RESUMEN
Antimicrobial therapy can increase the colonization density of gastrointestinal vancomycin-resistant enterococci (VRE). Among previously VRE-colonized patients, we evaluated VRE colonization before and after initiation of antimicrobial therapy by means of polymerase chain reaction (PCR) and culture. Perianal swab samples were obtained at admission to the hospital and after receipt of antimicrobial therapy. At admission, 12 (21%) of 56 patients were culture positive, and 17 (30%) had vanA or vanB genes detected by PCR. Culture results showed that 25 (86%) of 29 culture-negative patients from whom a second swab sample was obtained remained culture negative, 2 (6.9%) had a relapse of colonization with a strain related to the previously colonizing strain type (2 and 6 days after admission), and 2 (6.9%) tested positive for a previously undetected strain type (16 and 19 days after admission). PCR at admission detected VRE in 1 of the 2 patients who later relapsed. Patients with negative results of culture of the initial swab sample and of PCR were unlikely to relapse after receipt of antimicrobial therapy.
Asunto(s)
Antibacterianos/farmacología , Enterococcus/efectos de los fármacos , Resistencia a la Vancomicina/fisiología , Vancomicina/farmacología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Reacción en Cadena de la PolimerasaRESUMEN
This reports the synthesis and in vitro antimicrobial properties of a series of 2-thioether-linked quinolonyl-carbapenems. Although the title compounds exhibited broad spectrum activity, the MICs were generally higher than those observed for selected benchmark carbapenems, quinolonyl-penems, and quinolones. Enzyme assays suggested that the title compounds are potent inhibitors of penicillin binding proteins and inefficient inhibitors of bacterial DNA-gyrase. Uptake studies indicated that the new compounds are not substrates for the norA encoded quinolone efflux pump.
Asunto(s)
Carbapenémicos/química , Carbapenémicos/farmacología , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Quinolonas/química , Proteínas Bacterianas/efectos de los fármacos , Carbapenémicos/síntesis química , Proteínas Portadoras/efectos de los fármacos , División Celular , Bacterias Gramnegativas/enzimología , Bacterias Grampositivas/enzimología , Hexosiltransferasas/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Proteínas Asociadas a Resistencia a Múltiples Medicamentos , Complejos Multienzimáticos/efectos de los fármacos , Muramoilpentapéptido Carboxipeptidasa/efectos de los fármacos , Proteínas de Unión a las Penicilinas , Peptidil Transferasas/efectos de los fármacos , Relación Estructura-Actividad , Inhibidores de Topoisomerasa IIRESUMEN
Previous studies have identified intervening sequences that encode homing endonucleases within the genes encoding several archaeal DNA polymerases. We report the sequence of the gene encoding the DNA polymerase of Methanococcus voltae and describe evidence that it lacks analogous intervening sequences.