C-reactive protein as an indicator of inflammatory responses to experimentally induced cystitis in dogs

The aim of this study was to demonstrate and assess C-reactive protein (CRP) changes in dogs with induced bacterial cystitis with or without antibiotics. We also evaluated availability of CRP levels to serve as an indicator for monitoring or diagnosing bacterial cystitis. Serial CRP concentrations in dogs with induced bacterial cystitis were higher than those of controls (p < 0.001). CRP concentrations peaked on day 7 and gradually decreased thereafter. In the treatment group, CRP concentrations decreased after medication compared to the untreated group (p = 0.032). CRP levels had a linear correlation with urine white blood cell counts among all groups (r = 0.837, p < 0.001, n = 140). Compared to the negative urine culture group, dogs with positive urine culture results had higher CRP concentrations (median 43.8 mg/L vs. 5.9 mg/L; p < 0.001). Area under the receiver operating characteristic curve was 0.955; when cut-off value was 12.2 mg/L, CRP measurements were found to have a sensitivity of 92.3% and specificity of 86.4%. This result indicates that rapid increases of CRP occurred after inducing bacterial cystitis and CRP may be a useful indicator for monitoring or diagnosing canine bacterial cystitis together with sediment urinalysis and urine bacterial culture.

Epidemiology of Ciprofloxacin Resistance and Its Relationship to Extended-Spectrum beta-Lactamase Production in Proteus mirabilis Bacteremia

BACKGROUND/AIMS: We evaluated the clinical features of ciprofloxacin-resistant Proteus mirabilis bacteremia and risk factors for ciprofloxacin resistance. METHODS: From October 2000 to July 2009, 37 patients with clinically significant P. mirabilis bacteremia were identified and data from patients with ciprofloxacin-resistant and ciprofloxacin-susceptible P. mirabilis bacteremia were compared. RESULTS: The most common underlying diseases were neurologic disease (37.8%) and solid tumors (29.7%). The most common site of infection was the urinary tract (35.1%). Ten of the 37 patients (27.0%) were infected with ciprofloxacin-resistant isolates, and univariate analysis revealed a significant relationship between ciprofloxacin-resistant P. mirabilis bacteremia and neurologic disease, recent operation, L-tube insertion, percutaneous tube use, and extended-spectrum beta-lactamase (ESBL) production (all p < 0.05). ESBL was detected in six of 10 (60%) ciprofloxacin-resistant isolates, while only three of 27 (11%) ciprofloxacin-susceptible isolates produced ESBL (p = 0.005). In a logistic regression analysis, ESBL production remained a significant factor associated with ciprofloxacin resistance, after adjusting for other variables. CONCLUSIONS: These data indicate a close association between ciprofloxacin resistance and ESBL-production in P. mirabilis bacteremia. This association is particularly troublesome because the therapeutic options for serious infections caused by ESBL-producing P. mirabilis are severely restricted.

Remoçäo percutânea de cálculo em ureter de rim transplantado em paciente grávida / Percutaneous removal of an ureteral calculous from a transplanted kidney in a pregnant patient

We report a case of nephro-ureteral lithiasis causing obstruction in a pregnant woman at 23 weeks of gestation, treated successfully by percutaneous surgery. The kidney was punctured and dilated to 18 Fr. The ureter was antegrade accessed with a rigid ureteroscope (11.5 Fr) and the calculous was fragmented and retrieved with stone forceps. A double-J cateter was left in place and a nephrostomy tube was placed. The patient did well and the pregnancy was uneventful until a health newborn at term

Infections in the bite site after envenoming by snakes of the Bothrops genus

Envenomation caused by snakes of the Bothrops genus produces a lesion in the bite site and can result in extensive necrosis. The dead tissue can be secondarily infected by bacteria that come from the snake, and the bacteria can be inoculated at the moment of the bite. The bacteria that most commonly cause infection are the enterobacteria, mainly Morganella morganii, Proteus rettgeri, Enterobacter sp., and Escherichia coli. Group D streptococci including here Enterococcus sp. and the Bacteroides sp. are also involved. Based on a study of the sensibility of these bacteria, it has been suggested that this infection must be treated with chloramphenicol, as a sole antimicrobial agent, or with the combinations of benzylpenicillin or ampicillin with aminoglycoside or trimethoprim/sulfamethoxazole. Although Governmental Health Services do not recommend the prophylactic use of antimicrobial drugs, it is not yet clear that such a procedure would not be useful in cases with a high probability of infection.

Estudo comparativo da eficácia clínica, microbiológica e da tolerância da associaçäo de gentamicina 0,3 por cento e fluorometolona 0,1 por cento versus neomicina 0,35 por cento e fluorometolona 0,1 por cento no tratamento de conjuntivite bacteriana aguda / Evaluation of thje clinical and microbiological efficacy and tolerability of gentamicin-fluorometholone versus neomycin-fluorometholone eye drops solution, in the treatment of acute bacterial conjunctivitis

Os autores apresentam os resultados de um estudo clínico, controlado, duplo mascarado, compreendendo 40 pacientes distribuidos em 2 grupos de 20, obtidos da avaliaçäo comparativa da eficácia clínica, microbiológica e da tolerância da associaçäo de gentamicina 0,3 por cento e fluorometolona 0,1 por cento versus neomicina 0,35 por cento e fluorometolona 0,1 por cento no tratamento de conjuntivites bacterianas agudas. Os testes de sensibilidade in vitro revelaram que a prevalência de resistência à neomicina foi maior que à gentamicina. As taxas de negativaçäo das culturas inicialmente positivas näo mostraram diferenças entre a açäo de uma medicaçäo em relaçäo à outra. Os resultados das avaliaçöes quanto à melhora clínica (90 por cento) e microbiológica (85 por cento) foram similares entre os dois grupos estudados. Dos pacientes tratados com gentamicina-fluorometolona, 4 (20 por cento) relataram como desconforto: ardor e queimaçäo à instilaçäo (dois casos), prurido (um caso) e erosäo puntiforme epitelial (um caso). Dentre os pacientes tratados com neomicina-fluorometolona, 5 (25 por cento) referiram ardor e queimaçäo à instilaçäo (dois casos), erosäo puntiforme epitelial (dois casos) e reaçäo de hipersensibilidade (um caso). As altas taxas de melhora clínica e tolerância no tratamento de conjuntivites bacterianas agudas

Isquemias de territorio carotídeo en trombosis séptica del seno cavernoso / Brain ischemic lesions within the carotid artery territory en cavernous sinus thrombosis

Se presentan dos pacientes con clínica de tromboflebitis del seno cavernoso, quienes desarrollaron complicaciones isquémicas del territorio carotídeo asociado. Uno de ellos presentó embolia de la arteria central de la retina y trombosis carotídea proximal. El segundo mostró un infarto silviano homolateral al proceso infeccioso. El mecanismo iniciador de este inusual tipo de complicación podría ser la arteritis y estenosis focal del segmento intravenoso de la carótida interna, a partir del cual se desencadenarían fenómenos embólicos (distales al estrechamiento) y/o trombóticos (proximales al mismo)