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1.
Praxis (Bern 1994) ; 109(2): 109-115, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-32019460

RESUMEN

A Holiday Souvenir with Consequences - an Interdisciplinary Challenge Abstract. We describe a patient with a diabetic foot and challenging infectious complications. After a hospital stay in Sri Lanka due to a soft tissue infection of the foot he was relocated to Switzerland. After proof of multiple resistant bacteria, an amputation of the forefoot with a split skin cover was performed, followed by a short resistance-adapted antibiotic treatment, with good clinical results. This case illustrates the increase of multidrug-resistant bacteria, even in Switzerland. It emphasizes the importance of infection control measures in travellers returning from countries with high prevalence of multidrug-resistant bacteria (especially after a hospitalisation), and the need of a close interdisciplinary collaboration in these cases to guarantee the best treatment and to limit the spreading of multidrug-resistant bacteria.


Asunto(s)
Antibacterianos , Pie Diabético , Antibacterianos/uso terapéutico , Pie Diabético/tratamiento farmacológico , Farmacorresistencia Bacteriana Múltiple , Humanos , Masculino , Suiza
2.
Instr Course Lect ; 69: 229-242, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32017730

RESUMEN

In the past, the diagnosis and treatment of periprosthetic joint infection (PJI) in joint arthroplasty has often been frustrating for orthopaedic surgeons. The application of certain diagnostic criteria and different treatment strategies can be better directed if these infections are placed in the context of microbial biofilms. An understanding of this biofilm mode of microbial infection can help to explain the phenomenon of culture-negative infection as well as provide an understanding of why certain treatment modalities often fail. Continued basic research into the role of biofilms in infection will likely provide improved strategies for the clinical diagnosis and treatment of PJI. This is a review of the current preclinical knowledge of biofilm in relation to PJI with an overview of current practices applied in the diagnosis, treatment, and prevention of biofilm formation in this setting.


Asunto(s)
Artritis Infecciosa , Infecciones Relacionadas con Prótesis , Antibacterianos/uso terapéutico , Artroplastia , Biopelículas , Humanos
3.
N Engl J Med ; 382(5): 427-436, 2020 01 30.
Artículo en Inglés | MEDLINE | ID: mdl-31995688

RESUMEN

BACKGROUND: Helicobacter pylori infection and a family history of gastric cancer are the main risk factors for gastric cancer. Whether treatment to eradicate H. pylori can reduce the risk of gastric cancer in persons with a family history of gastric cancer in first-degree relatives is unknown. METHODS: In this single-center, double-blind, placebo-controlled trial, we screened 3100 first-degree relatives of patients with gastric cancer. We randomly assigned 1838 participants with H. pylori infection to receive either eradication therapy (lansoprazole [30 mg], amoxicillin [1000 mg], and clarithromycin [500 mg], each taken twice daily for 7 days) or placebo. The primary outcome was development of gastric cancer. A prespecified secondary outcome was development of gastric cancer according to H. pylori eradication status, assessed during the follow-up period. RESULTS: A total of 1676 participants were included in the modified intention-to-treat population for the analysis of the primary outcome (832 in the treatment group and 844 in the placebo group). During a median follow-up of 9.2 years, gastric cancer developed in 10 participants (1.2%) in the treatment group and in 23 (2.7%) in the placebo group (hazard ratio, 0.45; 95% confidence interval [CI], 0.21 to 0.94; P = 0.03 by log-rank test). Among the 10 participants in the treatment group in whom gastric cancer developed, 5 (50.0%) had persistent H. pylori infection. Gastric cancer developed in 0.8% of participants (5 of 608) in whom H. pylori infection was eradicated and in 2.9% of participants (28 of 979) who had persistent infection (hazard ratio, 0.27; 95% CI, 0.10 to 0.70). Adverse events were mild and were more common in the treatment group than in the placebo group (53.0% vs. 19.1%; P<0.001). CONCLUSIONS: Among persons with H. pylori infection who had a family history of gastric cancer in first-degree relatives, H. pylori eradication treatment reduced the risk of gastric cancer. (Funded by the National Cancer Center, South Korea; ClinicalTrials.gov number, NCT01678027.).


