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Five hundred and sixty-eight patients were enrolled: 410 women and 158 men. The overall bacteria's distribution was similar to that observed in previous strictly microbiological studies with a more prominent role of E. coli (87.5%) to the detriment of other species. The overall susceptibility of E. coli to antibiotics recommended in the empiric treatment of pyelonephritis and prostatitis was preserved: ciprofloxacin (95.8%), cefotaxime (98%), gentamicin (99.4%). In women over 65 years, the susceptibility of E. coli to systemic fluoroquinolones fell up 89.7%. This could affect the empiric oral treatment of pyelonephritis in older women.
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To report an atypical case of chorioretinopathy in a patient with bilateral renal transplantations.
We analyzed sensitivity of 123 vaginal lactobacillus strains to antibacterial substances. All lactobacillus strains were sensitive to ampicillin, cefazolin, cefotaxime, and vancomycin, and insensitive to metronidazole, trimethoprim/sulfamethoxazole, and levofloxacin. Lactobacillus strains demonstrated different sensitivity to gentamycin, clindamycin, erythromycin, ciprofloxacin, and tetracycline. The phenomenon of preferential selective influence of antibacterial drugs on the composition of lactobacilli of the vaginal microbiota, in which some lactobacilli survive as part of the vaginal microbiota and have a selective advantage over other types of lactobacilli, should be taken into account during treatment of vaginal infections and dysbiosis.
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To determine if increased expression of efflux pumps, mutations in the genes encoding regulatory proteins for efflux pumps, or the combination is associated with multidrug-resistant (MDR) Pseudomonas aeruginosa isolates.
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In 2000, the Minnesota Department of Health (MDH) implemented active, sentinel site surveillance for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Data from 2000-2005 were analyzed to determine trends in case characteristics, pulsed-field types (PFTs), and antimicrobial susceptibilities including inducible clindamycin resistance (ICR).
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About half of the patients received antibiotic. The most common infecting bacteria were Escherichia coli followed by Enterococcus sp. and Staphylococcus aureus. E. coli showed high rate of sensitivity to carbapenems and nitrofurantoin and high rate of resistance to co-trimoxazole and ciprofloxacin. Enterococcus sp. in both wards had high rate of resistance to ampicillin and were all sensitive to linezolid. Unlike to the nephrology ward, more than 50% of Enterococcus sp. from kidney transplant ward was resistant to vancomycin. The most common type of S. aureus in this nephrology ward was methicillin-resistant S. aureus (MRSA). Most commonly-prescribed antibiotics were carbapenems followed by vancomycin, ciprofloxacin, and ceftriaxone. Antibiotic regimens were 75% and 83%, 85% and 91%, and 80% and 87% compatible with international guidelines in antibiotic types, dosages, and treatment durations, respectively, in nephrology and kidney transplant wards, respectively.
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In Kenya, leaves and roots from Croton macrostachyus are used as a traditional medicine for infectious diseases such as typhoid and measles, but reports on possible antimicrobial activity of stem bark do not exist. In this study, the antibacterial and antifungal effects of methanol, ethyl acetate and butanol extracts, and purified lupeol of C. macrostachyus stem bark were determined against important human gram-negative pathogens Escherichia coli, Salmonella typhi, Klebsiella pneumoniae, and Enterobacter aerogenes, gram-positive Listeria monocytogenes, and a fungus Candida albicans. The most promising broad scale antimicrobial activity against all the studied pathogens was shown by the ethyl acetate extract. The ethyl acetate extract induced the zone of inhibition between 10.1 ± 0.6 mm and 16.0 ± 1.2 mm against S. typhi, E. coli, K. pneumoniae, E. aerogenes, and L. monocytogenes with weaker antimicrobial activity against C. albicans (zone of inhibition: 5.6 ± 1.0 mm). The antibiotic controls (amoxicillin, ciprofloxacin, ampicillin, benzylpenicillin, clotrimazole, and cefotaxime) showed antimicrobial activity with zones of inhibition within 13.4 ± 0.7-22.1 ± 0.9 mm. The ethyl acetate extract had MIC in the range of 125-250 mg/mL against all the studied bacteria and against C. albicans MIC was 500 mg/mL. The present results give scientific evidence and support the traditional use of C. macrostachyus stem bark as a source for antimicrobials. We show that C. macrostachyus stem bark lupeol is a promising antimicrobial agent against several important human pathogens.
