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PubMed2000

[Urinary tract infections--still a real problem].

By analyzing the standard works in the scientific world literature, it was possible to construct a contemporary view on the etiology and antibiotic therapy of some urinary tract infections. It can be stated, that the most effective remedies are cotrimoxazol and fluoroquinolones. In contrary to beta-lactam antibiotics, cotrimoxazole and fluoroquinolones work with a rapid bactericidal effect, they have long elimination half-times and better sterilization capacity in the periurethral region, and it use brings minimal risk of recurrence of the infection. This facts are compared with results of bacteriological investigation of urine, which were done in the microbiological laboratories of University Hospital Hradec Králové, Czech Republic, in 1998. The most frequent origins of urinary tract infections are Escherichia coli and Enterococcus spp. Stains. The are keeping high susceptibility to contrimoxazole, furantoin and oxoline acid. The other Gram negative rods isolated from hospitalised patients are highly resistant to most of antimicrobial agents included fluorochinolons, which resistance culminates to 50%. The widest spectrum of pathogens and the highest resistance was found in the hospitalised patients of the university hospital. High percentages of resistant strains was also in patients from the district hospitals. The results are discussed.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Monitoring bacterial resistance to antibiotics in the CroatianRepublic].

In 1996 a Committee for antibiotic resistance surveillance in Croatia was founded by the Croatian Academy of Medical Sciences. In this study antibiotic surveillance results for the period June 1-December 31, 1997 from 12 microbiology laboratories throughout Croatia are presented. Sensitivity to antibiotics was determined by disk diffusion method for the following bacteria: Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa. In general, high proportion of resistant isolates was recorded throughout Croatia, although some regional variations were noticed. Mean resistance of pneumococci to penicillin was 38%, in S. aureus resistance to methicillin was 47%, and 3rd generation cephalosporin-resistance in E. coli was 6% and in Klebsiella spp. 21%. In P. aeruginosa resistance to gentamicin averaged 50%, to imipenem 13% and to ceftazidim 8%. Future aims of the Committee are to continue routine antibiotic resistance surveillance during certain periods every year, and to estimate clinical significance of resistant bacteria, detect mechanisms of resistance and improve the quality of laboratory work through education and quality control projects.

Croatia↗
PubMed2001

[Clinical significance of infection pathogen resistance in a urological clinic for selection of antibacterial therapy regimes for the treatment of complicated urinary infections].

Data on changes of etiological structure of the complicated urinary tract infections treated at the Research Institute of Urology and Hospital No. 47 at the 5-year period (1996-2000) are given. It was shown that the most important microorganisms were the following: Enterobacter spp., E. coli, Proteus spp., Staphylococcus spp., Enterococcus faecalis. The correlation between frequency of the microorganisms isolation and their susceptibility to antimicrobial agents at different periods was analysed. The results of analysis allowed to elaborate algorithm of etiotropic therapy. Choice of the drug depends on pathogen susceptibility to antibiotics, bacteriuria level and clinical symptoms severity.

Anti-Bacterial Agents↗
PubMed2001

[Prevalence of nosocomial infections in Intensive Care Units in Triveneto area, Italy].

