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Biomedical subjects

F Paradisi

Publications and source records attributed to F Paradisi.

At least 19 recordsLinked to original sources
PubMed2004

In-vitro activity of nisin against clinical isolates of Clostridium difficile.

Nisin is a cationic peptide produced by Lactococcus lactis. Its activity against clinical isolates of Clostridium difficile was compared to that of vancomycin and metronidazole by minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time-kill studies. Nisin was more active than the other agents, with a MIC90 of 0.256 mg/L and strong bactericidal activity. Nisin may be a promising agent for the management of C. difficile associated diarrhea.

Anti-Bacterial Agents↗
PubMed2004

[The role of linezolid in the therapy of infections caused by multiresistant gram-positive cocci].

Gram-positive cocci are becoming more and more common agents of nasocomial infections, primarily enterococci and staphylococci in the field of surgical site and bloodstream infection. At the same time, the frequency of multiresistant enterococci and methicillin-resistant staphylococci has increased, whereas glycopeptide-resistant enterococcal strains and, recently, staphylococci with reduced susceptibility to glycopeptides have appeared, so making the use of glycopeptides as the "last-chance drugs" ineffective. Under those circumstances, the synthesis of new potent antibiotics, such as oxazolidinones, is both desirable and welcome. Linezolid possesses a high activity against all multiresistant gram-positive cocci, favourable pharmacokinetics, a good safety profile, a complete bioavailability after and administration permitting switch therapy, a low capacity of inducing resistance, and both clinical and microbiologic efficacy as demonstrated by a number of clinical trials conducted on thousands of patients. So, linezolid is an important therapeutic option in the treatment of infections caused by multiresistant enterococcal and staphylococcal strains.

Acetamides↗
PubMed2003

Evaluation of a rapid immunochromatographic test for the serologic diagnosis of tuberculosis in Italy.

OBJECTIVE: To determine specificity, sensitivity and predictive values of a rapid immunochromatographic assay (ICT tuberculosis) for the diagnosis of tuberculosis (TB) in an Italian clinical setting, and to identify tentative new guidance for the interpretation of test results. METHODS: The ICT tuberculosis test is an immunochromatographic test based on the detection of IgG antibodies directed against five highly purified antigens secreted by Mycobacterium tuberculosis during active growth. Sera from 60 patients with active pulmonary (48 sputum smear-positive and six sputum smear-negative cases) and extrapulmonary (six cases) TB were obtained. Personal, anamnestic and clinical data were investigated and recorded for each patient. The control groups comprised 156 subjects: 40 healthy individuals, half of them Mycobacterium bovis BCG-vaccinated, and 116 patients with mycobacterial diseases other than TB (five cases), with nonmycobacterial lung diseases (30 cases), with nonmycobacterial nonlung diseases (30 cases), with nonmycobacterial diseases and rheumatoid factors positivity (30 cases), and with asymptomatic HIV infection (21 cases). For 21 individuals the test was simultaneously performed with both serum and whole blood sample. Each positive result of the ICT test was reported with regard to the number (1-4), position (A, B, C, D) and color intensity (+ to ++++) of the evidenced lines in order to assess the quality of the antibody response. RESULTS: The overall sensitivity and specificity were 56.7% and 90.4%, respectively. The sensitivity for pulmonary TB patients was 61.1% (66.7% for smear-positive and 16.7% for smear-negative cases) and 16.7% for extrapulmonary TB patients. The difference between ICT results in pulmonary TB patients and control subjects was statistically significant (P < 0.0001). The analysis of the positive ICT tests revealed that samples with strong color intensity (>/=++) and specific antibodies bound to antigens immobilized on line D were significantly more frequent in TB patients than in controls (P = 0.001 and P= 0.027, respectively). ICT test results with the presence of at least three visible lines were more often observed in the TB patients than in controls, although not reaching statistical significance (P = 0.052). No difference was observed between the results of the ICT test performed both on serum and whole blood sample. CONCLUSIONS: The ICT tuberculosis test was confirmed to be rapid and easy to perform without requiring special equipment, both on serum and whole blood sample. Our data, in accordance with those obtained in a previous study conducted in extra-European countries, confirmed higher sensitivities for the smear-positive TB patients than for the smear-negative TB patients, and for pulmonary TB patients than for the extrapulmonary TB patients. Data obtained on the quality of antibody response in the ICT positive samples, might be used to improve the performance of the test.

