Diagnostic microbiology and infectious disease
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Diagn. Microbiol. Infect. Dis. · Jan 2009
Randomized Controlled Trial Multicenter Study Comparative StudySafety and efficacy of intravenous tigecycline in treatment of community-acquired pneumonia: results from a double-blind randomized phase 3 comparison study with levofloxacin.
Tigecycline exhibits potent in vitro activity against many community-acquired pneumonia (CAP) pathogens, including antibiotic-resistant ones. Its spectrum of activity and ability to penetrate lung tissue suggest it may be effective for hospitalized CAP patients. Hospitalized CAP patients (n=418) were randomized to receive intravenous (i.v.) tigecycline or levofloxacin. ⋯ Nausea and vomiting occurred in significantly more tigecycline-treated patients; elevated alanine aminotransferase and aspartate aminotransferase levels were reported in significantly more levofloxacin-treated patients. There were no significant differences in hospital length of stay, median duration of i.v. or oral antibiotic treatments, hospital readmissions, or number of patients switched to oral levofloxacin. Tigecycline was safe, effective, and noninferior to levofloxacin in hospitalized patients with CAP.
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Diagn. Microbiol. Infect. Dis. · Dec 2008
Case ReportsSepsis caused by Elizabethkingia miricola successfully treated with tigecycline and levofloxacin.
Elizabethkingia miricola is a Gram-negative rod that was initially isolated from condensation water of the space station Mir. This is the 1st reported case of human disease caused by this organism.
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Diagn. Microbiol. Infect. Dis. · Nov 2008
Pharmacodynamic assessment of doripenem in peritoneal fluid against Gram-negative organisms: use of population pharmacokinetic modeling and Monte Carlo simulation.
This study aimed to assess the peritoneal pharmacodynamics of intravenous doripenem using population pharmacokinetic modeling and Monte Carlo simulation. Drug concentrations in peritoneal fluid (PF) and serum from 11 laparotomy patients and MIC distributions against clinical isolates in Japan for 4 Gram-negative organisms were used. ⋯ Prolonged (4-h) infusion regimens resulted in increase of the target attainment probabilities in PF for P. aeruginosa. These results should help to achieve a better understanding of the peritoneal pharmacodynamics of doripenem while also helping to rationalize and optimize the dosing regimen for intra-abdominal infections.
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Diagn. Microbiol. Infect. Dis. · Nov 2008
Association between antibiotic usage and subsequent colonization or infection of extensive drug-resistant Acinetobacter baumannii: a matched case-control study in intensive care units.
Nosocomial spreading of extensive drug-resistant Acinetobacter baumannii (EDRAB) is an emerging problem. To clarify the association between prior antibiotic usage and subsequent EDRAB acquisition, we conducted a one-to-one matched case-control study among patients in all intensive care units (ICUs) at the National Taiwan University Hospital, Taipei, Taiwan, during a 1-year period. A total of 113 pairs of patients were identified. ⋯ Ceftazidime use with stronger treatment potency was also strongly associated with subsequent nosocomial EDRAB acquisition (OR = 5.5, 95% CI = 1.5-21.0). The OR of EDRAB acquisition greatly increased in patients who had previously been exposed to any 1 (OR = 5.5, 95% CI = 2.3-13.2) or to any 2 or 3 (OR = 11.1, 95% CI = 2.7-46.4) of the abovementioned antibiotics. Based on these findings, we conclude that usage of imipenem, meropenem, and/or ceftazidime is associated with subsequent acquisition of EDRAB in critically ill patients in ICUs.
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Diagn. Microbiol. Infect. Dis. · Oct 2008
Comparative StudyComparison of BD Directigen EZ RSV and Binax NOW RSV tests for rapid detection of respiratory syncytial virus from nasopharyngeal aspirates in a pediatric population.
The BD Directigen EZ RSV (BD) assay and the Binax NOW RSV (BN) assays are lateral flow immunochromatographic assays used in the rapid diagnosis of respiratory syncytial virus (RSV) infection. A prospective study was undertaken to compare the performance characteristics of the BD and BN assays using 99 fresh nasopharyngeal aspirate specimens from children. All specimens were cultured by tube cultures and R-mix shell vials. ⋯ Three specimens negative by both assays were positive by viral culture. The rapid lateral flow immunochromatographic assays were easy to perform and easy to interpret, and the results are available in less than 30 min. The reduced turnaround time offered by these assays is particularly useful in the rapid detection of RSV infections in children from outpatient settings.