Vulnerabilidades, concepções e atitudes relacionadas à saúde do homem / Susceptibilities, thoughts and attitudes related to men's health / Susceptibilidad, concepciones y actitudes relacionadas con la salud de los hombres

Objetivo: Este estudo objetivou analisar as vulnerabilidades relacionadas à saúde homem, bem como evidenciar as concepções e atitudes sobre saúde na ótica dos homens. Método: Para tanto, realizou-se um estudo descritivo/exploratório com abordagem qualitativa, de agosto a dezembro de 2012 com funcionários de uma Instituição de Ensino Superior, utilizando um roteiro de entrevista semiestruturado e análise dos dados através da técnica Análise de Conteúdo. Resultado: Da análise resultaram três categorias: concepções e atitudes sobre a saúde na óptica dos homens; vulnerabilidades relacionadas à saúde do homem; e resistência masculina para a busca dos serviços de saúde. Conclusão: Os costumes, pensamentos e estilo de vida dos homens, influenciam na baixa procura dos mesmos aos serviços de saúde, má alimentação, sedentarismo, acidentes de trânsito e de trabalho

Objective: The study's goal has been to analyze the susceptibilities related to men's health, as well as to highlight the thoughts and attitudes about health according to men's viewpoint. Methods: It is a descriptive-exploratory study with a qualitative approach, which was carried out from august to december 2012 with employees from a higher education Institution and using a semi-structured interview script. Data analysis was performed through the content analysis technique. Results: The analysis resulted in the following three categories: thoughts and attitudes about health according to men's viewpoint; susceptibilities related to men's health; and, male resistance to searching for health services. Conclusion: Men's habits, thoughts and lifestyle influence their low demand for health services, poor diet, sedentary lifestyle, and both traffic and work accidents

Objetivo: Este estudio tuvo como objetivo analizar las vulnerabilidades relacionadas con la salud de los hombres, así como destacar las concepciones y actitudes sobre la salud desde la perspectiva de los hombres. Método: Para este propósito, se realizó un estudio descriptivo / exploratorio con un enfoque cualitativo, de agosto a diciembre de 2012 con empleados de una institución de educación superior, utilizando un guión de entrevista semiestructurada y análisis de datos utilizando la técnica de análisis de contenido. Resultado: El análisis dio como resultado tres categorías: concepciones y actitudes sobre la salud desde la perspectiva de los hombres; vulnerabilidades relacionadas con la salud de los hombres; y resistencia masculina a la búsqueda de servicios de salud. Conclusión: Las costumbres, los pensamientos y el estilo de vida de los hombres influyen en su baja demanda de servicios de salud, mala alimentación, inactividad física, accidentes de tránsito y laborales

Screening and characterisation of two Pseudomonas aeruginosa from aquaculture and water environment

Aims@#Pseudomonas has been associated with diseases occurring in people with weakened or compromised immune system after exposure to contaminated water. The diseases are commonly treated with antibiotics. However, the bacteria had developed resistances to commonly used antibiotics making treatment a difficult task. Therefore, the continuous surveillance of susceptibility of Pseudomonas especially for the human pathogen P. aeruginosa to commonly clinical and aquaculture farming used antibiotics is important to ensure that serious infections remain susceptible to those antibiotics.@*Methodology and results@#In this study, the bacteria were screened from water, sediment and fish from rivers and aquaculture farms around Kuching, Sarawak. A total number of 38 presumptive P. aeruginosa were isolated using CHROMagar TM Pseudomonas and subjected to a series of biochemical tests. Out of all the isolates tested, only two isolates designated as AS-R10(S) and BK2-OLT2(S) fulfilled the biochemical characteristics of P. aeruginosa. 16S rRNA gene sequencing further confirmed these two isolates as P. aeruginosa based on their 100% similarity with P. aeruginosa strain GD1 and P. aeruginosa strain PA1201 in NCBI database. These two isolates were tested for their susceptibilities against nine common antibiotics used in both clinical and aquaculture farming nowadays: imipenem, piperacillin, meropenem, amikacin, gentamicin, ciprofloxacin, ceftazidime, tobramycin and norfloxacin according to CLSI standard using disk diffusion method.@*Conclusion, significance and impact of study@#The two isolates exhibited total susceptibility to all the antibiotics analysed, suggesting the effectiveness of the antimicrobial agents towards P. aeruginosa isolated from aquaculture and water environment in the study area.