Adolescent↗
PubMed2002

Epilepsy, cysticercosis, and toxocariasis: a population-based case-control study in rural Bolivia.

OBJECTIVE: To assess the relationship between epilepsy and infection with Taenia solium and Toxocara canis with a case-control study, in the rural area of the Cordillera Province, Bolivia. METHODS: A preliminary two-phase door-to-door prevalence survey determined the prevalence of epilepsy and identified cases and control subjects. At least two control subjects per case were selected, matching on sex, age, and community of residence. Cases and control subjects were assessed serologically for antibodies against T. canis by ELISA and against T. solium by enzyme-linked immunoelectrotransfer blot (EITB). RESULTS: The prevalence survey found 130 confirmed cases of epilepsy, of which 113 were eligible for the case-control study (59 partial seizures and 54 generalized seizures). Two hundred thirty-three control subjects were selected. Multivariable analysis for a matched case-control study was carried out. There was an association between EITB positivity for T. solium and epilepsy with an OR of 1.85 (95% CI 0.99 to 3.4) for all cases. A stronger association was found in those with partial epilepsy with a late onset of disease (15 years and older), where the OR was 3.66 (95% CI 1.10 to 12.10). A positive association was also found with T. canis for all cases with an OR of 2.70 (95% CI 1.41 to 5.19). This increased for those with late-onset partial epilepsy to an OR of 18.22 (95% CI 2.10 to 158.10). CONCLUSION: This finding suggests that both neurocysticercosis and toxocariasis may in part explain the higher prevalence of epilepsy, particularly partial epilepsy, in developing countries.

Adult↗
PubMed2001

Antistaphylococcal (MSSA, MRSA, MSSE, MRSE) antibiotics.

S. aureus and coagulase-negative staphylococci such as S. epidermidis are important causes of infection of the bloodstream, cardiac valves, implanted devices, and skin, with repercussions on mortality and increased economic costs. Treatment of staphylococcal infections is made difficult by the increasing emergence of resistance to beta-lactams and other antimicrobials, including reduced susceptibility to glycopeptides. Penicillin must be used for infrequent penicillin-susceptible isolates, oxacillin and nafcillin are to be considered the major option for penicillin-resistant staphylococci, and glycopeptides are the drugs of choice for infections caused by methicillin-resistant strains. Co-trimoxazole, lincosamides, macrolides, tetracyclines, and fluoroquinolones are alternative agents, primarily in subjects allergic to beta-lactams. Newly introduced or experimental drugs, such as streptogramins (quinupristin-dalfopristin), oxazolidinones (linezolid), carbapenems (LY 333328), everninomicins (SCH 27899), and derivatives of tetracyclines (glycylcyclines), could be useful for therapy of infections caused by multiresistant staphylococci.

Anti-Bacterial Agents↗
PubMed2001

Infections in multiple myeloma.

Multiple myeloma is a relatively rare but severe hematologic malignancy. Marked depression in production of normal immunoglobulins, mild neutropenia, and alkylant/steroid therapy or BMT/SCT all produce major suppression of the immune system in the totality of patients. Recurrent bacterial, fungal, and viral infections are an important cause of morbidity and the most common cause of death in these subjects. Prompt diagnosis and appropriate anti-infective chemotherapy are essential in order to reduce the risk of mortality.

Bacterial Infections↗
PubMed2001

Streptococcus pneumoniae as an agent of nosocomial infection: treatment in the era of penicillin-resistant strains.

