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PubMed1992

Travelers' diarrhea. Prevention and treatment.

Travelers' diarrhea affects almost half of all travelers from developed to developing nations. Its occurrence frequently alters planned activities. Enterotoxigenic Escherichia coli and other bacterial pathogens endemic to the area visited account for the majority of pathogens isolated. Newer research technologies are assisting in defining virulence properties and epidemiologic characteristics. Prudence exercised during travel remains the preferred mode of prevention, reserving antimicrobial prophylaxis for specific situations. Oral rehydration and early pharmacologic intervention with antimicrobial and antimotility agents significantly decrease length of illness when diarrhea occurs.

Diarrhea↗

PubMed2003

Occurrence of pathogens on vegetables harvested from soils irrigated with contaminated streams.

The study assesses the contamination level, the seasonal distribution and the toxigenicity of pathogens isolated from irrigated vegetables and the water used for irrigation. A total of 196 samples of water used for irrigation and 326 irrigated vegetables were obtained from Kawo drain, Sabon Gari drain and River Galma and examined using standard procedures for coliform and viable counts and the presence of E. coli, Salmonella and Vibrio during the dry and wet seasons. Irrigation water from Kawo drain had significantly higher coliform counts by location and season than water from the other two locations. Although all the vegetables had coliform counts higher than the recommended standard (range 3.40-6.38 log(10) cfuml(-1)), amaranthus had significantly higher (P<0.05) counts than other vegetables during the dry season. Salmonella was significantly more likely to be detected during the dry season than during the wet (OR 4.91, 1.07<OR<31.16). Of the 39 enteropathogenic E. coli isolated, 15 (38.5%) were toxigenic by ileal loop test. There is need to educate farmers on the risk involved in the use of waste contaminated water for irrigation. The need to wash and disinfect raw vegetables before consumption is stressed.

Escherichia coli↗

PubMed1999

Effects of induced endometritis on the life-span of corpora lutea in pseudopregnant rabbits and incidence of spontaneous uterine infections related to fertility of breeding does.

A significant percentage of rabbit does fail to become pregnant after AI. We hypothesized that uterine infections induced by the insemination procedure are related to delayed luteolysis and high progesterone concentrations noted to present at the time of AI. The rabbits, randomly assigned to 4 groups (3 animals/group), were given 0.8 microgram GnRH analogue (Day 0) just prior to infusing the uterus with sterile extender (control group) or with extender inoculated with 0.5, 1, and 2 x 10(6) Pasteurella multocida (treated groups). The effects of treatments on functional life-span of CL were assessed by evaluating plasma progesterone from Day 0 to Day 23 of pseudopregnancy. In treated rabbits, the progesterone profiles closely overlapped those found in controls until approximately Day 14. Thereafter, they varied greatly between animals, but luteolysis was delayed by at least 5-6 d and developed less rapidly than in controls. On Day 21, progesterone concentrations were higher than normal in 4 treated does. In a field survey, vaginal swabs were collected at the time of the second AI from 114 non-pregnant rabbits and those positive to bacteriological culture, were killed humanely 16 d later to collect uterine swabs. Positive uterine swabs were found only in 19 of the 34 does having a positive vaginal swabs and all of them were not pregnant. The most frequent pathogen isolated was S. aureus (50%), followed by E. coli (37.5%) and P. multocida (12.5%). We demonstrated that uterine infection increases the life-span of CL in non-pregnant does and that infections of the genital tract system are quite common among does on breeding farms, probably related to using AI.

Animals↗

PubMed1986

Infection and colonisation of neonates by Hansenula anomala.

Over a 13-month period 52 neonates (10% of those admitted to the Mersey Regional Neonatal Intensive Care Unit) were found to be colonised with the ascosporagenous yeast Hansenula anomala. 8 babies became infected, all but 1 of whom were heavily colonised before infection. 7 of the 8 infected babies were of very low birth-weight (less than 1500 g). All 8 had multiple problems associated with low birth-weight and prematurity and were kept in the intensive care unit. 5 babies had fungaemia, 2 had fungaemia and ventriculitis, and 1 had ventriculitis only. In each case H anomala was the sole pathogen isolated. Anti-Hansenula antibodies developed in 5 babies within 3 months of infection. Infected babies were successfully treated with a combination of 5-flucytosine and amphotericin B. Despite extensive searches the babies appeared to be the only reservoir of the yeast.

