[Vancomycin-resistant enterococci].
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Anti-Bacterial Agents↗
Biomedical subjects
V Plecko
Publications and source records attributed to V Plecko.
An autopsy study of systemic fungal infections in patients with hematologic malignancies.
The aim of this study was to determine the incidence of fungal infections detected on autopsy in a group of 40 patients with hematologic malignancies treated with intensive chemotherapy or bone marrow transplantation, and to evaluate the risk factors for fungal infections. A control group included 38 patients with nonhematologic diseases and without granulocytopenia but with at least one of the known risk factors for fungal infections. Standard histopathological and microbiological methods were used. A higher incidence of invasive fungal infections was found in patients with hematologic malignancies as compared to the control group (p < 0.01). The predominant causes of fungal infections were Candida albicans and Aspergillus spp. The incidence of fungal infections caused by Aspergillus was higher (p < 0.05) in patients with hematologic malignancies than in the control group. The independent risk factors for fungal infections were fungal colonization, number of antibiotics and duration of antibiotic therapy, duration of fever and skin rash. A higher proportion of fungal infections was diagnosed on autopsy than during the patients' life (p < 0.01).
Adolescent↗
Helicobacter pylori: in vitro induction of resistance to azithromycin.
Helicobacter pylori resistance to macrolides is possibly an important factor for the failure of macrolide therapy for H. pylori infection. The aim of this study was to assess the propensity of H. pylori to develop in vitro resistance to azithromycin. In 73 clinical isolates taken from patients before starting antimicrobial therapy of H. pylori infection, MIC was determined using an agar dilution method (Müller-Hinton agar with 7.5% unlysed horse blood, pH = 7.2, at 35 degrees C, during 72 h in a humid microaerobic atmosphere). Each strain was first cultivated at half minimal inhibitory concentration (MIC) then in doubling concentrations until growth arrest. All experiments for induction of resistance were performed on the same media, incubation temperature, atmosphere and time of MIC determination. MIC interpretative standards for sensitivity, intermediate sensitivity and resistance of H. pylori to azithromycin were < or = 2, 4 and > or = 8 mg/l, respectively. Of 73 strains, 5 died during the experiments, and in the remaining 68 strains, serial passage with increasing azithromycin concentrations resulted in the development of resistance in 19 (26.9%) strains. Two strains had an MIC of 16 mg/l azithromycin. Thirty-three (48.5%) strains kept the same MIC or doubled their MIC, 16 (23.5%) strains had 4- to 16-fold MIC but still remained sensitive, 2 resistant strains had 128-fold MICs and 17 resistant strains had increased their MICs more than 128 times. Seventeen highly resistant strains (MIC > 128 mg/l) were kept frozen at -70 degrees C for 3 months in a brain-heart infusion broth with 15% glycerol. MIC was assessed again to determine the stability of resistance. Eleven strains kept MICs > 128 mg/l, 2 became sensitive and 1 intermediate, but reverted easily, after only 2 passages, to an MIC of > 128 mg/l azithromycin. Although macrolides are very active against H. pylori, the propensity to develop resistance in a high proportion of strains has a clear impact on the choice of the right combinations of macrolides with other agents as well as the dosage of the macrolide antibiotics.
Anti-Bacterial Agents↗
[Seroprevalence of Helicobacter pylori infection in health personnel in 3 hospitals in Zagreb].
By this study we wanted to investigate the seroprevalence of H. pylori infection in 175 health care workers of three Zagreb city hospitals. The obtained results were compared with those of 2492 volunteer blood donors. The influence of age, education, socioeconomic status and length of service at specific hospital working places were investigated in relation to the frequency of H. pylori seropositivity. The blood samples were tested by commercial kits of immunoenzyme assay (ELISA) and complement fixation (CF), according to manufacturers instructions. The mean seroprevalence of infection was 58.6% in the group of blood donors and 53.7% in the group of health care workers (NS). Statistically significant difference was found between physicians (29%) and all other health care workers: nurses (58.6%; p < 0.005), laboratory technicians (60.6%; p < 0.005), clerical workers (66.6%; p < 0.005) and auxiliary workers (82.6%; p < 0.001). Concerning the age, the infection seroprevalence was higher in workers aged more than 40 years than in those younger, and that difference was of statistical significance among nurses and laboratory technicians. Physicians under 29 yrs were of the lowest seropositivity (14.8%). Among health care workers with less than 20 working years, physicians expressed the lowest rate of infection (17.9%) in comparison with nurses (48.5%) and laboratory technicians (53.3%). In all health care workers with more than 20 working years there was significant increase of infection prevalence, particularly among nurses. The employees in gastrointestinal endoscopy laboratories were more often serologically positive than medical workers in other medical departments (58.3% versus 35.0%; p < 0.05).
Adult↗