Letters to the Editor
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2. Falagas ME, Lourida P, Poulikakos P, Rafailidis PI, Tansarli GS. Antibiotic treatment of infections due to carbapenemresistant Enterobacteriaceae: systematic evaluation of the available evidence. Antimicrob Agents Chemother 2014;58: 654e63. 3. Bulik CC, Nicolau DP. Double-carbapenem therapy for carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2011;55:3002e4. 4. Ceccarelli G, Falcone M, Giordano A, Mezzatesta ML, Caio C, Stefani S, et al. Successful ertapenem-doripenem combination treatment of bacteremic ventilator-associated pneumonia due to colistin-resistant KPC-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2013;57:2900e1. 5. Giamarellou H, Galani L, Baziaka F, Karaiskos I. Effectiveness of a double-carbapenem regimen for infections in humans due to carbapenemase-producing pandrug-resistant Klebsiella pneumoniae. Antimicrob Agents Chemother 2013;57: 2388e90. 6. Hong JH, Clancy CJ, Cheng S, Shields RK, Chen L, Doi Y, et al. Characterization of porin expression in Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae identifies isolates most susceptible to the combination of colistin and carbapenems. Antimicrob Agents Chemother 2013;57:2147e53. 7. Kwa A, Kasia SK, Tam VH, Falagas ME, Polymyxin B. similarities to and differences from colistin (polymyxin E). Expert Rev Anti Infect Ther 2007;5:811e21. 8. Akajagbor DS, Wilson SL, Shere-Wolfe KD, Dakum P, Charurat ME, Gilliam GL. Higher incidence of acute kidney injury with intravenous colistimethate sodium compared with polymyxin B in critically ill patients at tertiary care medical center. Clin Infect Dis 2013;57:1300e3.
Nathalie Grace Chua Yvonne Peijun Zhou Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Thuan Tong Tan Pushpalatha Bangalore Lingegowda Department of Infectious Diseases, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Winnie Lee Tze Peng Lim Jocelyn Teo Yiying Cai Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Andrea L. Kwa* Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Emerging Infectious Diseases Program, DUKE-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore *Corresponding author. Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, Level 3 18 Science Drive 4, Singapore 117543, Singapore. Tel.: þ65 63266959; fax: þ65 62202780.
E-mail address: [email protected] Accepted 1 October 2014
http://dx.doi.org/10.1016/j.jinf.2014.10.001 ª 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Pneumococcal meningitis-associated pyogenic ventriculitis
KEYWORDS S. pneumoniae; Pneumococcal meningitis; Pyogenic ventriculitis; Diffusion-weighted magnetic resonance imaging
As Domingo and colleagues recently published in this Journal, neurologic complications are still common in adults with pneumococcal meningitis despite antibiotic therapy and intensive neurologic care.1 The most frequent sequelae are cerebral vasculopathy, cerebral oedema, and hydrocephalus that have been reported to affect up to 56%, 29%, and 16% of patients, respectively.2,3 Their development is associated with a poor outcome. During the last years, an increasing number of patients with pneumococcal meningitis received cerebral imaging using magnetic resonance imaging (MRI), but studies on MRI findings in meningitis patients are limited. Besides parenchymal and sulcal signal changes, pyogenic ventriculitis has been reported only in single cases.4e6 However, its impact on the clinical course of the disease is still unknown. Therefore, we evaluated the data of patients with pneumococcal meningitis who received MR imaging at our institution between January 2009 and December 2012. The diagnosis of pneumococcal meningitis was made on the basis of (i) positive cerebrospinal fluid (CSF) culture, (ii) positive CSF Gram stain, (iii) positive antigen detection from CSF using latex particle agglutination, or (iv) growth of pneumococci from blood cultures plus typical CSF findings (CSF white cell count >1000 cells/ml, protein >100 mg/dl, and CSF/serum glucose
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2. Falagas ME, Lourida P, Poulikakos P, Rafailidis PI, Tansarli GS. Antibiotic treatment of infections due to carbapenemresistant Enterobacteriaceae: systematic evaluation of the available evidence. Antimicrob Agents Chemother 2014;58: 654e63. 3. Bulik CC, Nicolau DP. Double-carbapenem therapy for carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2011;55:3002e4. 4. Ceccarelli G, Falcone M, Giordano A, Mezzatesta ML, Caio C, Stefani S, et al. Successful ertapenem-doripenem combination treatment of bacteremic ventilator-associated pneumonia due to colistin-resistant KPC-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2013;57:2900e1. 5. Giamarellou H, Galani L, Baziaka F, Karaiskos I. Effectiveness of a double-carbapenem regimen for infections in humans due to carbapenemase-producing pandrug-resistant Klebsiella pneumoniae. Antimicrob Agents Chemother 2013;57: 2388e90. 6. Hong JH, Clancy CJ, Cheng S, Shields RK, Chen L, Doi Y, et al. Characterization of porin expression in Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae identifies isolates most susceptible to the combination of colistin and carbapenems. Antimicrob Agents Chemother 2013;57:2147e53. 7. Kwa A, Kasia SK, Tam VH, Falagas ME, Polymyxin B. similarities to and differences from colistin (polymyxin E). Expert Rev Anti Infect Ther 2007;5:811e21. 8. Akajagbor DS, Wilson SL, Shere-Wolfe KD, Dakum P, Charurat ME, Gilliam GL. Higher incidence of acute kidney injury with intravenous colistimethate sodium compared with polymyxin B in critically ill patients at tertiary care medical center. Clin Infect Dis 2013;57:1300e3.
Nathalie Grace Chua Yvonne Peijun Zhou Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Thuan Tong Tan Pushpalatha Bangalore Lingegowda Department of Infectious Diseases, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Winnie Lee Tze Peng Lim Jocelyn Teo Yiying Cai Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Andrea L. Kwa* Department of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Emerging Infectious Diseases Program, DUKE-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore *Corresponding author. Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, Level 3 18 Science Drive 4, Singapore 117543, Singapore. Tel.: þ65 63266959; fax: þ65 62202780.
E-mail address: [email protected] Accepted 1 October 2014
http://dx.doi.org/10.1016/j.jinf.2014.10.001 ª 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Pneumococcal meningitis-associated pyogenic ventriculitis
KEYWORDS S. pneumoniae; Pneumococcal meningitis; Pyogenic ventriculitis; Diffusion-weighted magnetic resonance imaging
As Domingo and colleagues recently published in this Journal, neurologic complications are still common in adults with pneumococcal meningitis despite antibiotic therapy and intensive neurologic care.1 The most frequent sequelae are cerebral vasculopathy, cerebral oedema, and hydrocephalus that have been reported to affect up to 56%, 29%, and 16% of patients, respectively.2,3 Their development is associated with a poor outcome. During the last years, an increasing number of patients with pneumococcal meningitis received cerebral imaging using magnetic resonance imaging (MRI), but studies on MRI findings in meningitis patients are limited. Besides parenchymal and sulcal signal changes, pyogenic ventriculitis has been reported only in single cases.4e6 However, its impact on the clinical course of the disease is still unknown. Therefore, we evaluated the data of patients with pneumococcal meningitis who received MR imaging at our institution between January 2009 and December 2012. The diagnosis of pneumococcal meningitis was made on the basis of (i) positive cerebrospinal fluid (CSF) culture, (ii) positive CSF Gram stain, (iii) positive antigen detection from CSF using latex particle agglutination, or (iv) growth of pneumococci from blood cultures plus typical CSF findings (CSF white cell count >1000 cells/ml, protein >100 mg/dl, and CSF/serum glucose
