scholarly journals Endophthalmitis Panorama in The Jerusalem Area

2021 ◽  
Author(s):  
Juan Martin Sanchez ◽  
Hila Elinav ◽  
Liran Tiosano ◽  
Radgonde Amer
Keyword(s):  
Bacterial Resistance ◽  
Management Strategies ◽  
Western World ◽  
Diabetic Patients ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Tertiary Referral Center ◽  
Intraocular Surgery ◽  
Microbial Spectrum

Abstract Purpose: The spectrum of microbial infections and the pattern of their susceptibility is variable among communities. Researching this data will lead to the establishment of the most appropriate national management strategies. The purpose of this study was to analyze the epidemiological, clinical, microbial spectrum and antibiotic susceptibility of endophthalmitis cases in a tertiary referral center in Jerusalem.Methods: Retrospective review of medical charts of patients presenting with endophthalmitis over a 12-year-period.Results: Included were 74 eyes of 70 patients (males 56%). Mean age±SD at presentation was 60±19.5 years. Exogenous endophthalmitis accounted for 78% of cases; of which, 62% followed an intraocular surgery, 21% occurred after intravitreal injections, 10% followed infectious keratitis and 7% were post-traumatic. Endogenous cases were predominantly observed in diabetic patients. Microbial isolates were identified in 44 samples. Of them, gram-positive bacteria were the predominant microorganisms detected in 33 samples (75%); Staphylococcus epidermidis and Enterococcus faecalis were the most commonly detected pathogens. Mean presenting±SD LogMAR visual acuity (VA) was 2.38±1.21 and it improved at last follow-up to 1.7±1.37 (p=0.004, paired t-test). Cases secondary to gram-positive microbes were associated with improved VA during the follow-up while cases secondary to gram-negative microbes was correlated with poor final VA (p=0.046, r2=0.4). There was no evidence of bacterial resistance in the antibiograms for either vancomycin, ceftazidime, ceftriaxone or amikacin.Conclusions: Intraocular surgery remains the most common event preceding endophthalmitis with coagulase-negative staphylococci being the most frequently detected microorganisms. The microbial spectrum of endophthalmitis is similar to that in the western world.

scholarly journals Are dipeptidyl peptidase-4 inhibitors effective and safe in long term when added to ongoing therapies of diabetics? a real-life study in tertiary referral center

2019 ◽  
Vol 6 (2) ◽  
pp. 264
Author(s):  
Deniz Avci ◽  
Ali Cetinkaya
Keyword(s):  
Hemoglobin A1c ◽  
Real Life ◽  
Dipeptidyl Peptidase ◽  
Diabetic Patients ◽  
Mean Values ◽  
Tertiary Referral Center ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors

Background: The aim of this study was to determine how HbA1c, lipid, renal functions and such parameters were affected in the long term by adding dipeptidyl peptidase-4 inhibitors to the ongoing treatment regimens of patients with Type 2 diabetes mellitus.Methods: The study was conducted in diabetes mellitus outpatient clinic of Kayseri Training and Research Hospital between February 2012 and May 2017, with patients who did not achieve the sufficient success in diabetes their controls at the time of admission. From these patients, those who added (dipeptidyl peptidase-4 inhibitors) to their treatments were selected. Patients were followed up as long as they continued to these new treatments and the parameters at the baseline were compared with final values.Results: A total of 80 diabetic patients were followed in the study. The median age of the patients was 56.08±9.71 years. During this follow-up, an average decrease of 1.03% was noted when patients were compared with 9.53±1.87% of the initial hemoglobin A1c, and 8.50±1.48% of the Hemoglobin A1c values at the end of follow-up. This decrease was statistically significant (p <0.001). However, differences in the initial and final values of the lipid parameters of the patients were not statistically significant.Conclusions: Addition of dipeptidyl peptidase-4 inhibitors to patients' treatments causes significant decreases in Hemoglobin A1c mean values. This decline is long lasting. However, there are no positive or negative effects on biochemical parameters such as lipids, kidney and liver functions.

scholarly journals DALBACEN cohort: dalbavancin as consolidation therapy in patients with endocarditis and/or bloodstream infection produced by gram-positive cocci

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Carmen Hidalgo-Tenorio ◽  
David Vinuesa ◽  
Antonio Plata ◽  
Pilar Martin Dávila ◽  
Simona Iftimie ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Bloodstream Infection ◽  
Consolidation Therapy ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Hospitalised Patients ◽  
Pharmacodynamic Profile ◽  
Cost Effective Treatment ◽  
Gram Positive Cocci

