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The aim of the study was to monitor the prevalence of pathogens and development of resistance in bacteria isolated from bacteremic patients. Five University Clinics and/or Regional Hospitals in the Slovak Republic participated in the study and a total of 421 isolates were collected in the second half of the year 2002. The most prevalent organisms were coagulase-negative staphylococci (CONS) (19%), Staphylococcus aureus (18.3%), among Gram-negative bacteria Escherichia coli (13.3%), Klebsiella pneumoniae (11.4%) and Pseudomonas aeruginosa (7.8%) followed by enterococci, Acinetobacter baumannii and Enterobacter sp. All CONS and S. aureus were susceptible to vancomycin; resistance to oxacillin was observed for 55% of the CONS and only for 4% of S. aureus isolates. A higher prevalence of resistance to erythromycin, clindamycin, gentamicin and ofloxacin was found in CONS in comparison to S. aureus. Enterococcus sp. isolates were fully susceptible to vancomycin and teicoplanin. Gentamicin, amoxicillin/clavulanate, third generation cephalosporins and ciprofloxacin showed good activity against E. coli. Although 17% of K. pneumoniae isolates were resistant to ciprofloxacin, it was the most effective drug against K. pneumoniae; the prevalence of resistance to other antibiotics was rather higher. Gentamicin and ciprofloxacin were the most active against Enterobacter sp. isolates and ceftazidime and meropenem against P. aeruginosa.
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An ultra-performance liquid chromatography coupled with high resolution time-of-flight mass spectrometry method (UPLC/HRTOF-MS) has been developed for the simultaneous analysis of 19 antibiotics in dairy products. The sample was treated with acetonitrile and acidic acetonitrile to remove protein and fat, and then the supernatant was concentrated with a concentrator system. The antibiotics in the prepared sample were separated on a BEH column, and then qualitatively and quantitatively analyzed by HRTOF-MS in positive ionization mode within 10 min. A screening database containing the qualitative information of the antibiotics was built with TargetAnalysis software. Matrix matching was used in the antibiotic analysis to compensate for the matrix effects that influence analytical response. The linear range of the antibiotics was 10-500 or 15-1 000 microg/L. The limits of detection (LOD) were from 3 to 5 microg/L. At the spiked levels of 20 and 100 microg/L, the average recoveries were from 68.4% to 96.7% with the relative standard deviations ranging from 2.1% to 12.5%. The screening results of a spiked milk sample showed that all the spiked antibiotics could be detected with their deviations of retention time < or = 0.1 min, the deviations of mass < 5 mDa, the degrees of isotope pattern match > or = 87.4%, and most spiked antibiotics were detected with high scores. Furthermore, the developed method was applied for the analysis of antibiotics in more than 40 milk and dairy products of seven manufacturers, and the target antibiotics were not detected in all the samples. The method is rapid, sensitive and easy to operate, and is suitable for the screening of antibiotic residues in milk and dairy products.
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It is still unclear whether Helicobacter pylori infection is associated with risk factors for coronary artery disease. The aim of this study was to determine whether eradication of H. pylori infection affects serum lipid levels and C-reactive protein (CRP) levels. Seventy-eight patients who had H. pylori antigen positivity in their stools were enrolled. Clarithromycin, 1 g/day, amoxicillin, 2 g/day, and omeprazole, 40 mg/day, were given for 14 days. Serum total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and CRP were measured at baseline and 8 weeks after therapy. According to H. pylori stool antigen study after 8 weeks, individuals in whom H. pylori was eradicated were recruited as group A and those in whom H. pylori was not eradicated formed group B. Group A comprised 57 patients, and group B 21 patients. Patients in group A comprised 32 women and 25 men and their ages ranged from 35 to 59 years. Patients in group B included 13 women and 8 men, aged 32-61 years. No significant difference in LDL, TC, or TG serum levels were found between group A and group B. Although CRP and HDL serum levels were found to be the same before and after treatment in group B, CRP levels were found to decrease and HDL levels to increase significantly in group A (P < 0.05). We conclude that H. pylori infection may affect lipid metabolism in a way that could increase the risk of atherosclerosis. Thus H. pylori infection is an independent risk factor for coronary artery disease.
