[Changes over a period of five years of Serratia marcescens endemia at the Centre Hospitalier de Strasbourg].
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Biomedical subjects
Publications and source records attributed to A Dammron.
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A total of 1,499 Serratia marcescens strains were isolated in Strasbourg University Hospital within a period of three years. Serotyping could split this collection into 37 different serotypes. Two serotypes (014:H12 and 013:H17) were responsible for a persistent S. marcescens endemic. Serotype 014:H12 was mostly recovered from sputa, whereas serotype 013:H17 was mostly recovered from urine. These two serotypes had different antibiotic resistance patterns.
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The determination of the serum and urine concentrations of cephaloridine permitted calculation of the pharmacokinetic constants of this antibiotic: after administration of a 1-gram intravenous dose in five normal subjects; after administration of a 1-gram intramuscular dose in five normal subjects, five patients with renal impairment and five patients on maintenance hemodialysis. In normal subjects, serum half-life averaged 1.56 h (Ke=0.4445) after intravenous administration and 1.63 h (Ke=0.4254) after intramuscular administration of a 1-gram dose of the antibiotic. The urinary excretion of cephaloridine over the 6 h following its intramuscular administration in normal subjects amounted to 56.4% of the administered dose. The renal clearance of cephaloridine was 194 ml/min. A linear correlation (Ke=0.0670+0.0028 CrCl) was established between overall elimination rate-constant values and the creatinine clearances of the patients under investigation. These data were used to calculate the maintenance and loading doses and intervals adjusted to creatinine clearance values. Accurate dosage regimens adjusted to the renal status of each individual patient were derived from the calculated values.
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