Amphotericin B↗

PubMed2002

A prospective, randomized, double-blind multicenter comparison of parenteral ertapenem and ceftriaxone for the treatment of hospitalized adults with community-acquired pneumonia.

BACKGROUND: Ertapenem is a once-daily parenteral beta-lactam licensed in the United States in November 2001 and in Europe in May 2002. OBJECTIVE: This study compared the efficacy and safety profiles of ertapenem with those of ceftriaxone for the treatment of hospitalized adult patients with serious community-acquired pneumonia (CAP) requiring parenteral therapy. METHODS: In this prospective, double-blind (with sponsor blinding), multicenter study, adult patients with CAP were stratified by Pneumonia Severity Index (< or = 3 or > 3) and age (< or = 65 or > 65 years) and randomized (2:1) to receive IV or intramuscular (IM) ertapenem 1 g once daily or IV or IM ceftriaxone 1 g once daily. Investigators could switch patients to an oral antimicrobial agent if clinical improvement was shown after at least 3 days of parenteral therapy. RESULTS: A total of 364 patients were randomized to treatment: 239 to the ertapenem group and 125 to the ceftriaxone group. Three patients in the ertapenem group and 2 in the ceftriaxone group did not receive study therapy. Of the treated patients, 77.1% (182/236) of patients in the ertapenem group and 75.6% (93/123) in the ceftriaxone group were clinically evaluable. Among clinically evaluable patients, the mean (SD) durations of parenteral and total (parenteral plus optional oral) therapy were 5.5 (2.6) and 11.5 (2.7) days for ertapenem and 5.6 (2.8) and 11.7 (3.0) days for ceftriaxone, respectively. Streptococcus pneumoniae was the most frequently isolated pathogen in both treatment groups. Cure rates were 92.2% for clinically evaluable patients in the ertapenem group and 93.6% for those in the ceftriaxone group (95% CI for the difference, adjusted for stratum, -8.6 to 5.7), fulfilling the criteria for statistical equivalence. At completion of parenteral therapy, 94.7% of patients in the ertapenem group and 95.8% in the ceftriaxone group showed clinical improvement. Infused vein complications (ertapenem, 3.4% [8/236]; ceftriaxone, 7.3% [9/123]) and elevated transaminase levels (ertapenem, 6.3% [13/207]; ceftriaxone, 7.1% [8/113]) were the most common adverse events in both groups. CONCLUSIONS: In this study of hospitalized adult patients, ertapenem therapy, with an oral switch option, was as effective as ceftriaxone with the same oral switch option for treatment of CAP requiring initial parenteral therapy. The overall safety profiles of the 2 drugs were comparable.

Aged↗

PubMed2002

Clinafloxacin versus piperacillin/tazobactam in the treatment of severe skin and soft-tissue infections in adults at a Veterans Affairs medical center.