BACKGROUND: Nosocomial infection is one of the most common complications affecting patients admitted in intensive care units (ICU). The aim of this study is to evaluate rates of ICU-acquired infections, potential risk factors for these infections, causative microorganisms and antibiotic resistance patterns. METHODS: A 1-day point-prevalence study was conducted in 39 ICUs in Triveneto area (Italy) in November 1998. The overall study population included 188 patients with mean age of 61.4+/-19.3 years; the mean SAPS II score at entry into the ICU was 44.4+/-16.8 and the median duration of hospitalization was 9 days (range 2-636). RESULTS: A total of 59 patients (31.4%) had 79 episodes of ICU-acquired infections; pneumonia (45.5%), bloodstream infection (30.4%), and urinary tract infection (11.4%) were the most frequent types of infection. The leading causative microorganisms were S. aureus (24.4%, 77% of them were resistant to methicillin), Enterobacteriaceae (24.4%), P. aeruginosa (23.2%), fungi (12.2%), coagulase-negative staphylococci (7.3%) and Enterococcus spp (4.9%). Independent risk factors for nosocomial infections were duration of hospitalization >7 days (OR 4.29, 95% CI 1.82-10.1), SAPS II score >30 (OR 3.34, 95% CI 1.0-11.18), total parenteral nutrition (OR 2.69, 95% CI 1.19-6.07) and tracheostomy (OR 1.88, 95% CI 0.84-4.20). CONCLUSIONS: Nosocomial infections are relatively frequent in Triveneto area ICUs. The predominance of pneumonia and bloodstream infection, and the high frequency of antibiotic-resistant pathogens indicate that resources had to be assigned towards the implementation of control programs of those infections, monitoring of antibiotic resistance and prescription, and antibiotic therapy guidelines.

Adolescent↗
PubMed2001

[Microbiology of open surgical wounds after delivery--episiotomy and cesarean section].

UNLABELLED: The aim of the study is to assess the microbe find in the secretion of the open surgical wounds of the Cesarean Section and the perineal wounds. 81 young mothers have been examined--57 with open perineal wounds on 5th day after the delivery and 24 with open surgical wounds of Cesarean Section on the 7th day after the operation. RESULTS: The west frequent microbe find in the open perineal wounds is Streptococcus group "D" (enterococcus sp.)--53% of the cases and E. coli--26% of the cases. The most frequent microbe find in the open surgical wounds in the Cesarean Section is Enterococcus sp.--42% of the cases and St. aureus--21% of the cases. Considering the effectiveness of Penicillins (Ampicillin, Augmentin, Azlocillin, Karbencillin)--94%-99% against Enterococcus spp. and of Gentamycin against E. coli and St. aureus--90%-95% their application is recommended if is necessary.

Adult↗
PubMed2001

[Surveillance of bacterial resistance in Shanghai].

OBJECTIVE: To analyze the surveillance data on bacterial resistance in Shanghai hospitals reported from January 1 to December 31, 1999. METHODS: Data on bacterial susceptibility testings of 14 855 clinical isolates collected from eleven Shanghai hospitals were performed using Kirby-Bauer method and the results were analyzed according to NCCLS (1999). RESULTS: Methicillin resistant strains accounted for 64% and 77% of S. aureus and CNS respectively; and no vancomycin resistant strains were found. In Enterococcus spp, vancomycin resistant strains accounted for 3.5% and 1.7% of E.fecalis and E.fecium, respectively. Resistant rates of E.coli against piperacillin, gentamicin and fluoroquinolones were about 50% or higher. Resistant rates of Klebsiella spp, Enterobacter spp, Citrobacter spp and Acinetobacter spp against the third generation cephalosporins have increased markedly. Besides, the resistant rates of P.aeruginosa against ceftazidime and imipenem have increased to 27% and 20% respectively. CONCLUSION: A national strategy on the restrictive and prudent use of antibiotics is urgently needed.

Anti-Bacterial Agents↗
PubMed2002

[Asymptomatic bacteriuria in type 2 diabetics women ].

BACKGROUND: Urinary tract infection (UTI) is frequent among diabetics, especially women. It may be preceded by asymptomatic bacteriuria. AIM: To study the frequency of asymptomatic bacteriuria in type 2 diabetic women. PATIENTS AND METHODS: Fifty women with type 2 diabetes and 50 non diabetic women were studied. In aseptic conditions, morning midstream urine specimens were obtained for microbiological analysis. The test was repeated in similar conditions during consecutive days. Urine samples were cultured in blood agar, Mac Conkey agar and CPS ID 2. Colony forming units were counted. Asymptomatic bacteriuria was defined as the presence of 100,000 or more colony forming units per ml. Leukocyturia was also quantified. RESULTS: There was microbial growth in 40% of samples from diabetic women and 6% of samples from controls (p < 0.01). Asymptomatic bacteriuria was present in 32% of diabetics and 4% of controls (p < 0.01). E Coli was the most frequently isolated strain, in 55% of patients and 100% of controls. Klebsiella pneumoniae was isolated in 10% of diabetics, coagulase negative Staphylococcus in 10%, Enterococcus spp in 10% and Pseudomonas aeruginosa in 5%. Leukocyturia of more than 10 cells per field, was present in 80% of diabetic women with positive culture. Women with positive cultures had a longer lasting diabetes than those with negative cultures. There was no association between urine microbiological results and glycosilated hemoglobin, fasting blood glucose, chronic complications of diabetes and treatment received. CONCLUSIONS: This study shows a high prevalence of asymptomatic bacteriuria among diabetic women.

