Peritonitis is one of the major complications of continuous ambulatory peritoneal dialysis (CAPD). Multidrug-resistant organisms, including vancomycin-resistant enterococci (VRE), have been reported as pathogens of CAPD-associated peritonitis. The incidence of hospital-associated infections caused by VRE has recently increased. Some drugs, such as linezolid and quinupristin/dalfopristin, have been introduced as treatments of VRE infection. However, there is limited information about the effects of VRE-associated CAPD peritonitis. We present a case of successful treatment of CAPD peritonitis caused by VRE with quinupristin/dalfopristin and include a review of the literature.
Acetamides ; Humans ; Incidence ; Oxazolidinones ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; linezolid

Lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients. Although impaired tissue oxygenation is usually responsible for the rise in lactate production, lactic acidosis could be caused by drugs including metformin and the nucleoside reverse-transcriptase inhibitors. Linezolid, an oxazolidinone antibiotic, is currently indicated to treat serious infections caused by vancomycin-resistant enterococcus and other gram-positive organisms. A 74-year old woman was found to have pyogenic vertebral osteomyelitis and treated with linezolid. Thirty-one days after linezolid therapy, she developed severe lactic acidosis. We report a case of lactic acidosis associated with prolonged linezolid therapy.
Acetamides ; Acidosis ; Acidosis, Lactic ; Enterococcus ; Female ; Humans ; Lactic Acid ; Metformin ; Osteomyelitis ; Oxazolidinones ; Oxygen ; Linezolid

Postoperative meningitis after spinal surgery is a rare complication that can result in a life-threatening condition. Linezolid (LZD) is an oxazolidinone which has been approved in Japan for infections caused by methicillin-resistant Staphylococcus aureus. The authors encountered a case of postoperative meningitis with cerebrospinal fluid leakage (liquorrhoea) that occurred after resection of a cervical cord tumor. The infection was caused by methicillin-resistant Staphylococcus epidermidis(MRSE). Debridement and suture of the dura matter was carried out. LZD was given intravenously. The infection was cured without any sequelae. Based on this result, we concluded that LZD might be considered as one of the first choices for the treatment of postsurgical meningitis caused by MRSE.
Acetamides ; Debridement ; Humans ; Japan ; Meningitis ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Staphylococcus ; Sutures ; Linezolid

The incidence of vancomycin-resistant enterococcus (VRE) meningitis is increasing. We present a 56-year-old man who suffered from VRE meningitis after cerebellar hemorrhage and intraventricular catheter insertion. The patient recovered completely after treatment with linezolid for 6 weeks. This is the first report on effectiveness of linezolid in treating VRE meningitis in Korea.
Acetamides ; Catheters ; Enterococcus ; Hemorrhage ; Humans ; Incidence ; Meningitis ; Middle Aged ; Oxazolidinones ; Linezolid

Vancomycin is the primary antibiotic administered for treatment of methicillin-resistant S. aureus (MRSA) infection; however, treatment failure of vancomycin is currently not uncommon in patients with in vitro vancomycin susceptibile S. aureus (MIC < or = 2 microg/mL) infection. In this report, we describe a case of septic arthritis caused by persistent MRSA bacteremia and treated successfully with linezolid after failure of initial vancomycin therapy.
Acetamides ; Arthritis, Infectious ; Bacteremia ; Humans ; Linezolid ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Treatment Failure ; Vancomycin

Vancomycin-resistant enterococci (VRE) infection is a serious problem because optimal therapy has not been established. Different agents in various combinations, including teicoplanin, chloramphenicol, and quinupristin/dalfopristin, have been used to treat patients with VRE meningitis, but the efficacy of these agents is not satisfactory because of their limited ability to penetrate into the cerebrospinal fluid. We report a case of nosocomial vancomycin-resistant Enterococcus faecium meningitis in a patient with ventriculoperitoneal shunt that was successfully treated with linezolid. We will also review previously reported cases of vancomycin-resistant E. faecium meningitis treated by linezolid.
Acetamides ; Chloramphenicol ; Enterococcus ; Enterococcus faecium ; Humans ; Linezolid ; Meningitis ; Oxazolidinones ; Teicoplanin ; Vancomycin ; Ventriculoperitoneal Shunt

OBJECTIVETo develop an analytical method and quality control for determination of zolmitriptan and related substances.

