No abstract available.
Ceftazidime ; Endophthalmitis ; Humans ; Intravitreal Injections ; Vancomycin

In 44 out of 218 cases of contact lens related infectious keratitis from 19 hospitals throughout the country, contact lenses or contact lens storge cases were cultured. Microorganism was detected in 40 cases[90.9%]. Two or more organisms were isolated in 31 cases[77.5%]. Pseudomonas was the most common organism isolated from contact lens or contact lens storage medium[31 out of 84, 45.2%], followed by Serratia[15 out of 84, 17.9%], fungi [4], and acanthamoeba[4]. Acanthamoeba was found only in one hospital. Antibiotic sensitivity test for isolated pseudomonas showed that 96%of cases was sensitive to ciprofloxacin and 88%to ceftazidime.
Acanthamoeba ; Ceftazidime ; Ciprofloxacin ; Contact Lenses ; Fungi ; Keratitis* ; Pseudomonas

PURPOSE: We encountered two patients who developed Bacillus cereus endophthalmitis following trauma and eventually underwent enucleation, after aggressive antibiotic therapy. METHODS: When removing the intraocular foreign bodies, vancomycin and ceftazidime were injected intravitreally. The patients received postoperative topical fortified antibiotics hourly and underwent intravenous antibiotic therapy. RESULTS: After the operation, rapid corneal melting progressed to impending perforation in one patient's eye and enucleation was done on postoperative day 11. The eye of another patient progressed to phthisis bulbi and the patient underwent enucleation on postoperative day 45. CONCLUSIONS: Bacillus cereus is one of the most aggressive and devastating organisms that causes post-traumatic endophthalmitis and results in poor visual outcome. It is thought to be better to prevent the loss of anatomic integrity and visual function than to perform early intravitreal injection of antibiotics when the operation might be delayed.
Anti-Bacterial Agents ; Bacillus cereus* ; Bacillus* ; Ceftazidime ; Endophthalmitis* ; Foreign Bodies ; Freezing ; Humans ; Intravitreal Injections ; Vancomycin

BACKGROUND: This study was designed to evaluate the ability of the Vitek and MicroScan ESBL test by comparing with NCCLS ESBL phenotypic confirmatory test by disk diffusion and to know the frequency of ESBL producers in the Seoul Veterans Hospital. METHODS: A total of 1,261 isolates(Escherichia coli 705, Klebsiella pneumoniae 502, K. oxytoca 54) from 883 patients were included in ESBL screening test by Vitek (494 strains) and MicroScan (767 strains). After excluding repetitive isolates from same patients, NCCLS ESBL confirmatory test was performed for 197 ESBL screening positives and 184 ESBL screening negatives. RESULTS: The overall frequency of ESBL screening positives was 22.3% (by MicroScan 26.2%, by Vitek 15.6%), and that of NCCLS ESBL positives was 18.9%(18.3% in E. coli, 21% in K. pneumoniae). MicroScan and Vitek ESBL test showed 100% and 92.3% sensitivity, 77.1% and 95.5% specificity, respectively. Among the 158 NCCLS ESBL positives, 17.7% showed clavulanic acid effect in cefotaxime only, 10.1% in ceftazidime only, and 72.2% in both. MicroScan Neg ComboPanel Type 21 test revealed that 91.4% of suspicious ESBL producers flagged by one or two antimicrobials were erroneous. In contrast, 96.2% of strains flagged by all five antimicrobials were correct. CONCLUSION: Suspicious ESBL producers by MicroScan showing three or four antimicrobial flags should be retested by NCCLS ESBLconfirmatory test. But strains with two or less flags and strains with all 5 flags can be reported as Non-ESBL producers and ESBL producers, respectively.
Cefotaxime ; Ceftazidime ; Clavulanic Acid ; Diffusion ; Hospitals, Veterans ; Humans ; Klebsiella pneumoniae ; Mass Screening ; Sensitivity and Specificity ; Seoul

PURPOSE: To report a case of chronic dacryocystitis caused by Achromobacter xylosoxidans. CASE SUMMARY: A 73-year-old female was referred to our clinic for management of chronic dacryosyctitis from which she did not to recover despite empirical therapy. A. xylosoxidans was isolated from purulent discharge. Based on the results of susceptibility testing, therapy was changed to fortified ceftazidime eye-drop 6 times a day and intravenous tazocin 4.5 g/20 ml (piperacillin 2 g/tazobactam 0.25 g) 3 times a day. All symptoms were resolved after treatment with sensitive antibiotics and external dacryocystorhinostomy. CONCLUSIONS: To our knowledge, this is the first report of A. xylosoxidans dacryocystitis. A. xylosoxidans are rare but potential pathogens which cause dacryocystitis. The cultures and sensitivity test were collected and processed to detect the presence of unusual pathogens in a case with persistent infection despite conventional treatment.
Achromobacter ; Achromobacter denitrificans ; Aged ; Anti-Bacterial Agents ; Ceftazidime ; Dacryocystitis ; Female ; Humans ; Penicillanic Acid ; Piperacillin

