scholarly journals COMPARATIVE ANALYSIS OF THE ACTIVITY OF GLYCOPEPTIDES AND LINEZOLID AGAINST NOSOCOMIAL STRAINS OF GRAM-POSITIVE MICROORGANISMS ISOLATED FROM CANCER PATIENT

2021 ◽  
Vol 20 (5) ◽  
pp. 93-99
Author(s):  
N. V. Dmitrieva ◽  
I. N. Petukhova ◽  
Z. V. Grigoryevskaya ◽  
N. S. Bagirova ◽  
I. V. Tereshchenko ◽  
...  

The purpose of the study: to compare the activity of vancomycin, teicoplanin and linezolid and to determine their place in the current treatment of nosocomial infections caused by gram-positive microflora.Material and Methods. 640 gram-positive microorganisms (S. aureus, E. faecium, E. faecalis) isolated in 2018 from various pathological materials from cancer patients treated at N.N. Blokhin National Medical Research Center of Oncology were studied. Literature data from 1982 to 2019, concerning efficacy of glycopeptides (vancomycin, teicoplanin) and linezolid against these pathogens were analyzed.Results. Data analysis showed that percentage of methicillin-resistant Staphylococcus aureus (MRSA) was 89 % and percentage of vancomycinresistant enterococci (VRE) was 5.1 % among Enterococcus faecalis and 16.4 % among Enterococcus faecium. The susceptibility of the studied gram-positive microorganisms to teicoplanin, vancomycin and linezolid ranged from 83.3 to 98.8 % (p>0.5). In general, teicoplanin, vancomycin, and linezolid had equally high microbiological activity against nosocomial strains of S. aureus and Enterococcus spp. Also, according to the literature data, a comparative assessment of the clinical effectiveness and cost-effectiveness of glycopeptides and linezolid was assessed.Conclusion. Vancomycin and teicoplanin are still the main drugs for the treatment of various infections caused by resistant gram-positive microflora. However, teicoplanin, with an efficacy equal to that of vancomycin, has a number of significant advantages over the latter: better tolerability, lower frequency of adverse reactions, and pharmacokinetic features that make it possible to use it once a day both intravenously and intramuscularly. Both drugs, along with linezolid, can be used to treat infections caused by gram-positive microorganisms in cancer patients. 

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruofei Du ◽  
Xin Wang ◽  
Lixia Ma ◽  
Leon M. Larcher ◽  
Han Tang ◽  
...  

Abstract Background The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. Methods A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. Results A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. Conclusion The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 385
Author(s):  
Michele Ghidini ◽  
Mariaceleste Nicoletti ◽  
Margherita Ratti ◽  
Gianluca Tomasello ◽  
Veronica Lonati ◽  
...  

Diarrhoea is one of the main side effects that cancer patients face. The literature showsthat the incidence of chemotherapy (CT)-induced diarrhoea (grade 3–4) in treated patients is in the range of 10–20%, particularly after 5-fluorouracil (5-FU) bolus or some combination therapies of irinotecan and fluoropyrimidines. The aim of the present study was to evaluate the clinical effectiveness of Lactobacillus kefiri LKF01 (Kefibios®) in the prevention or treatment of CT-related diarrhoea in the cancer population. We conducted a prospective observational study. Patients enrolled were adults treated for at least four months with 5-FU-based CT. Kefibios® was administered to patients every day. The primary outcome was the evaluation of the incidence of grade 3–4 CT-induced diarrhoea. We included 76 patients in the final analysis. A 6.6% incidence of high-grade diarrhoea was found in the evaluated population (4.7% of patients treated with 5-FU-based therapy and 8.5% of patients treated with capecitabine-based CT). The overall incidence of high-grade diarrhoea observed was higher in the 1st and 2nd cycles (3.9%), with a subsequent sharp reduction from the 3rd cycle (1.3%) and negativisation from the 5th cycle. Lactobacillus kefiri LKF01 (Kefibios®) is safe and effective in preventing severe diarrhoea in cancer patients receiving 5-FU or capecitabine-based treatment.


