Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “pathogen isolation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,243 records · Page 69Linked to original sources
PubMedDate not supplied

[Clinical and laboratory findings in a series of cases of infective endocarditis].

OBJECTIVE: To describe clinical and laboratory data of infective endocarditis (IE) in 28 children from Vitória, state of Espírito Santo, Brazil. METHODS: We reviewed the medical records of 28 children aged 18 years and under admitted to the Infectious Diseases Unit of Nossa Senhora da Glória Children's Hospital with a diagnosis of IE from January 1993 to December 2001. The diagnosis of IE was based on the criteria established by the Duke Endocarditis Service (Duke University, Durham, North Carolina, USA): positive blood cultures and echocardiogram (primary criteria); and fever, history of heart disease, recent heart murmur, and vascular and immunological phenomena (secondary criteria). A specific protocol was filled out by interns and medical students and revised by physicians from the hospital medical team to obtain the following data: age, sex, clinical and laboratory findings, and results of transthoracic echocardiography. In all cases, three blood samples were collected under aseptic conditions and inoculated in aerobic and anaerobic environments. The samples were then incubated at 37 degrees C and tested with the VITEC SYSTEM automatized system (BIOLAB). RESULTS: Among 28 patients, 16 were boys. Age was between 3 and 180 months (mean 70.6 +/- 59.2 months). Most children (68%) came from the metropolitan area of Vitória, and half presented a history of cardiopathy. The most frequent clinical findings which led to suspicion of IE were: prolonged fever in all cases, new or changing regurgitant murmur (67.9%), dyspnea (57.1%), hepatomegaly (57.1%), vascular phenomena (32.2%), splenomegaly (28.6%), and Osler's nodes (7.1%). Blood cultures were positive in 16 patients (57.1%), and community-acquired S. aureus was the most frequently isolated pathogen (56.6%). Despite the treatment, fever persisted for 2.5 to 30 days (median=18.0 days). Mean leukocyte count at admission was 11,657 +/- 7,085 mm3. Transthoracic echocardiography showed endocardial lesion in all patients, evidencing vegetations in the tricuspid valve (25%), mitral valve (25%), and intraventricular communication border (28%). Thirteen (46.4%) children presented concomitant sepsis and three (10.7%) developed hospital-acquired infection. There was one death (3.6%). CONCLUSIONS: IE in our country is frequent among children younger than 2 years with congenital cardiopathy. Community-acquired S. aureus was the most frequently isolated microorganism in children with no previous cardiac lesion. Acute infective endocarditis, bacterial endocarditis, Staphylococcus aureus, transthoracic echocardiography.

Adolescent↗
PubMed2006

[Resistance of Staphylococcus aureus isolated from burn wounds to antibiotics].

OBJECTIVE: To determine the colonization rate of Staphylococcus aureus in burn wounds and to assess the variation in the resistance of Staphylococcus aureus strains to antibiotics. MATERIAL AND METHODS: A retrospective study of 72 patients with burn wounds was carried out during 1997 and 2003. Specimens taken from burn wounds at first, fifth, and later every seventh day of hospitalization were placed in transport medium. Isolates were grown on mannitol salt agar. Cultures of Staphylococcus aureus were determined using plasmacoagulase and DNA-ase tests. The resistance of Staphylococcus aureus strains to penicillin, oxacillin, ceftazidime, vancomycin, gentamicin, kanamycin, tobramycin, doxycycline, ciprofloxacin, cefepime, fusidic acid, and clindamycin was determined. The isolated strains of Staphylococcus aureus were tested for resistance to methicillin by performing a disc diffusion method using commercial discs (Oxoid) (5 microg methicillin per disk and 1 microg oxacillin per disk). RESULTS: During 1997-2003, a total of 221 Staphylococcus aureus cultures were isolated from burn wounds. More than one-fourth of all isolated Staphylococcus aureus strains (25.3%) were resistant to methicillin; 64% of methicillin-sensitive Staphylococcus aureus strains were resistant to clindamycin and 28-30% - to gentamicin and kanamycin. The resistance rate of methicillin-resistant Staphylococcus aureus strains to doxycycline, clindamycin, oxacillin, tobramycin, gentamicin, and kanamycin was 78.5-98%. Majority of Staphylococcus aureus strains were non-susceptible to ceftazidime (91-100%); the rate of resistance to clindamycin decreased from 99% to 36%, (p<0.05) and to ciprofloxacin - increased from 55-65% to 81% (p<0.05). CONCLUSIONS: Staphylococcus aureus was the most prevalent pathogen isolated from burn wounds. On the first day of hospitalization Staphylococcus aureus isolates were obtained from 25.3% of patients; 12.5% of patients with burn wounds had methicillin-resistant Staphylococcus aureus at the end of the first week of hospitalization and 66% of patients--after two weeks and later. The resistance of methicillin-susceptible Staphylococcus aureus to gentamicin, tobramycin, and clindamycin decreased. The resistance of methicillin-resistant Staphylococcus aureus to clindamycin decreased and to ciprofloxacin--increased.

