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Persistent buffalo mastitis caused by Staphylococcus spp. gives rise to economic losses and may be resistant to antimicrobial therapy. The aim of the present study was to determine resistance patterns and the presence of mecA, blaZ, and efflux pump in Staphylococcus spp. isolated from cases of mastitis in Brazilian buffalo herds. Susceptibility to antimicrobials was determined by the disk diffusion test and detection of the mecA and blaZ genes by polymerase chain reaction. The efflux pump screening test was performed by growing samples in Muller-Hinton agar containing ethidium bromide. The percentages for resistance to the drugs tested were: 71.8% to penicillin, 49.2% to amoxicillin, 65.8% to oxacillin, 62.3% to cefquinome, 44.7% to cephalonium, 45.2% to ciprofloxacin, 32.6% to enrofloxacin, 58.7% to erythromycin, 42.7% to florfenicol, 34.6% to gentamicin, 35.1% to trimethoprim-sulfamethoxazole, 8.5% to tetracycline + neomycin + bacitracin, 43.2% to cephalothin, 38.1% to streptomycin, 58.7% to tetracycline, 31.6% to norfloxacin, 45.2% to ceftriaxone, 43.2% to nitrofurantoin, 57.7% to doxycycline, and 53.7% to cephalexin. Simultaneous resistance to 4 or more antimicrobial drug groups was observed in 112 isolates, using the mecA (11) and blaZ (79) genes, and efflux pump (47). It is concluded that Staphylococcus spp. isolates from cases of mastitis in Brazilian buffalo show varying levels of resistance to antibiotics, and caution should be exercised in choosing therapeutics in order to minimize the risk to public health.
Many fluoroquinolone (FLQ) antibiotics undergo rapid photodegradation in sunlit waters and form multifaceted photo-products. The high photodegradation rate is primarily ascribed to their photosensitizing properties. Though widely studied, the photo-reaction pathways are not completely revealed; photo-products mediated by different reactive oxygen species are not identified. In our study, photo-degradation of fluoroquinolone norfloxacin was investigated. A rapid degradation in buffered water was observed with a first-order rate constant of 2.45/hr and a quantum yield of 0.039. After light screening correction, selected DOMs (5 mg C/L) slightly enhanced the photodegradation rate with the exception of Suwannee river hydrophobic organic matter (SR-HPO). Three major photo-products were identified using high resolution mass spectrometry (HRMS). With (1)O2 dark formation and competitor experiments, norfloxacin self-sensitized (1)O2 was found to oxidize norfloxacin by inducing its piperazine chain cleavage. DOMs exhibited a dual role by inhibiting the (1)O2-mediated reaction while enhancing the heterolytic defluorination pathway. DOMs were proposed to enhance heterolytic defluorination by donating electron to triplet state FLQ, this proposal was supported with specific UV absorbance (SUVA) as an indicator for the abundance of π bonds. Fluoride formation indicated a 79% elimination ratio of fluorine, an important functional group for antimicrobial activity. This work provides important new insights into the photochemical fate of fluoroquinolone antibiotics in natural water.
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Out of 1726 patients, 549 (31.8%) showed bacterial growth. Escherichia coli was most common (72.5%), followed by Klebsiella pneumoniae (11.3%), Staphylococcus aureus (3.1%), coagulase negative Staphylococcal species (2.7%) and others (10.1%). There was a female dominance of 3.2:1 compared to males, except in the 61 and above age range. Infections were most common in young adults (21-30 years). The most effective antibiotic was Nitrofurantoin followed by Norfloxacin, Ciprofloxacin and Ofloxacin. Some isolates were resistant to Norfloxacin, Ampicillin, Cotrimoxazole and Ciprofloxacin.
