MedWorm: Bactrim

sulfamethoxazole and trimethoprim, Bactrim, Septra

MedicineNet Mens Health General — Thu, 02 Feb 2012 07:00:00 +0100

Title: sulfamethoxazole and trimethoprim, Bactrim, SeptraCategory: MedicationsCreated: 12/31/1997Last Editorial Review: 2/2/2012 (Source: MedicineNet Mens Health General)

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Determination of six sulfonamide antibiotics, two metabolites and trimethoprim in wastewater by isotope dilution liquid chromatography/tandem mass spectrometry.

Talanta — Mon, 30 Jan 2012 05:00:00 +0100

Authors: Le-Minh N, Stuetz RM, Khan SJ Abstract A highly sensitive method for the analysis of six sulfonamide antibiotics (sulfadiazine, sulfathiazole, sulfapyridine, sulfamerazine, sulfamethazine and sulfamethoxazole), two sulfonamide metabolites (N(4)-acetyl sulfamethazine and N(4)-acetyl sulfamethoxazole) and the commonly co-applied antibiotic trimethoprim was developed for the analysis of complex wastewater samples. The method involves solid phase extraction of filtered wastewater samples followed by liquid chromatography-tandem mass spectral detection. Method detection limits were shown to be matrix-dependant but ranged between 0.2 and 0.4ng/mL for ultrapure water, 0.4 and 0.7ng/mL for tap water, 1.4 and 5.9ng/mL for a laboratory-scale membrane bioreactor (MBR) mixed liquor, 0...

Prospective epidemiologic surveillance of invasive pneumococcal disease and pneumonia in children in San José, Costa Rica.

Vaccine — Mon, 30 Jan 2012 05:00:00 +0100

CONCLUSIONS: There is a considerable burden of IPD and pneumonia in children in San José. These epidemiologic data serve as a baseline to evaluate the effectiveness of the incorporation of new conjugate pneumococcal vaccines into the National Immunization Program in Costa Rican children. PMID: 22300725 [PubMed - as supplied by publisher] (Source: Vaccine)

Molecular characterization of β-lactam-resistant Escherichia coli isolated from Fu River, China

World Journal of Microbiology and Biotechnology — Wed, 25 Jan 2012 18:07:41 +0100

Abstract The present study aims to demonstrate the β-lactam resistance phenotypes and genotypes of Escherichia coli isolates from the Fu River in Chengdu, southwestern China. We obtained 108 E. coli isolates from nine sampling sites during May and December 2010. The total bacterial count varied from 79 colony-forming units (CFU)/ml to 14,550 CFU/ml, and coliform group number from 13 to 1,435 MPN/ml. Among the 108 isolates, 0–31.48% were resistant to β-lactams and β-lactam inhibitors, 1.85–7.40% to aminoglycoside, 1–20% to fluoroquinolone, and 50% to trimethoprim- sulfamethoxazole. The total bacterial count and antimicrobial resistance of different sites were significantly correlated (P < 0.05). Among the 34 ampicillin-resistant isolates, polymerase ...

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Genetic analysis of multiple antimicrobial resistance in Salmonella isolated from diseased broilers in Egypt

Microbiology and Immunology — Wed, 25 Jan 2012 05:00:00 +0100

ABSTRACTTo date, no information is available on the molecular bases of antimicrobial resistance in Salmonella spp. from poultry in Egypt or even in Africa. Therefore, the objective of this study was to analyze, at the molecular level, the mechanism of multidrug‐resistance in isolates of Salmonella recovered from diseased broilers in Egypt. A total of 21 Salmonella isolates were identified; 13 isolates were Salmonella enterica serovar Enteritidis and eight isolates were Salmonella enterica serovar Typhimurium. 17 (81%) Salmonella isolates displayed multidrug resistance phenotypes, particularly against ampicillin, streptomycin, spectinomycin, kanamycin, tetracycline, chloramphenicol, and trimethoprim/sulfamethoxazole. PCR and DNA sequencing identified class 1 integrons in nine (42.9%) isol...

Paracoccidioidomycosis: chronic adult unifocal form

International Journal of Dermatology — Tue, 17 Jan 2012 17:43:38 +0100

We report a case of paracoccidioidomycosis affecting the left great toe of a man, leading to complete destruction of the nail plate. Treatment was done with the sulfamethoxazole plus trimethoprim with excellent results. (Source: International Journal of Dermatology)

A Comparison of the Prevalence and Antimicrobial Resistance of Escherichia coli from Different Retail Meats in the United States: 2002-2008.

Applied and Environmental Microbiology — Fri, 13 Jan 2012 05:00:00 +0100

Authors: Zhao S, Blickenstaff K, Bodeis-Jones S, Gaines SA, Tong E, McDermott PF Abstract Escherichia coli were recovered from the National Antimicrobial Resistance Monitoring System retail meat program and examined for antimicrobial susceptibility. Retail meat samples (N= 11,921) from four U.S. states collected during 2002-2008 were analyzed, consisting of 2,988 chicken breast, 2,942 ground turkey, 2,991 ground beef and 3,000 pork chops. A total of 8,286 E. coli were recovered. Most chicken (83.5%) and turkey (82.0%) were contaminated with the organism, followed by beef (68.9%) and pork (44.0%). Resistance to tetracycline was most common (50.3%), followed by streptomycin (34.6%), sulfamethoxazole/sulfisoxazole (31.6%), ampicillin (22.5%), gentamicin (18.6%), kanamycin (8.4%), amox...

Prophylaxis for Recurrent Urinary Tract Infections: Nitrofurantoin, Not Trimethoprim-Sulfamethoxazole or Cranberry Juice [Editor's Correspondence]

Archives of Internal Medicine — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

Prophylaxis for Recurrent Urinary Tract Infections: Nitrofurantoin, Not Trimethoprim-Sulfamethoxazole or Cranberry Juice--Reply [Editor's Correspondence]

Archives of Internal Medicine — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

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Trimethoprim-sulfamethoxazole Prophylaxis and Antibiotic Non-susceptibility in Invasive Pneumococcal Disease.

Antimicrobial Agents and Chemotherapy — Mon, 09 Jan 2012 05:00:00 +0100

This study informs empirical treatment of suspected IPD in patients with a history of TMP-SMX use. PMID: 22232291 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Determinants of Quinolone Versus Trimethoprim/Sulfamethoxazole Use for Outpatient Urinary Tract Infection.

Antimicrobial Agents and Chemotherapy — Mon, 09 Jan 2012 05:00:00 +0100

Conclusion: Quinolones are commonly prescribed to outpatients with UTI. Non-clinical factors influence the choice of quinolones versus TMP/SMX, which may provide opportunities for interventions to improve prescribing patterns and control quinolone resistance. PMID: 22232276 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

SULFAMETHOXAZOLE AND TRIMETHOPRIM DOUBLE STRENGTH (Sulfamethoxazole And Trimethoprim ) Tablet [Lake Erie Medical DBA QualityL Care Products LC]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 05 Jan 2012 05:00:00 +0100

Updated Date: Jan 5, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Postcoital Penile Drug Eruption in a Co‐Trimoxazole‐Sensitive Patient Following Vaginal Use of Triple Sulfa Vaginal Cream by His Partner

The Journal of Sexual Medicine — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion. To our knowledge, this is the fourth case of proven postcoital penile drug eruption in a patient following vaginal use of triple sulfa vaginal cream in his partner. Our case illustrates the importance of history taking. In clinical practice of urology, it is not rare to see patients who present with strange penile lesions following coitus. To reach a correct diagnosis, one should obtain a drug history of the sexual partner and allergic history of the patient in such cases. Zargooshi J, Kavoussi H, Rahmanian E, Motaee H, Kohzadi M, and Nourizad S. Postcoital penile drug eruption in a co‐trimoxazole‐sensitive patient following vaginal use of triple sulfa vaginal cream by his partner. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)

Comparative Effectiveness of Antibiotic Treatment Strategies for Pediatric Skin and Soft-tissue Infections: Williams DJ, Cooper WO, Kaltenbach LA, et al. Pediatrics 2011;128:479–87.

The Journal of Emergency Medicine — Sun, 01 Jan 2012 05:00:00 +0100

This was a retrospective cohort study of 47,501 children aged 0–17 years comparing the effectiveness of treatment with trimethoprim-sulfamethoxazole (TMP-SMX) or a β-lactam vs. clindamycin in drained and undrained skin and soft-tissue infections (SSTI). Children with an SSTI and prescription for either clindamycin (reference treatment), trimethoprim-sulfamethoxazole, or a β-lactam (penicillin or cephalosporin) filled within 2 days of the SSTI were included in the study and grouped based on drainage status. Exclusion criteria included: SSTI within the last 365 days, treatment with multiple agents, treatment with topical antibiotics, SSTI requiring hospital admission, burns, foreign bodies, or surgical-site infections. Effectiveness of each antibiotic therapy was defined with respect to ...

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A Hidden Reservoir of Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococcus in Patients Newly Admitted to an Acute Rehabilitation Hospital

PM and R — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: We found a 16% incidence of a hidden reservoir of multiple drug-resistant organisms in patients admitted to rehabilitation hospitals. We believe that all patients admitted to a rehabilitation facility should be screened for MRSA and VRE. (Source: PM and R)

Change of Antimicrobial Susceptibility among Escherichia coli Strains Isolated from Female Patients with Community-Onset Acute Pyelonephritis.

Yonsei Medical Journal — Tue, 27 Dec 2011 03:56:19 +0100

Conclusion: The antimicrobial susceptibility of E. coli changed over the study period, however, this change occurred mainly in the complicated APN patients. In Korea, ciprofloxacin is still useful as an empirical agent for uncomplicated APN patients, but this is not the case for patients with complicated APN because of high resistance rate to ciprofloxacin in these patients. For the complicated APN patients, the rate of resistance to ciprofloxacin is already more than 30%. PMID: 22187248 [PubMed - in process] (Source: Yonsei Medical Journal)

The Increased Risk for Pneumocystis Pneumonia in Patients Receiving Rituximab-CHOP-14 Can Be Prevented by the Administration of Trimethoprim/Sulfamethoxazole: A Single-Center Experience.

Acta Haematologica — Fri, 16 Dec 2011 05:00:00 +0100

Authors: Hardak E, Oren I, Dann EJ, Yigla M, Faibish T, Rowe JM, Avivi I Abstract Recent studies suggest an increased risk for Pneumocystis jirovecii pneumonia (PJP) in adults receiving short-interval rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) therapy for diffuse large cell B cell lymphoma (DLBCL). This retrospective study evaluates precise PJP incidence and the efficacy of anti-PJP prophylaxis in DLBCL. Patients with DLBCL, aged ≥18 years and treated between December 2004 and December 2010, were included. Details of treatment-related respiratory infections, focusing on PJP incidence, risk factors and prophylaxis, were assessed. A total of 132 patients were analyzed; 47 were treated with rituximab-CHOP therapy every 21 days (R-CHOP-21) and 85 were ...

The Increased Risk for Pneumocystis Pneumonia in Patients Receiving Rituximab-CHOP-14 Can Be Prevented by the Administration of Trimethoprim/Sulfamethoxazole: A Single-Center Experience

Karger Publishers — Thu, 15 Dec 2011 23:00:00 +0100

Acta Haematol 2012;127:110–114 (DOI:10.1159/000334113) (Source: Karger Publishers)

Pneumocystis Pneumonia

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 775-782DOI: 10.1055/s-0031-1295725ABSTRACTPneumocystis (carinii) jiroveci pneumonia can occur in immunocompromised individuals, especially hematopoietic stem and solid organ transplant recipients and those receiving immunosuppressive agents, and is the most common opportunistic infection in persons with advanced human immunodeficiency virus (HIV) infection. The Pneumocystis genus was initially mistaken as a trypanosome and later as a protozoan. Genetic analysis identified the organism as a unicellular fungus. Pneumocystis jiroveci is the species responsible for human infections. A slow indolent time course with symptoms of pneumonia progressing over weeks to months is characteristic in HIV-infected patients. Fulminant respiratory failure associated with...

