Successful Treatment of Vancomycin-Resistant Enterococcus Faecium Pyelonephritis with Daptomycin During Pregnancy

2008 ◽  
Vol 42 (5) ◽  
pp. 722-725 ◽  
Author(s):  
Katherine Shea ◽  
Esther Hilburger ◽  
Allison Baroco ◽  
Edward Oldfield
Keyword(s):  
Successful Treatment ◽  
Enterococcus Faecium ◽  
Pregnant Patient ◽  
Multidrug Resistant ◽  
Successful Outcome ◽  
History Of ◽  
Vancomycin Resistant ◽  
Tract Infections ◽  
In Pregnancy ◽  
Lower Urinary

Objective: To report successful treatment using daptomycin for pyelonephritis associated with van cornycin-resistant Enterococcus faecium (VRE) in a 27-week pregnant woman. Case Summary: A 20-year-old 27-week pregnant patient with a history of spina bifida, neurogenic bladder, and multiple hospitalizations for recurrent urinary tract infections (UTIs) was diagnosed with pyelonephritis. She was treated with daptomycin 260 mg (4 mg/kg) daily for 14 days on the basis of a urine culture that revealed E. faecium resistant to ampicillin, nitrofurantoin, and vancomycin. All cultures following treatment revealed no growth, and the patient as well as the neonate displayed no adverse effects. Discussion: VRE UTIs can be treated safely in pregnancy with nitrofurantoin, if the organism is susceptible. Other viable options in the treatment of VRE, including linezolid, doxycycline, and quinupristin/dalfopristin, have lower urinary concentrations, teratogenic risk, or limited findings regarding their safety in pregnancy. Daptomycin was selected in this case due to its efficacy in the treatment of VRE, high urinary concentrations, pregnancy category B, and one case report indicating its successful use in pregnancy. Conclusions: Treatment of VRE in pregnancy can be challenging due to the teratogenicity or unknown safety of available options. The use of daptomycin in our patient enabted a successful outcome of multidrug-resistant E. faecium in a complicated pregnant patient without observed neonatal abnormalities.

scholarly journals Risk factors of multidrug-resistant bacteria in community-acquired urinary tract infections

2021 ◽  
Vol 21 (1) ◽  
pp. 214-9
Author(s):  
Ertugrul Guclu ◽  
Fikret Halis ◽  
Elif Kose ◽  
Aziz Ogutlu ◽  
Oğuz Karabay
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Antibiotic Usage ◽  
Advanced Age ◽  
History Of ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are one of the most seen infection among community. Objectives: In this cross-sectional study we aimed to investigate the risk factors of multidrug-resistant (MDR) bacteria that caused community-acquired UTI (CA-UTI). Methods: Consecutive patients admitted to the Urology and Infectious Diseases policlinics with the diagnosis of CA-UTI were included in the study. A standard form including possible predisposing factors for MDR bacteria was applied. Results: In total, 240 patients (51.3% females) were enrolled in the study. The mean age of participants were 59.8 ± 18.3 years old. Escherichia coli (n =166; 69.2%)was the most frequently isolated bacteria and its incidence was higher in females than in males (p=0.01). In total, 129 (53.8%) of the identified pathogens were MDR bacteria. According to multivariate analysis, the use of antibiotics three or more times increased the risk of infection with MDR bacteria by 4.6 times, the history of urinary tract infection in the last 6 months by 2 times, being male and over 65 years old by 3 times. Conclusion: Doctors should consider prescribing broad-spectrum antibiotics in patients with severe UTIs with a history of UTI, advanced age, male gender, and multiple antibiotic usage, even if they have a CA-UTI. Keywords: Urinary tract infection; community acquired; multidrug-resistant; male; multiple antibiotic usage; advanced age.

scholarly journals Successful Treatment of Persistent Vancomycin‐Resistant Enterococcus faecium Bacteremia with Linezolid and Gentamicin

1999 ◽  
Vol 28 (3) ◽  
pp. 689-690 ◽  
Author(s):  
Gary A. Noskin ◽  
Farida Siddiqui ◽  
Valentina Stosor ◽  
Julie Kruzynski ◽  
Lance R. Peterson
Keyword(s):  
Successful Treatment ◽  
Enterococcus Faecium ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Resistant

scholarly journals 1069: Bad bugs: antibiotic-resistant lower urinary tract infections and risk of pyelonephritis in pregnancy

2020 ◽  
Vol 222 (1) ◽  
pp. S660
Author(s):  
Anna DeNoble ◽  
Madison Krischak ◽  
Heather Rosett ◽  
Sarika Sachdeva ◽  
Kristin Weaver ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Lower Urinary Tract ◽  
Antibiotic Resistant ◽  
Tract Infections ◽  
In Pregnancy ◽  
Lower Urinary

scholarly journals When the Uterus Competes for Perfusion: Management of a Pregnant Patient with Bypass Graft Occlusion

