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At least 73 records · Page 4Linked to original sources
PubMed2002

Synercid plus vancomycin for the treatment of severe methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci infections: evaluation of 5 cases.

Synercid (quinupristin/dalfopristin), the first semi-synthetic injectable streptogramin, is a promising alternative to glycopeptides against many Gram-positive multiresistant bacteria. Vancomycin is still considered an effective agent for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections but therapeutic failures with glycopeptides have been observed, even for the treatment of infections caused by S. aureus strains sensitive to vancomycin. Synercid, in combination with a glycopeptide, may address this problem without causing significant side effects due to the different toxicity patterns of the 2 antimicrobials. This study reports our experience with the combination of Synercid and vancomycin in 5 patients with severe infection caused by MRSA or methicillin-resistant coagulase-negative Staphylococcus.

Abdominal Abscess↗
PubMed1981

HLA antigens and HBV infection: evaluation in the chronic carrier state and in a large family.

HLA antigens were determined in 65 apparently well chronic carriers of HBsAg, in race-matched controls and in 42 members of a family with a high frequency of hepatitis B virus infection. The only apparent significant association in the chronic carriers was negative, i.e., no HLA-B7 specificities were found among whites. B7 may confer resistance for whites to chronic infection with hepatitis B. In the family neither active (HBsAg) nor prior (anti-HBs) hepatitis B infection was associated with HLA specificities. HLA antigens in this family failed to provide a clue to the genetics of hepatitis B infection.

Carrier State↗
PubMedDate not supplied

Diagnosis of Schistosoma haematobium infection: evaluation of ELISA using keyhole limpet haemocyanin or soluble egg antigen in comparison with detection of eggs or haematuria.

Keyhole limpet haemocyanin (KLH) was compared with Schistosoma haematobium soluble egg antigen (SEA) in the enzyme-linked immunosorbent assay (ELISA) for detection of S. haematobium infection, using 187 human sera collected from the S. haematobium endemic area of Pemba Island, Tanzania, and 30 normal sera from blood donors in Europe. There was a clear separation in terms of immunoglobulin (Ig) G and IgM titres between parasitologically positive patients and the blood donors, but titres of many parasitologically negative individuals in the endemic area were significantly high in comparison with the normal controls. Using as cut-off point the mean optical density +2 SD of sera from the blood donors to define ELISA positivity, and comparing the results with urine egg counts, the sensitivity of IgG-ELISA using KLH or SEA was high (91.11% and 95.56%, respectively) but the specificity was poor (43.30% and 31.90%, respectively. Similar results were obtained with IgM. When the 'gold standard' of haematuria and/or egg positivity as indicative of infection was used, the sensitivity of the ELISAs was similar but the specificity was increased to 59.25% and 44.44%, respectively. These results suggest that the patients with haematuria were probably infected with S. haematobium, which further supported the diagnostic value of haematuria detection for S. haematobium infection in endemic areas, and KLH was found to have a potential use in immunodiagnosis of S. haematobium infection in endemic areas. With both KLH and SEA antigens, the trend of reactivity in ELISA provided a correlate of the egg output (parasite burden) of infected patients.

Animals↗
PubMed1996

Value of serology (ELISA) for the diagnosis of Helicobacter pylori infection: evaluation in patients attending endoscopy and in those with fundic atrophic gastritis.

In the present study we assessed the diagnostic accuracy of four commercial IgG enzyme-linked immunosorbent assay (ELISA) kits (Autoplate, H.pylori-EIA-Well, Enzygnost, Helori-test) and evaluated the performance of these tests in patients with fundic atrophic gastritis. Serum antibodies to Helicobacter pylori were measured in 70 out-patients attending endoscopy for dyspepsia and 43 patients with non-autoimmune fundic atrophic gastritis. Using the cut-off values recommended by the manufacturers, and comparing serological findings with gastric biopsy results of dyspeptic out-patients attending endoscopy, the four kits showed a sensitivity and specificity, respectively, of 91% and 96%, for Autoplate, 67% and 100% for H.pylori-EIA-Well, 79% and 100% for Enzygnost, and 81% and 96% for Helori-test. Evaluation in patients with atrophic gastritis revealed a high prevalence of antibodies to Helicobacter pylori (84%) and it demonstrated that patients with and those without gastric colonization by this microorganism had a similar rate of seropositivity (76-84% vs 50-78%). In conclusion, our data demonstrate that: a) this assay is a reliable and valid method to detect gastric colonization by Helicobacter pylori; b) positive serum antibody associated with a negative detection of Helicobacter pylori in the gastric mucosa suggests mucosal atrophy; c) patients with fundic atrophic gastritis should be excluded from studies investigating the value of serology in diagnosing Helicobacter pylori infection.

Adult↗
PubMedDate not supplied

Oral manifestations associated with HIV infection: evaluation, assessment, and significance.

During the course of HIV disease, oral lesions frequently are the initial manifestation of underlying immune deterioration. Typically, these lesions are readily accessible and lend themselves to being examined. Therefore, it is important to perform oral examinations routinely both in dental and medical settings. The recognition and treatment of these early signs of immune suppression may have a significant impact on the survival and the quality of life of HIV-infected patients. This article briefly discusses the HIV epidemic and common intraoral manifestations associated with HIV disease progression.

