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PubMedDate not supplied

[Pleural effusion infected with Salmonella enteridis].

The authors describe the case of a 49 year-old caucasian male with left pleural effusion. The etiology of the effusion was exsudative with a preponderance of neutrophils. Ten days after admission and on empirical antibiotic therapy, the patient still had fever and the pleural effusion that became purulent. The thoracic echography and computerized tomography showed a subcapsular splenic abcess. The diagnosis was established by the culture of the pleural effusion and the isolation of Salmonella enteritidis enteritidis serotype. According to the antibiogram, a treatment with cotrimoxazole was established with clinical improvement. A splenectomy was performed.

Humans↗
PubMed2000

In vitro activity of teicoplanin against gram-positive cocci.

The glycopeptide susceptibility of 443 clinical isolates of gram-positive cocci collected from nine general hospitals in 1996 was determined according to the recommendations of the CA-SFM (the Antibiogram Committee of the French Society for Microbiology). In total, 234 isolates of Staphylococcus aureus, 84 isolates of coagulase-negative staphylococci (CNS), 98 enterococci and 27 streptococci were collected. The mecA gene confirming resistance to methicillin was found in 42.7% of S. aureus isolates and 51.2% of CNS isolates. No resistance to teicoplanin and vancomycin was found in S. aureus but four isolates of CNS had an MIC of teicoplanin > or = 8 mg/L. All isolates of Enterococcus faecalis tested were susceptible to both glycopeptides. This study confirms that teicoplanin has a very good in vitro activity against gram-positive cocci, isolated in France from nosocomial infections.

Anti-Bacterial Agents↗
PubMed2001

Nosocomial bloodstream infection in pediatric patients: Siriraj Hospital, Bangkok; 1996-1999.

A retrospective study on nosocomial bloodstream infection (NBSI) in pediatric patients hospitalized at Siriraj Hospital from January 1996 to December 1999 was performed. Of the 18,087 blood specimens sent for culture, 533 (3%) were positive for organisms after 72 hours of hospitalization and were defined as NBSI. The rate of NBSI detected in blood culture specimens was highest among neonates (5.2%). Gram-positive cocci and gram-negative rods caused NBSI in an equal proportion (46% and 44% respectively) and Candida caused 10 per cent of NBSI. Coagulase-negative staphylococci was the most common pathogen followed by K. pneumoniae and Enterobacter. Antibiogram showed that 15 of the 35 (43%) S. aureus identified were methicillin-resistant. Only 35-38 per cent of Enterobacteriaceae were sensitive to cefotaxime or ceftazidime. Cefoxitin was still effective against 95 per cent of K. pneumoniae. Compared with other third generation cephalosporins, combination of cefoperazone and betalactamase-inhibitor (sulbactam) possessed an increased in vitro efficacy against K. pneumoniae, Enterobacter, E. coli, Acinetobacter and non-fermentative gram-negative rods. Resistant rate of amikacin among all gram negative rods was 25-69 per cent. Ciprofloxacin sensitivity varied from 62-100 per cent among all gram-negative rods. Imipenem was excellent against all gram-negative rods with the sensitivity of 80-100 per cent. Epidemiological data of this study is important for the decision of the appropriate empirical antimicrobial treatment in our hospital.

Bacteremia↗
PubMed2001

[A case of tongue actinomycosis].

The authors present a case of actinomyces of the tongue indicating initial actinomyces with signs of ulceration possibly neoplastic. A swab from a discharge confirmed actinomycosis. A diagnosis by antibiogram led to a cure of the specific location and the general infection.

Actinomycosis↗
PubMed2001

DNA fingerprinting of methicillin-resistant Staphylococcus aureus by pulsed-field gel electrophoresis (PFGE): comparison of strains from 2 Malaysian hospitals.

