A Randomized, Controlled Trial of Cefoperazone vs. Cefamandole-Tobramycin in the Treatment of Putative, Severe Infections with Gram-Negative Bacilli

Warren, John W.; Miller, Earl H.; Fitzpatrick, Brian; DiFranco, Diane; Caplan, Ellis S.; Tenney, James H.; Anthony, William C.

doi:10.1093/clinids/5.supplement_1.s173

Cited by 34 publications

(13 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These included human commensal isolates (n ϭ 67) (23,25), animal commensal isolates from the Escherichia coli collection of refer-ence (ECOR) (n ϭ 32) (25) (18), DEC isolates (n ϭ 29; 10 enteropathogenic, 10 enterohemorrhagic, and 9 enterotoxigenic E. coli isolates) (2,28,40), NMEC isolates (n ϭ 30) (41), and UPEC isolates (n ϭ 293), including isolates from patients with asymptomatic bacteriuria (ABU; n ϭ 65) (11,25), complicated UTI (n ϭ 82) (22,39), uncomplicated cystitis (n ϭ 69) (7,25,34; this study), and pyelonephritis (n ϭ 77) (23,25,38). Urine was collected at the University of Michigan Urology Center and University Health Services from women over 18 years of age presenting with symptoms of a urinary tract infection and streaked for isolation onto MacConkey agar.…”

Section: Strain Collectionmentioning

confidence: 89%

Escherichia coli Isolates That Carry vat , fyuA , chuA , and yfcV Efficiently Colonize the Urinary Tract

et al. 2012

View full text Add to dashboard Cite

h Extraintestinal Escherichia coli (ExPEC), a heterogeneous group of pathogens, encompasses avian, neonatal meningitis, and uropathogenic E. coli strains. While several virulence factors are associated with ExPEC, there is no core set of virulence factors that can be used to definitively differentiate these pathotypes. Here we describe a multiplex of four virulence factor-encoding genes, yfcV, vat, fyuA, and chuA, highly associated with uropathogenic E. coli strains that can distinguish three groups of E. coli: diarrheagenic and animal-associated E. coli strains, human commensal and avian pathogenic E. coli strains, and uropathogenic and neonatal meningitis E. coli strains. Furthermore, human intestinal isolates that encode all four predictor genes express them during exponential growth in human urine and colonize the bladder in the mouse model of ascending urinary tract infection in higher numbers than human commensal strains that do not encode the four predictor genes (P ‫؍‬ 0.02), suggesting that the presence of the predictors correlates with uropathogenic potential. Extraintestinal pathogenic Escherichia coli (ExPEC), a heterogeneous group of E. coli pathotypes defined by isolation from infections outside the intestinal tract, includes uropathogenic E. coli (UPEC), avian-pathogenic E. coli (APEC), and neonatal meningitis E. coli (NMEC) (20,32). ExPEC strains are a diverse group of pathogenic E. coli strains that cause disease in poultry and companion animals as well as humans (32). While many virulence factors are associated with ExPEC, no core set of virulence factors can unambiguously distinguish the ExPEC subgroups from one another. Therefore, strains can be designated UPEC, APEC, or NMEC only on the basis of the isolation source (20). Unlike diarrheagenic E. coli (DEC) strains, which are obligate intestinal pathogens, ExPEC strains can commensally colonize the human intestine; thus, the intestinal tract can serve as a reservoir for extraintestinal E. coli (20).This ExPEC reservoir is of particular importance for women with recurrent urinary tract infections (UTIs), as UPEC is the predominant cause of uncomplicated UTIs. It is estimated that over 50% of women will have a UTI in their lifetime; 25% will then experience a second UTI and 3% will have a third UTI within 6 months of the initial infection (5). One explanation for recurrence is that such a reservoir of UPEC in the gastrointestinal tract of this population of women is reintroduced to the urinary tract, allowing subsequent infections to occur. Indeed, UPEC clones persist long term as commensals within the intestinal tract and can even be shared among family members and household pets (13,24). A diagnostic test that could identify potential carriers of UPEC, therefore, would be beneficial for medical practitioners to determine a course for prevention of recurrent UTI. Identification of reservoirs of uropathogens could be used to identify at-risk populations and reduce disease transmission. Once carriers of UPEC are identified, the patients can be t...

