Cefuroxime therapy for urinary tract infections caused by a multi-resistant, epidemic Klebsiella aerogenes.
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Biomedical subjects
Publications and source records attributed to A J Bint.
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An outbreak of infection caused by a strain of Staphylococcus aureus resistant to gentamicin and tobramycin and other antibiotics occurred in two wards in a hospital. Eight patients were colonized, of whom six had clinical infections. Previous administration of gentamicin appeared to predispose the patients to infection with the strain. Restriction of the use of gentamicin and tobramycin is essential to preserve their value in serious infections.
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The distribution of mannose-resistant (MRHA) and mannose-sensitive (MSHA) fimbrial haemagglutinins was examined in 482 strains of Escherichia coli isolated from 390 adult women and 45 pregnant mothers with a variety of urinary tract infections (UTI), and from 47 healthy controls. The proportion of MRHA strains was significantly higher in patients with symptomatic UTI (75%) than in women with non-significant bacteriuria (30%, p less than 0.001), pregnant women with asymptomatic UTI (34%, p less than 0.0001) and healthy controls (0%). The proportion of MSHA strains was significantly lower in patients with symptomatic UTI (22%) than in women with non-significant bacteriuria (46%, p less than 0.001) and pregnant women with asymptomatic UTI (52%, p less than 0.01). Only 17% of the strains from healthy controls had MSHA activity. In pregnant women with UTI, whether this was symptomatic or asymptomatic, there was a significant association between infection with MRHA strains of E. coli and a past history of UTI. Thus, in a pregnant woman with an infection and a past history of UTI there is a seven-fold greater chance that this infection is due to an MRHA-bearing organism than in pregnant women without such a history. There was also a significant association between MRHA organisms and symptomatic infection. The risk of symptomatic patients having an infection with an MRHA strain is six times greater than that for a patient with a covert infection.