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136441. Relationship between molecular epidemiology and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) in a French teaching hospital. Full Text available with Trip Pro

Relationship between molecular epidemiology and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) in a French teaching hospital. The objective of this study was to investigate the relationship between molecular epidemiology and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) over a period of 4 years. The antibiotype of all MRSA isolates that were identified during a yearly period of 3 months was determined; 50 consecutive non (...) frequently susceptible to ofloxacin (31.8 versus 1.1 %) and tobramycin (45.4 versus 16.8 %) than epidemic strains; those isolates that were susceptible to all antibiotics tested belonged to sporadic clones. The increase of erythromycin susceptibility within MRSA isolates was caused by the emergence of clone C. This study suggests that when selection pressure exerted by an antibiotic is insufficient (i.e. below a threshold level), fitness advantages play a predominant role in the dissemination of MRSA

2003 Journal of Medical Microbiology

136442. Laboratory diagnosis of Clostridium perfringens antibiotic-associated diarrhoea. Full Text available with Trip Pro

Laboratory diagnosis of Clostridium perfringens antibiotic-associated diarrhoea. Clostridium perfringens has been reported as the cause of up to 15% of cases of antibiotic-associated diarrhoea (AAD) and may be diagnosed by detection of enterotoxin (CPEnt) in faeces. The performance of a commercial ELISA method for CPEnt, with culture and PCR methods to confirm the presence of enterotoxigenic C. perfringens, was evaluated in 200 consecutive specimens from patients with clinical details

2002 Journal of Medical Microbiology

136443. Fitness of antibiotic resistant Staphylococcus epidermidis assessed by competition on the skin of human volunteers. Full Text available with Trip Pro

Fitness of antibiotic resistant Staphylococcus epidermidis assessed by competition on the skin of human volunteers. Antibiotic resistance typically confers a biological fitness cost on bacteria that can be manifested as a decreased growth rate in culture media and experimental animals. However, there are limited experimental data on the relative fitness of resistant and susceptible bacteria during growth in their natural environment.We have developed a human competition model to investigate (...) the relative fitness of antibiotic-resistant and -susceptible bacteria.A non-epidemic Staphylococcus epidermidis strain was isolated from skin, and a rifampicin-resistant (RifR) clone was selected. The RifR marker was used to distinguish the inoculated strains from the resident population of coagulase-negative staphylococci. The RifR strains were further selected for resistance to ciprofloxacin (CipR) and fusidic acid (FusR). A 1:1 mix of susceptible and resistant bacteria was applied on the forearms of 12

2003 Journal of Antimicrobial Chemotherapy

136444. Antibiotic prescriptions in children. Full Text available with Trip Pro

Antibiotic prescriptions in children. The aim of this study was to evaluate antibiotic prescription for children in Emilia Romagna, a Northern Italian region with 414 880 people aged 1-14 years.The regional Prescription Database of drugs reimbursed by the Italian National Health Service was used in this study. Antibiotic use was estimated as the proportion of children who received at least one prescription during the year 2000 (number of children treated per 100 inhabitants per year (...) ). To evaluate the frequency of exposure for each child, all the prescriptions given within a period shorter than 12 days were considered as a single treatment.In the year surveyed, 511,270 antibiotic prescriptions in 219,257 children were identified. In all, 52.9% of children received at least one antibiotic; this percentage decreased with age, ranging from 70.4% in children 1-2 years old to 35.8% in children >11 years old. Fifty-two per cent of inhabitants under the age of 15 years were treated

2003 Journal of Antimicrobial Chemotherapy

136445. Antibiotic activity against urinary tract infection (UTI) isolates of vancomycin-resistant enterococci (VRE): results from the 2002 North American Vancomycin Resistant Enterococci Susceptibility Study (NAVRESS). Full Text available with Trip Pro

Antibiotic activity against urinary tract infection (UTI) isolates of vancomycin-resistant enterococci (VRE): results from the 2002 North American Vancomycin Resistant Enterococci Susceptibility Study (NAVRESS). The purpose of this study was to assess the prevalence of vancomycin-resistant enterococci (VRE) in urinary isolates in North America, and the activity of various antibiotics against VRE.Twenty-eight medical centres in the United States and 10 centres in Canada assessed the prevalence

2003 Journal of Antimicrobial Chemotherapy

136446. Prevalence of multiple antibiotic resistance in 443 Campylobacter spp. isolated from humans and animals. Full Text available with Trip Pro