AIDS-Related Opportunistic Infections↗
PubMed1999

Five micro-curie urea breath test for the diagnosis of Helicobacter pylori infection: evaluation in a South-East Asian population.

BACKGROUND: Helicobacter pylori is an important pathogen responsible for significant morbidity and mortality. Its prevalence varies widely in different geographical locations and is especially high in parts of Asia. METHODS: A double-blind study was carried out to evaluate the use of the 5 microCi (185 KBq) [14C]-urea breath test ([14C]-UBT) in a South-East Asian population by validating its diagnostic accuracy against histology and the CLO test. RESULTS: The sensitivity and specificity of the [14C]-UBT was 100% when compared against the CLO test. When histology was used as the 'gold standard', the sensitivity and specificity were 100% and 97.2%, respectively. There was no overlap or indeterminate values between positive and negative results on the [14C]-UBT. CONCLUSIONS: Among South-East Asian populations where the prevalence of H. pylori infection is high, the high sensitivity of the 5 microCi [14C]-UBT makes it a very important test in the detection of H. pylori.

Adult↗
PubMed2001

'Chemical condoms' for the prevention of HIV infection: evaluation of novel agents against SHIV(89.6PD) in vitro and in vivo.

BACKGROUND: Vaginal agents which are antiviral and/or inhibit the entry of HIV into the cell could prevent heterosexual transmission of HIV, and protect women who cannot negotiate condom use. METHODS: Four agents have been investigated for activity in vitro and in vivo against SHIV(89.6PD): two anionic polymers, dextrin-2-sulphate (D2S) and PRO 2000 (P2K), and two virucidal agents; a non-ionic detergent, nonoxynol-9 (N9) and a cyclic peptide ionophore, gramicidin-D (GD). All four agents were investigated in rhesus macaques, using an intra-vaginal challenge of two inoculations of 1 x 104 50% tissue culture infectious doses (TCID)50 of SHIV(89.6PD). RESULTS: D2S, P2K, GD and N9 all inhibited SHIV(89.6PD) in vitro. In vivo, three out of four control macaques were infected as judged by viral culture, seroconversion, DNA and RNA PCR; infection was confirmed in four out of eight macaques pre-treated with P2K, two out of four pre-treated with D2S, one out of four pre-treated with N9, two out of four pre-treated with GD and four out of four pre-treated with D2S + GD, a combination additive in vitro. INTERPRETATION: D2S and PRO-2000, novel inhibitors of HIV entry, showed evidence of protection in vivo, comparable to that seen with the virucide, N9. These data, together with the results of phase I and phase II studies in healthy women which have shown minimal toxicity, support plans for a phase III efficacy trial of chemically simple inhibitors of HIV entry with low toxicity, for the prevention of HIV infection in women.

Administration, Intravaginal↗
PubMed2000

["Rapid" serology for the diagnosis of Helicobacter pylori infection. Evaluation of its accuracy compared with a gold-standard and its concordance with "classic" serology].

AIM: To prospectively evaluate the validity of a rapid office-based diagnostic serological test (using capillary blood) in our population, taking as reference a combination of standard diagnostic methods, as well as to compare the results of this technique with those of "classic" serological tests (using venous blood). PATIENTS AND METHODS: We prospectively studied 39 consecutive patients with symptoms of the upper digestive tract who had undergone oral gastroscopy. Gastric biopsies were taken for histology and rapid urease testing, and a 13C-urea breath test was performed. An enzyme-linked immunoassay that detects IgG antibodies against Helicobacter pylori was used as a "classic" serological test and the commercial kit FlexPack HP was used as a "rapid" serological test. The endoscopist, the pathologist and those responsible for reading the rapid urease test, the 13C-urea breath test and both serological tests did not know the results of the other diagnostic methods. Patients were considered H. pylori positive when at least two of the three validated tests (rapid urease test, histology, and 13C-urea breath test) revealed infection and were considered free of infection when all tests were negative. RESULTS: Thirty-nine patients were studied. Thirty-eight per cent were male (mean age 48 +/- 15 years). The prevalence of H. pylori infection detected by the gold standard was 69.2%. The sensitivity and specificity of the "classic" serological test was 96% 95% (CI: 79-99) and 91% (59-100). "Rapid" serological testing was positive in nine patients, negative in 28 and indeterminate in two. A single digital puncture was sufficient in 80% of the patients, 15% needed two and 5% needed three. Most patients (77%) had no preference for either type of serological test while 20.5% preferred digital puncture and 2.5% venous puncture. The sensitivity, specificity, positive predictive value and negative predictive value were 31% (16-50), 91% (59-100), 89% (52-100) and 36% (19-56) respectively. Sensitivity was unaffected by age but specificity was lower in patients older than 40 years (89% vs. 100%; McNemar's test: 8; p < 0.01). Kappa's coefficient between the "classic" and the "rapid" serological tests was 0.16 (SE 0.1) and McNemar's test was 12.2 (p < 0.001), which indicates that the prevalence of infection diagnosed by both methods was not homogeneous. CONCLUSION: The "rapid" office-based serological test used in our study is of insufficient diagnostic accuracy to be used in clinical practice to identify H. pylori infection.

