scholarly journals Investigation of the effect of N-Acetylcysteine on colistin mic values in Acinetobacter Baumannii strains isolated from clinical samples

2021 ◽  
Vol 38 (4) ◽  
pp. 471-473
Author(s):  
Fahriye EKŞİ ◽  
Mehmet ERİNMEZ
Keyword(s):  
Respiratory Tract ◽  
Acinetobacter Baumannii ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Clinical Samples ◽  
Chronic Obstructive ◽  
Identification System ◽  
Lower Respiratory Tract Infections ◽  
Broth Microdilution Method ◽  
Tract Infections

Acinetobacter baumannii is an opportunistic pathogen which colonize inpatients and cause severe infections, septic shock and death. With emergence of multi-drug resistant gramnegative species and being effective in A. baumannii infections, colistin becomes a treatment option again. N-acetylcysteine (NAC), is a mucolitic agent which used commonly in lower respiratory tract infections especially patients who have cronic respiratory disorders like Chronic obstructive pulmonary disease, cystic fibrosis and bronchiectasis. In this study we aim to investigate the effect of NAC, which commonly added in lower respiratory tract infections tratment regime, on MIC values colistin used in A. baumanni tratment. Fifty A.baumannii isolates were included in the study. The isolates were identified by automated identification system. With broth microdilution method, we investigated and compared the MIC (minimum inhibitory concentration) values of colistin and NAC+Colistin combination. Colistin MIC50 value is 0.25 μg/mL and MİK90 value is 1 μg/mL, NAC+Colistin combination MIC50 value is 0.25 μg/mL and MİK90 value is 1 μg/mL. The screening for the effectiveness of clinical drugs may provide clinical strategy to improve treatment outcomes of A. baumannii and reduce hospitalization days.

scholarly journals Impact of Chronic Obstructive Pulmonary Disease on Incidence, Microbiology and Outcome of Ventilator-Associated Lower Respiratory Tract Infections

2020 ◽  
Vol 8 (2) ◽  
pp. 165 ◽  
Author(s):  
Anahita Rouzé ◽  
Pauline Boddaert ◽  
Ignacio Martin-Loeches ◽  
Pedro Povoa ◽  
Alejandro Rodriguez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Tract ◽  
Pulmonary Disease ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Tract Infections

Objectives: To determine the impact of chronic obstructive pulmonary disease (COPD) on incidence, microbiology, and outcomes of ventilator-associated lower respiratory tract infections (VA-LRTI). Methods: Planned ancillary analysis of TAVeM study, including 2960 consecutive adult patients who received invasive mechanical ventilation (MV) > 48 h. COPD patients (n = 494) were compared to non-COPD patients (n = 2466). The diagnosis of ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP) was based on clinical, radiological and quantitative microbiological criteria. Results: No significant difference was found in VAP (12% versus 13%, p = 0.931), or VAT incidence (13% versus 10%, p = 0.093) between COPD and non-COPD patients. Among patients with VA-LRTI, Escherichia coli and Stenotrophomonas maltophilia were significantly more frequent in COPD patients as compared with non-COPD patients. However, COPD had no significant impact on multidrug-resistant bacteria incidence. Appropriate antibiotic treatment was not significantly associated with progression from VAT to VAP among COPD patients who developed VAT, unlike non-COPD patients. Among COPD patients, patients who developed VAT or VAP had significantly longer MV duration (17 days (9–30) or 15 (8–27) versus 7 (4–12), p < 0.001) and intensive care unit (ICU) length of stay (24 (17–39) or 21 (14–40) versus 12 (8–19), p < 0.001) than patients without VA-LRTI. ICU mortality was also higher in COPD patients who developed VAP (44%), but not VAT(38%), as compared to no VA-LRTI (26%, p = 0.006). These worse outcomes associated with VA-LRTI were similar among non-COPD patients. Conclusions: COPD had no significant impact on incidence or outcomes of patients who developed VAP or VAT.

scholarly journals Appropriate antibiotic management of bacterial lower respiratory tract infections

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1121 ◽  
Author(s):  
Charles Feldman ◽  
Guy Richards
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Empiric Therapy ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Pneumococcal Infections ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections

Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of treatment for the most important bacterial lower respiratory tract infections, namely acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP), is the use of antibiotics. Yet despite a number of recent publications, including clinical studies as well as several systematic literature reviews and meta-analyses, there is considerable ongoing controversy as to what the most appropriate antibiotics are for the empiric therapy of CAP in the different settings (outpatient, inpatient, and intensive care unit). Furthermore, in the case of AECOPD, there is a need for consideration of which of these exacerbations actually need antibiotic treatment. This article describes these issues and makes suggestions for appropriately managing these conditions, in the setting of the need for antimicrobial stewardship initiatives designed to slow current emerging rates of antibiotic resistance, while improving patient outcomes.

scholarly journals Activity of ceftolozane/tazobactam against Gram-negative isolates from patients with lower respiratory tract infections – SMART United States 2018–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
James A. Karlowsky ◽  
Sibylle H. Lob ◽  
Katherine Young ◽  
Mary R. Motyl ◽  
Daniel F. Sahm
Keyword(s):  
United States ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
The United States ◽  
Lower Respiratory Tract Infections ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
Broth Microdilution Method ◽  
Tract Infections