BACKGROUND: Severe skin and soft-tissue infections (SSTIs), particularly diabetic foot infections, are a source of considerable morbidity and mortality. Inappropriate antimicrobial therapy may contribute to the increasing emergence of bacterial resistance, as well as to increased health care costs. Thus, there is a continuing search for reasonably safe, well-tolerated, and effective antimicrobial agents that are less susceptible to the development of resistance than older agents. OBJECTIVE: The Department of Veterans Affairs (VA) Medical Center in Nashville, Tennessee, was I site in a multicenter, Phase III, randomized, investigator-blinded clinical trial comparing the safety and efficacy of clinafloxacin with those of piperacillin/tazobactam in the treatment of adult patients with SSTI. METHODS: Over an 18-month period, patients aged > or = 18 years with physical findings of acute bacterial SSTI requiring hospitalization and intravenous antimicrobial therapy were randomized in a 1:1 ratio to receive either clinafloxacin 200 mg IV every 12 hours or piperacillin/tazobactam 3.375 g IV every 6 hours. After a minimum of 3 days of intravenous therapy, a switch to oral therapy with clinafloxacin 200 mg PO every 12 hours or amoxicillin/clavulanate 500 mg PO every 8 hours could be made in the respective treatment groups. RESULTS: The center enrolled 84 patients (42 in each group), all but I of whom were male, reflecting the typical VA medical center population. The mean age was 60 years (range, 36-80 years) in the clinafloxacin group and 65 years (range, 35-87) in the piperacillin/tazobactam group; the latter group was significantly older (P = 0.0482), which could have affected recovery rates. Sixty-six patients were white and 18 were black. The mean ( +/- SD) duration of treatment was 10.69 +/- 5.34 days in the clinafloxacin group and 12.07 +/- 5.06 days in the piperacillin/tazobactam group; the mean length of stay was 10.83 +/- 10.28 days and 14.95 +/- 19.20 days, respectively. Fifty-three (63%) patients were switched to oral therapy (21 in the clinafloxacin group, 32 in the piperacillin/tazobactam group). The most commonly isolated pathogens were Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, and Enterobacter cloacae. Clinical cure rates and microbiologic eradication rates were similar between the 2 treatments. The piperacillin/ tazobactam arm experienced more all-cause adverse events than the clinafloxacin arm, although the difference was not statistically significant. The clinafloxacin arm experienced significantly more adverse events (eg, photosensitivity) that were judged by the investigator to be drug related (P = 0.034). CONCLUSIONS: In this study population of hospitalized adults, clinafloxacin was as effective as piperacillin/tazobactam in the treatment of complicated SSTIs. Appropriate precautions must be taken against exposure to sunlight and ultraviolet light in patients receiving clinafloxacin, and adequate monitoring is necessary. Further investigation is necessary into how the phototoxic effects of the flu oroquinolones can be limited.

Adult↗

PubMedDate not supplied

Cefdinir versus cephalexin for the treatment of skin and skin-structure infections. The Cefdinir Adult Skin Infection Study Group.

Because of increasing resistance to older antimicrobial agents, newer drugs need to be evaluated for the treatment of skin and skin-structure infections (SSSIs). This double-masked, randomized, comparative, multicenter study enrolled patients aged 13 years or older with SSSIs to receive either cefdinir 300 mg BID or cephalexin 500 mg QID for 10 days. Nine hundred fifty-two patients (474 in the cefdinir group and 478 in the cephalexin group) took part, primarily white males between 18 and 65 years of age. There were two follow-up visits, with efficacy determined at the test-of-cure visit, 7 to 16 days posttherapy. Many patients were not microbiologically assessable, primarily because of negative cultures at study admission. Patients who required surgical intervention (e.g., incision and drainage) at the site of infection more than 24 hours after the initiation of drug therapy were defined as treatment failures. Significantly more isolated pathogens were resistant to cephalexin than to cefdinir. In the 178 efficacy-assessable cefdinir-treated patients, the rate of pathogen eradication was 93% (200/215), and the rate of successful clinical response was 88% (157/178), compared with 89% (221/247) and 87% (177/204), respectively, in the 204 efficacy-assessable cephalexin-treated patients. Using confidence-interval analysis, the microbiologic and clinical response rates of the cefdinir-treated patients were statistically equivalent to those of the cephalexin-treated patients. At the follow-up visits, patients were questioned about any adverse events occurring since their previous visit. Any untoward symptom occurring during or within 2 days after completion of drug treatment was considered an adverse reaction if the investigator judged it to be definitely, probably, or possibly related to the study drug. One hundred twenty-three (26%) cefdinir-treated patients and 77 (16%) cephalexin-treated patients experienced at least one adverse reaction, a statistically significant difference. Study drug was discontinued for adverse reactions in 20 (4%) cefdinir-treated patients and 13 (3%) cephalexin-treated patients; in the two groups, 10 and 7 patients, respectively, were discontinued for diarrhea. Cefdinir taken BID was as effective as cephalexin taken QID in the treatment of mild-to-moderate SSSIs and was well tolerated by most patients. The increased antibacterial activity of cefdinir must be balanced against the higher rate of diarrhea seen in patients treated with this drug.