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This study provides a snapshot of UPEC complexity in Jamaica and highlights the significant clonal heterogeneity among strains. Such outcomes emphasise the need for evidence-based strategies in the effective management and control of UTIs.
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At present, no evidence is available to support the routine use of systemic antibiotics in promoting healing of venous leg ulcers. However, the lack of reliable evidence means that it is not possible to recommend the discontinuation of any of the agents reviewed. In terms of topical preparations, some evidence supports the use of cadexomer iodine. Current evidence does not support the routine use of honey- or silver-based products. Further good quality research is required before definitive conclusions can be drawn about the effectiveness of povidone-iodine, peroxide-based preparations, ethacridine lactate, chloramphenicol, framycetin, mupirocin, ethacridine or chlorhexidine in healing venous leg ulceration. In light of the increasing problem of bacterial resistance to antibiotics, current prescribing guidelines recommend that antibacterial preparations should be used only in cases of clinical infection, not for bacterial colonisation.
This study from 2005 to 2009 showed that the levofloxacin resistance rates of E. coli were high at over 25%. The risk factors that affected the levofloxacin resistance rates of E. coli were underlying neurogenic bladder, ciprofloxacin administration history, urolithiasis, levofloxacin administration history, and older age. Levofloxacin should be prescribed cautiously in patients with these risk factors until the pathogen is identified.
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In this study, 112 Escherichia coli and 55 Klebsiella pneumoniae isolates with a multidrug-resistant (MDR) phenotype were collected from 2007 to 2009. All isolates simultaneously exhibited resistance to cefotaxime (or ceftazidime), ciprofloxacin (or levofloxacin) and amikacin. Plasmid-mediated 16S rRNA methylases, including armA, rmtA, rmtB, rmtC, rmtD, rmtE and npmA, were detected by polymerase chain reaction (PCR) amplification. Common β-lactamase genes, including bla(TEM), bla(SHV), bla(CTX-M), bla(PER), bla(VEB), bla(GES) and bla(OXA), as well as plasmid-mediated bla(AmpC) and plasmid-mediated quinolone resistance (PMQR) determinants, including qnrA, qnrB, qnrS, qepA and aac(6')-Ib-cr, were also screened. The transferable capacity of resistance plasmids was established by conjugation testing. The genetic relatedness of isolates was analysed by pulsed-field gel electrophoresis (PFGE). Only armA and rmtB genes were detected in this study. Data showed that 93.8% of MDR E. coli and 94.5% of MDR K. pneumoniae carried at least one of armA or rmtB. The armA and rmtB genes were present in 11.6% and 82.1% of MDR E. coli, respectively. In parallel, 58.2% and 40.0% of MDR K. pneumoniae were armA- and rmtB-positive, respectively. Furthermore, the qepA gene was present in 66.3% of rmtB-carrying MDR E. coli, but it was rarely detected in MDR K. pneumoniae. Approximately 71.9% of armA-positive MDR K. pneumoniae simultaneously co-carried qnrB and bla(DHA). Moreover, 78.1% and 63.6%, respectively, of armA-positive and rmtB-positive MDR K. pneumoniae strains harboured qnr alleles and 53.1% and 59.1% harboured aac(6')-Ib-cr. In addition, MDR E. coli strains exhibited a low prevalence of qnr alleles and aac(6')-Ib-cr. PFGE analysis revealed divergent genetic relatedness, suggesting horizontal dissemination of armA and rmtB along with common β-lactamases and PMQR determinants amongst clinical MDR E. coli and K. pneumoniae isolates.
