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PubMed1992

Cefodizime: the Japanese clinical experience.

In a clinical trial conducted in Japan from 1985-1988, the efficacy of cefodizime was studied in 2,227 adult and 449 pediatric patients. Of these, 1,366 adult and 203 pediatric patients had pathogens isolated and were evaluable. Cefodizime was effective in 78.8% of the adult patients, and adverse reactions occurred in 2.3%. In pediatric patients cefodizime was effective in 91.1% of the cases, and adverse reactions developed in 5.1%. A very high concentration of cefodizime is achieved in blood soon after administration and its penetration into tissues is also high. Moreover, cefodizime exhibits phagocytosis enhancement activity. The above-mentioned excellent efficacy rates, low rates of side effects and enhancement of phagocytic activity make cefodizime an antibiotic of choice in adult and pediatric patients.

Adolescent↗
PubMed1993

[Possibilities for the use of 2nd generation cephalosporins in perioperative antibiotic prophylaxis].

Perioperative antibiotic prophylaxis has proven to prevent infections in a variety of surgical interventions such as colorectal, biliary and vascular surgery. The antimicrobial spectrum of an antibiotic used for perioperative prophylaxis should include Staphylococcus spp., Streptococcus spp. and Escherichia coli which are among the most frequent pathogens isolated from surgical infections. Second generation cephalosporins provide appropriate activity against these microorganisms. In colorectal surgery, combination with an anti-anaerobic agent is mandatory. During the past few years no major resistance development has been observed against second generation cephalosporins which are used at a dosage of 1.5 to 2 g. A single dose may provide sufficient serum levels for approximately three hours. Prolonged surgical procedures need an additional dose. Single dose prophylaxis with a second generation cephalosporin appears to be an appropriate strategy for infection prevention in surgery with regard to efficiency, safety and costs.

Bacterial Infections↗
PubMedDate not supplied

Acute mastoiditis--relevant once again.

During recent years, a significantly increased incidence of acute mastoiditis was observed at the University Children's Hospital, Tübingen, Germany (1975-1979: 1.4 patients/year; 1987-1992: 4.2 patients/year; p < 0.05). We therefore reviewed the records of all patients with acute mastoiditis (n = 58) that had been treated at the Children's Hospital between 1975 and 1992 and at the Clinic of Otorhinolaryngology between 1978 and 1992. The male to female ratio was 1.8:1 and 60.4% of the patients were younger than 24 months. Retroauricular swelling was more often observed (n = 49) than protrusion of the pinna (n = 45) and retroauricular redness (n = 38). Streptococcus pneumoniae was the most frequently isolated pathogen. Several factors predisposing for the development of acute mastoiditis were identified. These included withholding antimicrobials for treatment of the preceding episode of otitis media; use of suboptimal agents for therapy of otitis media (penicillin and, possibly, erythromycin ethylsuccinate); and insufficient duration of treatment.

Acute Disease↗
PubMedDate not supplied

Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women.

In a multicentre study 163 women with acute lower urinary tract infection were treated orally with either 125 mg cefuroxime axetil or 100 mg ofloxacin twice daily for three days. Both antimicrobial agents were generally well tolerated. Four patients in the group treated with cefuroxime axetil and two in the group treated with ofloxacin experienced adverse events. Clinical cure and improvement were registered in 56 of 66 (84.8%) and 59 of 62 (95.2%) of the evaluable patients treated with cefuroxime axetil and ofloxacin, respectively. Seven to nine days after therapy, bacteriuria (CFU < 10(3)/ml) had been eliminated in 53 of 66 (80.3%) and 57 of 64 (89.1%) of the evaluable patients receiving cefuroxime axetil and ofloxacin, respectively. The results were not statistically significantly different (p > 0.1). Pathogens present at baseline were eliminated by up to an MIC of 16 mg/l of cefuroxime axetil, independent of susceptibility to this agent. There was no difference with regard to efficacy and tolerance between patients treated with cefuroxime axetil and those treated with ofloxacin. On the basis of the MICs of six antimicrobial agents (cefuroxime, ofloxacin, cefadroxil, ampicillin, trimethoprim with and without sulfamethoxazole) determined for the pathogens isolated prior to therapy, resistance rates were lowest for cefuroxime (2.2%) and ofloxacin (3.4%).

Acute Disease↗
PubMed1989

Candidiasis.