Adolescent↗

PubMed2003

Evaluation of infectious etiology and prognostic risk factors of febrile episodes in neutropenic cancer patients.

OBJECTIVES: Febrile neutropenic cancer patients are at risk for development of serious infections, morbidity and mortality. The aim of this study was to determine the type and frequency of infections and to evaluate some prognostic risk factors. METHODS: 220 episodes of neutropenic fever in 177 cancer patients have been reviewed. RESULTS: Infections could be documented microbiologically in 38 (17.3%) episodes and suspected clinically in 29 (13.2%). The most common focus of infection was the lower respiratory tract (11.4%) followed by the urinary tract (6.4%). The most frequently isolated pathogen was Escherichia coli (31%) followed by Klebsiella pneumoniae (18%), Pseudomonas aeruginosa (13%) and Streptococcus pneumoniae (13%). The median durations of neutropenia and fever were 4 and 3 days, respectively. Mortality was seen in 25 patients (11.4%). Its rate was higher in documented infections except for non-bacteremic microbiologic infections in which no death was seen. Hypotension and shock were the most significant determinants of poor prognosis. CONCLUSIONS: The management of these special patients should be given adequate attention and be considered important since the success of therapy depends on revealing of etiologic agents.

Adult↗

PubMed2004

Antibacterial resistance among children with community-acquired respiratory tract infections (PROTEKT 1999-2000).

OBJECTIVE: To determine the susceptibility of bacterial respiratory tract pathogens, isolated from children (0-12 years) as part of the global PROTEKT surveillance study (1999-2000), to a range of antibacterials, including the ketolide telithromycin. METHODS: Minimum inhibitory concentrations of the antibacterials studied were determined at a central laboratory using the NCCLS microdilution broth method. Macrolide resistance mechanisms were detected by PCR. RESULTS: Of 779 Streptococcus pneumoniae isolates worldwide, 43% were non-susceptible to penicillin (18% intermediate; 25% resistant) and 37% were resistant to erythromycin, with considerable intercountry variation. Eighteen per cent of 653 Haemophilus influenzae and >90% of 316 Moraxella catarrhalis isolates produced beta-lactamase. Of 640 Streptococcus pyogenes isolates, 10% were resistant to erythromycin, with considerable intercountry variation. All S. pneumoniae and 99.8% of H. influenzae isolates were susceptible to telithromycin using breakpoints proposed to the NCCLS (<or=1 and <or=4 mg/L, respectively). All M. catarrhalis and 97% of S. pyogenes and isolates were susceptible to <or=1 mg/L telithromycin. CONCLUSIONS: Antibacterial resistance complicates the empirical treatment of respiratory tract infections in children and requires continued monitoring. Telithromycin may be a useful therapeutic alternative as it is highly active against strains exhibiting various resistance phenotypes.

Anti-Bacterial Agents↗

PubMed1988

Universal immuno-stick test for direct rapid identification of microbial antigens within 5 minutes. Preliminary report.

Based on experiences with ELISA and biochemical fluorescence assays we have developed a new serologic identification system for detecting all conceivable particle and soluble antigens within 5 min using a very simple, sensitive procedure. This assay represents a sandwich ELISA that has been modified with regard to the sorbent, the enzyme substrate and the identification step. The test is performed as follows: 10 microliter aliquots of antigen dilution, specific or control antibody, respectively, and a phosphatase-conjugated anti-antibody are consecutively mixed. A small strip of special indicator sorbent paper (test stick) is moistened with this mixture for one minute. Subsequently it is dipped 3-5 times alternately in 0.1 M NaOH and a solution of the enzyme-substrate 4-methylumbelliferyl phosphate and immediately evaluated under a UV lamp. Positive samples instantaneously show brilliant light blue fluorescence and decolorization from dark red to white. Although the principle behind the reaction is not yet fully understood, the test works specifically and sensitively within a pg range. Thus far, for example, we have been able to identify Salmonella from suspended milk powder and streptococci from milk (3-5 cells/ml) without previous incubation, enterotoxins from staphylococcal colonies, Aflatoxin M1 and organ-phosphates. Results from examinations of staphylococcal enterotoxins are presented in more detail. Moreover, using a defined antigen, antibodies from different sera could be identified in the same rapid, sensitive and specific manner. Thus, we are convinced that the usual time-consuming enrichment methods for isolating pathogenic bacteria and other immunogenic substances as also current serologic assays will turn out to be superfluous.