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The aim of this work was to develop a polypropylene (PP) artificial abdominal wall implant for the prolonged release of ciprofloxacin (CFX). This sustained release effect was obtained by functionalization of the textile mesh with citric acid and hydroxypropyl-γ-cyclodextrin (HPγCD) or maltodextrin (MD). In both cases the textile finishing reaction yielded a cyclo- or malto-dextrin crosslinked polymer coating the fibers. The modified supports were characterized by thermogravimetric analysis (TGA), differential scanning calorimetry and scanning electron microscopy. The sorption capacities and the kinetics of CFX release were studied by batch tests coupled with spectrophotometric assays. Microbiological assays were carried out on Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli, while proliferation and viability tests used fibroblasts. The main results were as follows. (i) Due to the differences between the range of temperature of thermal degradation of the (cyclo)dextrins polymers and of the PP fibers TGA was a reliable method for quantifying the degree of functionalization of the textiles. (ii) Both modified supports showed improved sorption/desorption capacities for CFX, compared with the virgin mesh. The HPγCD-finished support showed an increased sorption capacity and a lower release rate of CFX compared with the MD modified support. (iii) Microbiological assays confirmed the latter result, with greater sustained antibacterial activity of the HPγCD treated support. These experiments have demonstrated the role of the cyclodextrin cavity in interactions with CFX: the antibiotic was not only adsorbed via hydrogen and acid-base interactions with the polyCTR-HPγCD network, but also via host-guest complexation. (iv) Biological tests revealed a slight decrease in fibroblast proliferation after 6 days on the modified supports, but cell viability tests showed that this was not due to toxicity of the (cyclo)dextrin polymer coatings.
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Systematic review of studies retrieved from Medline (1961-July 2009), Embase (1961-July 2009), and Cochrane Library (up to July 2009). A complementary hand search was also performed. The selection criteria were as follows: (population) u-SpA patients; (intervention) nonsteroidal anti-inflammatory agents, disease-modifying antirheumatic drugs, anti-tumor necrosis factor α, anakinra, abatacept, biphosphonates, or thalidomide; (outcome) pain, function, structural damage and quality of life; (study design) randomized controlled trials (RCT), cohort studies, and case reports; (level of evidence) according to The Oxford Centre for Evidence-based Medicine (update 2009). An additional narrative review was performed to analyze the effects of drug therapies in patients with spondyloarthritis according new Assessment of Spondyloarthritis International Society criteria.
All cases had a history of corneal trauma, there was corneal metallic foreign body removal at one hospital in 11 cases, corneal reed trauma in 1 case. The characteristic signs involved grayish-blue crystalloid keratopathy, multifocal infiltrates, satellites, radical form changes in the Descemet's membrane. The results of laboratory examinations of the scrapings of the cornea infection were as follows: all cultures (12/12) were positive for rapidly growing mycobacteria, and isolates from 5 patients were all diagnosed as mycobacterium chelonae subspecies abscess; acid-fast staining revealed positive bacilli in all the 4 patients; seven of 8 patients were positive for bacterium by PCR. Transmission electron microscopy in all the 3 specimens showed many slender rod-shaped or short coarse-shaped bacteria which were phagocytized by monocytes, and some necrotic tissue. Infections in 10 eyes were resolved by combined treatment regimen including a combination of antimicrobial agents (amikacin, rifampin, gatifloxacin, ciprofloxacin, azithromycin and/or ofloxacin, etc.) and local lesion cleaning followed by cauterization with 5% tincture of iodine within 2-5 months; two cases resolved by keratoplasty which poorly responded to antibiotic therapy for 6 months.
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The epidemiology and outcomes of bloodstream infections (BSIs) caused by Escherichia coli ST131 isolates not producing extended-spectrum β-lactamases (ESBLs) are not well defined despite being more prevalent than ESBL-producers. In this study, risk factors and the impact on outcome of BSIs caused by non-ESBL-producing ST131 E. coli versus non-ST131 E. coli were investigated. A case-control study was performed in two tertiary centres to identify risk factors for ST131. Molecular methods were used to investigate all E. coli isolates from blood cultures for those belonging to O25b:H4-ST131 clonal group. fimH alleles were characterised in ST131 isolates. Multivariate analysis was performed by logistic regression or Cox regression as appropriate. A total of 33 ST131 E. coli cases and 56 controls were studied. ST131 isolates showed higher rates of resistance to ampicillin and ciprofloxacin; fimH alleles were H30 in 14 isolates (42.4%) and H22 in 12 isolates (36.4%). Only recent surgery (OR = 7.03, 95% CI 1.71-28.84; P = 0.007) and unknown source of bacteraemia (OR = 5.37, 95% CI 0.93-30.81; P = 0.05) were associated with ST131. ST131 isolates showed no association with 30-day mortality, therapeutic failure, presentation with severe sepsis/shock or length of stay. Bacteraemia due to non-ESBL-producing O25b:H4-ST131 E. coli showed few differences in terms of risk factors as well as similar outcome to non-ST131 E. coli. These data support the notion that ST131 strains are not less clinically virulent despite showing increased antimicrobial resistance, but also that they are not more virulent than other clonal groups causing BSI.