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Inhibidores de la Bomba de Protones/uso terapéutico , Neoplasias Gástricas/prevención & control , Adenoma/epidemiología , Adenoma/etiología , Adenoma/prevención & control , Adulto , Anciano , Amoxicilina/uso terapéutico , Claritromicina/uso terapéutico , Método Doble Ciego , Quimioterapia Combinada , Femenino , Infecciones por Helicobacter/complicaciones , Humanos , Incidencia , Estimación de Kaplan-Meier , Lansoprazol/uso terapéutico , Masculino , Persona de Mediana Edad , República de Corea , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología , Neoplasias Gástricas/genética
6.
J Zoo Wildl Med ; 50(4): 1012-1015, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926539

RESUMEN

Adenoviruses have been reported to affect a broad range of host species, tend to be species specific, and often affect the respiratory system. This report describes the isolation of an adenovirus from deep nasal swabs of two wild North American porcupines (Erethizon dorsatum) with respiratory diseases that presented to a wildlife hospital. Partial sequences of the deoxyribonucleic acid polymerase gene of the isolated virus were identical to skunk adenovirus (SkAdV-1), also known as pygmy marmoset adenovirus. Both porcupines survived and were released back to the wild after successful medical treatment and rehabilitation. The significance of the adenovirus isolated from these porcupines is unknown; however, this is the first report of an adenovirus in porcupines, and the first report of SkAdV-1 in a rodent.


Asunto(s)
Infecciones por Adenoviridae/veterinaria , Adenoviridae/clasificación , Puercoespines , Infecciones del Sistema Respiratorio/veterinaria , Adenoviridae/aislamiento & purificación , Infecciones por Adenoviridae/tratamiento farmacológico , Infecciones por Adenoviridae/virología , Animales , Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Broncodilatadores/uso terapéutico , Enrofloxacina/uso terapéutico , Masculino , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/virología , Terbutalina/uso terapéutico
7.
Medicine (Baltimore) ; 99(2): e18387, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914016

RESUMEN

RATIONALE: Congenital adrenal hyperplasia (CAH) is caused by various enzyme deficiencies, among which 21-hydroxylase (21-OH) deficiency accounts for more than 90% of cases. Neonatal screening became mandatory only a few decades ago. Many patients who were born before this went undiagnosed and some of the severely virilized females were raised as men. PATIENT CONCERNS: A 58-year old man with a history of excisional surgery in the external genitalia when he was a toddler presented with three days of dysuria and low abdominal pain. DIAGNOSIS: The patient's laboratory results showed leukocytosis and elevated C-reactive protein (CRP); thus, the physicians decided to perform a computed tomography (CT) scan. The CT demonstrated pelvic inflammatory disease (PID), left adrenal gland myelolipoma, and a mesenteric mass. Meanwhile, we suspected CAH based on the clinical history and assessed the patient's hormone levels. Seventeen-hydroxyprogesterone (17-OH-PG) was markedly elevated and the patient was diagnosed with classic simple virilizing CAH. INTERVENTIONS: Intravenous antibiotics were administered, and positron emission tomography-CT (PET-CT) was performed to evaluate any metastases. OUTCOMES: After 2 weeks of antibiotic treatment, CRP decreased to 0.12 mg/dL and PID was resolved. The patient opted for resection of the female genitalia along with the mesenteric and adrenal gland tumors in the near future, and was safely discharged. LESSONS: The adrenal gland myelolipoma was thought to have developed as a result of a longstanding exposure to adrenocorticotropic hormone. There are controversies regarding the management of female genitalia in CAH patients who identify themselves as men. In this case, the physician and patient decided to remove the female genitalia because the surgery for the mesenteric mass was inevitable and there was a possibility of recurrent PID. To our knowledge, this is the first article to report primary mesenteric tumor in a CAH patient to date. In conclusion, patients who were born before neonatal screening for CAH became the mainstay, who are suspected to have CAH from their history, and present with abdominal pain must be diagnosed by performing an imaging study, testing levels of serum 17-OH-PG, and screening for female genitalia and adrenal gland myelolipoma.