Candida spp. are the most common fungal pathogens isolated in immunocompromised hosts, particularly cancer patients. Numerous clinical manifestations of candidiasis have been recognized, including localized infection such as oropharyngeal candidiasis or focal hepatic candidiasis, and disseminated infection resulting from hematogenous spread, with or without documented fungemia. Granulocytopenic patients are particularly at risk. Candida albicans is isolated in approximately 40% of cases of fungemia, other Candida spp. now also commonly being isolated. The rate of morbidity and mortality secondary to candidiasis is still significant despite numerous attempts to develop better diagnostic techniques, and more effective means of chemoprophylaxis and therapy. Currently, new antifungal agents and galenic preparations of amphotericin B are being evaluated with the aim of improving the prognosis of candidiasis in immunocompromised hosts.

Candida↗
PubMed1994

Severe diarrhea associated with Arcobacter butzleri.

Two patients with chronic disease (diabetes mellitus type I, hyperuricemia and alcohol abuse, respectively) were hospitalized with persistent diarrhea and severe abdominal cramps. Using routine methods, the only pathogen isolated in stool specimens was Arcobacter butzleri. In both cases acute symptoms subsided quickly after antibiotic therapy. After termination of antibiotic treatment, Arcobacter butzleri could no longer be detected in stool specimens. Although very little is known about the clinical significance of Arcobacter butzleri infections in humans, it is highly likely that in both cases Arcobacter butzleri played a major causative role in acute disease.

Diarrhea↗
PubMed1994

Randomized comparative trial with ampicillin/sulbactam versus cefamandole in the therapy of community acquired pneumonia.

In a randomized prospective study ampicillin/sulbactam and cefamandole were compared in the therapy of patients hospitalized with community acquired pneumonia. Patients receiving ampicillin/sulbactam (n = 37) and cefamandole (n = 38) were similar with respect to age (mean age 70 vs. 76 years respectively), clinical characteristics, severity of illness and underlying disease. Pathogens isolated from patients in the cefamandole and ampicillin/sulbactam group, respectively, were Streptococcus pneumoniae (7 vs. 7 patients), Haemophilus parainfluenzae (7 vs. 6 patients), Haemophilus influenzae (5 vs. 5 patients), Staphylococcus aureus (5 vs. 4 patients), Escherichia coli (4 vs. 4 patients), Klebsiella pneumoniae (3 vs. 3 patients), Enterobacter spp. (2 vs. 3 patients), Moraxella catarrhalis (1 vs. 2 patients), and organisms of the oral flora (4 vs. 3 patients). The rate of resistance to penicillin was 80%, to clindamycin 76%, to erythromycin 45%, to ampicillin 43%, and to cefazolin 18%. Overall successful treatment rates of 81% for cefamandole and 97% for ampicillin/sulbactam (p = 0.05) were observed. Both cefamandole and ampicillin/sulbactam were shown to be effective agents for therapy of community acquired pneumonia; however ampicillin/sulbactam demonstrated superior overall clinical efficacy.

Adult↗
PubMed1985

Analysis of thirty-seven cases of pleural empyema.

A retrospective analysis of 37 pediatric patients with pleural empyema revealed that Streptoccoccus pneumoniae was the most frequently isolated pathogen (41%), followed by Staphylococcus aureus (14%). Twenty-three patients were treated with thoracic drainage and systemic antibiotics, and the other 14 patients with antibiotics only. The case fatality ratio (11%), the complication rate (38%), the length of hospital stay, and the number of febrile days did not differ significantly between the two treatment groups. The immediate insertion of drainage tubes is probably not indicated in all children with pleural empyema but should be reserved for specific indications.

Adolescent↗
PubMed1994

Hydrophobic bile salt inhibits bacterial adhesion on biliary stent material.

