[Bacterial meningitis in adults: a retrospective multicentric study in Tuscany (Italy)]. / Le meningiti batteriche dell'adulto: studio retrospettivo multicentrico della Toscana.

The Infectious Diseases Unit of Lucca Hospital conducted a multicentric retrospective study to evaluate the epidemiological and clinical features of adult patients affected by bacterial meningitis attending all the Infectious Diseases Units of Tuscany (Italy) from July 1999 to June 2004. A specific questionnaire was sent to all the units to collect information about each case of bacterial meningitis occurring in patients older than sixteen. Patients with meningitis by Mycobacterium tuberculosis were excluded from the analysis. Nine out of 12 Infectious Diseases Units of Tuscany took part in the study and 197 cases were identified. Most cases of meningitis occurred during 2002 with a slight reduction in cases in subsequent years. Streptococcus pneumoniae and Neisseria meningitidis were the most frequently isolated pathogens with an increase in diagnosis from 1999 to 2004; in 23.8% of patients no pathogens were isolated, with a reduction in meningitis from unknown aetiology from 1999 to 2004. Most patients were treated with a combination of two antibiotics, and corticosteroid drugs were added to the therapy; in the group of patients treated with corticosteroid drugs invalidating complications occurred in 23% of cases and 5% of patients died. In all, 27 out of 197 subjects (13.7%) developed invalidating complications and 20 out of 197 patients (10.2%) died.

Effect of enoxacin, norfloxacin and pefloxacin on polymorphonuclear leukocytes chemiluminescence.

We studied the interactions between the neutrophilic granulocytes and three quinolone antibiotics, enoxacin, norfloxacin and pefloxacin, using the luminol-enhanced chemiluminescence method to evaluate the respiratory burst of the cells. Neutrophils obtained from healthy human volunteers were exposed to different therapeutic concentrations of the drugs for one and three hours and then opzonized zymosan was added to stimulate chemiluminescence reaction. None of the three drugs tested exercised any influence on neutrophil function.

Influence of teicoplanin on the chemiluminescence of phagocytosing human granulocytes.

Teicoplanin is a new glycopeptide antibiotic that is structurally related to vancomycin. It is especially active against virtually all gram positive bacteria including methicillin-resistant staphylococci. The aim of this study was to evaluate the influence of teicoplanin on the phagocytosis of human neutrophils, using the chemiluminescence reaction method. We incubated three different concentrations (2, 5, 10 microg/ml) of teicoplanin for one and three hours with polymorphonuclear leukocytes of healthy human volunteers and then measured the chemiluminescence reaction during zymosan phagocytosis. The neutrophil function was not influenced by teicoplanin.

The influence of ofloxacin versus trimethoprim-sulfamethoxazole on the aerobic flora in granulocytopenic subjects.

Ofloxacin (300 mg twice a day) and trimethoprim-sulfamethoxazole (TMP-SMZ) (160 mg trimethoprim and 800 mg sulfamethoxazole twice a day) were given prophylactically to 19 adult patients with acute leukemia undergoing induction chemotherapy. The influence of the two regimens on the bacterial aerobic flora was evaluated. Both of the prophylactic regimens conditioned the aerobic microflora of the patients. Both groups acquired new microorganisms, prevalently gram-positive cocci, but also gram-negative bacteria with the TMP-SMZ regimen. Both treatment groups acquired yeasts.

Cluster of cases of Salmonella enterica serotype Rissen infection in a general hospital, Italy, 2007.

