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Interferon research abs 1 || Hemoglobin research abs || Stem cell research abs || Nucleic acid research abs || Herpes research abs || Bronchitis research abs || Schizophrenia research abs || Tuberculosis research abs || Pneumonia research abs

Infect Control Hosp Epidemiol. 1999 Apr;20(4):242-6.
Bloodstream infections in a neonatal intensive-care unit: 12 years' experience with an antibiotic control program.

Cordero L, Sananes M, Ayers LW.

Department of Pediatrics, The Ohio State University Medical Center, Columbus 43210-1228, USA.

OBJECTIVE: To assess the prevalence of gram-positive coccal (GPC), gram-negative bacillary (GNB), and fungal blood-stream infections (BSIs) during a 12-year period in which a consistent antibiotic treatment protocol was in place; to evaluate the efficacy of these antibiotic policies in relation to treatment, to the emergence of bacterial or fungal resistance, and to the occurrence of infection outbreaks or epidemics. STUDY DESIGN: Case series. METHODS: Demographic, clinical, and bacteriological information from 363 infants born during 1986 through 1991 and 1992 through 1997 who developed 433 blood-culture-proven BSIs was analyzed. Early-onset BSIs were defined as those infections discovered within 48 hours of birth, and late-onset BSIs as those that occurred thereafter. Suspected early-onset BSIs were treated with ampicillin and gentamicin, and suspected late-onset BSIs with vancomycin and gentamicin. Antibiotics were changed on the basis of organism antimicrobial susceptibility. RESULTS: Early-onset BSIs were noted in 52 of 21,336 live births and 40 of 20,402 live births during 1986 through 1991 and 1992 through 1997, respectively. GPC (83% due to group B streptococcus [GBS]) accounted for approximately one half of early-onset BSI cases and GNB (68% Enterobacteriaceae) for the remainder. Early-onset GBS declined from 24 to 11 cases (P=.04) and late-onset BSI increased from 111 to 230 cases (P<.01) from the first to the last study period. Sixty-eight percent of late-onset BSIs were due to GPC (primarily coagulase-negative Staphylococcus), 18% to GNB, and 14% to fungus. Over the study period, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa isolated from the newborn intensivecare unit (unlike those strains from other hospital units) remained fully susceptible to ceftazidime and gentamicin. Although the hospitalwide prevalence of methicillin-resistant Staphylococcus aureus increased, all 17 newborn BSI cases were due to methicillin-sensitive strains. Prevalence of methicillin-resistant coagulase-negative Staphylococcus increased, although all strains remained vancomycin-susceptible, as did the 16 Enterococcus faecalis isolates. All fungi recovered (from 48 patients) were susceptible to amphotericin. CONCLUSION: We observed a decrease in the prevalence of early-onset BSIs due to GBS and an increase in late-onset BSIs due to GPC, GNB, and fungi. The combination of ampicillin and gentamicin for suspected early-onset BSIs and vancomycin and gentamicin for late-onset BSIs has been successful for treatment of individual patients without the occurrence of infection outbreaks or the emergence of resistance. Controlled antibiotic programs and periodic evaluations based on individual unit and not on hospitalwide antibiograms are advisable.

PMID:_10219874 J Coll Physicians Surg Pak. 2003 Jun;13(6):337-9.
Infections in children with nephrotic syndrome.

Moorani KN, Khan KM, Ramzan A.

Department of Paediatric Medicine, National Institute of Child Health, Karachi. nicyber.net.pk

OBJECTIVE: To determine the different types of infections in nephrotic children and their association with the activity of disease. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: It was carried out at National Institute of Child Health (NICH), Karachi from August 1995-July 1996. PATIENTS AND METHODS: All children with nephrotic syndrome who had various infections during the study period were evaluated for the activity of disease and type of infections. RESULTS: Out of 62 children with nephrotic syndrome having infections, 45 (72.58%) were boys and 17 (27.42%) girls in a ratio of 2.5:1. Out of them 53 (85.45%) were known nephrotics and 36 (58%) of them were on steroid therapy. Nine were new cases and had not received steroids. A total of 74 episodes of infections were observed in 62 children. Acute respiratory infections (ARI) and skin infections were the most common (29.27% and 27.02% respectively) followed by diarrhoea (13.51%), UTI (12.5%) and peritonitis (10.81%). Two patients had pulmonary tuberculosis and 3 patients had more than one infection (cellulitis, peritonitis and pneumonia). All children with cellulitis and peritonitis were in active disease, whereas more than 80% of patients with ARI, diarrhoea and UTI were having either relapse or had recent onset of disease. CONCLUSION: The study showed that ARI, cellulitis and diarrhoea were most common infections followed by UTI and peritonitis. Majority of the infections (>78%) were associated with active disease

PMID:_12814532 [PubMed - in process] Eur Urol. 2003 Jul;44(1):115-8.
Perioperative antibiotic prophylaxis in ureteroscopic stone removal.