Asunto(s)
Hiperplasia Suprarrenal Congénita/diagnóstico , Antibacterianos/administración & dosificación , Genitales Femeninos/cirugía , Enfermedad Inflamatoria Pélvica/diagnóstico por imagen , 17-alfa-Hidroxiprogesterona/sangre , Administración Intravenosa , Hiperplasia Suprarrenal Congénita/tratamiento farmacológico , Hiperplasia Suprarrenal Congénita/patología , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mielolipoma/diagnóstico por imagen , Mielolipoma/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento
8.
Medicine (Baltimore) ; 99(2): e18714, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914082

RESUMEN

To investigate the situation of antibiotic consumption and to assess the inappropriate use on pediatric inpatients of different types hospitals in Sichuan, China.A cross-sectional survey of antibiotic prescriptions among hospitalized children aged 1month -14years were conducted from April 2018 to June 2018 in southwestern China. Antibiotic prescriptions were extracted from electronic records during hospitalization of each inpatient in five different types hospitals.In this study, the antibiotic prescription rate of hospitalized children was 66.9% (1176/1758). Compared with tertiary children hospital (TC) (46.1%), general hospitals and non-tertiary children hospitals has higher rate of antibiotic prescription (almost 85%) (P < .001). 93.4% of inpatients received parenteral antibiotic. Overall, the most common antibiotics were Cefoperazone and enzyme inhibitor, Cefixime and Azithromycin. Lower respiratory tract infection (LRTI) was the leading reason for antibiotic consumption in pediatric wards (56.8%), followed by upper respiratory tract infection (URTI) (22.2%). For children with LRTI, Cephalosporins were heavy prescribed, especially broad-spectrum third-generation Cephalosporins (60.3%). The antibiotic prescription proportion of URTI in general hospitals and non-tertiary children hospitals (more than 18%) was higher than TC (8.1%) (P < .001).There was inappropriate use of antibiotic in hospitalized children including overuse of parenteral administration, overprescribing of antibiotic on URTI and misuse of third-generation Cephalosporins in pediatric inpatients with LRTI. Compared with tertiary freestanding children hospital, the irrational antibiotic prescription of general hospitals and non-tertiary children hospitals were more serious. Management strategy should be implementer on quality improvement of antibiotic use.


Asunto(s)
Antibacterianos/uso terapéutico , Utilización de Medicamentos/estadística & datos numéricos , Hospitales/estadística & datos numéricos , Prescripción Inadecuada/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adolescente , Antibacterianos/administración & dosificación , Niño , Niño Hospitalizado , Preescolar , China , Estudios Transversales , Femenino , Hospitales Pediátricos/estadística & datos numéricos , Humanos , Lactante , Masculino , Infecciones del Sistema Respiratorio/tratamiento farmacológico
9.
Medicine (Baltimore) ; 99(2): e18769, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914101

RESUMEN

BACKGROUND: Complicated urinary tract infections (cUTI) are universal reasons for hospitalization, and highly likely to develop into sepsis or septic shock. Carbapenem antibiotics with potentially higher efficacy or with fewer and milder side effects have increased in popularity, but evidence is limited by a scarcity of randomized controlled trials (RCTs) comparing different carbapenem antibiotics for cUTI. Network meta-analysis is a useful tool to compare multiple treatments when there is limited or no direct evidence available. OBJECTIVE: The aim of this study is to compare the efficacy and safety of different carbapenems with alternative antibiotics for the treatment of cUTI. METHODS: Pubmed, Medline, CENTRAL, and Embase were searched in November 2018. Studies of cUTI patients receiving carbapenem were included. We performed network meta-analysis to estimate the risk ratio (RR) and 95% credible interval (CrI) from both direct and indirect evidence; traditional meta-analysis was also performed. Primary outcomes were clinical and microbiological treatment success. RESULTS: A total of 19 studies and 7380 patients were included in the analysis. Doripenem (DOPM) was associated with lower clinical treatment success rates than other carbapenems. Although the efficacy of other carbapenems by RRs with 95% CrIs did not show statistical differences, the cumulative rank probability indicated that meropenem/vaborbactam (MV), ertapenem (ETPM), and biapenem (BAPM) had higher clinical and microbiological treatment success rates; imipenem/cilastatin (IC) and MV showed higher risk of adverse events (AEs). CONCLUSIONS: MV was associated with higher treatment success rates for cUTI, especially for cUTI caused by carbapenem-resistant uropathogens, but also with higher risk of AEs. Our findings suggest MV as a first-choice treatment of carbapenem-resistant cUTI. ETPM, BAPM, and meropenem (MEPM) is another reasonable choice for cUTI empiric therapy.


