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PubMed2004

In vitro combined bactericidal activity of cefpirome and glycopeptides against glycopeptides and oxacillin-resistant staphylococci.

Infections caused by coagulase-negative staphylococci are becoming increasingly important, particularly those of nosocomial origin, as the organisms are frequently multi-resistant. New antimicrobial strategies are needed. The bactericidal activity of a combination of cefpirome with either vancomycin or teicoplanin against 12 strains of methicillin-resistant staphylococci with a decreased susceptibility to teicoplanin was determined in vitro by a time killing method. Strains Mu3 and Mu50 of Staphylococcus aureus were also studied. Cefpirome (0.125-0.5 x MIC) combined with vancomycin (0.25-1 x MIC) or teicoplanin (0.125-1 x MIC) acted synergically against 12 isolates over 18 h in most cases. A synergistic killing effect was also observed with the Mu3 and Mu50 strains of glycopeptide-intermediate S. aureus but over a longer period.

Anti-Bacterial Agents↗
PubMed2005

Rapid detection of methicillin resistance in teicoplanin-resistant coagulase-negative staphylococci by a penicillin-binding protein 2' latex agglutination method.

Thirty-five clinical isolates of coagulase-negative staphylococci with decreased glycopeptide sensitivity were examined by a penicillin-binding protein (PBP2') latex agglutination (LA) test and were compared to the detection of the mecA gene by PCR, and oxacillin susceptibility determined minimum inhibitory concentrations. The latex test demonstrated high sensitivity and specificity for detecting methicillin resistance in coagulase-negative staphylococci after PBP2' induction with oxacillin.

Anti-Infective Agents↗
PubMed2006

[Retroperitoneal abscess in a man with severe necrotizing pancreatitis].

HISTORY AND ADMISSION FINDINGS: A 65-year-old man was admitted to the emergency unit of another hospital with severe acute abdominal pain. Medial laparotomy revealed a tear in the lower pole of the capsule of the enlarged spleen. Results of some laboratory tests became available only after the procedure: Lipase and amylase levels were markedly elevated at 5097 U/l (normal range < 100 U/l) and 1776 U/l (normal range < 60 U/l), respectively. These findings suggested acute pancreatitis as cause of the acute abdominal pain. Conservative treatment was initiated, but because of progressive clinical deterioration with fever, dyspnea and tachyarrhythmia he was transferred to our hospital for further treatment. INVESTIGATIONS, DIAGNOSIS AND TREATMENT: Chest X-ray revealed bilateral pleural effusion. Contrast-enhanced abdominal CT scan revealed an acute peripancreatic fluid collection and extensive pancreatic necrosis extending into the perirenal space, hilum of the spleen and transverse mesocolon. Despite the placement of multiple percutaneous pigtail catheters clinical improvement of the severe necrotizing pancreatitis was only temporary and repeated episodes of fever and septicaemia occured. Supported by a multidisciplinary consensus an endoscopic ultrasound (EUS)-guided transgastric drainage of the pancreatic abscess was performed with placement of two double-pigtail catheters and a nasocystic drain for irrigation. After this intervention the patient}s condition rapidly improved, inflammatory parameters normalized and the retroperitoneal abscess gradually resolved. CONCLUSION: A multidisciplinary consensus and modern interventional approaches such as EUS-guided endoscopic therapy are mandatory to successfully approach severe necrotizing pancreatitis and its complications.

Abdomen, Acute↗
PubMed1985

[Determination of resistance and antibiotic therapy in bacterial eye diseases of childhood].

From June 1982 to December 1983 children aged between 3 days and 5 years (average 2-1/2 years) with bacterial conjunctivitis, blennorrhea or perforated corneal ulcers were examined microbiologically. The results of 30 antibiotic susceptibility tests were compared with those of adults. Prevalence of Escherichia coli (6%) and Staphylococcus aureus haemolyticus (17%) was observed; Candida species was not found in the young children. Pediatric diseases revealed themselves to be more pronounced in general. The authors diagnosed 3 chlamydial blennorrheas in newborn aged 7, 8 and 10 days. Mixed infections were found significantly less often in children (21%) than in adults (64%). The authors point out the need for epidemiologic antibiotic susceptibility studies to facilitate decision making for ad hoc therapeutic measures that are sometimes indicated in endophthalmitis or severe blennorrhea. The possible complications of antibiotic polypragmasia and the use of fixed combinations are discussed.