Analysis of microbiological trends and antibiotic susceptibility in 711 episodes of peritoneal dialysis-related peritonitis / 中华肾脏病杂志

Objective To investigate the microbiological trends and antibiotic susceptibility of peritoneal dialysis(PD)-related peritonitis (PDAP).Methods All patients who developed PDAP between 2004 and 2015 in Renji Hospital,Shanghai Jiao Tong University School of Medicine were enrolled.Demographic data,results of dialysate pathogen culture and drug susceptibility test were recorded.The trend of peritonitis incidence was measured by Poisson regression and the chi-square test or Fisher exact test method was used to compare the composition of causative organisms and their antimicrobial susceptibilities over time.Results During the study period,a total of 711 episodes of PDAP were occurred in 386 patients.The culture positive rate of pathogens rose from 52.0％ in 2004 to 77.0％ in 2015 (P ＜ 0.001).The distribution of causative organisms of the culture positive peritonitis was gram-positive bacteria (270,59.5％),followed by gram-negative bacteria (129,28.4％),polymicrobial(39,8.6％),fungi (15,3.3％) and mycobacteria (1,0.2％).From 2004 to 2015,the incidence of peritonitis decreased from 0.214 to 0.160 episodes/patient·year (P=0.034).The incidence of coagulase-negative staphylococcus peritonitis decreased from 0.049 to 0.027 episodes/patient · year (P=0.025),while others had no significant change;A significant decline was observed in the sensitivity of Gram-positive strains to the first generation cephalosporin and ampicillin/sulbactam in 2010-2015 group compared with those in 2001-2009 group (61.3％ vs 88.2％,P ＜ 0.001;61.7％ vs 85.5％,P=0,001),whereas the sensitivity to vancomycin remained the same.The sensitivity of Gram-negative strains to ceftazidime and amikacin showed no significant change.As for the gram-positive peritonitis treated with cefradine as empirical treatment,compared with those in 2004-2009 group,in 2010-2015group the proportion of patients requiring to change their treatment regime was significantly higher,and the treatment course was longer.Conclusions A gradual decline is observed in the incidence of PDAP and the culture positive rate of pathogens improves.Peritonitis caused by coagulase-negative staphylococcus decreases overtime.The present empirical treatment protocols may need re-evaluation considering the decreased rate of the first generation cephalosporin sensitivity in recent years.

Analysis on the Antimicrobial Susceptibilities and the Prevalence of ESBLs Encoding Genes of Escherichia Coli Isolates Collected from Blood / 现代检验医学杂志

Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coli isolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed by confirmatory pheno-typic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2nd or 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,ami-kacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5% (72),38.8% (47)and 4.1% (5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and bla-TEM,1(0.8%)isolate carried both of blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and sin-gle amide antimicrobial agents should be chosen according to susceptibility results.

A 5-year Surveillance Study on Antimicrobial Resistance of Acinetobacter baumannii Clinical Isolates from a Tertiary Greek Hospital / 감염과화학요법