Asunto(s)
Antibacterianos/uso terapéutico , Carbapenémicos/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Antibacterianos/efectos adversos , Carbapenémicos/efectos adversos , Humanos , Metaanálisis en Red , Infecciones Urinarias/microbiología
10.
Orv Hetil ; 161(2): 50-55, 2020 Jan.
Artículo en Húngaro | MEDLINE | ID: mdl-31902236

RESUMEN

Introduction: Exudative tonsillitis is a common clinical picture during childhood. The majority of these cases are caused by viruses (Epstein-Barr virus [EBV], cytomegalovirus [CMV], influenza virus, parainfluenza virus, and adenovirus), and only some infections are caused by bacteria, mainly group A streptococci (GAS). On the basis of international guidelines, routine use of early antibiotic treatment is not recommended in these cases, because it seems not to prevent GAS-associated complications. Aim: Our aim was to determine those laboratory results which are useful to distinguish between bacterial and viral infections in children with exudative tonsillitis to reduce antibiotic overuse. Method: In our study, we evaluated 135 clinical data from 133 children with exudative tonsillitis. Patients were grouped according to the following criteria: the first group contained patients with acute CMV or EBV infections, while in the second group, CMV or EBV infections were not confirmed using serology. Results: On the basis of our results, EBV or CMV infections (66/135, 48.8%) were serologically confirmed in the majority of cases with exudative tonsillitis between 2016 and 2017, while the causative role of GAS was minimal in this patient group (3/65, 4.61%). In spite of this finding, the majority of patients (92%) were treated with antibiotics. Conclusion: Our retrospective findings confirmed that it is not possible to determine the causative agent of this clinical picture on the basis of symptoms, and physical findings, moreover laboratory results, such as high white blood cell count could not confirm bacterial infection. At the same time, elevated transaminase levels may refer to viral origin of infection, especially EBV or CMV with high predictive value; the use of extended laboratory tests may reduce the unnecessary antibiotic consumption. Orv Hetil. 2020; 161(2): 50-55.


Asunto(s)
Infecciones Estreptocócicas/etiología , Tonsilitis/etiología , Virosis/etiología , Antibacterianos/uso terapéutico , Anticuerpos Antibacterianos/análisis , Anticuerpos Antivirales/análisis , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/tratamiento farmacológico , Niño , Humanos , Faringe/microbiología , Faringe/virología , Estudios Retrospectivos , Tonsilitis/tratamiento farmacológico , Virosis/diagnóstico , Virosis/tratamiento farmacológico
11.
Braz Oral Res ; 33: e112, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939496

RESUMEN

This clinical trial compared the efficacy of doxycycline (DOX) in ß-cyclodextrin (DOX)/ßCD) with DOX- alone in gel on thirty-three subjects with periodontitis. Patients were randomized to group 1 GI; 10% DOX + scaling and root planning (SRP); group 2 (GII (10% DOX /ß-CD + SRP), and group 3 (GIII; SRP). Gels were applied in GI and GII at baseline (T0) and 30 days later (T1). Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI) were evaluated at (T0), 30 days (T1) and 60 days after T0 (T2). Bone density was analyzed after 18 months (T3). GII showed the most significant reduction of PPD (2.62 mm; p <0.003), and greatest gain in CAL (2.54 mm p <0.003) at T2. BOP and the VPI had a strong reduction in all groups at T2 (p <0.05), both decreased by ≥5 times and 2 times, respectively, in all groups at T1. Bone density increased in all groups in radiographs (T3). The use of DOX encapsulated in ß-CD gel with SRP resulted in significant improvements in clinical periodontal parameters; such molecular inclusion of doxycycline into ß-CD in gel for local application is relatively simple and useful in dentistry.