Adult↗
PubMed2003

[Incidence of peritonitis and catheter exit site infection in children undergoing automatic continuous cyclic peritoneal dialysis].

The aim of this study was to find out the clinical aspects of peritonitis and catheter exit site infection in children undergoing continuous cyclic peritoneal dialysis. The incidence of peritonitis and catheter related infections were reviewed in 8 children on continuous cyclic peritoneal dialysis over a mean period of 14.9+/-15.8 months. Peritonitis occurred in 4 children. There were 14 episodes of peritonitis. The mean time from starting dialysis to the first episode of peritonitis was 1.9+/-1.0 months. The incidence of peritonitis was 1 episode in 9 treatment months. Gram-negative organisms (Enterococcus spp.) were responsible for the majority of episodes (35.7%) of peritonitis and gram-positive bacteria mainly caused the catheter exit site infections (Staphylococcus epidermidis). The incidence of catheter exit site infection was one episode in 8 treatment months. Recurrent peritonitis was present in 1 case. Most patients with dialysis-related peritonitis and catheter exit site infection responded to antibiotic therapy. Catheter was replaced in 2 patients. The mortality rate was 2 out of 8 patients but none of the deaths were related to peritonitis. Patients with exit site infection had 7 times higher risk than those without developing peritonitis.

Adolescent↗
PubMed1992

[Recent trend and development of novel antimicrobial agents for MRSA infections].

Gram-positive organisms such as Staphylococcus aureus (including MRSA), coagulase-negative staphylococci, Enterococcus spp., and Streptococcus spp. have in recent years emerged as significant pathogens in hospitals and are now being isolated more frequently than gram-negative bacilli. These organisms are often multidrug resistant. Therefore, alternative agents with potent activity against gram-positive organisms are of considerable interest. In addition to the glycopeptide antibiotic vancomycin and the aminoglycoside antibiotic arbekacin, which can be used in MRSA infections, teicoplanin, RP 59500 and daptomycin are now under basic research in Japan. These antimicrobial agents are very active against gram-positive organisms, including MRSA and appear to be potent agents against infections due to gram-positive cocci, particularly MRSA.

Daptomycin↗
PubMed1992

[Postoperative infection control in patients with hepatic, biliary tract, and pancreatic cancers].

Postoperative infection occurs more frequently in patients with malignant disease than in patients with benign disease. Postoperative infection control in patients with hepatic cancer, biliary tract cancer and pancreatic cancer is studied. Although in patients with jaundice due to malignancy the rate of positive bacterial culture of the bile collected at the time of PTCD was low, the rate of positive bile culture increased after 10 to 14 days of PTCD. The predominant strain was Enterococcus spp., followed by Klebsiella spp., Enterobacter spp. and E. coli in that order. These bacteria isolated from the bile were considered to be causative organisms of postoperative infection. Prophylactic antibiotics after the operation for jaundice due to malignancy should be chosen based on the results of bile culture. In patients undergoing hepatectomy, which is considered to be an aseptic operation, gram positive cocci such as S. aureus was the most frequently encountered organism. On the other hand, in patients undergoing hepatectomy and intestinal anastomosis, enteric bacteria were frequently isolated from the infectious foci. In this study there were 6 cases of methicillin-resistant S. aureus (MRSA) postoperative infection, 3 cases after pancreatoduodenectomy, and 3 cases after hepatectomy. Even after an aseptic operation, postoperative MRSA infection is likely to occur in patients undergoing a more invasive operation, so hospital infection control should be again emphasized.

