International Journal of Antimicrobial Agents最新文献_第3页

Pharmacodynamic Target Attainment at Infection Site during Treatment of Post-Neurosurgical Ventriculitis Caused by Carbapenem-Resistant Klebsiella pneumoniae with Ceftazidime-Avibactam-Based Regimens: a case report. 以头孢唑肟-阿维巴坦为基础的治疗方案治疗耐碳青霉烯类肺炎克雷伯氏菌引起的神经外科手术后脑室炎时感染部位的药效学目标达成情况：一份病例报告。

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-10-08 DOI: 10.1016/j.ijantimicag.2024.107356

Yinru Chen, Wanzhen Li, Xiaofen Liu, Yan Chen, Jing Zhang, Nanyang Li, Lei Yang

引用次数: 0

Neutralizing Chimeric Anti-F1 Monoclonal Antibody against Yersinia pestis Infection. 针对鼠疫耶尔森菌感染的中和嵌合抗 F1 单克隆抗体

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-10-08 DOI: 10.1016/j.ijantimicag.2024.107354

Xi Wang, Qing Xie, Ying Huang, Jiansheng Lu, Lei Chen, Jiazheng Guo, Yujia Jiang, Qinglin Kang, Xinrui Yu, Wei Zhang, Meng Lv, Lingfei Hu, Rong Wang, Zhixin Yang, Tao Zheng

引用次数: 0

Investigating an Outbreak of Extensively Drug-Resistant Acinetobacter baumannii in a Tertiary Healthcare Centre in Lebanon Using Next-Generation Sequencing 利用新一代测序技术调查黎巴嫩一家三级医疗保健中心爆发的广泛耐药鲍曼不动杆菌疫情

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-10-01 DOI: 10.1016/j.ijantimicag.2024.107353

{"title":"Investigating an Outbreak of Extensively Drug-Resistant Acinetobacter baumannii in a Tertiary Healthcare Centre in Lebanon Using Next-Generation Sequencing","authors":"","doi":"10.1016/j.ijantimicag.2024.107353","DOIUrl":"10.1016/j.ijantimicag.2024.107353","url":null,"abstract":"<div><div>The frequent occurrence of <em>Acinetobacter baumannii</em> in hospital settings and the elevated rate of antimicrobial resistance in this pathogen represent a serious clinical and public health threat worldwide, and particularly in Lebanon where outbreak surveillance and control are still insufficient. Whole-genome sequencing (WGS) is a fast and reliable tool to study outbreaks at the molecular level and obtain actionable knowledge, leading to better control measures. A total of 59 <em>A. baumannii</em> isolates were collected from intensive care unit (ICU) patients (57 isolates) and from the hospital environment (2 isolates) between August 2022 and May 2023, antimicrobial susceptibility testing (AST) was performed and gDNA was subjected to WGS. Analysis was performed to reveal the sequence types (ST), the relatedness to strains that caused other outbreaks and the arsenal of resistance genes harboured by these bacteria. Of 59 isolates, 85% were categorised as extensively drug-resistant (XDR), 13.6% as multidrug-resistant (MDR) and 1.7% as pan-drug-resistant. All isolates belonged to international clone (IC)2, of which the majority were of ST2 (91.5%). The isolates clustered well with those of a previous outbreak in the same hospital. In addition, isolates from hospitals in Lebanon clustered well together and some clustered with those originating from other countries. The observed genetic relatedness between the current isolates and those from the previous outbreaks underscores the importance of strict surveillance to limit the threat of outbreaks. Moreover, the clustering of isolates from Lebanon with others from distant countries proves the necessity to further investigate the international spread of drug-resistant pathogens and the implementation of control strategies.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Title Page & Editorial Board 扉页和编辑委员会

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-10-01 DOI: 10.1016/S0924-8579(24)00263-2

引用次数: 0

In Vivo Emergence of Ceftazidime/Avibactam, Cefiderocol and Aztreonam/Avibactam Cross-Resistance in a Patient With KPC-Producing Klebsiella pneumoniae Infection After Cefiderocol-Based Treatment 一名感染了产KPC肺炎克雷伯菌的患者在接受头孢羟氨苄治疗后，体内出现了头孢唑肟/阿维菌素、头孢羟氨苄和阿兹曲南/阿维菌素交叉耐药性。

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-10-01 DOI: 10.1016/j.ijantimicag.2024.107343

引用次数: 0

Renal function and its impact on the concentration of ceftazidime-avibactam: A cross-sectional study 肾功能及其对头孢唑肟-阿维巴坦浓度的影响：一项横断面研究

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-10-01 DOI: 10.1016/j.ijantimicag.2024.107351