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Acute pyelonephritis in women (2011 review)

Clinical Cases and Images — Mon, 12 Dec 2011 13:26:00 +0100

This is a 2011 review from the official journal of the AAFP, American Family Physician:Acute pyelonephritis is a bacterial infection of the renal pelvis and kidney most often seen in young women.Symptoms of acute pyelonephritisMost patients have fever, although it may be absent early in the illness. Flank pain is nearly universal.Tests for acute pyelonephritisA positive urinalysis confirms the diagnosis.Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens.Escherichia coli is the most common pathogen in acute pyelonephritis. In the past decade, there has been an increasing rate of E. coli resistance to extended-spectrum beta-lactam antibiotics.Imaging, usually with contrast-enhanced CT is not nece...

Concentration-dependent effects of antimicrobials on Staphylococcus aureus toxin-mediated cytokine production from peripheral blood mononuclear cells

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions S. aureus toxins stimulate production of inflammatory cytokines in PBMCs. Antimicrobials with high tissue penetration, including tigecycline, clindamycin, trimethoprim/sulfamethoxazole and linezolid, reduced cytokine production, which, along with their antimicrobial effects, may have importance in the therapeutic outcome of severe infections. (Source: Journal of Antimicrobial Chemotherapy)

The efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the istanbul study.

Antimicrobial Agents and Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

THE EFFICACY AND TOLERABILITY OF ANTIBIOTIC COMBINATIONS IN NEUROBRUCELLOSIS: RESULTS OF THE ISTANBUL STUDY. Antimicrob Agents Chemother. 2011 Dec 12; Authors: Erdem H, Ulu A, Kilic S, Karahocagil M, Sheeta G, Eren-Tulek N, Yetkin F, Celen MK, Ceran N, Gul HC, Mert G, Tekin-Koruk S, Dizbay M, Inal AS, Nayman-Alpat S, Bosilkovski M, Inan D, Saltoglu N, Abdel-Baky L, Adeva-Bartolome MT, Ceylan B, Sacar S, Turhan V, Yilmaz E, Elaldi N, Kocak-Tufan Z, Ugurlu K, Dokuzoguz B, Yilmaz H, Gundes S, Guner R, Ozgunes N, Ulcay A, Unal S, Dayan S, Gorenek L, Karakas A, Tasova Y, Usluer G, Bayindir Y, Kurtaran B, Sipahi OR, Leblebicioglu H Abstract No datum exists in the literature whether Brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or should an intra...

A multicenter surveillance of antimicrobial resistance on Stenotrophomonas maltophilia in Taiwan.

Journal of Microbiology, Immunology, and Infection — Sat, 10 Dec 2011 05:00:00 +0100

CONCLUSION: In this 10-year study, minocycline and TMP-SMX remained the two antimicrobials with better in vitro activities against S. maltophilia than ceftazidime, levofloxacin, and ticarcillin-clavulanic acid. The activity of levofloxacin against S. maltophilia in Taiwan declined during the past 10 years. PMID: 22154599 [PubMed - as supplied by publisher] (Source: Journal of Microbiology, Immunology, and Infection)

Antimicrobial resistance of Moraxella catarrhalis isolates in Taiwan.

Journal of Microbiology, Immunology, and Infection — Thu, 08 Dec 2011 05:00:00 +0100

CONCLUSION: The rates of resistance to cefaclor, cefuroxime, tetracycline and SXT are now increasing in Taiwan. Molecular typing showed that at least two closely related BRO-1 clones are circulating. Although amoxicillin + clavulanate remains the antimicrobial therapy of choice for M. catarrhalis infections, continued surveillance of antimicrobial susceptibility and application of control measures against further transmission are required to inhibit the emergence of the resistant strains. PMID: 22154675 [PubMed - as supplied by publisher] (Source: Journal of Microbiology, Immunology, and Infection)

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Attaching and effacing Escherichia coli and Shiga toxin-producing E. coli in children with acute diarrhoea and controls in Teresina/PI, Brazil

Transactions of the Royal Society of Tropical Medicine and Hygiene — Mon, 05 Dec 2011 22:39:33 +0100

In conclusion, EPEC is very common in children with diarrhoea and controls in the population we studied, with a-EPEC predominating. This diarrhoeagenic E. coli (DEC) pathotype is more common in infant males and is resistant to drugs frequently used in clinical practice. (Source: Transactions of the Royal Society of Tropical Medicine and Hygiene)

Management of Single‐Ventricle Patients With Berlin Heart EXCOR Ventricular Assist Device: Single‐Center Experience

Artificial Organs — Thu, 01 Dec 2011 05:00:00 +0100

This study aims to describe our center's multidisciplinary team management of single‐ventricle patients supported long term with the Berlin Heart EXCOR Pediatric VAD. Patient #1 was a 4‐year‐old with double‐outlet right ventricle with aortic atresia, L‐looped ventricles, and heart block who developed heart failure 1 year after Fontan. She initially required extracorporeal membrane oxygenation support and was transitioned to Berlin Heart systemic VAD. She was supported for 363 days (cardiac intensive care unit [CICU] 335 days, floor 28 days). The postoperative course was complicated by intermittent infection including methicillin‐resistant Staphylococcus aureus, intermittent hepatic and renal insufficiencies, and transient antithrombin, protein C, and protein S deficiencies resu...

Antibiotic resistance in primary care in Austria - A systematic review of scientific and grey literature

BMC Infectious Diseases — Mon, 28 Nov 2011 05:00:00 +0100

Conclusion: Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are published in peer-reviewed journals. The grey literature, therefore, is a very valuable source of relevant information. It could be speculated that the situation of published literature is similar in other countries as well. (Source: BMC Infectious Diseases)

SULFAMETHOXAZOLE AND TRIMETHOPRIM (Sulfamethoxazole And Trimethoprim) Tablet [PD-Rx Pharmaceuticals, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 16 Nov 2011 05:00:00 +0100

Updated Date: Nov 16, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Antibiotic use in long-term care facilities

Journal of Antimicrobial Chemotherapy — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions Antibiotic use is common among long-term care residents, variable across institutions, and may benefit from focused antimicrobial stewardship interventions to standardize treatment indications and duration. (Source: Journal of Antimicrobial Chemotherapy)

Antibiotic Resistance of Bacterial Strains Isolated from Patients with Community-Acquired Urinary Tract Infections: an Exploratory Study in Palestine.

Current Clinical Pharmacology — Fri, 11 Nov 2011 05:00:00 +0100

Conclusion: E. coli was the most frequent bacterium in the studied sample and showed high resistance to first-line antibiotics. Our results highlight the need for developing local guidelines where elevated resistance to antibiotics should influence prescribing decisions. PMID: 22082328 [PubMed - as supplied by publisher] (Source: Current Clinical Pharmacology)

Factors associated with the occurrence of MRSA CC398 in herds of fattening pigs in Germany

BMC Veterinary Research - Latest articles — Thu, 10 Nov 2011 05:00:00 +0100

Background: The purpose of this study was to investigate the prevalence of MRSA in herds of fattening pigs in different regions of Germany, and to determine factors associated with the occurrence of this pathogen. For this purpose pooled dust samples were collected, and a questionnaire covered information regarding herd characteristics and management practices. Samples were pre-enriched in high-salt medium followed by selective enrichment containing cefoxitin/aztreonam, and culturing. Presumptive colonies were confirmed by multiplex-PCR targeting nuc-, mecA- and 16S rRNA-genes. Isolates were spa- and SCCmec-, and in selected cases, multilocus sequence-typed. Susceptibilities to 13 antimicrobials were determined by broth microdilution. Statistical analysis was carried out using backward ste...

Potentially Harmful Drug-Drug Interactions in the Elderly: A Review.

The American Journal of Geriatric Pharmacotherapy — Thu, 10 Nov 2011 05:00:00 +0100

CONCLUSIONS: Several population-based studies have reported significant harm associated drug interactions in elderly patients. Increased awareness and interventions aimed at reducing exposure and minimizing the risks associated with potentially harmful drug combinations are needed. PMID: 22078863 [PubMed - as supplied by publisher] (Source: The American Journal of Geriatric Pharmacotherapy)

Photolichenoid plaques with associated vitiliginous pigmentary changes.

Dermatol Online J — Tue, 08 Nov 2011 04:35:03 +0100

Authors: Tran K, Hartman R, Tzu J, Meehan S, Sanders SE, Pomeranz MK, Sanchez M Abstract A 49-year-old man with advanced HIV/AIDS on anti-retroviral therapy (HAART) and trimethoprim-sulfamethoxazole (TMP-SMX) presented with a several-month history of pruritic, erythematous, lichenified papules that coalesced into hyperkeratotic plaques on the trunk and extremities in a sun-exposed distribution. He shortly thereafter developed a progressive depigmentation over more than 80 percent of his body surface area. A biopsy specimen of an erythematous plaque on the trunk showed a superficial and mid-dermal infiltrate of lymphocytes with eosinophils, most consistent with either chronic lichenoid drug eruption or atypical lymphoproliferative disorder (ACLD) of HIV. The patient's lichenoid skin...

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Drug Shortages Addressed on National Level

SCCM RSS News — Mon, 07 Nov 2011 14:42:40 +0100

The Society of Critical Care Medicine’s (SCCM) Advocacy Committee has been engaged in several activities surrounding drug shortages. This week, U.S. President Barack Obama signed an executive order calling for the Food and Drug Administration (FDA) and the Department of Justice to broaden reporting of potential drug shortages, expedite regulatory reviews that can help prevent shortages, and examine whether potential shortages have led to price gouging. According to The Wall Street Journal, the FDA reported a record 178 drug shortages in 2010 and has said the number of shortages is greater so far this year. Most of the shortages have involved injectable agents commonly used in the intensive care unit, such as anti-infectives, cardiovascular agents and drugs influencing the central nervou...

Simulated antibiotic exposures in an in vitro hollow fiber infection model influence toxin gene expression and production in community-associated MRSA strain MW2.

Antimicrobial Agents and Chemotherapy — Mon, 07 Nov 2011 05:00:00 +0100

Conclusion:Linezolid, clindamycin and minocycline were the most effective agents on decreasing the virulence potential in CA-MRSA, notably after 8h of treatment. SXT had minimal effects on toxin gene regulation, but it increased production and cytotoxicity of PVL toxin in the model and may enhance virulence when treating severe infections. PMID: 22064533 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Stenotrophomonas maltophilia in the respiratory tract of medical intensive care unit patients

European Journal of Clinical Microbiology and Infectious Diseases — Sun, 06 Nov 2011 05:33:20 +0100

Abstract The purpose of this study was to investigate characteristics of critically ill patients with Stenotrophomonas maltophilia (S. maltophilia) isolated from the respiratory tract, to identify risk factors for S. maltophilia-pneumonia and intensive care unit (ICU) mortality and to analyze antibiotic susceptibility of S. maltophilia. This was a retrospective analysis of 64 medical ICU patients with S. maltophilia in the respiratory tract. Thirty-six patients fulfilled the criteria for diagnosis of pneumonia. A significantly higher lung injury score (LIS) was observed in patients with pneumonia compared to patients with colonization (p = 0.010). Independent risk factors for S. maltophilia-pneumonia were higher Sequential Organ Failure Assessment (SOFA) score (p = 0.00...

Stenotrophomonas maltophilia: emerging resistance to TMP-SMX in Brazilian isolates. a reality?