Antigens, Bacterial↗

PubMed1992

Difficulty in predicting bacteremia in elderly emergency patients.

STUDY OBJECTIVES: To characterize the clinical presentation and identify factors predictive of bacteremia in elderly patients. DESIGN: Retrospective review of emergency department charts, hospital records, and microbiology reports. SETTING: Community teaching hospital with annual ED census of 65,000 adults. PARTICIPANTS: Seven hundred fifty elderly patients (aged 65 to 99 years) who were evaluated by the emergency physician, had blood cultures obtained in the ED, and were hospitalized with a suspected infectious process during a 12-month period. MEASUREMENTS: Records were analyzed for demographic information, underlying diseases, clinical presentation, laboratory findings, sources of infection, and causative organisms. Using contingency tables, 79 patients with positive blood cultures were compared with a random sample of 136 patients with sterile blood cultures to identify clinical variables significantly (P less than .05) associated with bacteremia. Logistic regression analysis was performed with significant factors to develop a model to predict bacteremia. Sensitivity, specificity, and predictive values were calculated for the model. MAIN RESULTS: The prevalence of bacteremia was 10.6%. Escherichia coli was the most commonly isolated pathogen (29% of cases), and the urinary tract was the most common source of infection (44.3% of cases). Logistic regression analysis showed that altered mental status (odds ratio, 2.88; 95% confidence interval [Cl], 1.52 to 5.50), vomiting (odds ratio, 2.63; 95% Cl, 1.16 to 6.15), and WBC band forms of more than 6% (0.06) (odds ratio, 3.50; 95% Cl, 1.58 to 5.27) were independent predictors of bacteremia. The presence of at least one of these three factors had a sensitivity of 0.85 (95% Cl, 0.75 to 0.92) and a specificity of 0.46 (95% Cl, 0.38 to 0.55) for predicting bacteremia in the study group. The positive predictive value was 0.16 (95% Cl, 0.12 to 0.19) and the negative predictive value was 0.96 (95% Cl, 0.94 to 0.98) for the ED patient group that met inclusion criteria. CONCLUSION: Elderly patients fail to manifest identifiable clinical features indicative of bloodstream infection. The sensitivity and specificity of the best statistical model for identifying bacteremic elderly patients suggest that clinical indicators alone are unreliable predictors of bacteremia in the geriatric ED population studied.

Aged↗

PubMed1980

Mammalian bite wounds.

Clinical data were collected prospectively from a series of 160 patients presenting with mammalian bite wounds. Anaerobic and aerobic cultures were prepared from sterile swabs placed in 65 bite wounds prior to cleansing. Infection was noted in 11 of 22 cat bites, six of 37 human bites, three of 80 dog bites, and in none of the 21 bites caused by other mammals. Pasteurella multocida was recovered from six infected cat and dog bites, all of which developed infection within 24 hours of injury. Staphylococcus aureus and Streptococcus viridans were the principal pathogens isolated from the remaining infected cat, dog, and human bites. Infection most commonly followed puncture wounds caused by cats (10/19) and lacerations into subcutaneous tissue of the hand caused by humans (4/17). None of the 10 sutured wounds became infected. All infected bite wounds responded to antibiotic therapy. No conclusions regarding the value of prophylactic antibiotics could be made.

