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Disseminated mucocutaneous herpes simplex virus infection in an immunocompetent woman

Disseminated mucocutaneous herpes simplex virus (HSV) infection in an immunocompetent person is quite rare. A 19-year-old healthy Japanese woman presented with painful, umbilicated vesicles and pustules on her genital region, both nipples and on the forearm 10 days after the last sexual contact with her partner who had cold sore at that time. Tzanck test and biopsy confirmed the diagnosis of disseminated mucocutaneous HSV infection. She did not have any visceral HSV disease. Skin lesions improved after treatment with acyclovir and erythromycin for seven days. We propose that like herpes gladiatorum, HSV dissemination in this case was acquired by close body contact. (Source: International Journal of STD and AIDS)

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Natural products as lead-structures; a role for biotechnology.

Authors: John JE Natural products as lead-structures; a role for biotechnology Natural products play a key role in healthcare and pharma research, as many medicines are either natural products or derivatives thereof. It is estimated that about 40% of all medicines are either natural products or their semi-synthetic derivatives [1]. This may not be surprising as herbal medicine has been a tradition of healthcare since ancient times and natural-extracts screening has been one of the roots of pharma research, where penicillin, erythromycin and rifampicin (bacterial infections), statins (cholesterol lowering/hyperlipidemia), quinine and artimesinin (malaria), paclitaxel, vinblastin and vincristin (cancer), salicylic acid and non-addictive cocaine derivatives (pain relief), are a few well-k...

Pharmacology Review: Pharmacologic Treatment of Feeding Intolerance in Neonates

Successful establishment of enteral feedings is major goal in the treatment of very low-birthweight infants, but functional immaturity of the gastrointestinal tract may hamper such efforts. Prokinetic agents often are used in an attempt to overcome the functional immaturity by speeding up gastric emptying and increasing small intestinal motility. This brief review examines the currently used candidate drugs: erythromycin, metoclopramide, and domperidone, as well as the potential role for prebiotics and probiotics. (Source: NeoReviews recent issues)

Corneal Abrasions in Young Infants

CONCLUSIONS: Corneal abrasions are extremely common among 1- to 12-week-old infants and have unclear clinical significance. Primary care physicians should be careful about attributing unexplained persistent crying to corneal abrasions, potentially missing a more-serious problem. (Source: PEDIATRICS)

Erythromycin ointment supply improves [NEWS AND FEATURES]

(Source: AAP News)

Biosynthesis of the Putative Siderophore Erythrochelin Requires Unprecedented Crosstalk between Separate Nonribosomal Peptide Gene Clusters.

We report here the production by S. erythraea, even under iron-sufficient conditions, of a 2,5-diketopiperazine siderophore candidate we have named erythrochelin. Deletion of the nonribosomal peptide synthetase (NRPS) gene ercD within the nrps5 cluster abolished erythrochelin production. The tetrapeptide backbone of erythrochelin (alpha-N-acetyl-delta-N-acetyl-delta-N-hydroxyornithine-serine-delta-N-hydroxyornithine-delta-N-acetyl-delta-N-hydroxyornithine) suggests an orthodox colinear model for erythrochelin assembly. Curiously, the delta-N-acetyltransferase required for erythrochelin biosynthesis is encoded within a remote NRPS-cluster (nrps1) whose own NRPS contains an inactivating mutation. Disruption of the nrps1 gene mcd abolished erythrochelin biosynthesis, which could then be resto...

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Blame inappropriate implementation for failure of intrapartum antibiotic prophylaxis for group B Streptococcus

In this issue of The Journal, Blaschke et al from Salt Lake City, Utah, provide the case that was bound to happen. With increasing resistance of group B Streptococcus (GBS) to erythromycin and clindamycin, and too-quick, too-easy reflex to substitute clindamycin for penicillin or ampicillin when mother has a history of penicillin “allergy,” the math was going to add up to transmission and disease due to a clindamycin-resistant GBS in a newborn. Blaschke et al provide the case—an “old fashioned” one—of severe early-onset disease in an otherwise healthy term infant, whose mother received IAP with clindamycin. (Source: The Journal of Pediatrics)

Characterization of CEM-101 Activity Against Gram-Positive Organisms.

Authors: Woosley LN, Castanheira M, Jones RN In vitro activity of CEM-101, a new fluoroketolide, was determined against Gram-positive organisms with various macrolide susceptibility profiles. Experiments for determination of MIC and MBC, timed-killing, single-step and multistep mutation rates, erythromycin induction of resistance, post-antibiotic effect (PAE) and drug interactions were performed for CEM-101 and results compared to telithromycin, macrolides and lincosamides. CEM-101 MBC results remained overall lower than those of telithromycin and CEM-101 displayed a two-fold greater potency compared the ketolide. Timed-killing curve testing resulted in CEM-101 having greater bactericidal activity than telithromycin (>/=3 log10 CFU/ml decrease of initial inoculum at 24 hours) for th...

Chlamydophila pneumoniae

is estimated to cause about 10% of community-acquired pneumonia (CAP) cases and 5% of bronchitis cases, although most patients with C pneumoniae infection are asymptomatic, and the course of respiratory illness is relatively mild. The incubation period of C pneumoniae infection is around 21 days, and such symptoms as cough and malaise show a gradual onset, yet may persist for several weeks or months despite appropriate antibiotic therapy. Diagnosis by nasopharyngeal specimen culture, serum antibody titers, or molecular techniques is usually delayed with respect to the onset of symptoms, antibiotic treatment, or disease resolution and there is no accurate, standardized, commercial US Food and Drug Administration–cleared diagnostic method available. Erythromycin, tetracycline, and doxycyc...

CwrA, a gene that specifically responds to cell wall damage in Staphylococcus aureus.

Authors: Balibar CJ, Shen X, McGuire D, Yu D, McKenney D, Tao J Transcriptional profiling data accumulated in recent years for the clinically relevant pathogen Staphylococcus aureus have established a cell wall stress stimulon, which is comprised of a coordinately regulated set of genes which are upregulated in response to blockage of cell wall biogenesis. In particular, the expression of cwrA (SA2343, N315 notation), which encodes a putative 63-amino acid polypeptide with unknown biological function, increases over 100-fold in response to cell wall inhibition. Herein we seek to understand the biological role this gene plays in S. aureus. CwrA was found to be robustly induced by all cell wall targeting antibiotics tested - vancomycin, oxacillin, penicillin G, phosphomycin, imipenem, hy...

Molecular characterization and antimicrobial susceptibility profiles in Streptococcus agalactiae colonizing strains: association of erythromycin resistance with subtype III-1 genetic clone family

Clin Microbiol Infect Knowledge of the epidemiology of Streptococcus agalactiae in Portugal is limited: therefore, the present study aimed to investigate the carriage rate of S. agalactiae among Portuguese women of reproductive age and the prevalence of antibiotic resistance, as well as to perform a molecular characterization of the clinical isolates. S. agalactiae was recovered from 6.2% of 4269 women during the period 2005[ndash]2007, with a predominance of capsular genotypes III (35%), V (33%), Ia (16%) and II (10%) in a sample of 100 isolates. To our knowledge, this is the first report of the S. agalactiae colonization rate in Portugal determined according to CDC guidelines. All isolates were susceptible to penicillin and vancomycin, whereas resistance to clindamycin and erythromycin w...

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Erythromycin extravasation mimicking necrotising fasciitis in the infant

We present a case of erythromycin extravasation in a 1-year-old child with significant comorbidities. The presentation of blistering and deep dermal necrosis followed extravasation of an unknown volume of erythromycin and required urgent plastic surgery review and tissue reconstruction. This represents the first reported case of erythromycin extravasation and graphically illustrates the potentially devastating effects of this uncommon injury. Little is known about the mechanism of injury in erythromycin extravasation, though it is likely to be multifactorial. Immediate management is with local irrigation of the injury site, elevation and symptomatic relief. In large-volume extravasations and late diagnosis, the clinical signs are much more pronounced, with rapid necrosis and tissue l...

Potential Use of Erythromycin to Prevent and Treat Prosthetic Failure.

Authors: Zhang P, Qin L Prolonged prosthetic life span is a goal that orthopedic surgeons are pursuing. Both septic and aseptic loosening may lead to prosthetic failure. For decades, antibiotics have been applied in arthroplasty to prevent septic loosening, with excellent clinical results, although few therapies have been able to prevent aseptic loosening. Research on aseptic loosening indicates that osteoclasts play an essential role in this process. Thus, the exploration of osteoclastogenesis inhibitor has become of interest. Erythromycin is a broad-spectrum antimicrobial that has been used to prevent postoperative infection after artificial joint replacement. A new function to inhibit particle-induced osteolysis has been discovered recently. Fundamental research indicates that eryth...

A toddler with facial nodules: A case of idiopathic facial aseptic granuloma.

We describe the case of a 3-year-old boy who presented with several asymptomatic facial nodules present for six months. A skin biopsy obtained from the nodules showed a moderately well-defined granuloma in the superficial and deep dermis. A squamous epithelial lined cyst, extravasated keratin, or shadow cells were not identified. Bartonella henselae titers and the Coccidioidomycosis immitis immunodiffusion test were negative; a Tuberculin Skin Test was non-reactive. Fite, Periodic acid-Schiff (PAS) and Gomori-Grocott methenamine silver (GMS) stains failed to identify microorganisms. In addition, tissue cultures for bacteria, fungus, and acid fast bacilli were negative. In light of the clinical findings, histology, and negative cultures, a diagnosis of idiopathic facial aseptic granuloma (I...

Linear IgA bullous dermatosis: The more frequent bullous dermatosis of children.

CONCLUSION: This study confirms that LAD is the most common AIBD in children in Tunisia and it frequently occurs in preschool-aged males. Independently of the medication chosen for treatment, a long term remission is frequently observed. PMID: 20137744 [PubMed - in process] (Source: Dermatol Online J)

Decline of EMRSA-16 amongst methicillin-resistant Staphylococcus aureus causing bacteraemias in the UK between 2001 and 2007

Conclusions EMRSA-15 and EMRSA-16 remain the main MRSA strains in bacteraemia in the UK, but the proportion of EMRSA-16 declined from the late 1990s, thus preceding the general decline in MRSA bacteraemias that began in the middle of the present decade. (Source: Journal of Antimicrobial Chemotherapy)

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Erythromycin ointment supply improves [News and Features]

(Source: AAP News)

Antibiotic Susceptibility of Bifidobacterial Strains Distributed in the Japanese Market.

Authors: Xiao JZ, Takahashi S, Odamaki T, Yaeshima T, Iwatsuki K The aim of the present study was to analyze the antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. A total of 23 strains, including probiotic isolates from foods, supplements, pharmaceuticals and reference strains of each species (or subspecies), were tested for susceptibility to 15 antibiotics by the broth microdilution method and examined for the presence of possible resistant determinants. The strains were susceptible overall to chloramphenicol, ampicillin, vancomycin and linezolid, and were intrinsically resistant to aminoglycoside group agents. Susceptibility to erythromycin, clindamycin, rifampicin, tetracycline and trimethoprim varied among the strains. All strains of Bifidobac...

Occurrence and Persistence of Erythromycin Resistance Genes (erm) and Tetracycline Resistance Genes (tet) in Waste Treatment Systems on Swine Farms.

In this study, we evaluated the efficiency of three different on-farm waste treatment systems in reducing AR. Three classes of erythromycin resistance genes (erm) genes (B, F, and X) conferring resistances to macrolide-lincosamides-streptogramin B (MLS(B)) and one class of tetracycline resistance genes (tet) gene (G) conferring resistance to tetracyclines were used as models. Real-time polymerase chain reaction assays were used to determine the reservoir sizes of these AR genes present in the entire microbiome. These classes of AR genes varied considerably in abundance, with erm(B) being more predominant than erm(F), erm(X), and tet(G). These AR genes also varied in persistence in different waste treatment systems. Aerobic biofiltration reduced erm(X) more effectively than other AR genes, ...