Jornal Brasileiro de Patologia e Medicina Laboratorial — Fri, 04 Nov 2011 02:45:57 +0100

CONCLUSION: Although TMP-SMX is the standard treatment for S. maltophilia infections, there may be resistance to this antibiotic, which hinders the therapeutic approach, hence the significance of susceptibility tests. The disk diffusion technique showed a good correlation with microdilution. Among the new therapeutic options, both tigecycline and moxifloxacin presented significant activity in vitro (Source: Jornal Brasileiro de Patologia e Medicina Laboratorial)

Prevalence of non-fermenting Gram-negative bacilli among inpatients from Porto Alegre-RS

Jornal Brasileiro de Patologia e Medicina Laboratorial — Fri, 04 Nov 2011 02:45:57 +0100

CONCLUSION: Three hundred twenty-six samples of non-fermenting Gram-negative bacilli were isolated. The most prevalent species were Pseudomonas aeruginosa (65.03%), Acinetobacter baumannii (16.56%), and Stenotrophomonas maltophilia (9.5%). Other species showed rates lower than 5%. The microorganisms were isolated from several infectious sites and the biological materials that showed higher positivity were the following: tracheal aspirate (38.34%), spittle (18.71%) and urine (15.95%). Bacterial resistance was higher with tetracyclines (89.57%) and sulfamethoxazole/trimethoprim (79.75%). The most active antimicrobials were polymyxin B and piperacillin/tazobactam with 100% and 75.2% sensibility, respectively (Source: Jornal Brasileiro de Patologia e Medicina Laboratorial)

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[Correspondence] Multidrug-resistant Salmonella enterica

The Lancet Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Multidrug-resistant (MDR) Salmonella enterica (serotypes typhi and paratyphi A) has become an emerging problem in endemic countries. In 2002, after giving a presentation at the annual convention of the Society of Internal Medicine of Nepal, a Nepalese physician asked me what they could use to treat multidrug-resistant typhoid. The resistance of S enterica to oral antibiotics including ampicillin, chloramphenicol, co-trimoxazole (trimethoprim-sulfamethoxazole), ofloxacin, and ciprofloxacin was increasing across all endemic areas. (Source: The Lancet Infectious Diseases)

Antimicrobial Drug Resistance in Corynebacterium diphtheriae mitis.

Emerging Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Barraud O, Badell E, Denis F, Guiso N, Ploy MC Abstract To the Editor: Corynebacterium diphtheriae is the agent of pharyngeal and cutaneous diphtheria. We did a retrospective analysis of the antimicrobial drug susceptibilities of 46 C. diphtheriae isolates sent during 1993 through 2010 to the French National Reference Centre of Toxigenic Corynebacteria. The isolates came from metropolitan France and French overseas departments and territories. Only 1 isolate, C. diphtheriae biovar mitis, FRC24, expressed the following antimicrobial drug susceptibility profile: susceptible to penicillin, amoxicillin, ciprofloxacin, clindamycin, erythromycin, gentamicin, imipenem, kanamycin, rifampin, tetracycline, and vancomycin and resistant at an uncommonly high level to trimethoprim, sul...

Global Distribution and Epidemiologic Associations of Escherichia coli Clonal Group A, 1998-2007.

Emerging Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Johnson JR, Menard ME, Lauderdale TL, Kosmidis C, Gordon D, Collignon P, Maslow JN, Tambic Andrasevic A, Kuskowski MA Abstract Escherichia coli clonal group A (CGA) was first reported in 2001 as an emerging multidrug-resistant extraintestinal pathogen. Because CGA has considerable implications for public health, we examined the trends of its global distribution, clinical associations, and temporal prevalence for the years 1998-2007. We characterized 2,210 E. coli extraintestinal clinical isolates from 32 centers on 6 continents by CGA status for comparison with trimethoprim/sulfamethoxazole (TMP/SMZ) phenotype, specimen type, inpatient/outpatient source, and adult/child host; we adjusted for clustering by center. CGA prevalence varied greatly by center and continent, was s...

Clinical Characteristics, Antimicrobial Susceptibilities, and Outcomes of Patients with Chryseobacterium indologenes Bacteremia in an Intensive Care Unit.

Japanese Journal of Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Chou DW, Wu SL, Lee CT, Tai FT, Yu WL Abstract Ten patients with intensive care unit (ICU)-acquired Chryseobacterium indologenes bacteremia between January 2004 and December 2008 were studied. The primary site of infection was unknown for 80% of the cases. The known primary sites of infection were empyema (10%) and catheter-related bacteremia (10%). Eight patients (80%) had polymicrobial bacteremia, spent more than 21 days in the ICU, and received more than 14 days of broad-spectrum antibiotic therapy prior to the onset of C. indologenes bacteremia. All isolates were 100% susceptible to minocycline and trimethoprim/sulfamethoxazole. Vancomycin, imipenem, piperacillin/tazobactam, ciprofloxacin, and levofloxacin exhibited 0%, 10%, 20%, 30%, and 30%, respectively, susceptibil...

Lipidomic approach to identify patterns in phospholipid profiles and define class differences in mammary epithelial and breast cancer cells

Breast Cancer Research and Treatment — Sat, 29 Oct 2011 05:47:00 +0100

Abstract Breast cancer is the leading cause of cancer-related deaths in women. Altered cellular functions of cancer cells lead to uncontrolled cellular growth and morphological changes. Cellular biomembranes are intimately involved in the regulation of cell signaling; however, they remain largely understudied. Phospholipids (PLs) are the main constituents of biological membranes and play important functional, structural and metabolic roles. The aim of this study was to establish if patterns in the PL profiles of mammary epithelial cells and breast cancer cells differ in relation to degree of differentiation and metastatic potential. For this purpose, PLs were analyzed using a lipidomic approach. In brief, PLs were extracted using Bligh and Dyer method, followed by a separa...

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Blastocystis subtypes in symptomatic and asymptomatic family members and pets and response to therapy

Internal Medicine Journal — Thu, 27 Oct 2011 04:00:00 +0100

Conclusions: Conventional therapy is ineffective for symptomatic Blastocystis infection. The high prevalence of Blastocystis infection within households suggested transmission between humans and their pets. Sub‐typing analysis of SSU rDNA alone in Blastocystis does not appear to predict pathogenicity. (Source: Internal Medicine Journal)

Review of methemoglobinemia neither clear nor current

The Poison Review — Thu, 27 Oct 2011 01:08:44 +0100

Methemoglobin 2.5 out of 5 stars Methemoglobinemia: Pathogenesis, Diagnosis, and Management. South Med J November 2011;104:757-761. Abstract It’s hard to figure out what the editors of Southern Medical Journal thought the point of publishing this review article was. It is not up-to-date — no mention that methylene blue can be associated with serotonin syndrome — and it is not particularly clear in it’s discussion of pathophysiology. In addition, I find some of the authors’ facts and recommendations unjustified. They list (without reference) acetaminophen (APAP) as a cause of acquired methemoglobinemia. I am not aware of any human cases in which APAP was even a probably cause of this condition. Certainly, even if this occurs, it is so exceedingly rare that ...

Common UTI antibiotic can have serious adverse reactions

Modern Medicine — Wed, 26 Oct 2011 23:50:46 +0100

A commonly prescribed antimicrobial, trimethoprim-sulfamethoxazole (TMP-SMX [Bactrim, Septra]), may cause serious adverse reactions in some patients, say Canadian researchers. (Source: Modern Medicine)

SULFAMETHOXAZOLE AND TRIMETHOPRIM (Sulfamethoxazole And Trimethoprim) Tablet [Physicians Total Care, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 19 Oct 2011 05:00:00 +0100

Updated Date: Oct 19, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Data Mining Derived Treatment Algorithms From the Electronic Medical Record Improve Theoretical Empirical Therapy for Outpatient Urinary Tract Infections

The Journal of Urology — Wed, 19 Oct 2011 04:00:00 +0100

Conclusions: Antimicrobial resistance patterns in outpatient urinary tract infections are time dependent, and drug and site specific. Data mining directed therapy significantly improved theoretical outcomes compared to conventional therapy for Department of Urology outpatients and for female patients in the Emergency Department. (Source: The Journal of Urology)

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Universal perioperative antimicrobial prophylaxis is not necessary in kidney transplantation

Clinical Transplantation — Mon, 17 Oct 2011 04:00:00 +0100

Laftavi MR, Rostami R, Patel S, Kohli R, Laftavi H, Feng L, Said M, Dayton M, Pankewycz O. Universal perioperative antimicrobial prophylaxis is not necessary in kidney transplantation. Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01531.x. © 2011 John Wiley & Sons A/S.Abstract: Despite significant improvements in renal transplantation, certain basic issues remain unresolved such as the routine use of perioperative antimicrobial prophylaxis (AMP). To address the need for AMP, we retrospectively evaluated the clinical course of 442 consecutive renal transplant recipients (RTRs) who did not receive any AMP except for trimethoprim/sulfamethoxazole. Three hundred and forty RTRs received induction therapy with low‐dose rabbit anti‐thymocyte globulin, while the other 102 pa...

Antibacterial resistance, genes encoding toxins and genetic background among Staphylococcus aureus isolated from community-acquired skin and soft tissue infections in France: a national prospective survey

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 14 Oct 2011 06:09:15 +0100

We described prospectively the characteristics of the Staphylococcus aureus isolated from 71 non-teaching French hospitals and implicated in CA-SSTIs: antimicrobial susceptibility (mecA polymerase chain reaction [PCR], disk diffusion method), virulence factor gene (sea, tst, pvl) prevalence and genetic background (agr allele). During November 2006, 235 strains were collected (wound infection: 51%, abscess: 21%, whitlow: 8%, diabetic foot: 7%, furunculosis: 3%). sea, tst and pvl were identified in 22.1, 13.2 and 8.9% strains, respectively. agr allele 1 was the most frequently encountered genetic background, whatever the methicillin susceptibility. Among the 34 methicillin-resistant S. aureus (MRSA, 14.5% of all S. aureus), only one strain (2.9%) harboured pvl (belonging to the European ST...

Serious Adverse Reactions Possible From Common Antibiotic - Trimethoprim-Sulfamethoxazole

Health News from Medical News Today — Wed, 12 Oct 2011 09:00:00 +0100

A commonly prescribed antimicrobial - trimethoprim-sulfamethoxazole - that has been used since 1968 can cause serious adverse reactions and physicians need to be aware of these in prescribing, states a review in CMAJ (Canadian Medical Association Journal). Trimethoprim-sulfamethoxazole is the most commonly prescribed antibiotic for urinary tract infections in Canada, and is used to treat community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and other bacterial infections... (Source: Health News from Medical News Today)

Septra, Bactrim Linked to 'Serious' Side Effects (CME/CE)

MedPage Today Infectious Disease — Tue, 11 Oct 2011 16:00:00 +0100

(MedPage Today) -- Trimethoprim-sulfamethoxazole -- a widely used antibiotic sold as Septra, Bactrim, and others -- has a set of adverse reactions that range from minor to potentially fatal, according to a literature review. (Source: MedPage Today Infectious Disease)

Common antibiotic can have serious adverse reactions

EurekAlert! - Infectious and Emerging Diseases — Tue, 11 Oct 2011 04:00:00 +0100

(Canadian Medical Association Journal) A commonly prescribed antimicrobial -- trimethoprim-sulfamethoxazole -- that has been used since 1968 can cause serious adverse reactions and physicians need to be aware of these in prescribing, states a review in CMAJ. (Source: EurekAlert! - Infectious and Emerging Diseases)

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Diagnosis and treatment of acute uncomplicated cystitis.