Anti-Bacterial Agents↗
PubMed2000

Clinicomicrobiologic evaluation of active tubotympanic type chronic suppurative otitis media.

OBJECTIVES: This prospective study was conducted to determine the spectrum of micro-organisms encountered in patients with active-stage chronic suppurative otitis media (CSOM) (tubotympanic type) and to see whether prescribing an antibiotic after culture sensitivity was more beneficial as compared to initial treatment without cultures. DESIGN: Prospective randomized study of 110 patients of active CSOM (tubotympanic type) divided into two groups of 55 cases each. SETTING: Departments of Ear, Nose and Throat and Microbiology of a tertiary care hospital. METHODS: The patients in group A were prescribed an antibiotic according to the culture and sensitivity, whereas in group B, culture was not done at the first visit, and a broad-spectrum antimicrobial, namely, co-trimoxazole, was prescribed blindly for a maximum period of 2 weeks. The cases that still had ear discharge were then subjected to culture and sensitivity and the antibiotic was prescribed accordingly. MAIN OUTCOME MEASURES: All patients in group A were subjected to bacterial culture and sensitivity and fungal culture. Only failed cases in group B were subjected to the same. RESULTS: In group A, 47 patients (85.50%) had positive bacterial culture and 20 patients had positive fungal culture. Pseudomonas aeruginosa was the most common bacterial isolate. All of these 47 patients had a dry ear with a maximum 2 weeks of antibiotic therapy. Among the remaining 8 patients who had negative bacterial culture, 5 patients (9.0%) showed fungal isolates on culture and responded to topical antifungal treatment. The remaining 3 failed cases (5.5%) responded to daily dry mopping alone. In group B, 41 patients (74.54%) attained a dry ear. Bacterial culture and sensitivity were done in the remaining 14 (25.46%) failed cases. The culture was positive in 11 patients (20.0%) and sterile in 3 patients (5.5%). In the latter group, only 1 patient had fungus on culture and the remaining 2 patients responded to daily dry mopping alone, which was done at a maximum for a week only. The most common fungal pathogen isolated was Aspergillus flavus. CONCLUSIONS: Pseudomonas aeruginosa was the most common bacteria and Aspergillus flavus the most common fungus isolated in this study. In group A patients, the failed cases were less as compared to the control group B, but the p value was .2. Hence, there is no definite role of culture and sensitivity in the initial management plan of all cases of CSOM. Ideally, every such case should be prescribed a broad-spectrum antibiotic and only in failed cases should culture and sensitivity be done.

Adolescent↗
PubMed2005

Prevalence of nosocomial infection and antibiotic use at a university medical center in Malaysia.

