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PubMed1989

Incidence of enterotoxin producing Staphylococcus aureus among pyogenic skin infections.

Out of the total 68 S. aureus strains isolated and studied from pyoderma patients, 33 (48.5%) strains produced enterotoxin. Isolates from IED, impetigo and folliculitis exhibited high degree of enterotoxigenicity. SE-C and its combinations with other enterotoxins was common. 60.6% of the SE producers were found phage nontypable. Typable enterotoxigenic strains were associated with III, IV and mixed phage groups. S. aureus var. hominis and S. aureus var. bovis are the prevalent subspecies types and potent SE producers among pyogenic skin infections.

Bacteriophage Typing↗

PubMed1989

[Clinical studies on cefpodoxime proxetil in the pediatric fields].

Cefpodoxime proxetil (CPDX-PR, CS-807) was given orally to 18 children with acute bacterial infections including 10 with acute tonsillitis, 3 with acute bronchitis, 1 with pneumonia, 3 with staphylococcal scalded skin syndrome and 1 with infectious impetigo. Daily dosages per kg bodyweight ranging from 7.5 to 18 mg were given in 2 or 3 divided doses per day for 5 to 15 days. Clinical responses were excellent in 3 (16.7%), good in 11 (61.1%), fair in 4 (22.2%) and poor in 0 (0%), with an overall efficacy rate of 77.8%. Good bacteriological responses were obtained in 6 out of the 7 cases from which pathogens were identified. No side effect was observed. The above results suggest that CPDX-PR is a useful new oral cephalosporin derivative for the treatment of bacterial infections in children.

Acute Disease↗

PubMed1989

[Study of efficacy, safety and dosage on cefpodoxime proxetil in pediatric infections].

Cefpodoxime proxetil (CS-807, CPDX-PR), a new cephalosporin antibiotic, was investigated for its usefulness in pediatrics. 1. The total number of patients treated were 21 with their ages ranging from 3 months to 9 years and 1 month, consisting of 5 male and 16 female infants. 2. Single dosages of the drug ranged between 4.4 mg and 5.8 mg/kg with oral administration for 3 times daily in fasting. A total aggregated dosage was between 46.4 mg/kg and 200.0 mg/kg. The length of administration was 3 to 12 days. 3. The breakdown of symptoms were 9 cases of acute pharyngitis, 5 cases of acute tonsillitis, 3 cases of acute bronchitis, and 1 case each of impetigo + purulent rhinitis, cervical lymphadenitis, scarlet fever, and urinary tract infection. 4. The clinical efficacy rate was 100% with 18 excellent responses and 3 good responses. 5. The bacteriological efficacy rate was 90.9% in eradication rate, based on results on 17 strains of suspected causative microorganism among which 10 strains were eradicated, 1 strain was decreased, and 6 strains were unknown. 6. There was no side effect during the treatment and after the discontinuation, while, in clinical laboratory tests, GOT and GPT were elevated in 1 case which was judged as abnormal. No patient refused the drug. CPDX-PR was considered to be very useful drug because of its excellent efficacy and safety in pediatrics in treating infectious diseases.

Administration, Oral↗

PubMed1989

[Laboratory and clinical studies of cefpodoxime proxetil in pediatric field].

We have carried out laboratory and clinical studies on cefpodoxime proxetil (CS-807, CPDX-PR). The results are summarized as follows. CPDX-PR was given via oral administration to each 2 children at a single dose of 3 mg/kg and to each of 3 children in a 100 mg tablet. After the oral administration, mean peak serum levels of CPDX obtained for the 2 dose levels were 1.86 +/- 0.35 micrograms/ml and 2.16 +/- 0.63 micrograms/ml at 2 hours, respectively, and mean half-lives were 1.31 +/- 0.02 hours and 1.47 +/- 0.18 hours, respectively. The mean urinary excretion rate of CPDX was 32.8 +/- 1.0% in the first 12 hours after the oral administration of 3 mg/kg. When a dose of 100 mg tablet was given to each of the 3 children, urinary excretion rates in the first 12 hours were 43.5%, 48.6% and 24.8%, respectively. Treatment with CPDX-PR was done in 38 cases of pediatric bacterial infections; 19 cases of tonsillitis, 3 cases of pharyngitis, 1 case of bronchitis, 3 cases of pneumonia, 3 cases of scarlet fever, 2 cases of impetigo, 4 cases of UTI and 1 case each of phlegmone, subcutaneous abscess and balanitis. Results obtained were excellent in 23 cases, good in 15 cases. No significant side effect due to the drug was observed in any cases.

