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Fosfomycin and nitrofurantoin slow release best fulfill the requirements for drugs in the treatment of uncomplicated cystitis. No comparative studies have been performed with the 3-day treatment of uncomplicated cystitis with nitrofurantoin slow release or with trimethoprim. Fluoroquinolones play no important part in the treatment of uncomplicated cystitis, mainly because of the risk of development of resistance.
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Vaginal colonization with group B Streptococcus (GBS) is the predominant risk factor for the development of invasive neonatal GBS diseases and puts newborns at increased risk for morbidity and mortality. This study is aimed to determine the colonization rate and antimicrobial susceptibility pattern of group B Streptococcus among pregnant women.
Clinical and epidemiological data were collected from domiciliary cases and also from patients attending two medical camps that had been set up for the purpose. Stool and water samples were collected for isolation of diarrhoeagenic pathogens.
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The effect of siliconized latex urinary catheters on the in vitro activity of amikacin, ceftazidime, ciprofloxacin, norfloxacin and meropenem against Pseudomonas aeruginosa was determined by a microdilution assay. MICs of amikacin and meropenem increased at least 4-fold and 16-fold respectively in the presence of catheter material. The effect of catheter material on meropenem activity was not strain dependent and was similar for different brands of catheters. The susceptibility to antimicrobial agents of Pseudomonas aeruginosa attached to catheters for 6 and 24 hours was also evaluated. When bacteria attached for 6 hours were used as inoculum, MBCs increased at least 8-fold for amikacin, 64-fold for ceftazidime, 64-fold for ciprofloxacin, 32-fold for norfloxacin and 2048-fold for meropenem. Similar results were observed when bacteria attached to catheters for 24 hours were used as inoculum. It is concluded that catheter material itself affected the in vitro activity of meropenem, and that the bactericidal activity of all antimicrobial agents against Pseudomonas aeruginosa present in biofilms on the surface of siliconized latex urinary catheters decreased dramatically, this effect being more pronounced with meropenem.
Linezolid may be administered in combination with norfloxacin, gatifloxacin, levofloxacin, moxifloxacin, and tinidazole for the treatment of various infections, such as urinary and respiratory tract infections, to improve the efficacy of the treatment or to reduce the duration of therapy. Knowledge of the antibiotic plasma concentrations combined with bacterial susceptibility evaluated in terms of minimum inhibitory concentration would optimize treatment efficacy while limiting the risk of dose-related adverse effects and avoiding suboptimal concentrations.
Both Salmonella Typhimurium strains were resistant to tetracycline, streptomycin and sulphonamides, while Se20 was also resistant to nalidixic acid, ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, amikacin, tobramycin, kanamycin and trimethoprim. PFGE and MLST showed a clonal relationship between the strains, which belonged to the sequence type ST36. Both strains contained the repC-sul2-strA-strB structure and tet(A) and qnrS1 genes, and strain Se20 also contained the aac(6')-Ib-cr gene, the Ser83-->Tyr substitution in GyrA and one class 1 integron with the dfrA17 + aadA5 gene cassette arrangement lacking qacEDelta1 + sul1. Two different transconjugants from Salmonella Se20 (TCSe20B and TCSe20L) harboured qnrS1 and sul2 genes and the class 1 integron. The TCSe20B strain also acquired the aac(6')-Ib-cr gene located on a non-typeable plasmid. qnrS1 was identified on a ColE-type plasmid and the class 1 integron on an IncI1-type plasmid.
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While selective intestinal decontamination (SID) can alter the hyperdynamic circulatory state of cirrhosis, the impact of SID on portal pressure remains unclear especially in the setting of clinically significant portal hypertension.
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The prevalence of hepatocellular carcinoma in cirrhotic patients with spontaneous bacterial peritonitis is high, and its presence should be actively sought. Advanced tumor impairs both hospital and long-term survival, and should be considered in the design of future trials.