Streptococcus pneumoniae is a well-known agent of community-acquired infections such as sinusitis, otitis media, pneumonia, bacterial meningitis, bacteremia and acute exacerbations of chronic bronchitis. However, the role of S. pneumoniae as a cause of nosocomial infections of respiratory tract, bloodstream and central nervous system is more and more recognized, primarily in high-risk patients with depression of their immune function. Therapy of pneumococcal infections is made difficult by the emergence and spread of bacterial resistance to penicillin and other beta-lactams as well as to a number of antimicrobials such as macrolides, chloramphenicol, tetracyclines and sulfonamides. This epidemiological situation is a cause for concern world-wide, but it primarily affects some European countries, North America, South Africa and the Far East. The main consequence on therapeutic grounds is that in severe infections such as bacterial meningitis, the addition of vancomycin to a third-generation cephalosporin is advisable while awaiting laboratory test results, even in areas with low prevalence of penicillin-resistant pneumococci. However, a beta-lactam agent can also be a valid choice in the presence of potentially lethal infections such as pneumonia or in the case of penicillin intermediately resistant isolates. In recent years, new alternative molecules have been introduced into clinical practice for therapy of infections caused by penicillin-resistant pneumococci. In both in vivo and in vitro studies, drugs of the classes of fluoroquinolones (levofloxacin, moxifloxacin, gatifloxacin), streptogramins (quinupristin/dalfopristin) and oxazolidinones (linezolid) have shown good microbiologic and clinical efficacy against penicillin-resistant pneumococci. In this era of world-wide spread of penicillin-resistant pneumococci, use of polysaccaride or conjugated vaccines is highly recommended.

Adult↗
PubMed2000

Nosocomial bacterial and fungal meningitis in children; an eight year national survey reporting 101 cases. Pediatric Nosocomial Meningitis Study Group.

One hundred and one cases of nosocomial meningitis in children from a national survey over 8 years have been analyzed for risk factors and outcome. From 101 cases, 115 organisms were isolated. Seventy six were Gram-positive bacteria, 29 were Gram-negative and there were ten fungal isolates. Major risk factors for acquisition of nosocomial meningitis were neurosurgery (70.2%), ventriculoperitoneal shunt (42.9%), prior therapy with broad spectrum antibiotics (64.1%), central venous catheter (94.5%), premature neonates with very low birth weight (32.8%) and total parenteral nutrition (68.8%). Overall attributable mortality was 14. 9%; in bacterial infection it was 13.2% and in fungal nosocomial meningitis, 30.0%. Higher mortality was significantly related to perinatal pathology with CNS abnormality, prematurity polymicrobial infection with Enterobacteriaceae and concomitant bacteraemia. Prematurity in neonates, very low birth weight and infection with Enterobacteriaceae were significantly associated with a worse outcome.

Adolescent↗
PubMed2000

Distribution and antibiotic resistance of isolates from lower respiratory tract and blood cultures from patients in three Italian intensive care units: a 2-year comparison.

The distribution and antibiotic resistance of major pathogens isolated from patients in ICUs were studied by three Italian microbiological laboratories. Consecutive aerobic strains were collected over two different time periods from protected brushing bronchoscopy, broncho-alveolar lavage and blood cultures. A total of 420 strains were isolated during the first period (47.3% gram-negative and 52.7% gram-positive) and 412 over the second period (50.5% gram-negative and 49.5% gram-positive). Pseudomonas aeruginosa was the most frequently isolated organism from the respiratory tract followed by Staphylococcus aureus. Methicillin resistance was 47.9 and 44.5% in S. aureus and 63.0 and 65.1% in coagulase-negative staphylococci over the two periods. No glycopeptide-resistance was found in gram-positive organisms. Ceftazidime-resistance in Klebsiella pneumoniae was very high.

Anti-Bacterial Agents↗
PubMed2000

Clinical and microbiologic efficacy and safety profile of linezolid, a new oxazolidinone antibiotic.

