1.Distribution and Drug Resistance of Pathogens in Oral Mucositis Associated with Chemotherapy in Patients with Malignant Hematopathy.
Jin QIU ; Zi-Hao ZHANG ; Xiao-Ting LIU ; Cheng-Long LIU ; Si-Yi ZHU ; Zhao-Qu WEN
Journal of Experimental Hematology 2023;31(1):274-279
OBJECTIVE:
To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control.
METHODS:
From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests.
RESULTS:
A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05).
CONCLUSION
Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).
Humans
;
Vancomycin/therapeutic use*
;
Cefuroxime
;
Levofloxacin
;
Oral Ulcer/drug therapy*
;
Drug Resistance, Bacterial
;
Anti-Bacterial Agents/adverse effects*
;
Ampicillin
;
Penicillins
;
Cefotaxime
;
Gram-Positive Bacteria
;
Gram-Negative Bacteria
;
Gentamicins
;
Stomatitis/drug therapy*
2.Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection.
Ting XU ; Ke-Liang WU ; Ke JIE
Chinese Journal of Traumatology 2022;25(6):325-330
PURPOSE:
Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC.
METHODS:
The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching "total knee arthroplasty", "antibiotic-loaded cement", "antibiotic prophylaxis", "antibiotic-impregnated cement" and "antibiotic-laden cement" in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC. The modified Jadad scale was employed to score the qualities of included articles.
RESULTS:
Eleven quantitative studies were enrolled, including 34,159 knees undergoing PTKA. The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA, whereas there was no significant reduction in the rate of superficial incisional SSI. Moreover, gentamicin-loaded cement was effective in preventing deep incisional SSI, and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA. Besides, no significant adverse reactions and complications were stated during the use of ALBC in PTKA.
CONCLUSION
The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation.
Humans
;
Bone Cements
;
Arthroplasty, Replacement, Knee/methods*
;
Anti-Bacterial Agents/therapeutic use*
;
Prosthesis-Related Infections/etiology*
;
Retrospective Studies
;
Arthritis, Infectious/etiology*
;
Gentamicins
;
Surgical Wound Infection/drug therapy*
3.Modified titration intratympanic gentamicin injection for unilateral intractable Ménière's disease.
Bo LIU ; Yang-ming LENG ; Hong SHI ; Ren-hong ZHOU ; Jing-jing LIU ; Wen-juan ZHANG ; Su-lin ZHANG ; Wei-jia KONG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2015;35(5):747-751
This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection (ITG) in the patients with unilateral intractable Ménière's disease (MD). Modified titration protocol of ITG at a low dose (20 mg/mL) was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis, the patients might or might not be given any more injections, depending on the appearance of unilateral vestibular loss (UVL). ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack, functional level scores and postural balance were evaluated. Of the 10 cases, 8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections, and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases, and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD.
Adult
;
Drug Administration Schedule
;
Ear, Inner
;
drug effects
;
microbiology
;
pathology
;
Female
;
Follow-Up Studies
;
Gentamicins
;
therapeutic use
;
Hearing
;
drug effects
;
physiology
;
Humans
;
Injection, Intratympanic
;
Male
;
Meniere Disease
;
drug therapy
;
microbiology
;
pathology
;
Middle Aged
;
Postural Balance
;
drug effects
;
physiology
;
Protein Synthesis Inhibitors
;
therapeutic use
;
Vertigo
;
drug therapy
;
microbiology
;
pathology
4.First Case of Bartonella quintana Endocarditis in Korea.
Min Hee LIM ; Doo Ryeon CHUNG ; Wook Sung KIM ; Kyung Sun PARK ; Chang Seok KI ; Nam Yong LEE ; Sang Min KIM
Journal of Korean Medical Science 2012;27(11):1433-1435
Since microbial gene sequencing was utilized for etiologic diagnosis of culture-negative endocarditis, cases of Bartonella endocarditis have been reported in various countries. Herein we report the first case of Bartonella quintana endocarditis, which was confirmed for the first time in Korea by 16S rRNA gene sequencing from the excised valve. A 75-yr-old woman was hospitalized due to dyspnea. Echocardiography demonstrated large oscillating vegetation at the aortic valve. Blood culture was negative. She underwent valve replacement and sequencing of the 16S rRNA gene from excised valve identified Bartonella quintana. She was successfully treated with combined use of ceftriaxone and gentamicin.
Aged, 80 and over
;
Anti-Bacterial Agents/therapeutic use
;
Aortic Valve/pathology
;
Bartonella quintana/genetics/*isolation & purification
;
Ceftriaxone/therapeutic use
;
Drug Therapy, Combination
;
Dyspnea/etiology
;
Echocardiography
;
Endocarditis, Bacterial/*diagnosis/drug therapy/microbiology
;
Female
;
Gentamicins/therapeutic use
;
Humans
;
RNA, Ribosomal, 16S/genetics
;
Republic of Korea
;
Sequence Analysis, RNA
5.Repeat transoesophageal echocardiogram is recommended in endocarditis patients with paravalvular oedema despite sensitivity to antibiotics and improving parameters.
