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Biomedical subjects

F Paradisi

Publications and source records attributed to F Paradisi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Patterns of antimicrobial use and antimicrobial resistance among healthy children in Bolivia.

OBJECTIVE: To determine the incidence of antimicrobial-resistant, nonpathogenic Escherichia coli among healthy children aged 6-72 months in Camiri town and a rural village, Javillo, in south-eastern Bolivia. METHOD: A community-based survey: stool samples were obtained from 296 healthy children selected by modified cluster sampling in Camiri and all 25 eligible children in Javillo. E. coli isolates were tested for antimicrobial susceptibility according to the standard disc diffusion method. By a questionnaire survey of 12 pharmacies and by using simulated patients, we investigated the antimicrobial availability and the usage patterns in Camiri town. RESULTS: In Camiri, over 90%, and in Javillo over 70% of children carried E. coli resistant to ampicillin, trimethoprim-sulphamethoxazole (TMP/SMX) or tetracycline. Overall, 63% of children carried E. coli with multiple resistance to ampicillin, TMP/SMX, tetracycline and chloramphenicol. In the simulated patients study, antimicrobials were dispensed inappropriately for 92% of adults and 40% of children with watery diarrhoea, and were under-prescribed for males with urethral discharge (67%) or females with fever and dysuria (58%). The dose and/or duration of antimicrobials dispensed was almost always too low. CONCLUSION: Our study showed a disturbingly high prevalence of carriage of nonpathogenic E. coli resistant to antimicrobials. The prevalence of resistance to ampicillin and TMP/SMX was higher than that previously reported in developing countries. The existence of a large reservoir of resistance genes in healthy individuals in developing countries represents a threat to the success of antimicrobial therapy throughout the world. Programmes to improve rational and effective drug use in developing countries are urgently needed.

Adult↗
PubMed1998

Is Streptococcus pneumoniae a nosocomially acquired pathogen?

Streptococcus pneumoniae is most prominently a major cause of community-acquired infections of the respiratory tract, central nervous system, and bloodstream, but there is an increasing interest in its role in the epidemiology of hospital-acquired infections. Penicillin-resistant pneumococcal strains appeared 3 decades ago and now are present worldwide, often displaying multiple resistance due to antibiotic selective pressure. Horizontal spread can cause either sporadic cases or hospital outbreaks, primarily in younger children and elderly patients. Pneumococcal transmission from one patient to another can be documented by polymerase chain reaction or pulsed-field gel electrophoresis typing. Nosocomial acquisition of infection, along with pediatric age, previous hospitalization, and previous beta-lactam therapy, are the main risk factors significantly associated with penicillin-resistant pneumococcal infections. Nosocomial acquisition also is associated with higher mortality from pneumococcal disease. The importance of penicillin resistance as a risk factor significantly associated with higher mortality from pneumococcal infection is found in some studies, but not in others. Mortality from pneumococcal pneumonia is approximately the same for human immunodeficiency virus (HIV)-infected patients without acquired immunodeficiency syndrome (AIDS) as for HIV-negative subjects, but it is significantly higher in AIDS patients. Penicillin-resistant strains are involved in the vast majority of hospital outbreaks, whether presenting as clinically manifest infection or a simple colonization. Pneumococcal vaccination is recommended universally in order to lower the incidence of invasive infection, although a number of problems can limit its effectiveness.

Bacteremia↗
PubMed1998

Treatment of otitis media.

Otitis media is a very common reason for the prescription of antibiotics in children. Antimicrobial therapy is mostly empirical, based on the knowledge of the frequency and susceptibility patterns of causative pathogens and of the penetration and other pharmacokinetic properties of several oral antibiotics. Pharmacoeconomic considerations must also be taken into account.

Journal Article↗
PubMed1998

A neuroepidemiological survey in rural Bolivia: background and methods.

A door-to-door survey was carried out in rural areas of the Cordillera province, Santa Cruz Department, Bolivia. A cluster sample of 10,124 inhabitants was selected. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism and peripheral neuropathy) in this population using a modification of the World Health Organization screening instrument. 1,130 subjects screened positive and were then investigated by neurologists. In this paper we describe the background and methods of the survey and the characteristics of the population.

Adolescent↗
PubMed1997

Serologic survey for antibodies to Borrelia burgdorferi in sheep, goats and dogs in Cordillera Province, Bolivia.

A serosurvey for antibodies to Borrelia burgdorferi using an enzyme-linked immunosorbent assay (ELISA) was conducted on sheep, goat and dog serum samples collected in Cordillera Province, Bolivia, in 1992 Sera from 98 sheep, 218 goats and 43 dogs were tested. The observed seroprevalence in sheep and dogs was 0.0%, whereas the seropositivity rate for goat serum samples was 5.0%. Upon analysing 10 positive sera by Western immunoblotting, five reacted against the specific protein antigens and all of them met the criteria for positivity on the basis of immunoglobulin G (IgG) bands, indicating that goats in Cordillera Province were exposed to B. burgdorferi. These findings, which are further proof of the existence of B. burgdorferi infection in Bolivia, indicate the serologic analysis of goats as a suitable tool for Lyme borreliosis surveillance.

