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Gonorrhea is the second most frequently reported notifiable disease in the United States and is becoming increasingly common in Europe. The purpose of this review was to assess the current state of drug-resistant Neisseria gonorrhoeae in order to evaluate future prospects for its treatment. An exhaustive literature search was conducted to include the latest research regarding drug resistance and treatment guidelines for gonorrhea. Gonococci have acquired all known resistance mechanisms to all antimicrobials used for treatment. Currently, the European Union, the United States, and the United Kingdom have established surveillance programs to assess, on a yearly basis, the development of gonococcal resistance. Current treatment guidelines are being threatened by the increasing number of ceftriaxone-, cefixime-, and azithromycin-resistant N. gonorrhoeae strains being detected worldwide. This has led the scientific community to develop new treatment options with new molecules in order to persevere in the battle against this "superbug".
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Escherichia coli O157:H7 is an emergent pathogen associated with food transmitted diseases. In 1982, Escherichia coli O157:H7 was for the first time identified as the cause of two hemorrhagic colitis outbreaks in the United States. It is now well known that most cases of hemolytic uremic syndrome are caused by these bacteria. The objective of this work was to detect the microorganism in fresh ground beef and hamburgers. From April 2003 to August 2004 samples were taken at sale points of our supermarket chain, totalling 37 and 43, respectively. These samples were processed using the EC selective enrichment broth containing novobiocin, then followed by the application of an immunocapture method (TECRA E. COLI O157 IMMUNOCAPTURE ECOICM 20), and later isolation in MacConkey sorbitol agar with cefixime and potassium tellurite, in a chromogenic medium. The suspected strains were genotypically characterized by PCR detection of the stx1, stx2, eaeA, and EHEC-hlyA genes, and by a colony blot hybridization assay. Serotyping, antimicrobial susceptibility patterns, and production of Stx by a specific cytotoxicity assay on Vero cells were also determined. E coli O157:H7 was isolated in only one fresh ground beef sample (2,7%), identified as gene eae (+)/ stx2/EHEC-hlyA.
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Of 6173 isolates from 2007 to 2011, 4684 (82%) were susceptible to penicillin, 3899 (68%) to ciprofloxacin, and 5240 (91%) to cefixime. All subgroups of the MSM population had fewer than 95% of isolates susceptible to penicillin, ciprofloxacin, or cefixime. Higher proportions of isolates from heterosexual patient subgroups were susceptible to these antimicrobials. Multivariable models identified the following associations between patient characteristics and infection with susceptible isolates: patients aged 13 to 24 years (penicillin: 92.3% susceptible adjusted odds ratio and associated 95% confidence interval [aOR CI] 1.84-2.97; ciprofloxacin: 88.3%, aOR CI 2.22-3.39; cefixime: 98.7%, aOR CI 1.29-3.52) patients of black ethnicity (penicillin: 93.9%, aOR CI 2.72-4.91; ciprofloxacin: 92.0%, aOR CI 3.94-6.7; cefixime: 99.1%, aOR CI 1.78-6.4), and patients with concurrent chlamydia (penicillin: 93.9%, aOR CI 1.8-3.22; ciprofloxacin: 91.7%, aOR CI 2.71-4.58; cefixime: 99.0%, aOR CI 1.27-4.54).
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Therapy to eradicate pharyngeally carried group A streptococci (GAS) has increasingly been used in the management of institutional outbreaks and is now recommended for household contacts of patients with streptococcal toxic shock syndrome. In this randomized, controlled trial, contacts of patients with GAS infections were screened for pharyngeal GAS colonization. Those whose cultures were positive were randomized to receive either cefixime (8 mg/[kg.d]; maximum 400 mg) or rifampin (20 mg/kg; maximum, 600 mg) once a day for 4 days. Two to five days following completion of therapy, repeated cultures were negative for 13 (38%) of 34 rifampin recipients and 71 (77%; 95% CI, 69%-85%) of 97 cefixime recipients. At 10-14 days after treatment, only 53% of cefixime recipients remained culture-negative. Rates of successful clearance improved with increasing age (P < .01); among 17 adults who received cefixime, the success rate was 94%. Four days of therapy with rifampin is not effective for eradication of pharyngeally carried GAS. Four days of therapy with cefixime may be effective for adults, but further studies are needed.
