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1.
Eur J Pediatr ; 166(5): 467-71, 2007 May.
Article in English | MEDLINE | ID: mdl-17033806

ABSTRACT

Among young children, pneumococcal nasopharyngeal colonization (NPC) rates of >90% have been described. The aim of our study was to assess the effect of amoxicillin exposure on the NPC. From Dec 2001 to Feb 2004, less than 5 years old children with respiratory symptoms and fever who were prescribed amoxicillin were eligible. Three nasopharyngeal swabs were taken: at the time of the initial visit (IV), 60 hours after amoxicillin discontinuation (end of treatment visit, ETV), and 4 weeks later (follow-up visit, FUV). One hundred and thirty four children were included. NPC was detected in 58.5%, 42.9% and 51% of <1, 1-2 and >2 years-old children respectively (NS). Vaccine serotypes (VS) or vaccine-related serotypes (VRS) were identified in 80%, 40% and 55% of <1-year-old, 1-2 year-old and >2-year-old children respectively (NS). The proportion of PNSSP was 60% in <1-year-old children, 43% in 1-2 year-old children and 40% in >2-year-old children (NS). 49 out of 134 (36.5%) children completed the three study visits. 51%, 22.4% and 46.9% of those were colonized at IV, ETV and FUV, respectively (p=0.007). The percentage of resistant SP was 28%, 45.5% and 8.7% (p=0.05) for penicillin. In children <1 year of age, a higher proportion of SP colonization, presence of VS and PNSSP was found. A downfall of NPC at the end of therapy was observed. NPC returned to baseline levels thanks to "de novo" colonization in half of the cases, a few weeks after.


Subject(s)
Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Nasopharynx/microbiology , Pneumococcal Infections/drug therapy , Streptococcus pneumoniae/drug effects , Amoxicillin/pharmacology , Anti-Bacterial Agents/pharmacology , Chi-Square Distribution , Child, Preschool , Clavulanic Acid/pharmacology , Clavulanic Acid/therapeutic use , Drug Resistance, Microbial , Female , Humans , Infant , Infant, Newborn , Male , Penicillin Resistance , Prevalence , Streptococcus pneumoniae/isolation & purification
3.
Clin Infect Dis ; 34(12): 1568-75, 2002 Jun 15.
Article in English | MEDLINE | ID: mdl-12032891

ABSTRACT

JC virus (JCV) is the causative agent of progressive multifocal leukoencephalopathy (PML), a demyelinating central nervous system infection that mainly affects patients with acquired immunodeficiency syndrome. The diagnostic value of the detection of JCV DNA in cerebrospinal fluid (CSF) has been proved. A correlation between the JCV burden in CSF and the PML prognosis has been proposed. To our knowledge, the present study is the first to examine JCV burden in CSF in relation to the magnitude of neurological damage. An in-house quantitative polymerase chain reaction assay was used for measurement of the JCV burden in CSF samples from 12 patients with PML. A wide variation in JCV load (6.4 log) was found among the patient CSF samples, a finding that makes JCV load measurements worthwhile. Virus load values of >4.68 log were associated with shorter patient survival time. No correlation was found between the virus load values and the global volume of brain tissue damaged. Our data suggest that factors other than the volume of neurological lesions influence the shedding of JCV in the CSF.


Subject(s)
Central Nervous System/pathology , DNA, Viral/cerebrospinal fluid , JC Virus/physiology , Leukoencephalopathy, Progressive Multifocal/virology , Nervous System Diseases/pathology , Viral Load , Adult , Female , Humans , JC Virus/classification , JC Virus/genetics , Leukoencephalopathy, Progressive Multifocal/mortality , Leukoencephalopathy, Progressive Multifocal/pathology , Male , Nervous System Diseases/virology , Polymerase Chain Reaction/methods , Quality Control , Statistics as Topic , Survival Analysis
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