Streptococcus pneumoniae as cause of infection in infants less than 60 days of age: serotypes and antimicrobial susceptibility

Objective: The aim of this study was to determine the distribution of serotypes and the antimicrobial susceptibilities of Streptococcus pneumoniae clinical isolates causing invasive and non-invasive disease in children aged ≤60 days in hospitals in Mexico. Methods: A 15-year retrospective study was conducted for the period 2000 to 2014. Pneumococcal clinical isolates were serotyped by Quellung reaction, and antimicrobial susceptibility testing was performed with the broth microdilution method. Results: A total of 126 pneumococcal isolates were collected. Pneumonia was the most frequent diagnosis (40.5%), followed by meningitis (29.4%), septicemia (16.7%), and other clinical entities, including otitis media and conjunctivitis (13.5%). The most frequent serotypes before the introduction of heptavalent pneumococcal conjugate vaccine (PCV7) were 19F, 23F, 7F, and 35B. Serotypes 3, 6A, 10A, 12F, and 15A/B increased after the introduction of PCV7. Serotype 19A was isolated most frequently in the pneumonia and meningitis cases only after the introduction of PCV7, and it displayed a high resistance to penicillin. Conclusions: Although the number of infections in infants aged ≤60 days was low, such infections were not unusual events. New vaccination strategies should be evaluated to limit the risks in this age group

Resistance trends in gram-negative bacteria: surveillance results from two Mexican hospitals, 2005–2010

<p>Abstract</p> <p>Background</p> <p>Hospital-acquired infections caused by multiresistant gram-negative bacteria are difficult to treat and cause high rates of morbidity and mortality. The analysis of antimicrobial resistance trends of gram-negative pathogens isolated from hospital-acquired infections is important for the development of antimicrobial stewardship programs. The information obtained from antimicrobial resistant programs from two hospitals from Mexico will be helpful in the selection of empiric therapy for hospital-acquired gram-negative infections.</p> <p>Findings</p> <p>Two thousand one hundred thirty two gram-negative bacteria collected between January 2005 and December 2010 from hospital-acquired infections occurring in two teaching hospitals in Mexico were evaluated. <it>Escherichia coli</it> was the most frequently isolated gram-negative bacteria, with >50% of strains resistant to ciprofloxacin and levofloxacin. <it>Klebsiella</it> spp. showed resistance rates similar to <it>Escherichia coli</it> for ceftazidime (33.1% vs 33.2%), but exhibited lower rates for levofloxacin (18.2% vs 56%). Of the samples collected for the third most common gram-negative bacteria, <it>Pseudomonas aeruginosa</it>, >12.8% were resistant to the carbapenems, imipenem and meropenem. The highest overall resistance was found in <it>Acinetobacter</it> spp. <it>Enterobacter</it> spp. showed high susceptibility to carbapenems.</p> <p>Conclusions</p> <p><it>E. coli</it> was the most common nosocomial gram-negative bacilli isolated in this study and was found to have the second-highest resistance to fluoroquinolones (>57.9%, after <it>Acinetobacter</it> spp. 81.2%). This finding represents a disturbing development in a common nosocomial and community pathogen.</p

A randomized trial of tigecycline versus ampicillin-sulbactam or amoxicillin-clavulanate for the treatment of complicated skin and skin structure infections

Background: Complicated skin and skin structure infections (cSSSIs) frequently result in hospitalization with significant morbidity and mortality.Methods: In this phase 3b/4 parallel, randomized, open-label, comparative study, 531 subjects with cSSSI received tigecycline (100 mg initial dose, then 50 mg intravenously every 12 hrs) or ampicillin-sulbactam 1.5-3 g IV every 6 hrs or amoxicillin-clavulanate 1.2 g IV every 6-8 hrs. Vancomycin could be added at the discretion of the investigator to the comparator arm if methicillin-resistant Staphylococcus aureus (MRSA) was confirmed or suspected within 72 hrs of enrollment. The primary endpoint was clinical response in the clinically evaluable (CE) population at the test-of-cure (TOC) visit. Microbiologic response and safety were also assessed. The modified intent-to-treat (mITT) population comprised 531 subjects (tigecycline, n = 268; comparator, n = 263) and 405 were clinically evaluable (tigecycline, n = 209; comparator, n = 196).Results: In the CE population, 162/209 (77.5%) tigecycline-treated subjects and 152/196 (77.6%) comparator-treated subjects were clinically cured (difference 0.0; 95% confidence interval [CI]: -8.7, 8.6). The eradication rates at the subject level for the microbiologically evaluable (ME) population were 79.2% in the tigecycline treatment group and 76.8% in the comparator treatment group (difference 2.4; 95% CI: -9.6, 14.4) at the TOC assessment. Nausea, vomiting, and diarrhea rates were higher in the tigecycline group.Conclusions: Tigecycline was generally safe and effective in the treatment of cSSSIs.Trial registration: ClinicalTrials.gov NCT00368537. © 2012 Matthews et al.; licensee BioMed Central Ltd