Asunto(s)
Antibacterianos/uso terapéutico , Doxiciclina/uso terapéutico , Periodontitis/tratamiento farmacológico , beta-Ciclodextrinas/uso terapéutico , Adulto , Índice de Placa Dental , Raspado Dental/métodos , Método Doble Ciego , Composición de Medicamentos , Femenino , Geles , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal , Índice Periodontal , Aplanamiento de la Raíz/métodos , Resultado del Tratamiento , Adulto Joven
12.
Rev Med Suisse ; 16(676-7): 55-58, 2020 Jan 15.
Artículo en Francés | MEDLINE | ID: mdl-31961085

RESUMEN

Among carefully selected patients, an early oral antibiotic switch is safe and efficient in severe bacterial infections. New data are available on dual antibiotherapy in severe Staphylococcus aureus infections. Neisseria gonorrhoeae strains resistant to ceftriaxone emerge, highlighting the necessity to develop new therapeutic strategies. Alongshan virus is a new tick-borne virus discovered in China. Ebola continues to rage in Democratic Republic of Congo, while Europe and Switzerland face measles outbreaks. North american guidelines for the diagnosis and management of Influenza have been updated, shortly before the FDA approval of baloxavir marboxil, a new antiviral treatment for Influenza infections.


Asunto(s)
Antibacterianos , Enfermedades Transmisibles , Antibacterianos/uso terapéutico , China , Enfermedades Transmisibles/tratamiento farmacológico , Enfermedades Transmisibles/epidemiología , Congo , Brotes de Enfermedades , Europa (Continente) , Humanos , Suiza
13.
Zhonghua Er Ke Za Zhi ; 58(1): 41-45, 2020 Jan 02.
Artículo en Chino | MEDLINE | ID: mdl-31905475

RESUMEN

Objective: To evaluate the effectiveness of eradication therapy based on Helicobacter pylori (Hp) susceptibility and CYP2C19 genotype in children with refractory Hp infection. Methods: In this prospective observational cohort study, 156 children with Hp refractory to amoxicillin+clarithromycin+omeprazole triple regimen in Baoding Children's Hospital from December 2017 to May 2018 were enrolled. Ninety-two of them underwent Hp culture and CYP2C19 detection. Seventy-five cases with positive Hp culture were defined as culture successful group and were treated according to Hp susceptibility and CYP2C19 genotype. Seventeen cases with negative Hp culture were defined as culture failed group and were treated only based on the results of CYP2C19 genotype. Sixty-four children who did not have Hp culture and CYP2C19 gene testing were defined as the empirical eradication therapy group and were treated with quadruple regimen (amoxicillin+metronidazole+omeprazole+bismuth). Bacterial resistance, CYP2C19 polymorphism and therapeutic effectiveness between the three groups were compared using chi-square test. Results: Among the 75 positive Hp culture results, 72 (96%) were resistant to clarithromycin, 3 (4%) were resistant to metronidazole, 5 (7%) were resistant to levofloxacin, 5 (7%) were resistant to rifampicin, 1 (1%) was resistant to tetracycline, and none was resistant to amoxicillin and furazolidone. The CYP2C19 polymorphism in 92 patients showed that 43 (47%) were extensive metabolizer (EM), 9 (10%) were poor metabolizer (PM), and 40 (43%) were intermediate metabolizer (IM). In terms of the effectiveness, eradication rate in the culture successful group,culture failed group and empirical eradication therapy group were 99% (74/75), 88% (15/17) and 72% (46/64), respectively (χ(2)=21.325, P<0.05). The eradication rate in the culture successful group was significantly higher than that in empirical eradication therapy group (χ(2)=21.005, P<0.05), while there was no difference between empirical eradication therapy group and culture failed group (χ(2)=1.154, P=0.283). Conclusion: Eradication regimen based on bacterial susceptibility and CYP2C19 genotype should be considered in children with refractory Hp infection.


Asunto(s)
Citocromo P-450 CYP2C19/genética , Quimioterapia Combinada , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/genética , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/genética , Omeprazol/uso terapéutico , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Bismuto/uso terapéutico , Niño , Claritromicina/administración & dosificación , Claritromicina/uso terapéutico , Estudios de Cohortes , Resistencia a Medicamentos/genética , Femenino , Genotipo , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Metronidazol/uso terapéutico , Omeprazol/administración & dosificación , Polimorfismo Genético , Estudios Prospectivos , Resultado del Tratamiento
14.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(1): 7-8, 2020 Jan.
Artículo en Chino | MEDLINE | ID: mdl-31948516