MLST and a genetic study of antibiotic resistance and virulence factors in vanA-containing Enterococcus from buzzards (Buteo buteo)

Conclusions: The intestinal tract of B. buteo could be a reservoir of vanA-positive enterococci.Significance and Impact of the Study: First study focused to define the occurrence of vanA-containing Enterococcus strains in B. buteo. (Source: Letters in Applied Microbiology)

Comparison of several extraction techniques for multiclass analysis of veterinary drugs in eggs using ultra-high pressure liquid chromatography-tandem mass spectrometry.

This study compared four extraction methods for the simultaneous determination of tetracyclines, macrolides, quinolones, sulphonamides and anthelmintics (including benzimidazoles and avermectins) in eggs by ultra-high pressure liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Solvent extraction, solid-phase extraction (SPE), matrix solid-phase dispersion (MSPD) and modified QuEChERS procedure were compared in terms of recovery and number of veterinary drugs extracted. The solvent extraction procedure with a clean-up step provided better results than the other tested procedures. The QuEChERS procedure was simpler and faster, but extracted fewer compounds than solvent extraction. MSPD did not extract tetracyclines and quinolones, whereas macrolides and tetracyclines we...

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Fera shipping erythromycin, bacitracin ointments

Fera Pharmaceuticals is now shipping erythromycin and bacitracin ophthalmic ointments. (Source: Modern Medicine)

Current and future therapeutic prokinetic therapy to improve enteral feed intolerance in the ICU patient.

Authors: Fraser RJ, Bryant L Malnutrition is associated with poor outcomes in critically ill patients, and providing enteral feeding to those who cannot eat is considered best practice. Enteral feeding is often unsuccessful when there is delayed gastric emptying. Recent research has given additional insight into the mechanisms underlying delayed gastric emptying. Pharmacological strategies to improve the success of feeding include prokinetic drugs such as metoclopramide and erythromycin alone or in combination. When drug treatment fails, either parenteral nutrition or direct small intestinal feeding is indicated. Simpler methods to access the duodenum and distal small bowel for feed delivery are under investigation. This review summarizes current understanding of the mechanisms underly...

Novel alternative to antibiotics in shrimp hatchery: effects of the essential oil of Cinnamosma fragrans on survival and bacterial concentration of Penaeus monodon larvae

Conclusion: Both C. fragrans essential oils, as antibiotic, exhibited significantly higher survival rates and lower bacterial concentrations of the larvae than the control (oil and antibiotic free).Significance and impacts of the study: The potential of C. fragrans essential oil to control the bacterial load in in vivo conditions, thereby enhancing survival rate of P. monodon larvae, makes it a relevant option for developing a novel alternative to antibiotics in shrimp hatchery culture. (Source: Journal of Applied Microbiology)

[Construction of a recombinant Lactobacillus acidophilus expressing high levels of Helicobacter pylori adhesin Hp0410.]

CONCLUSION: The recombinant Lactobacillus acidophilus with high constitutive expression of Hp0410 has been constructed successfully. PMID: 20159678 [PubMed - in process] (Source: Journal of Southern Medical University)

The physiological and morphological phenotype of a yeast mutant resistant to the quaternary ammonium salt N-(dodecyloxycarboxymethyl)-N,N,N-trimethyl ammonium chloride.

Authors: Obłąk E, Gamian A, Adamski R, Ułaszewski S We investigated the action of the quaternary ammonium salt (QAS) called IM (N-(dodecyloxycarboxymethyl)-N,N,N-trimethyl ammonium chloride) on Saccharomyces cerevisiae yeast cells. Changes in the yeast cell ultrastructure were confirmed by electron microscopy. We treated resistant mutant cells with QAS, and confirmed destruction of the mutant cytoplasm, an increase in the thickness of the cell wall, separation of the cell wall from the cytoplasm, and the accumulation of numerous lipid droplets. We also observed a relatively high production of lipids in the cells of the parental wild-type strain Sigma1278b and in its IM-resistant (IM(R)) mutant in the presence of the QAS. The IM(R) mutant showed increased sensitivity t...

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Periocular Ulcerative Dermatitis Associated with Gentamicin Ointment Prophylaxis in Newborns

We report a series of 26 newborns in whom a characteristic periocular ulcerative dermatitis developed after gentamicin ointment administration at 2 Philadelphia hospitals. (Source: The Journal of Pediatrics)

HIGH PREVALENCE OF EXTENDED-SPECTRUM β-LACTAMASES ESCHERICHIA COLI AND VANCOMYCIN-RESISTANT ENTEROCOCCI ISOLATES FROM CHICKEN PRODUCTS. A PROBLEM OF PUBLIC HEALTH

Twenty-nine chicken products were acquired from different supermarkets in Portugal during September to December 2007 and were analyzed for extended-spectrum [beta]-lactamases (ESBL) Escherichia coli and vancomycin-resistant enterococci (VRE). Cefotaxime-resistant E. coli isolates were recovered in 27 of 29 chicken samples representing 93% of the analyzed samples. The highest percentages of resistance (more than 50% of the isolates) were detected for ampicillin, nalidixic acid and tetracycline. VRE isolates were detected in 17 of 29 samples of chicken origin (59%) and were identified as Enterococcus durans (n = 15) and E. faecium (n = 2) with the highest percentages of resistance being detected for erythromycin, tetracycline, ampicillin and ciprofloxacin. Seven E. durans and the two E. faec...

Antimicrobial susceptibility patterns of lab isolated from wakalim, a traditional ethiopian fermented sausage

In this study, 168 lactic acid bacteria strains isolated during the fermentation of wakalim were evaluated for their antimicrobial resistance patterns. All of the isolates tested were sensitive to Amp, Pen, Ery, Cep, Aml, and Tet. Among the Lactobacillus isolates, the most frequent resistance was noted for methicillin (96%), followed by resistance to streptomycin (85%), vancomycin (72%), kanamycin (47%), and gentamycin (38%). The most frequent resistance among Pediococcus isolates was observed for vancomycin and streptomycin (96% each), followed by resistance to kanamycin (84%), gentamicin (55%), and methicillin (30%). A total of 13 multiple drug resistance (MDR) patterns were detected. About 42% of the isolates showed MDR to four drugs, 29% to five drugs, and 2% to six drugs. The most fre...

Risk factors for multidrug-resistant bacteria in patients with post-operative peritonitis requiring intensive care

Conclusions Our results suggest that broad-spectrum antibiotics should be used in ICU patients with POP who have received antimicrobial therapy in the 3 months prior to hospitalization, or with >5 days between the first operation and relaparotomy. (Source: Journal of Antimicrobial Chemotherapy)

Reduction in erythromycin resistance in invasive pneumococci from young children in England and Wales

(Source: Journal of Antimicrobial Chemotherapy)

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Identification of tetracycline- and erythromycin-resistant Gram-positive cocci within the fermenting microflora of an Italian dairy food product

Conclusions: We characterized tetracycline-and erythromycin-resistance genes in coccal species, representing the fermenting microflora of a typical Italian dairy product.Significance and Impact of the Study: These results are of particular relevance from the food safety viewpoint, especially in the light of the potential risk of horizontal transfer of antibiotic-resistance genes among foodborne commensal bacteria. (Source: Journal of Applied Microbiology)

Hepatic Clearance, but Not Gut Availability, of Erythromycin Is Altered in Patients With End-Stage Renal Disease.

Authors: Sun H, Frassetto LA, Huang Y, Benet LZ Nonrenal clearance of drugs can be significantly lower in patients with end-stage renal disease (ESRD) than in those with normal renal function. Using erythromycin (ER) as a probe compound, we investigated whether this decrease in nonrenal clearance is due to reduced hepatic clearance (CL(H)) and/or gut metabolism. We also examined the potential effects of the uremic toxins 3-carboxy-4-methyl-5-propyl-2-furan propanoic acid (CMPF) and indoxyl sulfate (Indox) on ER disposition. Route-randomized, two-way crossover pharmacokinetic studies of ER were conducted in 12 ESRD patients and 12 healthy controls after oral (250 mg) and intravenous (125 mg) dosing with ER. In patients with ESRD, CL(H) decreased 31% relative to baseline values (0.35 +/-...

Determination of antibiotics in sewage from hospitals, nursery and slaughter house, wastewater treatment plant and source water in Chongqing region of Three Gorge Reservoir in China.

Authors: Chang X, Meyer MT, Liu X, Zhao Q, Chen H, Chen JA, Qiu Z, Yang L, Cao J, Shu W Sewage samples from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water samples of Chongqing region of Three Gorge Reservoir were analyzed for macrolide, lincosamide, trimethoprim, fluorouinolone, sulfonamide and tetracycline antibiotics by online solid-phase extraction and liquid chromatography-tandem mass spectrometry. Results showed that the concentration of ofloxacin (OFX) in hospital was the highest among all water environments ranged from 1.660 mug/L to 4.240 mug/L and norfloxacin (NOR, 0.136-1.620 mug/L), ciproflaxacin (CIP, ranged from 0.011 mug/L to 0.136 mug/L), trimethoprim (TMP, 0.061-0.174 mug/L) were commonly detected. Removal range of antibiotics...

Micropollutant removal during biological wastewater treatment and a subsequent ozonation step.

Authors: Schaar H, Clara M, Gans O, Kreuzinger N The design criteria for wastewater treatment plants (WWTP) and the sludge retention time, respectively, have a significant impact on micropollutant removal. The upgrade of an Austrian municipal WWTP to nitrogen removal (best available technology, BAT) resulted in increased elimination of most of the analyzed micropollutants. Substances, such as bisphenol-A, 17alpha-ethinylestradiol and the antibiotics erythromycin and roxithromycin were only removed after the upgrade of the WWTP. Nevertheless, the BAT was not sufficient to completely eliminate these compounds. Thus, a pilot scale ozonation plant was installed for additional treatment of the effluent. The application of 0.6 g O(3) g DOC(-1) increased the removal of most of the micropollut...

Preterm birth

New evidence; conclusions changed for: Magnesium sulphate: Two systematic reviews added to the comments section. The first review reported that the percentage of women with a successful delay of delivery by 48 hours was 53% with control/placebo and 89% with magnesium sulphate. The percentage of women with successful delay of labour until 37 weeks was 36% with control/placebo and 42% with magnesium sulphate. Neonatal mortality occurred in 2% with placebo and 1% with magnesium sulphate. Overall rates of adverse effects were 1% with placebo and 3% with magnesium sulphate. However, no direct comparisons were made in this review. The second review reported that magnesium sulphate given before preterm delivery for neuroprotection has demonstrated a reduction in...

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BMJ Practice article: Long QT syndrome

Source: BMJ Area: News The authors of this article look at a case of long QT syndrome in a female student taking erythromycin for an infected leg abrasion, and go on to discuss why this phenomenon is missed, how common it is, and how it is diagnosed and managed. The key points identified are as follows: . Long QT syndrome is a familial condition associated with recurrent syncope and sudden cardiac death resulting from ventricular arrhythmias; it may be misdiagnosed as epilepsy . Triggers for arrhythmias may include medications that prolong the QT interval or subtype specific factors such as swimming and other exercise (long QT1), auditory stimuli and emotional stress (long QT2), and rest or sleep (long QT3) . ? blocker...

Resistance to linezolid in a porcine Clostridium perfringens strain carrying a mutation in the rplD-gene encoding for the ribosomal protein L4.

Authors: Hölzel CS, Harms KS, Schwaiger K, Bauer J Coresistance to human reserve antibiotics can be selected by antibiotics used in veterinary medicine. A Clostridium perfringens strain, isolated from pig manure, was resistant to the reserve drug linezolid and, simultaneously, resistant against florfenicol and erythromycin. We detected a new mutation in a highly conserved region of rplD, encoding for the protein L4 of the 50S ribosomal subunit. This is the first genetic substantiation of linezolid resistance in the genus Clostridium. PMID: 20065060 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Distribution of serotypes, genotypes and resistance determinants among macrolide-resistant Streptococcus pneumoniae.

