicans and Trichophyton mentagrophytes ). The new c-PLAI analogues were prepared through a combination of solid- and solution-phase syntheses, as previously employed for the synthesis of c-PLAI. The antimicrobial activity tests showed that the synthetic parent peptide c-PLAI was inactive or weakly active towards the bioindicators employed in the assay. The tests also indicated that cyclic c-PLAI analogues possessed enhanced antimicrobial properties against most of the bacteria and fungi tested. Furthermore, this study revealed that analogues containing cationic lysine residues displayed the highest activity towards most bioindicators. A combination of lysine and aromatic residues yielded analogues with broad-spectrum antimicrobial properties.

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Synthesis, Characterization and Antimicrobial Activities of Co (III) and Fe (III) Complexes of Imino-N-heterocyclic Carbenes Ligands

Chemical Science International Journal ◽

10.9734/csji/2021/v30i630238 ◽

2021 ◽

pp. 59-67

Author(s):

Samaila Abubakar ◽

Musa Muktari ◽

Rejoice Atiko

Keyword(s):

Escherichia Coli ◽

Salmonella Typhi ◽

Antimicrobial Activities ◽

Heterocyclic Carbenes ◽

Gram Negative Bacteria ◽

Disc Diffusion ◽

Gram Negative ◽

E Coli ◽

Gram Positive Bacteria

The synthesis and antimicrobial application of Co (III) and Fe (III) complexes of imine functionalized N-heterocyclic carbene (Imino-NHC) ligands is reported. The ligand precursors 1-(2-[(hydroxyl-benzylidene)-amino]-ethyl)-3-R-3H-imidazol-1-ium bromide where R = pyridyl (1a) and benzyl (1b) have been reported in our previous work. The in-situ generated ligands of 1a and 1b have been successfully coordinated to CoBr2 and [FeI(Cp)(CO)2] leading to the isolation of air-stable N^C^N^O four coordinate Co(III) complex 2 and a six-coordinate Fe(III) complex 3. The synthesised complexes were both found to be NMR inactive hence were characterize using FTIR and LRMS. The complexes were screened for antimicrobial activities against four gram-negative bacteria Escherichia Coli (E-coli), Shigella, Klebsiella pneumoniae (K. Pneumoniae) and Salmonella typhi (S. typhi) and a gram positive bacteria Staphylocossus aureus (S. aureus). The antimicrobial test was conducted using disc diffusion methods and based on the concentrations of 100, 200, 300, 400 and 500 µg/ mL, significant activities were recorded for both cobalt and the iron complexes.

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