Anti-Bacterial Agents↗
PubMed2005

Bilateral adrenocortical uptake of Ga-67 SPECT during septicemia in a heart transplant patient.

Gallium-67 scintigraphy is a valuable agent in the management of fever of unknown origin. The use of SPECT increases its sensitivity and may demonstrate unexpected findings. We report on a heart-transplanted 55-year-old man with postsurgical fever of unknown origin. Ga-67 SPECT showed bilateral abnormal adrenal gland uptake that disappeared after intensive antibiotic therapy as assessed by a new Ga-67 scintigraphy obtained 3 months later. Unilateral and bilateral adrenal uptake of gallium has been reported in several clinical settings, ranging from adrenocortical adenomas to malignant disease such as lymphoma or adrenal metastases. Only one similar case, septicemia with transient adrenal uptake of gallium, has been previously reported.

Adrenal Cortex↗
PubMed2005

Increasing ciprofloxacin resistance among prevalent urinary tract bacterial isolates in Gaza Strip, Palestine.

This article presents the incidence of ciprofloxacin resistance among 480 clinical isolates obtained from patients with urinary tract infection (UTI) during January to June 2004 in Gaza Strip, Palestine. The resistance rates observed were 15.0% to ciprofloxacin, 82.5% to amoxycillin, 64.4% to cotrimoxazole, 63.1% to doxycycline, 32.5% to cephalexin, 31.9% to nalidixic acid, and 10.0% to amikacin. High resistance to ciprofloxacin was detected among Acinetobacter haemolyticus (28.6%), Staphylococcus saprophyticus (25.0%),Pseudomonas aeruginosa (20.0%), Klebsiella pneumonia (17.6%), and Escherichia coli (12.0%). Minimal inhibitory concentration (MIC) of ciprofloxacin evenly ranged from 4 to 32 mu g/mL with a mean of 25.0 mu g/mL. This study indicates emerging ciprofloxacin resistance among urinary tract infection isolates. Increasing resistance against ciprofloxacin demands coordinated monitoring of its activity and rational use of the antibiotics.

Journal Article↗
PubMed2003

Use of drotrecorgin alfa--recombinant activated human protein C in treatment of septic shock in the course of therapy for nephrolithiasis.

BACKGROUND: Septic shock is the most dangerous complication of nephrolithiasis management utilizing percutaneous methods. CASE REPORT: The patient, D.M., aged 60 was subjected to scheduled percutaneous nephrolithotomy due to coral calculosis of the pyelocalyceal system. As pyuria was noted intraoperatively, nephrostomy was left after the procedure. Over ten hours after the surgery the patient developed the symptoms of severe septic shock with progressive respiratory distress, renal failure, intravascular coagulation syndrome and impaired consciousness. Nephrectomy was performed, antibiotic treatment and high doses of norepinephrine instituted. Hemodynamic stabilization was obtained, without, however, marked improvement of the patient's condition. Because of persistent coagulation disorders and multiorgan dysfunction, recombinant activated protein C preparation--drotrecorgin alfa (Xigris Eli Lilly) was added to the therapeutic regimen. From the second day of infusion, systematic improvement of the coagulation system parameters was observed, making it possible to reduce the doses of catecholamines, oxygen concentration in the gas mixture used for ventilation, as well as stabilization of the function of the preserved kidney. The patient was weaned off the respirator on the 8th day of treatment and on the 13th day referred to the Urology Department, from which she was soon discharged home. CONCLUSIONS: 1. Surgical resection of the infection source and cause of the septic shock is the prerequisite for successful pharmacological treatment. 2. Administration of rh-APC to a patient meeting the PROWESS criteria may be an effective and safe method of treatment in the complex management of septic shock.

Disseminated Intravascular Coagulation↗
PubMed2006

Applications of LightCycler Staphylococcus M-GRADE assay to detect Staphylococcus aureus and coagulase-negative staphylococci in clinical blood samples and in blood culture bottles.

We evaluated the applicability of the LightCycler Staphylococcus M(GRADE0 assay on artificially infected blood samples from healthy donors and on clinical specimens of 31 hospitalized patients. The sensitivity and specificity of the assay for detecting Staphylococcus aureus was 100% in blood samples, and 100% in blood culture bottles, when data from the BACTEC 9120 blood culture system were taken as gold standard. The same specificity and sensitivity was found during the search for CoNS (Coagulase Negative Staphylococci) in blood culture bottles, whereas a 93.33% sensitivity and 100% specificity was observed for detecting CoNS directly in blood clinical specimens.

