Antibiotics in yersiniosis.
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Biomedical subjects
Publications and source records attributed to C Ponte.
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In this French study with recombinant somatropin, the stimulation of growth in 32 prepubertal (age 10.0 +/- 3.5 years; mean +/- SD) and 19 pubertal (age 14 +/- 1.5 years) GH deficient children was compared; the stimulation of growth was similarly good in the two groups. The height velocity SD scores increased from -2.5 +/- 1.7 and -0.9 +/- 1.5 to 2.2 +/- 1.9 and 1.6 +/- 1.6 in prepubertal and pubertal children, respectively. Expressed as cm/year, these correspond to increases from 3.2 +/- 1.3 cm/year and 4.1 +/- 1.2 cm/year to 8.1 +/- 1.5 cm/year and 8.6 +/- 1.9 cm/year in the prepubertal and pubertal patients, respectively. Safety and tolerance were good and the immunogenicity of Genotonorm was low.
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We studied the records of 43 patients with significant bacteriuria caused by Corynebacterium group D2. All suffered from underlying diseases, and 54% were immunosuppressed. The predisposing factors were urologic procedures (100%), previous use of antibiotics (90%), age greater than 65 years (65%), and previous urinary tract infections (UTI;60%). Two-thirds of the patients had urinary tract symptoms, and these symptoms were more common in men than in women. The existence of previous lesions in the bladder favored the development of serious urinary symptoms (encrusted cystitis). Alkaline urine had abnormal sediment that yielded Corynebacterium group D2 in the absence of other microorganisms, a result suggesting that this organism could be an etiologic agent of UTI. Because cultures of urine may appear to be sterile, prolonged incubation must be used to detect Corynebacterium group D2. Correct treatment improved the outcome and probably prevented the development of encrusted cystitis in most of our patients.
The susceptibility in vitro of 28 Corynebacterium group D2 strains, mainly isolated from urine, to fifteen antimicrobial agents and acetohydroxamic acid (AHA) was determined at two pH values. The bactericidal activity of four antimicrobials and AHA was studied in three reference strains in broth at two pHs and with two inoculum sizes. The activity of norfloxacin and AHA, against one selected strain, in broth and human urine, was also determined. Vancomycin, ofloxacin and norfloxacin were the most active agents tested. Norfloxacin acted bactericidally in broth and in human urine but was not synergic with AHA.
The in vitro activities of nine antimicrobial agents against Corynebacterium group D2 strains isolated from clinical specimens and from healthy skin of hospitalized patients were studied. Ciprofloxacin, ofloxacin, norfloxacin, vancomycin, and teicoplanin were very active against these microorganisms. There were no significant differences in susceptibility between clinical and colonizing isolates.
After 24 h incubation of human urine experimentally inoculated with Corynebacterium group D2, struvite crystals appeared with an increase in pH and ammonium concentration as well as a decrease in the urea concentration. These changes were prevented by the addition of variable concentrations of acetohydroxamic acid. From these results it seems that the prevention of such crystal formation by Corynebacterium group D2 could be due to the inhibition of its urease activity besides acetohydroxamic acid having a significant antimicrobial activity, principally when tested in human urine. These effects were dose-related.
Corynebacterium group D2 inoculated into normal human urine formed struvite crystals and an increase in pH and ammonium concentration after 24 h of incubation. Zinc disks dipped into a broth culture of this microorganism and inserted into the bladders of rats produced stones with a mean weight of 12.5 mg (ranging from 1 to 57.7 mg) after 12 days. Analysis of the infrared spectrum determined the stones to be composed of struvite. From these results its seems that stone formation by Corynebacterium group D2 may be possible both in vitro and in vivo, which may confirm a previous report involving these bacteria in human clinical encrusted cystitis.
The in vitro susceptibility of 30 Corynebacterium group D2 strains to nine antimicrobial agents was determined. Vancomycin and norfloxacin were the most active agents tested. All strains were resistant to ampicillin and cephalothin, all except one were resistant to gentamicin, and the activity of erythromycin, novobiocin, tetracycline, and rifampin varied.
In four patients with alkaline-encrusted cystitis, Corynebacterium group D2 was isolated from consecutive urine cultures and stones. Encrusted cystitis occurred in bladders harboring inflammatory or tumorous lesions in patients with chronic or recurrent urinary tract infections appearing after surgery or instrumentation. The urease activity of Corynebacterium group D2 and the neutralization of this enzyme by acetohydroxamic acid are shown. Clinical improvement, disappearance of struvite crystals, and decrease of the urine pH were obtained when these bacteria were eliminated from urine samples. Corynebacterium group D2 strains were highly resistant to many antimicrobial agents but were highly susceptible to norfloxacin and vancomycin when tested at two pHs (7.4 and 8.5).
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Three families presenting one or several cases of brain or ophthalmic abnormalities and an hypopituitarism at least by one of the members have been observed. In the first family, the mother and one of her sons present bilateral choroidoretineal coloboma with amblyopia; one of these two suffers as well from panhypopituitarism. In the second family two premature twins, a brother and his sister, present a syndrome with hypophyseal dwarfism and ophthalmic abnormalities, consisting in the boy's case in an peripapillary depigmentation with no visible sight trouble whereas girl's is showing an extreme microphthalmia with major mental retardation. In the third family two 2nd degree cousins present a panhypopituitarism but only one of the two reveals through neuroradiological investigations corpus callosum and septum lucidum agenesia. The karyotype is normal in all the cases. An hereditary mechanism appears clearly in the first family. It is possible in the second, probable in the third one.
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The cases were studied of 109 patients admitted to the 2nd General Medical Division of the Umberto I Hospital in Turin in the course of a year. The study revealed 99 bacterial infections and 10 atypical forms including 7 mycoplasma pneumoniae and 3 virus infections. The importance of suspecting atypical pneumopathies is therefore emphasised and despite the technical difficulties that may at times arise, tests for the less common aetiological agents are recommended.
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The activity of cefotaxime and metronidazole against one strain of Escherichia coli and three of Bacteroides has been studied. A fixed cefotaxime concentration (8 mg/l) did not kill E. coli in presence of Bacteroides due to degradation of the drug by the anaerobe. However, the presence of metronidazole in the same system killed Bacteroides strains very effectively and prevented the degradation of cefotaxime which killed E. coli.