BACKGROUND AND OBJECTIVE: Most reports of nosocomial infection (NI) prevalence have come from developed countries with established infection control programs. In developing countries, infection control is often not as well established due to lack of staff and resources. We examined the rate of NI in our institution. METHODS: A point-prevalence study of NI and antibiotic prescribing was conducted. On July 16 and 17, 2001, all inpatients were surveyed for NI, risk factors, pathogens isolated, and antibiotics prescribed and their indication. NIs were diagnosed according to CDC criteria. Cost of antibiotic acquisition was calculated by treatment indication. SETTING: Tertiary-care referral center in Malaysia. PATIENTS: All inpatients during the time of the study. RESULTS: Five hundred thirty-eight patients were surveyed. Seventy-five had 103 NIs for a prevalence of 13.9%. The most common NIs were urinary tract infections (12.2%), pneumonia (21.4%), laboratory-confirmed bloodstream infections (12.2%), deep surgical wound infections (11.2%), and clinical sepsis (22.4%). Pseudomonas aeruginosa, MRSA, and MSSA were the most common pathogens. Two hundred thirty-seven patients were taking 347 courses of antibiotics, for an overall prevalence of antibiotic use of 44%. NI treatment accounted for 36% of antibiotic courses prescribed but 47% of antibiotic cost. Cost of antibiotic acquisition for NI treatment was estimated to be approximately 2 million per year (Malaysian dollars). CONCLUSION: Whereas the rate of NI is relatively high at our center compared with rates from previous reports, antibiotic use is among the highest reported in any study of this kind. Further research into this high rate of antibiotic use is urgently required.

Academic Medical Centers↗
PubMed1998

Clinical significance of alimentary tract microbes in bone marrow transplant recipients.

A prospective study on the microbes isolated from the alimentary tract in 120 bone marrow transplant (BMT) recipients (1991-1993) was undertaken to define the spectrum of organisms isolated under antimicrobial prophylaxis, their temporal sequence of emergence, and the associated morbidity and mortality. Clostridium difficile (n = 20), isolated in the pre-engraftment and early post-engraftment periods (day 2-45 post-BMT), was the most common microbe recovered from stool of patients with diarrhea. In contrast to previous reports, no significant difference in mortality was observed between patients with and without C. difficile isolated in stool. Two patients had neutropenic ileocecitis with concomitant bacteremia due to Escherichia coli and Klebsiella pneumoniae. One patient was found to have astrovirus gastroenteritis (day 7), and Giardia lamblia was recovered from the stool of another (day -7). Heavy growth of Staphylococcus aureus from direct smear-positive specimens was found from the upper airway of two patients with severe mucositis and complete dysphagia (day 12 and 23). Salmonella spp. of groups B and E were found in the stool of five asymptomatic patients at the time of conditioning. No specific organisms was recovered from the endoscopic brushing of two patients with lower end esophagitis, three patients with upper gastrointestinal bleeding, and three patients with perirectal cellulitis. During the post-engraftment period, five patients had documented cytomegalovirus gastroenterocolitis (days 34-97), one had Mycobacterium chelonae colitis (day 70), and another had nodular gastritis due to Acremonium falciforme (day 270). Overall, only 28% of patients with alimentary tract symptoms/syndrome had specific pathogens isolated from clinical specimens. Differentiation of the causation of alimentary tract symptoms was often difficult because noninfectious complications such as conditioning toxicity, graft-versus-host disease, and its treatment often caused alimentary tract symptoms in addition to predisposed BMT patient to infection. The reluctance of obtaining tissue biopsy for ascertaining the importance of those potential alimentary tract pathogens often dictate the use of empirical treatment.

Adolescent↗
PubMed1991

Synergistic antibacterial interaction of cefotaxime and desacetylcefotaxime.

Cefotaxime (CTX) is metabolized in desacetylcefotaxime (dCTX), a less potent compound which shows, however, a higher stability against selected beta-lactamases produced by Gram-negative organisms. The aim of this study was to verify if the antimicrobial activity of CTX against 260 clinical aerobic and anaerobic pathogens isolated in our institution was enhanced by its metabolic derivative dCTX. The combination of CTX and dCTX, assessed by checkerboard titration, was completely or partially synergistic towards 61% of the 220 aerobic organisms tested and against 68% of the 40 Bacteroides strains analyzed. In addition we have investigated, by the time-kill method, the in-vitro interactions against 50 aerobic strains of CTX and dCTX alone and in combination with netilmicin, a drug often employed in severe infections in combination with beta-lactam agents in order to provide effective killing of resistant nosocomial pathogens. Time-kill studies indicated that 36% of the aerobic nosocomial strains were synergistically inhibited by the combination of CTX/dCTX with netilmicin. These results indicate that dCTX makes an important contribution to the clinical efficacy of CTX.