Gram-positive cocci are important causes of infection both in the community and in the hospital, with repercussions on mortality and increased economic costs. Treatment of these infections is made difficult by the increasing emergence of multi-resistant organisms, primarily among Gram-positive cocci, such as vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, and penicillin-resistant pneumococci. Linezolid, a member of the new class of synthetic antimicrobials named oxazolidinones, has several favourable characteristics including high activity against multiresistant Gram-positive cocci. In a number of clinical trials, linezolid showed good clinical and microbiologic efficacy in the therapy of infections caused by these organisms. It can be considered a valid option for treating both community- and hospital-acquired infections due to multiresistant Gram-positive cocci.

Acetamides↗
PubMed2000

Antibiotic resistance in community-acquired pulmonary pathogens.

Among infectious diseases, pneumonia is still the ;;captain of the men of death.'' Etiologic diagnosis is often unreliable; consequently, clinicians must know epidemiology of community-acquired pneumonia for optimizing empiric antibiotic therapy. In recent years, all major pulmonary pathogens have become more and more resistant to conventional antibiotics. Penicillin-resistant and even multiresistant pneumococci have spread worldwide, but primarily in the United States, some European countries, South Africa, and the Far East. A similar trend is evidenced by ampicillin-resistant Hemophilus influenzae, whereas Moraxella catarrhalis almost invariably produces beta-lactamases. The widening of methicillin-resistant Staphylococcus aureus from hospitals to the community may be the new reality of the 1990s. Increasing erythromycin resistance of Streptococcus pyogenes requires beta-lactam therapy. The spread of both cromosomally and plasmid-mediated beta-lactamases makes treatment of infections caused by gram-negative enterobacilli more difficult. Bacterial resistance creates a challenge for clinicians from the viewpoint of correct and successful management of patients with community-acquired pneumonia.

Journal Article↗
PubMed1999

Prevalence of epilepsy in rural Bolivia: a door-to-door survey.

OBJECTIVE: To carry out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia, to determine the prevalence of neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in a sample of approximately 10,000 inhabitants. METHODS: A team of nondoctor health workers administered a standard screening instrument for neurologic diseases-a slightly modified version of the World Health Organization protocol. All subjects found positive during the screening underwent a neurologic examination. RESULTS: On screening, the authors found 1,130 positive subjects, of whom 1,027 were then investigated by neurologists. On the basis of the definition proposed by the International League Against Epilepsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of whom had active epilepsy (prevalence, 11.1/1,000) on the prevalence day (November 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year age group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1,000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standard EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the International League Against Epilepsy. The mean age at onset was 20.7 years for partial seizures and 13.6 years for generalized seizures. Only 10.5% of patients had received specific treatment for more than 2 months of their life. CONCLUSION: This report on epilepsy prevalence in Bolivia confirms that epilepsy is a major health problem in rural areas of developing countries.

Adolescent↗
PubMed1999

Prevalence of antibodies against hepatitis A and E viruses among rural populations of the Chaco region, south-eastern Bolivia.

We conducted a cross-sectional study to determine the seroprevalence of antibodies against hepatitis A and hepatitis E viruses (HAV and HEV) in the population of two rural areas, Camiri and Villa Montes, of the Chaco region, south-eastern Bolivia. HAV antibodies were detected in 461 (94.1%) of 490 serum samples tested, not differing significantly between sexes and study areas. The HAV seropositivity rate (64.7%) was high even in the youngest age group (1-5 years). The prevalence of HEV was 7.3%, with no significant differences between sexes. The prevalence of HEV antibodies in the population of the Camiri area (10.4%) was significantly higher than in the Villa Montes area (4.4%), possibly due to the better quality of drinking water in the Villa Montes area. In the population </= 30 years of age, the HEV seropositivity rate (4.4%) was significantly lower than in the >/= 31 year-old group. This is consistent with findings in other countries. This is the first report of the prevalence of HEV infection in Bolivia.

Adolescent↗
PubMed1999

Skeletal tuberculosis and other granulomatous infections.