Bacteria↗
PubMed2003

[Bacterial and fungal bloodstream infections in patients at the University Hospital of Cracow].

In presented material evaluation of changes in sepsis and types of bloodstream infections of hospitalized patients in Wards of the University Hospital in Cracow were examined. Results of 9,138 blood cultures studied in years 1989-1999 were analysed. All of the blood samples were recovered from 4,656 infected adults at Clinics of the University Hospital in Cracow. Microbiological blood examinations were held in system of constant monitoring of isolated cultures applying BacT/Alert--colorimetric system (Organon Teknika). Cultured micro--organisms were identified using commercial biochemical tests (bio-Merieux). During period of research changes of profile of isolated microorganisms was observed. Percentage of blood infections of Enterococcus spp. etiology increased from 2.2% in 1989 to 9.8% in 1997-98 (p = 0.014). Dynamic growth of non-fermentative S. maltophilia bacilli to 5.5% (p = 0.036) and Serratia marcescens to 13.8% (p = 0.042) in 1999 was revealed. Designed according to our research review of fungal flora in years 1989-1999 revealed tendency of systematic growth of invasive candidemia frequency, from 1.1% to 10.4%. Diagnostic and therapeutic profile of Departments was in a strict connection with increase of the number and meaning of the politiological bacteremias (p = 0.036) in total number of systemic infections cases.

Adult↗
PubMed2003

[Susceptibility and frequency of selected groups of bacteria isolated in 2001 from patients at the Holy Cross Cancer Center].

The aim of the presented study was the analysis of microbiological data obtained from patients hospitalized in The Holly Cross Cancer Center in Kielce in 2001. The frequency of important nosocomial pathogens in selected specimens and their susceptibility to antibiotics were determined. The strains were identified by using commercial tests (bioMerieux) and their antibiotic susceptibility patterns were performed by disc diffusion technique. The most prevalent bacteria were Gram-negative rods of Enterobacteriaceae family (43%), mainly Escherichia coli. Only 2.7% strains of isolated Escherichia coli isolated from clinical specimens collected from hospitalized patients were beta-lactamase--positive (ESBL+). The second important group of microorganisms were Staphylococci, followed by Enterococcus spp., Pseudomonas aeruginosa and Candida spp. About twenty eight percent of Staphylococcus aureus isolates were resistant to methicillin.

Anti-Bacterial Agents↗
PubMed2004

[Causes of urinary tract infection in pregnant women].

Data of etiology characteristics of uroinfections with pregnant women are presented treated at University Hospital of Obstetrics and Gynecology "Maichin dom" in three periods. Gram negative species of microorganisms (E. coli, proteus, Klebsiella) are the agens of uroinfections in 95.4% of cases in the period 1988/89. After 10-year period gram (-) are the uroinfection in 66.1% of the cases. The growing etiologycal importance of Gram positive species of microorganisms (S. aureus, Enterococcus, GBS) is 33,9% in the period 1997/98 and it is preserved in june 2001/may 2003 too. In cases of long lasting hospitalization or after repeated treatment with antibiotics the probability grows that the agents of uroinfections be polyresistant strains. In the period june 2001/may 2003 in 7% of the cases polyresistant E. coli are isolated, in 2.6% MRSaureus, in 7.6% Ampicillin - R Enterococcus spp. That suggest exact identification of the agen and therapy according to sensitivity to antibiotics.

Anti-Bacterial Agents↗
PubMed2003

Assessment of statistical methods used in library-based approaches to microbial source tracking.

