In vitro susceptibility of staphylococci to linezolid and other antimicrobial agents.

Linezolid is a member of the new class of antibacterial agents called oxazolidinones that are active against Gram positive organisms and exert their action by protein synthesis inhibition. In this study we investigated the in vitro activity of linezolid versus the other agent against clinical strains of staphylococci: Staphylococcus aureus (n = 82) and S. epidermidis (n = 32) collected in 2002 from hospitalized patients and healthy individuals, isolated from different biological samples. Agar dilution minimum inhibitory concentrations (MICs) were determined by using Mueller-Hinton agar according to the guidelines established by the National Committee for Clinical Laboratory Standards. Linezolid demonstrated excellent in vitro activity against all isolates tested, with MICs values in the range of susceptibility (< or = 8 microg/ml). No associated resistance between linezolid and other agents tested was observed. The resistance among Gram positive bacteria continues to spread and for many patients infected with these resistant organisms antimicrobial therapy is ineffective and linezolid may be a new alternative treatment.

Pseudomembranous colitis associated with a triple therapy for Helicobacter pylori eradication.

Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in humans, affecting half of world's population. Therapy for H. pylori infection has proven to be both effective and safe. The one-week triple therapy including proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole is still recommended as a first-line treatment to eradicate H. pylori infection in countries with low clarithromycin resistance. Generally, this therapy is well-tolerated, with only a few and usually minor side effects. However, rare but severe adverse effects such as pseudomembranous colitis have been reported, Clostridium difficile (C. difficile) infection being the main causative factor in all cases. We report the cases of two women who developed pseudomembranous colitis after a 1-wk triple therapy consisting of pantoprazole 20 mg bid, clarithromycin 500 mg bid, and amoxicillin 1 g bid to eradicate H. pylori infection. A limited colonoscopy showed typical appearance of pseudomembranous colitis, and the stool test for C. difficile toxins was positive. Rapid resolution of symptoms and negative C. difficile toxins were obtained in both patients with oral vancomycin. No relapse occurred during a four and eleven-month, respectively, follow up. These cases suggest that physicians should have a high index of suspicion for pseudomembranous colitis when evaluate patients with diarrhea following H. pylori eradication therapy.

Side effects of antiviral therapy in hepatitis C virus infection-sarcoidosis - case report.

Standard therapy in chronic hepatitis C virus infection is still a combination of peginterferon alfa2a/2b and ribavirin for 48 weeks. As of side effects, there are organic side effects, such as hematologic disorders, and functional side effects, reflected in the quality of life of hepatitis C patients. Up to 30% of the patients develop specific side effects such as headache, fever, fatigue. Sarcoidosis, known as a granulomatous disease of uncertain cause, is an uncommon finding in this category of patients. This cause-effect relation is accounted for by the convergent action of peginterferon and ribavirin of stimulating type 1 T helper cells and reducing type 2 helper T cells activation. We present the case of male patient known with chronic hepatitis C who developed pulmonary sarcoidosis following antiviral therapy. The first manifestation of the disease was unexplained fever accompanied by pulmonary tract disease. The diagnosis was established by immunophenotyping in bronchial aspirate

[Adverse reactions of different treatments in chronic hepatitis C]. / Consideratii privind reactiile adverse ale terapiei specifice in hepatita cronica cu virus C.

Hepatitis C virus infection is estimated to affect over 170 million people worldwide. Standard treatment for chronic HCV involves an interferon-based preparation and ribavirin for 24 to 48 weeks. These therapeutic regimens are associated with numerous adverse events, among which constitutional and neuropsychiatric symptoms, as well as hematological abnormalities, stand out. Adverse events resulting from the treatment of hepatitis C can jeopardize the quality of life of patients and their response to treatment. The control of those events involves medicinal and non-medicinal interventions. The latter include a reduction in the dosage of IFN or RBV and discontinuation of the treatment.

[Activity of fourth generation cephalosporins against clinical isolates of Enterobacteriaceae]. / Activitatea cefalosporinelor de generatia a patra asupra unor izolate clinice de enterobacterii.

Cefpirome and cefepime are a novel group of cephalosporins which contain a positively charged quaternary ammonium at carbon 3 of the dihidrothiazone ring. The antimicrobial agents cefpirome, cefepime, cefotaxime, ceftriaxone, ceftazidime, cefoperazone and imipenem were tested against clinical isolates of Escherichia coli (n = 302) and Klebsiella spp. (n = 62) obtained during september-december 2002 from patients of Galati Emergency Hospital. The fourth generation cephalosporins cefpirome and cefepime have similar in vitro activities to the third generation cephalosporins. E. coli showed the comparable resistance rates for all cephalosporins. Against Klebsiella spp. strains cefpirome was less active (35.5% resistance) than cefepime (25.8% resistance). As expected, imipenem had excellent activity (100% susceptibility).