[Susceptibility of Campylobacter jejuni clinical isolates from children to eight antibiotics]. / Sensibilidad de Campylobacter jejuni a ocho antibióticos en cepas aisladas de muestras clínicas de niños.

This study aimed to identify the activity of eight antibiotics (ofloxacin, moxifloxacin, azithromycin, erythromycin, clindamycin, ampicillin, amoxicillin-clavulanic acid and tetracycline) against 80 strains of Campylobacter jejuni isolated from children. Minimal inhibitory concentrations (MIC) were determined by an agar dilution method. Resistance to azithromycin and erythromycin was considered when MIC > or =8 mg/l, to clindamycin when MIC > or =1 mg/l, to amoxicillin-clavulanic acid and ampicillin when MIC > or =32 mg/l, to ofloxacin and moxifloxacin when MIC > or =4 mg/l, and to tetracycline when MIC > or =16 mg/l. All strains tested were susceptible to amoxicillin-clavulanic acid. The lowest frequency of resistance was to azithromycin (2%), erythromycin (3.7%), clindamycin (4.4%) and ampicillin (4.9%), and the highest was to ofloxacin and tetracycline (61.7% for both), and moxifloxacin (37%). Considered the antibiotics of choice for the treatment of infections caused by this microorganism, macrolides showed excellent activity with MIC(90)=0.5 mg/l for azithromycin and MIC(90)=0.5 mg/l for erythromycin.

Sensibilidad de Campylobacter jejunia ocho antibióticos en cepas aisladasde muestras clínicas de niños / Susceptibility of Campylobacter jejuni clinical isolates from children to eight antibiotics

El objetivo del presente estudio fue conocer la sensibilidad de Campylobacter jejuni a ocho antimicrobianos. Se estudió la sensibilidad de 80 cepas aisladas de heces diarreicas de niños a los siguientes antibióticos: ofloxacino, moxifloxacino, azitromicina, eritromicina, clindamicina,ampicilina, amoxicilina-ácido clavulánico y tetraciclina. Las concentraciones mínimas inhibitorias (CMI) se determinaron mediante un método de dilución en agar, considerando resistencia a azitromicina y eritromicina cuando la CMI 8 mg/l, a clindamicina si la CMI 1 mg/l, a amoxicilina-ácido clavulánico y ampicilina si la CMI 32 mg/l, a ofloxacino y moxifloxacino si la CMI 4 mg/l y a tetraciclina si la CMI 16 mg/l.Todas las cepas fueron sensibles a amoxicilina-ácido clavulánico. Las tasas de resistencia más bajas las presentaron azitromicina, eritromicina, clindamicina y ampicilina, siendo del 2 por ciento, 3,7 por ciento, 4,4 por ciento y 4,9 por ciento respectivamente, y las más altas ofloxacino, tetraciclina y moxifloxacino, con resistencias del 61,7 por ciento para los dos primeros y del 37 por ciento para el tercero. Los macrólidos probados, grupo de antibióticos de elección en el tratamiento de las infecciones producidas por este microorganismo, presentaron una excelente actividad, con una CMI90 de 0,5 mg/l para la azitromicina y 2 mg/l para la eritromicina (AU)

Primary cutaneous Mycobacterium kansasii infection in a child.

A 6-year-old girl with a primary cutaneous form of Mycobacterium kansasii infection is presented. Disseminated infection and immune deficiency were excluded in our patient. She was successfully treated with surgical excision and oral erythromycin. Primary cutaneous M. kansasii is an exceedingly rare infection in children.

[Meningococcal infection: changes in serogroups and penicillin resistance]. / Infección meningocócica: cambios en los serogrupós y en la sensibilidad a penicilina.

OBJECTIVE: There has been an increasing number of strains of meningococcus with reduced susceptibility to penicillin in Spain during the past few years. The serogroup distribution has also changed during this period. The objective of this study was to estimate the incidence of different N. meningitidis serogroups, the penicillin susceptibility and the clinical and laboratory data from the patients with meningococcal disease in our hospital. PATIENTS AND METHODS: A retrospective study of the patients admitted to the hospital during a 4 year period (1993-1996) with bacteriological data of meningococcal sepsis/meningitis was performed. Serogroup and penicillin minimum inhibitory concentration (MIC) were determined. Analysis of the clinical data from the patients with disease due to serogroups B or C was also performed. RESULTS: The incidence of serogroups C and B was 47% and 51.6%, respectively. There were 5 cases of decreased susceptivility to penicillin (MIC 0 0.25 microgram/ml). There were no clinical differences between the two groups of patients. CONCLUSIONS: There was a progressive increase in the incidence of serogroup C, while the incidence of serogroup B remained stable, as did the cases of meningococci with reduced susceptibility to penicillin. Although this study did not suggest a modification in the initial treatment, every strain of meningococci must be studied to show penicillin MIC to avoid treatment failure.

[Meningitis caused by Haemophilus influenzae: study of 28 cases]. / Meningitis por Haemophilus influenzae: estudio de 28 casos.

28 cases of Haemophilus influenzae meningitis were retrospectively treated in a children's hospital between October 1980 and March 1987. The average age was between 23 +/- 36 months, ranged between 3 months and 13 years. Eight were females and 20 males (1/2.5). Antibiograms were obtained from 14 samples (50%), 36% was resistant to ampicillin, 7% to chloramphenicol and 7% to both. All patients, with two exceptions, were treated with third generation cephalosporins. During the hospitalization period, the following complications were found: convulsions (18%), tone and/or mobility alterations (18%), hydrocephalus or transventricular echographic dilations (14%), early deafness (3%). 54% did not develop any complications and only one patient died. Considering the high proportion of cases resistant to ampicillin, chloramphenicol or both, it is suggested to evaluate cephalosporins as an alternative for the standard therapy.