Authors: Xu X, Cai L, Xiao M, Kong F, Oftadeh S, Zhou F, Gilbert GL Macrolide resistance in Streptococcus pneumoniae has emerged as an important clinical problem, worldwide, over the past decade. The aim of this study was to analyze the phenotypes (serotype, antibiotic susceptibility), genotypes (multilocus sequence type [MLST] and antibiotic resistance gene/transposon profiles) among the 31%, of invasive isolates (102/328) from children, in New South Wales Australia in 2005, which were resistant to erythromycin. Three serotypes - 19F (47; 46%), 14 (27; 26%), and 6B (12; 12%) - accounted for 86 (84%) of these 102 isolates. Seventy four (73%) isolates had the MLSB resistance phenotype and carried Tn916 transposons (most commonly Tn6002); of these, 73 (99%) contained the erythromycin rib...

Antibiotic Sensitivity Profiles Determined with an Escherichia coli Gene Knockout collection: Generating an Antibiotic Barcode.

Authors: Liu A, Tran L, Becket E, Lee K, Chinn L, Park E, Tran K, Miller JH We have defined a "sensitivity profile" for 22 antibiotics by extending previous work that tested the entire KEIO collection of close to 4,000 single gene knockouts in E. coli for increased susceptibility to one of fourteen different antibiotics (ciprofloxacin, CIP; rifampicin, RIF, vancomycin, VAN, ampicillin, AMP; sulfamethoxazole, SFX, gentamicin, GEN; metronidazole, MTR; streptomycin, STR; fusidic Acid, FUS; tetracycline, TET; chloramphenicol, CHL; nitrofurantoin, NIT; erythromycin, ERY; and triclosan, TRI). We screened one or more subinhibitory concentrations of each antibiotic, generating more than 80,000 data points and allowing a reduction of the entire collection to a set of 283 strains that display si...

ERYGEL (Erythromycin) Gel [Merz Pharmaceuticals, LLC]

Updated Date: Jan 8, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Antimicrobial susceptibility testing of rapidly growing mycobacteria by microdilution - Experience of a tertiary care centre

Conclusions:</b> We wish to emphasize that reporting of rapidly growing mycobacteria from clinical settings, along with their sensitivity patterns, is an absolute need of the hour. (Source: Indian Journal of Medical Microbiology)

Interaction between warfarin and ophthalmic erythromycin

Source: Am J Health-Syst Pharm Area: News A case-report describes an interaction between warfarin and erythromycin administered topically as eye ointment. The patient was prescribed warfarin because of her atrial fibrillation, and was stable on 14mg weekly with an INR ranging between 1.8 and 2.5 for a period of four months. She was then prescribed erythromycin eye ointment for chronic bacterial conjunctivitis and at routine monitoring three weeks later had an INR of 8.5. After missing four doses of warfarin, she was re-stabilised on 12mg weekly. At the next clinic visit, her INR was 1.5 and it was found that the erythromycin ointment had been stopped five days previously. She was then stabilised with an INR 2.9 to 3.4 on warfarin 16mg weekly: some five months later, she was fou...

SENTRY AQ MARDEL MARACYN (Erythromycin) Powder [Sergeant'S Pet Care Products, Inc.]

Updated Date: Jan 4, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Dissecting the ribosomal inhibition mechanism of a new ketolide carrying an alkyl-aryl group at C-13 of its lactone ring

Abstract: Ketolides are effective not only against macrolide-sensitive bacteria but also against some macrolide-resistant strains. Here we present data regarding a new ketolide with an alkyl-aryl side chain at C-13 of its lactone ring. It behaves as a strong inhibitor of protein synthesis in a model coupled transcription/translation system, although it does not affect the accuracy of translation. In addition, detailed kinetic analysis shows that it slowly forms a very tight, slowly reversible complex with prokaryotic ribosomes, a property that could be correlated with its superior activity compared with erythromycin against Escherichia coli both in vivo and in vitro. (Source: International Journal of Antimicrobial Agents)

Elevated International Normalized Ratio associated with concurrent use of ophthalmic erythromycin and warfarin.

CONCLUSION: An increase in INR values was reported after initiation of ophthalmic erythromycin in a patient receiving warfarin and recurred upon rechallenge with ophthalmic erythromycin. PMID: 20044367 [PubMed - as supplied by publisher] (Source: American Journal of Health-System Pharmacy : AJHP)

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Trends in antimicrobial susceptibility of Streptococcus pneumoniae in the Tohoku district of Japan: a longitudinal analysis from 1998 to 2007.

Authors: Suzuki K, Nishimaki K, Okuyama K, Katoh T, Yasujima M, Chihara J, Suwabe A, Shibata Y, Takahashi C, Takeda H, Ida S, Kaku M, Watanabe A, Nukiwa T, Niitsuma K, Kanemitsu K, Takayanagi M, Ohno I Streptococcus pneumoniae is a common cause of respiratory tract infections (RTIs). The prevalence of Streptococcus pneumoniae strains with reduced susceptibility to antimicrobial agents has dramatically increased worldwide. Susceptibility to nine antimicrobial agents and serotypes were determined among 1,644 Streptococcus pneumoniae strains isolated from patients with RTIs in the Tohoku district of Japan from October to December every year from 1998 to 2007. The prevalence of penicillin G-nonsusceptible Streptococcus pneumoniae (PNSP) strains increased gradually from 48.5% in 1998, reach...

Genome-wide dissection of globally emergent multi-drug resistant serotype 19A Streptococcus pneumoniae

Conclusions: Our results suggest a complex genetic picture where high-level drug resistance, vaccine selection pressure, and SPN mutational events have created a "perfect storm" for the emergence of MDR 19A. (Source: BMC Genomics - Latest articles)

Erythrochelin – a hydroxamate-type siderophore predicted from the genome of Saccharopolyspora erythraea

The class of nonribosomally assembled siderophores encompasses a multitude of structurally diverse natural products. The genome of the erythromycin-producing strain Saccharopolyspora erythraea contains 25 secondary metabolite gene clusters that are mostly considered to be orphan, including two that are responsible for siderophore assembly. In the present study, we report the isolation and structural elucidation of the hydroxamate-type tetrapeptide siderophore erythrochelin, the first nonribosomal peptide synthetase-derived natural product of S. erythraea. In an attempt to substitute the traditional activity assay-guided isolation of novel secondary metabolites, we have employed a dedicated radio-LC-MS methodology to identify nonribosomal peptides of cryptic gene clusters in the industriall...

Evaluation of the efficiency of the macrolactonization using MNBA in the synthesis of erythromycin A aglycon.

Authors: Shiina I, Katoh T, Nagai S, Hashizume M Various intermediates for the synthesis of erythronolide A, an aglycon of erythromycin A, are prepared from the corresponding seco-acids using 2-methyl-6-nitrobenzoic anhydride (MNBA) in the presence of 4-(dimethylamino)pyridine (DMAP) with or without triethylamine. The efficiency of the MNBA lactonization is assessed by studying this method and comparing the results with those of the other established macrocyclization protocols. It has been finally concluded that (i) the conformationally appropriate substrate for the monomeric cyclization gave the desired lactone in excellent yield under mild reaction conditions in the presence of MNBA and DMAP, (ii) the highly-strained substrate for the cyclization also afforded the monomeric lactone i...

Antimicrobial Susceptibility of Multidrug-Resistant Campylobacter jejuni and C. coli strains: in vitro Activities of 20 Antimicrobial Agents.

Authors: Lehtopolku M, Nakari UM, Kotilainen P, Huovinen P, Siitonen A, Hakanen AJ There is a paucity of information regarding antimicrobial agents suitable to treat severe infections caused by multidrug-resistant Campylobacter spp. Our aim was to identify agents potentially effective towards multiresistant Campylobacter strains. The in vitro activities of 20 antimicrobial agents against 238 Campylobacter spp. strains were analyzed by determining the MICs by the agar plate dilution method or the Etest. These strains were selected from 1808 Campylobacter spp. isolates collected from Finnish patients between 2003 and 2005 and screened for macrolide susceptibility using the disk diffusion test. The 238 strains consisted of 183 strains with erythromycin inhibition zone diameters </=23 m...

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Identified Safety Risks With Splitting and Crushing Oral Medications

Emergency nurses are occasionally in a position to administer oral medications to patients who, because of age or a variety of reasons, may not be able to swallow a tablet or capsule. Although some medications can be safely chewed, crushed, or cut (tablet splitting) to assist with administration, there is a growing list of products that, because of their formulations or pharmacokinetic properties, are deemed unsafe to manipulate in this manner. These drug classes are varied and include, but are not limited to, analgesics, cardiovascular medications, nonsteroidal anti-inflammatory agents, antiepileptics, and antibiotics. Drugs that should not be chewed or crushed include commonly used medications such as phenytoin, isosorbide, nifedipine, verapamil, Losec, MS Contin, oxycodone, and erythrom...

SENTRY AQ MARDEL MARACYN (Erythromycin) Powder [Sergeant'S Pet Care Products, Inc.]

Updated Date: Dec 23, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Antimicrobial Resistance of Enterococci Isolated from Mastitic Bovine Milk Samples in Korea

This study demonstrates that enterococcal isolates belonging to minor species showed antimicrobial resistance rates as high as those of E. faecium and E. faecalis, and that monitoring of antimicrobial resistance should not be restricted only to those two major species. (Source: Zoonoses and Public Health)

Species distribution and antimicrobial susceptibility of staphylococci isolated from canine otitis externa.

Authors: Penna B, Varges R, Medeiros L, Martins GM, Martins RR, Lilenbaum W Abstract The diversity of species of the genus Staphylococcus sp. and the antimicrobial resistance of isolates from 151 unmedicated dogs of both sexes with a clinical diagnosis of otitis were recorded. Ninety-one isolates of Staphylococcus spp. were identified by biochemical reactions and tested for susceptibility to 15 antimicrobials. Coagulase-positive species were most common; S. pseudintermedius (38.4%), S. schleiferi schleiferi (15.4%), S. aureus (14.3%), S. epidermidis (11%), S. simulans (11%), S. schleiferi coagulans (8.8%) and S. saprophyticus (1.1%). All the isolates showed resistance to at least one drug and 89% were multiresistant. Amoxicillin combined with clavulanic acid and oxacillin were the most...

Antibacterial Effects of Poly(2-(dimethylamino ethyl)methacrylate) against Selected Gram-Positive and Gram-Negative Bacteria.

Authors: Rawlinson LA, Ryan SM, Mantovani G, Syrett JA, Haddleton DM, Brayden DJ Antimicrobial coatings can reduce the occurrence of medical device-related bacterial infections. Poly(2-(dimethylamino ethyl)methacrylate) (pDMAEMA) is one such polymer that is being researched in this regard. The aims of this study were to (1) elucidate pDMAEMA's antimicrobial activity against a range of Gram-positive and Gram-negative bacteria and (2) to investigate its antimicrobial mode of action. The methods used include determination of minimum inhibitory concentration (MIC) values against various bacteria and the effect of pH and temperature on antimicrobial activity. The ability of pDMAEMA to permeabilise bacterial membranes was determined using the dyes 1-N-phenyl-naphthylamine and calcein-AM. Flo...

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Study on enantiomeric separation of basic drugs by NACE in methanol-based medium using erythromycin lactobionate as a chiral selector

In this study, an approach to the enantioseparation of basic drugs by means of NACE with erythromycin lactobionate (EL) belonging to the group of macrolide antibiotics has been investigated. Especially different from the above four classes of antibiotics, there are no reports concerned with the use of macrolides which belong to macrocyclic antibiotics as chiral selectors in CE. In this work EL is first used as a chiral selector in NACE for the enantiomeric separations of two racemic basic drugs that possess high separability consisting of propranolol and duloxetine. Furthermore, EL possesses advantages such as high solubility and low viscosity in the solvent and very weak UV absorption. The chiral separations were achieved using Tris-boric acid as the BGE and methanol as the organic medium...