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sarah McGriff ◽  
Paige Percer ◽  
Iberia Sosa ◽  
Hector Mendez-Figueroa ◽  
Joseph L. Mills ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Bypass Graft ◽  
Pregnant Patient ◽  
Arterial Disease ◽  
Graft Occlusion ◽  
Left Lower Extremity ◽  
Ct Angiogram ◽  
History Of ◽  
Peripheral Arterial ◽  
In Pregnancy

Background. Peripheral arterial disease (PAD) in pregnancy has serious implications and requires multidisciplinary management. This becomes even more complicated in the setting of active disease and history of prior vascular grafts. Case. A woman presented with increasing left lower extremity pain at 18 weeks of gestation with a complex history of PAD and a previous bifurcated aorta-left femoral, -right iliac bypass. CT angiogram demonstrated known occluded bypass graft. A multidisciplinary team of providers developed guidelines for potential surgical intervention based upon clinical symptoms. Conclusion. Pelvic PAD can worsen in pregnancy in the setting of the enlarging uterus, which can potentially deplete perfusion of existing collateral vessels. Symptomatic approach to worsening disease provided an effective management strategy in this case.

scholarly journals Cefpodoxime-Proxetil versus Trimethoprim-Sulfamethoxazole for Short-Term Therapy of Uncomplicated Acute Cystitis in Women

2003 ◽  
Vol 47 (3) ◽  
pp. 897-900 ◽  
Author(s):  
Demetra Kavatha ◽  
Helen Giamarellou ◽  
Zoe Alexiou ◽  
Nickolas Vlachogiannis ◽  
Stavroula Pentea ◽  
...  
Keyword(s):  
Randomized Study ◽  
Previous History ◽  
Term Therapy ◽  
Acute Cystitis ◽  
Cefpodoxime Proxetil ◽  
Bacteriological Eradication ◽  
Significant Difference ◽  
History Of ◽  
Tract Infections ◽  
Lower Urinary

ABSTRACT One hundred sixty-three women with uncomplicated acute lower urinary tract infections were included in a multicenter randomized study comparing cefpodoxime-proxetil (one 100-mg tablet twice daily) with trimethoprim-sulfamethoxazole (one double-strength tablet [160/800 mg] twice daily) for 3 days. A total of 30 women in both arms were excluded from the study for various reasons. At 4 to 7 days after the discontinuation of therapy, 62 of 63 (98.4%) cefpodoxime-proxetil recipients and 70 of 70 (100%) trimethoprim-sulfamethoxazole patients were clinically cured and demonstrated bacteriological eradication, respectively. At 28 days after treatment, 48 of 55 (87.3%) and 43 of 50 (86%) cefpodoxime-proxetil recipients as well as 51 of 60 (85%) and 42 of 50 (84%) trimethoprim-sulfamethoxazole recipients were clinically cured and demonstrated bacteriological eradication, respectively. Independently of the prescribed regimen, a significant difference (P < 0.001) in failure rates was observed only for patients with a previous history of three or more episodes of acute cystitis per year. With the exception of one patient in the trimethoprim-sulfamethoxazole arm who discontinued therapy because of gastrointestinal pain, both antimicrobials were well tolerated. In conclusion, cefpodoxime-proxetil treatment for 3 days was as safe and effective as trimethoprim-sulfamethoxazole for 3 days for the treatment of uncomplicated acute cystitis in women.

scholarly journals Unilateral Pulmonary Artery Aplasia in a Pregnant Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Chitra Lal ◽  
Jim Barker ◽  
Charlie Strange
Keyword(s):  
Pulmonary Hypertension ◽  
Chest Pain ◽  
Pulmonary Artery ◽  
Case Reports ◽  
Pregnant Patient ◽  
Pregnant Female ◽  
Prospective Evaluation ◽  
Rare Anomaly ◽  
History Of ◽  
In Pregnancy

Unilateral pulmonary artery aplasia is a rare anomaly. Case reports of this condition in pregnant patients are even more uncommon and the best approach to management of such patients is still unclear. We report a patient who presented with a history of dyspnea, chest pain, and hemoptysis. Imaging established the diagnosis in a newly pregnant female. Management of the pulmonary artery aplasia patient in pregnancy requires prospective evaluation of pulmonary hypertension.

Successful Treatment of Persistent Bacteremia due to Vancomycin-Resistant, Ampicillin-Resistant Enterococcus faecium

1995 ◽  
Vol 1 (3) ◽  
pp. 249-253 ◽  
Author(s):  
ENDALE T. MEKONEN ◽  
GARY A. NOSKIN ◽  
DONNA M. HACEK ◽  
LANCE R. PETERSON
Keyword(s):  
Successful Treatment ◽  
Enterococcus Faecium ◽  
Persistent Bacteremia ◽  
Vancomycin Resistant
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