Absorption↗

PubMed1989

[Pharmacokinetic and clinical studies of cefteram pivoxil granule in the pediatric field].

Cefteram pivoxil (CFTM-PI), the pivaloyloxymethyl ester of cefteram (CFTM) in which aminothiazol was also introduced into the 7 position of cephem nucleus, is a new oral cephem antibiotic. CFTM-PI was absorbed through the intestines and hydrolyzed to CFTM by esterases in the intestinal wall and existed in the body fluids as CFTM. A tablet form of this drug has been released in Japan and now a granular form for pediatric patients has been developed. We have determined MICs of 5 drugs (CFTM, cephalexin (CEX), cefaclor (CCL), ampicillin (ABPC), erythromycin (EM], against stock strains and MICs of 6 drugs (CFTM, CEX, CCL, ABPC, methicillin, cloxacillin) against fresh strains from patients received to CFTM-PI, with an inoculum size of 10(6) cfu/ml. A total of 149 strains included Gram-positive cocci i.e. Staphylococcus aureus (11), Streptococcus pyogenes (85), Streptococcus agalactiae (16) and Streptococcus pneumoniae (4), and Gram-negative rods i.e. Haemophilus influenzae (11), Bordetella pertussis (11), Escherichia coli (9), Proteus mirabilis (1) and Morganella morganii (1). The granular form of CFTM-PI was administered to 9 boys (age: 8 years 3 months approximately 10 years 10 months) to determine serum and urinary concentrations of the drug and its urinary recovery rates using bioassay. Doses of 1.5, 3.0 and 6.0 mg/kg were given orally 30 minutes after meal to 3 boys, respectively. Urinary concentrations and its urinary recovery rates of T-2525A, a main metabolite of CFTM, were determined using high performance liquid chromatography (HPLC). To study clinical and bacteriological effects of this drug, a mean daily dose of 3.3 mg/kg divided 3-4 times a day (3 times: 133 cases, 4 times: 9 cases) was administered for 8 days on the average to a total of 142 cases with pharyngitis (22), tonsillitis (12), acute bronchitis (3), pneumonia (11), pleurisy (1), scarlet fever (28), acute purulent otitis media (16), impetigo (13), abscess (2), purulent lymphadenitis (1) and urinary tract infection (33). Adverse reactions and abnormal effects on laboratory test values attributable to this drug were studied in patients. The results obtained are summarized as follows. 1. With regard to Gram-positive cocci, MICs of CFTM against 11 fresh strains of S. aureus ranged from 3.13 to 6.25 micrograms/ml except for 1 strain, thus CFTM was equally effective to CEX, but less active than the other drugs tested.(ABSTRACT TRUNCATED AT 400 WORDS)

Bacterial Infections↗

PubMed1985

[Dermatoses in the metallurgy industry].

The authors proceeded to a skin examination of 1,194 consecutive workers in a cutlery industry with 3,692 employees, in order to detect any cutaneous alterations among them. Only 223 (18.7%) had no skin pathology. Most of them, 971 (81.3%) presented some cutaneous disorder, related or not with their work. Hyperkeratosis of the fingers and hands (262 cases) caused by repeated traumas due to the manipulation of the instruments of work were the most noticeable and specific occupational skin alteration. In second place in order of frequency were the intertriginous mycotic inflammation of the toes: 255 cases. The authors call attention to the low incidence of the sexually transmitted diseases as well as of scabies, pediculosis and impetigo.

