View clinical trials related to Enterobacteriaceae Infections.
Filter by:The purpose of this study is to develop a new and very rapid diagnostic test for identifying a certain type of bacteria called Enterobacteriaceae in blood. Rapid identification of bacteria will assist in decreasing the use of antibiotics and help more patients survive bacterial infections of the blood.
The antimicrobial crisis is a real problem. Infections produced by multiresistant bacteria are becoming more and more frequent, and available antimicrobial agents are usually scarce. Reducing the duration of antimicrobial treatments is one of the most efficient measures to control the antibiotic pressure and to optimise the use of these agents. Bloodstream infections produced by Enterobacteria (EB) are very frequent, but the optimal duration of antibiotics to treat them is unknown, as long as no clinical trials have been specifically developed to answer this question. Basing on expert opinions, the Infectious Diseases Society pf America (IDSA) recommends the bacteremia by EB secondary to vascular catheter infections to be treated for 7 to 14 days. This represents a variability of up to 100%. No recommendations have been published regarding the duration of treatment of bacteremia from other sources. The objective of this project is to prove that the 7-day course of treatment for EB bacteremia is more efficient and equally safe than the 14-day scheme.
Resistance to broad-spectrum cephalosporins through the acquisition and expression of Extended-Spectrum β-lactamase (ESBL) among Enterobacteriacea is increasing. The clinical implications of ESBLs are extremely serious and sensitive diagnostic methods are urgently needed to guide therapy, monitor resistance development and implement intervention strategies. Conventionally, detection of expression of ESBLs was based on reduction of ceftazidime of cefotaxime MICs by ≥ 3 two fold dilutions in the presence of clavulanic acid. However, the use of the above method was limited to cover only some of the bacterial species, including predominantly E. coli and Klebsiella spp., or tested strains which were all transconjugants generated in vitro. ESBLs are now reported in a growing number of genera other than E. coli or Klebsiella spp., and Serratia marcescens. Carbapenems, including ertapenem, imipenem and meropenem, are the drugs of choice used for severe ESBL-producing bacterial infections. Failure to detect ESBL at the presence of AmpC β-lactamase might result in an important clinical concern because 4th generation cephalosporins, which are stable to AmpC β-lactamase, is not a drug of choice for severe infections caused by ESBLs-producing isolates. Fluoroquinolone-resistance in ESBL-producing Enterobacteriacea is common. In this study, the investigators will use isolates of Enterobacteriacea collected from different hospitals (isolates offered by the Taiwan Surveillance of Antimicrobial Resistance [TSAR] program) to investigate the susceptibility of ertapenem and five other antimicrobial agents against ESBLs-producing Enterobacteriacea.
Multidrug-resistant Enterobacteriaceae producing extended-spectrum β-lactamases (hereafter called ESBLs) have emerged as an important cause of bloodstream infection in hospitalized patients and urinary tract infections in the community. As is the case with other multidrug-resistant organisms chronic colonization is frequent, in the case of ESBLs mostly intestinal and urinary carriage. To the investigators knowledge no randomized, placebo-controlled clinical trial has been performed to study the efficacy of a systematic ESBL eradication strategy. Eradication of ESBL carriage would cause benefits for the individual patient - by reducing the risk of infection - and for the community - by reducing transmission. Even if eradication turns out to be impossible, transient suppression of ESBL might reduce the likelihood of transmission and thus still be beneficial from an ecologic perspective. The purpose of the proposed study is to test the hypothesis that the administration of a 10 day course of oral antibiotics active against ESBLs can lead to decolonization of ESBL carriage in hospitalized patients.
This research will be conducted to determine whether risk factors exist for piperacillin/tazobactam resistance in ESBL organisms.
The purpose of this study is to review patients with E. coli infections at the University of Pittsburgh Medical Center (UPMC) from July 1, 2007 to June 30, 2010 to determine if these infections have arisen in the community rather than in hospitals or nursing homes.