Beta-Lactamase Inhibitors
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
The antibacterial activity of ampicillin–sulbactam is much broader, including penicillinase- and non-penicillinase-producing staphylococci and streptococci and Gram-negative pathogens, such as beta-lactamase- and non-beta-lactamase-producing Enterobacteriaceae, Neisseria gonorrhoeae, M. catarrhalis, Haemophilus influenzae. Proteus mirabilis is more likely to be susceptible compared to P. vulgaris. S. marcescens, M. morganii, Enterobacter cloacae, Enterobacter aerogenes, Providencia rettgeri, P. stuartii, and Citrobacter freundii are frequently resistant. P. aeruginosa and S. maltophilia are resistant to ampicillin–sulbactam. The drug combination has activity against several anaerobes such as anaerobic streptococci, clostridia, and Bacteroides spp.
DRCOG MCQs for Circuit B Questions
Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Asymptomatic bacteriuria in pregnancy may be associated with:Escherichia coli infection.> 100,000 bacteria ml-1 urine.30% risk of acute pyelonephritis in pregnancy.Preterm labour.Proteus mirabilis infection.
Interpreting Routine Microbiology Results for Patient Care
Nancy Khardori in Bench to Bedside, 2018
A 72-year-old-woman is sent in from dialysis after she developed hypotension, chills and fever during her dialysis session. Due to the presence of her dialysis catheter, blood cultures are sent and she is started on Vancomycin to cover gram positive skin flora. Twelve hours later, blood culture gram stain shows a gram negative rod and Piperacillin-tazobactam is added to her regimen. Forty-eight hours later the bacteria is identified as Proteus mirabilis susceptible to multiple antibiotics. The positive gram stain allowed the clinician to add an appropriate antibiotic 48 hours before culture results were available.
In vitro activity of hyperthermia on swarming motility and antimicrobial susceptibility profiles of Proteus mirabilis isolates
Published in International Journal of Hyperthermia, 2021
Deniz Gazel, Hadiye Demirbakan, Mehmet Erinmez
Proteus mirabilis is a Gram-negative rod-shaped bacterium from the order of Enterobacterales. It is well-known for its urease production and distinctive ability to differentiate into elongated swarming cells, and its characteristic bull’s-eye/circular pattern of swarming motility on agar plates [12,13]. Swarming cells of P. mirabilis migrate rapidly and in a coordinated manner away from the colony as multicellular rafts until they pause in the consolidation stage and undergo some de-differentiation [14,15]. Regular cycles of migration and consolidation generate a colony on the agar surface with a characteristic circular swarming pattern [14,15]. P. mirabilis swarming involves the coordinate differentiation of short, motile, vegetative cells with a few peri-trichous flagella into multi-nucleate, hyper-flagellated swarm cells of up to 40 times the vegetative cell length and with much more surface density of flagella. The ability of P. mirabilis to express virulence factors, including urease and hemolysin, and to invade human urothelial cells, is reported to be coordinately regulated with swarming differentiation [15–17].
Ecthyma gangrenosum associated with Proteus bacteremia
Published in Baylor University Medical Center Proceedings, 2018
Andrew Hawrylak, Susan Seago, Edana Stroberg, Richmond Hunt, Megan Greene Newman
The patient was admitted and antibiotic therapy was initiated with meropenem and linezolid. Initial urine and blood cultures grew Proteus mirabilis. Dermatology was consulted for further evaluation of her necrotic skin ulcers and a punch biopsy illustrated acute inflammation and necrosis with Gram-negative bacterial organisms (Figure 2). Body tissue cultures from the ulcer sites grew both Proteus mirabilis and Enterococcus faecalis, and pathology was consistent with a diagnosis of ecthyma gangrenosum. A transesophageal echocardiogram illustrated no focal vegetation. Two weeks of intravenous meropenem were given as definitive therapy. Urology was consulted for possible percutaneous nephrolithotomy; however, she was again deemed a poor operative candidate. Sepsis recurred without additional ulcerations, and the patient was ultimately transitioned to palliative care.
An overview of cilastatin + imipenem + relebactam as a therapeutic option for hospital-acquired and ventilator-associated bacterial pneumonia: evidence to date
Published in Expert Opinion on Pharmacotherapy, 2021
Júlia Sellarès-Nadal, Simeón Eremiev, Joaquin Burgos, Benito Almirante
Specifically, isolates of Klebsiella pneumoniae, E. coli, Enterobacter spp. and Citrobacter spp. exhibit susceptibilities over 95% with imipenem-relebactam. In general, Proteus mirabilis and S. marcescens demonstrate lower susceptibility: 87% and 66% of isolates, respectively. CRE presents variable susceptibility rates. Based on different studies, IMI/REL exhibits activity against 100% of isolates of KPC-producing K. pneumoniae [31,39,40]. IMI/REL improves the activity of imipenem for Ambler class A ESBL-producing (2- to 16-fold MIC reduction) and KPC carbapenemase- producing (32- to 128-fold MIC reduction) Enterobacterales [38]. In contrast, the combination does not present activity against the Ambler class D carbapenemase OXA-48 [39–41] or against class B metallo-β-lactamases, such as VIM, IMP, and NDM [42,43].
Related Knowledge Centers
- Alkali
- Anaerobic Organism
- Bacteria
- Macconkey Agar
- Urease
- Urinary Tract Infection
- Urine
- Gram-Negative Bacteria
- Swarming Motility
- Lactose