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From October, 1993 to August, 1994, a post-marketing surveillance study enrolled 9,568 adults and children treated for respiratory tract infections with cefixime in a daily dose of 400 mg or 8 mg/kg body weight, respectively. Twice daily dosage was preferred with adults (60.4%) and children (54.4%). Bronchitis (45.5%) and otitis media (48.0%) were the most frequent indications given for cefixime use in adults and children, respectively. Bacterial analysis was done in 5.4% of adults and in 6.5% of children. With a median therapy of 6 days, cure or improvement was reported in 98.7% of adult patients and in 98.0% of children. Symptoms rapidly improved in a majority of patients. Adverse events occurred in 1.12% of adult patients and 1.92% of children. In 96.7% of all cases the dry syrup was very well or well accepted by children. In conclusion, high efficacy and low incidence of side effects make cefixime a drug of choice for treatment of respiratory tract infections.
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Out of the total number of 100 E. coli cases, 22 cases (22%) had class 1 integron. Resistance against cotrimoxazol, cefixime and ciprofloxacin antibiotics were 67%, 34% and 34% respectively. In 22 E. coli cases positive for integron class1 gene, resistance against three antibiotics were 100%, 95.45% and 90.90% respectively, which is statistically significant (p < 0.05).
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To determine U.S. trends in the prevalence of antimicrobial resistance of N. gonorrhoeae from 1988 to 2003.
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Cefprozil, cefpodoxime proxetil, loracarbef, cefixime, and cefributen are active in vitro against organisms frequently involved in community-acquired infections such as Streptococcus pneumoniae, Escherichia coli, beta-lactamase-positive or -negative Haemophilus influenzae, and Moraxella catarrhalis. Except for cefixime and ceflibuten, they all are active against methicillin-susceptible Staphylococcus aureus. Even though there were problems in study design (discussed within the text), clinical data demonstrate that these new oral beta-lactam compounds are as efficacious as conventional therapies for a variety of community-acquired infections.
The transport of dipeptides and beta-lactam antibiotics across the rat renal basolateral membrane was examined. The initial uptake of glycylsarcosine and cefadroxil by rat renal basolateral membrane vesicles was inhibited by the presence of all the di- and tripeptides and beta-lactam antibiotics that were tested in this study. However, the uptake of both substrates was not inhibited by glycine, an amino acid. The initial uptake of zwitterionic beta-lactam antibiotics, cefadroxil, cephradine, and cephalexin, was stimulated by preloaded glycylsarcosine (countertransport effect). On the other hand, the uptake of dianionic beta-lactam antibiotics, ceftibuten and cefixime, was not affected. A concentration-dependent initial uptake of glycylsarcosine and cefadroxil suggested the existence of a carrier-mediated mechanism, whereas the transport of ceftibuten did not show any saturated uptake. The transporter that participates in the permeation of dipeptides and beta-lactam antibiotics across basolateral membranes showed lower affinity than did PEPT1 and PEPT2. This is the first study that showed an evidence for a peptide transporter, expressed in the rat renal basolateral membrane, that recognizes zwitterionic beta-lactam antibiotics using basolateral membrane vesicles isolated from normal rat kidney.
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MICs of antibiotics were determined using broth microdilution. For beta-lactamase-negative isolates with reduced susceptibility to amoxicillin, the nucleotide sequence of the penicillin-binding domain of PBP3 was determined.
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Campylobacter jejuni is a slender, motile, non-spore-forming, helical-shaped, gram-negative bacterium. It is one of the most common causes of human gastroenteritis in the world. The aim of this study was to present a patient with acute lymphocytic leukemia (ALL), who was infected with Campylobacter jejuni.
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Out of 117 CSOM cases, 105 (86%) showed positive bacterial culture. The Staphylococcus aureus was the commonest aerobic isolate in CSOM. The sensitivity of Staphylococci spp. to commonly used antimicrobials varied from 27.2% for cefixime to 95.5% for gentamicin and coagulase positive. Pseudomonas isolates showed complete (100%) resistance to amoxicillin/clavulanate (co-amoxiclave), cloxacillin and cefixime, and high sensitivity to ciprofloxacin (95%) and cephalexin (90%).