Antibiotic resistance in Pseudomonas aeruginosa: an Italian survey.

In order to assess the current level of resistance to widely used antipseudomonal antibiotics in clinical isolates of Pseudomonas aeruginosa, a national survey was undertaken. Fifteen hospitals throughout Italy participated in the study. The University of Catania tested the antibiotic susceptibility of 1005 consecutive clinically significant P. aeruginosa collected from March to June 1995. Lack of susceptibility, according to NCCLS breakpoints, was at the following rates: meropenem, 9.1%; imipenem, 19.3%; ceftazidime, 13.4%; carbenicillin, 27.3%; piperacillin, 12%; ticarcillin/clavulanic acid, 22.8%; amikacin, 10.6%; and ciprofloxacin, 31.9%. About half of the isolates (44.4%) were not susceptible to at least one of the antibiotics tested.

In vitro activity of biapenem against recent gram-negative and gram-positive clinical isolates.

The in vitro activity of biapenem, a new carbapenem, against 535 clinical recent isolates was compared with those of other antibiotics. Biapenem showed broad-spectrum activity against gram-negative and gram-positive clinical isolates. The new carbapenem was more active than imipenem against members of the family Enterobacteriaceae with MIC90S ranging from 0.12 to 2 mg/l and from 0.25 to 4 mg/l, respectively. Moreover it was 2-fold more active than imipenem against Pseudomonas aeruginosa (MIC90, 8 and 16 mg/l, respectively). Taken together, these results indicate that biapenem shares the favorable in vitro activity properties of imipenem and merits further study in the treatment of infections caused by a wide range of pathogens.

[Primary closure of the perineum after Miles's abdominoperineal amputation for carcinoma of the rectum (author's transl)]. / La chiusura primaria del perineo dopo amputazione addomino-perineale sec. Miles per cancro del retto.

In view of the results obtained in 32 cases of primary closure of the perineum after amputation of the rectum for cancer, the authors believe that this policy is best after removal of the malignancy by the abdominoperineal approach. Unquestionable advantages are shortening of the patient's hospital stay and a more rapid recovery; the possible disadvantages are relatively rare, from an uncommonly severe dysmetabolic situation to local disorders such as poor hemostasis, contamination of the operation site, inadequate preoperative antibacterial protection, or an unusually large tumor.