Adolescent↗

PubMed1988

[Laboratory and clinical studies of rokitamycin in pediatric fields].

We have carried out laboratory and clinical studies on rokitamycin (RKM, TMS-19-Q). The results are summarized as follows. Serum and urinary concentrations of RKM were determined in 6 children with ages between 6 and 12 years given single oral doses of 5, 10 and 15 mg/kg. Mean serum concentrations peaked at 30 minutes after administration of 5, 10 and 15 mg/kg, and respective peak values were 0.30 microgram/ml, 0.79 microgram/ml and 1.32 micrograms/ml. Biological half-lives for 5, 10 and 15 mg/kg were 2.0 hours, 1.65 hours and 1.36 hours. The 6-hour urinary recovery ranged from 1.11% to 2.58% after administration of 5 mg/kg, and the mean 6-hour urinary recoveries were 1.35% after administration of 10 mg/kg and 2.28% after administration of 15 mg/kg. Therapeutic responses were recorded as excellent or good in 22 (73.3%) of the children, comprising 6 with tonsillitis, 2 with pharyngitis, 4 with bronchitis, 1 with bronchopneumonia, 1 with Mycoplasma pneumonia, 2 with whooping cough, 5 with streptococcal infections, 5 with Campylobacter enteritis, 3 with impetigo and 1 with SSSS. The microbiological effectiveness of RKM on identified pathogens comprising 4 strains of Staphylococcus aureus, 1 strain of Streptococcus pneumoniae, 6 strains of Streptococcus pyogenes, 4 strains of Haemophilus influenzae and 5 strains of Campylobacter spp. was not so satisfactory as evidenced by a eradication rate of 50.0%. No significant side effect due to the drug was observed in any cases. In conclusion, RKM was found to be efficacious and safe for the treatment of bacterial infections in children.

Administration, Oral↗

PubMed1986

[The clinical course and differential diagnosis of papular dermatitis in fattened pigs].

Since December 1981, dermatitis of unknown etiology in form of papular lesions has appeared in fattened pigs in some large herds in the Czech Socialist Republic. Clinical investigations of diseased pigs were performed in a large fattening house D. and in a large production herd of pigs M. in the region with frequent mines (lignite extraction). The diameter of the papules is mostly 3-5 mm, they are not painful when touched, are straggled irregularly, their large numbers are on the upper surface of the body. Papular dermatitis has a chronic course, affecting the gilts and castrated boars from the body weight of 30 kg, irrespective of their nutritional status. The overall health condition of pigs is not impaired and the disease does not cause itch. In the infected herds, there are usually fewer than 30% of pigs suffering from the disease. The incidence of the disease is highest in winter months. It is necessary to distinguish by differential diagnostics: swine pox, parakeratosis of swine, lesions of impetigo contagiosa suum, pustular dermatitis and scab of swine, from rarely occurring skin diseases of swine hypotrichosis cystica suis and demodicosis of swine. Neither did preventive nor therapeutic measures reduce expressively the incidence of skin lesions. We hope that the complex investigation of the internal environment of the infected pigs could help to reveal the pigs sensitive to the infection by this disease.

Animals↗

PubMed1986

[Biological, chemical and pathohistologic study of the skin in papular dermatitis in fattened pigs].