BACKGROUND: Acinetobacter baumannii has emerged as a major cause of nosocomial outbreaks. It is particularly associated with nosocomial pneumonia and bloodstream infections in immunocompromised and debilitated patients with serious underlying pathologies. Over the last two decades, a remarkable rise in the rates of multidrug resistance to most antimicrobial agents that are active against A. baumannii has been noted worldwide. We evaluated the rates of antimicrobial resistance and changes in resistance over a 5-year period (2010–2014) in A. baumannii strains isolated from hospitalized patients in a tertiary Greek hospital. MATERIALS AND METHODS: Identification of A. baumannii was performed by standard biochemical methods and the Vitek 2 automated system, which was also used for susceptibility testing against 18 antibiotics: ampicillin/sulbactam, ticarcillin, ticarcillin/clavulanic acid, piperacillin, piperacillin/tazobactam, cefotaxime, ceftazidime, cefepime, imipenem, meropenem, gentamicin, amikacin, tobramycin, ciprofloxacin, tetracycline, tigecycline, trimethoprim/sulfamethoxazole, and colistin. Interpretation of susceptibility results was based on the Clinical and Laboratory Standards Institute criteria, except for tigecycline, for which the Food and Drug Administration breakpoints were applied. Multidrug resistance was defined as resistance to ≥3 classes of antimicrobial agents. RESULTS: Overall 914 clinical isolates of A. baumannii were recovered from the intensive care unit (ICU) (n = 493), and medical (n = 252) and surgical (n = 169) wards. Only 4.9% of these isolates were fully susceptible to the antimicrobials tested, while 92.89% of them were multidrug resistant (MDR), i.e., resistant to ≥3 classes of antibiotics. ICU isolates were the most resistant followed by isolates from surgical and medical wards. The most effective antimicrobial agents were, in descending order: colistin, amikacin, trimethoprim/sulfamethoxazole, tigecycline, and tobramycin. Nevertheless, with the exception of colistin, no antibiotic was associated with a susceptibility rate >40% for the entire study period. The most common phenotype showed resistance against ampicillin/sulbactam, cephalosporins, carbapenems, aminoglycosides, ciprofloxacin, and tigecycline. An extremely concerning increase in colistin-resistant isolates (7.9%) was noted in 2014, the most recent study year. CONCLUSION: The vast majority of A. baumannii clinical isolates in our hospital are MDR. The remaining therapeutic options for critically ill patients who suffer from MDR A. baumannii infections are severely limited, with A. baumannii beginning to develop resistance even against colistin. Scrupulous application of infection control practices should be implemented in every hospital unit. Lastly, given the lack of available therapeutic options for MDR A. baumannii infections, well-controlled clinical trials of combinations of existing antibiotics are clearly needed.

Cáncer de la vesícula biliar: estudios necesarios para el diseño de estrategias de prevención y diagnóstico precoz / Gallbladder cancer: necessary studies to design strategies for prevention and early diagnosis

Chile tiene la mayor tasa de incidencia de cáncer de vesícula biliar (CVB) en el mundo (> 30 por 100.000). Siendo la principal causa de muerte por cáncer entre las mujeres chilenas. Para diseñar estrategias de prevención y diagnóstico precoz del CVB hay que entender los factores etiológicos del proceso carcinogénico vesicular. Hay consenso que para el desarrollo de este cáncer concurren factores -genéticos, hormonales, infecciones crónicas, e inflamaciones crónicas asociadas a litiasis vesicular; y también que este cáncer ocurre en condiciones de pobreza. Desafortunadamente es insuficiente el conocimiento sobre la carcinogénesis vesicular, sobre el mecanismo de acción de los factores de riesgo clásicos y sobre cuáles son relevantes en la iniciación y promoción del CVB. En este artículo centramos la discusión en la litiasis vesicular, considerado el principal factor de riesgo del CVB. Se analiza las estrategias de prevención y control y se discuten los programas actuales. Finalmente se presentan dos estudios sobre factores de riesgo y de susceptibilidad para CVB que están siendo implementados en Chile.

Chile has the highest gallbladder cancer (GBC) incidence rate in the world (>30 per 100,000 person-years) and is the leading cause of cancer deaths among Chilean women. To design strategies of prevention and early diagnosis of GBC we must understand the etiological factors of the gallbladder carcinogenic process; There is consensus that in the development of this cancer concurs genetic and hormonal factors, infection, and chronic inflammation associated with lithiasis; and that is strongly associated with poverty conditions; But unfortunately there is not enough information about this process or how the classic risk factors associated play a role in its development. There is also no information on which are important in the initiation and promotion of GBC. In this article we focus the discussion in gallstones, considered the main risk factor for GBC. We analize some strategies of prevention and control and discuss some aspects of the current program. Finally we will point out two studies on risk factors and genetic susceptibility to GBC that are being implemented in Chile.

Antimicrobial susceptibilities of Listeria monocytogenes human strains isolated from 1970 to 2008 in Brazil / Susceptibilidade antimicrobiana de cepas humanas de Listeria monocytogenes isoladas no período de 1970 a 2008 no Brasil