PURPOSE: There has not been any reports of Ralstonia paucula causing any ophthalmologic disease. However, we have detected Ralstonia paucula in the lens washing agents of a corneal ulcer patient wearing contact lens. METHODS: A 26-years-old female patient was admitted to our hospital complaining of loss of visual acuity and hyperemia. Slit lamp biomicroscopy and smear culture was done to the anterior segment of the eye and the lens cleansing agent. The patient was treated with antibiotic eye drop and intravenous antibiotic medication. RESULTS: The results of both smear and culture showed the presence of Ralstonia pacula and responded well to antibiotics treatment with ceftazidime.
Anti-Bacterial Agents ; Ceftazidime ; Corneal Ulcer* ; Detergents ; Female ; Humans ; Hyperemia ; Ralstonia* ; Visual Acuity

7-ACA(7-aminocephalosporanic acid) and ACT(aminocephalosporanic thiazine) are basic materials for development of 2nd and 3rd generation cephalosporin. Occupational asthmas(OA) induced by these materials have been very rarely reported. We had experienced 2 cases of OA by them. One was 26 year-old male laboratorian involving 7ACA manufacturing directly. The other case was 40 year-old male asthmatics working at the ware house keeping 7ACA and ACT, not directly making these. The result of skin prick test with 55 common inhalant allergens and 7ACA, ACT and several cephalosporins including Cefazolin, Cefuroxime, Ceftazidime, Cefotaxime, Ceftriaxone and Cefotetan. First case revealed positive reactions to 7ACA and Ceftriaxone, but second case, only positive to ACT. In first case, bronchial challenge with 7ACA only showed positive, but in second, those with 7ACA and ACT both showed positive, though negative to 7ACA in skin test.
Adult ; Allergens ; Asthma, Occupational* ; Cefazolin ; Cefotaxime ; Cefotetan ; Ceftazidime ; Ceftriaxone ; Cefuroxime ; Cephalosporins ; Humans ; Male ; Skin ; Skin Tests

Ceftazidime is a widely used third-generation cephalosporin. We report a case of ceftazidime-induced nonconvulsive status epilepticus in a patient with renal failure. A 56-year-old man experienced the gradual development of altered mentation after a diabetic foot ulcer was treated with ceftazidime. Rhythmic sharply contoured triphasic waves were evident in all electroencephalography leads. The clinical and electrographical seizures ceased after introducing antiepileptic drugs and discontinuing ceftazidime. This case demonstrates that altered mentality and nonconvulsive status epilepticus can be caused by ceftazidime in patients with renal dysfunction.
Anticonvulsants ; Ceftazidime ; Diabetic Foot ; Electroencephalography ; Humans ; Middle Aged ; Renal Insufficiency ; Seizures ; Status Epilepticus* ; Ulcer

Ceftazidime is a widely used third-generation cephalosporin. We report a case of ceftazidime-induced nonconvulsive status epilepticus in a patient with renal failure. A 56-year-old man experienced the gradual development of altered mentation after a diabetic foot ulcer was treated with ceftazidime. Rhythmic sharply contoured triphasic waves were evident in all electroencephalography leads. The clinical and electrographical seizures ceased after introducing antiepileptic drugs and discontinuing ceftazidime. This case demonstrates that altered mentality and nonconvulsive status epilepticus can be caused by ceftazidime in patients with renal dysfunction.
Anticonvulsants ; Ceftazidime ; Diabetic Foot ; Electroencephalography ; Humans ; Middle Aged ; Renal Insufficiency ; Seizures ; Status Epilepticus* ; Ulcer

Bacterial endophthalmitis is an ocular emergency that requires rapid diagnosis and therapeutic decision making. Before the use of intravitreal antibiotics, endophthalmitis almost always resulted in the loss of vision in the affected eye. The introduction of intravitreal injection of antibiotics had been a major advancement because it has resulted in a marked improvement in visual outcome. Current therapy is to administer broad-spectrum antibiotic agents covering both gram-positive and gram-negative organisms. Typically, vancomycin hydrochloride and aminoglycoside, such as amikacin sulfate, are administered as separate intrvitreal injections on an empiric basis. We experienced a case of culture-proven Pseudomonas aeruginosa endophthalmitis treated with intravitreal ceftazidime injection. We present it with a review of literature.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime* ; Decision Making ; Diagnosis ; Emergencies ; Endophthalmitis* ; Intravitreal Injections ; Pseudomonas aeruginosa* ; Pseudomonas* ; Vancomycin