show abstract

Section: Strain Collectionmentioning

confidence: 89%

Escherichia coli Isolates That Carry vat , fyuA , chuA , and yfcV Efficiently Colonize the Urinary Tract

et al. 2012

View full text Add to dashboard Cite

show abstract

“…In the recent past several candidate agents have been developed, and good clinical experience has resulted from their use (16,18,24). Methicillin-resistant S. aureus, however, has emerged as a significant pathogen in many centers around the country (2, 23).…”

Section: Discussionmentioning

confidence: 99%

Bactericidal activity of ciprofloxacin compared with that of cefotaxime in normal volunteers

Standiford¹,

Drusano²,

Forrest³

et al. 1987

Antimicrob Agents Chemother

View full text Add to dashboard Cite

We compared ciprofloxacin (200 mg) with cefotaxime (2 g) when each was administered intravenously over a 30-min period to six volunteers in a crossover manner 1 week apart. To integrate the pharmacologic and microbiologic activity, inhibitory and bactericidal activities in serum were obtained for both antibiotics 1 and 6 h after administration against 10 strains of Escherichia coli, 10 strains of Klebsiella pneumoniae, 15 strains of Pseudomonas aeruginosa, and 10 strains each of methicillin-susceptible and -resistant Staphylococcus aureus. Geometric mean bactericidal titers for E. coli 1 h after the infusion were 1:60 for ciprofloxacin and 1:252 for cefotaxime, and for K. pneumoniae they were 1:20 and 1:256, respectively. However, geometric mean titers were poor for both antibiotics against methicillin-susceptible S. aureus (<1:2 for ciprofloxacin versus 1:5 for cefotaxime) and methicillin-resistant S. aureus (<1:2 for both antibiotics), as well as against P. aeruginosa (1:3 for ciprofloxacin versus 1:2 for cefotaxime). These data suggest that ciprofloxacin may be useful for the treatment of serious infections caused by E. coli and K. pneumoniae. However, caution is suggested when this dose of ciprofloxacin is used in situations in which septicemia is caused by P. aeruginosa or S. aureus and originates outside the urinary tract.Ciprofloxacin is a new quinoline carboxylic acid which can be administered orally or intravenously. Results of previous microbiologic studies have shown that this compound has a broad spectrum of activity, encompassing members of the family Enterobacteriaceae, Pseudomonas aeruginosa, and methicillin-susceptible and -resistant Staphylococcus aureus (1,4,5). This suggests that it has the potential for singleagent therapy for serious bacterial infections. Therefore, to test this potential prior to clinical trials, we compared the bactericidal activity of ciprofloxacin in serum with that of a control regimen, cefotaxime, after each was administered intravenously to normal volunteers. Determination of the bactericidal activity in serum is a method used to integrate the microbiologic activity with many of the pharmacologic characteristics of the antibiotic, including the effect of the metabolites, and has been used in previous studies to compare experimental regimens with standards (10, 19-21). Additionally, in some studies it has been shown that there is a correlation between clinical effectiveness and bactericidal activity in serum, as performed by the Stratton-Reller technique, the method that was used in this evaluation (17, 21, 25). MATERIALS AND METHODSVolunteer studies. Six normal male volunteers (age, 21 to 35 years; weight, 74 to 90 kg), who were fully informed before the study, received ciprofloxacin and cefotaxime in a randomized crossover manner, with at least 6 days elapsing between each drug administration. Ciprofloxacin (200 mg) or cefotaxime (2 g) was infused intravenously via a Harvard Pump (Harvard Apparatus, Inc.) over 30 min. Blood was obtained for the serum inhibitory and b...

show abstract

“…A strain collection was assembled that contained 303 E. coli isolates, including human commensal (n ϭ 57) (35,37), animal commensal isolates from the ECOR collection (n ϭ 32) (37), and strains isolated from individuals with asymptomatic bacteriuria (ABU; n ϭ 54) (14, 37), complicated UTI (n ϭ 45) (31, 52), uncomplicated cystitis (n ϭ 38) (12,37,45), and pyelonephritis (n ϭ 77) (35,37,51).…”