INTRODUCTION: Listeria monocytogenes is the causative agent of listeriosis, a foodborne illness that affects mainly pregnant women, the elderly and immunocompromised patients. The primary treatment is a combination of ampicillin with an aminoglycoside, in addition to a second-choice drug represented by chloramphenicol, erythromycin, tetracycline and rifampicin. The aim of this study was to analyze the antimicrobial susceptibility profile of strains isolated from human sources in the last four decades. METHODS: Sixty-eight strains were selected from the culture collection of the Laboratory of Bacterial Zoonoses/LABZOO/FIOCRUZ isolated in different regions of Brazil from 1970 to 2008 and primarily isolated from cerebrospinal fluid and blood culture. Susceptibility tests to antimicrobials drugs were evaluated using the criteria established by Soussy using the Kirby-Bauer method and E-Test strips were used to determine the minimum inhibitory concentration (MIC). RESULTS: Among the strains tested, serovar L4b (60.3 percent) was the most prevalent, followed by serovar 1/2a (20.6 percent), 1/2b (13.2 percent) and the more uncommon serovars 1/2c, 3b and 4ab (5.9 percent). All strains were susceptible to ampicillin, cephalothin, erythromycin, gentamicin, teicoplanin and vancomycin. Only one strain (1.5 percent) showed resistance to rifampin, and two (3 percent) were resistant to trimethoprim-sulfamethoxazole. MICs with values up to 2μg/ml reinforce the need for microbiological surveillance. CONCLUSIONS: The study demonstrated low prevalence of strains resistant to the antimicrobial drugs indicated in the treatment of human listeriosis. Monitoring antimicrobial resistance profile is still very important to determine adequate treatment, especially in immunocompromised patients.

INTRODUÇÃO: Listeria monocytogenes é o agente etiológico da listeriose, doença de origem alimentar que acomete principalmente grávidas, pacientes imunodeprimidos e idosos. O tratamento primário é a associação de ampicilina a um aminoglicosídeo além de outros, em segunda escolha, representados por cloranfenicol, eritromicina, tetraciclina e rifampicina. O presente estudo teve como objetivo analisar o perfil de susceptibilidade aos antimicrobianos de amostras de origem humana isoladas nas últimas quatro décadas. MÉTODOS: Foram selecionadas 68 cepas provenientes de casos clínicos humanos ocorridos em diferentes regiões do país no período de 1970-2008. A susceptibilidade aos antimicrobianos testados foi determinada através dos critérios estabelecidos por Soussy pelo método de Kirby-Bauer e a concentração mínima inibitória realizada através do E-Test. RESULTADOS: A amostragem constituiu-se de 68 cepas, isoladas principalmente de líquido cefalorraquidiano, e hemocultura no período, pertencentes ao Laboratório de Zoonoses Bacterianas/LABZOO/Fiocruz. O sorovar L4b (60,3 por cento) foi o mais prevalente, seguido do sorovar 1/2a (20,6 por cento), 1/2b (13,2 por cento) e aqueles mais raros representados por 1/2c, 3b e 4ab (5,9 por cento). Todas as cepas foram sensíveis à ampicilina, cefalotina, eritromicina, gentamicina, teicoplanina e vancomicina. Apenas uma cepa (1,5 por cento) apresentou resistência à rifampicina, enquanto duas (3 por cento) foram resistentes à associação de sulfametoxazol-trimetoprim. CONCLUSÕES: Apesar de o estudo ter demonstrado uma baixa prevalência de amostras resistentes aos antimicrobianos indicados na terapêutica da listeriose humana, o sistema de monitoramento do perfil de resistência antimicrobiana é de extrema importância para a orientação do tratamento adequado, principalmente nas infecções em pacientes imunocomprometidos.

Clinical Aspects of Bacterial Meningitis in Cerebrospinal Fluid Culture Positive Patients in a Tertiary Care University Hospital / 대한임상미생물학회지

BACKGROUND: There have been previous clinical research studies on clinical manifestations of meningitis in adults or children; however, few have focused on including both groups and none on the causative organism and its susceptibilities to antibiotics. Here we describe the distribution of causative organism and its antibiotic susceptibilities of meningitis from spinal fluid positive patients of a university hospital. METHODS: Cases of spinal fluid culture results from admitted patients in Kyung Hee Medical Center from July 2004 to June 2009 were analyzed retrospectively by their medical records and laboratory results. RESULTS: Ninety five cases of positive spinal fluid culture results were obtained and 25 cases fit the diagnostic criteria for bacterial meningitis. 5 cases were spontaneous meningitis and 20 were post cranial surgery meningitis. Among the 25 patients, fever was the most common clinical presentation (100%) and ventriculoperitoneal shunt was the most common causative procedure of post cranial surgery meningitis. Streptococcus pneumoniae for spontaneous meningitis and Acinetobacter species for post cranial surgery meningitis was identified as the most common causative organisms. CONCLUSION: Recurrent positive spinal fluid culture results of the same organism was found in expired patients due to post cranial surgery meningitis and also from the culture results of the wound and intra-cranial inserted instruments, suggesting post operative infection control is directly related to morbidity requiring adequate usage of antibiotics rather than empirical broad spectrum antibiotics.

Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India.

Aims: To identify the etiology, incidence and prevalence of ocular bacterial infections, and to assess the in vitro susceptibility of these ocular bacterial isolates to commonly used antibiotics. Materials and Methods: Retrospective analysis of consecutive samples submitted for microbiological evaluation from patients who were clinically diagnosed with ocular infections and were treated at a tertiary eye care referral center in South India between January 2002 and December 2007. Results: A total of 4417 ocular samples was submitted for microbiological evaluation, of which 2599 (58.8%) had bacterial growth, 456 (10.3%) had fungal growth, 15 (0.34%) had acanthamoebic growth, 14 (0.32%) had mixed microbial growth and the remaining 1333 (30.2%) had negative growth. The rate of culture-positivity was found to be 88% (P < 0.001) in eyelids’ infection, 70% in conjunctival, 69% in lacrimal apparatus, 67.4% in corneal, 51.6% in intraocular tissues, 42.9% in orbital and 39.2% in scleral infections. The most common bacterial species isolated were Staphylococcus aureus (26.69%) followed by Streptococcus pneumoniae (22.14%). Sta. aureus was more prevalent more in eyelid infections (51.22%; P = 0.001) coagulase-negative staphylococci in endophthalmitis (53.1%; P = 0.001), Str. pneumoniae in lacrimal apparatus and corneal infections (64.19%; P = 0.001), Corynebacterium species in blepharitis and conjunctivitis (71%; P = 0.001), Pseudomonas aeruginosa in keratitis and dacryocystitis (66.5%; P = 0.001), Haemophilus species in dacryocystitis and conjunctivitis (66.7%; P = 0.001), Moraxella lacunata in blepharitis (54.17%; P = 0.001) and Moraxella catarrhalis in dacryocystitis (63.83%; P = 0.001). The largest number of gram-positive isolates was susceptible to moxifloxacin (98.7%) and vancomycin (97.9%), and gram-negative isolates to amikacin (93.5%) and gatifloxacin (92.7%). Conclusions: Gram-positive cocci were the most frequent bacteria isolated from ocular infections and were sensitive to moxifloxacin and vancomycin, while gram-negative isolates were more sensitive to amikacin and gatifloxacin.

Comparative in-vitro efficacy of fluoroquinolones against Streptococcus pneumoniae recovered from bacterial keratitis as determined by E-test.

Background and Objectives: The advent of new fluoroquinolones has drawn the attention for reliable methods on the in-vitro susceptibility testing of Streptococccus pneumoniae. This study attempts to determine the minimum inhibitory concentration (MIC) of second-generation (ciprofloxacin and ofloxacin), third-generation (levofloxacin) and the fourth-generation (moxifloxacin and gatifloxacin) fluoroquinolones against S. pneumoniae recovered from bacterial keratitis. Materials and Methods: In retrospect, the MICs of 50 strains of S. pneumoniae isolated from the corneal scrapes of patients with bacterial keratitis were determined against ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin and moxifloxacin using E-tests. The National Committee of Clinical Laboratory Standards (NCCLS) susceptibility patterns and the potencies of the MICs were statistically compared. Results: The median MIC of ciprofloxacin (0.25μg/ml) was found to be lower than the median MICs of ofloxacin (0.5μg/ml) (P<0.449) and levofloxacin (1.0μg/ml) (P<0.001). The median MICs of gatifloxacin (0.1μg/ml) was lower than the median MICs of ciprofloxacin (0.25μg/ml) (P<0.001), ofloxacin (0.5μg/ml) (P<0.001) and levofloxacin (1.0μg/ml) (P<0.001). Moxifloxacin (0.06μg/ml) had showed lower median MICs than gatifloxacin (0.1μg/ml) (P<0.001) levofloxacin (1.0μg/ml) (P<0.001), ofloxacin (0.5μg/ml) (P<0.001) and ciprofloxacin (0.25μg/ml) (P<0.001). Moxifloxacin (0.06μg/ml) had a lower MIC50 (μg/ml) than gatifloxacin (0.1μg/ml), levofloxacin (1.0μg/ml), ciprofloxacin (0.25μg/ml) and ofloxacin (0.5μg/ml). MIC90 (μg/ml) of moxifloxacin (0.06μg/ml) was found to be lower than the MIC90 (μg/ml) of gatifloxacin (0.5μg/ml), levofloxacin (1.0μg/ml), ofloxacin (0.5μg/ml) and ciprofloxacin (0.5μg/ml). Conclusion: Based on in-vitro testing, the five portrayed fluoroquinolones 100% sensitivity to S. pneumoniae. However, the fourth-generation fluoroquinolone, moxifloxacin appeared to be more effective against S. pneumoniae than gatifloxacin, levofloxacin, ofloxacin and ciprofloxacin.