Animals↗

PubMed2001

[Acute cystitis in women. Current microbial sensitivity in our setting].

INTRODUCTION AND OBJECTIVE: Acute cystitis is the most frequent symptomatic infection in females and the urological condition which results in more visits to the clinic. The empirical treatment commonly instituted requires a continuous update of local microbial susceptibility to keep resistance emergence under control and reduce costs. Our goal was to study the current susceptibility of all urological pathogens isolated in acute cystitis in female patients. MATERIAL AND METHODS: Prospective study on 218 cases of acute cystitis in females reported between March 2000 and November 2000 in Health Centres within our Health Care Area. Patients were distributed by age range also including other parameters such as history of previous cystitis and predisposing factors, clinical sings and symptoms, as well as isolated micro-organisms and their "in vitro" susceptibility and MIC (Minimum Inhibitory Concentration) against the anti-microbial agents most commonly used in the clinical practice. RESULTS: The larger age groups were 25-35 and 65-75 years. 162 cases were intermittent and 56 were repeat cystitis. Haematuria was present in 14% cases. The microbial spectrum was similar in all groups; overall E. coli was isolated in 82.1% cases, K. pneumonia in 6%, S. agalactiae 3.7%, E. faecalis 2.3%, P. mirabilis 1.8% etc. Resistance rates for E. coli were: 0.6% for cefixime, 1.1% for amoxycillin-clavulanate, 1.7% tobramycin, 2.8% fosfomycin, 3.3% nitrofurantoin, 18.4% ciprofloxacin, 19.6% norfloxacin, 22.3% pipemidic acid, 35.8% co-trimoxazol and 54.7% ampicillin. Repeat cystitis was more frequent in patients over 65 years with higher resistance rates mainly in the quinolones group (28.6% ciprofloxacin and 30.4% norfloxacin for E. coli). Mean MIC for ciprofloxacin with regard to E. coli was: 1.503 mcg/mL (range: 0.06-8) and 3.96 mcg/mL (range: 1-16) for amoxycillin-clavulanate. CONCLUSION: High E. coli resistance rates to quinolones are still persistent. Excellent susceptibility to amoxycillin-clavulanate, cefixime and aminoglycosides, which allows for their use in short-term treatment regimes. High resistance rates to urinary antiseptic agents such as co-trimoxazol and ampicillin, and low rates for agents such as fosfomycin and nitrofurantoin.

Acute Disease↗

PubMed2000

Effect of vaccination on the potentiation of porcine reproductive and respiratory syndrome virus (PRRSV)-induced pneumonia by Mycoplasma hyopneumoniae.

Porcine reproductive and respiratory syndrome virus (PRRSV) and Mycoplasma hyopneumoniae are frequently isolated pathogens from pigs with respiratory disease. A previous study conducted in our laboratory found that infection with M. hyopneumoniae increased the duration and severity of respiratory disease induced by PRRSV. The purpose of this experiment was to determine whether vaccination against M. hyopneumoniae and/or PRRSV decreased the enhancement of PRRSV-induced pneumonia. Both M. hyopneumoniae bacterin and PRRSV vaccine decreased the severity of clinical respiratory disease. Infection or vaccination with PRRSV appeared to decrease the efficacy of the M. hyopneumoniae bacterin. Vaccination with M. hyopneumoniae bacterin decreased the potentiation of PRRSV-induced pneumonia observed in the dual infected pigs. However, PRRSV vaccination in combination with M. hyopneumoniae bacterin eliminated this benefit and the amount of pneumonia induced by PRRSV increased. PRRSV vaccine alone did not decrease the potentiation of PRRSV pneumonia by M. hyopneumoniae.

Animals↗

PubMed2002

Successful medical management of multifocal psoas abscess following cesarean section: report of a case and review of the literature.