After several decades of steadily decreasing incidence, tuberculosis has had a resurgence in the past 15 years, not only in the lungs, but also in extrapulmonary sites. This is primarily a result of the AIDS pandemic, considering that HIV specifically affects cellular immunity, which is the first-line defence against tuberculosis. The generally non-specific clinical and radiological patterns of skeletal tuberculosis make it similar to other bacterial, fungal, inflammatory and neoplastic diseases of the bones and joints. Physicians must not omit tuberculosis in the differential diagnosis of any osteo-articular inflammatory process so that specific treatment may be initiated as soon as possible. Anti-tuberculous therapy is beset by important factors that limit its efficacy, such as the emergence of drug toxicity and of resistant or multiresistant mycobacterial strains. Surgical treatment may be indicated in selected cases where medical therapy alone is not sufficient to eradicate the problem.

Antitubercular Agents↗
PubMed1999

[Antibodies against Trichinella spiralis in the rural population of the Province of Cordillera, Bolivia].

A seroepidemiological study was conducted to determine the prevalence of antibodies to Trichinella spiralis among rural residents of Cordillera province, Santa Cruz Department, Bolivia. Using the enzyme-linked immunosorbent assay (ELISA), 234 serum samples were examined, and antibodies were detected in seven of the samples (3%). The results document for the first time the presence of human infestation with Trichinella in Bolivia and suggest the need to strengthen trichinelosis surveillance in the municipal slaughterhouses, to prevent the clandestine slaughter of animals, and particularly to ensure that residents and meat producers in the area become aware of the dangers of this zoonosis.

Abattoirs↗
PubMed1999

Multicenter randomized trial comparing meropenem (1.5 g daily) and imipenem/cilastatin (2 g daily) in the hospital treatment of community-acquired pneumonia.

An open, multicenter study with 144 patients, aged between 18 and 94 years, was performed to compare the efficacy and safety of meropenem with imipenem/cilastatin in the hospital treatment of community-acquired pneumonia. Patients were randomized to receive either intravenous meropenem (500 mg every 8 h) or intravenous imipenem/cilastatin (1,000 mg every 12 h). The primary end point was considered to be clinical efficacy and the secondary end points were bacteriological response and safety assessment. At the end of therapy, cure or improvement in signs and symptoms as a satisfactory clinical response was observed in 57 of 64 (89.1%) meropenem-treated patients and in 60 of 66 (90.9%) imipenem/cilastatin patients. The mean duration of treatment was 10 days for meropenem and 9.7 days for imipenem/cilastatin. In patients who were followed up for weeks 2-4, the response was satisfactory (100%) for both treatments. A satisfactory bacteriological response, defined as either presumed or confirmed eradication of all pathogens, was found in eight patients who had received meropenem and in 14 patients who had received imipenem/cilastatin. Response was considered satisfactory in 100% of the meropenem group and in 92.9% of the imipenem/cilastatin group and at follow-up, it was 100% for both treatments. Drug-related adverse events were reported in three (4.2%) meropenem-treated patients and in eight (11.0%) imipenem/cilastatin-treated patients. None of these events was classified as serious. The results of this study show that the clinical and bacteriological efficacy and tolerability of meropenem (500 mg every 8 h) are similar to that of imipenem/cilastatin (1,000 mg every 12 h) in the hospital treatment of community-acquired pneumonia.

Adolescent↗
PubMed1998

Urosepsis in the critical care unit.

Critical care unit patients show a higher risk of developing a bloodstream infection than ward patients. The urinary tract is the main source of hospital-acquired secondary bloodstream infection. Nosocomial urinary tract infection is promoted by bladder catheterization in the vast majority of cases. Aerobic gram-negative bacilli are the prevalent agents of bloodstream infection secondary to a nosocomial urinary tract infection. Sepsis and septic shock are severe complications of these infections in the critical care patient. Management of patients with a septic process of urinary source calls for the combination of adequate life-supporting care, an appropriate antibiotic therapy, and innovative adjunctive measures. Accurate catheter care is the best measure to adopt for the prevention of urosepsis.

Anti-Bacterial Agents↗