{"title":"Renal function and its impact on the concentration of ceftazidime-avibactam: A cross-sectional study","authors":"","doi":"10.1016/j.ijantimicag.2024.107351","DOIUrl":"10.1016/j.ijantimicag.2024.107351","url":null,"abstract":"<div><h3>Objective</h3><div>This study measured the effect of renal function on the plasma concentrations of ceftazidime and avibactam in critically ill patients. We also sought to measure the concentration ratio of ceftazidime to avibactam.</div></div><div><h3>Methods</h3><div>This was a cohort study at a tertiary referral centre in Italy, on patients treated with continuous infusion of ceftazidime-avibactam (CAZ-AVI) between November 2019 and December 2023. The association between creatine clearance (CrCl) and free plasma ceftazidime and avibactam concentration, as well as CAZ-AVI ratio was explored to assess correlation and potential risk to fail to achieve target therapeutic concentration.</div></div><div><h3>Results</h3><div>Fifty-two patients, predominantly male (75%), with a median age of 68.5 y were included. Our analyses provided strong evidence for inverse correlation between CrCl and both free-CAZ (<em>r</em> = -0.627; <em>R<sup>2</sup></em> = 0.3936; <em>P</em> < 0.001) and free-AVI plasma concentration (<em>r</em> = -0.619; <em>R</em><sup>2</sup> = 0.3832; <em>P</em> < 0.001). Overall CrCl alone could explain about 40% of overall variation of either free-CAZ and free-AVI. Linear models suggest that free-CAZ and free-AVI concentration drop of about 7.31% and 9.23% for each 10 point increase of CrCl, respectively. Assessment of the CAZ-AVI ratio supports a direct linear association with CrCl suggesting that free-AVI concentration is more affected by CrCl variation than free-CAZ concentration. Patients with CrCl ≥130 mL/min showed a significantly higher risk of suboptimal drug exposure (i.e., less than 4 times the MIC) both to CAZ and AVI.</div></div><div><h3>Conclusion</h3><div>The findings emphasise the need for individualised dosing strategies of CAZ-AVI based on renal function, for antibiotics used in critically ill patients. The study suggests that underdosing in patients with high CrCl is likely to be common and as such could affect drug effectiveness.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physiologically-based pharmacokinetic modelling in sepsis: A tool to elucidate how pathophysiology affects meropenem pharmacokinetics 脓毒症中基于生理学的药代动力学模型；阐明病理生理学如何影响美罗培南药代动力学的工具：败血症中美罗培南的 PBPK 模型。

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-09-28 DOI: 10.1016/j.ijantimicag.2024.107352

{"title":"Physiologically-based pharmacokinetic modelling in sepsis: A tool to elucidate how pathophysiology affects meropenem pharmacokinetics","authors":"","doi":"10.1016/j.ijantimicag.2024.107352","DOIUrl":"10.1016/j.ijantimicag.2024.107352","url":null,"abstract":"<div><h3>Objectives</h3><div>Applying physiologically-based pharmacokinetic (PBPK) modelling in sepsis could help to better understand how PK changes are influenced by drug- and patient-related factors. We aimed to elucidate the influence of sepsis pathophysiology on the PK of meropenem by applying PBPK modelling.</div></div><div><h3>Methods</h3><div>A whole-body meropenem PBPK model was developed and evaluated in healthy individuals, and renally impaired non-septic patients. Sepsis-induced physiological changes in body composition, organ blood flow, kidney function, albumin, and haematocrit were implemented according to a previously proposed PBPK sepsis model. Model performance was evaluated, and a local sensitivity analysis was conducted.</div></div><div><h3>Results</h3><div>The model-predicted PK metrics (AUC, C<sub>max</sub>, CL, V<sub>ss</sub>) were within 1.33-fold-error margin of published data for 87.5% of the simulated profiles in healthy individuals. In sepsis, the model provided good predictions for literature-digitised average plasma and tissue exposure data, where the model-predicted AUC was within 1.33-fold-error margin for 9 out 11 simulated study profiles. Furthermore, the model was applied to individual plasma concentration data from 52 septic patients, where the model-predicted AUC, C<sub>max</sub>, and CL had a fold-error ratio range of 0.98–1.12, with alignment of the predicted and observed variability. For V<sub>ss</sub>, the fold-error ratio was 0.81, and the model underpredicted the population variability. CL was sensitive to renal plasma clearance, and kidney volume, whereas V<sub>ss</sub> was sensitive to the unbound fraction, organ volume fraction of the interstitial compartment, and the organ volume.</div></div><div><h3>Conclusions</h3><div>These findings may be extended to more diverse drug types and support a more mechanistic understanding of the effect of sepsis on drug exposure.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genomic tracking the coexistence of mcr and carbapenemase genes in Gram-negative bacteria: a global perspective 革兰氏阴性细菌中 mcr 和碳青霉烯酶基因共存的基因组追踪：全球视角。

