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Susceptibility patterns of Streptococcus pneumoniae and Haemophilus influenzae collected over a 5-year period in a Beirut general university hospital were studied. Only 40.6-50% of S. pneumoniae isolates were susceptible to penicillin G. Susceptibility to clindamycin and erythromycin decreased from 94.1% and 89.7%, respectively, in 2000 to 75% and 71.9%, respectively, in 2004. All isolates were susceptible to ceftriaxone, ciprofloxacin and vancomycin. For H. influenzae, no resistance was observed to amoxycillin-clavulanate, ceftriaxone, ciprofloxacin and rifampicin, with >92% of isolates showing susceptibility to cefuroxime, chloramphenicol, erythromycin and tetracycline. The proportion of beta-lactamase-positive isolates varied between 22.7 and 30.8%.
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The BSI of B. cereus is mostly caused by venous catheter-related infections. Appropriate empirical therapy is important to achieve early clinical resolution in B. cereus BSI. Vancomycin is one of the appropriate selections of empirical therapy for B. cereus BSI.
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The primary objective of this study was to determine the etiology of skin abscesses in a pediatric emergency department (ED) during a 4-year period and to determine whether the incidence of methicillin-resistant Staphylococcus aureus (MRSA) skin abscesses has increased. The secondary objective was to characterize MRSA infections by antibiotic susceptibility during the same period.
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Methicillin-resistant Staphylococcus aureus (MRSA) infections have become common among both hospitalized and nonhospitalized patients. Optimal outpatient therapy for MRSA infections has yet to be determined, but this matter is complicated by the possibility of inducible macrolide-lincosamide-streptogramin B resistance (MLSBi). We studied the prevalence of MLSBi in community- and hospital-associated S. aureus isolates and the prevalence of community-associated MRSA (CA-MRSA) and identified clinical predictors of CA-MRSA and MLSBi. Among 402 S. aureus isolates, the overall prevalence of MLSBi was 52%, with 50% of MRSA and 60% of methicillin-susceptible S. aureus isolates exhibiting MLSBi. CA-MRSA represented 14% of all isolates and had a lower prevalence of MLSBi than hospital-associated MRSA (33% versus 55%). The presence of skin or soft-tissue infection was predictive for CA-MRSA, and the presence of a comorbidity was predictive for MLSBi. Due to the low prevalence of MLSBi among CA-MRSA isolates, clindamycin remains a useful option for outpatient therapy.
Infection postblepharoplasty is rare. When it occurs, tissue destruction can be potentially devastating. Prompt diagnosis, intravenous antibiotics, and close follow-up are essential.
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In a series of 18 patients with folliculitis decalvans attending the Oxford hair clinic, eight were found to have areas of tufted folliculitis either at presentation or follow-up. There was no difference between these two groups in their presentation, clinical course, growth of causative organism (Staphylococcus aureus) or investigations including histology. We suggest that these two entities form part of a spectrum of a single disease. We performed lymphocyte staining on affected scalp biopsies, including CD4: CD8 and T-cell/B-cell ratios, but found no evidence of local immune suppression or failure which would explain the abnormal host response to a common pathogen in this rare condition. We introduced a new treatment regimen for these patients, oral rifampicin and oral clindamycin together for 10 weeks. Ten of the 18 patients have responded well with no evidence of recurrence 2-22 months after one course of treatment, and 15 of the 18 responded after two or three courses.
Between 2012 and 2013, a total of 622 MRSA isolates from sterile sites with vancomycin MIC of 1 μg/mL or more were studied. The prevalence rates of hVISA and VISA among these isolates were 10.0% and 2.7%, respectively. The hVISA prevalence increased significantly compared to that in 2003. Compared with vancomycin-susceptible S. aureus, hVISA and VISA isolates were less susceptible to ciprofloxacin, clindamycin, daptomycin, gentamicin, rifampin, and trimethoprim/sulfamethoxazole, and are thus, more likely to have SCCmec II or III element. A twofold increase in either vancomycin or teicoplanin MIC doubled the probability of being hVISA.
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The vagina was colonized by pathogenic enterobacteriaceae, staphylococci and Candida albicans. The detection of the yeast by PCR-DGGE is particularly novel and enhances the ability of this tool to examine the true nature of the vaginal microflora. The patient had not responded to antifungal treatment, antibiotic therapy targeted at anaerobic Gram-negative pathogens such as Gardnerella, nor daily oral probiotic intake of Lactobacillus rhamnosus GG. The failure to find the GG strain in the vagina indicated it did not reach the site, and the low counts of lactobacilli demonstrated that therapy with this probiotic did not appear to influence the vaginal flora.
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Osteonecrosis has been well-documented in the past. We present an example of this complication that we recently saw in our department which on initial presentation appeared to be squamous cell carcinoma. This case is particularly important as the condition will become more and more prevalent and therefore it is imperative that GDPs in primary care are aware of it.
Campylobacter jejuni strains from 11 outbreaks were characterized by antimicrobial susceptibility, plasmid profile, and serotyping by the methods of Lior et al. and Penner and Hennessy. All 31 strains were susceptible to erythromycin, clindamycin, chloramphenicol, kanamycin, tobramycin, streptomycin, and gentamicin. A total of 21 strains from nine outbreaks were resistant to one or more of the following antimicrobial agents: tetracycline, metronidazole, ampicillin, or carbenicillin. Of the 31 strains, 19 possessed plasmid DNA; 4 of the strains containing plasmids were sensitive to all antimicrobial agents tested. All of the strains that were resistant to tetracycline contained a 38-megadalton plasmid, and these plasmids shared common nucleic acid sequences. No other antimicrobial resistance was associated with the presence of plasmid DNA. Eight outbreaks appeared to have been caused by a single serotype, whereas in three outbreaks multiple serotypes were found. In two of the three outbreaks with multiple serotypes, plasmid profiles were also indicative of multiple strains of C. jejuni. Antimicrobial susceptibility and plasmid profile are potentially useful epidemiological markers for C. jejuni and may be used to supplement serotyping.
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Our purpose was to determine the clinical effectiveness and cost-effectiveness of three antibiotic regimens for the treatment of pelvic inflammatory disease and tuboovarian abscess.