METHODSZolmitriptan and related substances were separated and determined on a shimadzu CLC-C(8) column (150 mm x 6 mm, 10 microm) with a mobile phase of acetonitrile-10 mmol/L phosphate buffer (25:75 pH 7.5) and a flow-rate of 1 ml/min; the UV-VIS detector was operated at 229 nm.

RESULTThe limit of detection for the related substances was 0.5 ng on the zolmitriptan basis (S/N >3). Linear calibration curve was gene rated from 4 - 40 microg/ml with a correlation coefficient of 0.9999. The recovery rate of zolmitriptan was 99.1% with a standard deviation of 0.2%. The results of HPLC method were consistent with those of nonaqueous titration method.

CONCLUSIONHPLC method is a rapid sensitive and accurate method for the determination of zolmitriptan and its related substances.

Tuberculosis (TB) is one of the largest health problems in the world today. And the incidence of nontuberculous mycobacteria (NTM) lung disease appears to be increasing worldwide. Recently, an automated, nucleic acid amplification assay for the rapid detection of both Mycobacterium tuberculosis and rifampin resistance was developed (Xpert MTB/RIF). And fixed-dose combinations of anti-TB drugs and linezolid have been introduced in the treatment of TB. And new NTM species, named Mycobacterium massiliense, which is very closely related to Mycobacterium abscessus was reported. In this review, these recent advances in the diagnosis and treatment of TB and clinical characteristics of M. massiliense lung disease are discussed.
Acetamides ; Incidence ; Lung ; Lung Diseases ; Mycobacterium ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Nucleic Acid Amplification Techniques ; Oxazolidinones ; Rifampin ; Tuberculosis ; Linezolid

Peritonitis is one of the major complications of CAPD(continuous ambulatory peritoneal dialysis). Recently, multidrug-resistant organisms, such as vancomycin-resistant enterococcus (VRE) have been rarely reported by the pathogen as of CAPD-associated peritonitis. But, there is limited information on choices of effective therapy for VRE peritonitis in patients undergoing CAPD. We present a pediatric case of successful treatment of CAPD-associated peritonitis due to VRE with linezolid, and review of the literature.
Acetamides ; Enterococcus ; Humans ; Oxazolidinones ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis

We have isolated 6 vancomycin resistant (VR) Enterococcus faecium and 5 VR-E. gallinarum. Vancomycin resistant enterococcus (VRE) isolates were resistant to multi-drugs, but susceptible to linezolid and quinupristin/dalfopristin. VRE isolates showed 10 VanA phenotypes and 1 VanB phenotype (E. gallinarum). However, all of them showed vanA genotype. vanA gene was detected on both genomic and plasmid DNA from all VRE isolates. Almost of VR-E. faecium had IS1216V which is worldwide type and almost of VR-E. gallinarum had IS1542 which is European type. IS1216V and IS1542 genes were not related with antibiotic types of VRE. Copy numbers of vanA were decreased in VRE with IS1216V or IS1542 but not in VRE with both ISs in broth without vancomycin. The copy numbers of vanA were significantly decreased in VanB phenotype of VRE with IS1542 in broth without vancomycin. Copy numbers of vanA were recovered in the presence of vancomycin. Growth time of reference E. faecium is faster than that of reference E. faecalis when cultured in the broth containing vancomycin. Reference strains cultured in the broth containing vancomycin showed intermediate resistance or resistance to antibiotics without acquisition of van genes. Naturally, multidrug-resistant E. faecium might be fast adapted in the presence of vancomycin compared to E. faecalis. Taken together, VanA phenotype E. gallinarum as well as E. feacium have been increasing in nosocomial infection and showed acquired inducible resistance. E. faecium and E. faecalis showed intermediate resistance in long exposure of vancomycin without acquisition of vanA.
Acetamides ; Anti-Bacterial Agents ; Coat Protein Complex I ; Cross Infection ; DNA ; Enterococcus ; Enterococcus faecium ; Genotype ; Oxazolidinones ; Phenotype ; Plasmids ; Vancomycin ; Vancomycin Resistance ; Linezolid