RHA™ anti-Cefalexin monoclonal antibody, clone cex

Objective The purpose of this study was to describe the species distribution and antimicrobial susceptibility patterns of Staphylococci isolated from naturally occurring canine ocular diseases. Samples and Procedures Samples obtained from 68 dogs with signs of external eye disease were processed for isolation of bacteria of the genus Staphylococcus sp. Isolates were identified by biochemical reactions and tested for susceptibility to 11 antimicrobials of six classes. Results Forty (58.8%) samples yielded Staphylococcus sp. in pure culture. Coagulase-positive Staphylococci were most common and Staphylococcus intermedius was the most frequent (45%) species, followed by S. aureus (22.5%) and the coagulase-negative species S. epidermidis (20%), and S. simulans (12.5%). Resistance to at least one drug was observed in 92.5% of the isolates, and multidrug resistance was a common finding (72.5%). The most effective drugs against Staphylococcus strains isolated from extra-ocular canine ocular diseases were ceftiofur and cefalexin. Conclusion This study highlights the presence of Staphylococcus sp. genus in naturally occurring extra-ocular canine ocular disease and the emergence of resistant strains to common antimicrobial drugs. It also emphasizes the need for bacterial culture with species identification and susceptibility testing in order to choose the appropriate antimicrobial therapy.

OBJECTIVE To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population. DESIGN Cohort study. SETTING UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. PARTICIPANTS Adults aged 65 and over with a prescription for trimethoprim, amoxicillin, cefalexin, ciprofloxacin, or nitrofurantoin prescribed up to three days after a primary care diagnosis of UTI between April 1997 and September 2015. MAIN OUTCOME MEASURES The outcomes were acute kidney injury, hyperkalaemia, and death within 14 days of a UTI treated with antibiotics. RESULTS Among a cohort of 1 191 905 patients aged 65 and over, 178 238 individuals were identified with at least one UTI treated with antibiotics, comprising a total of 422 514 episodes of UTIs treated with antibiotics. The odds of acute kidney injury in the 14 days following antibiotic initiation were higher following trimethoprim (adjusted odds ratio 1.72, 95% confidence interval 1.31 to 2.24) and ciprofloxacin (1.48, 1.03 to 2.13) compared with amoxicillin. The odds of hyperkalaemia in the 14 days following antibiotic initiation were only higher following trimethoprim (2.27, 1.49 to 3.45) compared with amoxicillin. However, the odds of death within the 14 days following antibiotic initiation were not higher with trimethoprim than with amoxicillin: in the whole population the adjusted odds ratio was 0.90 (95% confidence interval 0.76 to 1.07) while among users of renin-angiotensin system blockers the odds of death within 14 days of antibiotic initiation was 1.12 (0.80 to 1.57). The results suggest that, for 1000 UTIs treated with antibiotics among people 65 and over, treatment with trimethoprim instead of amoxicillin would result in one to two additional cases of hyperkalaemia and two admissions with acute kidney injury, regardless of renin-angiotensin system blockade. However, for people taking renin-angiotensin system blockers and spironolactone treatment with trimethoprim instead of amoxicillin there were 18 additional cases of hyperkalaemia and 11 admissions with acute kidney injury. CONCLUSION Trimethoprim is associated with a greater risk of acute kidney injury and hyperkalaemia compared with other antibiotics used to treat UTIs, but not a greater risk of death. The relative risk increase is similar across population groups, but the higher baseline risk among those taking renin-angiotensin system blockers and potassium-sparing diuretics translates into higher absolute risks of acute kidney injury and hyperkalaemia in these groups.