AIM OF STUDY: To determine and compare the pulsed-field gel electrophoresis (PFGE) patterns of endemic MRSA strains in 2 major Malaysian hospitals and to compare the PFGE patterns with antibiotypes of the strains studied. METHODS: Fifty-six MRSA strains selected randomly between September 1997 and July 1998 from Hospital Queen Elizabeth (HQE) and Hospital Umum Sarawak (HUS) were tested for antimicrobial resistance and DNA fingerprinting was carried out by pulsed-field gel electrophoresis (PFGE) technique. RESULTS: Seven PFGE types were recognised (A, B, C, D, E and F). All 7 PFGE types were observed in HQE while only 2 PFGE types (B, C) were noted in HUS strains. There is a predominance of a single PFGE pattern (type B) in both hospitals, as seen in 46% of HQE strains and 89% of HUS strains. Subtype B2 was the commonest subtype in HQE while subtype B1 predominated in HUS. Strains resistant to fusidic acid and rifampicin exhibited PFGE type F that is unique to HQE. All strains were resistant to penicillin, erythromycin, cotrimoxazole, tetracycline and gentamicin. Strains with the same antibiotic susceptibility pattern can be different PFGE types. CONCLUSION: Molecular typing of the MRSA by PFGE is a useful tool in the study of endemic strains present in an institution. Strains in HQE were found to be more heterogeneous than HUS strains. Common PFGE types can also be seen in both hospitals suggesting that some of the strains was genetically related and has propagated within and between the 2 hospitals. Our findings also indicate that the relationship between antibiotic susceptibility and PFGE patterns was not close and antibiograms should not be relied upon for typing strains in epidemiological studies. By knowing the DNA fingerprints of the isolates endemic in each hospital, the spread of MRSA with a particular PFGE type can be monitored within and between hospitals.

DNA Fingerprinting↗
PubMed2001

[Antibiotic therapy in Italy. Current data and proposals for the future].

Data concerning antibiotic therapy in italian ICUs are presented. These data were not directly measured: they have been derived from a previous study on costs of intensive care treatments. 78% of 1065 patients received antibiotic therapy. Empirical therapy was started in 82% of septic patients. 93% of septic patients had at least one antibiogram. In 96% of cases, 2 or more antibiotics were given. 85% of surgical non septic patients received antibiotic prophylaxis for an average of 3.6 days, with a 3rd generation cephalosporin in the majority of cases. 60% of medical non septic patients received antibiotic prophylaxis for an average of 6.2 days, mostly with a 3rd generation cephalosporin. These data raise doubts about the proper use of prophylaxis. These data can be considered a useful starting point for the development of a program of surveillance of infections in Italian ICUs.

Anti-Bacterial Agents↗
PubMed2001

Prevalence of resistance to antimicrobials of Escherichia coli isolates from clinical sources at a private hospital in Trinidad.

Antimicrobial susceptibility patterns of strains of Escherichia coli isolated between 1994 and 1998 were studied. Of the 1,283 strains examined, 75% were recovered from urine, 8.7% from wounds, 3.2% from blood, 2.6% from pus, and 10.5% from other sources. Isolates from inpatients and outpatients accounted for 46.1% and 53.9%, respectively. Gentamicin and nalidixic acid showed the greatest efficacy against isolates from both inpatients and outpatients, revealing a >90% sensitivity. Drugs with the lowest efficacies were ampicillin and amoxicillin-clavulanic acid, which showed a >45% resistance. Tetracycline showed a significant decline in resistance from 1994 to 1998 among strains from both inpatients and outpatients (P < 0.001). This decline may be related to a policy of restrictive antibiotic reporting by the Microbiology Laboratory and seminars for general practitioners, subsequent to an island-wide survey an antibiotic resistance. A similar pattern of declining resistance was also observed for cefuroxime. E. coli sensitivity to co-trimoxazole was relatively stable during the study period. Although the overall prevalence of resistance among E. coli strains is relatively low, on-going surveillance of bacterial resistance must continue. The microbial antibiogram can provide general practitioners and clinicians with data essential for optimum empiric choices. Further, the introduction of a policy of restrictive reporting may act "synergistically" with the education of doctors on resistance patterns, to effect island-wide reduction of antimicrobial resistance.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed2000

Neonatal meningitis.

OBJECTIVE: To determine the prevalent bacterial agents of neonatal meningitis and their antibiotic susceptibility in a referral intensive care unit in Assir Central Hospital, Saudi Arabia, during the years 1993-1998. METHODS: Records of newborn infants with positive cerebrospinal fluid culture during the period were retrospectively studied. RESULTS: There were 1473 nursery admissions, of which 32 episodes of meningitis occurred amongst 31 neonates. Klebsiella pneumoniae (31%) and Serratia marcescens (21%) were the main pathogens. The incidence of concurrent septicemia among these infants was 58%. Klebsiella pneumoniae appears to dominate in both early and late onset infections. The sex incidence was equal and the mortality rate was 48%. CONCLUSION: The survey identifies Klebsiella pneumoniae and Serratia sp. as the leading bacterial agents of neonatal meningitis in our environment. The relatively high frequency of Serratia infection in the present survey appears unique as this organism is comparatively rare in other reports across the globe. No Group B Streptococcus was isolated, which is in contrast to reports obtained in Europe, America and Australia where it is the predominant organism of neonatal sepsis or meningitis. Antibiogram identified imipenem and cefotaxime as the empirical antibiotics in infants with a clinical diagnosis of neonatal sepsis in our hospital; no more conventional use of ampicillin. In view of the changing bacterial pattern of infant infection with time even in the same environment, a periodic review of this subject is advocated.