RESUMEN

At present, non-standard use of antibiotics remains a common phenomenon in the treatment of preterm infants with early-onset sepsis (EOS) in China. The expert panel of neonatologists in Hunan Province formulated a consensus on the diagnosis and use of antibiotics for EOS in preterm infant [Chin J Contemp Pediatr, 2020, 22(1): 1-6], which has a positive effect on the rational use of antibiotics. Based on this consensus, this article points out that in order to use antibiotics accurately, it is necessary to accurately identify EOS in preterm infants, accurately understand their clinical manifestations and medical history, and accurately evaluate the laboratory test results. Also, this article offers suggestions for the use of antibiotics in preterm infants with EOS.


Asunto(s)
Antibacterianos/uso terapéutico , Enfermedades del Prematuro , Sepsis , Edad de Inicio , China , Humanos , Recién Nacido , Recien Nacido Prematuro , Factores de Riesgo , Sepsis/tratamiento farmacológico
15.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(1): 9-11, 2020 Jan.
Artículo en Chino | MEDLINE | ID: mdl-31948517

RESUMEN

This paper is a comment on "Recommendation on the diagnosis and the use of antibiotics for early-onset sepsis in preterm infants: consensus of the expert panel from Hunan Province" [Chinese J Contemp Pediatr, 2020, 22(1): 1-6]. This consensus offers suggestions for the diagnosis and antibiotic therapy of early-onset sepsis (EOS) in preterm infants in Hunan Province, which is of great significance for reducing unreasonable and unnecessary use of antibiotics. Based on this consensus, this comment discusses the diagnosis of EOS and the use of antibiotics in preterm infants.


Asunto(s)
Antibacterianos/uso terapéutico , Recien Nacido Prematuro , Sepsis , Atención , Humanos , Recién Nacido , Factores de Riesgo , Sepsis/tratamiento farmacológico
16.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(1): 12-16, 2020 Jan.
Artículo en Chino | MEDLINE | ID: mdl-31948518

RESUMEN

OBJECTIVE: To evaluate the efficacy and safety of C-reactive protein (CRP)-guided antibiotic treatment strategy for neonates with suspected early-onset sepsis (EOS). METHODS: A total of 428 neonates, with a gestational age of >35 weeks, who were admitted to the Children's Hospital of Chongqing Medical University from February to July, 2019 and were suspected of EOS were enrolled as the observation group. The effect of antibiotic treatment was prospectively observed, and if clinical symptoms were improved and CRP was <10 mg/L in two consecutive tests, discontinuation of antibiotics was considered. A total of 328 neonates (gestational age of >35 weeks) who were admitted to this hospital from February to July, 2018 and were suspected of EOS were enrolled as the control group, and the use of antibiotics was analyzed retrospectively. The two groups were compared in terms of duration of antibiotic treatment, length of hospital stay, incidence rate of repeated infection and clinical outcome. RESULTS: Compared with the control group, the observation group had significantly shorter duration of antibiotic treatment and length of hospital stay (P<0.05). There were no significant differences in the incidence rate of repeated infection and clinical outcome between the two groups (P>0.05). CONCLUSIONS: For neonates with a gestational age of >35 weeks and a suspected diagnosis of EOS, CRP-guided antibiotic treatment strategy can shorten duration of antibiotic treatment and length of hospital stay and does not increase the incidence rate of repeated infection. Therefore, it holds promise for clinical application.


Asunto(s)
Antibacterianos/uso terapéutico , Sepsis , Proteína C-Reactiva , Edad Gestacional , Humanos , Recién Nacido , Estudios Retrospectivos , Sepsis/tratamiento farmacológico
18.
Vasc Endovascular Surg ; 54(2): 191-194, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31578128

