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This study was to investigate the antibiotic resistance profile of H. pylori and the distribution of CYP2C19 gene polymorphism in rural population of Chongqing, China. 214 and 111 strains of H. pylori were isolated from rural and urban patients, respectively. 99.53%, 20.09%, and 23.36% of the isolates in rural patients were found to be resistant to metronidazole, clarithromycin, and levofloxacin, while the resistant rate in urban patients was 82.88%, 19.82%, and 24.32%. The multiple antibiotic resistance percentage significantly increased from 28.26% (below 45 years) to 41.80% (above 45 years) in rural patients. Up to 44.39%, 45.79%, and 9.81% of rural patients from whom H. pylori was isolated were found to be extensive metabolizers, intermediate metabolizers, and poor metabolizers. No correlation was observed between antibiotic resistance profile of H. pylori and genetic polymorphism of CYP2C19 among rural population. There was a high prevalence of H. pylori strains resistant to metronidazole, clarithromycin, and levofloxacin in rural patients in Chongqing, China. The choice of therapy in this area should be based on local susceptibility patterns. Amoxicillin, gentamicin, and furazolidone are recommended as the first-line empiric regimen.
Gram-positive organisms accounted for 124 of 154 (80.5%) culture-positive endophthalmitis isolates (146 of 229 [63.8%]). The sensitivity (0.36%) and specificity (0.71%) of AC culture results were poor predictors of positive vitreous culture. Positive and negative predictive values were less than 60%. Positive likelihood ratio (1.24) and negative likelihood (0.91) of AC culture results did not aid in predicting vitreous findings. Gram-positive isolates demonstrated in vitro resistance to moxifloxacin (47.1%), ciprofloxacin (43.4%), gatifloxacin (36.8%), levofloxacin (29.0%), gentamicin (19.2%), and ceftazidime (16.7%).
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A 39-year-old woman with diabetes mellitus type 2 and hyperlipidemia presented with difficulty ambulating as well as pain and swelling of her right foot. Prior to presentation, she sustained a toothpick puncture to her right foot; she removed the toothpick intact and did not know whether it had been used. Due to a penicillin allergy, she began treatment with levofloxacin, which was changed to clindamycin one day later. The patient was diagnosed with right Achilles tendonitis/cellulitis and was discharged on a one-week course of clindamycin. Twenty-five days later she was readmitted, complaining of pain and swelling in the same area, which this time presented as an abscess. Upon this admission, vancomycin and levofloxacin were initiated and incision and drainage (I & D) was performed. Cultures and sensitivities from I & D were significant for E. corrodens and A. odontolyticus, and treatment was changed to intravenous doxycycline 100 mg every 12 hours for 10 weeks. Oral doxycycline 100 mg every 12 hours was then used for 3 months, and treatment was successful.
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The decreased susceptibility (resistant and intermediate) observed was 40% for amoxicillin-clavulanate, 60% for piperacillin-tazobactam, 100% for ceftriaxone, 81% for imipenem, 61% for ertapenem, 2% for chloramphenicol, 34% for erythromycin, 90% for lincomycin, 2% for linezolid, 98% for levofloxacin, 17% for moxifloxacin and 0% for vancomycin, teicoplanin and metronidazole. The results obtained with the disk diffusion method were compared to MICs obtained with E-test and reference method.
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Endogenous endophthalmitis (EBE) is intraocular infection usually associated by bcteremia. Although, EBE is an uncommon disease, visually prognosis is very poor. Immune suppressive disease, such as diabetes or malignancy is a predisposing factor of EBE. Although, in east Asia, including Japan, gram negative organisms reported as common pathogen causing EBE, we here repot a case of group B streptococcus EBE. A 53- year old man, who has history of diabetes mellitus, was admitted to our hospital with compliant of sudden visual loss and pain at his right eye. His visual acuity was no hand perception in the right. In auscultation, there were coarse crackles at his left lung. Axial magnetic resonance imaging of eye showed exophthalmos of right eye and cellulites. Chest radiography revealed infiltration at the left middle lung field. EBE and pneumonia due to GBS were diagnosed and he was treated with intravenous cefotaxim. Despite of administration of antibiotics and vitreous surgery, deterioration of his visual activity was observed. Therefore antibiotics were changed to intravenous vancomicin and topical levofloxacin and amykacin were added also. But he finally lost his visual acuity of right eye.
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The PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) surveillance programme was started in 2000, to chart the emergence and spread of antimicrobial resistance among isolates of Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae from across the USA.
Long-term fluoroquinolone use to prevent unnecessary prostate biopsy may result in postbiopsy sepsis caused by fluoroquinolone resistant microorganisms.
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We studied an in vitro model of continuous venous-venous haemofiltration (CVVH), into which levofloxacin 100 mg was infused, to determine levofloxacin adsorption and to determine the effect of filter material and point of dilution (pre- or post-filter) on sieving coefficient. Mean (standard deviation; S.D.) adsorption was 18.7 (5.3) mg for the polyamide filter and 40.2 (2.0) mg for the polyacrylonitrile (PAN) filter (P < 0.001). Post-dilution resulted in a minor, but statistically significant, decrease in sieving coefficient (pre-dilution 0.96 (S.D. 0.10), post-dilution 0.88 (S.D. 0.11) with the PAN filter. These data indicate that the variability in published values for levofloxacin sieving coefficient are not due to variation in point of dilution or membrane type (PAN or polyamide). Significant adsorption of levofloxacin onto PAN filters occurs.
Transperineal 14-core biopsy can be carried out without major infectious complications in diabetic men. Oral levofloxacin 300 mg once before the procedure seems to represent an effective antimicrobial prophylaxis in diabetic men without other risk of infection.
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The aims of this study were to determine the empirical antibiotic therapy used in patients admitted to the Emergency Department who were later hospitalised, and to describe the antibiotic changes during their first days of hospitalisation.
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Overall, 29.4, 22.5, 0.9, and 0.02% of S. pneumoniae isolates were resistant to erythromycin, penicillin, levofloxacin, and telithromycin, respectively, with considerable regional variability. Multidrug resistance was stable at approx. 31%. Among macrolide-resistant isolates, mef(A) was the most prevalent resistance gene identified; however, the percentage of isolates with this gene decreased from 68.8% (2000) to 63.9% (2003), while the prevalence of isolates containing both the erm(B) and mef(A) genes increased (2000, 9.7%; 2003, 16.4%). Over 90% of these erm(B)+mef(A)-positive isolates were also resistant to penicillin, tetracycline, or trimethoprim-sulfamethoxazole, while 98.6% were susceptible to levofloxacin and 99.1% were susceptible to telithromycin.
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Retrospective analysis of medical and microbiological records of patients with suspected diagnosis of endophthalmitis and bacterial culture-proven at the Department of Ophthalmology, UNIFESP, between January 1 2000 and December 31 2005.