RESUMEN
The primary challenge in TB treatment is the emergence of multidrug-resistant TB (MDR-TB). One of the major factors responsible for MDR is the upregulation of efflux pumps. Permeation-glycoprotein (P-gp), an efflux pump, hinders the bioavailability of the administered drugs inside the infected cells. Simultaneously, angiogenesis, the formation of new blood vessels, contributes to drug delivery complexities. TB infection triggers a cascade of events that upregulates the expression of angiogenic factors and P-gp. The combined action of P-gp and angiogenesis foster the emergence of MDR-TB. Understanding these mechanisms is pivotal for developing targeted interventions to overcome MDR in TB. P-gp inhibitors, such as verapamil, and anti-angiogenic drugs, including bevacizumab, have shown improvement in TB drug delivery to granuloma. In this review, we discuss the potential of P-gp inhibitors as an adjunct therapy to shorten TB treatment.
Asunto(s)
Miembro 1 de la Subfamilia B de Casetes de Unión a ATP , Antituberculosos , Tuberculosis Resistente a Múltiples Medicamentos , Humanos , Antituberculosos/farmacología , Antituberculosos/uso terapéutico , Animales , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/antagonistas & inhibidores , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/metabolismo , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológicoRESUMEN
This report describes a case of Austrian syndrome (pneumonia, meningitis, and endocarditis, as a result of Streptococcus pneumoniae infection). A computerized medline search was performed for review of literature. In the review of literature, 54 cases including our case were found. Complete clinical and microbiological information was available only for 20 cases. Most invasive pneumococcal infections occurred in debilitated middle aged men with chronic alcoholism. Native aortic valve insufficiency was the commonest cause of cardiac failure among these patients, requiring valve replacement. Austrian syndrome is seen infrequently in this antibiotic era but is still associated with a poor outcome. Hence early recognition and appropriate medical or combined medical-surgical treatment needs to be considered promptly.
Asunto(s)
Endocarditis Bacteriana/diagnóstico , Meningitis Bacterianas/diagnóstico , Neumonía Neumocócica/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Ampicilina/uso terapéutico , Antibacterianos/uso terapéutico , Insuficiencia de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Aórtica/cirugía , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/tratamiento farmacológico , Humanos , Masculino , Meningitis Bacterianas/tratamiento farmacológico , Persona de Mediana Edad , Neumonía Neumocócica/tratamiento farmacológico , Síndrome , Vancomicina/uso terapéuticoRESUMEN
Corynebacterium amycolatum, a normal inhabitant of human skin, is a Gram-positive, non-spore-forming, mycolic acid-free, aerobic or facultative anaerobic bacillus. Since its description in 1988, it has only rarely been associated with infective endocarditis. This paper describes a case of infective endocarditis successfully treated by combination therapy with daptomycin and rifampicin. To the best of our knowledge, this is the first case report of C. amycolatum endocarditis from the USA successfully treated with these agents.
Asunto(s)
Infecciones por Corynebacterium/microbiología , Corynebacterium/aislamiento & purificación , Endocarditis Bacteriana/microbiología , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Infecciones por Corynebacterium/diagnóstico , Infecciones por Corynebacterium/tratamiento farmacológico , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/tratamiento farmacológico , Femenino , HumanosRESUMEN
Corynebacterium bovis, the causative agent of bovine mastitis, has rarely been described as a human pathogen since its description. We report a rare case of line related septicemia due to Corynebacterium bovis.
Asunto(s)
Infecciones por Corynebacterium/diagnóstico , Corynebacterium/aislamiento & purificación , Sepsis/microbiología , Anciano de 80 o más Años , Animales , Bovinos , Infecciones por Corynebacterium/microbiología , Femenino , HumanosRESUMEN
Corynebacterium minutissimum, the causative agent of erythrasma, is a gram-positive, non-spore forming, aerobic or facultative anaerobic bacillus. It has rarely been associated with extracutaneous disease, since its description in 1961. A computerized medline search for review of literature was performed. To our knowledge, there have been 18 cases of C. minutissimum infections that caused conditions other than erythrasma. These include reports of cases of abscess formation, intravascular catheter-related bacteremias, ophthalmologic involvement, endocarditis, peritonitis, cutaneous granulomas, pyelonephritis in an infant and primary bacteremia with underlying hematologic malignancy. We report a rare case of bacteremia and meningitis due to C. minutissimum successfully treated with intravenous ampicillin.