The high HIV incidence, morbidity and mortality in high-prevalence areas suggests that primary prophylaxis should be given in patients at high risk for toxoplasmic reactivation.
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The combination of trimethoprim-sulfamethoxazole has been used successfully in various infections. However the use of the combination was limited, due to the lack of a parenteral form of the drug. In this study a parenteral (i.m.) form of trimethoprim-sulfamethoxazole was given to 35 patients with various infections due to susceptible bacteria to the drug. Twenty-four patients had urinary tract infections, and 7 had various infections with gram negative organisms, and 4 had staphylococcal infections. In patients with urinary tract infection the cure rate was 62.5%. Twenty five per cent of the patients had persistent infection after treatment, and 12,5% had superinfection. The overall cure rate was 71,4% in 35 patients. No side effect was observed.
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In this study; E. coli strains isolated from 100 patients with urinary tract infections were investigated for their antibiotic susceptibility and metabolic deficiencies. The strains were found to be highly susceptible to gentamicin (%97), Bactrim (R) (%77) and resistant to the other antibiotics in changing but important degrees. Study of metabolic deficiencies revealed that 9 of the strains were in accord with the deficiency criteria and only one of them was thymin-dependent.
The case of a patient who developed aseptic meningitis, hemolytic anemia, hepatitis, and orthostatic hypotension simultaneously during treatment with trimethoprim-sulfamethoxazole is described.
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Retrospective study of all patients who had OSST from 1997 to 2007 and received follow-up for systemic immunosuppression at the Cincinnati Eye Institute. Patients were analyzed for demographics, systemic immunosuppression exposure, ocular surface stability, efficacy, and toxicity variables.
The human immunodeficiency virus (HIV) pandemic is one of the most serious health crises facing the world. Of the estimated 33.2 million people living with HIV worldwide, 22.5 million (68%) live in Sub-Saharan Africa, where women of childbearing age are most severely affected. Children primarily acquire HIV infection through mother-to-child transmission. Despite recent encouraging success, low-income countries have not been able to effectively curtail transmission of HIV to the infant during or after pregnancy, resulting in about 90% of the estimated 420,000 newly infected children per annum occurring in Sub-Saharan Africa.
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An increase in recovery of Xanthomonas maltophilia from clinical specimens at our institutions prompted, amongst other measures, an investigation of the antibiotic susceptibility patterns of the organism. Fifty-five consecutive first isolates of Xanthomonas maltophilia were obtained and antimicrobial susceptibility tests were carried out by the agar dilution method. Trimethoprim/sulfamethoxazole was the most active antimicrobial agent (94% susceptible), with 71% susceptible to ticarcillin/clavulanic acid, 56% susceptible to ciprofloxacin and 49% susceptible to ceftazidime. Amoxycillin/clavulanic acid and imipenem were inactive (0% susceptible), while aminoglycosides were effective against only 7% of isolates. Potentiation was observed with both the combination of trimethoprim and sulfamethoxazole and the combination of ticarcillin and clavulanic acid. Familiarity with the antibiotic susceptibility pattern of Xanthomonas maltophilia as well as the potential shortcomings of the in vitro susceptibility data are important in the effective clinical management of Xanthomonas maltophilia infections.
Mycobacterium branderi, a potential human pathogen first characterized in 1995, has been isolated from respiratory tract specimens. We report here a case in which M. branderi was the only organism isolated upon culture from a hand infection. This isolate, along with a second isolate from a bronchial specimen, was subjected to conventional identification tests for mycobacterial species. Further analysis by high-performance liquid chromatography (HPLC) of mycolic acids and 16S rRNA gene sequencing was performed, and the antibiotic susceptibility profile was determined for both strains. Biochemical tests and the HPLC pattern were consistent with that of M. branderi and M. celatum, which are very similar. The 16S rRNA gene sequence of both strains corresponded to that of M. branderi and enabled us to confidently differentiate this organism from other closely related species such as M. celatum. This contributes to a further understanding of the status of this species as a potential human pathogen as well as illustrating the need for molecular diagnostics as a complementary method for the identification of rare mycobacterial species.
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During the months of May, June and through early part of July 1994, an unusual occurrence of severe dehydrating watery diarrhoea cases and deaths were reported from Aizwal town, the capital of Mizoram, a North-Eastern state of India. Vibrio cholerae 01 biotype Eltor, the causative agent responsible for this outbreak, was isolated from 50.0% of hospitalised cases. The disease affected older children and adults more (52.9%) than younger children below five years of age. Vibrio cholerae 01 strains isolated were uniformly resistant to furazolidone and co-trimoxazole, which are commonly advocated in the treatment of cholera specially in children of developing countries. Emergence of such resistant strain is alarming and is of great public health importance.
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One hundred and one intravenous drug users hospitalized with S. aureus infection.
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We first noted the appearance of thymidine-requiring, gram-negative bacilli in clinical specimens 2 years ago. Since then we have seen 10 patients colonized or infected with these organisms. These strains do not grow on Mueller-Hinton media, growth on MacConkey agar is variable, and growth in API 20E (Analytab Products) and Enterobacteriaceae-Plus Cards (AutoMicrobic system; Vitek Systems Inc.) is inadequate for reliable identifications. Thymidine-requiring organisms are routinely resistant to sulfonamides and trimethoprim. Infection or colonization is associated with previous sulfamethoxazole-trimethoprim therapy in most cases. Of 10 patients, 1 had septicemia of urinary tract origin, 5 had urinary tract colonization or infection, 2 had wound colonization, and two had colonization of respiratory secretions. Thymidine-requiring, gram-negative bacilli can be pathogens and present potential problems in diagnosis, identification, and susceptibility testing.