American Family Physician — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Colgan R, Williams M Abstract Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or urologic abnormalities. Physical examination is typically normal or positive for suprapubic tenderness. A urinalysis, but not urine culture, is recommended in making the diagnosis. Guidelines recommend three options for first-line treatment of acute uncomplicated cystitis: fosfomycin, nitrofurantoin, and trimethoprim/sulfamethoxazole (in regions where the prevalence of Escherichia coli resistance does not exceed 20 percent). Beta-lactam antibiotics, amoxicillin/c...

Isolation of a Klebsiella pneumoniae Isolate of Sequence Type 258 Producing KPC-2 Carbapenemase in Korea.

The Korean Journal of Laboratory Medicine — Sat, 01 Oct 2011 04:00:00 +0100

We report the case of a patient with a urinary tract infection caused by KPC-2-producing K. pneumoniae. This is the second report of a KPC-2-producing K. pneumoniae infection in Korea, but the multilocus sequence type was ST258. The KPC-2-producing isolate was resistant to all tested β-lactams (including imipenem and meropenem), amikacin, tobramycin, ciprofloxacin, levofloxacin, and trimethoprim-sulfamethoxazole, but was susceptible to gentamicin, colistin, polymyxin B, and tigecycline. The KPC-2-producing isolate was negative to phenotypic extended-spectrum β-lactamase (ESBL) and AmpC detection tests and positive to modified Hodge test and carbapenemase inhibition test with aminophenylboronic acid. PMID: 22016687 [PubMed - in process] (Source: The Korean Journal of Laboratory Medici...

Diagnosis and Antimicrobial Therapy of Lung Infiltrates in Febrile Neutropenic Cancer Patients

Current Infectious Disease Reports — Thu, 29 Sep 2011 06:17:31 +0100

Abstract Pulmonary infiltrates develop in up to 25% of febrile neutropenic patients and are frequently refractory to broad-spectrum antibacterial therapy. Etiologically, Aspergillus spp., Pneumocystis jiroveci, multi-resistant Gram-negative rods as well as mycobacteria and respiratory viruses may be involved. Taking into account the predominant role of fungal pathogens, typically without microbiological proof, prompt addition of mold-active systemic antifungal therapy improves clinical outcome, while other microorganisms should typically be targeted based upon microbiological test results only. Microbial isolates from blood cultures, bronchoalveolar lavage or respiratory secretions must be critically interpreted with respect to their etiological relevance for pulmonary infi...

Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients with Connective Tissue Diseases

Seminars in Arthritis and Rheumatism — Thu, 29 Sep 2011 04:00:00 +0100

Conclusions: Sulfamethoxazole/trimethoprim single strength can be used effectively as a primary prophylaxis against PCP in high-risk CTD patients. Only mild ADR developed at this dosage. Further evaluations in larger groups of CTD patients are warranted. (Source: Seminars in Arthritis and Rheumatism)

Chemotherapy-induced neutropenia in lung cancer patients: The role of antibiotic prophylaxis

Cancer Letters — Wed, 28 Sep 2011 04:00:00 +0100

Highlights: ► We performed a PubMed literature search of manuscripts published until May 2011. ► Quinolones and trimethoprim/sulfamethoxazole were most frequently used. ► Episodes of febrile neutropenia and documented infections were fewer. ► Duration of hospitalisation was shorter. ► Prophylactic wide-spectrum antibiotics are an alternative preventive strategy.Abstract: Chemotherapy-induced neutropenia can cause fatal bacterial infections. Colony-stimulating factors (CSFs) are usually recommended as prophylaxis, while routine use of prophylactic antibiotics remains controversial. Based on our literature search in PubMed, quinolones and trimethoprim/sulfamethoxazole were the most frequently used prophylaxis, while CSFs were administered in 22.1% of patients. Lung cancer patients ...

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SULFAMETHOXAZOLE AND TRIMETHOPRIM (Sulfamethoxazole And Trimethoprim) Tablet [Med Health Pharma, LLC]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 27 Sep 2011 05:00:00 +0100

Updated Date: Sep 27, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Antimicrobial susceptibility of Salmonella isolates recovered from calves with diarrhoea in Australia

Australian Veterinary Journal — Fri, 23 Sep 2011 16:32:00 +0100

Conclusion The prevalence of antimicrobial resistance in Salmonella isolates from dairy calves in Australia is low compared with that reported overseas. From a human health perspective, resistance to antimicrobials used in the treatment of human salmonellosis was infrequent. (Source: Australian Veterinary Journal)

Fulminant myocarditis as a late sequela of DRESS: Two cases

Journal of the American Academy of Dermatology — Sun, 18 Sep 2011 01:35:54 +0100

To the Editor: A 31-year-old African American woman was diagnosed with drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS) following a presentation of fevers, facial edema, cervical lymphadenopathy, a diffuse morbilliform eruption (), leukocytosis with 11% eosinophilia, acute renal failure, and hepatitis (Case 1). A biopsy specimen of her eruption showed a vacuolar interface dermatitis with numerous apoptotic keratinocytes throughout the epidermis. She was treated with systemic corticosteroids, cyclosporine, and intravenous immunoglobulin (IVIG) due to a relapsing-remitting course of disease. Her new medications at original presentation consisted of trimethoprim-sulfamethoxazole for a respiratory tract infection and zonisamide for migrain...

The impaired physician reporting dilemma: Legal, moral, and ethical considerations for the practicing dermatologist

Journal of the American Academy of Dermatology — Sun, 18 Sep 2011 01:35:50 +0100

Jim Smith, the founding member of a five-person private practice dermatology group, is turning 72 years old. When he turned 70, he decreased his hours from 4 full days a week to 3 days a week. He does not plan on reducing his hours again, and jokes that he hopes to die “with my boots on at the office.” The four younger partners have recently noticed that when they are covering his patients, his medical judgment is impaired. He has prescribed Bactrim for a patient with mild acne, has been treating a severely involved 30-year-old psoriatic with only mild topical steroids even though the patient requested a biologic after reading about these medications online, and has prescribed a potent topical steroid for a patient with facial dermatitis. In addition, he desiccated and curetted a recur...

Emergence of blaCTX-M-15, qnrB1, and the aac(6')-Ib-cr resistance genes in Pantoea agglomerans and Enterobacter cloacae from Nigeria (sub-Saharan Africa).

Journal of Medical Microbiology — Thu, 15 Sep 2011 04:00:00 +0100

This report is the first description of CTX-M-15 production and the emergence of PMQR in P. agglomerans and E. cloacae isolates from Nigeria. Transfer of resistance genes by conjugation and the presence of mobile elements demonstrate the risk of further dissemination into other Enterobacteriaceae which may result in limited treatment options. PMID: 21921107 [PubMed - as supplied by publisher] (Source: Journal of Medical Microbiology)

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Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study

BMJ Online First — Mon, 12 Sep 2011 04:00:00 +0100

Objectives To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone.Design Population... (Source: BMJ Online First)

Antibodies to co-trimoxazole (trimethoprim and/or sulfamethoxazole) related to the presence of the drug in a commercial low-ionic-strength solution.

Transfusion — Mon, 12 Sep 2011 04:00:00 +0100

CONCLUSION: Antibodies against co-trimoxazole may only be detected when using a diluent for reagent RBCs containing the drug in question. Antibody pattern (anti-TMP and/or anti-SMX) may vary according to individuals' immune response. Drug-dependent antibodies may react as antibodies against a high-prevalence antigen, supporting the hypothesis of antibodies to drug and membrane components. Drug-dependent antibodies such as anti-co-trimoxazole may be a serologic finding without clinical features. PMID: 21910740 [PubMed - as supplied by publisher] (Source: Transfusion)

Treatment Duration of Febrile Urinary Tract Infections

Current Infectious Disease Reports — Thu, 01 Sep 2011 06:16:01 +0100

Abstract Although febrile urinary tract infections (UTIs) are relatively common in adults, data on optimal treatment duration are limited. Randomized controlled trials specifically addressing the elderly and patients with comorbidities have not been performed. This review highlights current available evidence. Premenopausal, non-pregnant women without comorbidities can be treated with a 5–7 day regimen of fluoroquinolones in countries with low levels of fluoroquinolone resistance, or, if proven susceptible, with 14 days of trimethoprim-sulfamethoxazole. Oral β-lactams are less effective compared with fluoroquinolones and trimethoprim-sulfamethoxazole. In men with mild to moderate febrile UTI, a 2-week regimen of an oral fluoroquinolone is likely sufficient. Alt...

Diagnosis and treatment of acute pyelonephritis in women.

American Family Physician — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Colgan R, Williams M, Johnson JR Abstract Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is nearly universal, and its absence should raise suspicion of an alternative diagnosis. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens. Escherichia coli is the most common pathogen in acute pyelonephritis, and in the past decade, there has been an i...

Delayed Graft Function and Cotrimoxazole

Transplantation Proceedings — Thu, 01 Sep 2011 04:00:00 +0100

Abstract: Acute interstitial nephritis is an infrequent cause of early allograft dysfunction. Prophylactic trimethoprim sulfamethoxazole (cotrimoxazole) is frequently prescribed early in the course of kidney transplantation. Herein we have reported a case of delayed graft function associated with eosinophilia in which the renal biopsy showed interstitial mononuclear infiltrates with abundant eosinophils. An initial methylprednisolone course failed to lower the serum creatinine, but renal function and eosinophilia persistently improved following cotrimoxazole withdrawal and a second course of steroids. Cotrimoxazole acute interstitial nephritis is an infrequent but treatable cause of kidney allograft dysfunction, which should be included in the differential diagnosis of delayed renal allogr...

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Prevalence of Methicillin-Resistant Staphylococcus aureus among Children in a Region with Controlled Antimicrobial Use.

Japanese Journal of Infectious Diseases — Thu, 01 Sep 2011 04:00:00 +0100

In conclusion, prevalence of MRSA in children in our study population could be decreased by eliminating unnecessary antimicrobial drug prescriptions. PMID: 21937829 [PubMed - in process] (Source: Japanese Journal of Infectious Diseases)

Serratia Ficaria isolated from sputum specimen.

Acta Microbiologica et Immunologica Hungarica — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Gul M, Dogan E, Kirecci E, Ucmak H, Dirican E, Karadag A Abstract Serratia ficaria was first described in 1979 as a Gram-negative facultative anaerobic rod. S. ficaria was found in figs, but also isolated from human specimens in a few cases. We now report an isolate of S. ficaria from sputum specimen.A 46-year-old man was suffering from a chronic renal failure of five years, four months of peritoneal dialysis and one week of fever due to respiratory tract infection, accompanied by cough. Sputum culture yielded a Gram-negative rod. It was identified as S. ficaria and the antibiotic susceptibility test was performed by automated Vitek II (bioMerieux). The tested S. ficaria strain was susceptible to amikacin, gentamicin, cefepime, trimethoprim-sulfamethoxazole, imipenem, mero...

Comparative Effectiveness of Antibiotic Treatment Strategies for Pediatric Skin and Soft-Tissue Infections

PEDIATRICS — Wed, 31 Aug 2011 23:00:00 +0100

CONCLUSIONS:Compared with clindamycin, use of trimethoprim-sulfamethoxazole or β-lactams was associated with increased risks of treatment failure and recurrence. Associations were stronger for those with a drainage procedure. (Source: PEDIATRICS)

Clonality behind the increase of multidrug-resistance among non-invasive pneumococci in Southern Finland

European Journal of Clinical Microbiology and Infectious Diseases — Thu, 25 Aug 2011 15:49:20 +0100

Abstract Multidrug-resistance among Streptococcus pneumoniae isolates, especially of serotype 19A, has increased in several countries recently. Even before the introduction of the pneumococcal conjugate vaccine into the Finnish National Vaccination Programme, the proportion of multidrug-resistant (MDR) pneumococci had doubled from 2007 to 2008, when it reached 3.6% in Southern Finland. Our aim was to look for a possible association between antimicrobial susceptibility and clonality among the MDR isolates. Twelve non-invasive isolates non-susceptible to penicillin, erythromycin, clindamycin, trimethoprim/sulfamethoxazole, and doxycycline from 2008 were available for serotyping, genotyping by multilocus sequence typing (MLST), and detection of genes encoding macrolide resista...