Drug Resistance, Microbial↗
PubMed2001

[Drug resistance of group B streptococci].

The group B streptococci (GBS) are one of the main infections' factors in neonates. The source of the infection is mother and the infection follows during childbirth. In many countries various methods of prophylaxis in reference to mother and neonate are introduced. Thus far the widest application have found a method of giving to pregnant women penicillins or cephalosporins. The purpose of the present work was to study how the drug-resistant of the GBS forms in our country and if using antibiotics in prophylactic purposes without doing any antibiograms is burdened with risk, resulted from the possibility of meeting resistant strains. 365 strains of the GBS, derived from colonised neonates, pregnant women and clinical materials were put to the scientific research. 120 animal strains isolated from events of mastitis in cows, represented the second group. The GBS, derived from pregnant women were sensitive to every examined antibiotics except lincomycin (5.9%). Amid the streptococcus isolated from neonates there were some strains resistant to every examined antibiotic (1.9-4.4%). More often resistant strains were isolated from clinical materials (3.9-9.0%). The highest percentage of the resistant strains was identified in animals (7.5-20.0%). The GBS as a rule were insensitive to cotrimoxasolum. As follows from our scientific researches, the GBS derived from people as a rule are sensitive to used antibiotics. But there were some strains resistant even to several antibiotics. Possibility of meeting these strains should be taken into consideration as in prophylaxis as in treatment of the infections. Amid the animal strains of the GBS the phenomenon of the resistance to antibiotics is more often met than in human ones.

Cephalosporins↗
PubMed2001

[Septicemia of dental origin and post-extraction coma. Apropos of 3 cases].

The authors report 3 cases of septicaemia and coma post dental extraction. These 3 patients had dental extraction in the same confessional dental clinic. After these acts the situation were so severe and they came to central hospital in Yaounde. Infections from dental origin proven by blood culture necessitate an early antibiotherapy and treatment, which propriate and sustain, but adapted to the antibiogram. The streptococcus of group F and Klebsiella pneumonia were challenged. One of the cases was negative. The presence of common signs (fever, tachycardia, chill) need the search for a secondary localisation which can be determine by X-ray.

Adolescent↗
PubMed2001

Correlation of beta-lactamase production/methicillin resistance and phage pattern of Staphylococcus aureus.

Multiple drug resistance is exhibited by coagulase positive staphylococcus aureus isolated from hospitals. Prevalence of MRSA due to prolonged stay in the hospital, instrumentation/invasive procedure, surgical intervention and misuse of antibiotics have been reported. Antibiogram of 200 coagulase staphylococci showed 10% MRSA strains. Predominant phage type 81 belonged to unclassified group followed by phage type 84 belonged to group 3. As the management of MRSA is not easy, efforts should be made to eradicate the MRSA by taking strict aseptic conditions and the severe infections should be treated according to the sensitivity pattern of the strain.

Animals↗
PubMed2001

[Profile of antimicrobial resistance of agents causing urinary tract infections in Chilean children. PRONARES surveillance program].

BACKGROUND: PRONARES (Programa Nacional de Vigilancia de Resistencia) is a national surveillance program for antimicrobial susceptibility, focused in different syndromes and among these, urinary tract infections. The work is done in a laboratory net that uses common protocols and whose data are centrally analyzed using the WHONET program. AIM: To analyze the pattern of antimicrobial susceptibility of agents causing urinary infections in children in the period 1997-1999. MATERIAL AND METHODS: In the study period, 5,525 strains were analyzed. Of these, 2,307 came from pediatric patients (1,495 hospitalized and 803 ambulatory). RESULTS: The most common causative agent was E. coli in 74.2% of cases, followed by Klebsiella spp in 8.2% and other agents in a lower frequency. Of E. coli strains, 74% were resistant to ampicillin, 52% to clotrimoxazole and 30% to first generation cephalosporins. These strains were sensitive to second and third generation cephalosporins, aminoglycosides, ciprofloxacin and nitrofurantoin. Strains from nosocomial or community infections had similar antimicrobial susceptibility. Klebsiella spp had a high rate of antimicrobial resistance (over 40%), that was even higher among nosocomial strains. It was 90% susceptible to ciprofloxacin and 100% to imipenem. All centers from which strains came had a similar pattern of susceptibility, with the exception of a pediatric center that had significantly higher resistance levels. CONCLUSIONS: The current therapeutic recommendations for urinary tract infections in children caused by E coli, are still pertinent, but the use of first generation cephalosporins must be cautious. The treatment of Klebsiella spp requires an individual antibiogram.

