Resistance to cephalosporins and carbapenems in Gram-negative bacterial pathogens

Pfeifer, Yvonne; Cullik, Angela; Witte, Wolfgang

doi:10.1016/j.ijmm.2010.04.005

Cited by 400 publications

(338 citation statements)

References 84 publications

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“…Fluoroquinolones, for example, have been associated with QT prolongation [68,69], which renders these drugs not preferable in patients with stroke, who often suffer from cardiac comorbidity. Despite their excellent efficacy, broad antibacterial spectrum and good tolerability, cephalosporins, which rapidly induce drug-resistant bacteria, are arguably not the ideal drugs for preventive therapy [70,71]. Previous studies on prophylactic antibiotic treatment in other settings did not support the assumption that short-term prophylactic antibiotic drug treatments facilitate the development of antibiotic drug resistance [38,72].…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

Schwarz

2016

Neurotherapeutics

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Infections, in particular pneumonia, are common complications in patients with acute stroke and are associated with a less favorable neurologic and functional outcome. Patients with severe stroke and dysphagia are at highest risk of infection. Experimental and clinical data suggest stroke-induced immunodeficiency as a major factor contributing to the high incidence of infection after stroke. Preclinical studies support the potential benefit of preventive antibiotic therapy in acute stroke for lowering the incidence of infection and improving clinical outcome. Several smaller clinical trials on preventive antibiotic therapy in patients with stroke conducted during the last 10 years yielded inconclusive results. Recently, 2 large, open-label, controlled trials failed to demonstrate an improved clinical outcome after preventive antibiotic therapy in patients with acute stroke treated in specialized stroke units. In the BPreventive Antibiotics in Stroke Study^, antibiotic therapy lowered the rate of infection but did not influence outcome. In the STROKE-INF study, performed in patients with dysphagia after stroke, antibiotic therapy did not lower the incidence of pneumonia and had no prognostic significance. At present, preventive antibiotic therapy cannot be recommended as a therapeutic option for acute stroke.

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Section: Discussionmentioning

confidence: 99%

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

Schwarz

2016

Neurotherapeutics

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“…La diffusione dei ceppi produttori di ESBL ha portato, nel tempo, ad un aumento dell'utilizzo dei carbapenemi per il trattamento delle infezioni da Enterobacteriaceae contro la maggior parte delle quali essi mantengono ancora, una buona efficacia (21). Tuttavia l'incremento nell'uso dei carbapenemi ha, a sua volta, creato una pressione selettiva, con il risultato di indurre la diffusione di ceppi resistenti in grado di produrre diverse classi di enzimi carbapenemici come MBL, OXA, KPC e GES sia tra le Enterobacteriaceae stessi, che in numerosi ceppi di P. aeruginosa e A. baumannii (19). La diffusione di ceppi produttori di ESBL all'interno del gruppo delle Enterobacteriaceae è quanto mai trasversale a causa dell'intrinseca facilità di trasferimento genico di tipo orizzontale, sia all'interno di ciascuna specie, sia tra specie diverse di Enterobatteri (14); inoltre la concomitante selezione di produttori di carbapenemasi pone il serio problema della comparsa ormai non più sporadica di ceppi potenzialmente resistenti a tutti gli antibiotici noti (MDR) (4).…”

Section: Discussionunclassified

EPIDEMIOLOGICAL OBSERVATORY: spreading of ESBL and carbapenemase positive strains in the period between January 2007 - June 2012, at the Hospital - University Campus - Hospital “Luigi Sacco” in Milan

Tocalli¹,

Boselli²,

Rimoldi³

et al. 2012

Microbiol Med

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“…Nem megoldott a dekolonizáció módja, probiotikumokkal történnek próbálkozások. E kóroko-zók által kiváltott kórképek kezelése egyre nehezebb [4][5][6]. A kis születési súly hajlamosít az ESBL-termelő Enterobacteriaceae törzsek megtelepedésére a koraszü-löttek bélrendszerében.…”

Section: Megbeszélésunclassified

Neonatális Intenzív Centrumban ellátást igénylő betegeink anyai széles spektrumú béta-laktamáz-termelő baktériummal történt kolonizációjának vizsgálata és követése

et al. 2016

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Bevezetés: A széles spektrumú béta-laktamáz-termelő bélbaktériumok várandósok és koraszülöttek vastagbelében is tünetmentes hordozást okozhatnak. Célkitűzés: A szerzők intézményében felmérték a szülés napján azon édesanyák között e kórokozó hordozásának gyakoriságát, akiknek a gyermeke Neonatalis Intenzív Centrumba került felvételre, azzal a céllal, hogy megakadályozzák a felismert kolonizált édesanyák újszülöttjeiben a kolonizáció kialakulását. Mód-szer: 2013. október 1. és 2015. október 31. között a koraszülés napján az édesanyák szűrését végezték. 751 esetben levett anorectalis törlés vagy székletminta 19 esetben adott pozitív eredményt. A pozitív mintájú édesanyák személy-re szóló higiénés oktatásban részesültek kézhigiéné témakörben. A gyermekek ellátásában ezt követően aktívan részt vettek. Egyes gyermekektől a felvétel napján gyomormosó folyadékból és fülváladékból mintát küldtek tenyésztésre, majd kórházi kezelésük alatt minimum egy alkalommal anorectalis szűrést végeztek széles spektrumú béta-laktamázt termelő kórokozó okozta kolonizáció irányába. Eredmények: A 19 pozitív mintájú édesanya egyetlen újszülöttje sem vált pozitívvá a megfigyelés ideje alatt. Következtetés: Felismert anyai kolonizáció esetén a kórházhigiénés szabályok betartásával a terjedés megelőzhető. Orv. Hetil., 2016, 157(34), 1353-1356.Kulcsszavak: széles spektrumú béta-laktamáz-termelő bélbaktérium, koraszülött, kolonizáció Examination of maternal extended spectrum beta-lactamase bacterial colonization and follow-up of newborns requiring Neonatal Intensive Care Unit admissionIntroduction: The extended beta-lactamase producing Enterobacteriaceae may cause asymptomatic carriage if present in the colon of premature infants or pregnant women. Aim: To assess the incidence of colonization among mothers whose infants were admitted to Neonatal Intensive Center on the day of their delivery for this pathogen. Method: From October 1, 2013 until October 31, 2015 the authors screened mothers on the day of their delivery for this pathogen. Nineteen of the 751 anorectal swabs or stool samples were found to be positive. Mothers having positive samples were given personal education for hand hygiene, then they actively participated in the care of their babies. From some premature infants ear swab and stomach washing were taken and sent for culture on the day of their admission. In the course of their hospital stay, anorectal swabs were taken and screened for this bacteria colonization at least once. Results: None of the premature infants of the 19 extended beta-lactamase producing Enterobacteriaceae-positive mothers became positive in the studied period. Conclusion: If the mother is colonized, the spreading of pathogen to newborns can be prevented by observing the hygienic rules.

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Resistance to cephalosporins and carbapenems in Gram-negative bacterial pathogens

Cited by 400 publications

References 84 publications

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

EPIDEMIOLOGICAL OBSERVATORY: spreading of ESBL and carbapenemase positive strains in the period between January 2007 - June 2012, at the Hospital - University Campus - Hospital “Luigi Sacco” in Milan

Neonatális Intenzív Centrumban ellátást igénylő betegeink anyai széles spektrumú béta-laktamáz-termelő baktériummal történt kolonizációjának vizsgálata és követése

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