A sensitive method for simultaneous determination of four macrolides by CE with electrochemiluminescence detection and its applications in human urine and tablets

A sensitive method for simultaneous determination of azithromycin (AZI), acetylspiramycin (ACE), erythromycin (ERY), and josamycin (JOS) was developed by CE coupled with electrochemiluminescence detection with Ru(bpy)32+. The parameters related to separation and detection were investigated in detail. The four macrolides were well separated and detected within 6 min under the optimized conditions. The LOD (S/N=3) of AZI, ACE, ERY, and JOS were 1.2×10-9, 7.1×10-9, 3.9×10-8 and 9.5×10-8 mol/L, respectively. The LOQ (S/N=10) of AZI, ACE, ERY, and JOS in human urine were 8.2×10-8, 2.5×10-7, 8.9×10-7 and 1.2×10-6 mol/L, respectively. The recoveries of the four macrolides in human urine and pharmaceutical tablet samples were 85.0-104.0% at different concentration levels. (Source: Electrop...

Use of erythromycin in pregnancy

Source: National Teratology Information Service (NTIS) Area: Evidence > Drugs in Pregnancy SUMMARY: Erythromycin is a broad spectrum macrolide antibiotic. The available data does not indicate that use of erythromycin is associated with an increased risk of congenital malformations or any other adverse fetal effects. A recent study has suggested a possible increased risk of cardiovascular malformations and pyloric stenosis, however causality has not been established and the individual risk, if any, is thought to be low. A randomised trial reported that the administration of erythromycin in women with spontaneous premature labour with intact membranes was associated with an increased risk of functional impairment and cerebral palsy in exposed children. However, there is no evidence to sug...

Erythromycin Ophthalmic Ointment Supply Increasing

A nationwide shortage of erythromycin (0.5%) ophthalmic ointment appears to be nearing its end, but hospitals and other customers are being asked to limit their orders to quantities that meet their immediate needs. The FDA said on its Web page dedicated to drug shortages that production has increased and is expected to increase again after the first quarter of 2010, allowing customers to build inventory. (Source: AAFP Clinical Care and Research)

Canadian province-level risk factor analysis of macrolide consumption patterns (2000-2006)

Conclusions The impact of associations among macrolide consumption, influenza and socioeconomic factors may reflect inappropriate use of these agents to treat viral infections and/or prescribing for secondary infections, and knowledge of the virus versus bacteria problem and accessibility of healthcare. Further research surrounding differences in access to antimicrobial prescriptions and treatment options between advantaged and disadvantaged populations is suggested to further understand the dynamics of antimicrobial use in Canada. (Source: Journal of Antimicrobial Chemotherapy)

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Antimicrobial susceptibility of pathogens isolated from more than 10 000 patients with infectious respiratory diseases: a 25-year longitudinal study

Abstract The Study Group on Antimicrobial Susceptibility of Pathogens Isolated from Respiratory Infections was established in 1981 in Japan to elucidate trends in such susceptibilities in patients with infectious respiratory diseases; the Group has conducted nationwide research in collaboration with 21 medical institutions. Examination of more than 10 000 patients by 2005 allowed a summary of study findings. Streptococcus pneumoniae started to become resistant to penicillin G in the 1990s, and the isolation rate of penicillin-intermediate and penicillin-resistant S. pneumoniae (PISP + PRSP) reached almost 60% in 2001. The proportion of PRSP also increased, reaching 19.4%. Thereafter, the rate of PISP + PRSP decreased somewhat to the mid-30% range. Macrolide resistance was a...

Short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics on surgical site infection and methicillin-resistant Staphylococcus aureus infection in elective colon cancer surgery: Results of a prospective randomized trial

Conclusion These findings suggest that short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics may be successfully applied to colon cancer surgery that is generally performed in Japan. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00595-009-3994-9Authors Keiichiro Ishibashi, Saitama Medical University Department of Digestive Tract and General Surgery, Saitama Medical Center 1981 Tsujido-machi, Kamoda Kawagoe, Saitama 350-8550 JapanKouki Kuwabara, Saitama Medical University Department of Digestive Tract and General Surgery, Saitama Medical Center 1981 Tsujido-machi, Kamoda Kawagoe, Saitama 350-8550 JapanToru Ishiguro, Saitama Medical University Department of Digestive Tract and General Surgery, Saitama Medic...

[Usefulness of Macrolides as Anti-Inflammatories in Respiratory Diseases.]

Authors: Sevilla-Sánchez D, Soy-Muner D, Soler-Porcar N The macrolides are antibiotics that, besides their anti-bacterial action, have an anti-inflammatory effect, by decreasing the activity of the immune cells and bacteria cell changes. An increase the survival of patients suffering from diffuse panbronchiolitis was already seen in the 1980s, after being treated with erythromycin. Currently, the use of macrolides in various chronic inflammatory diseases has increased significantly. Clinical improvements associated to the administration of macrolides have been observed in diseases such as, cystic fibrosis, asthma, and bronchiectasis. However, despite the apparent clinical benefit they seem to provide, the published results up until now are controversial and conclusive results are ...

Genetic commonality of macrolide-resistant group A beta hemolytic streptococcus pharyngeal strains

Conclusion: Community macrolide resistance has increased following increased macrolide use. These results may have treatment implications if use continues to be high. (Source: Annals of Clinical Microbiology and Antimicrobials)

Erythromycin lactobionate: Postprandial biliary colic: case report

(Source: Reactions)

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Interaction of the heptavalent pneumococcal conjugate vaccine and the use of individual antibiotics among children on nasopharyngeal colonization with erythromycin-resistant Streptococcus pneumoniae

Abstract The purpose of this study was to assess the complex interaction of the heptavalent pneumococcal conjugate vaccine (PCV7) and individual classes of antimicrobial agents on the nasopharyngeal carriage of erythromycin-resistant pneumococci within the day-care center population. Between February 2005 and May 2007, nasopharyngeal cultures for Streptococcus pneumoniae were obtained from 1,829 day-care center attendees in Central Greece. Thirty-one percent of the pneumococci were erythromycin-resistant; 85.2% of these isolates were also penicillin-nonsusceptible. PCV7 immunization was associated with decreased carriage of erythromycin-resistant PCV7 serotypes but not with an overall decrease in erythromycin-resistant S. pneumoniae colonization. The largest decline in the c...

The influence of antibiotics on the changing epidemiology of Clostridium difficile.

Authors: Taori SK, Hall V, Poxton I An increase in incidence of clinical cases of Clostridium difficile infection has been reported in recent years but few studies have examined the changes in molecular epidemiology and antibiotic resistance over a long period of time. A collection of 179 isolates of C. difficile obtained from symptomatic adult patients in southern Scotland between 1979 and 2004 was used to determine changes in the prevalence of epidemiological types and antibiotic susceptibilities to common antibiotics. PCR ribotyping and MICs were performed on all isolates. A total of 56 different ribotypes was identified among which ribotype 002 was the commonest type overall (14%), followed by ribotypes 014 (7.3%), 012 (5%), 015 (5%), 020(5%), and 001 (4.5%). Ribotype 078 was also ...

Synthesis and antibacterial activity of novel 3-O-carbamoyl derivatives of clarithromycin and 11,12-cyclic carbonate azithromycin.

Authors: Zhang L, Song L, Liu Z, Li H, Lu Y, Li Z, Ma S Two series of novel 3-O-carbamoyl derivatives of clarithromycin and 11,12-cyclic carbonate azithromycin were designed, synthesized and evaluated for their in vitro antibacterial activities. Compounds 4j and 4k were the most potent activity against erythromycin-susceptible Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae, which were comparable to those of clarithromycin and azithromycin. Compounds 4d, 4h and 4i showed potent activity against erythromycin-resistant S. pneumoniae encoded by the mef gene and compounds 4h and 4i displayed greatly improved activity against erythromycin-resistant S. pneumoniae encoded by the erm gene. Compound 7c exhibited improved activity against erythromycin-resistant S. pneu...

Mechanisms of antimicrobial resistance and genetic relatedness among enterococci isolated from dogs and cats in the United States

Conclusion: Enterococci from dogs and cats may be a source of antimicrobial resistance genes.Significance and Impact of the Study: Dogs and cats may act as reservoirs of antimicrobial resistance genes that can be transferred from pets to people. Although host-specific ecovars of enterococcal species have been described, identical PFGE patterns suggest that enterococcal strains may be exchanged between these two animal species. (Source: Journal of Applied Microbiology)

ERYTHROMYCIN ETHYLSUCCINATE AND SULFISOXAZOLE ACETYLgranule, For Suspension [Duramed Pharmaceuticals Inc.]

Updated Date: Nov 24, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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[Establishment of a rat model of mycoplasma pneumonia and the treatment.]

CONCLUSION: The approach described is practicable to establish rat models of MP. Erythromycin microspheres can effectively relieve the lung inflammations and has therapeutic effect on MP. PMID: 19923071 [PubMed - as supplied by publisher] (Source: Journal of Southern Medical University)

Environmental and human health risk assessment of organic micro-pollutants occurring in a Spanish marine fish farm.

Authors: Muñoz I, Martínez Bueno MJ, Agüera A, Fernández-Alba AR In this work the risk posed to seawater organisms, predators and humans is assessed, as a consequence of exposure to 12 organic micro-pollutants, namely metronidazole, trimethoprim, erythromycin, simazine, flumequine, carbaryl, atrazine, diuron, terbutryn, irgarol, diphenyl sulphone (DPS) and 2-thiocyanomethylthiobenzothiazole (TCMTB). The risk assessment study is based on a 1-year monitoring study at a Spanish marine fish farm, involving passive sampling techniques. The results showed that the risk threshold for irgarol concerning seawater organisms is exceeded. On the other hand, the risk to predators and especially humans through consumption of fish is very low, due to the low bioconcentration poten...

Comparison of the Effect of Azithromycin Versus Erythromycin on Antroduodenal Pressure Profiles of Patients with Chronic Functional Gastrointestinal Pain and Gastroparesis

Conclusions Azithromycin stimulates antral activity similar to erythromycin and moreover has a longer duration of effect. However, unlike erythromycin, azithromycin does not have significant drug–drug interactions and may be a potential new medication for the treatment of gastroparesis and gastrointestinal dysmotility. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-009-1038-3Authors Baharak Moshiree, University of Florida Division of Gastroenterology, Hepatology and Nutrition 1600 Southwest Archer Road PO Box 100214 Gainesville FL 32610 USARenee McDonald, University of Florida Division of Gastroenterology, Hepatology and Nutrition 1600 Southwest Archer Road PO Box 100214 Gainesville FL 32610 USAWei Hou, University of Florida Division of B...

Molecular Ecology Of Macrolide-Lincosamide-Streptogramin B Methylases in Waste Lagoons and Subsurface Waters Associated with Swine Production.

Authors: Koike S, Aminov RI, Yannarell AC, Gans HD, Krapac IG, Chee-Sanford JC, Mackie RI RNA methylase genes are common antibiotic resistance determinants for multiple drugs of the macrolide, lincosamide, and streptogramin B (MLS(B)) families. We used molecular methods to investigate the diversity, distribution, and abundance of MLS(B) methylases in waste lagoons and groundwater wells at two swine farms with a history of tylosin (a macrolide antibiotic structurally related to erythromycin) and tetracycline usage. Phylogenetic analysis guided primer design for quantification of MLS(B) resistance genes found in tylosin-producing Streptomyces (tlr(B), tlr(D)) and commensal/pathogenic bacteria (erm(A), erm(B), erm(C), erm(F), erm(G), erm(Q)). The near absence of tlr genes at these sites s...

Distribution of drug resistance among enterococci and Salmonella from poultry and cattle in Ethiopia

Abstract Enterococci and Salmonella were isolated from feces of chicken in intensive poultry farms and cattle which are maintained following traditional practices. Their resistance to different antibiotics was also determined. A total of 298 enterococcal isolates consisting of Enterococcus faecium (49.6%), Enterococcus durans (26.9%), Enterococcus hirea (11.9%), and Enterococcus faecalis (11.5%) were obtained. Among the enterococci, resistance to erythromycin (Ery), clindamicin (Cli), amoxicillin (Amo), ampicillin (Amp), and cephalothin (Cep) was high. Resistance to vancomycin (Van) was detected in all enterococcal species. Over 80% of the isolates showed multiple drug resistance. The most dominant patterns in poultry were Amo/Amp/Cep/Pen and Amo/Amp/Cep/Cli/Pen/Van. Among i...

