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    ABSTRACT: Telavancin is a dual action, bactericidal lipoglycopeptide. Its in vitro activity was compared with vancomycin and linezolid against 392 Gram-positive isolates from cancer patients. MIC90 values (μg ml(-1)) for telavancin, vancomycin and linezolid were determined for methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-susceptible (MS), methicillin-resistant (MR), coagulase-negative staphylococci (CoNS), viridans group streptococci (VGS), Streptococcus pneumoniae, Bacillus species, Corynebacterium species and Micrococcus species. Telavancin had potent activity against β-hemolytic streptococci and Staphylococcus lugdunensis. Whereas 100% of MRSA and 98% of MSSA had vancomycin MICs ⩾1.0 μg ml(-1) (minimum inhibitory concentrations (MICs) at which poor clinical responses have been reported), the highest telavancin MIC was 0.38 μg ml(-1). For CoNS, 95% of MS and 100% of MR isolates had vancomycin MICs ⩾1.0 μg ml(-1), whereas the highest telavancin MIC was 0.38 μg ml(-1). Furthermore, 48% of VGS had vancomycin MICs ⩾1.0 μg ml(-1), whereas the highest telavancin MIC was 0.064 μg ml(-1). A similar pattern was noticed for S. lugdunensis, Bacillus species, Corynebacterium species and β-hemolytic streptococci. These data suggest that telavancin and linezolid have potent activity against most Gram-positive organisms that cause infections in cancer patients. Consequently, they may be considered as alternatives to vancomycin, especially in institutions wherein a substantial proportion of infections are caused by organisms with vancomycin MICs ⩾1.0 μg ml(-1).The Journal of Antibiotics advance online publication, 14 May 2014; doi:10.1038/ja.2014.30.
    The Journal of Antibiotics 05/2014; · 2.19 Impact Factor
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    ABSTRACT: Aims: The aim of this study was to investigate the mannose-binding lectin 2 (MBL-2), interleukin (IL)-4, Toll-like receptor 4 (TLR-4), angiotensin converting enzyme (ACE), chemokine receptor 5 (CCR-5), and IL-1 receptor antagonist (RA) gene polymorphisms (GPs) in acute leukemias (ALs) and to evaluate their roles in febrile neutropenia (FN) resulting from chemotherapy. Methods: The study included 60 AL patients hospitalized between the period of July 2001 and August 2006. Polymorphisms for the genes ACE(I/D), CCR-5, IL-1RA, MBL-2, TLR-4, and IL-4 were typed by polymerase chain reaction (PCR) and/or PCR-restriction fragment length polymerase. Genotype frequencies for these genes were compared in the patient and control groups. The relationships between the genotypes and the body distribution of infections, pathogens, the duration of neutropenia, and febrile episodes in AL patients were evaluated. Results: No significant differences in either the genotype distribution or the allelic frequencies of TLR-4, IL-4, CCR-5, IL-1RN GPs were observed between patients and healthy controls. The AB/BB genotype (53.3%) in the MBL-2 gene was found to be significantly higher in the AL patients compared with control groups. There were correlations between the presence of MBL-2, TLR-4, and ACE polymorphisms and clinical parameters due to FN. Overall, bacteremia was more common in MBL BB and ACE DD. Gram-positive bacteremia was more common in ACE for ID versus DD genotype. Gram-negative bacteremia was more common for both the MBL-2 AB/BB genotype and TLR-4 AG genotype. Median durations of febrile episodes were significantly shorter in ACE DD and MBL AB/BB. Conclusion: Although TLR-4, ACE, and MBL-2 GPs have been extensively investigated in different clinical pictures, this is the first study to evaluate the role of these polymorphisms in the genetic etiopathogenesis of FN in patients with ALs. As a conclusion, TLR-4, ACE, and MBL-2 genes might play roles in the genetic etiopathogenesis of FN in patients with ALs.
    Genetic Testing and Molecular Biomarkers 05/2014; · 1.44 Impact Factor
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    ABSTRACT: Initial management of chemotherapy-induced febrile neutropaenia (FN) comprises empirical therapy with a broad-spectrum antimicrobial. Currently, there is sufficient evidence to indicate which antibiotic regimen should be administered initially. However, no randomized trial has evaluated whether adherence to an antimicrobial stewardship program (ASP) results in lower rates of mortality in this setting. The present study sought to assess the association between adherence to an ASP and mortality among hospitalised cancer patients with FN.
    BMC Infectious Diseases 05/2014; 14(1):286. · 3.03 Impact Factor

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