Ceftizoxime, Cefdinir, Cefditoren, Cefpodoxime, Ceftibuten, Cefsulodin, and Cefpiramide
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 clinical trials side effects of ceftizoxime have been mild and infrequent and are similar to those of most other cephalosporins. These include hypersensitivity rashes, eosinophilia, drug fever, and transient elevations of hepatic transaminases and serum alkaline phosphatase. Elevated platelet counts (thrombocytosis) occur not infrequently during ceftizoxime therapy. These are not associated with symptoms, and counts revert to normal after the drug is stopped. Reversible thrombocytopenia and neutropenia are less frequent. Some patients develop a positive Coombs test. Diarrhea, nausea, and vomiting are infrequent. Clostridium difficile–associated diarrhea has been reported. Transient elevations of blood urea and serum creatinine levels occur in some patients, but serious nephrotoxicity has not been encountered (Counts et al., 1982; Parks et al., 1982).
Febrile Neutropenia in the Critical Care Unit
Cheston B. Cunha, Burke A. Cunha in Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Microbiological documentation is an issue of great importance in order to adapt antibiotherapy and limit resistance emergence. In total, 10%–55% of patients have microbiologically documented infections, with bacteremia only documented in 10%–20% [1,53]. At least two sets of blood cultures should be drawn, with collection from each lumen of the central venous catheter and from a peripheral vein site. In patients without central venous catheter, two sets of blood cultures should be sent from two separate peripheral puncture sites. Colonization by antibiotic resistant bacteria has to be sought, especially for patients with hematological malignancies who received prior broad-spectrum antibacterial therapy. Other specimens should be driven by clinical signs, such as detection of Clostridium difficile toxins in case of diarrheas and urine sample for bacterial culture. Febrile patients with prolonged neutropenia need a special attention, as they are prone to develop invasive fungal infections, viral reactivation such as cytomegalovirus, adenovirus, and human herpes virus 6 infections.
Unexplained Fever in the Pediatric Age Group
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
During the last 50 years, marked changes in nursery pathogens have been noted. At present, significant differences can be found among various continents, countries, cities, and hospitals. Nevertheless, general trends can be recognized. In the U.S. and some Western European countries, group B streptococci (GBS) may account for as many as 1/3 of all cases of neonatal sepsis, being the most common bacterial agent causing bacteremia and/or meningitis in prematures and infants younger than 6 weeks of age.12 In a recent study from Israel, Weintraub et al. have shown a much lower maternal colonization and even rarer neonatal colonization with GBS than in other countries. The reasons for these differences are poorly understood.13 Other pathogens have been isolated from the blood or cerebrospinal fluid (CSF) of newborn and premature infants including E. coli, Group D Streptococci, Staphylococcus aureus, the Klebsiella-Enterobacter group, Listeria monocytogenes, and Pseudomonas aeruginosa. The group of bacteria usually found in infants and children beyond the neonatal period which can be occasionally isolated in sick newborns comprises Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitidis, Salmonella typhi-murium, and Shigella species. The role of anaerobes has not been fully clarified. High mortality and substantial morbidity have been associated with infections caused by Bacter-oides and Clostridium species.10
The antibiotic susceptibility pattern of gas gangrene-forming Clostridium spp. clinical isolates from South-Eastern Hungary
Published in Infectious Diseases, 2020
Károly Péter Sárvári, Dzsenifer Schoblocher
A total of 372 clinically relevant gas gangrene-forming Clostridium isolates (313 C. perfringens, 20 C. septicum, 10 C. sordellii, 10 C. sporogenes, 9 C. tertium, 6 C. bifermentans, 4 C. histolyticum) were cultured during the 10-year period. Patients had an average age of 65.0 years (0.2–93 years) and 51.6% were female, 48.4% were male. The number of isolates per year displayed an increasing trend from 2008 to 2017 (r = 0.771) (Figure 1). Isolates emanated from patients treated in surgery (37.1%), internal medicine (24.7%), the emergency department (8.9%), various intensive care units (ICUs) (6.5%), and from patients treated in other departments (Table 1). Bacteria were isolated either as a single pathogen in pure culture (21.5%) or in mixed culture (78.5%). Besides blood (14.8%), the most common sample types were wound (20.7%), bile (20.2%), abscess (14.8%), surgical samples (15.0%) and intraabdominal fluid (6.7%) (Table 2). Six clinical samples (four from wounds and two from bile) yielded C. perfringens together with a non-perfringens Clostridium spp. (Table 3). The Clostridium spp. isolates were two C. sporogenes, two C. bifermentans, and two C. sordellii. There was no relation between the patients and no suspicion of an outbreak in the different wards or units. Forty-three C. perfingens, and 12 non-perfringens Clostridia (five C. septicum, three C. sordellii, two C. tertium, one C. bifermentans and one C. sporogenes) were isolated from blood cultures.