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-09-27 DOI: 10.1016/j.ijantimicag.2024.107350

引用次数: 0

Population pharmacokinetic analysis and dosing optimization of colistin sulphate in lung transplant recipients with pneumonia: A prospective study 硫酸可乐定在肺移植受者肺炎患者中的群体药代动力学分析和剂量优化：前瞻性研究。

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-09-26 DOI: 10.1016/j.ijantimicag.2024.107346

{"title":"Population pharmacokinetic analysis and dosing optimization of colistin sulphate in lung transplant recipients with pneumonia: A prospective study","authors":"","doi":"10.1016/j.ijantimicag.2024.107346","DOIUrl":"10.1016/j.ijantimicag.2024.107346","url":null,"abstract":"<div><h3>Objective</h3><div>Currently, there is a lack of information on the clinical pharmacokinetics (PK), effectiveness, and safety of colistin sulphate (CS) in lung transplant recipients. This study aims to improve CS dosing regimens and evaluate its population PK in lung transplant recipients.</div></div><div><h3>Methods</h3><div>This study evaluated the clinical efficacy, microbiological efficacy, and adverse events of CS in lung transplant recipients. The NONMEM program was employed to construct the population PK model, and Monte Carlo simulations were executed to establish dosing regimens according to the probability of target attainment (PTA).</div></div><div><h3>Results</h3><div>The study included 146 CS concentrations, spanning from 0.05 to 4.18 mg/L from 39 lung transplant recipients with multidrug-resistant Gram-negative bacteria. 26 (66.67%) patients successfully eradicated bacteria, and 30 (76.92%) patients had clinical cure or improvement. Additionally, only 2 (5.13%) patients developed CS-related nephrotoxicity. The PK profile was effectively represented by a one-compartmental model with linear elimination. Creatinine clearance and concomitant furosemide use were recognized as covariates influencing the clearance of CS. Based on the PTA results, a daily dosage of 1.5 million IU, divided into 2–3 administrations, could attain a PTA exceeding 90% for MIC ≤ 1 µg/mL at creatinine clearance of about 110 mL/min. However, this regimen would lead to insufficient exposure for MIC ≥ 2 µg/mL.</div></div><div><h3>Conclusions</h3><div>The clearance of CS is significantly influenced by concomitant furosemide use and renal function. The currently recommended dosing regimens by label sheet may result in subtherapeutic exposure for MIC exceeding 1 mg/L in lung transplant recipients.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges and Potential Solutions for Cycloserine Dosing in Patients With Sepsis Undergoing Continuous Renal Replacement Therapy 对接受持续肾脏替代治疗的脓毒症患者使用环丝氨酸的挑战和潜在解决方案。

IF 4.9 2区医学

International Journal of Antimicrobial Agents Pub Date : 2024-09-23 DOI: 10.1016/j.ijantimicag.2024.107345

{"title":"Challenges and Potential Solutions for Cycloserine Dosing in Patients With Sepsis Undergoing Continuous Renal Replacement Therapy","authors":"","doi":"10.1016/j.ijantimicag.2024.107345","DOIUrl":"10.1016/j.ijantimicag.2024.107345","url":null,"abstract":"<div><div>Continuous kidney replacement therapy (CRRT) is a special form of dialysis, which has more significant advantages than traditional intermittent hemodialysis in treating critically ill patients. The impact of CRRT and disease complexity on drug clearance in critically ill patients has been reported in several studies; nevertheless, the pharmacokinetic changes of cycloserine in patients with sepsis undergoing CRRT have not been reported. Here, we report a case of a 52-year-old man with septic shock and severe multidrug-resistant tuberculosis who underwent anti-tuberculosis (anti-TB) therapy. The patient's anti-TB regimen included linezolid, clofazimine, cycloserine, and bedaquiline. Following continuous administration for 14 days, the patient was treated with CRRT due to acid–base imbalance and acute renal failure. Blood samples were collected at 0, 2, 4, 6, 10, and 12 hours following cycloserine administration (CRRT was initiated 2 hours after administration). Changes in plasma concentration of cycloserine before and after CRRT were measured. The peak concentration of cycloserine was 39.93 mg/L with a trough concentration of 7.90 mg/L, and the AUC<sub>0-12h</sub> was 294.36 mg·h/L. These findings suggest that the pharmacokinetics of cycloserine may be influenced by sepsis and CRRT therapy, and that cycloserine doses may need to be increased during CRRT therapy in patients with sepsis.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0