Blockage of indwelling biliary stents is caused by biliary sludge, which forms as a result of bacteria adhering to the surface of the stent material and forming adherent biofilm. As the adherence of bacteria on plastic surface involves hydrophobic interaction of the plastic polymer and the bacterial cell wall, we tested if the detergent property of bile salts might retard bacterial adherence. Three common biliary pathogens isolated from the bile of patients suffering from acute suppurative cholangitis were used in this experiment: E. coli (O21:H25) which form pili and a glycocalyx; E. coli (O101:H9), non-piliated but with a glycocalyx, and Enterococcus fecalis without either pili or a glycocalyx. Polyethylene disks (1 cm2 diameter) were used for the in vitro adhesion study. They were continuously perfused by the bacterial suspension, flowing at 50 ml/hr at 37 degrees C for 24 hr. The suspending media used were sterile human bile and tryptic soy broth. Two different bile salts, taurocholate and taurodeoxycholate, were added to the perfusion media. The number of bacteria adhering to the surface was assessed by viable bacterial count, epifluorescence microscopy, and scanning electron microscopy. The results showed that E. coli (O21:H25) exhibited better adherence than the nonpiliated E. coli (O101:H9), which in turn was better than the non-pili-, non-glycocalyx-producing Enterococcus fecalis. When a more hydrophobic bile salt, taurodeoxycholate, was added at 25 or 50 mM to the tryptic soy broth or to the human bile, the adherence of the two E. coli strains were reduced 100- to 1000-fold (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Adhesion↗
PubMed2002

Rotavirus and enteric pathogens in infantile diarrhoea in Manipal, South India.

The etiology of Rotavirus in acute diarrhoeal illness in children 0-5 years of age, admitted to the pediatric wards of Kasturba Medical College Hospital, Manipal was studied over a period of 5 years. Rotavirus in the faeces detected by Latex agglutination test accounted for 19.56% of the diarrhoea with maximum incidence (65%) in the 7-12 months of age group. Bacterial aetiological agents continued to play a significant role (69.6%) in diarrhoeal diseases. Enteroaggregative E. coli was common in the age group between 25-36 months, Shigellosis in 37-60 months and Salmonella typhimurium enteritis in 7-12 months of age. The other pathogens isolated were vibrio cholerae (4.98%), species of aeromonas (15.92%), along with cryptosporidium (6.47%) and candida albicans (3.98%). In a control group consisting of 100 children without history of diarrhoea, 2 were positive for rotavirus, 3 for cryptosporidium and 12 for Escherichia coli.

Child, Preschool↗
PubMed2000

Factors predicting occult bacteremia in young children.

A febrile child without a definite localizing sign of infection may be in initial phase of bacteremia which unless treated would result in systemic complication. These instances are referred to as "Occult bacteremia". The common pathogens isolated in these children are Streptococcus pneumoniae, Hemophilus influenzae and Neisseria meningitidis. A hundred consecutive children in the age group of 3-36 months attending pediatric outpatient department and casualty were clinically evaluated using AIOS (acute illness observation scale) score and were subjected to complete blood counts, smear for malarial parasites, ESR and blood culture. In the 19-month study period, 4 instances of occult bacteremia were identified. Streptococcus pneumoniae was cultured in 3 cases and H. influenzae in one. A febrile and toxic child in the age group of 3-36 months has a high risk of occult bacteremia. High fever of temperature > or = 102 degrees F, ESR > or = 15 mm/hour, and total leukocyte count > or = 15,000/mm3, in a child with AIOS score of > or = 10 may be considered for more detailed investigations and early intervention with antimicrobial therapy.

Bacteremia↗
PubMed1999

Three cases of serious infection caused by Aerococcus urinae.

Three cases of serious infection caused by Aerococcus urinae are presented: a patient with endocarditis and two patients with soft-tissue infection (phlegmon and balanitis respectively). The literature on Aerococcus urinae infections is reviewed and the antibiotic therapy discussed. Aerococcus urinae is a pathogen isolated primarily from urine specimens of elderly patients with local or systemic predisposing conditions. Most infections are mild, but serious infections such as endocarditis and septicemia/urosepsis have been described. Penicillin or ampicillin in combination with an aminoglycoside and close monitoring of the patient's clinical status and laboratory results would seem to be the best strategy for management of cases of serious infection.

Aged↗
PubMed2003

Association between molecular markers and blast resistance in an advanced backcross population of rice.