Adolescent↗
PubMed1996

Germicide effect of several glass ionomer cements.

One the most significant characteristics of glass ionomer cements is their ability to release fluoride compounds. This study was carried out to try establish relationships between this property and the possible effect on the growth of microorganisms that are found in carious lesions, Agar BHI medium containing Petri dishes were flooded with strains of Actinomyces naeslundii, Actinomyces israelii and Actinomyces odontolyticus. Cavities were then prepared in the agar and filled with mixtures of several glass ionomer cements. Some of them were polymerizable resin containing products. A zinc phosphate and a zinc oxide-eugenol cement were used as controls. After a seven day incubation at 37 degrees C under anaerobic conditions the inhibition halos around the specimens were measured in a way similar to that used for antibiograms. The statistical analysis of the results showed no significant differences among Actinomyces strains but a significant difference one among cements. Even when no definitive conclusions could be drawn it is worth taking into consideration the effect of glass ionomer cements on microorganisms such as the Actinomyces and continuing studies to establish more clearly what is required from the material to produce a clinically significant outcome.

Actinomyces↗
PubMed2001

[Basis and guidelines for empirical antibody therapy in the management of community-acquired pneumonia].

The choice of the antibiotic should be based on clinical, chest X-ray radiography and essentially microbiologic criteria. Incurrent practice treatment is more often empiric based on epidemiologic characteristics of the microbiologic agents and the particularities of each patient. A satisfactory approach requires, in addition, a perfect knowledge of different available antibiotics and the resistance of certain etiologic pathogens to these latters. because S. Pneumoniae is the most frequently encountered pathogen, B lactams and especially Penicillin G. and amoxicillin remain the most useful drugs prescribed for adults with risk factors. However, in advanced age patients and those with comorbidity, the spectrum should be enlarged and should include, besides S. Pneumoniae, H. influenzae and other Gram negative bacilli. When the pneumonia is more severe and has required hospitalization, the antimicrobial therapy must be immediate, multiple and large. The causal agent must be searched for desperately, so that the antimicrobial therapy can be adapted secondary to the results of the antibiogram.

Adult↗
PubMed1975

[Relation of intrahospital morbidity from staphylococcal infections to some properties of hospital strains].

Analysis of staphylococcus infection morbidity in a large obstetrical hospital for 5 years offered a possibility of establishing an association between the severity of the course of staphylococcus infections in patients, the bacteriophage type of the causative agent and its resistance to antibiotics. The qualitative changes in morbidity in the direction of the prevalence of minor forms and mild course ocurred in parallel with the changes of the leading bacteriophage type from the epidemic 75/77 and 80/81 to the nonepidemic bacteriophage types of the III bacteriophage group and the changes of the antibiograms of the causative agents in the direction of an increase in the number of strains sensitive to antibiotics. Since the severity of the course of staphylococcus infection characterized the pathogenicity of the strain of the causative agent a conclusion could be drawn on the association between the sign of virulence and determinants of the medicinal resistance and definite prophages in the hospital strains of staphylococcus.

Adult↗
PubMed2001

Antimicrobial resistance of Shigella spp isolated from diarrheal patients between 1989 and 1998 in Vietnam.

Shigellosis is an important cause of infectious diarrhea in Vietnam, caused mainly by Shigella flexneri. This study provides for the first time in the international literature, data on the development of antimicrobial resistance in Shigella between 1988 to 1998, including data reported to the National Program for Surveillance of Antimicrobial Resistance (NPSAR). Our studies show that about 80% of the Shigella strains tested were resistant to ampicillin, chloramphenicol, oxytetracycline, trimethoprim and sulfonamides. This combination of drugs was also the most common antibiogram among multiple-resistant S. flexneri (57%). Resistance to tetracyclines, sulfonamides and, in particular trimethoprim (p<0.001), increased during the study period. Our findings indicate that tetracyclines and co-trimoxazole (a combination of a sulfonamide and trimethoprim), which are recommended and commonly used drugs for the treatment of shigellosis in Vietnam, may have limited therapeutic effect. In contrast to neighboring countries, low percentages of resistance were found to nalidixic acid and norfloxacin (3-5%) and no resistance was found to ciprofloxacin, indicating that nalidixic acid with its low cost and safety in children could be recommended for the treatment of shigellosis. The NPSAR provides a useful picture of the levels and development of antimicrobial resistance in Vietnam and should receive continued support for further improvement by increasing the number of provinces covered, the numbers of isolates tested from rural areas, and the communication of results to medical practitioners and others prescribing and/or selling antimicrobials.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Clinical and biological study of acute diarrhea with mixed etiology in 48 patients].