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Sulfamethoxazole Crystalluria

American Journal of Kidney Diseases — Wed, 24 Aug 2011 23:56:54 +0100

We report a patient who presented with acute kidney injury after treatment with linezolid and Bactrim DS, 2 tablets twice a day, for a leg wound. The patient also was receiving furosemide for leg edema. Fractional excretion of sodium was 46%, and kidney ultrasound showed normal-sized kidneys with no hydronephrosis. Urinalysis showed pH of 5.5 and no protein, blood, leukocyte esterase, or nitrite. Polarized urine microscopy showed birefringent pleomorphic crystalluria (A). Some crystals had the characteristic “coffin lid” appearance suggesting struvite (triple phosphate) crystals. Others had notched edges suggestive of uric acid crystals. Still other crystals formed a rosette. (Source: American Journal of Kidney Diseases)

Wrong antibiotic used for resistant skin infections

Modern Medicine — Wed, 17 Aug 2011 23:00:00 +0100

For many pediatricians, trimethoprim-sulfamethoxazole (TMP-SMX) may be the oral antibiotic of choice when a patient presents with a community-associated methicillin-resistant Staphylococcus aureus skin infection, but another drug?clindamycin?may actually work better, according to a new study. Find out why the experts recommend clindamycin, even though there seemed to be good reasons to prescribe TMP-SMX. (Source: Modern Medicine)

Antibiotic Resistance Mechanisms of Clinically Important Bacteria.

Medicina (Kaunas) — Mon, 15 Aug 2011 23:45:03 +0100

Authors: Giedraitienė A, Vitkauskienė A, Naginienė R, Pavilonis A Bacterial resistance to antimicrobial drugs is an increasing health and economic problem. Bacteria may be innate resistant or acquire resistance to one or few classes of antimicrobial agents. Acquired resistance arises from: (i) mutations in cell genes (chromosomal mutation) leading to cross-resistance, (ii) gene transfer from one microorganism to other by plasmids (conjugation or transformation), transposons (conjugation), integrons and bacteriophages (transduction). After a bacterium gains resistance genes to protect itself from various antimicrobial agents, bacteria can use several biochemical types of resistance mechanisms: antibiotic inactivation (interference with cell wall synthesis, e.g., β-lactams and glycop...

Trimethoprim-sulfamethoxazole mightn't help soft tissue infection in kids

Modern Medicine — Sun, 14 Aug 2011 23:00:00 +0100

NEW YORK (Reuters Health) - In regions with prevalent community-acquired MRSA (methicillin-resistant Staphylococcus aureus), pediatric skin and soft-tissue infections will likely respond better to clindamycin than to trimethoprim-sulfamethoxazole (TMP-SMX) or beta-lactams, a new study suggests. (Source: Modern Medicine)

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Seventy-nine-year-old man with Langerhans cell histiocytosis treated with cladribine

Journal of the American Academy of Dermatology — Fri, 12 Aug 2011 16:59:51 +0100

To the Editor: A 79-year-old white man presented with a 6-year history of a pruritic rash that had progressed to skin breakdown in the body fold areas. Prior therapy included itraconazole, ketoconazole, trimethoprim-sulfamethoxazole, clindamycin, minocycline, doxycycline, penicillin VK, mupirocin, nystatin cream, and clobetasol lotion without resolution. (Source: Journal of the American Academy of Dermatology)

Antibiotic more effective than cranberry capsules at preventing UTIs

Modern Medicine — Wed, 10 Aug 2011 20:38:10 +0100

In premenopausal women who have repeated urinary tract infections, the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX [Bactrim, Septra DS]) appears to be more effective than cranberry capsules for preventing recurrent infections, at the risk of contributing to antibiotic resistance, Dutch researchers recently reported. (Source: Modern Medicine)

National survey of Escherichia coli causing extraintestinal infections reveals the spread of drug-resistant clonal groups O25b:H4-B2-ST131, O15:H1-D-ST393 and CGA-D-ST69 with high virulence gene content in Spain

Journal of Antimicrobial Chemotherapy — Mon, 08 Aug 2011 23:00:00 +0100

Conclusions The three clonal groups investigated accounted for 30% of the multidrug-resistant isolates, which gives evidence of an important clonal component in the emergence of resistances among extraintestinal pathogenic E. coli. Notably, a single high virulence clonal group (O25b:H4-B2-ST131) causes approximately 1 in every 10 extraintestinal infections in Spain, representing an important public health threat. A new variant of the ST131 clonal group, which is non-ESBL-producing but trimethoprim/sulfamethoxazole resistant and with high virulence content, is reported. (Source: Journal of Antimicrobial Chemotherapy)

Molecular characterisation of multidrug-resistant Salmonella enterica serotype Infantis from humans, animals and the environment in Italy

International Journal of Antimicrobial Agents — Mon, 08 Aug 2011 04:00:00 +0100

Abstract: During 2005–2006, Salmonella enterica serotype Infantis strains isolated from human and non-human sources and resistant to ampicillin (A), chloramphenicol (C), streptomycin (S), sulphonamide (Su), tetracycline (T), kanamycin (K) and trimethoprim/sulfamethoxazole (Sxt) emerged in Italy. The aim of this study was to analyse the molecular basis of antibiotic resistance and to evaluate the clonal origin of multiresistant S. Infantis strains isolated from different sources. Seventy S. Infantis strains, susceptible or resistant to antimicrobial drugs, were chosen for this study. Polymerase chain reaction (PCR) and conjugation experiments were performed to identify and localise the resistance genes in multidrug-resistant strains. PCR-based replicon typing was carried out for character...

Trimethoprim‐sulfamethoxazole increase micronuclei formation in peripheral blood from weanling well‐nourished and malnourished rats

Environmental and Molecular Mutagenesis — Sun, 07 Aug 2011 23:00:00 +0100

In this study, we have evaluated the frequency of spontaneous and TMP‐SMX‐induced micronuclei in the peripheral blood of weanling (21 days of age) rats using a flow cytometric analysis technique. The spontaneous frequency of micronucleated reticulocytes (MN‐RETs) was 2.7 times greater in the UN rats than in the WN rats. In rats that were not treated with TMP‐SMX, the percentage of reticulocytes was significantly lower (41.1%) in the UN rats than the WN controls. A therapeutic dose of TMP‐SMX (80 mg/kg (TMP), 400 mg/kg (SMX) for 48 hr) increased MN‐RETs in the WN and in the UN rats. The data demonstrate the genotoxic effect of this drug. The results indicate that severe protein‐calorie restriction and drug treatment enhance DNA damage in rat peripheral blood reticulocytes, pot...

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Measurement of trace levels of antibiotics in river water using on-line enrichment and triple-quadrupole LC-MS/MS.

Talanta — Thu, 04 Aug 2011 16:12:51 +0100

This study presents the development of an automated on-line solid phase extraction (SPE)-liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of 23 antibiotics in environmental water samples. After optimisation of LC-MS/MS conditions, SPE parameters such as sorbent type, sample pH or sample volume were optimised. Antibiotic recoveries ranged from 64% to 98% and compared favourably with those achieved using off-line SPE. Limits of detection were in the range 0.5-13.7ngL(-1). This on-line SPE-LC-MS/MS procedure was applied to the analysis of water samples taken in three rivers within the Seine River basin, near Paris (France). The obtained results revealed the occurrence of 12 antibiotics, including tylosin, erythromycin, tetracycline, amoxicillin, trimethop...

Importance of Upright Posture During Exercise in Detection of Provocable Left Ventricular Outflow Tract Gradient in Hypertrophic Cardiomyopathy

The American Journal of Cardiology — Wed, 03 Aug 2011 14:23:33 +0100

In the report by Heffernan et al, the investigators stated that left ventricular outflow tract gradient (LVOTG) was assessed during exercise in patients with hypertrophic cardiomyopathy (HC), as previously described by Maron et al. In that study, LVOTG was measured not during exercise but after exercise, when changing from upright to supine position was responsible for delayed LVOTG measurement. In Heffernan et al's study, from the same institution, although abnormal blood pressure response to exercise was analyzed during exercise in an upright position, LVOTG was measured not simultaneously with exercise but with some delay after exercise in a different (supine) position (according to the method described in the previous report). (Source: The American Journal of Cardiology)

Is Methicillin-Resistant Staphylococcus aureus Pneumonia Epidemiology and Sensitivity Changing?

The American Journal of the Medical Sciences — Tue, 02 Aug 2011 23:00:00 +0100

CONCLUSIONS:: Resistance to clindamycin has increased over time, but TMP/SMX has preserved its sensitivity against MRSA. TMP/SMX should be revisited as a viable antibiotic option against CA-MRSA and HA-MRSA, specifically against CA-MRSA. PMID: 21817882 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

Drug interactions of anti-microbial agents used in hematopoietic stem cell transplantation.

Revista Latino-Americana de Enfermagem — Sun, 31 Jul 2011 23:00:00 +0100

This study analyzed potential drug interactions (PDIs) of antimicrobials used in patients of hematopoietic stem cell transplantation and identified associated factors. The sample consisted of 70 patients admitted to a hospital in São Paulo. The PDIs were analyzed through the consultation of the Drug Interactions Facts and Drug Interactions Handbook. Descriptive statistics and logistic regression were used. Half of the sample was exposed to 13 PDIs, which occurred with fluconazole (53.8%), ciprofloxacin (30.8%) and sulfamethoxazole-trimethoprim (15.4%). Most (92.3%) were of moderate severity, with good evidence (61.6%), early delayed effect (61.5%) and need to have their therapy monitored (76.9%). Patients with four or more medications (p<0.001), aged between 40-49 years of age (p <0...

Antimicrobial resistance in uncomplicated urinary tract infections in 3 California EDs.

Accident and Emergency Nursing — Wed, 27 Jul 2011 23:00:00 +0100

CONCLUSION: In our population of ambulatory female ED patients, resistance to TMP/SMX is just below the 20% threshold that the Infectious Disease Society of America recommends for continued empiric use (Clin Infect Dis.1999;29(4):745-758, Clin Infect Dis.2011;52(5):e103-120), whereas resistance to other narrow-spectrum agents, such as nitrofurantoin and cephalexin, may be lower than published antibiograms for our sites. Fluoroquinolone resistance remains very low. PMID: 21802879 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)

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Better Way to Treat Urinary Tract Infections?