Prevalence of multiple antibiotic resistance in 443 Campylobacter spp. isolated from humans and animals. In view of recent findings that a multidrug efflux pump CmeABC exists in Campylobacter jejuni, 391 C. jejuni and 52 Campylobacter coli of human and animal origin were examined for a multidrug resistance phenotype.The MICs of ampicillin, chloramphenicol, ciprofloxacin, erythromycin, kanamycin, tetracycline, cetrimide, triclosan, acridine orange, paraquat and ethidium bromide were determined (...) . Resistance to organic solvents and the effect of salicylate (known inducer of the marRAB operon in Escherichia coli and Salmonella) were also examined.Two C. coli and 13 C. jejuni isolates, mainly from pigs or poultry, were resistant to three or more antibiotics and 12 of these strains had reduced susceptibility to acridine orange and/or ethidium bromide. Strains (n = 20) that were less susceptible to acridine orange, ethidium bromide and triclosan were significantly more resistant (P < 0.05

2003 Journal of Antimicrobial Chemotherapy

136447. In vitro activity of cethromycin, a novel antibacterial ketolide, against Chlamydia pneumoniae. Full Text available with Trip Pro

In vitro activity of cethromycin, a novel antibacterial ketolide, against Chlamydia pneumoniae. To investigate the in vitro activity of cethromycin, a new ketolide, against Chlamydia pneumoniae.The in vitro activity of cethromycin against 20 isolates of C. pneumoniae was compared with the activities of telithromycin, erythromycin A, azithromycin and clarithromycin against those isolates.The MIC at which 90% of the isolates were inhibited and the minimal chlamydiacidal concentration at which 90 (...) % of the isolates were killed by cethromycin were both 0.016 mg/L (range 0.016-0.031 mg/L). Cethromycin was the most active antibiotic tested in this study.Our results appear to indicate that cethromycin is an effective antibiotic that should play some role in the treatment of respiratory tract infections caused by C. pneumoniae.

2003 Journal of Antimicrobial Chemotherapy

136448. Comparison of microbial adherence to antiseptic and antibiotic central venous catheters using a novel agar subcutaneous infection model. Full Text available with Trip Pro

Comparison of microbial adherence to antiseptic and antibiotic central venous catheters using a novel agar subcutaneous infection model. An agar subcutaneous infection model (agar model), which simulates the rat subcutaneous infection model (rat model), was developed to assess the ability of antimicrobial catheters to resist microbial colonization. The catheters were implanted in the agar and rat models and the insertion sites were infected immediately or on day 7, 14 or 21 post-implantation (...) and Candida albicans in the agar model, whereas MR catheters were effective only against S. aureus and S. epidermidis strains. Silver catheters were ineffective against all the organisms. The agar model may be used to predict the in vivo efficacy of antimicrobial catheters against various pathogens.

2003 Journal of Antimicrobial Chemotherapy

136449. Outpatient antibiotic prescriptions from 1992 to 2001 in the Netherlands. Full Text available with Trip Pro

Outpatient antibiotic prescriptions from 1992 to 2001 in the Netherlands. Although Dutch outpatient antibiotic prescription rates are low compared with other European countries, continuing to scrutinize trends in outpatient antibiotic use is important in order to identify possible increases in antibiotic use or inappropriate increases in the use of particular classes of antibiotics.We assessed the volume of Dutch outpatient antibiotic prescriptions from 1992 to 2001 by calculating the mean (...) number of outpatient antibiotic prescriptions (indicating the number of times physicians decide to prescribe an antibiotic agent) per 1000 patients insured by the Dutch Sickness Fund per year, according to subgroups (narrow-spectrum penicillins, broad-spectrum penicillins, tetracyclines, macrolides, sulphonamides and trimethoprim, and quinolones). Data were obtained from the Dutch Drug Information Project/Health Care Insurance Board.The total volume of outpatient antibiotic prescriptions in 2001

2003 Journal of Antimicrobial Chemotherapy

136450. Considering resistance in systematic reviews of antibiotic treatment. Full Text available with Trip Pro

on resistance were reported in the original trials; and based on that, to offer a framework for taking resistance into account in systematic reviews.The Cochrane Database of Systematic Reviews (the Cochrane Library, 2001, issue 2); and MEDLINE, 1996-2000.(i) Systematic reviews or meta-analyses of antimicrobial therapy, published during 1996-2000. (ii) Randomized, controlled trials abstracted in systematic reviews that addressed a topic highly relevant to antibiotic resistance.We examined each systematic (...) Considering resistance in systematic reviews of antibiotic treatment. Microorganisms resistant to antibiotic drugs are a threat to the health and chances of survival of patients. Systematic reviews on antibiotic drugs that ignore the topic of resistance present readers with a skewed view, emphasizing short-term efficacy or effectiveness while ignoring long-term consequences.To examine whether systematic reviews of antibiotic treatment consider resistance; if not, to find out whether data

2003 Journal of Antimicrobial Chemotherapy

136451. Phage lytic enzymes as therapy for antibiotic-resistant Streptococcus pneumoniae infection in a murine sepsis model. Full Text available with Trip Pro