Enzyme-Linked Immunosorbent Assay↗
PubMed1983

The role of topical dimethyl sulfoxide in burn wound infection: evaluation in the rat.

The results of this study indicated that there were no statistically significant differences between the effectiveness of 1% silver sulfadiazine in DMSO and 1% silver sulfadiazine in a hydrophilic base (Silvadene), when these formulations were used as antimicrobials applied topically to thermal burn wounds. The antimicrobial efficacy of silver sulfadiazine was not destroyed by mixing this agent with DMSO, since the recovery of Pseudomonas aeruginosa was significantly lower in all animals treated with silver sulfadiazine, whatever the formulation, when compared to animals not treated with silver sulfadiazine. Further studies with higher concentrations of silver sulfadiazine in DMSO may be useful. Although the concept of DMSO as a medicinal "carrier" is not novel, with further investigation, it may prove to be germane in the treatment of eschar-covered thermal burns.

Absorption↗
PubMed1975

Isolation of Clostridium in human infections: evaluation of 114 cases.

One hundred fifty-two strains of Clostridium were isolated from 144 patients over a 14-month-peroid. These included 23 recognized species and 23 strains that were unclassified. Soft tissues or abscesses yielded 84 strains of Clostridium. Intraabdominal sites predominated, but clostridia were recovered from empyema, carcinoma, frostbite with gas gangrene, muscle abscess, aortic graft, and brain abscess. Blood cultures yielded 65 strains of Clostridium from 49 patients, representing 0.3% of 16,314 blood cultures (or 2.6% of 2,168 positive cultures). Clostridium perfringens was most common in blood, accounting for 37 isolates (57%). Clostridial bacteremia was often unrelated to the clinical setting and was found in alcoholics with aspiration or Streptococcus pneumoniae pneumonia, pulmonary tuberculosis, empyema, meningococcemia, and infantile gastroenteritis. In 20 of the 49 patients (41%), aerobic or other anaerobic bacteria were cultured concurrently from the blood. Thus, clostridial bacteremia should be interpreted with caution since there may be little correlation with the patient's clinical condition.

Abscess↗
PubMed1999

Empirical treatment of bacteraemic urinary tract infection. Evaluation of a decision support system.

INTRODUCTION: In a Danish county with a low prevalence of antibiotic resistance to most antibiotics, we have constructed and evaluated a decision support system (DSS) for guidance of empirical antibiotic therapy in patients with bacteraemia originating from the urinary tract. METHODOLOGY: The DSS was based upon a causal probabilistic network, and a decision theoretic approach was used to balance the costs of antibiotic therapy against the therapeutic benefit. The costs included direct cost of purchasing antibiotics, side effects, and the risk of development of antibiotic resistance. The therapeutic benefit was defined as the increase in life-expectancy caused by antibiotic therapy. Life-years were chosen as the common currency unit. Four hundred and ninety-one bacteraemias seen during 1992-1994 were used to construct the DSS (derivation set), and 426 bacteraemias during 1995-1996 were used for evaluation (validation set). The cases were identified in a regional register of bacteraemias. The study was non-interventional. RESULTS: The DSS suggested antibiotics which would provide coverage in 377 of the 426 episodes (88.5%) compared to 259 episodes (60.8%) for which empirical therapy actually provided coverage (p < 0.01, McNemar-test). The regimens suggested by the DSS included mecillinam as monotherapy in 240 episodes (56.3%), gentamicin as monotherapy in 81 (19.0%), and a combination of gentamicin and ampicillin in 80 (18.8%). CONCLUSION: A decision theoretic approach shows promise of improving empirical antibiotic treatment, and may be a measure to support an antibiotic policy.

Aged↗
PubMed1996

Blood-Brain Barrier Integrity in HIV Infection:Evaluation by Contrast-Enhanced Magnetic Resonance Imaging.

This study assesses the integrity of the blood-brain barrier (BBB) in human immunodeficiency virus (HIV) seropositive individuals to magnetic resonance imaging (MRI) contrast agent Gd-DTPA. Twelve HIV seropositive patients and six control subjects had T2-weighted and serial pre- and post-contrast TI-weighted MRI. Ten of the twelve seropositive patients demonstrated white matter hyperintensity with or without atrophy on T2-weighted MRI and 8/10 who underwent neurological examination demonstrated neurological abnormalities. No statistically significant differences of trends in white matter pixel values were observed between pre- and post-contrast scans in any of the patients or controls. Serial T1-weighted MRI does not demonstrate any change in the integrity of the BBB to Gd-DTPA in HIV seropositive patients, regardless of the presence or absence of white matter hyperintensity with or without atrophy on T2-weighted MRI or clinical signs of HIV-I associated with cognitive/motor complex.

Blood-Brain Barrier↗