Ampicillin–Sulbactam
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 in Kucers’ The Use of Antibiotics, 2017
In a randomized double-blind trial, the clinical and bacteriologic efficacy of AMP/S (2 g/1 g) and cefoxitin (2 g) administered i.v. every 6 hours were compared in patients with or without histories of injecting drug abuse who presented with cutaneous or other soft-tissue infections. AMP/S and cefoxitin were equally effective for the empirical treatment of cutaneous or other soft-tissue infections in injection drug users and patients who did not inject drugs (Talan et al., 2000). Cure or improvement occurred in 89.8% of AMP/S-treated patients, compared with 93.6% of cefoxitin-treated patients. The median time to resolution of all symptoms was 10.5 days with AMP/S treatment and 15.5 days with cefoxitin treatment. Mixed aerobic–anaerobic infection was encountered frequently in both groups. Patients with a history of injection drug abuse had a significantly higher percentage of Streptococcus strains than patients without a history of drug abuse (37% vs. 19%, respectively). Bacterial eradication was achieved in 100% of patients receiving AMP/S, whereas the eradication rate with cefoxitin was 97.9%.
Chylothorax and other pleural effusions in neonates
Prem Puri in Newborn Surgery, 2017
Owing primarily to improved antibiotic treatment of chest infections, empyema (purulent effusion) has become a rare condition in infants. The most common cause of empyema is a pneumonia caused by organisms such as Staphylococcus aureus, Staphylococcus pneumoniae, and Staphylococcus pyogenes. It may, however, be incurred through the introduction of skin bacteria during thoracentesis or thoracotomy. Empyema may also be accompanied by anaerobic infection. Symptoms include indications of respiratory distress in addition to abdominal distension, lethargy, and at times, a septicemic state. Diagnosis is suspected by chest radiographs in which the effusion and pneumonic process are identified. Ultrasonography during diagnostic thoracentesis if helpful in specifically localizing loculated fluid collection. Prior to beginning a course of antibiotic therapy, a fluid specimen taken during thoracentesis is sent for a Gram stain and aerobic and anaerobic culture. Although most cases resolve with effective intercostal tube drainage, fibrinolysis, and a prolonged period of systemic administration of antibiotics, anaerobic infection tends to be multilocular and may thus require debridement and, in rare instances, decortication.
Bacteroides
Dongyou Liu in Laboratory Models for Foodborne Infections, 2017
Species of Bacteroides are considered resident members in intestinal microbiota, and they are mostly recovered in intra- and extra-abdominal infections. Most anaerobic infections originate from the host’s resident microbiota and are considered infections of an endogenous nature. Conditions such as low blood supply into an affected site can predispose the host to anaerobic infection, as well as trauma, foreign body, malignancy, surgery, edema, shock, colitis, and vascular disease. Mixed infections with aerobic or facultative organisms make the local tissue conditions favorable for the growth of anaerobic bacteria. Anaerobic bacteria are the most common residents of the skin and mucous membrane surfaces and natural cavities’ microbiota. Anaerobes belonging to the resident microbiota of the oral cavity can be recovered from various infections adjacent to that area, such as cervical lymphadenitis, subcutaneous abscesses, and burns in proximity to the oral cavity, human and animal bites, tonsillar and retropharyngeal abscesses, chronic sinusitis, chronic otitis media, and periodontal abscess. Species of anaerobic Gram-negative rods including pigmented Prevotella, Porphyromonas, B. fragilis group, Fusobacterium, and Gram-positive anaerobic cocci are associated with several infections, such as peritonitis, liver abscess, intra-abdominal abscesses, neonatal infections, and recently to colorectal cancer.17,18 In addition, quantitative real-time PCR has provided a convenient, dependable, and rapid method to study the diversity of the presence of the bft subtypes and the significance of ETBF in clinical infections.12
Albucasis (936–1013), a pioneer in tonsillectomy
Published in Acta Chirurgica Belgica, 2022
Narges Tajik, Maryam Mohseni Seifabadi, Nasrin Musakazemi, Arman Zargaran
The lymphatic tissue of the pharynx is called the Waldeyer's tonsillar ring and consists of four parts: the two tonsils of the palate, the tonsils of the lingual tonsil, the adenoids (the third tonsil), and the pharyngeal bands [8]. It is quite susceptible to anaerobic infection, which is addressed in the first stage of pharmaceutical treatment. In cases that progress and show a non-response to treatment, the patient may need tonsillectomy surgery [9]. Although tonsillectomy seems to be a modern medical achievement, the history of this concept dates to antiquity. This article compares Albucasis's tonsillectomy with that of earlier and later surgeons to show the differences in both surgical methods and tools so as to help clarify the development of techniques for this surgery during the medieval era.