Phage lytic enzymes as therapy for antibiotic-resistant Streptococcus pneumoniae infection in a murine sepsis model. Phage-coded lysins, i.e. murein hydrolases, are enzymes that destroy the cell wall of bacteria. A rapid killing of Streptococcus pneumoniae in the nasopharynx of mice has been described recently using a phage-coded murein hydrolase (enzybiotic). The in vivo effects of a dose-ranging treatment, using either of the phage-coded lytic enzymes Cpl-1 lysozyme or the Pal amidase, have (...) been investigated here in a murine sepsis model.Purified Pal amidase and/or Cpl-1 lysozyme were used alone or in combination. These enzymes were injected intraperitoneally at different times after challenge with 5 x 10(7) cfu of a type 6B, antibiotic-resistant S. pneumoniae clinical isolate.Animals challenged with 5 x 10(7) cfu of this strain alone died within 72 h, whereas a single intraperitoneal injection of Cpl-1 or Pal (200 microg; 1100 U) administered 1 h after the bacterial challenge

2003 Journal of Antimicrobial Chemotherapy

136452. Pharmacological indices in antibiotic therapy. Full Text available with Trip Pro

Pharmacological indices in antibiotic therapy. After 60 years of antibiotic treatment, attempts to rationalize it have culminated in the use of pharmacological indices. These indices facilitate comparison of the activity of different antibiotics and serve as a sound basis for antibiotic dosing. Pharmacokinetic parameters (e.g. AUC, Cmax) and pharmacodynamic parameters (mostly MIC) are used for this purpose. For the so-called concentration-dependent antibiotics, the pharmacological indices AUC (...) /MIC and Cmax/MIC are used, whereas for time-dependent antibiotics, the pharmacological index T>MIC is used. Some authors believe that the index AUC/MIC can be used as a universal index, but, not all experts accept this generalization. As the various pharmacological indices have been defined inconsistently in the literature, the International Society for Anti-Infective Pharmacology (ISAP) has published a paper on the terminology of pharmacokinetic and pharmacodynamic parameters

2003 Journal of Antimicrobial Chemotherapy

136453. The susceptibility of ionophore-resistant Clostridium aminophilum F to other antibiotics. Full Text available with Trip Pro

The susceptibility of ionophore-resistant Clostridium aminophilum F to other antibiotics. To determine if ionophore-resistant ruminal bacteria are cross-resistant to other classes of antibiotics. Clostridium aminophilum was used as a model organism because this Gram-positive ruminal bacterium can adapt to ionophores (monensin and lasalocid). Non-adapted cultures lagged for at least 12 h with 1 microM monensin or lasalocid, but initiated no growth if the concentration was 10 microM. Adapted (...) cultures did not lag with 1 microM monensin or lasalocid, grew well even if the ionophore concentration was 10 microM and contained cells at least 100,000-fold more resistant than those in non-adapted cultures.Ionophore-adapted and non-adapted cultures were assayed for their susceptibility to other classes of antibiotics (penicillin G, ampicillin, cephalosporin C, vancomycin, carbenicillin, tetracycline, chloramphenicol, erythromycin, streptomycin, linocomycin, rifampicin, trimethoprim, novobiocin

2003 Journal of Antimicrobial Chemotherapy

136454. Treatment and outcome of Pseudomonas aeruginosa bacteraemia: an antibiotic pharmacodynamic analysis. Full Text available with Trip Pro

Treatment and outcome of Pseudomonas aeruginosa bacteraemia: an antibiotic pharmacodynamic analysis. To conduct a retrospective study of antibiotic pharmacodynamics in the treatment of Pseudomonas aeruginosa bacteraemia, and to identify pharmacodynamic indices associated with clinical cure.Cases of P. aeruginosa bacteraemia were identified, and information related to patient demographics, clinical status, antibiotic treatment and clinical outcome were documented. Anti-pseudomonal therapy (...) was assessed, and concentration versus time profiles were constructed using measured levels for aminoglycosides, or population pharmacokinetic models for other antibiotics. P. aeruginosa isolates from all patients were retrieved and MICs for the anti-pseudomonal agents used to treat the episode of bacteraemia were determined. Patient- and treatment-related factors were tested for associations with clinical outcome using univariate and multivariate analyses.Fifty cases of P. aeruginosa bacteraemia were

2003 Journal of Antimicrobial Chemotherapy

136455. Antibacterial susceptibility of a vancomycin-resistant Staphylococcus aureus strain isolated at the Hershey Medical Center. Full Text available with Trip Pro

Antibacterial susceptibility of a vancomycin-resistant Staphylococcus aureus strain isolated at the Hershey Medical Center. Staphylococcus aureus strain HMC3 isolated at the Hershey Medical Center, was resistant to vancomycin (VRSA) through the presence of the vanA resistance gene; it also contained mecA, erm(A), erm(B), tet(K) and aac(6')-aph(2"), conferring resistance to licensed beta-lactams, macrolides, tetracycline and aminoglycosides. HMC3 also had alterations in GyrA and GrlB

