International journal of antimicrobial agents
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Int. J. Antimicrob. Agents · Nov 2009
Efficacy of linezolid against Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) in a mouse model of haematogenous pulmonary infection.
Many strains of community-acquired meticillin-resistant Staphylococcus aureus (MRSA) have a pore-forming leukotoxin, known as Panton-Valentine leukocidin (PVL), which can cause severe necrotising pneumonia. Linezolid (LZD) is a new antibacterial agent with potent antibacterial activity against MRSA. In this study, a mouse model of haematogenous pulmonary infection was used to compare the efficacies of LZD and vancomycin (VAN) against pulmonary infection caused by PVL-positive S. aureus. ⋯ Histopathological examination and cytokine analysis also showed the beneficial efficacy of LZD compared with VAN. In conclusion, LZD significantly reduced bacterial numbers and inflammation in a mouse model of PVL-positive S. aureus haematogenous infection and improved the survival rate of infected mice compared with VAN. LZD is clinically effective against PVL-positive S. aureus.
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Int. J. Antimicrob. Agents · Nov 2009
Review Case ReportsTigecycline-induced acute pancreatitis: case report and literature review.
Tigecycline is a broad-spectrum antimicrobial agent structurally related to minocycline. Pancreatitis has been associated with the tetracycline class of antibiotics and concerns about tigecycline-induced acute pancreatitis have recently been raised. We describe a 69-year-old female who received tigecycline for treatment of a complicated skin and skin-structure infection. ⋯ According to the Naranjo adverse drug reaction probability scale, tigecycline was the probable cause of her acute pancreatitis. Clinicians should be aware of this potential adverse effect of tigecycline. We recommend that clinicians monitor patients for signs and symptoms of pancreatitis, including abdominal pain, during treatment with tigecycline.
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Int. J. Antimicrob. Agents · Nov 2009
Multicenter StudyMolecular analysis and susceptibility patterns of meticillin-resistant Staphylococcus aureus (MRSA) strains circulating in the community in the Ligurian area, a northern region of Italy: emergence of USA300 and EMRSA-15 clones.
For many years meticillin-resistant Staphylococcus aureus (MRSA) has been considered a typical nosocomial pathogen. Recently, MRSA has emerged as a frequent cause of infections in the community. A multicentre surveillance study was carried out in the Ligurian area of Italy to evaluate the incidence, molecular nature and susceptibility patterns of MRSA strains circulating among outpatients. ⋯ Both community-associated MRSA and healthcare-associated MRSA epidemic international clones circulate among outpatients in our region. It is alarming that members of the most represented clonal group in our collection (USA300) can acquire multiresistance as well as PVL genes. Infection control measures in our area should be improved to avoid the selection of microorganisms displaying both traits simultaneously as well as the spread of these epidemic international clones.
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Int. J. Antimicrob. Agents · Nov 2009
Clinical characteristics and risk factors of colistin-induced nephrotoxicity.
Since multidrug-resistant gram-negative organisms have been increasing, polymyxin E (colistin) has been reintroduced despite its nephrotoxicity. A case-control study was performed to investigate the incidence, clinical characteristics and risk factors of colistin-induced nephrotoxicity. From August 2006 to June 2008, 47 cases receiving at least one defined daily dose (DDD) of intravenous colistin were included; 15 (31.9%) of the 47 cases developed nephrotoxicity with preserved urine output, 3 (20%) of whom underwent renal replacement therapy. ⋯ In the univariate analysis, site of infection, hypoalbuminaemia and cumulative dosage of the second-generation fluoroquinolones, aminoglycosides and non-steroidal anti-inflammatory drugs (NSAIDs) co-administered during colistin treatment as well as concomitant use of NSAIDs were risk factors for nephrotoxicity. However, in the logistic regression hypoalbuminaemia and the use of NSAIDs were significant risk factors for increased nephrotoxicity during colistin administration, suggesting that free colistin might cause renal toxicity. In conclusion, colistin-induced nephrotoxicity occurred at a high rate, and hypoalbuminaemia and concomitant use of NSAIDs were significant risk factors.
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Int. J. Antimicrob. Agents · Oct 2009
Annual macrolide prescription rates and the emergence of macrolide resistance among Streptococcus pneumoniae in Canada from 1995 to 2005.
Over the last 20 years, Canadian pneumococcal surveillance studies have documented a steady rise in macrolide resistance. In the current study, we probed the nature of associations between the emergence of macrolide-resistant Streptococcus pneumoniae in Canada and changes in macrolide (azithromycin, clarithromycin and erythromycin) prescription rates. Macrolide susceptibility testing data for respiratory tract isolates of S. pneumoniae (n=15109) were acquired from two published national Canadian surveillance databases, and dispensed outpatient macrolide prescription data were acquired from the proprietary Intercontinental Medical Statistics (IMS) Health Canada CompuScript database. ⋯ When the data were analysed by provincial origin, no statistically significant associations were found between prescription rates of any macrolide and macrolide resistance rates by univariate and multivariate regression analyses. We conclude that increasing macrolide resistance among respiratory isolates of pneumococci in Canada from 1995 to 2005 was associated both with decreasing prescriptions for erythromycin and concurrent increases in prescriptions for azithromycin and clarithromycin (azithromycin>clarithromycin by univariate regression analysis). Resistance development is complex and factors other than macrolide use may also be associated with observed increases in macrolide resistance in Canada from 1995 to 2005.