scholarly journals Tigecycline Successfully Treats One Case of Relapsed Leukemia- Drug-resistant Double Sepsis

2020 ◽  
Author(s):  
Huang Jie ◽  
Li Xiao Han
Keyword(s):  
Blood Culture ◽  
Acute Leukemia ◽  
Medical Record ◽  
Enterococcus Faecium ◽  
Vancomycin Resistance ◽  
Leg Pain ◽  
Drug Resistant ◽  
Disturbance Of Consciousness ◽  
Bacteriostatic Agent ◽  
Imipenem Resistance

Abstract BackgroundNowadays, tigecycline is often used in combination with other antibiotics. To the best of our knowledge, this was the first documented use tigecycline alone for drug-resistant double sepsis in a patient suffering from leukemia.. The aim of this study is to reduce unnecessary drug combinations associated with tigecycline and use antibiotics reasonably. Case presentationA 29-year-old young man was admitted to the hospital because of "limb right leg, pain for 4 years, fever, blood in the stool, and sudden disturbance of consciousness for 1 week". The patient was a relapsed patient with advanced acute leukemia, with severe perianal infection and neutrophil deficiency. At the same time, blood culture suggested Acinetobacter luffi (Imipenem resistance) and Enterococcus faecium (vancomycin resistance). Tigecycline is used alone, and conventional doses are used to achieve the effect of curing double sepsis experience..ConclusionsGenerally speaking, tigecycline is a bacteriostatic agent, doctors are used to a combination of Tigecycline and other antibiotics in fighting infections.In this case, tigecycline is used alone, and conventional doses are used to achieve the effect of curing double sepsis experience. This medical record adds to the doctor,s experience with the use of tigecycline.

scholarly journals Tige Cycline Successfully Treats One Case of Relapsed Leukemia-drug-resistant Double Sepsis

2020 ◽  
Author(s):  
Huang Jie ◽  
Li Xiao Han ◽  
Fei Xiao Fan
Keyword(s):  
Blood Pressure ◽  
Blood Culture ◽  
Acute Leukemia ◽  
Enterococcus Faecium ◽  
Drug Susceptibility ◽  
Drug Resistant ◽  
Normal Blood Pressure ◽  
Bacteriostatic Agent ◽  
Imipenem Resistance ◽  
Rational Use Of Antibiotics

Abstract Background Nowadays, tigecycline is often used in combination with other antibiotics. To the best of our knowledge, this was the first documented use tigecycline alone for drug-resistant double sepsis in a patient suffering from leukemia.. The aim of this study is to reduce unnecessary drug combinations associated with tigecycline and use antibiotics reasonably. Methods The patient was a relapsed patient with advanced acute leukemia, with severe perianal infection and neutrophil deficiency. At the same time, blood culture suggested Acinetobacter luffi (Imipenem resistance) and Enterococcus faecium (vancomycin resistance). The doctor has no other choice according to drug susceptibility results. Tigecycline is used alone, and conventional doses are used . Results the patient's temperature gradually became normal, blood pressure was stable, blood in the stool stopped, perianal swelling subsided, pain was reduced, and infection improved. Conclusion generally speaking, tigecycline is a bacteriostatic agent; doctors are used to a combination of Tigecycline and other antibiotics in fighting infections.In this case, the patient's immunity is low.Tigecycline is used alone, and conventional doses are used to achieve the effect of curing double sepsis experience.This helps in the rational use of antibiotics.

scholarly journals Attributable mortality of vancomycin resistance in ampicillin-resistant Enterococcus faecium bacteremia in Denmark and the Netherlands: A matched cohort study

2021 ◽  
pp. 1-9
Author(s):  
Wouter C. Rottier ◽  
Mette Pinholt ◽  
Akke K. van der Bij ◽  
Magnus Arpi ◽  
Sybrandus N. Blank ◽  
...  
Keyword(s):  
Cohort Study ◽  
The Netherlands ◽  
Antibiotic Therapy ◽  
Enterococcus Faecium ◽  
Mortality Rates ◽  
Vancomycin Resistance ◽  
Attributable Mortality ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
The Impact

Abstract Objective: To study whether replacement of nosocomial ampicillin-resistant Enterococcus faecium (ARE) clones by vancomycin-resistant E. faecium (VRE), belonging to the same genetic lineages, increases mortality in patients with E. faecium bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy. Design: Retrospective, matched-cohort study. Setting: The study included 20 Dutch and Danish hospitals from 2009 to 2014. Patients: Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed. Methods: The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors. Results: The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06–2.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk. Conclusions: Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.