Several commonly used statistical methods for fingerprint identification in microbial source tracking (MST) were examined to assess the effectiveness of pattern-matching algorithms to correctly identify sources. Although numerous statistical methods have been employed for source identification, no widespread consensus exists as to which is most appropriate. A large-scale comparison of several MST methods, using identical fecal sources, presented a unique opportunity to assess the utility of several popular statistical methods. These included discriminant analysis, nearest neighbour analysis, maximum similarity and average similarity, along with several measures of distance or similarity. Threshold criteria for excluding uncertain or poorly matched isolates from final analysis were also examined for their ability to reduce false positives and increase prediction success. Six independent libraries used in the study were constructed from indicator bacteria isolated from fecal materials of humans, seagulls, cows and dogs. Three of these libraries were constructed using the rep-PCR technique and three relied on antibiotic resistance analysis (ARA). Five of the libraries were constructed using Escherichia coli and one using Enterococcus spp. (ARA). Overall, the outcome of this study suggests a high degree of variability across statistical methods. Despite large differences in correct classification rates among the statistical methods, no single statistical approach emerged as superior. Thresholds failed to consistently increase rates of correct classification and improvement was often associated with substantial effective sample size reduction. Recommendations are provided to aid in selecting appropriate analyses for these types of data.

Animals↗
PubMed2004

Emerging bacterial resistance patterns in febrile neutropenic patients: experience at a tertiary care hospital in Pakistan.

OBJECTIVE: To look at the clinical presentations, spectrum and site of isolation of the organisms, sensitivity patterns of the organisms and the antibiotic prescribing practices for the treatment of febrile neutropenic patients at our hospital. METHODS: The data were collected retrospectively from the records of all neutropenic patients with an absolute neutrophil count (ANC) of less than 500/ml admitted during the period of 3 years from August 1999 to July 2002 at AKUH. RESULTS: Out of the total of 404 patients, 65% had hematological malignancies and around half of them had leukaemia, 86% of the patients presented with fever. A total of 124 bacterial organisms were isolated from 96 patients among which 47% were gram positive and 53% were gram negative organisms; 16.1% of the patients had septicaemia. Coagulase Negative Staphylococci (CoNS) were the most common gram positive and E. coli was the most commonly isolated gram negative organism. Most of the gram positive organisms were isolated from blood (67%). There was emerging resistance to all commonly used antibiotics including imipenem, cloxacillin, vancomycin and amikacin. The average duration of neutropenia was 6.4 days. The mortality rate was 6%. CONCLUSION: There is increasing trend of gram negative organisms developing resistance to commonly used antibiotics. Gram positive bacteria including Enterococcus spp. and CoNS are also showing emerging resistance to vancomycin.

Amikacin↗
PubMedDate not supplied

[Infectious complications after renal transplantation].

Infections still represent a major clinical issue in the field of renal transplantation, impacting on graft and patient survival. Post-surgical complications in the immediate post-transplantation period, and immunosuppression (related to the use of new drugs such as mycophenolate mofetil, rapamicin, sirolimus and tacrolimus, and of increasingly aggressive immunosuppressive regimens) in later phases entail an increased risk for infection. Bacteria (in particular Enterobacteriaceae, non-fermenting Gram-negative bacilli and Enterococcus spp) and Candida spp are a frequent cause of urinary tract infection in the early post-transplantation phase. Cytomegalovirus (CMV) is a frequent infectious complication (20-60% of patients) whose risk is enhanced by mycophenolate mofetil. It can cause a variety of diseases: organ or disseminated acute disease, acute graft rejection, chronic allograft nephropathy, graft glomerulopathy, renal artery stenosis, induction of secondary bacterial or mycotic disease. Monitoring CMV antigenemia (pp65) allows a strategy based on pre-emptive therapy among patients with evidence of virological activity. BK virus (BKV) is a polyomavirus associated to various clinical syndromes in severely immunocompromised patients, such as haemorrhagic cystitis, ureteral stenosis and others. The variety and severity of infectious complications in this field mandate a multidisciplinary approach involving, next to the nephrologist and the surgeon, an infectious disease consultant and a clinical microbiologist.