Michael LIANG ; Gerard DEVLIN ; Dilesh JOGIA
Annals of the Academy of Medicine, Singapore 2011;40(2):102-103
Abscess
;
Adult
;
Anti-Bacterial Agents
;
therapeutic use
;
Aortic Valve
;
diagnostic imaging
;
microbiology
;
pathology
;
Echocardiography, Transesophageal
;
methods
;
Edema, Cardiac
;
diagnostic imaging
;
drug therapy
;
pathology
;
Endocarditis, Bacterial
;
diagnostic imaging
;
drug therapy
;
Gentamicins
;
therapeutic use
;
Humans
;
Male
;
Mitral Valve
;
diagnostic imaging
;
pathology
;
Tricuspid Valve
;
diagnostic imaging
;
pathology
;
Vascular Fistula
6.Local injection of gentamycin for female urethral syndrome: a clinical study.
Xin-Min DING ; Guo-Hua JIANG ; Hong-Bo WEN ; Jin-Yuan HE ; Guan-Hao CHEN ; Wei WANG
National Journal of Andrology 2011;17(9):794-798
OBJECTIVETo observe the therapeutic effect of local antibiotic injection into the female prostate on female urethral syndrome (FUS), and search for an effective treatment for this disease.
METHODSThis study included 163 FUS patients treated in the out-patient department between July 2009 and December 2010. According to the visiting order, the patients were randomly assigned to Groups A (n = 58), B (n = 55) and C (n = 50). All underwent routine treatment. Inaddition Group A received local injection of 2 ml of 80 000 U gentamycin + 2 ml of lidocaine, and Group B 2 ml of normal saline + 2 ml of lidocaine, both injected into the distal segment of the urethral back wall where the female prostate is located, twice a week for 3 weeks. The therapeutic effects were evaluated according to the changes of the patients' independent symptom scores at 2 and 4 weeks after the treatment. Disappearance of the symptoms was considered as "curative" , > 1/2 reduction in the symptom score as "obviously effective", 1/2 - > 1/4 reduction in the symptom score as "effective", and < 1/4 reduction or increase in the symptom score as "ineffective".
RESULTSAt 2 weeks after the treatment, the total effectiveness rate was significantly higher in Group A (77.5%) than in B (67.3%) and C (68.0%) (P < 0.05), but with no statistically significant difference between B and C (P > 0.05). At 4 weeks, the total effectiveness rate of Group A was slightly decreased, but still remarkably higher than that of group B or C (P < 0.05).
CONCLUSIONLocal injection of gentamycin into the female prostate is effective for the treatment of female urethral syndrome.
Administration, Topical ; Adult ; Aged ; Aged, 80 and over ; Female ; Gentamicins ; administration & dosage ; therapeutic use ; Humans ; Injections ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Urethral Diseases ; drug therapy ; Young Adult
7.Intramuscular gentamicin improves the efficacy of ciprofloxacin as an antibiotic prophylaxis for transrectal prostate biopsy.
Henry S S HO ; Lay Guat NG ; Yeh Hong TAN ; Mavis YEO ; Christopher W S CHENG
Annals of the Academy of Medicine, Singapore 2009;38(3):212-216
INTRODUCTIONInfection-related complications after transrectal ultrasound guided prostatic biopsy (TRPB) could be life threatening. Our centre observed sepsis after TRPB despite prophylactic oral ciprofloxacin. We reviewed all cases of post-TRPB sepsis with their bacteriology and evaluated if the addition of intramuscular (I/M) gentamicin to standard prophylaxis before TRPB could reduce its incidence.
MATERIALS AND METHODSIn a single urological centre, we performed an interventional study that compared a prospective group with retrospective control. The latter is known as the "cipro-only" group included consecutive patients who underwent TRPB between 1 September 2003 and 31 August 2004. The addition of I/M gentamicin 80 mg half an hour before TRPB started on 1 September 2004. All subsequent patients who underwent TRPB until 31 August 2005 were included in the "cipro+genta" group. Patients who did not receive the studied antibiotics were excluded.
RESULTSThere were 374 patients in the "cipro+genta" group and 367 patients in the "cipro-only" group with comparable profiles. There were 12 cases of post-TRPB sepsis in the "cipro-only" group and 5 cases in the "cipro+genta" group. Ciprofloxacin-resistant Escherichia coli (E. coli) was the only pathogen isolated in both groups. In the "cipro-only" group, 9 patients had positive blood cultures and 8 were sensitive to gentamicin. In the "cipro+genta" group, the only positive E. coli was gentamicin-resistant. One patient in the "cipro+genta" group was admitted to the intensive care unit with septicaemia.