Abstract Objectives To analyse the effectiveness of dalbavancin (DBV) in clinical practice as consolidation therapy in patients with bloodstream infection (BSI) and/or infective endocarditis (IE) produced by gram-positive cocci (GPC), as well as its safety and pharmacoeconomic impact. Methods A multicentre, observational and retrospective study was conducted of hospitalised patients with IE and/or BSI produced by GPC who received at least one dose of DBV. Clinical response was assessed during hospitalization, at 3 months and at 1 year. Results Eighty-three patients with median age of 73 years were enrolled; 73.5% were male; 59.04% had BSI and 49.04% IE (44.04% prosthetic valve IE, 32.4% native IE, 23.5% pacemaker lead). The most frequently isolated microorganism was Staphylococcus aureus in BSI (49%) and coagulase-negative staphylococci in IE (44.1%). All patients with IE were clinically cured in hospital; at 12 months, there was 2.9% loss to follow-up, 8.8% mortality unrelated to IE, and 2.9% therapeutic failure rate. The percentage effectiveness of DBV to treat IE was 96.7%. The clinical cure rate for BSI was 100% during hospital stay and at 3 months; there were no recurrences or deaths during the follow-up. No patient discontinued treatment for adverse events. The saving in hospital stay was 636 days for BSI (315,424.20€) and 557 days for IE (283,187.45€). Conclusions DBV is an effective consolidation antibiotic therapy in clinically stabilized patients with IE and/or BSI. It proved to be a cost-effective treatment, reducing the hospital stay, thanks to the pharmacokinetic/pharmacodynamic profile of this drug.

scholarly journals Susceptibility of bacterial endophthalmitis isolates to vancomycin, ceftazidime, and amikacin

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kuan-Jen Chen ◽  
Ming-Hui Sun ◽  
Chiun-Ho Hou ◽  
Hung-Chi Chen ◽  
Yen-Po Chen ◽  
...  
Keyword(s):  
Vision Loss ◽  
Multidrug Resistant ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
Tertiary Referral Center ◽  
Bacterial Endophthalmitis ◽  
Severe Vision Loss

AbstractBacterial endophthalmitis is a rare intraocular infection, and prompt administration of intravitreal antibiotics is crucial for preventing severe vision loss. The retrospective study is to investigate the in vitro susceptibility to the antibiotics vancomycin, amikacin, and ceftazidime of bacterial endophthalmitis isolates in specimens at a tertiary referral center from January 1996 to April 2019 in Taiwan. Overall, 450 (49.9%) isolates were Gram positive, 447 (49.6%) were Gram negative, and 4 (0.4%) were Gram variable. In Gram-positive isolates, coagulase-negative staphylococci were the most commonly cultured bacteria (158, 35.1%), followed by Streptococci (100, 22.2%), Enterococci (75, 16.7%), and Staphylococcus aureus (70, 15.6%). In Gram-negative isolates, they were Klebsiella pneumoniae (166, 37.1%) and Pseudomonas aeruginosa (131, 29.3%). All Gram-positive organisms were susceptible to vancomycin, with the exception of one Enterococcus faecium isolate (1/450, 0.2%). Of the Gram-negative isolates, 96.9% and 93.7% were susceptible to ceftazidime and amikacin, respectively. Nine isolates (9/447, 2.0%) were multidrug-resistant Gram-negative bacteria, comprising K. pneumoniae (4/164, 2.4%), Acinetobacter baumannii (2/3, 67%), and Stenotrophomonas maltophilia (3/18, 17%). In conclusion, in vitro susceptibility testing revealed that vancomycin remains the suitable antibiotic treatment for Gram-positive endophthalmitis. Ceftazidime and amikacin provide approximately the same degree of Gram-negative coverage. Multidrug-resistant bacterial endophthalmitis was uncommon.

Neonatal Bacteremia: Patterns of Antibiotic Resistance

2001 ◽  
Vol 22 (12) ◽  
pp. 767-770 ◽  
Author(s):  
Ruben Bromiker ◽  
Ilan Arad ◽  
Ofra Peleg ◽  
Aviya Preminger ◽  
Dan Engelhard
Keyword(s):  
Antibiotic Resistance ◽  
Early Onset ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Late Onset ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Live Births ◽  
Gram Negative Organisms