Activity of Oritavancin Against Gram-positive Pathogens Causing Bloodstream Infections in the United States Over 10 Years: Focus on Drug-Resistant Enterococcal Subsets (2010-2019)

2021 ◽  
Author(s):  
Cecilia G. Carvalhaes ◽  
Helio S. Sader ◽  
Jennifer M. Streit ◽  
Mariana Castanheira ◽  
Rodrigo E. Mendes
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Enterococcus Faecium ◽  
Bloodstream Infections ◽  
The United States ◽  
Drug Resistant ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Over Time

Oritavancin displayed potent and stable activity (MIC 90 range, 0.06-0.5 mg/L) over time (2010-2019) against Gram-positive pathogens causing bloodstream infections, including methicillin-resistant Staphylococcus aureus and resistant subsets of Enterococcus spp. Daptomycin and linezolid were also active against methicillin-resistant S. aureus and vancomycin-resistant Enterococcus . Only oritavancin and linezolid remained active against Enterococcus faecium isolates displaying an elevated daptomycin MIC (i.e., 2-4 mg/L). Proportions of methicillin-resistant S. aureus and vancomycin-resistant Enterococcus within the respective S. aureus and enterococcal populations decreased over this period.

scholarly journals Group-C Trisomy in Myeloid Metaplasia with Possible Leukemia

Blood ◽  
1964 ◽  
Vol 24 (6) ◽  
pp. 716-725 ◽  
Author(s):  
AVERY A. SANDBERG ◽  
TAKAAKI ISHIHARA ◽  
LOIS H. CROSSWHITE
Keyword(s):  
Bone Marrow ◽  
Blood Culture ◽  
Acute Leukemia ◽  
Chromosomal Abnormality ◽  
Blood Cells ◽  
Karyotype Analysis ◽  
Myeloproliferative Disorders ◽  
Normal Female ◽  
Myeloid Metaplasia ◽  
Definite Relationship

Abstract A chromosomal abnormality in marrow and blood cells has been found in only one patient out of a group of 20 subjects with myeloproliferative disorders other than leukemia. The abnormal karyotypic finding consisted of group C9 trisomy in a patient with myeloid metaplasia and an acute leukemia-like picture and indicates a definite relationship to acute leukemia. The latter has been shown to be not infrequently accompanied by C9 trisomy. The trisomy was accompanied by the presence of a substantial number of hypertetraploid cells in the marrow but not in the cultured blood cells. As a matter of fact, the blood culture yielded predominantly metaphases with 47 chromosomes (C9 trisomy) on the first examination and metaphases with 46 chromosomes and a normal female karyotype on the second occasion. The superiority of bone marrow karyotype analysis over that of blood cells in leukemic states is thus indicated.

scholarly journals Draft Genome Sequence of a Vancomycin-Resistant and Vancomycin-Dependent Enterococcus faecium Isolate

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Marion Blaschitz ◽  
Sarah Lepuschitz ◽  
Laura Wagner ◽  
Franz Allerberger ◽  
Alexander Indra ◽  
...  
Keyword(s):  
Genome Sequence ◽  
Enterococcus Faecium ◽  
Prolonged Exposure ◽  
Draft Genome ◽  
Vancomycin Resistance ◽  
Draft Genome Sequence ◽  
Nosocomial Pathogens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Faecium Isolate

Vancomycin-resistant enterococci have emerged as major nosocomial pathogens worldwide. While antimicrobial pressure promotes nosocomial colonization with these enterococci, prolonged exposure to vancomycin may foster the transition from vancomycin resistance to vancomycin dependence. Here, we report the draft genome sequence of a vancomycin-dependent Enterococcus faecium isolate showing partial teicoplanin dependence.

Characterization of a vancomycin-resistant Enterococcus faecium isolate and a vancomycin-susceptible E. faecium isolate from the same blood culture

2020 ◽  
Author(s):  
Kyriaki Xanthopoulou ◽  
Julia Wille ◽  
Janine Zweigner ◽  
Kai Lucaßen ◽  
Thorsten Wille ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enterococcus Faecium ◽  
Core Genome ◽  
Blot Hybridization ◽  
Southern Blot Hybridization ◽  
Vana Gene ◽  
Plasmid Analysis ◽  
Vancomycin Resistant ◽  
Faecium Isolate

Abstract Objectives To characterize two Enterococcus faecium isolates with different resistance phenotypes obtained from the same blood culture. Methods The isolates were identified by MALDI-TOF MS and antimicrobial susceptibility testing (AST) was performed using a VITEK® 2 AST P592 card and Etest. WGS was performed on the MiSeq and MinION sequencer platforms. Core-genome MLST (cgMLST) and seven-loci MLST were performed. Plasmid analysis was performed using S1-PFGE followed by Southern-blot hybridization. Results Both E. faecium isolates were ST203. AST revealed that one was a vancomycin-resistant E. faecium (VREfm) isolate and the other was a vancomycin-susceptible E. faecium (VSEfm) isolate. The VREfm isolate harboured the vanA gene cluster as part of a Tn1546-type transposon encoded on a 49 kb multireplicon (rep1, rep2 and rep7a) plasmid (pAML0157.1). On the same plasmid, ant(6)-Ia, cat-like and erm(B) were encoded. The VSEfm isolate harboured a rep2 plasmid (pAML0158.1), 12 kb in size, which was present in full length as part of pAML0157.1 from the VREfm isolate. The vanA-encoding pAML0157.1 was a chimera of the rep2 pAML0158.1 and a second DNA segment harbouring vanA, ant(6)-Ia, erm(B) and cat-like, as well as the replicons rep1 and rep7a. By cgMLST analysis, the VREfm and VSEfm isolates were identical. Conclusions Our results demonstrate that the VREfm and VSEfm blood culture isolates represented ST203 and were identical. The investigated heterogeneous resistance phenotypes resulted from the acquisition or loss of plasmid segments in the enterococcal isolates. These data illustrate that mobile genetic elements may contribute to the spread of vancomycin resistance among enterococci and to the genotypic and phenotypic variation within clonal isolates.

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