Pleural infection: a closer look at the etiopathogenesis, microbiology and role of antibiotics
Published in Expert Review of Respiratory Medicine, 2019
Eihab O. Bedawi, Maged Hassan, David McCracken, Najib M. Rahman
Various studies found that the causative organism and the setting of infection affect the outcome of pleural infection. In a study examining the bacteriology of 164 culture-positive pleural infections, isolates from the Streptococcus genus were the most common, but when specifically looking at patients who required ICU admission, the most common isolate was Klebsiella pneumoniae [42]. In another study involving patients with CA pleural infections, non-Strep. milleri pleural sepsis was associated with longer durations of hospitalization [55]. Analysis of the bacteriology of patients from the MIST1 trial [1] revealed that one-year mortality was significantly worse for patients with infections caused by Staph. aureus or mixed aerobic infection as opposed to infections caused by Strep. milleri or mixed anaerobic infection. The same study correlated the source of infection with effect on patient outcomes and found that mortality was higher with HA infection (commonly caused by the earlier groups of organisms) in comparison to CA infections (typically caused by the latter group) [1]. Another study also found that HA infection was a risk factor for worse 30-day mortality in patients with pleural infection [43]. Moreover, in patients referred for decortication, pleural fluid culture positivity was associated with longer duration of hospital stay [56]. This is likely to be supported by the recent finding that PAI-1 levels are higher in pleural effusions from gram-positive bacteria, compared to gram-negative and uncomplicated culture negative parapneumonic effusions [46].
Antimicrobial resistance in enteric bacteria: current state and next-generation solutions
Published in Gut Microbes, 2020
M. J. Wallace, S. R. S. Fishbein, G. Dantas
The Bacteroides and Parabacteroides species within the BFG group include some of the most well-characterized commensal GI species, but are also the most commonly isolated organisms in anaerobic extraintestinal infections and increasingly reported to harbor AMR.36 Although the most ubiquitous resistance elements in BFG confer resistance to classes such as tetracyclines and macrolides, resistance to clinically useful agents such as β-lactams, carbapenems, and metronidazole is emerging in the United States and Europe.35,71 Resistance to all three treatment options can be achieved through “activation” of otherwise silent ARGs by insertion sequences.35 Conjugative transposons, most notably CTnDOT, have been well described among BFG species and commonly confer resistance elements against tetracyclines and erythromycin (Table 1).36 Clindamycin resistance has also steadily risen among BFG and is associated with acquisition of erythromycin resistance methylase (erm) genes that originate in gram-positive species.36 AMR only further exacerbates the morbidity and mortality rates associated with anaerobic infection, and further research into resistance mechanisms and prevention measures are desperately needed. Notably, susceptibility testing of anaerobes is not routinely performed in the clinic despite these emerging issues. Future efforts to tailor antibiotic stewardship should include emphasis on novel diagnostics for resistance in BFG and other anaerobes.49
Related Knowledge Centers
- Anaerobic Organism
- Bacteroides
- Clostridium
- Endospore
- Fusobacterium
- Obligate Anaerobe
- Peptostreptococcus
- Porphyromonas
- Prevotella
- Facultative Anaerobic Organism