Knopf HJ, Graff HJ, Schulze H.

Department of Urology, Klinikum Dortmund gGmbH, Teaching Hospital of the University of Munster, Westfalendamm 403, D-44143 Dortmund, Germany. knopfhjwi-online.de

OBJECTIVE: This study shall settle the question whether a perioperative single shot prophylaxis in connection with a ureteroscopic stone removal has an influence on the rate of postoperative urinary tract infections (UTIs) and inflammable complications or not. METHODS: 113 patients were included in this prospective randomized study. In 57 patients 250mg Levofloxacin p. o. was given approximately 60 prior ureteroscopy, 56 patients had no prophylaxis. The evaluation of all data which were processed electronically was carried out with the help of a standardised questionnaire. RESULTS: Postoperatively symptomatic urinary tract infections or inflammable complications of the urogenital tract were found in neither of the two groups. In the group without prophylaxis, the rate of the postoperative significant bacteriurias was significantly higher than in the group with prophylaxis (7 patients [12.5%] vs. 1 patient [1.8%]) (p=0.026). In six cases there was an E. coli bacteriuria; additionally a Kl. pneumoniae and a not specified Staphylococcus bacteriuria were detected in further cases. CONCLUSION: Single shot prophylaxis using 250 mg Levofloxacin p. o. can be considered as cheap, the patient not burdened and regarding the missed selection pressure to nosocomial pathogens the preferred manner of perioperative antibiotic prophylaxis in ureteroscopic stone removal. In addition perioperative single shot prophylaxis may be beneficial in case of an unexpected intraoperative complication like e.g. ureter perforations.

PMID:_12814685 [PubMed - in process] Vet Microbiol. 2003 Jul 17;94(3):237-43.
Comparison of Pseudomonas aeruginosa isolates from mink by serotyping and pulsed-field gel electrophoresis.

Hammer AS, Pedersen K, Andersen TH, Jorgensen JC, Dietz HH.

Department of Poultry, Fish and Fur Animals, Danish Veterinary Institute, Hangoevej 2, DK-8200 Aarhus N, Denmark. asetinst.dk

Isolates of Pseudomonas aeruginosa from clinical infections in mink were subjected to serotyping and pulsed-field gel electrophoresis (PFGE) using SpeI. A total of 212 isolates of P. aeruginosa from the year 1998 to 2001 were included in this study: 168 isolates from mink obtained from 74 farm outbreaks of haemorrhagic pneumonia. Isolates from mink were separated into 34 distinct clones by PFGE subtyping. All isolates from mink infected during the same farm outbreak were identical, except in one case where two different strains were isolated from mink obtained from the same farm outbreak. P. aeruginosa of specific PFGE types were found to cause clusters of outbreaks on several farms within a few weeks of each other. However, PFGE types of strains causing clusters of farm outbreaks changed from year to year. These results suggest that some outbreaks of haemorrhagic pneumonia are caused by pathogenic strains of P. aeruginosa spread between farms and animals either mechanically, or through feed or water from a common source, rather than by random nosocomial infections with strains from the farm environment.

PMID:_12814891 [PubMed - in process] Int J STD AIDS. 2003 Jun;14(6):411-6.
Spectrum of opportunistic infections in hospitalized HIV-infected patients in Phnom Penh, Cambodia.

Senya C, Mehta A, Harwell JI, Pugatch D, Flanigan T, Mayer KH.

Preah Bat Norodom Sihanouk Hospital, Phnom Penh, Cambodia.

The aim of the study was to provide more comprehensive data on the clinical characteristics of hospitalized AIDS patients in Cambodia. Chart review of 381 HIV-infected patients admitted to a public hospital in Phnom Penh, Cambodia between December 1999 and May 2000 was performed. The in-hospital mortality rate was 43.6%. Approximately 50% of patients had two or more concurrent illnesses. Very advanced HIV disease was common, with CD4 cell counts below 10 cells/mm(3) in 43.2%. Only 28.3% of the patients had documentation of their HIV infection prior to hospitalization. Chronic diarrhoea was the most frequent opportunistic illness (41.2%), followed by tuberculosis (26%), cryptococcal meningitis (12.6%), Pneumocystis carinii pneumonia (8.4%), and encephalitis (4.7%). Chronic diarrhoea and tuberculosis were the most important opportunistic infections observed in HIV-infected hospitalized patients in Cambodia. These findings illustrate the need for early diagnosis of HIV-infection, effective prophylaxis for opportunistic infections and improved access to antiretroviral therapy in Cambodia.

PMID:_12816670

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