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A broad spectrum antimicrobial agent, 1-ethyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic acid (norfloxacin), has been successfully incorporated as a monomer into a polyurethane backbone structure via a three-step polymerization of norfloxacin, diisocyanatododecane (DDI), and polycaprolactone diol (PCL). The reaction was catalyzed by dibutyltin dilaurate and carried out in dimethyl sulfoxide. The sequential order of monomer feeding had a strong influence on the polymerization behavior and final polymer structure. In the preferred reaction scheme norfloxacin is initially reacted with DDI to form an oligomer. This is followed by a second reaction where PCL is introduced in order to produce a drug polymer chain with higher molecular weight and degradable segments. Cross-linking of urea linkages between the norfloxacin and DDI segments was a particular concern and was minimized by feeding PCL into the reaction system immediately following the completion of the first step. Chain extension by 1,4-butanediol or ethylenediamine was shown to be an effective approach for increasing the molecular weight of the polymers.
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We describe a 4 year old girl with acute Aeromonas hydrophila gastro-enteritis who presented with a combination of hypercalcemia, metabolic alkalosis, and renal impairment. Serum parathyroid hormone was not elevated. Both milk-alkali syndrome and intoxication of vitamins A and D were ruled out. The hypercalcemia, metabolic alkalosis, and renal impairment were improved by fluid infusion and intravenous administration of furosemide. Gastro-enteritis also improved with oral administration of the antibiotic norfloxacin. The association of A. hydrophila gastro-enteritis with hypercalcemia has not been described previously.
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Lachrymal concentrations of the fluoroquinolone norfloxacin were studied in 30 subjects (aged 24-35 years) after a single ocular instillation (0.3% solution, 50 ul) in comparison with ofloxacin instilled at the same dose. Lachrymal levels were measured by high performance liquid chromatography (HPLC). Lachrymal peak levels were comparable 5 min after instillation but norfloxacin appeared to have a longer elimination half-life than ofloxacin. The AUC (area under the curve) for norfloxacin was therefore higher than for ofloxacin (35.9 and 10.7 mg* min/ml, respectively). These data suggest that norfloxacin may have higher corneal retention than ofloxacin, so this antibiotic may be indicated in superficial infections dependent on fluoroquinolone-sensitive bacteria.
Acinetobacter baumannii is a major nosocomial pathogen which frequently develops multidrug resistance by acquisition of antibiotic resistance genes and overexpression of intrinsic efflux systems, such as the RND efflux pumps AdeABC and AdeIJK. A third RND system was characterized by studying spontaneous mutants BM4663 and BM4664, which were selected in the presence of chloramphenicol and norfloxacin, respectively, from the AdeABC- and AdeIJK-defective derivative A. baumannii BM4652. They exhibited enhanced resistance to fluoroquinolones, tetracycline-tigecycline, chloramphenicol, clindamycin, trimethoprim, sulfamethoxazole, sodium dodecyl sulfate, and dyes such as ethidium bromide, safranin O, and acridine orange. Comparison of transcriptomes of mutants with that of their parental strain, using a microarray technology, demonstrated the overexpression of three genes that encoded an RND efflux system, named AdeFGH. Inactivation of AdeFGH in BM4664 restored an antibiotic susceptibility profile identical to that of BM4652, indicating that AdeFGH was cryptic in BM4652 and responsible for multidrug resistance in its mutants. RNA analysis demonstrated that the three genes were cotranscribed. The adeFGH operon was found in 36 out of 40 A. baumannii clinical isolates, but none of the 22 isolates tested overexpressed the pump genes. Spontaneous MDR mutant BM4684, overexpressing adeFGH, was obtained from clinical isolate BM4587, indicating that adeFGH can be overexpressed in a strain harboring adeABC-adeIJK. An open reading frame, coding a LysR-type transcriptional regulator, named adeL, was located upstream from the adeFGH operon and transcribed in the opposite direction. Mutations in adeL were found in the three adeFGH-overexpressing mutants, suggesting that they were responsible for overexpression of AdeFGH.