Risks associated with lung transplantation in cystic fibrosis patients
Published in Expert Review of Respiratory Medicine, 2018
Susan S. Li, Dmitry Tumin, Katie A. Krone, Debra Boyer, Stephen E. Kirkby, Heidi M. Mansour, Don Hayes
Clostridium difficile colitis presents with diarrhea, abdominal pain, and fever. Fulminant infection and relapse are seen at higher rates in immunocompromised hosts. Up to 50% of patients with CF may be carriers of C. difficile [79], and the incidence of C. difficile colitis is particularly high in CF LTx recipients – close to twice that of the overall LTx recipient population. In a single center study of adults, there were 24.2 compared to 9.5 episodes per 100,000 patient-days in transplanted CF versus non-CF patients [80]. In a single center study of 78 pediatric LTx recipients, there were 6 episodes of C. difficile colitis, 4 of which were in patients with CF, providing an incidence of 8.9% in CF LTx compared to 5.4% in non-CF LTx [81]. The mechanism for this discrepancy is multifactorial. A recent single center study of pre-LTx CF adults found the C. difficile strains carried to be hypervirulent and toxigenic [79]. Furthermore, the use of aggressive antimicrobial therapy for both treatment and prophylaxis of respiratory infections following LTx can precipitate C. difficile colitis. Within the first year after LTx, the risk of developing C. difficile colitis increases 2–3 times in the CF population, resulting in severe and life-threatening disease [80,82]. A case series describes mortality from severe C. difficile colitis as up to 50% despite urgent colectomy [83]. It remains to be seen whether eradication of C. difficile while awaiting LTx could decrease the rate of colitis following LTx.
Clostridium perfringens: a rare cause of spondylodiscitis case report and review of the literature
Published in British Journal of Neurosurgery, 2018
M. Seller, R.D. Burghardt, T. Rolling, N. Hansen-Algenstaedt, C. Schaefer
Clostridia are ubiquitous gram-positive anaerobic spore-forming rods found in human and animal gastrointestinal tracts and female genital tracts, as well as in water and soil. Clostridium perfringens is most commonly known as a cause of traumatic gas gangrene. But Clostridium species have also been shown to be an unusual cause of tissue infection and bacteremia. The most common source of infection appears to be the gastrointestinal tract – due to diverticulosis or other gastrointestinal pathologies.1 Furthermore, Clostridium bacteremia occur mainly in patients with multiple comorbidities, most commonly with diabetes or underlying malignancy.1 The prognosis of clostridial bacteremia is mainly determined by the severity of these underlying comorbidities.1 Up to now, no case of involvement of the vertebral body in a Clostridium perfringens infection has been described. Regarding the literature only six cases of a spondylodiscitis caused by Clostridium perfringens have been published.2 Two of them developed in course of a spinal surgical intervention. One case came along with a sever gastrointestinal infection with development of a paralytic ileus. In three cases the portal of entry was unknown only in one of these cases the patient suffered from a concomitant chronic hepatitis treated with 60 mg of Prednisolon.2,3 Despite the iatrogenic cases the remaining four2,3 were successfully treated by antimicrobial therapy alone, mostly with penicillin or a β-lactam-antibiotic for between 3 to 12 weeks.
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