For rational treatment of urinary tract infection it is necessary to know the causative agents. These may be different in various departments of health care institution managing patients with different illnesses. The article presents results of urinary cultures performed in 2002 in Microbiology Laboratory of Vilnius University Children's Hospital. The urine specimens were sent to the Laboratory from all departments of the Hospital. The most common isolate in all departments was E. coli (63.1% of all cultures with growth of >/=10(5) cfu/ml). This organism was somewhat less common in urine specimens obtained from Department of Urology (54.8%); accordingly, species of other organisms were isolated somewhat more often. S. aureus most often was identified in urine specimens from neonatal departments (11.1% of all significant isolates). There were no significant differences in urinary microflora isolated from pediatric in-patients and out-patients. Majority of the strains of the main urinary pathogen, E. coli, showed susceptibility to gentamicin, II-III generation cephalosporins, co-amoxiclav, nitrofurantoin and ciprofloxacin. Thus for empirical treatment of urinary tract infection it is necessary to choose an antibiotic with good activity against E. coli. In more complex circumstances (e.g. in children with urinary tract anomalies and in those treated in intensive care units) it would be better to take into account the results of urinary culture and susceptibility testing.
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Forty strains of Escherichia coli isolated from children under 5 years of age with acute diarreas, coming from different provinces of the country , were analyzed. Four important phenotypical determinants were tested: sorbosa, sorbitol, enterohemolysin and 0157:H7 serology, in order to select those strains from enterohemorrhagic or Shiga toxin-producing category. Likewise, they were characterized by biotyping and antimicrobial susceptibility methods. The use of phenotypical tests showed six strains with presumptive characteristics, four of which were most likely to be Shiga toxin-producing strains. In antimicrobial susceptibility test, the strains showed high resistance mainly to ampicillin and trimethrophin-sulfamethoxasole. Another interesting finding were intermediate resistance and susceptibility values to augmentin, aztreonan and ceftriaxone. There were 12 antimicrobial resistance patterns of which 10 were multi-resistant.
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To analyse an Italian database of spontaneous reporting of suspected adverse drug reactions in order to compare the safety profile of amoxicillin and amoxicillin/clavulanic acid.
Antimicrobial therapy can have a significant impact in the treatment of acute infectious exacerbations in patients with chronic bronchitis, in whom repeated episodes are common. The aim of this randomised, double-blind, double-dummy, parallel group study was to compare the efficacy and safety of oral gatifloxacin (200 and 400 mg once daily) administered for 5 days with co-amoxiclav (500 mg amoxicillin/125 mg clavulanic acid t.i.d.) administered for 10 days in 414 adult patients with acute exacerbation of chronic bronchitis. Overall clinical response rates (cure plus improvement) were 86.2%, 79.4% and 81.7% in the gatifloxacin 200 mg, gatifloxacin 400 mg and co-amoxiclav groups, respectively, and the equivalence hypothesis used for statistical analysis showed equivalent efficacy for both gatifloxacin 200 and 400 mg compared to co-amoxiclav. The same was true for rates of bacterial response, with eradication or presumed eradication of causative pathogens achieved in 87.5%, 87.3% and 79.1% of cases in the gatifloxacin 200 mg, gatifloxacin 400 mg and co-amoxiclav groups, respectively. All treatments were well tolerated, with the nature and frequency of treatment-related adverse events similar in all groups. The results of the study show that gatifloxacin is a safe and effective agent for the treatment of patients with chronic bronchitis experiencing an acute infectious exacerbation.
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Sixty-nine percent of patients carried beta-lactamase-producing anaerobes, with a mean of one to two strains per patient. Seventy isolates of the beta-lactamase- producing strains formed 4% of the total cultivable anaerobic flora. Prevotella was the most prevalent beta-lactamase-producing species, followed by Capnocytophaga, Veillonella and Bacteroides.
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The west frequent microbe find in the open perineal wounds is Streptococcus group "D" (enterococcus sp.)--53% of the cases and E. coli--26% of the cases. The most frequent microbe find in the open surgical wounds in the Cesarean Section is Enterococcus sp.--42% of the cases and St. aureus--21% of the cases. Considering the effectiveness of Penicillins (Ampicillin, Augmentin, Azlocillin, Karbencillin)--94%-99% against Enterococcus spp. and of Gentamycin against E. coli and St. aureus--90%-95% their application is recommended if is necessary.
The infectious complication rate after appendicectomy was compared during two distinct periods (before/after study). During the first period, the guidelines for antibiotic administration were based on ticarcillin-clavulanic acid. During the second period, the guidelines were based on amoxicillin-clavulanic acid for non-perforated appendicitis or appendicitis with localized peritonitis, and clavulanic acid was reserved for general peritonitis. All children younger than 16 years of age who underwent appendicectomy during the periods studied were included. Data were retrospectively collected from surgical and anesthetics charts.
Out of the 391 short term peripheral venous catheters collected, 20.7% catheter tips and 11.3% catheter hubs were colonised. Phlebitis was observed in 17.4%. Bacteria isolated from colonised catheter tips were Staphylococcus aureus (60.5%), Staphylococcus epidermidis (23.5%). The most common organism isolated from the hub was Staphylococcus aureus (56.8%) followed by Staphylococcus epidermidis (18.1%). Gram positive and negative organisms were sensitive to ciprofloxacin, gentamycin for gram-negative organisms and augmentin, cefuroxime, ceftriaxone for the gram-positive organisms. After logistic regression, factors such oedema, modified Glasgow coma score of <10/15, 6 hourly benzyl penicillin were significantly associated with colonisation of the tip while use of 25% dextrose, chloramphenicol 6 hourly and blood transfusion were significantly associated with colonisation of the hub.
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Augmentin was used in treatment of mild forms of postnatal endometritis and serous mastitis. Augmentin tablets proved to be efficient in endometritis due to enterobacteria and obligate nonsporulating anaerobes and mastitis due to Staphylococcus aureus strains sensitive to the preparation. No adverse events were recorded. It was shown that in the treatment of mild postnatal infections the augmentin tablets were not inferior by their activity of combinations of antibiotics against aerobic and anaerobic microflora.