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Imipenem–Cilastatin and Imipenem–Relebactam
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Yoshiro Hayashi, David L. Paterson
Burkholderia cepacia and Stenotrophomonas maltophilia are resistant to imipenem (Sader and Jones, 2005; Kresken et al., 2008; Livermore et al., 2008; Xiao et al., 2008). The reason S. maltophilia is consistently resistant is that it produces a chromosomally encoded class B metallo-beta-lactamase (L1a, L1-BlaS, L1c, L1d, and L1e) (Walsh et al., 2005; Nico-demo and Paez, 2007). Chryseobacterium indologenes and Elizabethkingia meningoseptica are generally resistant to imipenem because of their production of chromosomally encoded class B metallo-beta-lactamases (Gales et al., 2005; Chen et al., 2006; Lee et al., 2006; Ceyhan et al., 2008; Lee et al., 2008; Lin et al., 2008).
Dilemma in identifying Chryseobacterium species
Published in Infectious Diseases, 2018
With reference to the recently published manuscript titled “Chryseobacterium bacteraemia: a single-centre case series” by Perez et al. [1], six isolates of Chryseobacterium indologenes along with one isolate of Elizabethkingia meningoseptica were reported as cause of bacteraemia in patients with severe underlying conditions. These isolates were identified using automated methods and also using MALDI-TOF mass spectrometry (Bruker Daltonics, Bremen, Germany) since 2014. Accurate identification holds the key for such unusual organisms for their appropriate management strategies. We, hereby, would like to highlight that even though MALDI-TOF mass spectrometry is a valuable tool for diagnosis and identification of unusual pathogens, discrepancies in correct identification of Chryseobacterium and Elizabethkingia species have been cited in recent documented studies [2–5].
Intraventricular administration of tigecycline for the treatment of multidrug-resistant bacterial meningitis after craniotomy: a case report
Published in Journal of Chemotherapy, 2018
Yuanxing Wu, Kai Chen, Jingwei Zhao, Qiang Wang, Jianxin Zhou
There are few studies regarding the use of tigecycline to treat nosocomial bacterial meningitis, and its efficacy also remains unclear. Although there have been some reports of successful treatments of patients with MDR bacterial meningitis using parenteral tigecycline,9–13 there have also been reports of the failures of tigecycline for treating MDR bacterial meningitis.5,14 Because of the low concentration of tigecycline in CSF and the modest CSF penetration of tigecycline, a case study reported that a patient with Elizabethkingia meningoseptica was treated with an intrathecal injection of tigecycline in combination with an injection of piperacillin/tazobactam, vancomycin and cotrimoxazole tablets. After 21 days, the patient improved clinically, and the CSF cultures became sterile15; however, the case report did not test the serum and CSF concentration of tigecycline.
Chryseobacterium bacteraemia: a single-centre case series
Published in Infectious Diseases, 2018
Justo Sandino Pérez, Ana Maria Mancilla, Edgar Pérez Barragán, Mario Fernández-Ruiz
We identified six patients with C. indologenes bacteraemia and one additional patient with Chryseobacterium meningosepticum (also termed Elizabethkingia meningoseptica) bacteraemia (Table 1). The incidence rates for Chryseobacterium bacteraemia over the study period were 0.016 and 0.021 cases per 1000 hospital admissions and per 10,000 hospital patient-days, respectively. Median age at presentation was 68.8 years (range: 40–84). Three patients had been diagnosed with solid organ or haematological malignancy and two of them had prolonged hospital admissions. Five cases were hospital-acquired, with a median length of hospitalization of 9 d (range: 6–21). All patients had intravascular indwelling devices (i.e. central or peripheral venous catheter or permanent pacemaker) at infection onset. Four of them had received broad-spectrum antibiotics within the preceding month (median duration of therapy: 14 d). Other pathogens were concurrently identified in incident BCs in 4 cases (with Acinetobacter baumannii being the most commonly isolated agent). The predominant sources of bacteraemia were intra-abdominal foci and intravenous catheters (3 cases each). One patient did not receive antibiotic therapy due to the rapidly progressive course of his underlying malignancy. Definitive therapy in the remaining patients was based on carbapenems (3 cases), piperacillin-tazobactam, levofloxacin and tigecycline (one case each). The median duration of therapy was 11 d (interquartile range: 8–14.8). One patient had persistent bacteraemia after 5 d of therapy with tigecycline, although subsequent blood cultures became negative without treatment modification. The all-cause 30-d mortality rate was 28.6% (2/7), with one of the two observed deaths deemed to be attributable to infection (septic shock in the first 48 h from diagnosis of bacteraemia). Regarding the susceptibility profile of Chryseobacterium spp. isolates, minocycline showed the best in vitro activity (83.3% [5/6] of susceptible isolates), followed by piperacillin-tazobactam (66.6% [4/6] of isolates). Ciprofloxacin and levofloxacin remained active in 60.0% (3/5) and 57.1% (4/7) of isolates, respectively. Resistance to carbapenems was common (85.7% [6/7] for imipenem and 71.4% [5/7] meropenem), whereas all the tested isolates were resistant to amikacin (7/7) and colistin (4/4).