An advanced backcross population consisting of 80 BC(3)F(3) lines derived from rice vars. Vandana/ Moroberekan was analysed for blast resistance and genotyped with 50 candidate genes and 23 simple sequence repeat (SSR) markers. Six candidate defence response genes [thaumatin, three nucleotide-binding site-leucine-rich repeat sequences from maize and two resistance gene analogue (RGA) markers] and one SSR marker (RM21) were significantly associated with partial blast resistance in rice ( P=0.01). These markers accounted for phenotypic variation ranging from 9.6% to 29.4% and contributed to 76% of the total variation of percentage diseased leaf area (DLA) observed under natural infection. Four candidate genes (oxalate oxidase, 14-3-3 protein and two RGA markers) and four SSR markers (RM21, RM168, RM215 and RM250) were significantly associated with resistance to a single pathogen isolate, PO6-6. Among these, two markers were for DLA, five for lesion number and one for lesion size. These markers accounted for 9.1-28.7% of the phenotypic variation. A moderate correlation ( r=0.48, P<0.01) was found between the level of partial resistance measured in the greenhouse and that measured under natural conditions. Analysis of BC(3)F(4) progeny using genotypes of BC(3)F(3) confirmed the phenotypic contribution of these markers. Cluster analysis of DNA profiles showed that the BC(3) population was genetically similar (>85%) to the recurrent parent Vandana. Although no obvious relationship between DNA profiles and resistant phenotypes was observed, three lines (VM19, VM46 and VM76) in a cluster with high similarity to Vandana (89-96%) expressed a high level of partial blast resistance in the field. Analysis of disease progress in the field confirmed the performance of selected lines based on greenhouse and nursery analyses. The advanced backcross progeny with resistance phenotypes tagged by markers will be useful for accumulating blast resistance in upland rice.

14-3-3 Proteins↗
PubMed2006

Genetic analysis of resistance to yellow rust in hexaploid wheat using a mixture model for multiple crosses.

DNA-based molecular markers have been used in numerous studies for tagging specific genes in wheat for subsequent use in marker-assisted selection. Usually in plant breeding, procedures for mapping genes are based on analysis of a single segregating population. However, breeding programmes routinely evaluate large numbers of progeny derived from multiple-related crosses with some parental lines shared. In most such related crosses, the number of progeny is quite small. Thus, statistical techniques for detecting quantitative trait loci (QTLs) using data from conventional multi-cross breeding programmes are interesting. The objective of this study is to present a mixture model for QTL mapping in crosses of multiple inbred varieties with non-normal phenotype distributions and to use this model to map QTLs for yellow rust resistance in elite wheat breeding material. Three doubled haploid populations consisting of 41, 42 and 55 lines, respectively, originating from four parental varieties were studied. Multi-cross QTL analysis with three specific pathogen isolates of Puccinia striiformis f. sp. tritici and a mixture of the isolates revealed QTLs for resistance at four different genomic locations. These QTLs were found on chromosome 2AL, 2AS, 2BL and 6BL and explained between 21 and 41% of the phenotypic variation. Two of these QTLs, one on the long arm of chromosome 2A and one on the short arm of chromosome 2A were identical to the known yellow rust resistance genes Yr32 and Yr17, respectively, whereas the QTLs located on the long arms of chromosomes 2B and 6B may reflect types of resistance to yellow rust, which have not previously been mapped.

Basidiomycota↗
PubMed2004

Procoagulant and fibrinolytic activity in ventilator-associated pneumonia: impact of inadequate antimicrobial therapy.

OBJECTIVE: To determine the homeostatic balance of patients with ventilator-associated pneumonia (VAP) with respect to the adequacy of antimicrobial therapy. DESIGN AND SETTING: Descriptive observational study in a 12-bed medical intensive care unit in a university-affiliated hospital. PATIENTS: Twenty-nine patients with VAP documented by quantitative culture of bronchoalveolar secretions and a control group of eight mechanically ventilated patients. METHODS: Serial bronchoalveolar lavage fluid (BALF) samples were assayed for prothrombin activation fragment (F1+2), thrombin-antithrombin (TAT) complex, fibrinolytic activity, urokinase-type plasminogen activator (u-PA), and plasminogen activator inhibitor type 1 (PAI-1) on days 1, 4, and 7 after VAP onset. RESULTS: Pathogens isolated from patients with inadequate empirical antimicrobial coverage included methicillin-resistant Staphylococcus aureus (n=2), Pseudomonas aeruginosa (n=4), and Acinetobacter baumannii (n=1). Compared to those who received adequate antibiotic therapy, TAT, F1+2, and PAI-1 levels increased while u-PA levels remained unchanged. Despite antibiotic adjustment on day 4, TAT levels remained elevated in those who lacked adequate antimicrobial coverage and were significantly correlated with PaO(2)/FIO(2). The procoagulant activity was accompanied by a local depression of fibrinolytic capacity that was attributed mainly to increased BALF PAI-1 levels. Nonsurvivors showed significantly higher levels of TAT and PAI-1 than survivors. No significant correlation between the bacterial burden and the homeostatic derangements was documented. CONCLUSIONS: The lung inflammatory response seems to promulgate a local procoagulant activity associated with hypoxemia in those with inadequate antibiotic therapy. The homeostatic derangement seems to be independent of the lung bacterial burden.