Abstract Background Ceftolozane/tazobactam (C/T) is approved in 70 countries, including the United States, for the treatment of patients with hospital-acquired and ventilator-associated bacterial pneumonia caused by susceptible Gram-negative pathogens. C/T is of particular importance as an agent for the treatment of multidrug-resistant (MDR) Pseudomonas aeruginosa infections. The current study summarizes 2018–2019 data from the United States on lower respiratory tract isolates of Gram-negative bacilli from the SMART global surveillance program. The CLSI reference broth microdilution method was used to determine in vitro susceptibility of C/T and comparators against isolates of P. aeruginosa and Enterobacterales. Results C/T inhibited 96.0% of P. aeruginosa (n = 1237) at its susceptible MIC breakpoint (≤4 μg/ml), including > 85% of meropenem-nonsusceptible and piperacillin/tazobactam (P/T)-nonsusceptible isolates and 76.2% of MDR isolates. Comparator agents demonstrated lower activity than C/T against P. aeruginosa: meropenem (74.8% susceptible), cefepime (79.2%), ceftazidime (78.5%), P/T (74.4%), and levofloxacin (63.1%). C/T was equally active against ICU (96.0% susceptible) and non-ICU (96.7%) isolates of P. aeruginosa. C/T inhibited 91.8% of Enterobacterales (n = 1938) at its susceptible MIC breakpoint (≤2 μg/ml); 89.5% of isolates were susceptible to cefepime and 88.0% susceptible to P/T. 67.1 and 86.5% of extended-spectrum β-lactamase (ESBL) screen-positive isolates of Klebsiella pneumoniae (n = 85) and Escherichia coli (n = 74) and 49.6% of MDR Enterobacterales were susceptible to C/T. C/T was equally active against ICU (91.3% susceptible) and non-ICU (92.6%) Enterobacterales isolates. Conclusion Data from the current study support the use of C/T as an important treatment option for lower respiratory tract infections including those caused by MDR P. aeruginosa.

Association of serum sphingomyelin profile with clinical outcomes in patients with lower respiratory tract infections: results of an observational, prospective 6-year follow-up study

2019 ◽  
Vol 57 (5) ◽  
pp. 679-689
Author(s):  
Thomas Baumgartner ◽  
Giedre Zurauskaite ◽  
Christian Steuer ◽  
Luca Bernasconi ◽  
Andreas Huber ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Short Term ◽  
Inflammatory Conditions ◽  
Tract Infections ◽  
The Impact

Abstract Background Sphingolipids – the structural cell membrane components – and their metabolites are involved in signal transduction and participate in the regulation of immunity. We investigated the prognostic implications of sphingolipid metabolic profiling on mortality in a large cohort of patients with lower respiratory tract infections (LRTIs). Methods We measured 15 different sphingomyelin (SM) types in patients with LRTIs from a previous Swiss multicenter trial that examined the impact of procalcitonin-guided antibiotic therapy on total antibiotic use and rates and duration of hospitalization. Primary and secondary end points were adverse outcomes – defined as death or intensive care unit admission within 30 days – and 6-year mortality. Results Of 360 patients, 8.9% experienced an adverse outcome within 30 days and 46% died within 6 years. Levels of all SM types were significantly lower in pneumonia patients vs. those with chronic obstructive pulmonary disease (COPD) exacerbation (p<0.0001 for all comparisons). Sphingomyelin subspecies SM (OH) C22:1 and SM (OH) C22:2 were associated with lower risk for short-term adverse outcomes (sex-, gender- and comorbidity-adjusted odds ratios [OR]: 0.036; 95% confidence interval [CI], 0.002–0.600; p=0.021 and 0.037; 95% CI, 0.001–0.848; p=0.039, respectively). We found no significant associations with 6-year mortality for any SM. Conclusions Circulating sphingolipid levels are lower in inflammatory conditions such as pneumonia and correlate with adverse short-term outcomes. Further characterization of the physiological, pathophysiological and metabolic roles of sphingolipids under inflammatory conditions may facilitate understanding of their roles in infectious disease.

Evaluation of Prescribing Patterns in lower Respiratory Tract Infections at Government Hospital – a Retrospective Study

2017 ◽  
Vol 3 (4) ◽  
pp. 375-382
Author(s):  
Hemamanogna Narne ◽  
Sushma Nimmagadda ◽  
Naveen Yaddanapalli ◽  
Koteswari Poluri
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Treatment Plan ◽  
Prescribing Patterns ◽  
Fever Hospital ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Prescribing Trends ◽  
Tract Infections

Objective: The aim of this study was to assess the prescribing trends in Lower Respiratory Tract Infections at Government Fever Hospital. Methods: A retrospective, observational, cross sectional study was carried out by collecting prescription of patients admitted to male and female departments of government fever hospital. The data were analyzed by using SAS software. Results and Conclusion: Prevalence of LRTIs was observed more in males than in females. Pulmonary tuberculosis was the most frequently observed disease, followed by chronic obstructive pulmonary disease (COPD) and Consolidation. Antibiotics, bronchodilators, corticosteroids, vitamins and minerals and analgesics were most commonly prescribed drugs, of those ceftriaxone was the common antibiotic followed by amoxicillin clavulanate, metronidazole, piperacillin+tazobactum and Salbutamol was commonly prescribed bronchodilator followed by ipratropium. Of corticosteroids dexamethasone was mostly prescribed drug. Other classes of drugs such as vitamins and minerals, anti-fungal, antiemetics, benzodiazepines, proton pump inhibitors, H2 receptor blockers and antihistamines were prescribed in patients with need. In some patients more number of antibiotics was prescribed, this may lead to development of resistance. But, the severity of the patient condition influences the treatment plan. Of 400 patients included in study, 331 (82.8%) patients were observed with complete prescription and 69 (17.2%) patients with incomplete prescription as 52 patients of them were left against medical advice and 17 patients were absconding.

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