We examined the skin samples from 23 fattened pigs with papular dermatitis (PD) and from 17 pigs showing no skin lesions; the live weight of the pigs was from 95 to 105 kg and the pigs came from a large fattening house D that is located in the region where the mines are frequent (lignite extraction). It was only in 26% of pigs with PD where the common ectoparasites Haematopinus suis and Sarcoptes scabiei var. suis were found out. The skin lesions were not fluorescent in the light of Wood's lamp. The fungi Aspergillus flavus, A. fumigatus, A. tereus, Chrysosporium, Mucor sp., Scopulariopsis sp. were sporadically isolated from the skin lesions in 39% of pigs with PD. In 65% of pigs with PD Staphylococcus aureus was isolated from the skin lesions, which was not found in pigs without dermal lesions. Staphylococcus epidermidis was isolated in 87% of pigs with PD and 58% of pigs without any skin changes. The skin lesions were virus-free. Increased concentrations of cadmium and mercury were observed in the skin of pigs with PD and in control pigs. The concentration of aflatoxin B1 in the skin of the two groups of pigs did not exceed the level of 5 micrograms X kg-1, in PD pigs it was, however, twice higher than in the clinically healthy pigs. The residues of chlorinated hydrocarbons in the subcutaneous fat were not higher than the certified hygienic levels. Both epidermis and corium are affected by inflammatory lesions. At the beginning, neutrophil infiltration with necrotization of epithelial cells prevails. It is followed by capillary proliferation with angioblast and fibroblast multiplication and straggled lymphoid infiltration. It is necessary to distinguish by differential diagnostics: swine pox, parakeratosis of swine, lesions of impetigo contagiosa suum, pustular dermatitis and scab of swine, and from rarely occurring skin diseases of swine hypotrichosis cystica suis and demodicosis of swine. No conclusions can be drawn explicitly on the etiology and pathogenesis of papular dermatitis in fattened pigs. We must study the potential interactions of negative environmental factors with regulating homeostatic and adaptation mechanisms in fattened pigs.

Animals↗

PubMed1988

[Laboratory and clinical studies of sultamicillin in pediatric field].

We have carried out laboratory and clinical studies on sultamicillin (SBTPC). The results are summarized as follows. SBTPC was given by oral administration to 2 children in a single dose at 5 mg/kg and to 3 children in a single dose at 10 mg/kg. After the oral administration, mean peak serum levels of ampicillin (ABPC) and sulbactam (SBT) obtained for the 2 dose levels were 1.91 +/- 1.34 and 2.06 +/- 1.06 micrograms/ml and 2.43 +/- 0.68 and 2.96 +/- 0.77 micrograms/ml at 1 hour, respectively, and mean half-lives were 0.80 +/- 0.10 and 0.98 +/- 0.46 hour and 1.57 +/- 0.57 and 2.01 +/- 0.70 hours, respectively. SBTPC was given to 2 children in a single dose at 15 mg/kg. After oral administration, the mean serum levels of ABPC and SBT at 30 minutes were 6.55 +/- 1.63 and 6.00 +/- 1.00 micrograms/ml, and the mean half-lives were 0.90 +/- 0.13 and 0.82 +/- 0.16 hour. SBTPC was given to 1 child at a single dose of 20 mg/kg. The peak serum levels of ABPC and SBT were 11.3 and 8.64 micrograms/ml, and the half-lives were 0.87 and 0.92 hour. Mean urinary excretion rates of ABPC and SBT were 38.4 +/- 2.7 and 34.6 +/- 4.7%, 43.0 +/- 3.6 and 41.6 +/- 5.8%, 47.7 +/- 5.2 and 51.6 +/- 3.5% in 6 hours and 66.1 and 59.2% in 8 hours after oral administration of 5 mg/kg, 10 mg/kg, 15 mg/kg and 20 mg/kg, respectively. Treatment with SBTPC was made in 34 cases of pediatric bacterial infections; 2 cases of pharyngitis, 19 cases of tonsillitis, 2 cases of bronchitis, 3 cases of impetigo, 2 cases of staphylococcal skalded skin syndrome, 4 cases of urinary tract infection and 1 case each of pneumonia and scarlet fever. Results obtained were excellent in 20 cases, good in 13 cases and poor in 1 case. No significant side effect due to the drug was observed in any cases.

Age Factors↗

PubMed1988

[Pharmacokinetic and clinical studies of sultamicillin granule in the pediatric field].