Animals↗
PubMed1997

Serological survey of leptospiral infections in sheep, goats and dogs in Cordillera province, Bolivta.

A serological survey for antibodies to Leptospira spp. was conducted on sheep, goat and dog serum samples collected in three localities in Cordillera province in the southern part of the Santa Cruz Department (Bolivia) in 1992. A total of 98 sheep, 218 goats and 43 dogs were tested against 29 leptospiral serovars using the microscopic agglutination test. At the time of blood collection all of the examined animals appeared healthy and presented no clinical sign suggestive of leptospirosis. Antibody prevalences, as determined by positive results at a 1:100 dilution or higher, was 14.3% in sheep, 19.7% in goats, and 14.0% in dogs. Agglutinins against six serovars (poi. shermani, pomona, canicola, javanica, djasiman) were found in positive animals. The highest serological prevalence in sheep and goats was recorded for serovar poi, followed by pomona in sheep and shermani in goats. Titres to shermani were the commonest in dogs. The results of this survey indicate that leptospiral infection is common in south-east Bolivia and that serovars of several serogroups concur in the etiology.

Agglutination Tests↗
PubMed1997

Tropical pulmonary eosinophilia. Report of a case.

Tropical pulmonary eosinophilia (TPE) is an unusual manifestation of filarial infection, most commonly found in South-East Asia and caused by immunologic hyperresponsiveness to Wuchereria bancrofti and Brugia malayi. This report concerns a case of TPE in a 25-year-old Indian male who had been living in Italy for two years and was admitted to hospital with chest pain. Diethylcarbamazine therapy proved effective in rapidly eliminating symptoms and pulmonary abnormalities, as well as normalizing of laboratory findings.

Adult↗
PubMed1996

[Gram positive microorganisms in urinary tract infections: epidemiology and therapy].

Urinary tract infections are the most frequent hospital acquired infections and represent one of the major problem in general practice. The predominant causative agents are enteric gram-negative bacteria. Nevertheless, the importance of gram-positive bacteria, particularly Staphylococcus aureus and Enterococcus, has progressively increased especially in nosocomial urinary tract infections. Such an increase is probably related to the indiscriminate use of beta-lactam antibiotics or to the growing number of susceptible patients (surgical procedures, immunodeficiency, ecc.) The therapeutic approach of community and hospital infections is different: while in the first case treatment is usually not difficult, the therapy for nosocomial urinary tract infections should be based on the results of antibiotic susceptibility tests since a multiantibiotic resistant microorganism is often involved.

English Abstract↗
PubMed1996

[Emerging pathogens in lower respiratory tract infections].

Pneumonia is one of the most important causes of death in industrialized countries where it is the infection with the overall highest mortality rate. In contrast to bacteremia, in which the cause of infection is readily established, the determination of the cause of acute pneumonia remains problematic. About half the patients requiring admission to the hospital do not have the cause of pneumonia diagnosed. The emergence of newer pathogens and the recognition of new presentations of older pathogens, however, have made it apparent that it will always be necessary to pursue aggressively an etiologic diagnosis in patients with pneumonia. This article briefly reviews some of new pathogens of lower respiratory tract infections that have become very important in the last years for their capability to determine severe clinical patterns, for their high frequency in some high-risk patient groups and for difficult diagnosis or treatment. Moreover we present new facets of the "old pathogens" of community-acquired pneumonia. Particularly we underline major changes occurred in the antibiotic-susceptibility of Streptococcus pneumoniae and Haemophilus influenzae.

English Abstract↗
PubMed1995

In vitro activity of MDL 62,879 against gram-positive bacteria and Bacteroides species.

The new thiazolyl peptide antibiotic MDL 62,879 (GE2270 A) showed excellent in vitro activity in testing against staphylococci and streptococci, with MIC90s ranging from 0.23 to 0.9 mg/l. It was very active against Clostridium difficile and Propionibacterium acnes (MIC90 0.06 mg/l in each case) and had variable activity against Bacteroides spp. MDL 62,879 had exceptionally good activity against Enterococcus faecalis, including against a collection of high-level aminoglycoside-resistant isolates where it had an MIC90 of 0.047. The antibiotic was bacteriostatic for enterococcal isolates but bactericidal for a methicillin-resistant isolate of Staphylococcus aureus.

Anti-Bacterial Agents↗
PubMed1995

Once-daily dosing regimen for aminoglycoside plus betalactam combination therapy of serious lower respiratory tract infections.