Bacteria↗
PubMed1996

Neonatal meningitis in northern Jordan.

A two-and-a-half year prospective study of neonatal meningitis in the two main referral hospitals in Northern Jordan was carried out to determine the clinical spectrum and particular characteristics of meningitis in the newborn. The 53 cases studied represented an incidence of 1.1 per 1000 live births. The commonest bacterial pathogen isolated was Klebsiella species (40 per cent) followed by Enterobacter (19 per cent). The mortality rate and neurological sequelae among surviving children were 32 and 39 per cent, respectively, with higher rates among preterm/low birth weight and early onset meningitis groups. Of the presenting clinical features, there was a highly positive association between two risk factors and outcome. A bulging anterior fontanelle was the only significant predictor of mortality (P = 0.009) and altered sensorium was the only predictive of post-meningitis sequelae (P = 0.016). The need to recognize that Klebsiella species is an increasingly important pathogen; cefotaxime or ceftazidime plus ampicillin are the most appropriate antibiotics to be used initially, and continuous surveillance thereafter have been stressed.

Anti-Bacterial Agents↗
PubMed1988

Cryptosporidium, malnutrition, and chronic diarrhea in children.

Cryptosporidium was found in the stools of 13.5% of 221 children hospitalized with diarrhea. It was the single most prevalent pathogen isolated. Children with Cryptosporidium-positive stools were significantly more malnourished than children in whom Cryptosporidium was not detected. Children with more severe malnutrition (ie, less than 50% of their expected weight) and with Cryptosporidium in their stools had a significantly longer duration of diarrhea than similarly malnourished children without Cryptosporidium (63 vs 32 days, respectively). In 77 better-nourished outpatients with diarrhea, Cryptosporidium was found in only 5.2% of cases and was associated with less-severe illness. Our findings are consistent with the hypothesis that in less-developed areas, Cryptosporidium is a major pathogen, not only in acute but also in chronic childhood diarrhea, and may play an important role in the interaction between diarrhea and malnutrition.

Body Weight↗
PubMedDate not supplied

Liver abscess in children: a single institutional experience in southern Taiwan.

Liver abscess is uncommon in children. The purpose of this study is to evaluate the predisposing factors, pathogens, duration of hospitalization, and the managements of liver abscess in children. From 1986 to 2001, fifteen children were admitted to our hospital under the diagnosis of liver abscess. Thirteen cases were older than 8 years old and two were younger than one year old. Fever (15/15, 100%) and abdominal pain (13/15, 87%) were the most common symptoms. Twelve patients (80%) had prolonged fever (fever for 7 days or longer before diagnosis). Eleven (73%) cases were cryptogenic in origin. Most of the microorganisms were obtained solely from cultures of pus. Klebsiella pneumoniae was the most common organism isolated (6/15, 40%). Beside administration of antibiotics, percutaneous catheter drainage (PCD) was performed in 11 patients (73%); only one underwent surgical intervention due to poor response to PCD management. All of our patients were surviving after at least one year follow-up. In conclusion, liver abscess should be suspected in the patients with prolonged fever of unknown origin and abdominal pain. PCD combined with adequate antibiotics were sufficient for therapy of liver abscess in most cases. K. pneumoniae was the most common isolated pathogen in southern Taiwan.

Adolescent↗
PubMed1982

Clostridium difficile in association with sporadic diarrhoea.

A total of 154 patients admitted to an infectious diseases unit were included in a year's prospective survey of sporadic diarrhoeal disease. Stools from 19 of them yielded Clostridium difficile, generally on more than one occasion. Twelve of these patients were assessed as having a severe or moderately severe gastrointestinal illness: Cl difficile was the only pathogen isolated from 10 of them, and two had an associated salmonella infection. Seven had had a recent course of antibiotics, but five had not taken antibiotics. Faeces from seven patients with moderate or mild gastrointestinal illness yielded Cl difficile, and two of these patients also had an associated salmonella infection. Two patients in this group had no antibiotic history. From these findings, the occurrence of C difficile in faeces could not be described as antibiotic-associated. Faecal Cl difficile cytotoxin was detected in only six patients, and generally at low levels. In such patients a more relevant pathogenic index might take account of the numbers of Cl difficile present and of their toxigenic potential.