Aged↗
PubMed2005

Community-level physiological profiles of cloacal microbes in songbirds (order: Passeriformes): variation due to host species, host diet, and habitat.

The relationship between microorganisms and birds has received increased attention recently. The state of knowledge of this relationship, however, is based largely on examination of sick or dead birds, and knowledge of the prevalence and community structure and function of microbes in healthy wild populations is limited. Using carbon substrate utilization profiles, microbial communities were examined in 91 cloacal samples from 14 species within apparently healthy summer and winter passerine populations. Within each season, gradient lengths and eigenvalues from ordination analyses suggested that many samples differed in their carbon substrate utilization and several had very different communities. Cloacal microbe carbon utilization profiles were distinguishable among host species, season-specific diet, and study site in the ordination analyses. However, these patterns were only observed for the analysis of the summer data set. The results of this study support the idea that the avian host's microbial community, relative to carbon substrate utilization, is related to host diet. Previously, this pattern had only been reported for potential pathogens isolated from the avian cloaca. Study site-specific patterns in the ordination analysis suggest that environmental conditions at a particular study site may influence cloacal microbial communities in birds. Results of this study indicate that examination of community-level physiological profiles may be a useful technique for distinguishing among avian cloacal samples, similar to that already established for discriminating aqueous and soil samples. Future studies that correlate microbe physiological profiles to condition-based indices of avian hosts may be most useful for eventually using the profile as an indicator of environmental conditions experienced by hosts.

Animals↗
PubMed2001

Massive structural allograft in revision of septic hip arthroplasty.

We reviewed 10 patients who had undergone two-stage reconstruction with massive structural allografts following failure of hip arthroplasty due to infection. The mean follow-up time was more than 5 years (range 3-10 years). There was no case of the infection recurring. The most common pathogen isolated at the time of first-stage surgery was Stalphylococcus epidermnidis. The mean preoperative modified Harris Hip score was 27.4 (range 9-58) and the mean postoperative score was 73.5 (range 53-92) with a mean increase in the score of 46.1 points. One patient required revision of the acetabular cup for aseptic loosening and another had a dislocation, which was stable after manual reduction. We conclude that the use of a massive structural allograft in revision of septic hip arthroplasty is a viable option.

Aged↗
PubMed2001

Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis.

Postoperative cholangitis is a frequent and unpredictable complication of unknown etiology following bile duct reconstruction (BDR), particularly for biliary atresia. This study was undertaken to correlate the growth of bacteria in the hepaticojejunostomy with that in the liver after BDR. Quantitative bacterial culture was done on the specimens taken from the liver and from the hepaticojejunostomy at 1 week (group 1, n = 7), 1 month (group 2, n = 7), and 2 months (group 3, n = 7) following BDR with Roux-en-Y hepaticojejunostomy in piglets after 2 weeks of common bile duct ligation. The histological examination of the liver and the hepaticojejunostomy, as well as serial monitoring of hemogram and liver function tests, were performed to correlate the findings with the bacterial concentration of the liver and the hepaticojejunostomy following BDR. The bacterial concentration of the hepaticojejunostomy, expressed as log10 colony-forming units per gram (log10 CFU/g) of the hepaticojejunostomy, showed a progressive decrease from 8.38 +/- 1.36 in group 1, 7.07 +/- 2.54 in group 2, to 3.56 +/- 1.31 in group 3 (p = 0.001). The log10 CFU/g of the liver also showed a progressive decrease from 5.02 +/- 1.59 in group 1, 3.16 +/- 1.56 in group 2, to 2.19 +/- 1.09 in group 3 (p = 0.006). There was a significant positive correlation of the log10 CFU/g of the liver (n = 21) with that of the hepaticojejunostomy (n = 21) following BDR (r = 0.600, p = 0.004). Most of the infectious pathogens isolated from the liver were also isolated from the hepaticojejunostomy. The changes in hemoglobin, bilirubin, albumin, and ammonia significantly correlated with the changes of the bacterial concentration of the liver. The results of the study suggests that hepatic bacterial proliferation after BDR is significantly affected by microbial overgrowth in the bilioenteric anastomosis and is associated with deteriorated liver function and hemogram.

Anastomosis, Surgical↗