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Novel Integron Gene Cassette Arrays Identified in a Global Collection of Multi-Drug Resistant Non-Typhoidal Salmonella enterica.

Authors: Krauland M, Harrison L, Paterson D, Marsh J Investigation of integron carriage in a global collection of multi-drug resistant Salmonella enterica identified 3 unique class 1 integron gene cassette arrays not previously reported in this species. The present study used PCR and DNA sequence analysis to characterize the structure of these gene cassette arrays. A ~4.0 kb integron containing the gene cassette array arr2/cmlA5/bla (OXA10) /aadA1 was found in isolates belonging to serovars Isangi and Typhimurium from South Africa. A ~6.0 kb integron containing the gene cassettes aac(6')IIc/ereA2/IS1247/aac/arr/ereA2 was found in isolates belonging to serovar Heidelberg from the Philippines. In this gene cassette array, the insertion sequence, IS1247, and two putative resistance genes,...

Plasmid incidence, antibiotic and metal resistance among enterobacteriaceae isolated from Algerian streams.

Authors: Habi S, Daba H Enterobacteriaceae isolates from surface water were examined to assess impact of feacal and/or metal pollution on heavy metal, antibiotics resistance and plasmid incidence. A bi-modal CMI distribution was noted for cadmium and mercury. On the other hand, modal distribution was observed for Pb. Critical metal concentration were >8, >32, > or =4096 microg mL(-1) for mercury, cadmium and lead, respectively. High resistance to Pb and low resistance to Cd were remarked in stream water polluted with heavy metal. Resistance to antibiotics was most frequent to erythromycin (45.45-68.8%), tetracyclin family (14-61.11%), streptomycin (16-24%) and furan (8.16-24.1%). Bacterial resistance to some antibiotics (kanamycin, tetracyclin, doxycyclin, furan and chloramphe...

Molecular Epidemiology and Antimicrobial Resistance Mechanisms of Methicillin-Resistant Staphylococcus aureus Isolated from Bovine Milk

The aim of this study was to identify methicillin-resistant Staphylococcus aureus (MRSA) strains gathered from 2002 to 2006 from milk samples in Aydin region in Turkey. Among 93 S. aureus strains isolated from bovine milk with mastitis, 16 were resistant to methicillin. Methicillin-resistant S. aureus strains were studied further for their staphylococcal cassette chromosome mec (SCCmec) types, pulsotypes, spa and MLST types, antimicrobial susceptibilities, mechanisms of resistance and presence of Panton[ndash]Valentine leucocidin (PVL) toxin gene. The MRSA strains were multi-drug resistant. The susceptibility rates to antimicrobials tested were 0%, 0%, 0%, 0%, 6.25%, 16.25% and 56.25% for erythromycin, clindamycin, chloramphenicol, gentamicin, tetracyclin, ciprofloxacin and vancomycin, res...

Macrolides, Ketolides, and Glycylcyclines: Azithromycin, Clarithromycin, Telithromycin, Tigecycline

The advanced macrolides, azithromycin and clarithromycin, and the ketolide, telithromycin, are structural analogs of erythromycin. They have several distinct advantages when compared with erythromycin, including enhanced spectrum of activity, more favorable pharmacokinetics and pharmacodynamics, once-daily administration, and improved tolerability. Clarithromycin and azithromycin are used extensively for the treatment of respiratory tract infections, sexually transmitted diseases, and Helicobacter pylori–associated peptic ulcer disease. Telithromycin is approved for the treatment of community-acquired pneumonia. Severe hepatotoxicity has been reported with the use of telithromycin. (Source: Infectious Diseases Clinics of North America)

A variant of the Southern German clone of methicillin-resistant Staphylococcus aureus is predominant in Croatia

Clin Microbiol Infect The aim of the present study was to investigate the antibiotic susceptibility patterns and molecular epidemiology of clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered in 24 hospitals in 20 cities in Croatia from October to December 2004. A total of 1815 consecutive S. aureus isolates were recovered, 248 of which were MRSA. The MRSA isolates were analysed using spa typing, multilocus sequence typing and SCCmec typing. Furthermore, the presence of Panton[ndash]Valentine leukocidin (PVL) genes was determined as a genetic marker for community-associated MRSA. The MRSA prevalence was 14%. Ninety-six per cent of the MRSA isolates were resistant to ciprofloxacin, 95% to clindamycin and azithromycin, 94% to gentamicin, and 93% to erythromycin. The...

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High clonal diversity in erythromycin-resistant Streptococcus pneumoniae invasive isolates in Madrid, Spain (2000-07)

Conclusions The resistance determinants erm(B) and the combination of erm(B) plus mef(A) were observed within multiple S. pneumoniae bacteraemic clones. The preservation of a polyclonal structure might provide a suitable background for further evolution of antibiotic resistance. (Source: Journal of Antimicrobial Chemotherapy)

E.E.S. (Erythromycin Ethylsuccinate) Suspension E.E.S. (Erythromycin Ethylsuccinate) Granule, For Suspension E.E.S. (Erythromycin Ethylsuccinate) Tablet, Film Coated [Abbott Laboratories]

Updated Date: Nov 10, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

[Promotility drugs use in critical care: Indications and limits?]

Authors: Libert N, De Rudnicki S, Cirodde A, Janvier F, Leclerc T, Borne M, Brinquin L Enteral feeding is often limited by gastric and intestinal motility disturbances in critically ill patients, particularly in patients with shock. So, promotility agents are frequently used to improve tolerance to enteral nutrition. This review summaries the pathophysiology, presents the available pharmacological strategies, the clinical data, the counter-indications and the principal limits. The clinical data are poor. No study demonstrates a positive effect on clinical outcomes. Metoclopramide and erythromycin seems to be the more effective. Considering the risk of antibiotic resistance, the first line use of erythromycin should be avoided in favor of metoclopramide. PMID: 19910155 [PubMed - as ...

Adverse effects of erythromycin on the structure and chemistry of activated sludge.

This study examines the effects of erythromycin on activated sludge from two French urban wastewater treatment plants (WWTPs). Wastewater spiked with 10 mg/L erythromycin inhibited the specific evolution rate of chemical oxygen demand (COD) by 79% (standard deviation 34%) and the specific N-NH(4)(+) evolution rate by 41% (standard deviation 25%). A temporary increase in COD and tryptophan-like fluorescence, as well as a decrease in suspended solids, were observed in reactors with wastewater containing erythromycin. The destruction of activated sludge flocs was monitored by automated image analysis. The effect of erythromycin on nitrification was variable depending on the sludge origin. Erythromycin inhibited the specific nitrification rate in sludge from one WWTP, but increased the nitrifi...

Non-invasive erythromycin-resistant pneumococcal isolates are more often non-susceptible to more antimicrobial agents than invasive isolates

Abstract: Multiresistant Streptococcus pneumoniae infections are of great concern as treatment failures may occur with commonly used treatment regimens using β-lactams and macrolides. The proportion of non-susceptible S. pneumoniae differs from country to country. In Denmark, the proportion of invasive penicillin- or erythromycin-non-susceptible isolates is still low. The aim of this study was to characterise and compare invasive and non-invasive penicillin-non-susceptible and erythromycin-resistant pneumococcal isolates from the same geographic area and the same time period with respect to serotype and antibiotic susceptibility profile. We aimed to identify which serotypes were multiresistant among Danish isolates and to confirm or reject whether there was a difference in serotype distri...

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Childhood ocular rosacea: Considerations for diagnosis and treatment

We report three cases of paediatric ocular rosacea responding to prolonged treatment with oral erythromycin. Our cases demonstrate the close association of periorificial dermatitis with childhood rosacea, and highlight the importance of eye signs in its diagnostic criteria. (Source: Australasian Journal of Dermatology)

Inducible clindamycin resistance in

Conclusions : Clindamycin is kept as a reserve drug and is usually advocated in severe MRSA infections depending upon the antimicrobial susceptibility results. We have reported a higher incidence of iMLS B from both community (66.67%) as well as hospital (33.33%) setup. Therefore clinical microbiology laboratory should report inducible clindamycin resistance routinely. (Source: Journal of Postgraduate Medicine)

In vitro activity of cem-101 against streptococcus pneumoniae and streptococcus pyogenes with defined macrolide resistance mechanisms.

IN VITRO ACTIVITY OF CEM-101 AGAINST STREPTOCOCCUS PNEUMONIAE AND STREPTOCOCCUS PYOGENES WITH DEFINED MACROLIDE RESISTANCE MECHANISMS. Antimicrob Agents Chemother. 2009 Nov 2; Authors: McGhee P, Clark C, Kosowska-Shick K, Nagai K, Dewasse B, Beachel L, Appelbaum PC CEM-101 had an MIC range against macrolide-susceptible pneumococci of 0.002-0.016 mug/ml and of 0.004-1 mug/ml against macrolide-resistant phenotypes. Only 3 strains with erm(B) +/- mef(A) had CEM-101 MICs of 1 mug/ml and 218/221 strains had CEM-101 MICs </=0.5 mug/ml. CEM-101 MICs were up to 4-fold lower than those of telithromycin against all strains. Against Streptococcus pyogenes, CEM-101 MICs ranged between 0.008-0.03 mug/ml against macrolide-susceptible, and 0.015-1 mug/ml against -resistant strains. Against...

Childhood ocular rosacea: considerations for diagnosis and treatment.

We report three cases of paediatric ocular rosacea responding to prolonged treatment with oral erythromycin. Our cases demonstrate the close association of periorificial dermatitis with childhood rosacea, and highlight the importance of eye signs in its diagnostic criteria. PMID: 19916971 [PubMed - in process] (Source: The Australasian Journal of Dermatology)

Detection of new mutations conferring resistance to linezolid in glycopeptide-intermediate susceptibility Staphylococcus hominis subspecies hominis circulating in an intensive care unit

This report alerts to the possible appearance of clinical strains of methicillin-resistant staphylococci with intermediate resistance to glycopeptides, resistance to linezolid, and multiple resistance to other second-line antibiotics. Content Type Journal ArticleCategory ArticleDOI 10.1007/s10096-009-0823-4Authors A. Sorlozano, University of Granada Departamento de Microbiologia, Facultad de Medicina Avda de Madrid 11 18012 Granada SpainJ. Gutierrez, University of Granada Departamento de Microbiologia, Facultad de Medicina Avda de Madrid 11 18012 Granada SpainT. Martinez, San Cecilio University Hospital Service of Microbiology Granada SpainM. E. Yuste, San Cecilio University Hospital Intensive Care Unit Granada SpainJ. A. Perez-Lopez, San Cecilio University Hospital Service of Microb...

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Identification, cloning, and functional characterization of EmrD-3, a putative multidrug efflux pump of the major facilitator superfamily from Vibrio cholerae O395.

Authors: Smith KP, Kumar S, Varela MF A putative multidrug efflux pump, EmrD-3, belonging to the major facilitator superfamily (MFS) of transporters and sharing homology with the Bcr/CflA subfamily, was identified in Vibrio cholerae O395. We cloned the emrD-3 gene and evaluated its role in antimicrobial efflux in a hypersensitive Escherichia coli strain. The efflux activity of this membrane protein resulted in lowering the intracellular concentration of ethidium. The recombinant plasmid carrying emrD-3 conferred enhanced resistance to several antimicrobials. Among the antimicrobials tested, the highest relative increase in minimum inhibitory concentration (MIC) of 102-fold was observed for linezolid (MIC = 256 mug/ml), followed by an 80.1-fold increase for tetraphenylphosphonium chlori...