OBJECTIVES: The study of incidence, clinical manifestation and treatment of acute diarrhea with mixed etiology. MATERIAL AND METHOD: Study of 48 patients with acute diarrhea with mixed etiology admitted in the Hospital of Infectious Diseases of Iaşi during 1995-1998. RESULTS: 12 cases (24%) were mixed bacterial infections with the following microorganisms associations: Salmonella + Shigella (10 cazuri); Salmonella + Yersinia enterocolitica (1 case); Salmonella + Rotavirus (1 case). 16 cases (44%) had mixed digestive infections with parasites, in double or triple associations: Giardia intestinalis + Ascaris lumbricoides (10 cases); Giardia intestinalis + Ascaris lumbricoides + Entamoeba coli (1 case); Giardia intestinalis + Enterobius vermicularis (3 cases); Ascaris lumbricoides + Trichiuris trichiura (2 cases). The rest of 20 cases presented mixed infections with bacteria and parasites: Salmonella + Rotavirus + Giardia (2 cases), Salmonella + Shigella + Giardia intestinalis or Ascaris lumbricoides (6 cases), Salmonella + Giardia intestinalis (8 cases); Salmonella + Entamoeba coli (3 cases); Shigella + Trichiura trichiuris + Entamoeba coli (1 case). The majority was male patients from rural areas with age between 5 month and 56 years, the majority being children, 4 cases were found in immunosupressed patients. The clinical symptomatology was dominated by diarrheal syndrome (100%) and the diagnosis was established by clinical characters and confirmed by coproculture and parasitologic exam. The ethiological therapy was guided by antibiogram, in the majority of cases we used fluorochinolones (associated with ceftriaxone in severe cases), together with antiparasitic medications. CONCLUSIONS: In this study predominated the bacterial and parasitic infections, most frequently being isolated Salmonella, Shigella and Giardia intestinalis; the therapy associated fluorochinolones with antiparasitic medication.

Adolescent↗
PubMed2002

[Antibiotic sensitivity of Salmonella isolated in army hospitals between 1998-1999].

OBJECTIVES: Monitor the evolution in France of antibiotic sensitivity of non-typhoid salmonella isolated in fecal cultures conducted in army hospital laboratories. METHODS: A prospective study was performed from January 1998 to December 1999 in all the biology departments of the 11 army hospitals in France. All the non-repetitive strains were sent to an official center for serotyping and determination of the minimum inhibiting concentrations, by dilution in Mueller Hinton's gelose. The antibiotics currently used in treatment were tested and interpretation endpoints followed the recent recommendations of the Antibiogram committee of the French society of microbiology. Identification of beta-lactamase was conducted by iso-electric focalization and polymerization by chain reaction (PCR). For Salmonella Typhimurium, research for the specific resistance locus of the DT104 clone was made using PCR. RESULTS: Two hundred and twenty-two non-repetitive salmonella strains were isolated. The principle serotypes found were: Salmonella Enterididis (23.9%), S. Typhimurium (21.2%) and S. Hadar (10.8%). All the strains were sensitive to ciprofloxacin and cefotaxim, whereas one third exhibited reduced sensitivity to aminopenicillin. Depending on the serotype, Typhimurium and Hadar serotypes exhibited significantly lesser sensitivity to aminopenicillin, nalidixic acid and tetracycline. For S. Typhimurium, resistance is related to the diffusion of the multiresistant DT104 clone, which involves half of the strains of this serotype. For S. Hadar, 18 out of 24 strains (75%) were resistance to nalidixic acid, and 5 of them exhibited reduced resistance to ciprofloxacin. There was no difference in sensitivity to antibiotics between the strains responsible for diarrhea and those isolated in systematic examinations for capacity to work in the food trade (respectively 54 and 46% of strains). CONCLUSION: Non-typhoid salmonella are frequently isolated in diarrhea of infectious origin. The increasing resistance to antibiotics is primarily related to the diffusion of the DT104 clone, regarding S. Typhimurium and to the increase in resistance to quinolone, regarding S. Hadar.

Anti-Bacterial Agents↗