Section: Methodsmentioning

confidence: 99%

Fimbrial Profiles Predict Virulence of Uropathogenic Escherichia coli Strains: Contribution of Ygi and Yad Fimbriae

et al. 2011

View full text Add to dashboard Cite

Escherichia coli, a cause of ϳ90% of urinary tract infections (UTI), utilizes fimbrial adhesins to colonize the uroepithelium. Pyelonephritis isolate E. coli CFT073 carries 12 fimbrial operons, 5 of which have never been studied. Using multiplex PCR, the prevalence of these 12 and 3 additional fimbrial types was determined for a collection of 303 E. coli isolates (57 human commensal, 32 animal commensal, 54 asymptomatic bacteriuria, 45 complicated UTI, 38 uncomplicated cystitis, and 77 pyelonephritis). The number of fimbrial types per E. coli isolate was distributed bimodally: those with low (3.2 ؎ 1.1) and those with high (8.3 ؎ 1.3) numbers of fimbrial types (means ؎ standard errors of the means). The fimbrial genes ygiL, yadN, yfcV, and c2395 were significantly more prevalent among urine isolates than human commensal isolates. The effect of deletion of Ygi and Yad fimbrial operons on growth, motility, biofilm formation, adherence to immortalized human epithelial cells, and pathogenesis in the mouse model of UTI was examined. Yad fimbriae were necessary for wild-type levels of adherence to a bladder epithelial cell line and for biofilm formation. Deletion of these fimbrial genes increased motility. Ygi fimbriae were necessary for wild-type levels of adherence to a human embryonic kidney cell line, biofilm formation, and in vivo fitness in the urine and kidneys. Complementation of each fimbrial mutant restored wild-type levels of motility, biofilm formation, adherence and, for ygi, in vivo fitness. A double deletion strain, ⌬ygi ⌬yad, was attenuated in the urine, bladder, and kidneys in the mouse model, demonstrating that these fimbriae contribute to uropathogenesis.Uropathogenic Escherichia coli (UPEC) is the most prevalent cause of uncomplicated urinary tract infection (UTI) and one of the most common human pathogens (7). To better combat this pathogen, through the development of vaccines or alternative therapeutic approaches, it is imperative to understand the factors required for UPEC to successfully colonize its host. Numerous virulence factors have been determined, including toxins, siderophores, capsule, and adhesins (21-24, 36); however, no core set of virulence factors has been identified that defines all UPEC isolates.The first recognized virulence factors of UPEC were two fimbrial adhesins, type 1 and P fimbriae (19). Indeed, E. coli encodes both the chaperone-usher fimbriae and type IV pili (53). Chaperone-usher fimbriae are rigid rod-like structures with flexible fibrillar tips that terminate in an adhesin (17, 48). These fimbriae are comprised of main subunits, accessory pilins, and adhesins that are transported to the periplasm through the Sec system. Periplasmic chaperones bind the subunits and ensure proper folding as well as transport the subunits to the outer membrane usher (17, 48). In the outer membrane, a dimer of usher proteins docks each subunit and adds it to a growing fimbria (17).Chaperone-usher fimbriae are subdivided into clades based on the sequence of the usher proteins, with type...

show abstract

A Randomized, Controlled Trial of Cefoperazone vs. Cefamandole-Tobramycin in the Treatment of Putative, Severe Infections with Gram-Negative Bacilli

Cited by 34 publications

References 12 publications

Escherichia coli Isolates That Carry vat , fyuA , chuA , and yfcV Efficiently Colonize the Urinary Tract

Escherichia coli Isolates That Carry vat , fyuA , chuA , and yfcV Efficiently Colonize the Urinary Tract

Bactericidal activity of ciprofloxacin compared with that of cefotaxime in normal volunteers

Fimbrial Profiles Predict Virulence of Uropathogenic Escherichia coli Strains: Contribution of Ygi and Yad Fimbriae

Contact Info

Product

Resources

About