Aminoglycosides are important antibacterial agents for treatment of serious gram-negative bacillary infections including lower respiratory tract infection. Once-daily aminoglycosides result in higher peak and lower trough plasma concentrations than conventional multiple daily dosing regimens; once-daily aminoglycoside therapy is equally effective, generally less toxic and much less expensive and therefore this regimen is more and more frequently used for treatment of suspected or confirmed gram-negative bacillary infections and of febrile episodes in neutropenic patients, in particular in combination with an appropriate betalactam antibiotic. Despite the lack of studies on this topic, once-daily aminoglycosides in combination with a betalactam agent can be used in subjects with lower respiratory tract infection, including patients with cystic fibrosis, in which tobramycin appears to be the aminoglycoside antibiotic of choice.

Administration, Oral↗
PubMed1994

[Pathogenetic mechanisms responsible for producing a secondary immunodeficiency state].

Abnormalities of the immune response can be secondary to old age, to several pathologic conditions (i.e. diabetes mellitus, renal failure, solid and lymphohematologic neoplasias, leukopenia, malnutrition, autoimmune diseases, AIDS), to surgical stress or to burns, and to immunosuppressive therapies, both medical (corticosteroids, cytotoxic agents, antilymphocytic globulins) and surgical (splenectomy) as well as radiant (extensive radiotherapy). Old age can affect both humoral (reduced antibody synthesis) and cell-mediated (thymus involution, diminished ratio Th/Ts, depression of both delayed hypersensitivity reactions and cytotoxic activity of K cells) immune response. Hyponutrition, often observed in the elderly, adds a reduced production of secretory IgA, lysozyme and interferon, diminished complementary activity, phagocytosis defects, and vitamin deficits. Furthermore, in some chronic diseases we can observe reduced primary antibody response or depression of delayed hypersensitivity reactions (renal failure, neoplasias), changes in leukocyte functions (diabetes mellitus, leukemias and lymphomas) and, in particular in solid neoplasias, increased activity of Ts lymphocytes and the presence of circulating immunocomplexes. Changes in phagocytosis, opsonization and chemotaxis are typically seen in burns, whereas surgical stress can cause some inhibition of cell-mediated immunity. Finally, after splenectomy it is possible to observe an increased synthesis of IgA and IgG and, on the contrary, reduced production of IgM and properdin.

Age Factors↗
PubMed1994

Prevalence of antibodies to Borrelia burgdorferi, Borrelia parkeri and Borrelia turicatae in human settlements of the Cordillera Province, Bolivia.

A seroepidemiological study to determine the prevalence of human Lyme borreliosis and tick-borne relapsing fever was carried out in three communities (Camiri, Boyuibe and Gutierrez) of the Cordillera Province, Santa Cruz Department, south-eastern Bolivia. Anti-B. burgdorferi, anti-B. turicatae and anti-B. parkeri antibodies, tested by the indirect immunofluorescent assay (IFA), were detected in 10.8, 16.1 and 8.2% of the serum samples tested, and confirmed by IFA-ABS in 1.3, 1.3 and 1.0%, respectively. This is the first report of the presence of Lyme borreliosis and tick-borne relapsing fever in Bolivia. For Lyme borreliosis these findings represent a further datum to support its existence in South America.

Adolescent↗
PubMed1993

Urinary tract infections in the city of Florence: epidemiological considerations over a twenty-year period.

Our study of significant bacteriurias indicated that the worldwide shift in the etiology of infections also holds true for the Florence area. In a twenty-year period (1970-1990), we noted a decreased frequency of Gram-negative bacilli, particularly of the family Enterobacteriaceae, and a significant increase of Gram-positive cocci in urinary patients. This finding was observed both in hospital and in community-acquired cases in the male sex and only in nosocomial bacteriurias in the female sex. There was a reduced isolation of "classic" urinary pathogens such as Proteus mirabilis: its prevalence in hospital-acquired urinary tract infection (UTI) decreased from 16% in 1970 to 5% in 1990 both in males and in females. On the other hand, we noted an increase of "difficult" microorganisms such as enterococci and methicillin-resistant staphylococci, particularly in the male sex; in 1970 enterococci were occasionally isolated in males both from hospital and from community-acquired UTIs (3% and 5%, respectively), whereas in 1990, on the contrary, they were encountered much more frequently (19% in both cases).

Bacteriuria↗
PubMed1993

Comparative efficacy of a single 400 mg dose of albendazole or mebendazole in the treatment of nematode infections in children.

The relative efficacy of a single 400 mg dose of albendazole or mebendazole in the treatment of nematode infections was assessed in 2- to 9-year-old children living in two different Bolivian rural communities. Both agents were equally very effective (100% cure rate) in treating ascariasis. Albendazole was clearly more active than mebendazole against hookworm infections, both in terms of egg reduction rate (92.8% vs. 62.4%) and cure rate (81.8% vs. 17.2%). As far as trichuriasis is concerned, albendazole produced a higher egg reduction rate than mebendazole (45.7% vs 15%), but a lower cure rate (33.3% vs 60%). Both drugs were well tolerated.

Age Factors↗