2003 Journal of Antimicrobial Chemotherapy

136456. Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysis. Full Text available with Trip Pro

Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysis. To evaluate an intervention to reduce inappropriate use of key antibiotics with interrupted time series analysis.The intervention is a policy for appropriate use of Alert Antibiotics (carbapenems, glycopeptides, amphotericin, ciprofloxacin, linezolid, piperacillin-tazobactam and third-generation cephalosporins) implemented through concurrent, patient-specific (...) feedback by clinical pharmacists. Statistical significance and effect size were calculated by segmented regression analysis of interrupted time series of drug use and cost for 2 years before and after the intervention started.Use of Alert Antibiotics increased before the intervention started but decreased steadily for 2 years thereafter. The changes in slope of the time series were 0.27 defined daily doses/100 bed-days per month (95% CI 0.19-0.34) and pound 1908 per month (95% CI pound 1238- pound 2578

2003 Journal of Antimicrobial Chemotherapy

136457. Modelling of escalating outpatient antibiotic expenditures. Full Text available with Trip Pro

Modelling of escalating outpatient antibiotic expenditures. To model the relative role of old and newly introduced antibiotics in shaping increased antibiotic use.Grouped data covering nationwide consumption and expenditure for out-of-hospital antibiotics in Greece (1990-1999) were used. The antibiotic formulations were categorized into 'common old formulations', 'old formulations with intermittent sales', 'recast formulations' and 'new substances'. The effect of each category was investigated (...) based on index and pricing analyses.We estimated a 143% net increase in out-of-hospital antibiotic use during 1990-1999. The increase was 59% when all formulations of antibiotic substances available by 1990 were considered. A rapid turnaround of formulations of old substances was noticed with 669 formulations marketed during the decade. Sixteen new antibiotic substances were first introduced after 1990 and by 1999 they accounted for 34.9% of total out-of-hospital antibiotic expenditures. Three new

2003 Journal of Antimicrobial Chemotherapy

136458. Enhancement of antibacterial and lipopolysaccharide binding activities of a human lactoferrin peptide fragment by the addition of acyl chain. Full Text available with Trip Pro

Enhancement of antibacterial and lipopolysaccharide binding activities of a human lactoferrin peptide fragment by the addition of acyl chain. Cationic antibacterial peptides are potentially therapeutic in the treatment of sepsis, because of their amalgamated antibacterial and lipopolysaccharide-binding activities. We prepared acyl analogues of the peptide fragment of human lactoferrin, which originally had weak antibacterial activity. It was found that 12 carbon units constitute the optimal (...) acyl chain length, enhancing the antibacterial activity and binding of lipopolysaccharide by up to two orders of magnitude. Lactoferrin-based lipopeptides approached the activity of polymyxin B, a lipopeptide of natural origin, but were also active against Gram-positive bacteria.

2003 Journal of Antimicrobial Chemotherapy

136459. Linezolid in vitro: mechanism and antibacterial spectrum. Full Text available with Trip Pro

Linezolid in vitro: mechanism and antibacterial spectrum. Oxazolidinones are prominent among the new Gram-positive antimicrobial agents now becoming available. They were discovered by DuPont Pharmaceuticals in the late 1980s but linezolid, the first analogue suitable for development, was found only when the family was re-examined by Pharmacia in the 1990s. Oxazolidinones bind to the 50S subunit of the prokaryotic ribosome, preventing formation of the initiation complex for protein synthesis (...) antibiotics, including methicillin-resistant staphylococci and vancomycin-resistant enterococci. MICs are 4-8 mg/L for Moraxella, Pasteurella and Bacteroides spp. but other Gram-negative bacteria are resistant as a result of endogenous efflux activity. Resistance is difficult to select in vitro but has been reported during therapy in a few enterococcal infections and in two MRSA cases to date; the mechanism entails mutation of the 23S rRNA that forms the binding site for linezolid. Risk factors

2003 Journal of Antimicrobial Chemotherapy

136460. Multiple antibiotic-resistance mechanisms including a novel combination of extended-spectrum beta-lactamases in a Klebsiella pneumoniae clinical strain isolated in Argentina. Full Text available with Trip Pro

Multiple antibiotic-resistance mechanisms including a novel combination of extended-spectrum beta-lactamases in a Klebsiella pneumoniae clinical strain isolated in Argentina. Klebsiella pneumoniae M1803, isolated from a paediatric patient with chronic urinary infection, presented nine antimicrobial resistance mechanisms harboured on two conjugative megaplasmids, in addition to the chromosomally mediated SHV-1 beta-lactamase. These nine antimicrobial resistance mechanisms comprised two extended

2003 Journal of Antimicrobial Chemotherapy

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