The psoas abscess is a rare complication in obstetric and gynaecology. Two types of psoas abscess are recognized. The primary psoas abscess is generally following haematogenous dissemination of an infectious agent and the source is usually occult. The most frequently isolated pathogen is Staphylococcus aureus. On the other hand, the secondary abscess is the result of local extension of an infectious process near the psoas muscle. We report the case of a patient who develops a bacteremia from an infected cesarean section wound. The complications were thigh and psoas abscesses with left sacroiliitis. Medical management with prolonged antibiotherapy permit clinical, biological and radiological improvement. Although it required a long hospital stay, medical treatment alone was effective. More experience is required to determine which therapeutic option: medical treatment and/or surgery, is the best choice for this type of complication.

Adult↗

PubMed2003

An RTX operon in hemolytic Moraxella bovis is absent from nonhemolytic strains.

Pathogenic isolates of Moraxella bovis express a calcium-dependent transmembrane pore forming cytotoxin that is an RTX toxin encoded by mbxA. The DNA flanking mbxA was cloned and sequenced to determine if M. bovis contained a classical RTX operon. Open reading frames (ORFs) with deduced amino acid sequence homology to putative activation (RTX C) and transport (RTX B and D) proteins were identified and have been designated MbxC, MbxB, and MbxD, respectively. Thus, hemolytic M. bovis contains a typical RTX operon comprised of four genes arranged (5'-3') mbxCABD. In addition, the deduced amino acid sequences of DNA flanking mbxCABD revealed ORFs with amino acid sequence similarity to transposases (5'). At the 3' end of the mbx gene cluster, an ORF with homology to bacterial tolC genes was identified. Thus, as with the cya RTX operon of Bordetella pertussis, M. bovis appears to have a secretion accessory protein linked to RTX genes. Analysis of genomic DNA isolated from 5 nonhemolytic M. bovis strains by PCR and Southern blotting revealed the absence of mbxCABD. These strains did, however, amplify with primers specific for the 5' region flanking mbxC. M. bovis harbors a classical RTX operon that is absent in nonhemolytic strains.

Amino Acid Sequence↗

PubMed2002

Efficacy and safety of gatifloxacin in elderly outpatients with community-acquired pneumonia.

To evaluate the safety and efficacy of gatifloxacin in adults <65, 65 to 79, or > or =80 years old with community-acquired pneumonia, adult male and female outpatients from general community-based practices were enrolled in an open-label, multicenter, noncomparative study. Gatifloxacin 400 mg once daily was administered for seven to 14 days. Medical history, physical examination, signs and symptoms of infection, Gram stain and culture if specimen available, clinical response, and safety were determined. Of 1655 treated patients, 1103 were at least 65 years old, 405 were 65 to 79, and 147 were at least 80. Patients > or =80 years old presented with chills, chest pain, fever, or headache less often than younger patients. Cure rates were 95.5% for patients <65 years old, 96.2% for those 65 to 79, and 90.2% for those at least 80 years old. Neither the frequency nor susceptibility of isolated pathogens appeared to differ with age. Between 93.7% and 100% of subsets of the two younger groups with verified Streptococcus pneumoniae or Hemophilus influenzae were cured. All oldest-group patients in the subset with verified S. pneumoniae and 71.4% (7) of patients with H. influenzae were cured. Each age group, including current or past smokers and patients receiving medications for concomitant conditions, tolerated treatment well. Gatifloxacin is safe and efficacious in adults of any age with community-acquired pneumonia, including the elderly up to 100 years old and patients with S. pneumoniae including penicillin-resistant strains.

Administration, Oral↗

PubMed1998

Extended spectrum beta-lactamase production and fluorquinolone resistance in pathogens associated with community acquired urinary tract infection.

We have evaluated the susceptibility of 199 pathogens isolated in pure culture from consecutive urine samples submitted from the community. Rates of susceptibility for all organisms were ampicillin, 48%; amoxycillin/clavulanic acid, 88%; cephalothin, 57%; cefuroxime axetil, 74%; nalidixic acid, 85%; ciprofloxacin, 99%; nitrofurantoin, 78%; and trimethoprim, 67%. Ciprofloxacin resistance and production of extended spectrum beta-lactamase enzymes were detected in Escherichia coli strains isolated from patients in the community.

Anti-Infective Agents↗