In 2007, three strains of Salmonella enterica serotype Rissen (S. Rissen) were isolated in the laboratory of diagnostic microbiology of the General Hospital of Prato, Tuscany, Italy, over a 1 month and half interval of time. The first isolate was recovered on January 26 from an outpatient with enteritis. Then, two strains were isolated on February 16 and March 11 respectively, from central venous catheters of patients who were being hospitalized in two departments of the Hospital. An epidemiologically linked cluster of cases of salmonellosis was suspected. The three strains were submitted to single enzyme-amplified fragment length polymorphism (SE-AFLP) and XbaI macrorestriction and pulsed-field gel electrophoresis (PFGE) that yielded undistinguishable profiles. Epidemiological investigations failed to identify a common source of infection within the Hospital. Moreover, the third patient had been exclusively total parenteral nutrition fed since his admission with a stomach cancer diagnosis. The first patient had a community-acquired infection, but the source of her illness was uncertain. Twenty-five further isolates identified in the years 2004-2007 in the same geographical area showed distinctly different PFGE and SE-AFLP patterns. The three patients seemed to represent a cluster of epidemiologically unrelated cases caused by a previously never recognized S. Rissen strain. Rapid subtyping of isolates is essential in the early investigation of potential outbreaks, but synthesis of conventional and molecular epidemiological investigation and availability of surveillance data is often critical to prevent the initiation of time-consuming, expensive and ineffective further investigations and control interventions.

Effect of a new fluorinated quinolone (ofloxacin) on the chemiluminescence of phagocytosing human neutrophils.

We measured the chemiluminescence (CL) of human neutrophils (PMNLs) exposed to different concentrations of ofloxacin (2, 4, and 6 micrograms/ml) readily achievable in therapy. CL reaction during zymosan phagocytosis by PMNLs obtained from human healthy volunteers was registered in a computer-linked LKB 1251 luminometer. Ofloxacin did not induce significant variations on the respiratory burst of PMNLs.

In vitro antimicrobial sensitivity of staphylococci isolated in the Santa Cruz region of Bolivia.

The in vitro antimicrobial susceptibility of staphylococci isolated in two different communities, Camiri and Javillo, of the Santa Cruz region in south-eastern Bolivia was tested by the agar diffusion technique and by a micro dilution susceptibility test to determine the Minimum Inhibitory Concentrations. Staphylococcal strains isolated from hospital staff of the Camiri Hospital were compared to that isolated from healthy people of Javillo, a very small community isolated in the jungle. In the Camiri Hospital, staphylococci showed a high prevalence of penicillin resistance, 100% for S. aureus strains and 73.5% for coagulase-negative staphylococci. Among coagulase-negative strains we found a high rate of multiresistant strains, mainly to ampicillin, tetracycline and chloramphenicol. In the rural population of Javillo we found staphylococcal strains highly susceptible to all the antibiotics tested.

Serological survey of antibodies to cytomegalovirus in the Santa Cruz region of Bolivia.

Cytomegalovirus (CMV) infection is known to be worldwide, and prevalent in developing countries (Krech & Tobin 1981). To our knowledge, no previous serologic studies of CMV infection have been reported from Bolivia. The present study was undertaken to determine the prevalence of CMV infection in the Santa Cruz region, south-eastern Bolivia.

Antimicrobial agent susceptibility patterns of staphylococci isolated in urban and rural areas of Bolivia.

Staphylococcal strains obtained from cutaneous swabs of hospital staff and school students of Camiri and Boyuibe and healthy people living in Javillo, Bolivia, were tested for their in-vitro antimicrobial susceptibility. The highest percentages of resistance to the antibiotics tested were found in staphylococcal strains isolated from hospital personnel. All the S. aureus strains from these subjects were resistant to penicillin. Coagulase-negative staphylococci from hospital personnel evidenced a high rate of multiresistant strains, mainly to penicillin, ampicillin, tetracycline, and chloramphenicol. The staphylococcal strains isolated in the rural population of Javillo were highly susceptible to all the antibiotics tested.

Prevalence of antibody to hepatitis A virus in the Santa Cruz region of Bolivia.

Several epidemiological studies have shown the worldwide distribution of hepatitis A with the highest prevalence of anti-HAV antibodies in developing countries (Papaevangelou 1984). There is no information about the epidemiology of hepatitis A in Bolivia. The goal of this study was to evaluate the anti-HAV antibody prevalence in the Santa Cruz region, southeastern Bolivia.