Bacteremia↗
PubMed1981

[Necrotizing fasciitis--a frequently mistaken disease (author's transl)].

A case of Fasciitis necroticans on the leg is reported in a female patient, age 28. The disease began with symptoms of an erysipelas, but it was resistant to penicillin. Within a few days necrotic decay of circumscribed skin areas occurred and the adjacent skin was widely undermined by the necrotizing process. Beta-hemolytic streptococci and Staphylococcus aureus haemolyticus were isolated. However, the disease could not be managed by adequate antibiotic therapy. Finally, the process was brought under control by extended incisions and removal of the necrotic masses. Defects were covered by plastic surgery.

Adult↗
PubMed1981

[Folliculitis decalvans].

A 58 year-old-male with folliculitis decalvans, a circumscribed chronic purulent folliculitis with subsequent hair loss and follicular atrophia is described. Staphylococcus aureus haemolyticus could be detected in the lesions. Local and systemic treatment with fusidic acid was effective.

Alopecia↗
PubMed2002

Antimicrobial susceptibility of staphylococci species from cow foremilk originating from dairy farms around Gaborone, Botswana.

OBJECTIVE: To determine the prevalence of antibiotic susceptibility of Staphylococcus species isolated from foremilk samples. SETTING: Milk was collected from five farms within a 70 km radius of Gaborone, Botswana. SUBJECTS: Two hundred and twenty five staphylococci isolates from foremilk samples. MAIN OUTCOME MEASURES: Antibiotic susceptibility tests to penicillin G, ampicillin, tetracycline, erythromycin, cephalothin, chloramphenicol, methicillin, gentamicin and vancomycin. RESULTS: The susceptibility patterns of the staphylococcal strains to the antibiotics were as follows: penicillin G (47.1%), ampicillin (58.7%), tetracycline (62.7%), erythromycin (72%), cephalothin (72.9%), chloramphenicol (79.1%), methicillin (86.2%), gentamicin (88.9%) and vancomycin (100%). Lower susceptibility to chloramphenicol, methicillin and gentamicin was displayed by Staphylococcus epidermidis, S. haemolyticus and S. saprophyticus. Only 19 (8.5%) of the isolates were susceptible to all the antibiotics tested. The most common multiple resistance patterns encountered were penicillin-ampicillin (9.3%), penicillin-erythromycin-ampicillin (6.1%) and erythromycin-tetracycline-ampicillin (3.6%). CONCLUSION: Most of the Staphylococcus isolates were resistant to one or more of the antimicrobial agents, with none being resistant to vancomycin. Inappropriate use of antibiotics is suspected to be a major contributory factor in the relatively high level of resistance to antimicrobial agents observed in this study. Therefore, milk can act as a very good source of antibiotic resistant Staphylococcus species posing a threat to consumers.

Animals↗
PubMed2004

[Analysis of microorganisms isolated from febrile neutropenic children with neoplastic disease].

The microbiological evaluation of the blood was carried out as a continued monitoring of the microorganism culture using the colourmetric system VITAL 200 (bio-Mérieux). There have been analysed 4660 bacteriological research results of the peripheral blood, blood from Broviac and from Broviac liquid of the children suffering from cancer treated in the years 1997-2000 in the Pediatric, Hematology and Oncology Clinique of the State Clinical Hospital in Bydgoszcz. There have been gained 1032 positive cultures from KZZ, KZB, PZB. There have been recognized 259 bacteremia and 22 fungemia by the children with fever in the neutropenia period. In the analysed four years in the blood dominated Gram-positive bacteria. Among Gram-positive bacteria there were mostly Staphylococcus spp. (42.5%), mostly CNS, fewer numerous were Streptococcus spp. (14.5%) and Corynebacterium spp. (5.9%). Among Gram-negative bacteria mostly were isolated Acinetobacter spp. (25.6%), Pseudomonas spp. (9.7%), E. coli (13.8%), Enterobacter spp. (13.9%), Klebsiella spp. (9.2%). There were observed few infections by strains resistant to many antibiotics, S. maltophilia, B. cepacia, E. faecium, S. haemolyticus. All strains Staphylococcus spp. were sensitive to vancomycin. There have not been found Enterococcus spp. resistant to glycopeptides. Most active against Gram-positive rods were carbapenems and aminoglycosides.

Bacteremia↗