Medical Headlines From Ivanhoe.com — Tue, 26 Jul 2011 05:00:00 +0100

(Ivanhoe Newswire) -- In premenopausal women who have repeated urinary tract infections (UTIs), the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX) appeared more effective than cranberry capsules for preventing recurrent infections, at the risk of contributing to antibiotic resistance, according to this study. (Source: Medical Headlines From Ivanhoe.com)

Vital Signs: Regimens: Downside for a Urinary Infection Remedy

NYT Health — Mon, 25 Jul 2011 20:28:39 +0100

Bactrim, a commonly used medication, is more effective than cranberry at controlling infections, but it encourages the development of resistant strains of bacteria. (Source: NYT Health)

Antibiotic Beats Cranberry Capsules In Preventing Recurrent Urinary Tract Infections - Antibiotic Resistance A Concern

Health News from Medical News Today — Mon, 25 Jul 2011 20:00:00 +0100

A human study found that trimethoprim-sulfamethoxazole (TMP-SMX), an antibiotic, was more effective at preventing recurrent urinary tract infections (UTIs) among premenopausal females than cranberry capsules. The researchers, from the Academic Medical Center, Amsterdam, reported their findings in the journal Archives of Internal Medicine. They added that the antibiotic may raise the risk of resistance. Recurrent UTIs are common among premenopausal females. Approximately half of all women are thought to be affected at some time... (Source: Health News from Medical News Today)

The association of antimicrobial resistance with cure and quality of life among women with acute uncomplicated cystitis

Infection — Mon, 25 Jul 2011 15:45:31 +0100

Conclusions Among women treated for acute uncomplicated cystitis with TMP/SMX, in vitro TMP/SMX resistance was associated with lower bacteriologic and clinical cure rates, and had greater impact on the time lost from daily activities compared to those with TMP/SMX-susceptible infections. Content Type Journal ArticlePages 1-8DOI 10.1007/s15010-011-0163-zAuthors F. M. Abrahamian, Division of Emergency Medicine, Department of Medicine, Olive View-University of California Los Angeles (UCLA) Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA 91342-1437, USAA. Krishnadasan, Division of Emergency Medicine, Department of Medicine, Olive View-University of California Los Angeles (UCLA) Medical Center, 14445 Olive View Drive, North Annex, Sylmar, CA 91342-1437, U...

Cranberries vs Antibiotics to Prevent Urinary Tract Infections: A Randomized Double-blind Noninferiority Trial in Premenopausal Women [Original Investigation]

Archives of Internal Medicine — Sun, 24 Jul 2011 23:00:00 +0100

Conclusion In premenopausal women, TMP-SMX, 480 mg once daily, is more effective than cranberry capsules, 500 mg twice daily, to prevent recurrent UTIs, at the expense of emerging antibiotic resistance. Trial Registration isrctn.org Identifier: ISRCTN50717094 (Source: Archives of Internal Medicine)

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Antibiotics trump cranberries for bladder infections

Multiple Sclerosis Trust — Sun, 24 Jul 2011 23:00:00 +0100

Cranberry extract was not as effective as trimethoprim-sulfamethoxazole (TMP-SMX) in preventing urinary tract infections in women, a double-blind study found. (Source: Multiple Sclerosis Trust)

Exercise-Induced Intraventricular Obstruction in a Child with Near Syncope and Chest Pain During Exercise

Pediatric Cardiology — Thu, 21 Jul 2011 18:10:44 +0100

We report the case of a 10-year-old girl with two episodes of light-headedness and chest pain during exercise. She had an unremarkable clinical record, physical examination, ECG, and echocardiogram. Noninvasive ischemia tests were positive, but coronary angiography was normal. Exercise stress echocardiogram revealed an exercise-induced intra-left-ventricular obstruction with a peak gradient of 78 mmHg and replicated her symptoms. After starting beta-blocker therapy her clinical status improved and no residual obstruction was detected. The authors review this unsuspected clinical condition, seldom reported in the adult population and, to our knowledge, never before in a child. Content Type Journal ArticlePages 1-4DOI 10.1007/s00246-011-0052-3Authors Artur Lopes, Cardiology ...

In vitro activity of sitafloxacin against Burkholderia pseudomallei

International Journal of Antimicrobial Agents — Tue, 19 Jul 2011 23:00:00 +0100

Burkholderia pseudomallei, an environmental Gram-negative bacterium, is the causative agent of the serious human infection called melioidosis, which is prevalent in Southeast Asia and Northern Australia. Antibiotic therapy of melioidosis is divided into intravenous and oral phases. Ceftazidime or a carbapenem antibiotic is recommended for initial parenteral therapy, which should be administered for at least 10–14 days. This is followed by a prolonged course of oral antimicrobial therapy with trimethoprim/sulfamethoxazole (SXT) with or without doxycycline or amoxicillin/clavulanic acid. It is necessary to complete 12–20 weeks of treatment, or longer if clinically indicated. Development of resistance of B. pseudomallei to the aforementioned antibiotics has been recognised, in particular ...

SEPTRA (Trimethoprim And Sulfamethoxazole) Tablet SEPTRA DS (Trimethoprim And Sulfamethoxazole) Tablet [Monarch Pharmaceuticals, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 18 Jul 2011 05:00:00 +0100

Updated Date: Jul 18, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

SULFAMETHOXAZOLE AND TRIMETHOPRIM (Sulfamethoxazole And Trimethoprim) Tablet [REMEDYREPACK INC. ]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 18 Jul 2011 05:00:00 +0100

Updated Date: Jul 18, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Stevens-Johnson syndrome in a juvenile systemic lupus erythematosus patient.

Lupus — Sun, 17 Jul 2011 23:00:00 +0100

In conclusion, SJS is a rare and severe vesiculobullous disease in a pediatric lupus population and is probably associated with infections and drug therapy. PMID: 21768172 [PubMed - as supplied by publisher] (Source: Lupus)

Molecular epidemiology and genetic diversity of pneumococcal carriage among children in Beni State, Bolivia

Transactions of the Royal Society of Tropical Medicine and Hygiene — Sun, 17 Jul 2011 22:03:37 +0100

Abstract: During 2007, a study of pneumococcal carriage in children was performed in two towns (Trinidad and Riberalta) in the Beni region of the Bolivian Amazon basin. Little has previously been reported regarding the epidemiology of pneumococcal carriage in Bolivia, and no multilocus sequence typing (MLST) of pneumococcal isolates from this region has previously been documented. A pneumococcal carriage rate of 34% was identified. Of 53 Streptococcus pneumoniae isolates that survived transportation for serotyping, antibiotic susceptibility testing and MLST, the commonest serotypes were 6A (9%), 34 (8%), 4 (6%), 9A (6%), 10A (6%), 19A (6%), 23F (6%) and 38 (6%); overall, 26 different serotypes were identified. Antibiotic susceptibility testing by Etest demonstrated high levels of susceptib...

Long-term follow-up of symptomatic patients with lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia treated with the anti-CD52 monoclonal antibody alemtuzumab

Blood — Wed, 13 Jul 2011 23:00:00 +0100

This study is registered at www.clinicaltrials.gov as NCT00142181. (Source: Blood)

Exposure to anti‐infective drugs during pregnancy and the risk of small‐for‐gestational‐age newborns: a case–control study

BJOG: An International Journal of Obstetrics and Gynaecology — Mon, 11 Jul 2011 23:00:00 +0100

Conclusions Exposure to sulfamethoxazole/trimethoprim during the last two trimesters of pregnancy was associated with SGA. Further research is needed to address the use of other therapeutic alternatives in the management of infections that predispose infants being born SGA in pregnant women with other risk factors for this condition. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Exposure to anti-infective drugs during pregnancy and the risk of small-for-gestational-age newborns: a case-control study.

BJOG : An International Journal of Obstetrics and Gynaecology — Mon, 11 Jul 2011 23:00:00 +0100

Conclusions Exposure to sulfamethoxazole/trimethoprim during the last two trimesters of pregnancy was associated with SGA. Further research is needed to address the use of other therapeutic alternatives in the management of infections that predispose infants being born SGA in pregnant women with other risk factors for this condition. PMID: 21749628 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

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Trimethoprim/sulfametrole: evaluation of the available clinical and pharmacokinetic/pharmacodynamic evidence

International Journal of Antimicrobial Agents — Sun, 10 Jul 2011 23:00:00 +0100

In conclusion, despite the scarcity of contemporary evidence, available data suggest that TMP/SMT could be an alternative treatment option to TMP/SMX, even in serious infections, when administered intravenously. (Source: International Journal of Antimicrobial Agents)

Scarlet Fever Caused by Community-associated Methicillin-resistant Staphylococcus aureus.

Indian Pediatrics — Wed, 06 Jul 2011 23:00:00 +0100

We describe a previously healthy 2.5-year-old boy with staphylococcal scarlet fever associated with acute suppurative otitis media due to community-associated methicillin-resistant Staphylococcus aureus. The patient was successfully treated by spontaneous drainage in combination with trimethoprim-sulfamethoxazole therapy. PMID: 21813926 [PubMed - in process] (Source: Indian Pediatrics)

Pneumocystis carinii Pneumonia Prophylaxis: Current Therapies and Recommendations

Journal of Pediatric Oncology Nursing — Tue, 05 Jul 2011 23:00:00 +0100

Pneumocystis pneumonia (PCP) can be life threatening for children receiving chemotherapy and immunosuppressive medication, including high-dose steroids. Although there are no current guidelines for prophylaxis in pediatric oncology patients, ongoing studies are evaluating the efficacy, side effects, ease of administration, and compliance of drugs used for PCP prophylaxis. Drugs currently being prescribed in practice include Bactrim, pentamidine, dapsone, and atovaquone. Bactrim remains superior for preventing PCP, but alternatives are being analyzed and investigated for those unable to tolerate Bactrim because of drug allergy or side effects. Educating patients and families about the importance of PCP prophylaxis and compliance should be a priority for all health care providers caring for ...

Evaluation of direct inoculation of the BD PHOENIX system from positive BACTEC blood cultures for both Gram-positive cocci and Gram-negative rods

BMC Microbiology - Latest articles — Wed, 29 Jun 2011 23:00:00 +0100

Conclusions: Inoculation of Phoenix panels directly from positive blood cultures can be used to report reliable results of AST of GNR a day earlier, as well as ID-results of Enterobacteriaceae. For Staphylococcus and Enterococcus species, results of AST can also be reported a day earlier for all antibiotics, except for erythromycin and trimethoprim-sulfamethoxazole. (Source: BMC Microbiology - Latest articles)

Anti‐Infection Dip Suggestions for the Coloplast Titan Inflatable Penile Prosthesis in the Era of the Infection Retardant Coated Implant

The Journal of Sexual Medicine — Wed, 22 Jun 2011 23:00:00 +0100

Conclusions. The Coloplast strips when dipped in several solutions showed equal or significantly larger ZOI against commonly infecting organisms than the InhibiZone coated strips. At the present time using off the shelf trimethoprim sulfamethoxazole infusion solution seems optimum. The flexibility of choosing the drug eluting from the Coloplast device seems promising in the changing bacterial environment. Wilson SK, Salem EA, and Costerton W. Anti‐infection dip suggestions for the coloplast titan inflatable penile prosthesis in the era of the infection retardant coated implant. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)

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Med Sci Monit 2011; 17(7):CR355-361 "Changes in bacterial resistance patterns in children with urinary tract infections on antimicrobial prophylaxis at University Hospital in Split"

Medical Science Monitor — Tue, 21 Jun 2011 17:51:00 +0100

Conclusions: Based on our results, we recommend excluding ampicillin altogether, and reconsideration of further use of TMP-SMX, as well as use of nitrofurantoin, cephalexin and amoxicillin/clavulonic acid for LTAP in our region. (Source: Medical Science Monitor)

Biodegradation and bio-sorption of antibiotics and non-steroidal anti-inflammatory drugs using immobilized cell process.

Chemosphere — Thu, 16 Jun 2011 23:00:00 +0100

Authors: Yu TH, Lin AY, Panchangam SC, Hong PK, Yang PY, Lin CF In the present study, the removal mechanisms of four antibiotics (sulfamethoxazole, sulfadimethoxine, sulfamethazine, and trimethoprim) and four non-steroidal anti-inflammatory drugs (acetaminophen, ibuprofen, ketoprofen, and naproxen) in immobilized cell process were investigated using batch reactors. This work principally explores the individual or collective roles of biodegradation and bio-sorption as removal routes of the target pharmaceuticals and the results were validated by various experimental and analytical tools. Biodegradation and bio-sorption were found as dominant mechanisms for the drug removal, while volatilization and hydrolysis were negligible for all target pharmaceuticals. The target pharmaceuticals res...

