Quinolone resistance and ornithine decarboxylation activity in lactose-negative Escherichia coli

Quinolones and fluoroquinolones are widely used to treat uropathogenic Escherichia coli infections. Bacterial resistance to these antimicrobials primarily involves mutations in gyrA and parC genes. To date, no studies have examined the potential relationship between biochemical characteristics and quinolone resistance in uropathogenic E. coli strains. The present work analyzed the quinolone sensitivity and biochemical activities of fifty-eight lactose-negative uropathogenic E. coli strains. A high percentage of the isolates (48.3%) was found to be resistant to at least one of the tested quinolones, and DNA sequencing revealed quinolone resistant determining region gyrA and parC mutations in the multi-resistant isolates. Statistical analyses suggested that the lack of ornithine decarboxylase (ODC) activity is correlated with quinolone resistance. Despite the low number of isolates examined, this is the first study correlating these characteristics in lactose-negative E. coli isolates.

Rationale of azithromycin prescribing practices for enteric fever in India.

Purpose: The present study was performed to assess the current susceptibility pattern of blood isolates of Salmonella spp from a super specialty hospital in North India against nalidixic acid, ciprofloxacin and azithromycin and compare the in vitro and in vivo response against azithromycin. Materials and Methods: We evaluated the minimum inhibitory concentration's (MIC's) of 107 blood isolates of Salmonella spp against nalidixic acid, azithromycin and ciprofloxacin and correlated in vitro and in vivo response of azithromycin from the treatment and discharge summaries from the Hospital Information System (HIS) software. Results: Among the 107 isolates evaluated, 94 (87.8%) were nalidixic acid-resistant (NAR) Salmonella and 36 were resistant to azithromycin by MIC testing. The MIC 90 value for azithromycin was 24 μg/mL. Among the 57 treatment histories evaluated using the HIS software, 19 (33%) patients had documented clinical non-response to azithromycin which required change of therapy. Conclusions: The present study observed a higher MIC 90 values for azithromycin compared to Salmonella isolates from Western studies. There was also a documented clinical non-response against azithromycin. The in vitro and in vivo findings in this study suggest a guarded use of azithromycin for cases of enteric fever in India. The study also augments the reversal of resistance pattern in favour of chloramphenicol, ampicillin and trimethoprim - sulfamethoxazole.

Manejo de la infección del tracto urinario / Management of the urinary tract infection

Se realizó el diseño de un estudio descriptivo, observacional y transversal del tipo de indicación-prescripción con elementos de esquema terapéutico y consecuencias prácticas. Se consideró como elegible para el estudio a los municipios que reportaron un mayor consumo de antimicrobianos para el tratamiento de las infecciones del tracto urinario (ITU). La muestra estuvo representada por 863 pacientes. Se utilizaron como principales fármacos el cotrimoxazol, la ciprofloxacina y el ácido nalidíxico. Se realizaron 7 diagnósticos de ITU, dos de ellos no pertenecían a la clasificación recomendada para esta entidad. Los antimicrobianos utilizados no se comportan según lo recomendado y los esquemas terapéuticos, en su mayoría, son inadecuados, además existen problemas en la clasificación de las infecciones del tracto urinario

Aspectos terapéuticos de las Fistulas Cutaneas de la Cara / Therapeutical features of the facial cutaneous fistula

Se realizo un estudio trasversal durante 5 anos (1984 a 1988) en los cuales fueron tratados 99 pacientes con fistula cutanea de la region facial, en le servicio de cirugia maxilofacial del Hospital Docente "Saturnino Lora" de Santiago de Cuba. Se comprobo que para establecer pronosticos terapeuticos favorables en esta entidad, el tratamiento de las fistulas agudas debe orientarse hacia la erradicacion o minimizacion de la fase aguda mediante farmacoterapia antimicrobiana del tipo de la betalactamasa, combinada con la eliminacion de los factores causales, seguida en una fase mediata de la fistuloplastia segun los requirimientos individuales de cada lesion; mientras que en las lesiones de curso cronico la conducta debe dirigirse hacia la eliminacion del agente causal y exeresis del trayecto fistuloso con plastia del area afectada en el mismo tiempo quirurgico, combinado con antibioticoterapia profilactica segun resultado bacteriologico. Se concluye que la evolucion posoperatoria de esta afeccion es significativamente satisfactoria; las de origen osteomieliticas tienen mayor incidencia de complicaciones