Esophagus - Band Ligation of Actively Bleeding Gastroesophageal Varices

A 53-year old female with hepatitis C, alcohol abuse, and child C cirrhosis presented with hematemesis for one day. Vital signs on admission were a blood pressure of 100/66 and heart rate of 110. Laboratory results were hemoglobin: 10 g/dL, platelets: 89,000, and INR: 2.8. She had a previous history of esophageal varices without any bleeding or history of variceal banding. Initial management consisted of packed red blood cells, IV Octreotide, a proton pump inhibitor, antibiotics, fresh frozen plasma, vitamin K, Erythromycin. Emergent endoscopy was undertaken. As the scope enters the gastroesophageal junction, an actively spurting vessel is seen at 2 o'clock on the screen in the cardia. Here is the retroflexed view also showing bleeding from the cardia. After evaluation of the rest o...

The changing patterns of covalent active site occupancy during catalysis on a modular polyketide synthase multienzyme revealed by ion-trap mass spectrometry

A catalytically competent, homodimeric diketide synthase comprising the first extension module of the erythromycin polyketide synthase was analysed using MS, after limited proteolysis to release functional domains, to determine the pattern of covalent attachment of substrates and intermediates to active sites during catalysis. Using the natural substrates, the acyltransferase and acylcarrier protein of the loading module were found to be heavily loaded with propionyl starter groups, while the ketosynthase was fully propionylated. The acylcarrier protein of the extension module was partly occupied by the product diketide, and the adjacent chain-releasing thioesterase domain was vacant, implying that the rate- limiting step is transfer of the diketide from the acylcarrier protein to the thio...

Impact of Not Measuring Residual Gastric Volume in Mechanically Ventilated Patients Receiving Early Enteral Feeding: A Prospective Before-After Study.

Conclusion: Early EN without RGV monitoring in mechanically ventilated patients improves the delivery of enteral feeding and may not increase vomiting or ventilator-associated pneumonia. (JPEN J Parenter Enteral Nutr.XXXX;xx:xx-xx). PMID: 19861528 [PubMed - as supplied by publisher] (Source: JPEN Journal Of Parenteral And Enteral Nutrition)

Characterization of {Phi}m46.1, the Main Streptococcus pyogenes Element Carrying mef(A) and tet(O) Genes.

Authors: Brenciani A, Bacciaglia A, Vignaroli C, Pugnaloni A, Varaldo PE, Giovanetti E Phim46.1, the recognized representative of the most common variant of mobile, prophage-associated genetic elements carrying resistance genes mef(A) (efflux-mediated erythromycin resistance) and tet(O) (tetracycline resistance) in Streptococcus pyogenes, was fully characterized. Sequencing of the Phim46.1 genome (55,172 bp) demonstrated a modular organization typical of tailed bacteriophages. Electron microscopic analysis of mitomycin-induced Phim46.1 revealed phage particles with the distinctive icosahedral head and tail morphology of Siphoviridae. The chromosome integration site was within a 23S rRNA uracil methyltransferase gene. BLASTP analysis revealed that the proteins of Phim46.1 had high amino...

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Prevalence of serotypes and antimicrobial resistance of invasive strains of pneumococcus in children: analysis of 9 years.

CONCLUSIONS: Penicillin resistance was detected in 9.9% of the strains, being predominant from 2004 to 2008. Twenty different pneumococcal serotypes were identified, and 71.9% of the serotypes were represented in the 7-valent conjugate vaccine (PN CRM7) currently available. PMID: 19859623 [PubMed - as supplied by publisher] (Source: Jornal de Pediatria)

Electrogastrography: a non-invasive measurement of gastric function

Conclusions EGG has a developing role in the assessment of gastric dysfunction and on the effect of medical treatment. The effect of surgery and anaesthesia on gastric myoelectric activity is less clear. Content Type Journal ArticleCategory ReviewDOI 10.1007/BF03168826Authors P. M. Lawlor, University Department of Surgery, St James’s Hospital GI Function Unit Dublin 8 IrelandJ. A. McCullough, University Department of Surgery, St James’s Hospital GI Function Unit Dublin 8 IrelandP. J. Byrne, University Department of Surgery, St James’s Hospital GI Function Unit Dublin 8 IrelandJ. V. Reynolds, University Department of Surgery, St James’s Hospital GI Function Unit Dublin 8 Ireland Journal Irish Journal of Medical ScienceOnline ISSN 1863-4362Print ISSN 0021-...

Penetration of azithromycin in experimental pleural empyema fluid.

Authors: Saroglou M, Ismailos G, Tryfon S, Liapakis I, Papalois A, Bouros D There were no data about the extent of azithromycin penetration into the empyemic pleural fluid in humans and in experimental animals. An empyema was created via the intrapleural injection of an Escherichia coli solution into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracocentesis, 24h post inoculation, azithromycin (15mg/kg) was administered intravenously. Antibiotic levels were determined in samples of pleural fluid and blood serum, collected serially at 2, 8, 24, 48 and 72h, after administration. Azithromycin levels were estimated using an HPLC analytical method with fluorimetric detection. Azithromycin penetrated well into the empyemic pleural fluid, exhibiting a slo...

Review: Diagnosis and management of gastro-oesophageal reflux disease in preterm infants

Source: Arch Dis Childhood - Fetal and Neonatal Edition Area: News This review addresses the diagnostic and management dilemmas of suspected gastro-oesophageal reflux disease in preterm infants on the neonatal unit. The authors summarise the best available evidence and use this pragmatically to devise a structured, clinical management strategy to assist diagnosis and avoid over treatment. The following management options are covered: . Positioning and feed regime alteration . Feed thickeners . Pharmacological agents: erythromycin, H2 antagonists, proton pump inhibitors, domperidone (Source: NeLM - News)

Erythromycin/phenoxymethylpenicillin: Clostridium difficile colitis and reactive arthritis in a child: case report

(Source: Reactions)

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Investigating the Structural Plasticity of a Cytochrome P450: THREE-DIMENSIONAL STRUCTURES OF P450 EryK AND BINDING TO ITS PHYSIOLOGICAL SUBSTRATE [Protein Structure and Folding]

Cytochrome P450s are heme-containing proteins that catalyze the oxidative metabolism of many physiological endogenous compounds. Because of their unique oxygen chemistry and their key role in drug and xenobiotic metabolism, particular attention has been devoted in elucidating their mechanism of substrate recognition. In this work, we analyzed the three-dimensional structures of a monomeric cytochrome P450 from Saccharopolyspora erythraea, commonly called EryK, and the binding kinetics to its physiological ligand, erythromycin D. Three different structures of EryK were obtained: two ligand-free forms and one in complex with its substrate. Analysis of the substrate-bound structure revealed the key structural determinants involved in substrate recognition and selectivity. Interestingly, the l...

Time–kill kinetics of oritavancin and comparator agents against Streptococcus pyogenes

Abstract: The activity of oritavancin in vitro against recent clinical isolates of Streptococcus pyogenes, including antibiotic-resistant strains, was characterised by determination of broth microdilution minimal inhibitory concentrations as well as time–kill assays. Ten clinical isolates of S. pyogenes, three of which were resistant to erythromycin, as well as one reference S. pyogenes strain were tested. In the time–kill assays, oritavancin and the comparators vancomycin, teicoplanin, linezolid, penicillin, erythromycin and daptomycin were tested at static concentrations approximating their free peak (fCmax) and free trough (fCmin) concentrations in plasma when administered at approved doses for skin and skin-structure infections. At its fCmax predicted from a 200mg dose in humans, o...

Ergotamine-induced lower extremity arterial vasospasm presenting as acute limb ischemia.

We present a case of acute lower limb ischemia with characteristic angiography findings of diffuse arterial spasm resulting from use of ergotamine and an erythromycin derivative, clarithromycin. The history of the patient and classic features seen on angiography helped us establish the diagnosis. The patient was successfully treated with low molecular heparin and epidural infusion of bupivacain. Since ergot vasospasm is a self limited and medically treatable condition, interventional radiologists must be aware of ergotamine-induced acute limb ischemia to avoid any unnecessary interventional procedures, unless necrosis and gangrene are imminent. PMID: 19821256 [PubMed - as supplied by publisher] (Source: Diagnostic and Interventional Radiology : The Turkish Society of Radiology)

Synthesis and Biochemical Analysis of Complex Chain-Elongation Intermediates for Interrogation of Molecular Specificity in the Erythromycin and Pikromycin Polyketide Synthases

Journal of the American Chemical Society, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Journal of the American Chemical Society)

Detection of antibiotic resistant E. coli and Enterococcus spp. in stool of healthy growing children in Portugal

From stool specimens of 118 healthy children's (1-14 years) in Portugal 92 E. coli and 101 Enterococcu s spp. strains have been isolated. Almost half (40.2%) of the E. coli isolates were resistant to ampicillin, 25.0% were resistant to tetracycline and 26.1% were resistant to streptomycin. Resistance genes detected by specific PCR included blaTEM and/or blaSHV and/or blaCTX-M (33 of 37 ampicillin and/or cefotaxime resistant isolates), tet (A) and/or tet (B) (16 of 23 tetracycline-resistant isolates), aad A (19 of 24 streptomycin-resistant isolates), cml A (in the two chloramphenicol-resistant isolates), aac (3)-II with/without aac (3)-IV (in the four gentamicin-resistant isolates), sul 1 and/or sul 2 and/or sul 3 (in all trimethoprim/sulfamethoxazole resistant isolates). The majority of th...

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Investigating the role of native propionyl-CoA and methylmalonyl-CoA metabolism on heterologous polyketide production in Escherichia coli

In this study, the sbm, ygfG, and ygfH genes were individually deleted and over-expressed to investigate their effect on heterologous 6dEB production. Our results indicate that the deletion and over-expression of sbm did not influence 6dEB production; ygfG over-expression reduced 6dEB production by fourfold while ygfH deletion increased 6dEB titers from 65 to 129 mg/L in shake flask experiments. It was also found that native E. coli metabolism could support 6dEB biosynthesis in the absence of exogenous propionate and the substrate provision pcc genes. Lastly, the effect of the ygfH deletion was tested in batch bioreactor cultures in which 6dEB titers improved from 206 to 527 mg/L. Biotechnol. Bioeng. © 2009 Wiley Periodicals, Inc. (Source: Biotechnology and Bioengineering)

Panton-Valentine leukocidin in pediatric community-acquired Staphylococcus aureus infections.

CONCLUSIONS: In a clonally heterogeneous population of pediatric community-acquired SA infections, pvl+ strains were associated with abscess formation and erythromycin susceptibility, but not invasive disease. PMID: 19796576 [PubMed - in process] (Source: Clinical and Investigative Medicine)

[Stevens-Johnson syndrome plus intrahepatic cholestasis caused by clindamycin or chlorpheniramine]

We present a discussion of this case and review the main characteristics of the Stevens Johnson Syndrome. PMID: 19624990 [PubMed - indexed for MEDLINE] (Source: Dermatol Online J)

Antibiograms and Molecular Subtypes of Methicillin-Resistant Staphylococcus aureus in Local Teaching Hospital, Malaysia.

In conclusion, no vancomycin-resistant isolate was observed. The Malaysian MDR MRSA isolates were mostly SCCmec type III and negative for PVL. These strains were genetically distinct from the SCCmec type IV strains, which were sensitive to SXT, tetracycline, and erythromycin. Only two strains were SCCmec IV and PVL-positive. The infections in the hospital concerned were probably caused by multiple subtypes of MRSA. PMID: 19884790 [PubMed - in process] (Source: Journal of Microbiology and Biotechnology)

Antibiotic resistance of probiotic strains of lactic acid bacteria isolated from marketed foods and drugs.

CONCLUSION: Antibiotic resistance is present in different species of probiotic strains, which poses a threat to food safety. Evaluation of the safety of lactic acid bacteria for human consumption should be guided by established criteria, guidelines and regulations. PMID: 20163065 [PubMed - in process] (Source: Biomedical and Environmental Sciences : BES)

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Prevalence, genetic diversity, and antimicrobial susceptibility profiles of Staphylococcus aureus isolated from bovine mastitis in Zhejiang Province, China.