Wegener Granulomatosis (Granulomatosis with Polyangiitis): Evolving Concepts in Treatment

Seminars in Respiratory and Critical Care Medicine — Mon, 13 Jun 2011 23:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 274-297DOI: 10.1055/s-0031-1279825ABSTRACTWegener granulomatosis (WG), the most common of the pulmonary granulomatous vasculitides, typically involves the upper respiratory tract, lower respiratory tract (bronchi and lung), and kidney, with varying degrees of disseminated vasculitis. The term Granulomatosis with Polyangiitis (Wegener) was recently proposed to replace the older term, WG. The term granulomatosis with polyangiitis can be abbreviated to GPA, with the idea that the eponym Wegener would be omitted over time. Cardinal histologic features include a necrotizing vasculitis involving small vessels, extensive “geographic” necrosis, and granulomatous inflammation. Clinical manifestations of WG are protean; virtually any organ can be invo...

Consensus review of the epidemiology and appropriate antimicrobial therapy of complicated urinary tract infections in Asia-Pacific region

Journal of Infection — Sun, 12 Jun 2011 23:00:00 +0100

Summary: Urinary tract infections (UTIs) are among the most prevalent infectious diseases in the general population. They cause a substantial financial burden in the community and are associated with significant morbidity and mortality, particularly in hospitals. With increased rates of antimicrobial resistance, especially in the Asia-Pacific region, treatment of complicated UTIs (cUTIs) can be challenging for clinicians. Consideration of an optimal antimicrobial agent should be based on local resistance patterns, patient-specific factors, pharmacokinetic and pharmacodynamic principles, and cost. In the Asia-Pacific region, nearly half of Escherichia coli urinary isolates were resistant (including intermediate and resistant) to levofloxacin or ciprofloxacin and ≥30% were resistant to thi...

Fatal hemorrhagic pneumonia caused by Stenotrophomanas maltophilia in a patient with non-Hodgkin lymphoma

Journal of Infection and Chemotherapy — Wed, 08 Jun 2011 15:47:03 +0100

We report on a 57-year-old woman treated with intensive chemotherapy for non-Hodgkin lymphoma who developed severe neutropenia, hemorrhagic pneumonia, and acute respiratory failure, which led to her death within 36 h of onset of pneumonia. Postmortem examination revealed bilateral extensive intraalveolar hemorrhage associated with severe infection by the gram-negative bacterium Stenotrophomonas maltophilia. In vitro susceptibility testing showed resistance to carbapenem, cephalosporines and aminoglycosides, but sensitivity to minocycline, ciprofloxacin, levofloxacin, and trimethoprim/sulfamethoxazole (cotrimoxazole). Early diagnosis and adequate antibiotic treatment were difficult, as the clinical course was rapid and fulminant, and this bacterium is resistant to multiple antibi...

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National Ambulatory Antibiotic Prescribing Patterns for Pediatric Urinary Tract Infection, 1998-2007

PEDIATRICS — Tue, 31 May 2011 23:00:00 +0100

CONCLUSIONS: Ambulatory care physicians commonly prescribe broad-spectrum antibiotics for the treatment of pediatric UTIs, especially for febrile infants in whom complicated infections are more likely. The doubling in use of third-generation cephalosporins suggests that opportunities exist to promote more judicious antibiotic prescribing because most pediatric UTIs are susceptible to narrower alternatives. (Source: PEDIATRICS)

Characterization of Staphylococcus aureus strains isolated from raw milk of bovine subclinical mastitis in Tehran and Mashhad.

Acta Microbiologica et Immunologica Hungarica — Tue, 31 May 2011 23:00:00 +0100

Authors: Sahebekhtiari N, Nochi Z, Eslampour MA, Dabiri H, Bolfion M, Taherikalani M, Khoramian B, Zali MR, Emaneini M Staphylococcus aureus is considered one of the most important food borne pathogens.A total of 111 isolates of S. aureus were cultured from raw milk samples during January 2009 to June 2009 from Tehran and Mashhad. The coagulase gene polymorphism and the prevalence of classical enterotoxin genes of S. aureus strains were determined by PCR-RFLP (restriction fragment length polymorphism) and Multiplex-PCR. Disk diffusion method was used to determine the susceptibility of isolates to antimicrobial agents as instructed by Clinical and Laboratory Standards Institute.Sixty-seven % of the isolates harboured one or more enterotoxin genes. The most prevalent gene was sec, found ...

Nitrofurantoin Compares Favorably to Recommended Agents as Empirical Treatment of Uncomplicated Urinary Tract Infections in a Decision and Cost Analysis

Mayo Clinic Proceedings — Mon, 30 May 2011 23:00:00 +0100

CONCLUSION: From a payer perspective, nitrofurantoin appears to be a reasonable alternative to TMP-SMX and fluoroquinolones for empirical treatment of uncomplicated UTIs, especially given the current prevalence of antibiotic resistance among community uropathogens. On the basis of efficacy, cost, and low impact on promoting antimicrobial resistance, clinicians should consider nitrofurantoin as a reasonable alternative to TMP-SMX and fluoroquinolones for first-line therapy for uncomplicated UTIs. (Source: Mayo Clinic Proceedings)

Prevalence of Methicillin‐Resistant Staphylococci on a Farm: Staff can Harbour MRS When Animals Do Not

Zoonoses and Public Health — Thu, 26 May 2011 17:34:25 +0100

SummaryThe aim of this work was to establish the prevalence of methicillin‐resistant Staphylococci (MRS) in the animals and staff of a teaching and research farm. Samples of dairy cattle (36), beef cattle (26), sheep (19), horses (21), pigs (23), goats (23) and humans (13) were collected and screened for the presence of MRS. The detection of mecA gene was performed by PCR to determine the resistance of the samples to methicillin. Antimicrobial‐resistance testing to penicillin, meropenem, ceftriaxone, cephalothin, oxacillin, levofloxacin, enrofloxacin, chloramphenicol, ciprofloxacin, gentamicin, clindamycin, erytromycin, linezolid, sulfamethoxazole/trimethoprim, tetracycline, doxycycline and vancomycin was performed on the mecA+ isolates. From the 161 samples, four methicillin‐resista...

Evaluation of demographic, clinical characteristics, and genetic polymorphism as risk factors for pelvic organ prolapse in brazilian women

Neurourology and Urodynamics — Sun, 22 May 2011 23:00:00 +0100

ConclusionsThe type III collagen exon 31 polymorphism is not a risk factor for pelvic genital prolapse in this sample. Neurourol. Urodynam. © 2011 Wiley‐Liss, Inc. (Source: Neurourology and Urodynamics)

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SULFAMETHOXAZOLE AND TRIMETHOPRIM (Sulfamethoxazle And Trimethoprim) Tablet [REMEDYREPACK INC. ]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 19 May 2011 05:00:00 +0100

Updated Date: May 19, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Persistent Neutrophilic Meningitis in an Immunocompetent Patient after Basilar Skull Fracture: Case report.

BMC Infectious Diseases — Wed, 18 May 2011 23:00:00 +0100

Conclusions: Due to the difficulty in obtaining a microbiologic diagnosis, appropriate treatment in cases of persistent neutrophilic meningitis is often delayed leading to morbidity. This case highlights a number of the unique features of Nocardia meningitis and the importance of considering Nocardia infection as a cause of persistent neutrophilic meningitis even in immunocompetent patients. (Source: BMC Infectious Diseases)

Pain in HIV: An Evolving Epidemic

The Journal of Pain — Wed, 18 May 2011 23:00:00 +0100

JG was a 46-year-old man with acquired immune deficiency syndrome (AIDS) proven to be refractory to antiretroviral therapy. He presented to the emergency room with severe oral pain and odynophagia developing over 2 weeks, limiting his nutritional intake significantly with 10 pounds of weight loss. Additional medical history was significant for seizures and a cerebrovascular accident (CVA) 4 years prior. On review of systems, he denied fevers, diarrhea, or skin lesions; however, he reported several months of painful tingling in both feet that was worsened when wearing socks and shoes. Medications on admission included sulfamethoxazole-trimethoprim, valacyclovir, azithromycin, fluconazole, as well as several antiretroviral agents. (Source: The Journal of Pain)

Seasonal variation of Stevens-Johnson syndrome and toxic epidermal necrolysis associated with trimethoprim-sulfamethoxazole

Journal of the American Academy of Dermatology — Wed, 18 May 2011 16:52:02 +0100

To the Editor: In the April 2009 issue of the Journal, Wanat et al reported, for the first time, a seasonal variation of Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) associated with exposure to trimethoprim-sulfamethoxazole (TMX). We sought to replicate their findings based on two large data sources—the Severe Cutaneous Adverse Reaction (SCAR) study (1989-1995) and EuroSCAR (1997-2001). These two case control studies were conducted prospectively using similar methods. Cases were ascertained by visits to departments of dermatology, burn, intensive care, and pediatric units in hospitals in defined populations of several European countries and Israel. The diagnoses were confirmed by panels of dermatologists based on the appearance and location of skin lesions, the e...

Disseminated nocardiosis with thyroid involvement: A case report.

Journal of Microbiology, Immunology, and Infection — Tue, 10 May 2011 10:15:14 +0100

We report a case of disseminated nocardiosis with pneumonia, brain abscesses, meningitis, and thyroiditis, for an individual with recent steroid therapy. Recovery was uneventful with a 4-month course of sulfamethoxazole-trimethoprim. PMID: 21524621 [PubMed - in process] (Source: Journal of Microbiology, Immunology, and Infection)

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Determination of pharmaceutical and personal care products in wastewater by capillary electrophoresis with UV detection.

Talanta — Mon, 09 May 2011 12:00:35 +0100

In this study, we have developed a method that can simultaneously analyze eight different PPCP compounds in untreated wastewater (ibuprofen, triclosan, carbamazepine, caffeine, acetaminophen, sulfamethoxazole, trimethoprim, and lincomycin), using capillary electrophoresis with UV detection (CE-UV). The method detection limit (MDL) ranged from 1.6 to 68.7ppb through solid phase extraction. The standard limit of quantification (LOQ) ranged from 0.63 to 7.72ppm. Factors affecting separation and quantification of PPCPs, such as pH, electrophoretic potential, buffer strength, buffer type, and additives, were investigated and optimized. Water samples from two different wastewater treatment plants were collected and analyzed. The results obtained were comparable with those of LC-MS/MS. The techni...

A novel combination of selective agents for isolation of Leptospira species

Microbiology and Immunology — Wed, 04 May 2011 23:00:00 +0100

ABSTRACTA novel combination of antimicrobial agents (sulfamethoxazole, 40 μg/ml; trimethoprim 20 μg/ml; amphotericin B, 5 μg/ml; fosfomycin 400 μg/ml; and 5‐fluorouracil, 100 μg/ml) was developed for selective isolation of leptospires from contaminated samples. The growth of 16 microorganisms, considered as possible contaminants during isolation of Leptospira, could be inhibited by this antimicrobial cocktail. In contrast, the growth of a smaller inoculum (101 cells per ml) of 25 Leptospira strains (representing 18 serovars/serogroups of 5 species) was not suppressed by this antimicrobial combination. This cocktail, after incorporating in Leptospira growth medium (Korthof's), could successfully detect leptospires from environmental soil and water. Based on the results, our selective...

Lansoprazole-induced acute allergic interstitial nephritis in a renal transplant recipient: a case report

International Urology and Nephrology — Tue, 03 May 2011 05:52:36 +0100

Abstract Drug-induced interstitial nephritis is one of the causes of graft dysfunction in renal transplant recipients. Although commonly implicated as a cause of drug-induced interstitial nephritis in the general population, proton pump inhibitor-induced interstitial nephritis has not yet been reported in renal transplant recipients. Trimethoprim-sulfamethoxazole is responsible for most cases of interstitial nephritis in this population. Here, we describe the first case of proton pump inhibitor-related interstitial nephritis in a renal transplant recipient. Content Type Journal ArticlePages 1-4DOI 10.1007/s11255-011-9972-3Authors Tolga Yildirim, Department of Nephrology, Hacettepe University, Ankara, TurkeyRahmi Yilmaz, Department of Nephrology, Hacettepe University, ...

