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Infections
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
In addition to the treatment of urinary tract infection, the newer quinolones are useful for systemic Gram-negative infections and may find a role in the treatment of chlamydial and rickettsial infections. They may also be useful in infections caused by other intracellular organisms such as L. pneumophila and S. typhi, and in combination with other agents for ‘atypical’ mycobacteria. They are active against staphylococci, but less so against streptococci. Enterococci are resistant. [30]. Ciprofloxacin, ofloxacin and moxifloxacin can all be administered orally.
Vancomycin-Resistant Enterococci
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Frequent and prolonged hospital admission increases the likelihood that patients become colonized with VRE. VRE are low-virulent organisms, so it is not unsurprising that patients with breaches in physiological barriers or compromised immunity are at increased risk of progression from colonization to infection: for example, VRE infections have been well documented in liver transplant recipients, haematopoietic stem cell transplant recipients and surgical patients. Factors that further promote infection are chemotherapy-induced mucositis, neutropenia, intravascular devices, surgery and broad-spectrum antibiotics that can reduce the colonization resistance of the gut flora (see Chapter 1.1). It is important to realize that these risk factors are general infection risk factors, not specific to enterococci, and patients more often develop infections caused by Gram-negative bacteria.
Lactic Acid Bacteria Application to Decrease Food Allergies
Published in Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani, Lactic Acid Bacteria, 2020
Vanessa Biscola, Marcela Albuquerque Cavalcanti de Albuquerque, Tatiana Pacheco Nunes, Antonio Diogo Silva Vieira, Bernadette Dora Gombossy de Melo Franco
The proteolytic activity of LAB enzymes against milk allergens is dependent on the strain used and on the process conditions. Different strains have been reported to produce enzymes capable of hydrolyzing milk antigens. Although Enterococcus spp. is frequently reported as one of the most proteolytic LAB found in dairy products, possessing a very efficient proteolytic system and a strong activity against both caseins and β-lactoglobulin, its application in foods for technological purposes is a controversial issue, since Enterococcus spp. are related to nosocomial infections and reported to harbor several virulence factors (Kim et al. 2016). LAB species belonging to other genera, such as Lactobacillus spp., Lactococcus spp. and Streptococcus spp. have also been reported to produce proteolytic enzymes with activity against milk allergens. The interest in their application in foods relies on their relevant role as fermentation starters and/or on their association with beneficial health effects, some being recognized as probiotics.
Increasing trend in enterococcal bacteraemia and vancomycin resistance in a tertiary care hospital in Croatia, 2017–2021
Published in Infectious Diseases, 2023
Zrinka Todorić, Ivana Majdandžić, Tea Keretić Kregar, Zoran Herljević, Mario Ćorić, Joško Lešin, Tomislav Kuliš, Ivana Mareković
As expected, most enterococcal bacteraemia, especially those caused by E. faecium, were healthcare-associated and found in patients hospitalised in the ICU. The spread of enterococci is health- care-associated due to transmission from health professionals and the contaminated environment around the patient. Another important factor is widespread resistance to antibiotics. Previous antibiotic use, especially vancomycin and cephalosporins, disrupts the normal gut microflora [2]. Healthcare-associated BSIs are more often caused by E. faecium than E. faecalis and E. faecium has previously been associated with BSI in more severely ill patients [3]. Recent studies show that Enterococcus spp. is one of the five most frequent nosocomial pathogens in Europe and accounts for 6.1% to 17.5% of all pathogens isolated from patients with HAI [11]. In contrast, Enterococcus spp. is less frequently found in patients with HAI in the US and China, 5% and 3.1% of all HAI pathogens, respectively [11,23,24]. Enterococci are important emerging pathogens in intensive care units where they are more frequently found in surgical patients, and in patients with long ICU stay, parenteral nutrition and prior use of broad-spectrum antimicrobial agents. Various artificial devices and machines, plastic materials and invasive methods are used, which, in addition to the above factors, facilitate the spread of bacteria [7].
Enterococcus hirae infections in the clinical practice
Published in Infectious Diseases, 2023
Daniele Piccinini, Enos Bernasconi, Caroline Di Benedetto, Gladys Martinetti Lucchini, Marco Bongiovanni
Recently in this journal the incidence and risk factors for development of enterococcal bloodstream infection was evaluated on a population basis. The disease occurred predominantly in older adults with co-morbidity, and cancer in particular [1]. As compared with Enterococcus faecalis, patients with E. faecium were more likely to be of hospital-onset and more likely to have an intra-absominant/pelvic focus. We here add information on E. hirus, a third enterococcal species which is only rarely reported in human infection. Enterococcus hirae, which was first identified in 1985 [2], is a well-documented cause of infections in animals (e.g. diarrhoea in rats, endocarditis in chickens, mastitis in cattle, cholangitis and pancreatitis in cats, septicaemia in birds), but human infections are relatively rare, ranging from 0.4% to 3.03% of all enterococcal infections according to the latest studies [3]. In particular, pyelonephritis, infective endocarditis and biliary tract infections due to E. hirae have been reported in the past [4–9]; although E. hirae has been found to cause severe diseases in humans, few cases have been reported to date due to the difficult in identifying the bacteria, and the lack of comprehensive reports on clinical characteristics and treatments [10].
Burden and mortality of sepsis and septic shock at a high-volume, single-center in Vietnam: a retrospective study
Published in Hospital Practice, 2022
Truong Hong Hieu, Pham Thi Ngoc Thao, Federica Cucè, Nguyen Hai Nam, Abdullah Reda, Osman Gamal Hassan, Le Thanh Hung, Dinh Thi Kim Quyen, Jeza M Abdul Aziz, Loc Le Quang, Alison Marie Carameros, Nguyen Tien Huy
Gram-negative bacteria (59.5%) were dominant in this study, while other studies reported an alternating higher prevalence of either gram-negative or positive bacteria [41–43]. Among gram-positive bacteria, up to 85.7% of Staphylococcus aureus were resistant to oxacillin, but the same bacteria were highly sensitive to vancomycin, teicoplanin, and linezolid. As for Enterococcus spp. and coagulase-negative Staphylococci, the rate of resistance to oxacillin was 100%, and for Enterococcus spp. high rates of resistance to vancomycin (42.8%), teicoplanin (42.8%), and linezolid (28.5%) were reported. Enterococci and especially the coagulase-negative Staphylococci are common in hospital infections [44,45]. However, the sample size in our study is modest, and thus the results of reported cases can have a limited impact. Moreover, only 42.7% of patients with staphylococcal infections were resistant to ciprofloxacin.Even though it could be an effective for many patients, it should not be the first treatment of choice, due to the increased risk of antibiotic resistance and the associated increase in isolation MRSA compared to MSSA [46,47].