Antimicrobial Susceptibilities of Ureaplasma urealyticum and Mycoplasma hominis in Pregnant Women / 대한임상미생물학회지

BACKGROUND: Ureaplasma urealyticum and Mycoplasma hominis are associated with an increased risk of pregnancy complications, such as preterm birth and premature membrane rupture. The purpose of this study was to determine the isolation rates and antimicrobial susceptibilities of genital mycoplasma in a sample of pregnant women from Jinju, Korea. METHODS: Vaginal swabs were obtained from 258 pregnant women between 2004 and 2008 and tested for the presence of U. urealyticum and M. hominis at Gyeongsang National University Hospital. The identification and antimicrobial susceptibilities of U. urealyticum and M. hominis were determined with a commercially available kit, the Mycoplasma IST2 Kit (bioMe- rieux, Marcy-l'Etoile, France), and evaluated according to standards set by the Clinical and Laboratory Standards Institute (CLSI). RESULTS: U. urealyticum only was detected in 105 specimens (38.6%), while M. hominis only was detected only in 2 specimens (1.8%). Seven specimens (6.7%) were positive both for U. urealyticum and M. hominis. Susceptibilities of U. urealyticum to azithromycin, erythromycin, clarithromycin, and doxycycline were 75.2%, 82.9%, 88.6%, and 88.6%, respectively, while almost all of the isolates were susceptible to josamycin (99.0%) and pristinamycin (100%). The susceptibility of U. urealyticum to ofloxacin and ciprofloxacin was 56.2% and 15.2%, respectively. CONCLUSION: The rate of isolation of genital mycoplasma in pregnant women was 44.2% in Jinju; most of the mycoplasma were U. urealyticum. U. urealyticum and M. hominis were highly resistant to quinolones, but susceptible to josamycin. Therefore, empirical treatment without prior identification and determination of the antimicrobial susceptibility of genital mycoplasma will fail in many cases.

Healthcare-associated Bacterial Meningitis: A Review of 120 Episodes / 中华医院感染学杂志

OBJECTIVE To characterize clinical feature,frequency of isolation and antimicrobial susceptibility of bacterial pathogens isolated from patients with healthcare-associated bacterial meningitis(HABM).METHODS We review the charts of all patients in whom the diagnosis was based on(national) diagnostic criteria of healthcare-(associated) infections at Huashan Hospital from 1995 through 2004.The pathogens were routinely isolated,(identified) and susceptibilities against antimicrobial agents were determined by Kirby-Bauer methods.RESULTS During the 10-year study period,109 patients were treated for 120 episodes of HABM.Most of patients had a(history) of recent and remote neurosurgery.Fever was present in all patients,while nuchal rigidity and decrease consciousness were present in less than half of all patients.CSF opening(pressure,) white blood cell count and(protein) were elevated with predominance of neutrophils.A total of 120 strains were isolated from CSF specimen,Gram-positive bacteria and Gram-negative bacilli were accounted for 35.8% and(64.2%) of all isolates,respectively.Acinetobacter spp(24.2%),coagulase-negative staphylococci(22.5%),Klebsiella pneumoniae(12.5%),Pseudomonas aeruginosa(10%),Enterobacter cloacae(8.3%) and Staphylococcus aureas(7.5%) were the 6 most frequent isolates and resistance to the first line antibiotics was common among all pathogens isolated.(CONCLUSIONS) The most common risk factor for HABM is neurosurgery.Gram-negative bacilli and staphylococci are important causes of HABM,resistance to the first line antibiotics is common among all pathogens isolated.