Cancer ◽  
2013 ◽  
Vol 119 (22) ◽  
pp. 4028-4035 ◽  
Author(s):  
Inbal Vinograd ◽  
Noa Eliakim-Raz ◽  
Laura Farbman ◽  
Rina Baslo ◽  
Ahmed Taha ◽  
...  

Author(s):  
Yu. L. Shevchenko ◽  
O. E. Karpov ◽  
V. O. Sarzhevskiy ◽  
S. A. Fateev ◽  
P. S. Vetshev ◽  
...  

Organizational aspects of specialized including high-tech oncological medical care in a multi-field hospital are shown. A 10-year experience of the Pirogov National Medical and Surgical Center regarding optimization of the treatment of cancer patients is reported. Effectiveness of oncological care organization in a multi-field hospital is preliminary concluded. It is emphasized that multidisciplinary approach is essential for selecting a personalized program of cancer treatment in these patients. The need for further searching for ways to improve the diagnosis and treatment of cancer patients by accumulating and analyzing large clinical material is marked.


2015 ◽  
Vol 12 (1) ◽  
pp. 27-32
Author(s):  
Borelli Zlatkov ◽  
Jean Filipov ◽  
Emil Paskalev ◽  
Boyka Markova ◽  
Yuliya Marteva-Proevska ◽  
...  

Abstract Introduction. Urinary tract infection (UTI) among kidney transplant recipients (KTRs) is one of the most common complications after transplantation. The aim of our study was to analyze the antibiotic sensitivity and resistance of the most common agents causing UTI in Bulgarian KTRs followed up in our Transplant Center. Methods. We analyzed the antibiotic resistance and sensitivity of the most common strains of bacteria causing UTI in the Bulgarian KTRs, namely class Enterobac-teriaceae and Enterococcus spp. We used conventional biochemical methods to identify different strains of uro-pathogens-miniApi (bioMerieux, France) and BBL Crystal (BD). The antibiotic sensitivity was determined via disc-diffusing method, according to the accepted Bulgarian CLSI standard. We used WHONET, version 5.6 to analyze the antibiotic resistance data. Results. The total number of tested patients was 366 [males 228, females 138]. The total number of tested urine samples was 829 [positive ones-203), negative samples 606, contaminated 20]. The most commonly detected uropathogens in Bulgarian KTRs were Gram /-/ negative bacteria (63.80%). Of these, 93.28% belonged to the Enterobacteriaceae group, with E. coli, K. pneumoniae and the PPM /Proteus, Providentia, Mor-ganela/subgroup being the most common (54.5%, 19.20% and 16%, respectively). Gram /+/ positive bacteria were detected in 28.09% of the patients, Enterococcus spp being the most commonly isola-ted-67.79%. In the Enterococcus group, the strains of E. faecalis and E. faecium were the most commonly detected. The bacteria belonging to Enterobacteriaceae group were most sensitive to carbapenems and aminoglycosides, with sensitivity peaking to almost 100%, whereas they were least sensitive to aminopenicillines [sensitivity below 20%]. The PPM subgroup revealed very high sensitivity to beta-lactamase protected broad spectrum penicillins (Piperacillin/Tazobactam, sensitivity - 90%). Gram /+/ positive uropathogens were mostly sensitive to Linezolid, Vancomycin, Teicoplanin (100%). These strains were least sensitive to Erythromycin and Tetracicline (17.50%). Conclusions. Our results were similar to previous studies. The differences detected can be explained with the characteristics of the bacterial strains and the specific practice of each transplant center. Having in mind the possible complications of UTIs, further studies are needed to clarify the problem with antimicrobial resistance in uropathogens and the use of antibiotics after KT.


Author(s):  
Sanjana Ramakrishnan ◽  
Sourabh Radhakrishnan ◽  
Sonu Lazar Cyriac

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin.  Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.


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