Adult↗
PubMed2002

Haemophilus influenzae in respiratory tract infections in community-based clinical practice: therapy with gatifloxacin.

In this community-based safety surveillance study, the advanced-generation fluoroquinolone gatifloxacin was administered empirically to 15625 adults with community-acquired respiratory tract infections (RTIs), including 1562 clinically evaluable patients with community-acquired pneumonia (CAP) and 2391 with acute exacerbations of chronic bronchitis (AECB). Haemophilus influenzae was the most common pathogen isolated in AECB (40.1%) and the second most common in CAP (36.8%). In vitro susceptibility to gatifloxacin and other fluoroquinolones, amoxicillin/clavulanate, ceftriaxone, cefuroxime axetil, tetracycline, and azithromycin ranged from 95.8% to 100%. In comparison, a significant percentage of the isolates were not susceptible to clarithromycin ( approximately 41%), ampicillin (22% to 28%), and trimethoprim/sulfamethoxazole (14% to 18%). The susceptibility pattern was generally independent of exposure to another antimicrobial in the previous 30 days. CAP and AECB patients infected with H. influenzae had signs and symptoms similar to those infected with Streptococcus pneumoniae. Among clinically evaluable patients with H. influenzae, gatifloxacin cured 159 of 166 (95.8%) with AECB and 112 of 118 (94.9%) with CAP. The cure rate was independent of the beta-lactamase status or serotype of the H. influenzae strain. H. influenzae is not a more benign pathogen in community-acquired RTIs but causes signs and symptoms that are indistinguishable from those caused by other pathogens, notably S. pneumoniae.

Administration, Oral↗
PubMedDate not supplied

Incidence of pulmonary disease caused by mycobacteria other than tuberculosis in British Columbia.

CONTEXT: The incidence of pulmonary disease due to mycobacteria other than tuberculosis (TB) in Canada has not been documented. OBJECTIVE: To determine the incidence of pulmonary disease due to mycobacteria in the nonimmunocompromised population of British Columbia. DESIGN: A retrospective cohort study of 110 cases of mycobacteria infection other than TB identified from 1991 to 1995. SETTING: British Columbia Centre for Disease Control, Division of TB Control. RESULTS: The overall incidence rate of infection with mycobacteria other than TB was 0.63 10-5/year. This incidence rate was significantly higher among women (relative risk [RR]=2, P=0.0006) and in those aged 55 years or older (RR=8, P<0.00001). In contrast with TB, patients were more frequently born in Canada (P<0.00001) or in industrialized countries other than Canada (P<0.00001), and were less likely to be Aboriginal (P=0.0007) or foreign born from Asia (P<0.0001). The most common organism isolated in British Columbia was Mycobacterium avium-intracellulare (82.7%). Overall, 78 (71%) cases had underlying lung disease. Drug intolerance was very common (42%). After treatment, 55% and 41% of the patients were rendered smear negative or culture negative, respectively. Radiological improvement was noted in 55% of patients, and 60% of patients responded symptomatically to treatment. CONCLUSIONS: The overall incidence of pulmonary disease is low. It is a disease predominantly of women 55 years and older, and targets completely different ethnic groups than TB, suggesting a protective effect of infection with Mycobacterium tuberculosis. M avium-intracellulare was the most common pathogen isolated. Further investigation is required into the natural history of so-called 'colonizers'. Considerable morbidity may be prevented with earlier intervention.

British Columbia↗
PubMed1979

Comparative study of erythromycin, amoxicillin and ampicillin antimicrobial activity against human respiratory tract pathogens.

