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The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
In another development, there has been a resurgence of interest in chemosensitivity testing in which tumor cells from biopsies from cancer patients are grown in vitro and exposed to a panel of approved anticancer agents to identify those with the best cytotoxicity which can then be selected for administration. This approach is analogous to antibiotic sensitivity testing which is routinely carried out on patient body fluids and tissue samples in hospitals throughout the world. The advantages and disadvantages of this personalized approach are discussed in Section 11.6.9.
Peritonitis (General Considerations)
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Donald E. Fry, Susan Galandiuk
Despite appropriate source control of the primary event resulting in peritonitis, and despite appropriate support care and antibiotic treatment, patients will develop abscess in the abdominal cavity. Abdominal abscess may be the result of a large inoculum of bacteria that has overwhelmed the innate inflammatory response of the host. Antibiotic sensitivity of microorganisms is inoculum-dependent,77 and densities of bacteria that exceed 106 organisms/mL may not be influenced by the best antibiotic choices. The inoculum effect also explains why abscesses will have pathogens that are actually sensitive to the antibiotic therapy that the patient has received. Local conditions in the abdomen with residual clot, pooled serosanguinous drainage or retained necrotic tissue will result in abscess. Abscess in the abdomen may be the result of failure of a suture line. Abscess may be the result of microbial access to the abdomen from drains placed at the original operation. Regardless of cause, intra-abdominal abscesses need to be drained.
Microbiological diagnosis: The human endometrial microbiome—Endometritis
Published in Carlos Simón, Linda C. Giudice, The Endometrial Factor, 2017
Inmaculada Moreno, Carlos Simón
The prevalence of CE in patients with RIF has been estimated to be between 30.3% and 66% (85,91). In patients with unexplained RM, CE has been diagnosed in 12.9% of cases by immunohistochemistry (96), but this proportion reaches 60% when diagnosed by hysteroscopy, although one-third of them were negative by microbial culture (97). Antibiotic treatment administered to CE patients, even when they were negative for microbiological culture, resulted in improved reproductive outcomes in terms of pregnancy rates and live birth rates in RIF and RM patients. This positive effect was stronger when antibiotic therapy was based on specific antibiotic sensitivity (antibiogram) than in patients subjected to broad-spectrum antibiotics (85,97).
Ex vivo evaluation of antibiotic sensitivity in samples from endodontic infections
Published in Journal of Oral Microbiology, 2023
Álvaro Villanueva-Castellote, Carmen Llena Puy, Miguel Carda-Diéguez, Álex Mira, María D. Ferrer
Under the tested conditions of temperature and culture medium, there is little difference in the values of inhibition and stimulation of biofilm formation by the tested antibiotics between 4 and 8 hours of monitoring. This means that at 4 hours, preliminary values available are very similar to those that will be obtained at 8 hours. Therefore, the RTCA impedance system is proposed as a rapid in vitro model for antibiotic sensitivity testing. It is worth noting that antibiotic sensitivity tests routinely used in the hospital setting, such as microdilution tests or E-tests performed on pure cultures, take at least 24 h to produce a result; in addition, genetic antibiotic sensitivity tests performed on periodontal samples also require at least 24 h for diagnosis [50]. On the other hand, the system presented here requires fresh samples to be cultured within 24 h for optimal results. This could present logistical problems, which could be partially solved by using means of transport for anaerobic organisms [51].
Risk Factors for Development of Endophthalmitis after Open Globe Injury in Children: A Case-Control Study
Published in Ocular Immunology and Inflammation, 2022
Pradhnya Sen, Gaurav Mohan Kohli, Chintan Shah, Amit Mohan, Amrita Tiwari, Rashmi Ingale, Pratik Shenoy, Alok Sen
Following wound closure, eyes presenting with endophthalmitis underwent vitreous biopsy and intravitreal vancomycin 1 mg/0.1 ml and ceftazidime 2.25 mg/0.1 ml. An undiluted volume (0.4 ml) of cut vitreous was manually aspirated using a 1 ml plastic syringe attached to a 25 gauge vitrector probe, set at a cut-rate of 5000 cuts per minute. Of the obtained vitreous sample, 0.2 ml was used for direct microscopy evaluation using Gram stain and 10% potassium hydroxide (KOH) stain. The remaining 0.2 ml was plated on the nutrient agar plates using a sterile swab in the operating room itself. The collected sample was transferred to the in-house lab for processing. The nutrient agar plates (sheep blood agar and chocolate agar) were incubated at 37 degrees Celsius in a biological oxygen demand incubator (SI-440, YORCO®, York scientific industries, India) for seven days while the Sabouraud dextrose agar plate was incubated at 25–27 degrees Celsius for 14 days. On obtaining growth, Gram and KOH analysis of the microbial colony was performed and VITEK −2 ® (BioMerieux,© North Carolina, USA) was used for microbe identification. The antibiotic sensitivity analysis was carried out using the Kirby-Bauer disc diffusion method.
The war against bacteria, from the past to present and beyond
Published in Expert Review of Anti-infective Therapy, 2022
Lucrezia Bottalico, Ioannis Alexandros Charitos, Maria Assunta Potenza, Monica Montagnani, Luigi Santacroce
Antibiotic sensitivity tests are performed in vitro, measure the response (growth) of an isolated microorganism to one or more antibiotics, and must be carried out under standardized conditions (the technical implementation must meet perfectly standardized criteria periodically updated by various National Committees, CLSI, etc.) to guarantee the reproducibility of the results. Cumulative data from individual antibiotic susceptibility tests are used to create an antibiogram, whose aim is to predict appropriate empiric antimicrobial therapy prior to the availability of specific information on the patient’s isolates and help the choice of the antibiotic together with clinical information and professional experience [212].