Sultamicillin (SBTPC) is a combined drug of ampicillin (ABPC) and sulbactam (SBT) which is an inhibitor of beta-lactamase, in a clinical form of tosylate with equivalent molecules in ester linkages. A tablet form of this combined drug has been released since July, 1987 in Japan and now a granular form for pediatric patients has been developed. Hence, the granular form of SBTPC was administered to 6 boys (age: 8 years 5 months-11 years 5 months) to determine plasma and urinary concentrations of the drug and its urinary recovery-rates. The dose of 10 mg/kg or 15 mg/kg was given orally just after meal to 3 boys. To study clinical and bacteriological effects of this drug, a mean daily dose of 27.1 mg/kg divided 2-4 times a day was administered for 9 days on the average to a total of 57 cases with pharyngitis (5), tonsillitis (5), laryngitis (1), bronchitis (1), pneumonia (8), scarlet fever (1), typhoid fever (1), impetigo (16), furuncle (2), abscess (6), lymphadenitis (1) and urinary tract infection (10) except 2 cases which were unevaluable for clinical effects. MICs of 7 drugs (SBTPC, ABPC, SBT, methicillin (DMPPC), cloxacillin (MCIPC), cephalexin and cefaclor) against 12 of 22 strains isolated from patients with infections of skin and soft tissue were determined with inoculum-sizes of 10(8) and 10(8) CFU/ml to study beta-lactamase producing activities. Adverse reactions and abnormal effects on laboratory test values attributable to this drug were studied in patients including dropped-out cases. The results obtained are summarized as follows. 1. Mean plasma peak levels of ABPC and SBT were observed at 1 hour after administration in both of the 10 mg/kg and the 15 mg/kg groups with values of 2.34 and 5.57 micrograms/ml for ABPC and 1.87 and 4.66 micrograms/ml for SBT, respectively. Mean concentrations of SBT were lower than those of ABPC in both groups and individuals. Dose-responses in plasma levels and AUCs were observed in both groups. Mean half-life values of ABPC and SBT in the 2 groups were 1.93 and 1.12 hours for ABPC and 1.97 and 1.22 for SBT, respectively. Mean half-life values for ABPC and SBT were similar in each group and this tendency was also seen among individuals.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1988

Dermatoses of pregnancy.

Hormonal alterations contribute to the physiologic skin changes in pregnancy, which include hyperpigmentation and melasma, striae gravidarum and vascular phenomena, such as spiders, palmar erythema and varicosities. Hair, nails and sweat glands may also be affected. Dermatoses associated with pregnancy include herpes gestationis, impetigo herpetiformis, pruritic urticarial papules and plaques of pregnancy and papular dermatitis of pregnancy. Some skin tumors are affected by or are unique to pregnancy.

Female↗

PubMed1988

Blistering distal dactylitis in an adult.

Streptococci are responsible for a diverse spectrum of cutaneous infections like erysipelas, impetigo, and cellulitis. Blistering distal dactylitis is an infrequent, superficial infection of the anterior fat pad of the distal portion of the finger described classically in children. We report a case of blistering distal dactylitis in an adult caused by group A beta-hemolytic streptococci that was cured with oral phenoxymethyl penicillin. Familiarity with blistering distal dactylitis should permit the dermatologist and internist to diagnose this new entity in adults.

Adult↗

PubMed1987

Rapid development of diffuse crescents in post-streptococcal glomerulonephritis.

A 14-year-old boy presented with 3 days of hematuria and oliguria following impetigo. Renal biopsy showed diffuse endocapillary proliferative glomerulonephritis with subendothelial electron dense deposits but no crescents. Due to recrudescence of clinical abnormalities after initial improvement, the patient was re-biopsied 10 days later. This biopsy showed circumferential crescents in 83% of the glomeruli. Treatment with intensive plasma exchange, prednisolone, cyclophosphamide and dipyridamole was accompanied by prompt improvement in renal function. The need to carefully monitor the course in patients with acute post-streptococcal glomerulonephritis is emphasized.

Adolescent↗

PubMed1986

[Study on the use of cefotiam in neonates].