An in vitro test system was used to compare the antimicrobial activity of erythromycin, amoxicillin and ampicillin against respiratory tract pathogens isolated from man. The minimum inhibitory concentrations (MICs) of fresh clinical isolates of Streptoccus pyogenes, Streptocuccus pneumoniae, Staphylococcus aureus and Haemophilus influenzae to the macrolide and penicillins ranged between 0.01 and 0.9 microgram/ml. The microbes were exposed to each antibiotic for approximately 3 h at 1x,2x and 5x the relevant MIC. Irreversible surface defects and intracellular lesions were resolved by scanning and transmission electron microscopy in all antibiotic-treated bacterial species, irrespective of the antimicrobial used. In each case, inhibition of growth was recorded by turbometric assay; no significant difference was observed among the declining slopes of post-dosing growth curves for either erythromycin-, amoxicillin- or ampicillin-treated pathogens. The experimental observations show that the onset of antimicrobial activity and the bactericidal effectiveness of equipotent concentrations of erythromycin, amoxicillin and ampicillin were comparable in this study. The results complement previous clinical, bacteriologic and ultrastructure studies in vivo and demonstrate the contribution of the combined in vivo/in vitro study design for better understanding of antimicrobial activity in human respiratory tract infections.

Amoxicillin↗
PubMed2006

Pharmacokinetically enhanced amoxicillin/clavulanate (2,000/125 mg) in acute bacterial rhinosinusitis caused by Streptococcus pneumoniae, including penicillin-resistant strains.

We evaluated the efficacy of a new pharmacokinetically enhanced formulation of amoxicillin/clavulanate (2,000/125 mg) twice daily for the treatment of acute bacterial rhinosinusitis (ABRS) caused by Streptococcus pneumoniae, particularly penicillin-resistant S pneumoniae (PRSP; penicillin minimum inhibitory concentrations [MICs]: > or = 2 microg/ml. A total of 2,482 patients received study medication (safety population). Of these, 2,324 were clinically evaluable (efficacy population), and 1,156 of them had at least one pathogen isolated at screening (bacteriology population). S pneumoniae was isolated from 371 patients in the bacteriology population, including 37 with PRSP. Follow-up in the bacteriology population on days 17 through 28 revealed that amoxicillin/clavulanate therapy was successful in 345 of 371 patients with S pneumoniae infection (93.0%) and in 36 of 37patients with PRSP infection (97.3%), including 7 of 8 patients (87.5%) whose amoxicillin/clavulanic acid MICs were 4/2 microg/ml or higher. Pharmacokinetically enhanced amoxicillin/clavulanate was generally well tolerated, as only 2.2% of patients withdrew because of adverse events. This agent represents a valuable new therapeutic option for the empiric treatment of ABRS, particularly in areas where antimicrobial-resistant pathogens (including beta-lactamase-positive organisms) are prevalent, and for the treatment of patients who are at increased risk of infection with PRSP.

Acute Disease↗
PubMed1992

Streptococcus salivarius bacteremia and meningitis following upper gastrointestinal endoscopy and cauterization for gastric bleeding.

Streptococcus salivarius is a normal inhabitant of the oral cavity. When isolated from blood cultures, this viridans streptococcus is often disregarded as a contaminant. Viridans streptococci, although a common cause of endocarditis, are rarely associated with bacterial meningitis and account for less than 1% of all cases of purulent meningitis. We report a case of bacteremia and meningitis due to S. salivarius that occurred in a patient who underwent upper gastrointestinal endoscopy and cauterization for control of gastric bleeding. Although bacteremia following gastrointestinal procedures has been well documented, its incidence is low (ranging from 2% to 10%), and its course is usually transient without major clinical sequelae. This case is unique with respect to the pathogen isolated, the length of bacteremia, and the meningitis that subsequently developed following a gastroesophageal procedure.

Bacteremia↗
PubMed2004

Tissue and serum levofloxacin concentrations in diabetic foot infection patients.

