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The aim of this study was to assess the efficacy of the ertapenem loaded articulating spacers in two-stage revision for polymicrobial TKA infection.
The carbapenem antibiotic disks used for each isolate were ertapenem (10mg), imipenem (10mg), meropenem (10mg) and doripenem (10mg).
On page 1316, the last sentence of the fourth paragraph should read, "The modification of the CDC CRE surveillance definition in January 2015 to include organisms that are resistant to ertapenem or that possess a carbapenemase gene should improve sensitivity for detecting OXA-48-producing CRE (9)."
That review noted one potential exception to the all-antibiotics-are-similarly-effective principle: a randomized phase-Ill study that found tigecycline to be inferior to ertapenem with or without vancomycin (Diagn Microbiol Infect Dis.
Standard antibiotics such as penicillin-G (10 units), ampicillin (10 [micro]g), erythromycin (15 [micro]g), oxacillin (1 [micro]g), vancomycin (30 [micro]g), clindamycin (2 [micro]g), linezolid (30 [micro]g), for gram-positive bacteria and ceftriaxone (30 [micro]g), cefotaxime (30 [micro]g), 9 (30 [micro]g), cefuroxime (30 [micro]g), imipenem (10 [micro]g), meropenem (10 [micro]g), ertapenem (10 [micro]g), doripenem (10 [micro]g), tobramycin (10 [micro]g), ciprofloxacin (5 [micro]g), levofloxacin (5 [micro]g), co-trimoxazole (1.25/23.75 [micro]g), gentamicin (10 [micro]g), amikacin (30 [micro]g), and piperacillin/tazobactam (100/10 [micro]g) (HiMedia, Mumbai, India) for gram-negative bacteria were tested.
The level of resistance to the carbapenems varied from 2% for ertapenem up to 23% for imipenem.
These isolates were resistant to carbapenems, with a minimum inhibitory concentration (MIC) [greater than or equal to] 2 [micro]g/mL for imipenem or meropenem and an MIC [greater than or equal to] 1 [micro]g/mL for ertapenem. Because of that, they were screened for carbapenemase production by testing commercially available disks containing carbapenems with and without EDTA (0.1 M), cloxacillin (75 mg/mL) orphenylboronicacid (40 mg/mL), as recommended by the National Health Surveillance Agency (ANVISA) technical guidelines (6).
Before surgical reintervention, blood cultures were performed and empirical antiinfective therapy was started using ertapenem (1g/day), vancomycin (1g/12h) and fluconazole (800mg/day) and was continued for the next 3 days.
The intravenous antibiotic treatment was linezolid (600 mg) twice a day for 1 week and ertapenem 1 g per day for 1 month, according to the sensitivity of the micro-organism.
The micro-dilution procedure for Salmonella isolates was performed with an automated micro scan system (Walk-Away[R] plus) using the following antimicrobials: Ampicillin, Amoxicillin/clavulanic acid, Piperacillin, Cefazolin, Cefuroxime, Cefoxitin, Cefotaxime, Ceftazidime, Cefepime, Imipenem, Ertapenem, Aztreonam, Nalidixic acid, Norfloxacin, Ofloxacin, Ciprofloxacin, Tetracycline, Tigecycline, Nitrofurantoin, Trimethoprim/sulfamethoxazole, Chloramphenicol, Colistin, Amikacin, Gentamicin, and Tobramycin.
The strain was sensitive to amikacin and ertapenem and was resistant to ciprofloxacin, ofloxacin, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin/tazobactam, cefazolin, cefuroxime and aztreonam.
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