Comparative efficacy of furazolidone and nalidixic acid in the empirical treatment of acute invasive diarrhea: randomized clinical trial.

Efficacy of furazolidone and nalidixic acid was compared in a randomized trial involving 72 children with acute invasive diarrhea. Thirty six children received furazolidone (7.5 mg/kg/day) and 36 children received nalidixic acid (55 mg/kg/day). Clinical characteristics of the two treatment groups were comparable on admission. Of these, 34 children in furazolidone treated group and 29 children in nalidixic acid treated group completed the full course of treatment and were analyzed finally for clinical efficacy. Clinical cure was observed in 29(85.3%) children treated with furazolidone and 29(100.0%) children treated with nalidixic acid. Nalidixic acid treated group had statistically significantly higher cure rate (p = 0.039) as compared to furazolidone treated group. However, 85% cure rate in furazolidone treated group may be potentially useful for the treatment of acute invasive diarrhea because of decreasing efficacy of nalidixic acid against shigellosis in many countries.

Evaluación del efecto del ácido nalidíxico, ampicilina, kanamicina, penicilina G y polimixina B en los cultivos de promastigotes de leishmania / Evaluation the effect of nalidixic acid, ampicillin, kanamycin, penicillin G and polimyxin B in leishmania promastigote cultures

Se evaluó el efecto de diferentes concentraciones de ácido nalidíxico, ampicilina, kanamicina, penicilina G y polimixina B, sobre la población de promastigotes de Leishmania braziliensis braziliensis, Leishmania donovani chagasi y Leishmania mexicana amazonensis in vitro. La penicilina G y la ampicilina se pueden utilizar hasta concentraciones 1000 ug/ml y 500 ug/ml respectivamente en cultivo de promastigotes de cualquier cepa de Leishmania sin que éstos se afecten. La polimixina B disminuye la población de promastigotes por lo cual es preferible no usarse en cultivos de Leishmania. El ácido nalidíxico y kanamicina pueden ser utilizados in vitro pero teniéndose en cuenta la especie de Leishmania y la concentración de antimicrobiano recomendado para la misma

Nalidixic acid in diarrhoea.

In a private practice set-up from June 21, 1982 to December 31, 1984, 109 children who were admitted to the hospital with acute bacterial diarrhoea diagnosed on the basis of clinical findings and faecal leucocytes over 10/high power field, were treated with nalidixic acid 55 mg/kg in 4 divided doses to find out its effectiveness. The youngest in this study group was of 18 days, the oldest was of 16 years and the mean age was 2.61 years. In this group 72 were male children and 37 female. The average duration of stay in hospital was 2.71 days. Before admission 40 children (36%) had prior antimicrobial treatment elsewhere. These children were re-evaluated 14 hours after treatment and clinical improvement was observed in most of the cases. It was found that nalidixic acid was an effective and safe antimicrobial agent in acute infectious diarrhoea. It cut down the days of hospitalisation and cost. It was well tolerated even in children less than 3 months.

Effect of protein rich diet during acute phase of dysentery.

Ninety six children upto the age of five years suffering from uncomplicated acute dysentery of less than 3 days' duration were studied to find out the impact of feeding of extra-protein rich diet during their acute phase of illness. These children were randomly allocated to either control group (receiving only hospital diet) and study group (receiving hospital diet and extra milk which constituted 30% of ideal total calorie requirement of patients. Patients in the two groups were comparable on admission. Forty percent reduced food intake was observed among the children of both the groups due to severe anorexia which was reflected by no significant differences in clinical outcome, anthropometrical measurements and haematological parameters between the two groups on day 7 of hospitalisation and on day 15 after discharge.