AbstractObjective:To determine the incidence and evaluate the antimicrobial-susceptibility patterns of bacterial infections in our neonatal units.Design:Retrospective surveillance study.Setting:The neonatal units of the Hadassah University Hospitals, Jerusalem, Israel.Patients:All newborns admitted from January 1994 through February 1999.Methods:The records of all patients with positive blood and cerebrospinal fluid cultures were reviewed. Bacteremia was considered early-onset (vertical) when occurring within the first 72 hours of life and late-onset (nosocomial) when occurring later. The prevalence and antibiotic-resistance patterns of vertically transmitted and nosocomially acquired strains were compared and studied over time.Results:219 of 35,691 newborn infants had at least one episode of bacteremia (6.13/1,000 live births). There were 305 identified organisms, of which 21% (1.29/1,000 live births) were considered vertically transmitted and 79% nosocomially acquired. The most common organism causing early-onset disease (29.2%) was group B streptococcus (0.38/1,000 live births), whereas coagulase-negative staphylococci (51%) were the most prevalent in late-onset disease. All gram-positive bacteria were susceptible to vancomycin. Most gram-positive organisms other than staphylococci were susceptible to ampicillin. Gram-negative organisms represented 31% of all isolates. Generally, there was a trend of increasing resistance to commonly used antibiotics among nosocomially acquired gram-negative organisms, compared to those vertically transmitted, with statistically significant differences for ampicillin and mezlocillin (P<.05 andP<.01, respectively). Over the years, a trend toward an increasing resistance to antibiotics was observed among gram-negative organisms.Conclusions:The trend of increasing bacterial resistance to commonly used antibiotics necessitates the implementation of a rational empirical treatment strategy, based on local susceptibility data, reserving certain agents for emerging resistant pathogens.

scholarly journals Susceptibility of Bacterial Endophthalmitis Isolates to Vancomycin, Ceftazidime, and Amikacin

2021 ◽  
Author(s):  
Kuan-Jen Chen ◽  
Ming-Hui Sun ◽  
Chiun-Ho Hou ◽  
Hung-Chi Chen ◽  
Yen-Po Chen ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Vision Loss ◽  
Multidrug Resistant ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
Tertiary Referral Center ◽  
Bacterial Endophthalmitis

Abstract Bacterial endophthalmitis is a rare intraocular infection, and prompt administration of intravitreal antibiotics is crucial for preventing severe vision loss. The retrospective study is to investigate the in vitro susceptibility to the antibiotics vancomycin, amikacin, and ceftazidime of bacterial endophthalmitis isolates in specimens at a tertiary referral center from January 1996 to April 2019 in Taiwan. Overall, 450 (49.9%) isolates were gram positive, 447 (49.6%) were gram negative, and 4 (0.4%) were gram variable. In gram-positive isolates, coagulase-negative staphylococci were the most commonly cultured bacteria (158, 35.1%), followed by streptococci (100, 22.2%), enterococci (75, 16.7%), and Staphylococcus aureus (70, 15.6%). In gram-negative isolates, they were Klebsiella pneumoniae (166, 37.1%) and Pseudomonas aeruginosa (131, 29.3%). All gram-positive organisms were susceptible to vancomycin, with the exception of one Enterococcus faecium isolate (1/450, 0.2%). Of the gram-negative isolates, 96.9% and 93.7% were susceptible to ceftazidime and amikacin, respectively. Nine isolates (9/447, 2.0%) were multidrug-resistant gram-negative bacteria, comprising Klebsiella pneumoniae (4/164, 2.4%), Acinetobacter baumannii (2/3, 67%), and Stenotrophomonas maltophilia (3/18, 17%). In conclusion, in vitro susceptibility testing revealed that vancomycin remains the suitable antibiotic treatment for gram-positive endophthalmitis. Ceftazidime and amikacin provide approximately the same degree of gram-negative coverage. Multidrug-resistant bacterial endophthalmitis was uncommon.

Microbial Spectrum and Antibacterial Susceptibility of Endophthalmitis Cultures in a Tertiary Referral Center in the Midwestern United States: An Analysis From 295 Patients

2020 ◽  
pp. 247412642093645
Author(s):  
Michael Gemayel ◽  
Ashley Neiweem ◽  
Brent Aebi ◽  
Peter Bracha ◽  
Thomas Ciulla
Keyword(s):  
United States ◽  
Fungal Culture ◽  
Indiana University ◽  
Tertiary Referral ◽  
Gram Positive ◽  
Gram Negative ◽  
Midwestern United States ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Microbial Spectrum

