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Biomedical subjects

J E Conte

Publications and source records attributed to J E Conte.

57 records · Page 4Linked to original sources

Non-O:1 Vibrio cholerae bacteremia: case report and review.

A case of non-O:1 Vibrio cholerae bacteremia and prostatic abscess in a patient with idiopathic aplastic anemia was studied, and the data were compared with those from 23 previously reported cases of non-O:1 V. cholerae bacteremia. The case-fatality rate for the 13 cases for which the outcome is known is 61.5%. The majority of known cases have occurred in immunocompromised patients, particularly those with hematologic malignancy or cirrhosis. Host susceptibility is potentially important in this condition. Bacterial products such as a cholera-like toxin and El Tor hemolysin also may play a role in the disease process. The incidence of enteritis due to non-O:1 V. cholerae is unclear because of the methods used for routine stool culture; however, the small number of reported isolates from blood is likely to reflect the infrequency of bacteremia, since Vibrio species are readily identifiable on sheep blood agar. While non-O:1 V. cholerae is sensitive to most antibiotics in vitro, no data are available on antibiotic efficacy.

Abscess↗

Pharmacokinetic disposition of cefonicid in patients with renal failure and receiving hemodialysis.

Cefonicid is a new cephalosporin with a spectrum of activity similar to that of cefamandole. The pharmacokinetic disposition of the drug was examined in patients with various degrees of renal dysfunction and who were receiving hemodialysis. After patients were given a 7.5 mg/kg dose as an iv infusion, multiple blood and urine samples were obtained at frequent intervals, and the samples were analyzed for cefonicid concentration. Five patients receiving hemodialysis received an additional dose before a dialysis period to assess removal of the drug. The half-life of cefonicid increased markedly with declining renal function (approximately 70 hr in anuric patients). Total clearance and renal clearance decreased linearly with decreases in creatinine clearance. Steady-state volume of distribution remained approximately the same (0.11 liter/kg) in all patients. Cefonicid dosage can be reduced in proportion to decreases in creatinine clearance from normal levels. A simple nomogram is provided.

Adult↗

Emergence of multiple antibiotic resistance during the therapy of Klebsiella pneumoniae meningitis.

A patient is described in whom multiple antibiotic resistance developed during the course of therapy of Klebsiella pneumoniae meningitis. Sequential resistance developed to chloramphenicol, gentamicin and eventually amikacin. As previously reported, the use of the chloramphenicol alone in the therapy of gram-negative bacillary meningitis can result in rapid emergence of resistance and treatment failure. In this patient, the subsequent emergence of gentamicin and amikacin resistance may have been related to the omission of intrathecal aminoglycoside. A short review of the literature is presented and recommendations are made for the therapy of gram-negative bacillary meningitis.

Aged↗