OBJECTIVES: Levofloxacin has a high bioavailability and a broad antibacterial spectrum which covers the common pathogens found in acute and chronic diabetic foot infections. The purpose of our study was to determine the serum and tissue concentrations of levofloxacin when administered orally in patients with infected diabetic foot ulcers and to compare these values with microbiological findings. PATIENTS AND METHODS: Ten outpatients with diabetes and ulcerations of the lower extremity were included. All patients received oral levofloxacin therapy at a dose of 500 mg once daily. Wound tissue and serum samples were collected and levofloxacin concentrations determined by HPLC with fluorescence detection. Additionally, microbiological cultures were performed from swabs and debrided wound tissue, both before and after treatment. MICs of levofloxacin for all bacterial isolates were determined using the Etest. RESULTS: Following oral treatment with levofloxacin for an average of 10 +/- 3.8 days, all patients received debridement at the affected limbs. The levofloxacin concentrations in necrotic wound tissue were between 2.33-23.23 mg/kg and between 0.12-6.41 mg/L in serum. Tissue-to-serum ratios of levofloxacin concentrations for each patient were >1.0. The MIC values for all 17 initially isolated bacteria were < or = 2 mg/L. In half of our patients, fluoroquinolones were one of the few oral monotherapy options where the spectrum covered all initially isolated pathogens. CONCLUSION: Our data showed good tissue penetration of levofloxacin in diabetic foot ulcers. In combination with adequate surgical debridement, levofloxacin seems well suited to the treatment of skin structure infections of diabetics caused by susceptible organisms.

Administration, Oral↗
PubMed2002

The effect of pathogen-specific clinical mastitis on the lactation curve for somatic cell count.

Data from 274 Dutch herds recording clinical mastitis (CM) over an 18-mo period were used to investigate the effect of pathogen-specific CM on the lactation curve for somatic cell count (SCC). Analyzed pathogens were Staphylococcus aureus, coagulase-negative staphylococci, Escherichia coli, Streptococcus dysgalactiae, Streptococcus uberis, other streptococci, and the culture-negative samples. The dataset contained 178,754 test-day records on SCC, recorded in 26,411 lactations of 21,525 cows of different parities. In lactations without both clinical and subclinical mastitis, SCC was high shortly after parturition, decreased to a minimum at 50 days in milk (DIM), and increased slowly toward the end of the lactation. Effects of CM on lactation curves for SCC differed among the pathogens isolated. Before a case of clinical E. coli mastitis occurred, SCC was close to the SCC of lactations without both clinical and subclinical mastitis, and after the case of CM had occurred, SCC returned rather quickly to a low level again. Similar curves were found for lactations with cases of CM associated with culture-negative samples. Before a case of clinical Staph. aureus mastitis occurred, average SCC was already high, and it remained high after the occurrence. Effects of CM associated with Strep. dysgalactiae, Strep. uberis, and other streptococci on the lactation curve for SCC were comparable. They showed a continuous increase in SCC until the case of pathogen-specific CM occurred, and afterwards SCC stayed at a higher level. Using SCC test-day records, these typical characteristics of each pathogen may be used to find more effective indicators of CM.

Animals↗
PubMed2001

Community-acquired pneumonia in patients requiring hospitalization.

OBJECTIVE: This study aimed to investigate the microbial aetiology of community-acquired pneumonia (CAP) in patients requiring hospitalization. METHODOLOGY: A prospective study of consecutive non-immunocompromised patients aged 12 years and above admitted with CAP from August 1997 to May 1999 was undertaken. RESULTS: Of 127 patients hospitalized for CAP, an aetiological diagnosis was achieved in 53 cases (41.7%). Klebsiella pneumoniae was the most frequently isolated pathogen and caused 10.2% of all the cases, followed by Streptococcus pneumoniae (5.5%), Haemophilus influenzae (5.5%), Mycoplasma pneumoniae (3.9%) and Pseudomonas aeruginosa (3.9%). Gram-negative bacilli were significantly more frequently identified in patients aged 60 years or older and in patients with comorbid illnesses. Twelve of 13 patients who died from CAP had other comorbid illnesses compared to 63 of 114 patients who survived (P = 0.014). Three of eight bacteraemic patients died compared with 10 of 119 non-bacteraemic patients (P = 0.035). CONCLUSIONS: The microbiology of CAP in patients requiring hospitalization in Malaysia appears to be different from that in Western countries. Gram-negative bacilli were more frequently isolated in older patients and in those with comorbidity. Mortality from CAP is more likely in patients with comorbidity and in those who are bacteraemic.

Adolescent↗