RESUMEN

Aortic graft infections are uncommon complications after endovascular aortic surgery. In the majority of cases, gram-positive and then gram-negative organisms are the causative agents leading to this condition. Atypical organisms are traditionally not responsible for graft infection unless the patient is immunocompromised. We are reporting a case of culture-confirmed mycobacterium avium complex infection of an aortic graft in a well-controlled patient with HIV who had an undetected viral load and a CD4 count of 324 while on highly active antiretroviral therapy.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Prótesis Vascular/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Complejo Mycobacterium avium/patogenicidad , Infección por Mycobacterium avium-intracellulare/microbiología , Infecciones Relacionadas con Prótesis/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/terapia , Adulto , Antibacterianos/uso terapéutico , Terapia Antirretroviral Altamente Activa , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Implantación de Prótesis Vascular/instrumentación , Remoción de Dispositivos , Infecciones por VIH/diagnóstico , Infecciones por VIH/inmunología , Humanos , Huésped Inmunocomprometido , Masculino , Complejo Mycobacterium avium/inmunología , Infección por Mycobacterium avium-intracellulare/diagnóstico , Infección por Mycobacterium avium-intracellulare/inmunología , Infección por Mycobacterium avium-intracellulare/terapia , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/inmunología , Infecciones Relacionadas con Prótesis/terapia , Resultado del Tratamiento
19.
Food Chem Toxicol ; 135: 110936, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31682933

RESUMEN

Palygorskite (PGS) is a kind of clay minerals with the property of absorbent capacity, and ginger essential oil (GEO) is a kind of natural antibacterial substances. In the present study PGS was used as carrier of GEO, and thus, a kind of new anti-bacterial composite GEO-PGS has been obtained. Characterization, inhibitory effect of GEO-PGS on Escherichia coli (E. coli) and its function of improvement of intestinal health would be investigated. Results showed that characterization analysis of GEO-PGS (FTIR, TG-DSC, BET, Zeta potential, specific surface area, total pore volume and size, TEM observation) demonstrated combination of GEO and PGS, and GEO was absorbed on the surface of PGS, partially filled the micropores of PGS. GEO-PGS had obvious inhibitory effect on E.coli, in combination of the antibacterial activity of GEO and bacteria-absorbed capability of PGS. GEO-PGS also had ameliorating effect on enteritis and intestinal dysfunction in vivo, which might be related to the inhibition of gene expression of inflammatory cytokines (TLR2, IL-6, TNFα, and IL-8). In conclusion, the novel composite GEO-PGS has the potential usage as functional component having effect of improving intestinal health.


Asunto(s)
Antibacterianos/uso terapéutico , Enteritis/tratamiento farmacológico , Escherichia coli/efectos de los fármacos , Jengibre/química , Compuestos de Magnesio/uso terapéutico , Aceites Volátiles/uso terapéutico , Compuestos de Silicona/uso terapéutico , Animales , Citocinas/genética , Citocinas/metabolismo , Sinergismo Farmacológico , Enteritis/microbiología , Expresión Génica/efectos de los fármacos , Intestino Delgado/efectos de los fármacos , Intestino Delgado/patología , Ratones , Pruebas de Sensibilidad Microbiana
20.
Acta Odontol Scand ; 78(1): 64-73, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31483177

RESUMEN

Background: The objective of the study was to assess the effect of prophylactic antibiotics on the outcome of bone augmentation and subsequent dental implant placement by combining the recommended quality assessment methods for systematic reviews and primary studies.Materials and methods: This is a complex systematic review in which systematic reviews as well as primary studies are scrutinised. A search of Medline (OVID), The Cochrane Library (Wiley) and EMBASE, PubMed and Health technology assessment (HTA) organisations as-well as a complementary hand-search was carried out. Selected primary studies were assessed using GRADE. Each study was reviewed by three authors independently.Results: Abstract screening yielded six potential systematic reviews allocated for full-text inspection. A total of ten primary studies were read in full-text. No relevant systematic reviews regarding the topic of this article were found. The quality assessment resulted in two primary studies with a moderate risk of bias. Of the two studies with a moderate risk of bias, one compared a single dose of clindamycin 600 mg preoperatively with the same preoperative dose followed by four doses of 300 mg every 6 h. The second study compared a single dose prophylaxis of two different types of antibiotic compounds.Conclusion: In conclusion, the scientific evidence regarding the use of antibiotic prophylaxis for reducing the risk of infection in conjunction with bone augmentation procedures during dental implant placement is very limited. The infection rate as compared to nonusage of prophylactic antibiotics, selection of the most suitable compound, and the optimal duration of prophylactic treatment is still unknown.


Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Trasplante Óseo , Implantes Dentales , Humanos , Complicaciones Posoperatorias/prevención & control , Revisiones Sistemáticas como Asunto
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