Efficacy and safety of ertapenem dosing in patients with ESBL producing infections utilizing renal replacement therapies.

Purpose: The clinical efficacy and safety of ertapenem use in patients undergoing renal replacement therapies (RRT) are not well-documented. Therefore, we aimed to investigate the safety and efficacy of ertapenem in patients with sepsis secondary to Enterobacterales who are undergoing RRT.

Methods: A retrospective cohort study was conducted on patients who met the inclusion criteria at our hospital between May 2015 and December 2021.

Microbiologic outcomes of ceftazidime-avibactam dosing in patients with sepsis utilizing renal replacement therapies.

Introduction: The suggested dose of ceftazidime-avibactam (CEF/AVI) in patient with multidrug resistant organisms and utilizing renal replacement therapies (RRTs) is not validated in clinical studies. The objective of this study was to evaluate the microbiologic cure of bacteremia and pneumonia using the recommended CEF/AVI dosing in patients utilizing RRT.

Methods: A retrospective observational study conducted at our institution between September 15, 2018 and March 15, 2022.

Urinary tract infections in hemodialysis patients-The controversy of antimicrobial drug urine concentrations.

Background: Major infectious diseases societies recommend the use of antimicrobials that achieve high-urinary concentrations to treat urinary tract infection (UTI), which is a concept of little relevance to the oliguric and anuric hemodialysis (HD) dependent population. Outcome studies in this population are more relevant, but unfortunately scarce. We sought to investigate the impact of different antimicrobials on clinical and microbiologic outcomes in HD dependent population.

Nocardial Infection in the Early Period after Kidney Transplantation.

Patients with solid organ transplant have weaker immune system and can develop opportunistic infections. Prophylactic antimicrobials can help lower that risk but do not prevent it completely. High index of suspicion increases the chance of diagnosing rare opportunistic infections in immunocompromised patients and helps early and effective treatment.

Outcomes of caspofungin use in the treatment of -related urinary tract infections, a case series.

Echinocandins are generally excluded in the treatment of related urinary tract infections due to their poor urinary concentration. In the presence of fluconazole resistant species, such as and , alternative therapies are needed. We herein report the use of caspofungin for the treatment of 10 patients with candiduria, including .

Multiple concomitant life-threatening opportunistic infections due to uncontrolled hypercortisolism.

Opportunistic infections associated with severe cortisol excess carry a high mortality rate and are most prevalent with ectopic ACTH syndrome. There are limited reports of these cases described in the literature. In this case report, we describe multiple severe life-threatening opportunistic infections due to endogenous hypercortisolism.

Varicella-Zoster Meningitis in an Immunocompetent Male without Fever or Rash.

Varicella-Zoster virus (VZV) is a human herpesvirus that primarily causes chickenpox and can reactivate later in life. Chickenpox occurs mostly in children and is characterized by a typical generalized vesicular rash. Following the primary infection, VZV can remain latent and can reactivate decades later to produce Zoster, being more common in the elderly as well as immunosuppressed individuals.

Hydroxychloroquine is associated with slower viral clearance in clinical COVID-19 patients with mild to moderate disease.

There are conflicting data regarding the use of hydroxychloroquine (HCQ) in COVID-19 hospitalized patients. The objective of this study was to assess the efficacy of HCQ in increasing SARS-CoV-2 viral clearance.Hospitalized adult patients with confirmed SARS-CoV-2 infection were retrospectively included in the study.

Treatment of severe pneumonia due to COVID-19 with peginterferon alfa 2a.

The outbreak of the new coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. Until now, no definite effective treatment has been identified. We reported 3 patients with severe COVID-19 treated with pegylated interferon alfa 2a with satisfactory recovery.

Treatment of recurrent urinary tract infections in anuric hemodialysis patient, do we really need antimicrobial urinary concentration?

Providing care for patients with chronic kidney disease requires considerations that are unique to this population. Several references recommend the treating urinary tract infections with antibiotics that achieve considerable concentrations in urine however this is not applicable in anuric patients undergoing hemodialysis who are unable to excrete antibiotics significantly in urine. We report successful treatment of several episodes of urinary tract infections in hemodialysis patient highlighting the questionable need for antimicrobial urine concentration.