Purpose: This work evaluates the microbial spectrum and antibiotic susceptibility pattern of endophthalmitis cases in a large tertiary referral center in the Midwestern United States. Methods: This retrospective case series included patients with clinically diagnosed endophthalmitis between April 14, 2006 and April 14, 2016, in whom ocular samples were submitted to the Microbiology Department at Indiana University. The patients were assessed by 11 vitreoretinal surgeons from 6 different sites in Indianapolis, including Indiana University and private practices, who receive patients from urban, suburban, and rural agricultural areas. Submitted specimens were cultured with the following media: blood agar, chocolate agar, MacConkey agar, and thioglycolate broth. Results: A total of 327 specimens from 295 patients were analyzed, with 96 (32.5%) samples from 90 (30.5%) patients meeting the criteria of confirmed growth. Of these 96 positive specimens, 83 (86.5%) organisms were identified as bacterial, and 13 (13.5%) were identified as fungal. Coagulase-negative Staphylococcus was the most common isolate (37.5%). Fifty gram-positive isolates and 10 gram-negative isolates underwent susceptibility testing. All 40 of the gram-positive isolates tested for vancomycin sensitivity were susceptible, whereas all 7 of the gram-negative isolates tested for ceftazidime sensitivity were susceptible. Conclusions: Empiric treatment with vancomycin and ceftazidime remains appropriate in most cases of endophthalmitis in the Midwestern United States, with 100% susceptibility of bacterial organisms tested with these antibiotics in this series. The high fungal culture rates in this study highlight the utility of obtaining vitreous cultures and potential need for antifungal agents in suspicious cases.

Empiric Treatment of Foot Infection in Patients with Severe Diabetes

2021 ◽  
Author(s):  
Alexandre Sacchetti Bezerra ◽  
◽  
Flavia Altheman Loureiro ◽  
Carla Maria Pasquareli Vazquez ◽  
Afonso Cesar Polimanti ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Bacterial Resistance ◽  
Empirical Therapy ◽  
Empirical Treatment ◽  
Diabetic Patients ◽  
Gram Positive ◽  
International Consensus ◽  
Gram Negative ◽  
Severe Diabetes ◽  
High Incidence

Background: Despite being treated with antibiotics of broad spectrum recommended by International Consensus, severe diabetic patients with lower limb infection do not present a positive clinical evolution during empirical treatment. This study’s bacterial profile was analysed and compared with other worldwide hospital centers. Objective: To confirm the need of an individualized empirical treatment for severe diabetic patients with foot infection. Methods: Retrospective analysis of cultures and antibiograms of severe diabetic patients admitted by foot infection. Results: The results were consistent with the socioeconomic realities of developing countries. Gram-negative bacteria (52,11%) were present in most bone cultures. Results presented a high incidence of Enterococcus faecalis in both gram-positive (21,2%) and polymicrobial (34,7%) samples. Bacterial resistance with the use of ordinary antibiotics in the statistical analysis was high. Conclusion: The community infections should undergo broad spectrum empirical therapy combining amikacin (80,43%) or meropenem (72,00%) with gram-negative and vancomycin (100%) or teicoplanin (90,00%) or linezolid (74,19%) with gram-positive.

scholarly journals Incidence of Tetracycline and Erythromycin Resistance in Meat-Associated Bacteria: Impact of Different Livestock Management Strategies

2021 ◽  
Vol 9 (10) ◽  
pp. 2111
Author(s):  
Cecilia Fontana ◽  
Vania Patrone ◽  
Constanza Maria Lopez ◽  
Lorenzo Morelli ◽  
Annalisa Rebecchi
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Management Strategies ◽  
Tetracycline Resistance ◽  
Animal Husbandry ◽  
Growth Promoters ◽  
Erythromycin Resistance ◽  
Coagulase Negative Staphylococci ◽  
Associated Bacteria

The extensive use of antibiotics as growth promoters, or their continued abusive misuse to cure or prevent the onset of bacterial infections as occurs in the intensive farming, may have played a pivotal role in the spread of reservoirs of antibiotic resistance (AR) among food-associated bacteria including pathogens representing risks to human health. The present study compares the incidence of tetracycline and erythromycin resistances in lactic acid bacteria (LAB) and coagulase negative staphylococci (CNS) from fermented products manufacturing using meat from intensive animal husbandry (industrialized manufacturing Italian salami) and from extensive farms (artisanal sausages facilities pork and llama Argentinean sausages). A higher incidence of tetracycline resistance (TET-R) compared to erythromycin resistance (ERY-R) was observed among the 205 isolates. Unlike CNS strains, the LAB showed a significant correlation between the TET-R and the ERY-R phenotypes. Genotypic assessment shows a high correlation with tetK and tetM for the TET-R strains and with ermB and ermC for the ERY-R strains. Multiple correspondence analyses have highlighted the association between AR phenotypes and CNS species isolated from Italian salami, while the susceptible phenotypes were associated with the LAB species from Argentinean sausages. Since antibiotic resistance in meat-associated bacteria is a very complex phenomenon, the assessment of bacterial resistance in different environmental contexts with diverse farming practices and food production technologies will help in monitoring the factors influencing AR emergence and spread in animal production.

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