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This report describes a case of pulmonary tuberculosis in a liver transplant patient without a history of previous exposure to Mycobacterium tuberculosis (MTB) complex. Prior to transplantation, the tuberculin skin test was negative and the QuantiFERON-TB Gold (QFT Gold), an interferon gamma-based blood test, was negative before and after transplant including a period beginning on postoperative day 55 when the patient developed a febrile illness with an interstitial infiltrate and pleural effusion that was unresponsive to broad-spectrum antibiotic therapy. Empiric treatment with isoniazid, ethambutol, and levofloxacin resulted in resolution of the clinical symptoms. A sputum culture grew MTB on postoperative day 87. This case illustrates the need for caution when QFT Gold is used as diagnostic tool for latent tuberculosis during the pretransplant assessment. Further studies evaluating the usefulness of QFT Gold and other interferon gamma tests in posttransplantation active infection are warranted.
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The National Antimicrobial Surveillance Forum is a continuous surveillance organisation comprising all academic/public and private sector laboratories in South Africa.
To evaluate cross-reactivity of quinolone antimicrobials in common opiate screening assays and to assess the in vivo implications of this phenomenon.
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The adsorption behavior of levofloxacin on a glassy carbon electrode was explored by cyclic and square-wave voltammetry. The drug was accumulated on a glassy carbon electrode and a well-defined oxidation peak was obtained in acetate buffer pH 5.0. Using square-wave anodic stripping voltammetry and accumulation at +0.4 V versus Ag/AgCl (saturated KCl) for 300 s, linear calibration graph was obtained from 6.0x10(-9) to 5.0x10(-7) M levofloxacin. The detection limit was calculated to be 5.0x10(-9) M. The R.S.D. determined from ten determinations at the 1.0x10(-7) M level was 1.7%. The method was applied for the direct determination of levofloxacin in diluted urine samples. It was validated using high-performance liquid chromatography (HPLC) as a reference method.
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Inappropriate antibiotic therapy (ie, the selection of an empiric agent without activity against the responsible pathogen) of secondary peritonitis may result in poor patient outcomes. The selection of an appropriate agent can be challenging because of the emerging resistance of target organisms to commonly prescribed antibiotics.
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Streptococcus pyogenes causes various diseases in humans. While the prevalence of fluoroquinolone-resistant S. pyogenes isolates has been increasing since 2000 in the USA and Europe, it has remained very low in Japan. We isolated a fluoroquinolone-resistant S. pyogenes strain and analysed its genetics.
To investigate the retinal toxicity of different doses of intravitreal injections of levofloxacin in a rabbit model, which is the levorotatory component of ofloxacin and approximately twice as potent as ofloxacin and highly active in vitro against gram-positive and -negative bacteria, and anaerobic bacteria including many ocular pathogens.
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Clinical isolates of respiratory tract pathogens were susceptibility tested against six different antimicrobial agents. The in vitro activity of moxifloxacin was compared with that of levofloxacin, cefaclor, amoxicillin-clavulanate acid, azithromycin and trimethoprim-sulfamethoxazole against 111 isolates, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and other species isolated from respiratory tract infections. All isolates were susceptible to moxifloxacin, except for two isolates of Pseudomonas aeruginosa which showed intermediate-resistance (MIC=6µg/mL), and one isolate of Escherichia coli which showed resistance (MIC>32µg/mL). Only moxifloxacin and amoxicillin-clavulanic acid were active against 100% of S. pneumoniae isolates at the suceptible breakpoint (MIC90, 0.25 µg/mL and 0.064 µg/mL respectively). The rank order of the activity among this group of drugs against S. pneumoniae was as follows (% of susceptibility): moxifloxacin = amoxicillin-clavulanic acid (100%) > levofloxacin (97%) > cefaclor (71%) > trimethoprim-sulfamethoxazole (54%) > azithromycin (53%). Except for trimethoprim-sulfamethoxazole, all antimicrobial agents were 100% active against H. influenzae and M. catarrhalis. The fluoroquinolones, moxifloxacin and levofloxacin, were the most potent compounds against these pathogens (MIC(90) 0.032 0.19 µg/mL). These in vitro susceptibility testing data of moxifloxacin support the view that this fluoroquinolone will have an important therapeutic role in the treatment of respiratory tract diseases.
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The worldwide H. pylori antibiotic resistance towards different antibiotics has increased. Such a phenomenon may affect therapeutic management in different countries.