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These results provide a plausible mechanism for the immunomodulatory effects of norfloxacin in cirrhosis beyond its bactericidal effect.
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Forty-three women with acute, symptomatic urinary tract infections were randomized to receive either norfloxacin (400 mg) twice daily or trimethoprim-sulfamethoxazole (160-800 mg) twice daily for 10 days. Of the 43 patients, 7 (16%) had low-count bacteriuria and pyuria and were included in the evaluation. Escherichia coli was isolated in 72% of the infections, whereas coagulase-negative staphylococci were isolated in 14%. All isolates were susceptible to the assigned study drug. The MICs for 90% of the strains susceptible to norfloxacin and trimethoprim-sulfamethoxazole were less than or equal to 2 and less than or equal to 0.8-16 micrograms/ml, respectively. The cure rates for norfloxacin and trimethoprim-sulfamethoxazole were 95 and 90%, respectively. There were 17 patients with presumptive upper tract infections; only 1 of these relapsed after therapy. The effects on the periurethral flora were similar in both groups, but the infecting organism was eradicated from the fecal flora in 93% of the patients treated with norfloxacin and in 57% of the patients treated with trimethoprim-sulfamethoxazole. More early reinfections occurred in the trimethoprim-sulfamethoxazole group, with resistant organisms appearing in urine and in the periurethral and fecal flora in all cases. Three patients in each group experienced adverse clinical effects, but these were more severe in the trimethoprim-sulfamethoxazole group. No adverse hematological or biochemical changes were noted. From these results, we concluded that norfloxacin is at least as effective as trimethoprim-sulfamethoxazole in the therapy of acute, symptomatic urinary tract infections in women.
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The patients included those with isolation of P. aeruginosa hospitalized for more than 48 h in the ICU from April to May 1998. Environmental and staff cultures were obtained simultaneously. Minimal inhibitory concentrations, plasmid DNA profiles, and PFGE genomic patterns of enzyme restriction chromosomal DNA were compared.
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Bacterial translocation (BT) can be involved in the pathogenesis of severe infections due to bacteria of enteric origin that complicates bleeding cirrhotic patients. To assess the effect of hemorrhagic shock (HS) on the incidence of BT and if selective intestinal decontamination (SID) reduces this incidence, we studied six groups of Sprague-Dawley rats: ascitic rats, ascitic rats exposed to HS with and without previous norfloxacin prophylaxis, healthy rats, and healthy shocked rats with and without previous norfloxacin prophylaxis. BT tended to be higher in ascitic rats with shock than without shock (69% vs. 41%, P = .15) and was significantly higher in healthy rats with than without shock (50 percent vs. 0 percent, P = .01). Norfloxacin significantly reduced translocation in ascitic shocked rats in comparison with nondecontaminated ascitic shocked rats (31 percent vs. 69 percent, P = .038). This effect was due mainly to a reduction of gram-negative BT (O percent vs. 37 percent, P = .008). In addition, norfloxacin prevented translocation in healthy shocked rats. Accordingly, aerobic gram-negative bacteria disappeared from fecal flora in all rats administered norfloxacin, except for Klebsiella species in one control rat. Cecal severe submucosal edema, chronic inflammatory infiltrate, and intestinal lymphangiectasia were significantly more frequent in ascitic rats than in control rats. Intestinal mucosal injury related with HS, particularly subepithelial cecal edema, was observed only in ascitic shocked rats. In conclusion, HS increases the incidence of BT both in ascitic cirrhotic and healthy rats. Norfloxacin reduces significantly the incidence of translocation after shock, especially in those cases caused by aerobic gram-negative bacilli.
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As calculated from our model in respect to the length of the selection period, long serum half-lives of recently developed compounds could not be compensated for by a more favourable activity in terms of MPC. Higher concentrations of ciprofloxacin may be required under an anaerobic atmosphere to prevent the emergence of resistant mutants among 10(10) cfu.