A case of acute disseminated encephalomyelitis following infection.

We report a case of acute disseminated encephalomyelitis (ADEM) secondary to infection that failed to improve with methylprednisolone and intravenous immunoglobulin (IVIG); who responded with plasmapheresis. A 21- year- old female with an unremarkable medical history, initially presented to an outside hospital with fever and an influenza-like illness and was subsequently intubated for worsening sensorium. Brain magnetic resonance imaging was suggestive of ADEM or vasculitis for which she received five days of pulse steroids and IVIG.

Successful treatment of multidrug resistant using dual carbapenem regimen in immunocompromised patient.

This report describes a longitudinal case of immunocompromised patient post kidney transplant who was admitted to our institution repeatedly for treatment of various infections caused by multi-drug resistant The patient was successfully treated with a combination of ertapenem/meropenem on multiple occasions despite the elevated MICs. Our observations corroborate previous preclinical studies and case reports showing the efficacy of double carbapenem regimens against resistant Enterobacteriaceae.

Comparison of antimicrobial activity between ceftolozane-tazobactam and ceftazidime-avibactam against multidrug-resistant isolates of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.

Objective: This study compared the activity of ceftolozane-tazobactam and ceftazidime-avibactam against 120 bacterial strains, including extended-spectrum beta-lactamase (ESBL) producers, carbapenem-resistant Enterobacteriaceae (CRE), and Pseudomonas aeruginosa, isolated from patients admitted to Cleveland Clinic Abu Dhabi, United Arab Emirates.

Methods: In vitro susceptibility was tested using the Etest strip minimum inhibitory concentration (MIC) method, and PCR was used to characterize the carbapenemase enzymes produced by CRE strains.

Results: All 29 ESBL isolates were susceptible to ceftazidime-avibactam (MIC 0.

Behavior of concentrically loaded CFT braces connections.

Concrete filled tubes (CFTs) composite columns have many economical and esthetic advantages, but the behavior of their connections is complicated. Through this study, it is aimed to investigate the performance and behavior of different connection configurations between concrete filled steel tube columns and bracing diagonals through an experimental program. The study included 12 connection subassemblies consisting of a fixed length steel tube and gusset plate connected to the tube end with different details tested under half cyclic loading.

Beach impacts of shore-parallel breakwaters backing offshore submerged ridges, Western Mediterranean Coast of Egypt.

Seven breakwaters were constructed behind offshore submerged ridges to create a safe area for swimming and recreational activities west of Alexandria on the Mediterranean coast of Egypt. Morphodynamic evaluation was based on the modified Perlin and Dean numerical model (ImSedTran-2D) combined with successive shoreline and beach profile surveys conducted periodically between April 2001 and May 2005. Results reveal insignificant morphologic changes behind the detached breakwaters with slight coastline changes at the down and up-drift beaches of the examined breakwaters (+/-10 m).

Emergence of KPC-possessing Klebsiella pneumoniae in Brooklyn, New York: epidemiology and recommendations for detection.

Among 257 isolates of Klebsiella pneumoniae collected in Brooklyn, NY, 24% were found to possess bla(KPC). Clinical microbiology laboratories that used automated broth microdilution systems reported 15% of the KPC-possessing isolates as susceptible to imipenem. The imipenem MIC was found to be markedly affected by the inoculum.

Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: molecular epidemiology and in vitro activity of polymyxin B and other agents.

Objectives: To describe the molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in Brooklyn, NY and assess the in vitro activity of various antibiotic combinations.

Methods: Clinical isolates with suspected carbapenem resistance were referred to the central research laboratory from August 2003 to June 2004. Isolates underwent MIC testing, ribotyping, and were analysed for the presence of KPC carbapenemases.

Ten years of disease-free survival between two diagnoses of small-cell lung cancer: a case report and a literature review.

Small-cell lung carcinoma (SCLC) represents one-fifth of all cases of bronchopulmonary cancer and has a 5-yr survival of 2-4%. Long-term survivors of SCLC are at risk for developing second primary aerodigestive tumors. We report a case of a long-term survivor who had a 10-yr disease-free survival between two diagnoses of SCLC.