This study was conducted to determine genetic diversity and antimicrobial susceptibility profiles of Staphylococcus aureus recovered from bovine mastitis in Zhejiang Province, China. Out of 3178 quarter milk samples from 846 lactating cows, among which 459 cows (54.3%) were found HMT positive, 890 quarters (28%) were found having subclinical mastitis. From 75 representative S. aureus isolates, 16 distinct types were identified by pulsed-field gel electrophoresis (PFGE). Four major PFGE types (A, B, C, and D) accounted for 82.7% of all isolates, and type A (41.3%) was observed in multiple herds across the studied areas. Each region was found to have a predominant type: Hangzhou type A (64.1%), Ningbo type C (34.5%) and type B (23.1%), Jinhua type D (53.3%), and Taizhou type C (62.5%). Resul...

ERY-TAB (Erythromycin) Tablet, Delayed Release [KAISER FOUNDATION HOSPITALS]

Updated Date: Sep 29, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Guidance issued on erythromycin ophthalmic ointment shortage [NEWS AND FEATURES]

(Source: AAP News)

Influence of oral hygiene in patients with fixed appliances in the oral carriage of antimicrobial-resistant Escherichia coli and Enterococcus isolates

Conclusions: Poor or improper oral hygiene in individuals with fixed appliances favors the oral carriage of antimicrobial-resistant E. coli and enterococci. Additional investigations are needed to assess its implication in human health. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)

Antimicrobial resistance profiling and molecular subtyping of Campylobacter spp. from processed turkey

Conclusions: Ciprofloxacin and erythromycin resistance in Campylobacter recovered from processed turkey occurred more frequently among C. coli than C. jejuni. Fla-PFGE types were associated with a particular species, antimicrobial resistance profiles, and a specific plant. Molecular subtyping in this study provided more information about the relationships among antimicrobial-resistant Campylobacter at the processing level. (Source: BMC Microbiology - Latest articles)

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Characterization of a New Metallo-{beta}-lactamase gene, blaNDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India.

Authors: Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, Walsh TR A Swedish patient of Indian origin travelled to New Delhi and acquired a UTI caused by a carbapenem resistant Klebsiella pneumoniae typing to complex ST14. The isolate, K. pneumoniae 05-506, was shown to possess a metallo-beta-lactamase (MBLs) but was negative for previously known MBL genes. Gene libraries and amplification of class 1 integrons revealed three resistant regions; the first, contained blaCMY-4 flanked by ISEcP1 and blc. The second region of 4.8 kb contained a complex class 1 integron with the gene cassettes, arr-2, a new erythromycin esterase gene, ereC, aadA1 and cmlA7. An intact ISCR1 was shown to be downstream from the qac/sul genes. The third region consisted of a new MBL gene, designated blaNDM...

The Cochrane Library and Treatment for Community Acquired Pneumonia in Children: An Overview of Reviews

Globally, pneumonia is the leading cause of death among children and also results in significant morbidity. The most common treatment options include anti-pyretics and antibiotics. Other treatments include vitamins and over-the-counter cough syrup.This overview presents a summary of the results of previous Cochrane reviews on the treatment of community acquired pneumonia (CAP) in children.The Cochrane Database of Systematic Reviews was searched for all systematic reviews examining the treatment of pediatric pneumonia or lower respiratory tract infections. All reviews that were under the heading "pneumonia" on the Cochrane Acute Respiratory Infections (ARI) Group's Topic List and the ARI group were consulted. Data were extracted and entered into tables; data were synthesized using qualitati...

Cost analysis and antimicrobial susceptibility testing comparing the E test and the agar dilution method in Campylobacter jejuni and Campylobacter coli

Abstract: Although numerous reports have compared the antimicrobial susceptibility of Campylobacter spp., controversy still exists about the use of the E test as an alternative to the agar dilution method suggested by the Clinical and Laboratory Standards Institute. MICs of 8 antimicrobials were determined using the E test and agar dilution methods for 103 Campylobacter jejuni and Campylobacter coli isolates from fresh chicken randomly purchased from stores in 3 southern Ontario counties. Overall, 72.6% of E test MIC values were within 1 log2 dilution and 95.7% within 2 log2 dilutions of the corresponding agar dilution MICs. For individual antimicrobials, agreement within 1 log2 dilution and 2 log2 dilutions was as follows: ampicillin (n = 103), 90.3% and 98.1%, respectively; chloramphenic...

Comparative activity of oritavancin against meticillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates from Geneva University Hospital

In this study, we assessed by broth microdilution the in vitro activity of oritavancin, a semisynthetic lipoglycopeptide currently under development, against selected meticillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates (n=56) from Geneva University Hospital, Switzerland, displaying a wide range of vancomycin minimum inhibitory concentrations (MICs) (0.25–4μg/mL). The MRSA resistance phenotype was confirmed by broth microdilution (oxacillin MIC ≥4μg/mL) for all isolates; 89% and 100% of the tested isolates were also resistant to erythromycin and ciprofloxacin, respectively. For 53 MRSA isolates for which vancomycin MICs were in the susceptible range (0.5–2.0μg/mL), the oritavancin MICs ranged from 0.03μg/mL to 0.5μg/mL. For these 53 vancomycin-susceptible isola...

CDC Updates Guidance on Ophthalmia Neonatorum Prophylaxis

The CDC has updated its recommendations to physicians for prophylaxis against ophthalmia neonatorum, or neonatal conjunctivitis, in light of the current shortage of erythromycin ophthalmic ointment (0.5%), which is the only product available in the United States that is FDA-approved for this indication. (Source: AAFP Clinical Care and Research)

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The role of efflux pumps in macrolide resistance in Mycobacterium avium complex

This study demonstrates that efflux pumps play an important role in MAC resistance to antibiotics. (Source: International Journal of Antimicrobial Agents)

Isolation and characterization of methicillin-resistant Staphylococcus aureus from swine and workers in China

Conclusions MRSA from Chinese pigs and farm workers (ST9) differed from the European pig-associated clone (ST398) with regard to clonal type, SCCmec content and resistance profile. (Source: Journal of Antimicrobial Chemotherapy)

Guidance issued on erythromycin ophthalmic ointment shortage [NEWS AND FEATURES]

(Source: AAP News)

Comparative In Vitro Activity Profile of Oritavancin against Recent Gram-Positive Clinical Isolates.

Authors: Arhin FF, Draghi DC, Pillar CM, Parr TR, Moeck G, Sahm DF Oritavancin activity was tested against 15,764 gram-positive isolates from 246 hospital centers in 25 countries between 2005-2008. Organisms included Staphylococcus aureus (n=9075), coagulase-negative staphylococci (n=1664), Enterococcus faecalis (n=1738), Enterococcus faecium (n=819), Streptococcus pyogenes (n=959), Streptococcus agalactiae (n=415), Group C, G and F streptococci (n=84), and Streptococcus pneumoniae (n=1010). Among the evaluated staphylococci, 56.7% were resistant to oxacillin. The vancomycin resistance rate among enterococci was 21.2%. Penicillin -resistant and -intermediate rates were 14.7% and 21.4%, respectively, among S. pneumoniae. Among non-pneumococcal streptococci, 18.5% were non-susceptible to...

Erythromycin Ophthalmic Ointment in Short Supply

The CDC is informing physicians of a shortage of erythromycin (0.5%) ophthalmic ointment, which is the only product available in the United States that is recommended for prophylaxis against ophthalmia neonatorum, or neonatal conjunctivitis. (Source: AAFP Clinical Care and Research)

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The role of active efflux in antibiotic - resistance of clinical isolates of<i> Helicobacter pylori</i>

Conclusion: </b> Energy-dependant efflux plays a role in the resistance of <i> H. pylori</i> clinical isolates to structurally unrelated antibiotics in a broadly specific multidrug efflux manner. Difference in the efflux potential of MAR isolates may be related to the presence or absence of functional efflux-pumps in diverse<i> H. pylori </i> isolates. (Source: Indian Journal of Medical Microbiology)

Inappropriate use of vancomycin for preventing perinatal group B streptococcal (GBS) disease in laboring patients

Journal of Perinatal Medicine 37 (5): 487-489 Abstract Objective: The 2002 CDC guidelines for the prevention of perinatal group B streptococcus (GBS) stipulate that vancomycin is reserved for penicillin-allergic women at high risk for beta-lactam anaphylaxis with resistance to clindamycin or erythromycin. Our objective was to evaluate practitioner adherence to these guidelines. Methods: This is a retrospective chart review of patients admitted to labor and delivery who received vancomycin for GBS prophylaxis from January 1st, 2005 to June 1st, 2007. Identification and documentation of allergic reactions to beta lactams and performance of GBS sensitivities at the time of screening were recorded. Results: Eighty-seven patients reporting a penicillin allergy received vancomycin during labor. ...

Distribution of Tetracycline and Erythromycin Resistance Genes Among Human Oral and Fecal Metagenomic DNA

Microbial Drug Resistance Sep 2009, Vol. 15, No. 3: 159-166. (Source: Microbial Drug Resistance)

In vitro susceptibility to 17 antimicrobials of clinical Clostridium difficile isolates collected in 1993–2007 in Sweden

This study investigated the MICs of 17 antimicrobials, for 606 toxigenic clinical isolates of Clostridium difficile collected between 1993 and 2007 in Sweden. Low MIC90 values were found for metronidazole (0.5 mg/L), vancomycin (1.0 mg/L), teicoplanin (0.125 mg/L), fusidic acid (1.0 mg/L), linezolid (2.0 mg/L), daptomycin (2.0 mg/L) and tigecycline (0.064 mg/L). Three isolates (0.5%) had elevated MICs for vancomycin (4[ndash]8 mg/L); however, these isolates originated from the same patient, who was receiving long-term intravenous vancomycin treatment. High-level clindamycin resistant isolates (MIC >256 mg/L) peaked in 1997 with 39 of 95 (41%) and out of these, 36% were also highly resistant to erythromycin. [beta]-Lactams such as penicillin V and piperacillin displayed MIC90s of 8 and 32 m...

New Approach To A Classic Structure

Oxidative ring-closing reaction boosts yield of key erythromycin precursor. (Source: Chemical and Engineering News)

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Options for obtaining erythromycin ophthalmic ointment during shortage [NEWS AND FEATURES]

(Source: AAP News)

Influence of trace erythromycin and erythromycin-H(2)O on carbon and nutrients removal and on resistance selection in sequencing batch reactors (SBRs).

Authors: Fan C, Lee PK, Ng WJ, Alvarez-Cohen L, Brodie EL, Andersen GL, He J Three sequencing batch reactors (SBRs) were operated in parallel to study the effects of trace erythromycin (ERY) and ERY-H(2)O on the treatment of a synthetic wastewater. Through monitoring (1) daily effluents and (2) concentrations of nitrogen (N) and phosphorous (P) in certain batch cycles of the three reactors operated from transient to steady states, the removal of carbon, N, and P was affected negligibly by ERY (100 microg/L) or ERY-H(2)O (50 microg/L) when compared with the control reactor. However, through analyzing microbial communities of the three steady state SBRs on high-density microarrays (PhyloChip), ERY, and ERY-H(2)O had pronounced effects on the community composition of bacteria related to N...

50 Years Ago in The Journal of Pediatrics: Staphylococcal Pneumonia in Children—A Review of 83 Cases

Koch R, Carson MJ, Donnell G. J Pediatr 1959;55:473-480 Koch et al published a review on staphylococcal pneumonia in children that covered a period between 1944 and 1958, during which a total of 83 patients were diagnosed on the basis of clinical and radiologic evidence of pneumonia together with pyopneumothorax or isolation of the organism from blood or empyema fluid. The authors noted an increase in incidence over the study period, the reason for which was unknown. The highest “hit” rate was among those younger than 12 months, and the mortality rate was significant at 12% with all fatality but 1 occurring in infants younger than 4 months. The combination of chloramphenicol and erythromycin was the most frequently prescribed therapy in those days. (Source: The Journal of Pediatrics)

New susceptibility breakpoints in antimicrobial resistance rates of invasive pneumococcal strains.

