In vitro synergy (or at least an additive effect between antibiotics in vitro) is likely to have clinical significance. Data in the literature strongly suggest that, in patients who lack the natural mechanisms of defense against infection, better clinical results can be achieved by treatment with two drugs to which the pathogenic organism is sensitive rather than only one. Moreover, there is some evidence that the use of antibiotic combinations found to be synergistic in vitro is associated with a better clinical outcome in patients with decreased mechanisms of defense against infection, especially neutropenia. The use of synergistic drug combinations should be continued as empirical therapy in severely neutropenic or otherwise compromised patients, especially in those with malignant tumors.

Animals↗

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Bacterial pathogens of increasing significance in hospital-acquired infections.

Despite the introduction of many effective antibiotics and an increased understanding of appropriate infection control measures, new pathogens continue to emerge as nosocomial opportunities. Some of these bacteria have developed increased antibiotic resistance; others have acquired the ability to survive in antiseptics, in intravenous infusion solutions, or on intravascular catheters; and still others are ubiquitous in the hospital and readily colonize compromised patients. Because some of these organisms are fastidious, they have not always been readily cultured and identified. Other species have not been fully appreciated as nosocomial pathogens because of taxonomic uncertainties. The changing spectrum of hospital-acquired infection continues to pose new challenges that necessitate the development of highly active agents such as imipenem for effective treatment.

Acinetobacter Infections↗

PubMedDate not supplied

Vaginal colonization with mycoplasma hominis and ureaplasma urealyticum.

Vaginal cultures obtained from unselected young women who consulted the gynecologist in a student health service were examined for Ureaplasma urealyticum and Mycoplasma hominis. Each participant completed a confidential questionnaire. Multiple logistic regression analysis was used to determine which variables, of a large number ascertained, were associated with mycoplasmal colonization. U. urealyticum was isolated from 273 (56.8%) of 481 participants. The following variables were significantly predictive of colonization with U. urealyticum: black race, absence of antibiotic use, cigarette smoking, and number of sexual partners during the last year. Lifetime number of sexual partners was significantly predictive only in women who used nonbarrier methods of contraception. M. hominis was isolated from 85 (17.7%) of the 481 participants. Independent variables that were significantly predictive of colonization with M. hominis included black race, young age, and, for users of nonbarrier methods of contraception, lifetime number of sexual partners.

Black or African American↗

PubMedDate not supplied

The incidence of genitourinary infections in a cohort of healthy women.

BACKGROUND AND OBJECTIVES: Few data are available on the incidence and frequency of occurrence of vaginitis and urinary tract infections in population-based groups. GOAL OF THIS STUDY: To assess the incidence and frequency of occurrence of vaginitis and urinary tract infections among a population of healthy adult women. STUDY DESIGN: A questionnaire regarding genitourinary infections was sent to 500 women, 315 (63%) of whom responded. RESULTS: A history of one or more urinary tract infections was reported by 199 (63.2%) of the women. Trichomoniasis was reported by 82 (26%) and bacterial vaginosis by 91 (29%) of the participants. A history of physician-diagnosed vulvovaginal candidiasis was noted by 210 (67%) of the respondents, 70 (22%) of whom had been treated for vulvovaginal candidiasis during the preceding year. Classical sexually transmitted conditions such as gonorrhea (4.8%), genital herpes (6.7%), and genital warts (7.6%) were reported less often than vaginal and urinary tract infections. CONCLUSION: Urinary tract infections and vaginal infections, especially vulvovaginal candidiasis, are common events among healthy adult women.

Adolescent↗

PubMedDate not supplied

Significance of blood pressure in infancy. Familial aggregation and predictive effect on later blood pressure.

Blood pressure was measured in 730 infants and their mothers within 5 days of birth. Paternal blood pressures were obtained where possible, and follow-up measurements were made on participants at 1 week and 1, 6, 12, 18, and 24 months. Infant blood pressures were adjusted for such variables as age, observer, cuff size, and sleep/activity status. Infant blood pressure correlated with maternal blood pressure corrected for age and observer shortly after birth (r = 0.138, p less than 0.001 for systolic pressure; r = 0.169, p less than 0.001 for diastolic pressure). Father-infant correlations were significant only at 1 month after birth (r = 0.179, p = 0.031; r = 0.250, p = 0.002 for systolic and diastolic pressures respectively), and sibling correlations were significant from 6 months after birth (r = 0.173, p = 0.011 for systolic pressure; r = 0.265, p less than 0.001 for diastolic pressure). Blood pressures of infants before 6 months after birth were not consistently predictive of later pressures, but systolic and diastolic blood pressures 6 and 12 months after birth were significantly and positively related to pressures at later ages (for systolic pressures at 6 and 12 months, r = 0.147, p = 0.003; 6 and 18 months, r = 0.218, p less than 0.001; 6 and 24 months, r = 0.212, p less than 0.001). These results indicate that the familial aggregation of blood pressure and blood pressure tracking can be detected early in life.

Adult↗

PubMedDate not supplied

Factors affecting blood pressures in newborn infants.

Blood pressure (BP) was measured in 837 newborn infants ranging in age from 1-6 days and their mothers in Boston, Massachusetts, and Providence, Rhode Island. The BP increased significantly with age in days, birth weight, weight on day of measurement, arm circumference, and ponderal index. There was no relation of sex, race, pulse rate, type of feeding, or Apgar scores to BP in the neonatal period. Significant correlation was found between maternal and infant BP (r = 0.196 for systolic (SBP) and 0.157 for diastolic (DBP) pressures, p < 0.001). Preliminary analysis shows a trend for resemblance of 1-month and newborn BP.

Age Factors↗