Antimicrobial Resistance in Urinary Tract Pathogens in Canada from 2007 to 2009: CANWARD Surveillance Study.

Antimicrobial Agents and Chemotherapy — Sun, 01 May 2011 23:00:00 +0100

Authors: Karlowsky JA, Lagacé-Wiens PR, Simner PJ, Decorby MR, Adam HJ, Walkty A, Hoban DJ, Zhanel GG From January 2007 to December 2009 an annual Canadian national surveillance study (CANWARD) tested 2943 urinary culture pathogens for antimicrobial susceptibilities following Clinical and Laboratory Standards Institute (CLSI) guidelines. The most frequently isolated urinary pathogens (n, % of all isolates) were Escherichia coli (1581, 54%), enterococci (410, 14%), Klebsiella pneumoniae (274, 9%), Proteus mirabilis (122, 4%), Pseudomonas aeruginosa (100, 3%), and Staphylococcus aureus (80, 3%). Rates of susceptibility to trimethoprim-sulfamethoxazole (SXT) were 78%, 86%, 84%, and 93%, respectively, for E. coli, K. pneumoniae, P. mirabilis, and S. aureus. Rates of susceptibility to nitr...

Molecular Epidemiologic Analysis of Methicillin-Resistant Staphylococcus aureus Isolates from Bacteremia and Nasal Colonization at 10 Intensive Care Units: Multicenter Prospective Study in Korea.

J Korean Med Sci — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Kwon JC, Kim SH, Park SH, Choi SM, Lee DG, Choi JH, Park C, Shin NY, Yoo JH We investigated molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolated at 10 intensive care units (ICUs) in Korea. MRSA isolates from bacteremia and nasal colonization were collected prospectively from October 2008 through May 2009 at 10 University-affiliated hospital ICUs. A total of 83 and 175 MRSA strains were isolated from bacteremia and nasal colonization, respectively. Acquired group accounted for 69.9% (n = 58) of bacteremia and 73.1% (n = 128) of nasal colonization. Pulsed-field gel electrophoresis (PFGE) type B (SCCmec type II/ST5) was dominant in the acquired group followed by PFGE type D (SCCmec type IVA/ST72; a community genotype). Seven of 58 (12.1%) acquired...

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Acute rhinosinusitis in adults.

American Family Physician — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Aring AM, Chan MM Rhinosinusitis is one of the most common conditions for which patients seek medical care. Subtypes of rhinosinusitis include acute, subacute, recurrent acute, and chronic. Acute rhinosinusitis is further specified as bacterial or viral. Most cases of acute rhinosinusitis are caused by viral infections associated with the common cold. Symptomatic treatment with analgesics, decongestants, and saline nasal irrigation is appropriate in patients who present with nonsevere symptoms (e.g., mild pain, temperature less than 101°F [38.3°C]). Narrow-spectrum antibiotics, such as amoxicillin or trimethoprim/sulfamethoxazole, are recommended in patients with symptoms or signs of acute rhinosinusitis that do not improve after seven days, or that worsen at any time. Limit...

Increased liver steatosis in anabolic‐androgenic steroid users: more evidence towards toxicant‐associated fatty liver disease development

Liver International — Sat, 30 Apr 2011 23:00:00 +0100

(Source: Liver International)

Cutaneous manifestations of Strongyloides stercoralis hyperinfection in an HIV-seropositive patient.

Skinmed — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Martin SJ, Cohen PR, MacFarlane DF, Grossman ME A 41-year-old human immunodeficiency virus (HIV)-positive man was hospitalized with complaints of a 4-week history of nausea and vomiting, associated with decreased oral intake, and a 4-day history of frontal headache and fever. His medical history was significant for a gunshot wound to the head 3 years prior, with a residual seizure disorder. He also had two previous hospitalizations, both for culture-negative bacterial meningitis; the first episode occurred 12 months before admission and the second episode occurred 5 months later. At that time, he was found to be positive for serum antibodies against HIV and a CD4+ T-lymphocyte count of 126/mm3. He had no known drug allergies and was not receiving any medication. On admission, ...

High‐risk antimicrobial prescriptions among ambulatory patients on warfarin

Journal of Clinical Pharmacy and Therapeutics — Sat, 23 Apr 2011 23:00:00 +0100

Conclusions: A high percentage (42·6%) of antimicrobial prescriptions among warfarin users were for high‐risk antimicrobials that carry excess bleeding risk. Although clinicians were somewhat less likely to prescribe high‐risk antimicrobials to warfarin users compared with non‐users, the incidence of co‐prescription remains high. (Source: Journal of Clinical Pharmacy and Therapeutics)

Ophthalmic Methicillin-resistant Staphylococcus aureus Infections: Sensitivity and Resistance Profiles of 234 Isolates

Journal of Community Health — Sat, 16 Apr 2011 15:57:59 +0100

Abstract To identify the sensitivity and resistance profiles of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a large, diverse demographic. The electronic database of a large health maintenance organization was searched for patients who had an ophthalmic bacterial culture performed from 2002 to 2008 which grew MRSA. Data collected included culture source, sensitivity and resistance profiles, and whether the infection was community or nosocomially-acquired. In this retrospective study, not all isolates were tested for all the antibiotics. All isolates tested for vancomycin, trimethoprim/sulfamethoxazole, and rifampin were sensitive to these antibiotics and none were resistant. Gentamycin and chloramphenicol had the next highest sensitivity to resistance r...

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Predominance of ST320 among Streptococcus pneumoniae serotype 19A isolates from 10 Asian countries

Journal of Antimicrobial Chemotherapy — Sun, 10 Apr 2011 23:00:00 +0100

Conclusions Although diverse clones were identified among 19A S. pneumoniae isolates, MDR ST320 was the predominant clone in Asian countries. Its predominance, even in countries with no or low coverage of PCV7, may indicate that its emergence and dissemination was due to more than just vaccine selection pressure in Asian countries. A longitudinal investigation of the change of serotypes and genotypes since the introduction of PCV7 is required to understand the emergence and dissemination mechanisms of a certain clone of 19A S. pneumoniae isolates. (Source: Journal of Antimicrobial Chemotherapy)

'Septrin psychosis' among renal transplant patients with Pneumocystis jirovecii pneumonia

Journal of Antimicrobial Chemotherapy — Sun, 10 Apr 2011 23:00:00 +0100

Conclusions With increasing solid organ transplantation and the use of immunosuppressants, vigilance regarding trimethoprim/sulfamethoxazole dose modification is required and the routine use of therapeutic drug monitoring should be considered. (Source: Journal of Antimicrobial Chemotherapy)

Spatial and seasonal distribution of selected antibiotics in surface waters of the Pearl Rivers, China.

Thu, 31 Mar 2011 23:00:00 +0100

Authors: Yang JF, Ying GG, Zhao JL, Tao R, Su HC, Liu YS The distribution and occurrence of 15 antibiotics in surface water of the Pearl River System (Liuxi River, Shijing River and Zhujiang River) and effluents of four wastewater treatment plants (WWTPs) were investigated in two sampling events representing wet season and dry season by using rapid resolution liquid chromatography-electrospray tandem mass spectrometry (RRLC-MS/MS) in positive ionization mode. Only eight antibiotics (sulfadiazine, sulfapyridine, sulfamethazine, sulfamethoxazole, trimethoprim, roxithromycin, erythromycin-H(2)O and norfloxacin) were detected in the water samples of the three rivers and the effluents. The detection frequencies and levels of antibiotics in the dry season were higher than those in the wet se...

Molecular characterization and resistance profile of Salmonella Enteritidis PT4 and PT9 strains isolated in Brazil.

Journal of Medical Microbiology — Thu, 31 Mar 2011 23:00:00 +0100

Authors: Kottwitz LB, Scheffer MC, Dalla-Costa LM, Farah SM, Moscalewski WS, Magnani M, de Oliveira TC A total of 41 Salmonella Enteritidis (SE) strains, including phago-types PT4 and PT9, were characterized by antimicrobial resistance profiles and pulsed-field gel electrophoresis (PFGE). Of these strains, 34 strains were isolated from patients and foods, and 7 strains were of poultry origin. All strains were susceptible to ampicillin, chloramphenicol, cefotaxime, ciprofloxacin and trimethoprim/sulfamethoxazole, and 41.5 % (n = 17) of the strains were resistant to nalidixic acid (NAL). PFGE analysis using XbaI and SpeI restriction enzymes resulted in X1S1 as the prevalent pattern, which was present in 48.8 % (n = 20) of epidemic strains and in one strain isolated from discarded hatchin...

Salivary gland nocardiosis in an immunocompetent patient.

Asian Journal of Surgery — Thu, 31 Mar 2011 23:00:00 +0100

We report a case of nocardiosis in an immunocompetent patient who presented with pain and multiple swellings in the face. Nocardia asteroides was isolated from the parotid and submandibular salivary glands. The patient was successfully treated by surgical drainage and oral administration of trimethoprim and sulfamethoxazole. To the best of our knowledge, this is the first reported case from India on N. asteroides affecting the salivary gland. PMID: 21723475 [PubMed - in process] (Source: Asian Journal of Surgery)

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Clinical and Microbiologic Outcomes in Trauma Patients Treated for Stenotrophomonas maltophilia Ventilator-Associated Pneumonia

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Tue, 29 Mar 2011 23:00:00 +0100

Conclusion. Critically ill trauma patients with S. maltophilia VAP responded well to therapy despite high rates of inadequate empiric antibiotic administration. Trimethoprim-sulfamethoxazole was the most common therapy, but clinical success rates did not differ significantly based on antibiotic selection. This study adds significantly to the available S. maltophilia VAP outcomes data. (Source: Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy)

Exercise Echocardiography in Hypertrophic Cardiomyopathy—Upright Evaluation Needed

The American Journal of Cardiology — Tue, 29 Mar 2011 15:00:24 +0100

Nistri et al state that “in patients with hypertrophic cardiomyopathy without outflow obstruction at rest, the earlier onset of [left ventricular] outflow tract gradients during physiologic exercise was associated with impaired exercise performance. These findings provided insights into the determinants of functional impairment in [hypertrophic cardiomyopathy] and support the potential value of exercise echocardiography in the clinical assessment of patients with hypertrophic cardiomyopathy.” (Source: The American Journal of Cardiology)

Authors' Reply

The American Journal of Cardiology — Tue, 29 Mar 2011 15:00:24 +0100

We appreciate the interest of Prof. Cotrim in our recent report showing that earlier onset of left ventricular outflow tract gradients during physiologic exercise is associated with impaired exercise performance in patients with hypertrophic cardiomyopathy (HC). In our study, gradients measured upright during exercise or supine immediately after exercise were similar. Therefore, we concluded that the 2 approaches may be considered equivalent for clinical purposes. However, Prof. Cotrim questions this view, arguing that gradients assessed after exercise in the upright position may be greater than those measured supine and therefore more accurately reflect the magnitude of obstruction occurring during physiologic exercise provocation. This observation, however, is based on patients with HC a...

Clinical characteristics of Pneumocystis pneumonia in non-HIV patients and prognostic factors including microbiological genotypes

BMC Infectious Diseases — Fri, 25 Mar 2011 00:00:00 +0100

Conclusions: In non-HIV PCP, poorer general and respiratory conditions at diagnosis were independent predictors of mortality. Beta-D-glucan may not be useful for monitoring the response to treatment, and genotypes were not associated with mortality. (Source: BMC Infectious Diseases)