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P. mirabilis isolates (n= 1,396) were obtained from routine cultures at the University Hospital Complex of Santiago de Compostela from January 2006 to August 2009. Identification to the species level and antimicrobial susceptibility testing were achieved with Vitek 2. The isolates showing intermediate or total resistance to amoxicillin-clavulanic and cefoxitin, cefotaxime or ceftazidime were selected for AmpC phenotypic detection by double-disk synergy test, and molecular confirmation by multiplex PCR. Molecular typing of the isolates was performed by automated rep-PCR and MALDI-TOF.
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Three hundred and thirty-nine patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomized to receive omeprazole, 20 mg, amoxicillin, 1 g, and clarithromycin, 500 mg, all b.d., or omeprazole, 20 mg b.d., tetracycline chloride, 500 mg, metronidazole, 500 mg, and bismuth subcitrate, 120 mg, all t.d.s. Cure was defined as a negative urea breath test at least 2 months after treatment.
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The use of drugs in children and adolescents is higher in southern Italy and is inversely related to latitude and average annual income. More efforts should be devoted to informing physicians, patients and policy makers in order to plan effective initiatives to improve the situation.
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Subgingival biofilm specimens from inflamed deep periodontal pockets were removed before treatment from 400 adults with CP in the United States. The samples were cultured, and selected periodontal pathogens were tested in vitro for susceptibility to amoxicillin at 8 mg/L, clindamycin at 4 mg/L, doxycycline at 4 mg/L, and metronidazole at 16 mg/L, with a post hoc combination of data for amoxicillin and metronidazole. Gram-negative enteric rods/pseudomonads were subjected to ciprofloxacin disk-diffusion testing.
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This prospective, randomized, case-control, clinical 12-month study compared open-flap debridement and surface decontamination with titanium curettes and 24% ethylenediaminetetraacetic acid gel (n = 16) to the same protocol but with the addition of PTG (n = 16). One-, two-, and three-wall infrabony defects were included. Patients were given amoxicillin and metronidazole 3 days before surgery and for 7 days afterwards. Implants were submerged and allowed to heal for 6 months. Probing pocket depths, bleeding on probing, implant stability using resonance frequency analysis, and radiographic evaluation were performed at baseline and at 12 months. The threshold for significance was set at .05.
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To compare the use of intravenous vs. oral antibiotic therapy.
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Amoxicillin (AMX) is a widespread β-lactam-antibiotic and, together with some of its transformation products (TPs) originating from hydrolysis, a known environmental contaminant. To shed light on the abiotic degradation of AMX and the stability of its known TPs, laboratory hydrolysis experiments of AMX were carried out at pH 3, 7 and 11. Not only the rate of hydrolysis but also the pattern of TPs was strongly pH-dependent. The time courses of the obtained transformation products were analyzed by UPLC-HR-QToF-MS. AMX penicilloic acid (TP 1), AMX 2',5'-diketopiperazine (TP 2), AMX penilloic acid (TP 3) and 3-(4-hydroxyphenyl)pyrazinol (TP 4) were found at neutral pH. Surprisingly, the first three were not stable but transformed into 23 yet unknown TPs within three to four weeks. Seven TPs were tentatively identified, based on their product ion spectra and, where possible, confirmed with reference standards, e.g. penicillamine disulfide, 2-[amino(carboxy)methyl]-5,5-dimethyl-1,3-thiazolidine-4-carboxylic acid and dehydrocarboxylated amoxicillin penilloic acid. Analysis of samples from municipal wastewater treatment plants confirmed these findings with TP 1 being the dominant TP in the influent and a shift towards TP 2, TP 3 and TP 4 in the effluents. The lab experiments predicted up to 13 consecutive TPs from TP 1, TP 2 and TP 3 under neutral conditions. Their detection from surface waters will be difficult, because their large number and slow formation kinetics will lead to comparatively low environmental concentrations. Nevertheless the abiotic degradation of TP 1, TP 2 and TP 3 to further TPs needs to be considered in future studies of the environmental fate of amoxicillin.