CONCLUSIONThe addition of I/M gentamicin to oral ciprofloxacin is a safe and effective prophylactic antibiotic regime in reducing the incidence of post-TRPB sepsis.
Administration, Oral ; Adult ; Aged ; Antibiotic Prophylaxis ; methods ; Biopsy ; Ciprofloxacin ; administration & dosage ; therapeutic use ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Gentamicins ; administration & dosage ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Prospective Studies ; Prostate ; diagnostic imaging ; pathology ; Rectum ; Ultrasonography
8.Effect of acupuncture on target action of ligustrazine in treatment of toxic deafness induced by gentamicin in guinea pigs.
Hua-Ping ZHENG ; Feng WANG ; Quan-Zhen XU ; Fei XU ; Guo-Jun ZHANG ; Peng WANG ; Yong-Hua WANG ; Jin-Hong LIU ; Bing-hua FAN
Chinese Acupuncture & Moxibustion 2008;28(7):515-518
OBJECTIVETo explore an effective method for treating Gentamicin-induced deafness and the mechanism.
METHODSGuinea pigs were randomly divided into 5 groups: normal control group (group A), model group (group B), Ligustrazine group (group C), acupuncture group (group D) and Ligustrazine plus acupuncture group (group E). The group C, D and E were treated respectively by simple Ligustrazine, simple acupuncture at "Tinggong" (SI 19), "Yifeng" (TE 17), and "Waiguan" (TE 5), and Ligustrazine plus acupuncture. Ten days later, the auditory brainstem response (ABR) thresholds for the wave III , apoptosis and expressions of Bcl-2 and Bax proteins in the organ of Corti of the guinea pig were detected.
RESULTSIn the group E, the ABR threshold was significantly lower than that in the group C (P<0.05), and apoptotic cells, the expression of Bax protein and the ratio of Bax/Bcl-2 were lower than those in the group C and D in the organ of Corti, and Bcl-2 protein expression was increased.
CONCLUSIONAcupuncture at "Tinggong" (SI 19), "Yifeng" (TE 17), and "Waiguan" (TE 5) has a certain target-synergistic action on Ligustrazine and can increase therapeutic effect of Ligustrazine on Gentamicin-induced deafness, which are possible related with the inhibition of apoptosis, down-regulation of Bax expression and up-regulation of Bcl-2 expression.
Acupuncture Therapy ; Animals ; Anti-Bacterial Agents ; toxicity ; Deafness ; chemically induced ; therapy ; Evoked Potentials, Auditory, Brain Stem ; drug effects ; Female ; Gentamicins ; toxicity ; Guinea Pigs ; Male ; Pyrazines ; therapeutic use
9.Research and clinical value of antibacterial-application software.
Yong-jie LIANG ; Xiao-bo ZHAI ; Li-xian HE ; Zhong-liang GUO ; Tao REN ; Zhi-gao HE ; Lu ZHANG ; Yong-hua ZHENG
Chinese Medical Journal 2008;121(1):86-89
Adult
;
Aged
;
Aged, 80 and over
;
Anti-Bacterial Agents
;
therapeutic use
;
Cephalosporins
;
administration & dosage
;
Enterobacter cloacae
;
Enterobacteriaceae Infections
;
drug therapy
;
Female
;
Gentamicins
;
adverse effects
;
Humans
;
Imipenem
;
adverse effects
;
Isosorbide Dinitrate
;
adverse effects
;
analogs & derivatives
;
Male
;
Ofloxacin
;
adverse effects
;
Software
10.Observation on curative effect of chronic ulcerative colitis treated by retention enema with combination of Chinese and Western drugs.
Xiao-Yan WANG ; Ying WU ; Xiao-Meng JIANG
Chinese Journal of Integrated Traditional and Western Medicine 2007;27(12):1123-1125
OBJECTIVETo evaluate the effect of retention enema with combination of Chinese and Western drugs in treating chronic ulcerative colitis (CUC).
METHODSThe therapeutic effects of retention enema with combination of Chinese and Western drugs (as tested group) and with Western drugs alone (as control group) were compared in a randomized controlled trial.
RESULTSThe total effective rate of clinical curative in the tested group and the control group was 96.7% and 73.3% respectively, the difference between them was significant (chi2 = 4.71, P < 0.05). Statistical difference in comparing pre- and post-treatment condition and comparing between groups was shown in comparison of symptoms, scores of endoscopic picture (except that of polypus), and routine examination of stool (except pus cell number, all P < 0.05). The total recurrence rate of the tested group was 33.3% and the control group 60.0%, the difference between them was significant (chi2 = 4.286, P < 0.05).
CONCLUSIONRetention enema with combination of Chinese and Western drugs has good curative effects in treating CUC.
Administration, Rectal ; Adult ; Aged ; Anti-Inflammatory Agents ; administration & dosage ; therapeutic use ; Colitis, Ulcerative ; drug therapy ; Dexamethasone ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Gentamicins ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

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