Clinical Experience of Patients Receiving Doripenem-Containing Regimens for the Treatment of Healthcare-Associated Infections

<div><p>In this study, we retrospectively reviewed the clinical experience of patients receiving doripenem-containing regimens for the treatment of healthcare-associated infections (HCAIs) in a tertiary care center and assessed the clinical usefulness of doripenem therapy in this clinical setting. In this retrospective study, the medical records of all adult patients who had ever received doripenem-containing therapy for the treatment of HCAIs were reviewed between September 1, 2012 and August 31, 2014, and the following data were extracted: age, gender, type of infection, disease severity, underlying comorbidities or conditions, and laboratory results. Additionally, we also extracted data regarding the rates of mortality and clinical and microbiological response. A total of 184 adult patients with HCAIs who had received doripenem-containing therapy were included in this study. Respiratory tract infections (n = 91, 49.5%) were the most common type of infection, followed by urinary tract infections, intra-abdominal infections and skin and soft tissue infections. The mean APACHE II score was 14.5. The rate of clinical success was 78.2%, and the overall in-hospital mortality rate was only 13.0%. Among patients, in-hospital mortality was independently and significantly associated with APACHE II score (odds ratio (OR), 1.2825; 95% CI, 1.1123–1.4788) and achieving clinical success (OR, 0.003; 95% CI, 0.0003–0.409). In conclusion, the overall in-hospital mortality rate was low and the clinical success rate was high among HCAI patients receiving doripenem treatment. These results suggest that doripenem may be judiciously used for the treatment of patients with HCAIs.</p></div

Clinical characteristics of included patients.

<p>Clinical characteristics of included patients.</p

Distribution of the eight most commonly detected organisms by sampling location.

<p>Distribution of the eight most commonly detected organisms by sampling location.</p

Sites, clinical sources, and causal organisms of infection among cases who did not achieve microbiological eradication.

<p>Sites, clinical sources, and causal organisms of infection among cases who did not achieve microbiological eradication.</p

Comparisons between deceased and surviving patients.

<p>Comparisons between deceased and surviving patients.</p

Clinical manifestations of 78 patients with clinical isolations of carbapenem-resistant <i>Enterobacteriacae</i> that were acquired from community or healthcare setting.

<p>Clinical manifestations of 78 patients with clinical isolations of carbapenem-resistant <i>Enterobacteriacae</i> that were acquired from community or healthcare setting.</p

Schematic maps of (a) pLK75 and (b) pLK78.

<p>The black blocks on the outer circle are the coding DNA sequences of the positive strand, and the black blocks on the inner circle are the coding DNA sequences of the negative strand. The remarkable features are indicated. Consensus regions similar to other plasmids/replicons are marked with thick black lines inside the circles, with non-consensus sections between the conserved regions shown by thin lines. The 26-kb inversion regions are marked in the inner circles, and the flanking sequences are shown. The sequences at both ends of the inversion region are shown in bold. The positions of the 244-bp Tn<i>3</i>-like repeats (c) are marked by black arrowheads on the circles. The 244-bp repeat sequence is shown in (c). The putative inverted repeats flanking this sequence are shown in bold with an underline.</p

Identification of the genetic determinants of serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions-1

<p><b>Copyright information:</b></p><p>Taken from "Identification of the genetic determinants of serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions"</p><p>http://www.biomedcentral.com/1471-2180/8/126</p><p>BMC Microbiology 2008;8():126-126.</p><p>Published online 25 Jul 2008</p><p>PMCID:PMC2527010.</p><p></p

Identification of the genetic determinants of serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions-2

Densitometry and expressed (Arabic numbers) relative to the value for transcription obtained from the static LB broth culture condition. The intensities of 16S rRNA shown indicates that equivalent amounts of total RNA were used in the experiment.<p><b>Copyright information:</b></p><p>Taken from "Identification of the genetic determinants of serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions"</p><p>http://www.biomedcentral.com/1471-2180/8/126</p><p>BMC Microbiology 2008;8():126-126.</p><p>Published online 25 Jul 2008</p><p>PMCID:PMC2527010.</p><p></p

Clinical Significance of Community- and Healthcare-Acquired Carbapenem-Resistant Enterobacteriaceae Isolates

<div><p>This study was conducted to investigate the clinical significance, manifestations, microbiological characteristics and outcomes of carbapenem-resistant Enterobacteriaceae (CRE) isolates, and compare the clinical features of community- and healthcare-acquired CRE isolates. A total of 78 patients were identified to have CRE. <i>Klebsiella pneumoniae</i> was the most common pathogens (n = 42, 53.8%), followed by <i>Enterobacter cloacae</i> (n = 24, 30.8%), and <i>Escherichia coli</i> (n = 11, 14.1%). Most of the patients acquired CRE from healthcare settings (n = 55, 70.5%), and other cases got CRE from community settings (n = 23, 29.5%). Nine cases (11.5%) were classified as CRE colonization. Among the remaining 69 cases of CRE infections, pneumonia (n = 28, 40.6%) was the most common type of infections, followed by urinary tract infection (n = 24, 34.8%), and intra-abdominal infection (n = 16, 23.2%). The patients acquired CRE from community settings were more likely to be elderly, female, and had more urinary tract infections than from healthcare settings. In contrast, the patients acquired CRE from healthcare settings had more intra-abdominal infections, intra-abdominal surgery, and presence of indwelling device than from community settings. In conclusion, community-acquired CRE are not rare, and their associated clinical presentations are different from healthcare-acquired CRE.</p></div