Outbreak of dysentery due to nalidixic acid resistant S. dysenteriae 1 at Agartala, Tripura: a hospital based study.

During the epidemic of bacillary dysentery at Agartala, Tripura, a total of 62 hospitalized patients suffering from diarrhoeal diseases were studied during the later part (11-16 June, 1988) of the epidemic. Principal features of Shigellosis cases were discussed. Of these 62 cases investigated, 19(30.6%) cases had the mucoid diarrhoea. From them S.dysenteriae type 1 and S.flexneri had been recovered from 31.6% and 10.5% cases, respectively. All the strains of S.dysenteriae type 1 isolated during the period of investigation were resistant to nalidixic acid.

Efficacy of nalidixic acid in the treatment of acute bloody diarrhea.

Of sixty four children (mean age 20.1 +/- 1.2 mo) with acute bloody diarrhea and high fever, 47 had infection with non-typhoidal Salmonella (NTS) (20), Shigella (15) and enteropathogenic E. coli (EPEC) (12) and were treated with nalidixic acid (NA). The mean duration (h) of presence of macroscopic blood in the stool following institution of treatment was significantly shorter (p less than 0.05) in those with EPEC (11.5 +/- 4.9) as compared to NTS (30.4 +/- 15.4) or Shigella groups (22.9 +/- 15.6). The number of children having less than or equal to 50% reduction in stool frequency within 72 h was: NTS (17); Shigella (14); EPEC (10). Negative stool cultures on day 5 were obtained in all patients with Shigella and EPEC and 16 (80%) of those with NTS. Two patients with NTS and one with EPEC failed to respond to NA.

In vitro sensitivity of organisms causing urinary tract infections to four common oral antibiotics and to pivmecillinam

The in-vitro sensitivity to ampicillin, cotrimoxazole, nitrofuratoin, nalidixic acid and mecillinam was determined for 511 organisms isolated from 399 consecutive urine specimens. Urine specimens were divided into those of hospital in-patient origin (group A) and those from comunity patients(group B). Group B organisms were more sensitive than group A organisms. Over 75% of all group B organisms were sensitive to nitrofurantoin, nalidixic acid and mecillinam. Organisms resistant to multiple antibiotics were more frequently isolated from group A catheterized patients and are now less frequently isolated than in 1983. The antibiotic implications of these findings are discussed

Infecçöes do trato urinário: um enfoque atual no manejo destes doentes / Urinary tract infection: atual approach in the handling of patients

Os autores descrevem de forma sucinta os principais aspectos na investigaçäo e terapêutica dos pacientes com infecçäo do trato urinário. Há preocupaçäo em lembrar a mudança do consenso corrente a respeito da duraçäo do tratamento desta patologia, o que é feito de maneiro täo prática quanto possível

Investigación clínica sobre la eficacia y seguridad de la norfloxacina en el tratamiento de infecciones del tracto urinario / Clinical research on the efficacy and safety of norfloxazine in urinary tract infections

Se presentan los resultados de un estudio abierto no comparativo, controlado, para valorar la eficacia, tolerancia y seguridad de norfloxacina por vía oral en pacientes con infecciones de vías urinarias no complicadas causadas por microorganismo sensibles al medicamento. La población de estudio incluye 15 pacientes de ambos sexos con bacteriuria superior a 10 colonias por ml de orina. Los resultados se catalogaron como muy satisfactorios, ya que curaron 7 pacientes, mejoraron otros 7 y sólo hubo un fracaso. La tolerancia fue muy buena, habiéndose registrado solo dos casos con efectos secundarios de poca magnitud y escasa duración: éstos fueron cefalea y náusea en uno y rash en el otro. No se reportaron efectos tóxicos atribuibles al medicamento motivo del estudio