CONCLUSIONS: When the new breakpoints for in vitro susceptibility were applied, penicillin resistance rates dropped 97%, from 33 to 1%. PMID: 19830357 [PubMed - in process] (Source: Jornal de Pediatria)

Induction of Multidrug Resistance Mechanism in Escherichia coli Biofilms by Interplay between Tetracycline and Ampicillin Resistance Genes.

Authors: May T, Ito A, Okabe S Biofilms gain resistance to various antimicrobial agents, and the presence of antibiotic resistance genes is thought to contribute to a biofilm-mediated antibiotic resistance. Here we showed the interplay between the tetracycline resistance efflux pump TetA(C) and the ampicillin resistance gene (blaTEM-1) in biofilms of Escherichia coli harboring pBR322 in the presence of the mixture of ampicillin and tetracycline. E. coli in the biofilms could obtain the high-level resistance to ampicillin, tetracycline, penicillin, erythromycin and chloramphenicol during biofilm development and maturation, as a result of the interplay between the marker genes on the plasmids, the increase of plasmid copy number, and consequently the induction of the efflux systems on th...

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Enhancement of Lovastatin Production by Supplementing Polyketide Antibiotics to the Submerged Culture of Aspergillus terreus.

Authors: Jia Z, Zhang X, Zhao Y, Cao X Feedback inhibition existed in lovastatin biosynthesis from Aspergillus terreus. Exogenous lovastatin and other different polyketide antibiotics biosynthesized by polyketide synthase were supplemented to the cultures of A. terreus to investigate their influences on lovastatin production. Supplementing exogenous lovastatin of 100 mg l(-1) at the early stage of fermentation and the fast stage of its biosynthesis resulted in decreases of 76.4% and 20% in final lovastatin production, respectively. However, the fungal cell growth was not affected; the growing cycle was only prolonged in the submerged cultivation. Separate supplementation of the five kinds of polyketide antibiotics such as tylosin, erythromycin, tetracycline, daunorobin, and rifamycin t...

Bacteriological profile and antimicrobial resistance patterns of clinical bacterial isolates in a University Hospital

The objective of this study was to determine the patterns of bacterial isolates found in blood culture of patients with bactermia in King Abdul Aziz University Hospital in addition to determination of antibiotic resistance. A retrospective analysis of the 672 positive samples collected over the period of December 2006–December 2008. The observed mean age was 40 years with comparable distribution in both genders. 65.2% of the population were Non-Saudi. 65.5% of isolates were Gram positive, mainly Staphylococcus epidermidis, on the other hand Klebsiella was the common Gram negative bacteria. Diabetes has been observed in 38.5%. Mortality was 32.4 (P-value 0.001) in diabetic patients versus non-diabetics. Benzyl penicillin, clindamycin, erythromycin, tetracycline, ciprofloxacin, oxacillin c...

The outer membrane of a heterocyst-forming cyanobacterium is a permeability barrier for uptake of metabolites that are exchanged between cells

The multicellular Anabaena sp. strain PCC 7120 is a filamentous cyanobacterium that can fix N2 in differentiated cells called heterocysts, which exchange nutritional and regulatory compounds with the neighbour photosynthetic vegetative cells. The outer membrane of this bacterium is continuous along the filament defining a continuous periplasmic space. The Anabaena alr0075, alr2269 and alr4893 gene products were characterized as Omp85-like proteins, which are generally involved in outer membrane protein biogenesis. Open reading frame alr2269 is the first gene of an operon that also carries genes for lipopolysaccharide lipid A biosynthesis including alr2270 (an lpxC homologue). Strains carrying inactivating alr2269 or alr2270 constructs showed enhanced sensitivity to erythromycin, SDS, lysoz...

Splitting the dose of neonatal BCG vaccination: a naïve practice.

Splitting the dose of neonatal BCG vaccination: a naïve practice. Ann Trop Paediatr. 2009 Sep;29(3):243-5 Authors: Fretzayas A, Moustaki M, Stefos E, Nicolaidou P Bilateral axillary lymphadenitis complicating BCG vaccination in both arms (0.025 ml) in an immunocompetent 13-month-old boy is described. Prompt administration of isoniazid and erythromycin did not prevent suppuration of the affected lymph nodes. It was managed by bilateral surgical excision of the nodes. PMID: 19689870 [PubMed - in process] (Source: Annals of Tropical Paediatrics)

Erythromycin-induced CXCR4 expression on microvascular endothelial cells

In this study, we demonstrated that EM markedly induced CXCR4 surface expression on microvascular endothelial cells in vitro and lung capillary endothelial cells in vivo. This ability to induce CXCR4 surface expression on endothelial cells was restricted to 14-membered ring macrolides and was not observed in other antibiotics including a 16-membered ring macrolide, josamycin. Furthermore, this EM-induced expression of CXCR4 on endothelial cells was functionally significant as demonstrated by chemotaxis assays in vitro. These findings suggest that EM-induced CXCR4 surface expression on endothelial cells may promote migration of CXCR4-expressing endothelial cells into sites of tissue injury, which may be associated with the known anti-inflammatory activity of this macrolide. (Source: AJP: Lu...

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Simultaneous Determination of Several Antibiotics: Application to Human Plasma Extracts, and Impurities and Degradants in Drug Preparations

This application note describes a gradient HPLC-EC Array method for the determination of beta-lactam and macrolide antibiotics. The method has low pg sensitivity, a wide dynamic range, excellent linearity and demonstrates the determination of vancomycin, azithromycin, clindamycin, erythromycin, oleandomycin and amoxicillin in extracts of human plasma. Impurities and degradants in pharmaceuticals were determined at the 0.1% level. (Source: PharmaManufacturing.com)

Emergence of Streptococcus pneumoniae of serotype 19A in France: molecular capsular serotyping, antimicrobial susceptibilities, and epidemiology

Abstract: We have studied 457 Streptococcus pneumoniae isolated in 2007 from adults and children. For all isolates, both latex agglutination and molecular capsular typing were performed. Antibiotic resistance patterns were determined. S. pneumoniae 19A was the most frequently isolated serotype (34.7%) both in children and adults. It represented 12.8% of the strains isolated from invasive infections in adults and 27.0% in children and 63.6% (110/173) of strains isolated from acute otitis media. Between children and adults, no difference concerning antibiotic susceptibility was observed for penicillin, amoxicillin, cefotaxime, and erythromycin in strains isolated from invasive diseases. Comparing antibiotic susceptibilities according to the serotype, the 19A isolates appeared to be the least...

Methicillin-resistant Staphylococcus aureus strain USA300: origin and epidemiology

Methicillin-resistant Staphylococcus aureus (MRSA) PFGE strain type USA300 (multilocus sequence type 8, clonal complex 8, staphylococcal cassette chromosome mec type IV) was first reported in the USA as a cause of skin and soft issue infection among college football players in Pennsylvania and among prisoners in Missouri in 2000. Over the next 5 years, USA300 became the predominant community-associated MRSA strain in the USA. It was the most common PFGE type recovered from skin and soft tissue infections in persons presenting to 11 emergency departments across the USA, and caused outbreaks in Native American populations, children in daycare centres, military recruits, prison inmates and among men who have sex with men. Although predominantly a cause of skin and soft issue infection, USA300...

BSAC standardized disc susceptibility testing method (version 8)

There have been considerable changes to the format of the recommendations since the previous version (version 7). The majority of the footnotes to the tables have been removed and the notations added to the end column; it is hoped that this change will avoid confusion in interpretation. Antibiotics have been separated into groups, e.g. β-lactams, aminoglycosides, etc. Recommendations for urinary tract infections (UTIs) have been removed for most agents except for those that are administered solely for the treatment of uncomplicated UTIs or where there are limited recommendations for specific organisms, e.g. trimethoprim. For agents that previously had dual recommendations, systemic recommendations remain and the intermediate category can be used for interpretation for UTIs because int...

Molecular characterization of macrolide resistance determinants [erm(B) and mef(A)] in Streptococcus pneumoniae and viridans group streptococci (VGS) isolated from adult patients with cystic fibrosis (CF)

Conclusions Long-term treatment with azithromycin in CF patients may reduce antibiotic susceptibility in commensal VGS, where these organisms may potentially act as a reservoir of macrolide resistance determinants for newly acquired and antibiotic-susceptible pathogens. (Source: Journal of Antimicrobial Chemotherapy)

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Correlation between usage of macrolide antibiotic and resistance of Streptococcus pneumoniae clinic isolates from chongqing children's hospital

To investigate the reasons of growing resistance problem of Streptococcus pneumoniae against macrolide in Chongqing, a retrospective method was employed to measure the minimal inhibition concentrations (MIC) of macrolide antibiotic against 1,210 S. pneumoniae clinic isolates. The defined daily doses (DDDs) of macrolide antibiotic were calculated. Polymerase chain reaction (PCR) was used to determine the presence of the erythromycin-resistant genes in 100 macrolide-resistant S. pneumoniae isolates. A decrease in macrolide consumption, from 371,100 DDDs in 2002 to 182,500 DDDs in 2005 (51% reduction); however, the rate of erythromycin resistance in S. pneumoniae showed continued increase from 88.0% in 2002 to 96.0% in 2005. No linear correlation was observed between the decline in macrolide ...

Co-Transfer of Antibiotic Resistance Genes and a hylEfm-Containing Virulence Plasmid in Enterococcus faecium.

Authors: Arias CA, Panesso D, Singh KV, Rice LB, Murray BE The hylEfm gene (encoding a putative hyaluronidase) has been found almost exclusively in Enterococcus faecium clinical isolates and, recently, it was shown to be on a plasmid which increased the ability of E. faecium strains to colonize the gastrointestinal tract. In this work, mating experiments between hylEfm-containing strains of E. faecium belonging to clonal cluster 17 (CC17) and isolated in the USA and Colombia indicated that the hylEfm gene of these strains is also carried on large plasmids (> 145 kb) which we showed readily transfer from clinical strains to E. faecium hosts. Co-transfer of resistance to vancomycin, high-level resistance (HLR) to aminoglycosides (gentamicin and streptomycin) and erythromycin was also ...

[Acute generalised exanthematosus pustulosis (AGEP) due to diltiazem - a case report.]

Authors: Barcik K, Protas-Drozd F, Weiss-Rostkowska W, Flis E, Placek W A case of a patient who developed acute generalised exanthemotosus pustulosis (AGEP) due to diltiazem therapy is presented. On the day of the admission to hospital skin changes were present on the whole body in the form of sterile spots of an erythema origin. The laboratory tests showed anaemia, leucocytosis, hypocalcaemia, increased liver enzymes and increased ESR. The skin changes were accompanied by high temperature and bad condition. On the basis of medical history, clinical picture and medical tests, AGEP was diagnosed. After the application of a general treatment with erythromycin and external preparations, the skin changes subsided completely. PMID: 19784887 [PubMed - in process] (Source: Kardiologia Pol...

Antimicrobial susceptibility of Pasteurella multocida isolated from swine and poultry.

Authors: Sellyei B, Varga Z, Szentesi-Samu K, Kaszanyitzky E, Magyar T Pasteurella multocida causes infectious diseases in a wide range of animal species. Antimicrobial therapy is still an effective tool for treatment. Generally, P. multocida isolates are susceptible to most of the widely used commercial antimicrobial agents but their excessive and unjustified use accelerates the emergence of resistant strains. We defined the antimicrobial sensitivity pattern of 56 P. multocida strains isolated from poultry (20) and swine [16 P. multocida toxin (PMT) positive and 20 PMT negative] to 16 widely applied antibiotics (apramycin, cefquinome, chloramphenicol, colistin, doxycycline, enrofloxacin, erythromycin, florfenicol, flumequine, neomycin, oxolinic acid, penicillin, trimethoprim potentiat...

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