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

BACKGROUND

The use of ceftazidime-avibactam (CAZ-AVI) has been recently introduced to combat multidrug-resistant organisms (MDROs) in the pediatric population. Case reports have documented the successful off-label use of CAZ-AVI in the treatment of MDRO sepsis in neonates; however, data remains to be limited, especially in the Philippines.

This study aims to explore the effects of CAZ-AVI on clinical outcomes including mortality rate, length of hospital stay since treatment initiation, and bacteriological eradication among patients admitted at the NICU with MDR Klebsiella hospital-acquired sepsis. Other objectives include comparing these outcomes betwee those who received CAZ-AVI (in combination with aztreonam, ATM) and those who received other 2nd line MDR-antibiotic regimens used for carbapenem-resistant Klebsiella growths, as well as exploring the association of factors such as gestational age and age at sepsis diagnosis of patients with their outcomes post-treatment with CAZ-AVI± ATM.

This is a retrospective cohort study of admitted patients in a neonatal intensive care unit of a tertiary hospital with MDR Klebsiella hospital-acquired sepsis across a two-year period. A review of medical records was done, and data were collected and analyzed.

There were a total 11 patients treated with CAZ-AVI ± ATM compared with 11 patients given other 2nd line antibiotic treatment regimens. The use of CAZ-AVI ± ATM exhibited a trend towards a decreased mortality rate (54.5%, p = 0.17), shorter length of hospital stays from treatment initiation (30.7 days, p = 0.50), and increased bacteriological eradication rates (63.6%, p < 0.05), compared with other 2nd line antibiotic treatment regimens, regardless of gestational age and age at sepsis diagnosis.

The use of CAZ-AVI ± ATM showed a more favorable trend compared with other 2nd line antimicrobials for with MDR Klebsiella hospital-acquired sepsis. These observations, however, require further confirmation with a prospective study, a longer study period, and an increase in sample size.

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: 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

PURPOSE: The organisms causing peritonitis and their antibiotic sensitivities vary in different regions and centers, and these data are necessary to establish regional treatment guidelines. The aim of this study was to investigate the changes in incidence and characteristics of the organisms that cause peritonitis in children undergoing peritoneal dialysis (PD) during recent 10 years. METHODS: We retrospectively collected and analyzed the data from medical records of 110 children on PD during the period from 2000 to 2010. RESULTS: One hundred and forty episodes of peritonitis have occurred in 57 patients. The overall incidence of peritonitis was 0.43 episodes/patient.year, and similar incidence have been maintained since 2003. Sixty percent of the patients experienced peritonitis within 1 year of PD, and all patients commencing PD in infancy experienced peritonitis. Gram positive (G (+)), gram negative (G (-)) organisms and fungi were cultured in 58%, 38%, and 4.1% respectively and cultures were negative in 13.6%. Staphylococcus was the most common G (+) organism, and Pseudomonas and Acinetobacter were 2 most frequent G (-) organisms isolated. Fifty-six percent of the G (+) organisms were sensitive to first generation cephalosporin and 91% of G (-) pathogens were sensitive to ceftazidime. Methicillin-resistance rate was not higher in children less than 2 years of age than in those more than 2 years. CONCLUSION: An additional breakthrough has to be made to further reduce the incidence of peritonitis. Treatment guideline customized for peritonitis in Korean children on PD need to be established through a nationwide co-work.
Acinetobacter ; Ceftazidime ; Child ; Fungi ; Humans ; Incidence ; Medical Records ; Peritoneal Dialysis ; Peritonitis ; Pseudomonas ; Retrospective Studies ; Staphylococcus

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

BACKGROUND: The aim of this study was to determine a nation-wide prevalence of Ambler class A and D extended-spectrum-lactamases (ESBL) in Klebsiella pneumoniae isolates in Korea. METHODS: During the period of April to May 2005, 189 isolates of K.pneumoniae were collected from 11 Korean hospitals. Antimicrobial susceptibilities to ceftazidime and cefotaxime were tested by the disk diffusion method, and ESBL production was determined by double-disk synergy test. Determinants of ceftazidime or cefotaxime-resistance were transferred to Escherichia coli J53 (azide-resistant) by transconjugation. Genotypes of class A and D ESBL genes were determined by PCR amplification and sequencing. RESULTS: One hundred-sixty isolates of K.pneumoniae showed positive results in double-disk synergy test. The most prevalent ESBL was SHV-12 (n=148). Also detected were genes encoding ESBLs including TEM-52 (n=1), SHV-2a (n=2), CTX-M-3 (n=15), CTX-M-9 (n=6), CTX-M-12 (n=2), CTX-M-14 (n=9), CTX-M-15 (n=1), PER-1 (n=1), GES-5 (n=3), and OXA-30 (n=2) beta-lactamases. CONCLUSION: With the emergence of CTX-M-12, PER-1, and OXA-30 beta-lactamases, the ESBLs in K.pneumoniae isolates are becoming more diverse in Korea.
beta-Lactamases ; Cefotaxime ; Ceftazidime ; Diffusion ; Escherichia coli ; Genotype ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Polymerase Chain Reaction ; Prevalence

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