Bacterial Infections↗
PubMed1992

[A study on in vitro antibacterial activity and clinical usefulness in respiratory tract infections of panipenem/betamipron, a newly synthesized carbapenem antibiotic].

Panipenem/betamipron (PAPM/BP) is a combination drug of PAPM, a new parenteral carbapenem antibiotic and BP, an amino acid derivative at a weight ratio of 1:1. Its in vitro antibacterial activities against clinically isolated respiratory pathogenic bacteria were determined. It was superior to imipenem (IPM) in the in vitro antibacterial activities against Haemophilus influenzae, Haemophilus parainfluenzae, Branhamella catarrhalis, Staphylococcus aureus including MRSA, Klebsiella pneumoniae, Serratia marcescens and Escherichia coli. PAPM had antibacterial activities almost equal to those of IPM against Streptococcus pneumoniae and Enterococcus spp. Against Pseudomonas aeruginosa, however, its antibacterial activity was about 1/4 that of IPM. The clinical usefulness of PAPM/BP was studied by dissolving it in a solution containing lactate and administering the solution by intravenous drip infusion to 12 cases of respiratory tract infections. Out of 11 cases with respiratory tract infections excluding cytomegalovirus pneumonia, the efficacy rate was 90.9%, with 4 cases of excellent and 6 cases of good responses. In terms of its bacteriological efficacies, eradication of pathogenic bacteria including super-infection were observed in 2 out of 4 strains, but 2 strains of P. aeruginosa remained unchanged. Six strains appeared as superinfected bacteria during and after administration of this preparation substituting original pathogens. Side-effects were not observed in the 12 cases, and in laboratory tests, slight transient increases of S-GOT and S-GPT were found in 1 case. In conclusion, PAPM/BP is a very useful parenteral antibiotic against respiratory tract infections and can be one of the drugs of the first choice.

Adult↗
PubMed1990

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1987). II. Background of patients].

In the retrospective survey of the sensitivity of clinical isolates reported in this journal, patients' backgrounds were also investigated. Some findings are summarized below. 1. Age distribution by sex: Patients with ages 50 years and older accounted for a majority, irrespective of their sexes amounting 67.6% for both sexes combined. 2. Annual distribution of sexes by age group: Females accounted for a majority in younger age brackets, but the proportion of males increased with age, accounting for a majority in patients 70 years or older. This pattern has been repeated practically every year. 3. Distribution of infection types by sex: Complicated urinary tract infections were predominant in males, while simple urinary tract infections were more frequent in females. 4. Annual distribution of sexes by type of infection: Complicated and simple urinary tract infections combined accounted for approximately 70% in both males and females. This pattern has been repeated practically every year. 5. Distribution of infection types by age: Patients of advanced ages were predominant as a whole but this trend was particularly pronounced in complicated urinary tract infection cases. 6. Annual distribution of infection types by age: The frequency of simple urinary tract infections among patients older than 20 years of age declined with age and this pattern has been repeated practically every year. Among patients older than 20 years of age, annual frequencies of complicated urinary tract infections have been on the decrease. 7. Distribution of isolated bacteria by sex: Escherichia coli was more frequent in females, while Enterococcus faecalis and Pseudomonas aeruginosa were more frequent in males. Compared with the previous year, the frequencies of coagulase-negative staphylococci, Enterococcus spp., and E. coli increased, while that of P. aeruginosa decreased. 8. Distribution of isolated bacteria by age: E. coli was most frequent on the whole, followed by E. faecalis, P. aeruginosa, Klebsiella spp., and coagulase-negative staphylococci, in that order. By age group, E. coli was frequent in younger patients and the frequencies of E. faecalis and P. aeruginosa increased with age. 9. Annual distribution of isolated bacteria by infection type: Coagulase-negative staphylococci increased as a whole and P. aeruginosa and Serratia marcescens decreased compared to 1986, but E. coli continued to be the most frequent. E. coli was isolated from a majority of simple urinary tract infection cases. The frequencies of E. faecalis and P. aeruginosa were high in cases of complicated urinary tract infections.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