Gender Differences in Psychiatry: Psychopathology Across the Life Cycle / 대한정신약물학회지

Psychopathology can occur from infancy to death. A certain psychopathology is limited to a specific life stages, while most occur at any stage. Certain mental disorders reach a peak age at onset during specific life stage, and some symptom expressions become different in relation with age. Men and women differ in the disease susceptibilities, age at the greatest risk, manifestations, and prognoses.

Antimicrobial Resistance of Neisseria gonorrhoeae Isolated in Korea / 감염

BACKGROUND: The aim of this study was to monitor trends in antimicrobial susceptibilities of Neisseria gonorrhoeae isolates, in particular, to examine the possibility of increasing prevalence of fluoroquinolone resistance in Korea and the relationship between patterns of mutations involving gyrA and parC genes and the ciprofloxacin resistance level. METHODS: The antimicrobial susceptibilities of 489 gonoccocal isolates which were nationwide collected from patients visiting Health Centers were determined by NCCLS disk diffusion and agar plate dilution methods. PCR and direct DNA sequencing of the amplicons were performed to identify mutations within the quinolone resistance-determining regions of gyrA and parC genes. RESULTS: The proportion of resistance to penicillin, tetracycline, or both remained as high as 94%. The isolates with ciprofloxacin resistance remarkably increased from 1% in 1999 to 5% in 2000 and also resistance to cefoxitine and ceftriaxone were shown to be increased. The strains resistant to spectinomycin was little reported. Four isolates with 16 microgram/mL of MIC for ciprofloxacin all showed the same alternations of Ser-91 to Phe, Asp-95 to Gly in GyrA and Ser-87 to Arg in ParC, but ciprofloxacin-susceptible strains have little amino acid substitution. CONCLUSION: Considering the increasing prevalence of isolates with resistance to ciprofloxacin and ofloxacin, it is likely that the antibiotics such as spectinomycin, or ceftriaxone are recommended as the first-line treatment for gonoccocal infections in Korea. The results from this study suggest that mutation analysis for quinolone resistance-determining regions of gyrA and parC genes are important in epidemiological studies for the spread of ciprofloxacin resistant strains.

Surveillance for antimicrobial resistance of Streptococcus pneumoniae among children attending day care center in Seoul, Korea / 대한임상병리학회지

BACKGROUND: Multidrug-resistant Streptococcus pneumoniae occasionally cause treatment failure in various pneumococcal infection in children. The pneumococcal strains carried at the nosopharynx are frequently found at the time of invasive infection in one individual. We investigated the prevalence of nasopharyngeal carriage of S. pneumoniae and antibiotic susceptibility patterns among children attending day care center and compared the rates of antibiotic resistance of those strains with strains recovered from clinical specimens of patients at a tertiary care hospital. METHODS: Two-hundred nine children from 3 centers distributed at Jong-Ro area of Seoul, Korea were enrolled from May to June, 1998. Swabs were obtained from posterior nasopharynx and cultured onto tryptic soy agar containing 5% sheep blood without and with 10 microgram/mL gentamicin for 24 hours. Clinical isolates included the non-invasive isolates from sputum, ear discharge and sinus aspirate and the invasive isolates from cerebrospinal fluid and blood. Antimicrobial susceptibilities were determined with E-test and agar dilution method. RESULTS: The overall prevalence of nasopharyngeal carriage was 32.5%(68/209). The children >4, 5< OR = years of age have the highest carriage rate(36.7%). But there were no significant differences of prevalence in gender and centers. The prevalences of decreased antibiotic susceptibilities in the nasopharyngeal isolates and clinical isolates were, respectively: penicillin(75% vs 86%, NS); cefotaxime(20% vs 48%, p<0.05); multiresistance(57% vs 86%, p<0.05). Younger the age and female in gender, higher the resistance rate to penicillin. CONCLUSIONS: There was no significant difference in antimicrobial resistance of pneumococci between healthy nosopharyngeal carriages and clinical isolates causing invasive or non-invasive infections. The results acquired from this surveillence would provide a useful guide in an appropriate choice of antimicrobial agents for management of pneumococcal diseases.