Pharmacokinetic and clinical studies were carried out regarding the use of cefotiam (CTM) in the treatment of infections in newborn infants. Absorption and excretion: CTM was administered by bolus intravenous injection at a dose of 20 mg/kg to 9 newborns ranging in age from 1 to 28 days (gestational age, 34-40 weeks; birth weight, 2,000-3,380 g) and 6 infants aged 30 to 87 days (gestational age, 33 approximately 40 weeks; birth weight, 2,100-3,600 g) and its serum concentration and urinary excretion were determined. In the newborns, mean serum concentrations were 43.3 micrograms/ml at 1/4 hour, 36.7 microgram/ml at 1/2 hour, 27.8 micrograms/ml at 1 hour, 17.7 micrograms/ml at 2 hours, 8.8 micrograms/ml at 4 hours and 4.8 micrograms/ml at 6 hours, and in the infants, they were 44.5 micrograms/ml, 31.2 micrograms/ml, 19.1 micrograms/ml, 7.6 micrograms/ml, 2.2 micrograms/ml and 0.7 micrograms/ml at the above sampling times, respectively. Mean half-lives were 1.92 hours for the newborns and 0.96 hour for the infants, and mean urinary recoveries within 6 hours were 41.2% and 50.1% for the newborns and the infants, respectively. Taking individual differences into account, serum peak levels (at 1/4 hour) in newborns were very similar to each other irrespective of age (days after birth), and did not appear to be greatly different from those in infants. Half-lives, however, became shorter with aging, and the half-life of the serum CTM level in infants of about 1 month old should be close to those in young children or school-age children. From these observations, it is suggested to establish a standard regimen in which CTM is administered at a dose of 20 mg/kg once or twice a day to newborns within 3 days after birth, twice or 3 times a day to those aged 4 to 7 days, and 3 or 4 times a day to those aged 8 days or older. Clinical study: The CTM was administered to 11 patients with acute pneumonia, 2 patients each with suspected septicemia and with bullous impetigo, 1 patient with purulent lymphadenitis, 3 patients with idiopathic respiratory distress syndrome and 1 patient with pneumothorax, and its clinical effect was investigated. Excellent responses were observed in 12 of the 15 evaluated cases,good responses in 2, and a poor response in 1, thus an overall clinical effectiveness was 93.3%.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗

PubMed1977

[Cutaneous microbiol flora in 206 children with diaper dermatitis and pyodermitis].

Staphylococcus aureus (60 p. 100) and Candida albicans (50 p. 100) were mostly found in 73 cases of diaper dermatitis. They were present together in 16 out of these 73 cases. This study enables us to think this is a matter of opportunistic infection. Staphylococcus aureus (75 p. 100) and beta-hémol. Streptococcus A (28 p. 100) were found in 40 children with impetigo contagiosa. They were present together in 7 out of the 40 cases. Nephritis was never found either in those cases or in other 93 cases of pyodermitis.

Candida albicans↗

PubMed1986

[Benign chronic bullous dermatosis in childhood with involvement of the mouth mucosa].

We report on a rare case of benign chronic bullous dermatosis of childhood (BCBDC) in a 5-year-old girl. In addition to the characteristic symptoms such as abrupt onset of the disease, tense blisters, predominant affection of the face, and later imitation of impetigo, we observed uncommonly extensive involvement of the oral mucosa. Whereas histopathology was not diagnostic, direct immunofluorescence could verify BCBDC as it showed linear deposits of IgA along the basement membrane zone. This case gives rise to the discussion of the clinical entity and nomenclature of BCBDC in relation to similar bullous diseases of childhood and adults.

Basement Membrane↗

PubMed1986

Acute glomerulonephritis: three episodes demonstrated by light and electron microscopy, and immunofluorescence studies--a case report.

The patient, a white boy, had 3 episodes of recurrent acute glomerulonephritis at 7, 12 and 17 years of age. The episodes were preceded by impetigo and there was a good clinical and laboratorial recovery after all of them. Renal biopsies were performed during the acute episodes, and the light, immunofluorescence and electron microscopy studies showed only lesions typical of acute glomerulonephritis. Four months after the third episode another renal biopsy demonstrated only lesions compatible with the subsiding stages of acute glomerulonephritis.

Acute Disease↗