Subject(s)
Anti-Bacterial Agents/pharmacology , Bacterial Proteins , Carrier Proteins/genetics , Hexosyltransferases , Muramoylpentapeptide Carboxypeptidase/genetics , Mutation , Penicillin Resistance , Peptidyl Transferases , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/drug effects , Adolescent , Child , Child, Preschool , Drug Resistance, Multiple, Bacterial , Greece , Humans , Microbial Sensitivity Tests , Penicillin-Binding Proteins , Pneumococcal Infections/microbiology , Polymerase Chain Reaction , Serotyping , Streptococcus pneumoniae/isolation & purificationABSTRACT
We prospectively examined the epidemiology of invasive Haemophilus influenzae type b (Hib) infections among children under 5 y of age in the Greater Athens area before the introduction of immunization. The annual incidence of systemic Hib infections was 12/100000. Meningitis was the most common clinical entity and accounted for 69% of the cases. In the prevaccine era, the incidence of systemic Hib disease, particularly that of meningitis, was much lower in Greece compared to rates reported from Northern and Central Europe.
Subject(s)
Bacteremia/epidemiology , Haemophilus Infections/epidemiology , Haemophilus influenzae type b/isolation & purification , Bacteremia/diagnosis , Child, Preschool , Cohort Studies , Female , Greece/epidemiology , Haemophilus Infections/diagnosis , Humans , Immunization/trends , Incidence , Infant , Male , Meningitis, Haemophilus/diagnosis , Meningitis, Haemophilus/epidemiology , Prospective Studies , Risk Factors , Sex Distribution , Time FactorsABSTRACT
The epidemiology of community-acquired Pseudomonas aeruginosa infections in children during a one-year period (January through December 1993) was evaluated. A total of 6,859 clinical samples, each one representing a separate individual with suspected infection, were cultured. Pseudomonas aeruginosa was isolated from 218 children with various infections occurring in the following order of frequency: chronic suppurative otitis media, 76.3%; appendicitis/peritonitis, 10.3%; osteomyelitis, 8.9%; skin or soft tissue infection, 6.3%; acute conjunctivitis, 3.0%; and urinary tract infection, 0.1%. A variety of O serogroups were identified: O1 (15.2%), O6 (14.7%), O11 (12.4%), O10 (11.5%), O3 (10.6%), O5 (5.1%), and O9 (4.6%). Other serogroups and nontypable strains were recovered at a frequency of 11.2% and 14.7%, respectively. Nontypable strains predominated in chronic otitis media (18.9%), while serogroups O1 (18.3%), O6 (17.5%), and O11 (17.5%) were recovered most frequently among the typable isolates. Susceptibility of Pseudomonas aeruginosa to antipseudomonadal agents was extremely high. The rate of susceptibility to ceftazidime was 99.6%, to azlocillin 98.6%, to piperacillin 98.2%, to aztreonam 97.3%, to gentamicin and netilmicin 97.7%, and to ciprofloxacin 99.1%. All isolates were susceptible to tobramycin, imipenem, and amikacin. The results might suggest that community-acquired Pseudomonas aeruginosa infections in children can be treated successfully with any antipseudomonadal antibiotic.
Subject(s)
Pseudomonas Infections/epidemiology , Age Factors , Anti-Bacterial Agents/therapeutic use , Appendicitis/diagnosis , Appendicitis/epidemiology , Appendicitis/microbiology , Child , Child, Preschool , Community-Acquired Infections , Conjunctivitis, Bacterial/diagnosis , Conjunctivitis, Bacterial/epidemiology , Conjunctivitis, Bacterial/microbiology , Humans , Osteomyelitis/diagnosis , Osteomyelitis/epidemiology , Osteomyelitis/microbiology , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/epidemiology , Otitis Media, Suppurative/microbiology , Pseudomonas Infections/drug therapy , Pseudomonas Infections/immunology , Seasons , Seroepidemiologic Studies , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/epidemiology , Skin Diseases, Infectious/microbiology , Soft Tissue Infections/diagnosis , Soft Tissue Infections/epidemiology , Soft Tissue Infections/microbiology , Urinary Tract Infections/diagnosis , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiologyABSTRACT
Among 34 women aged 74-96 years, residents of a Home for the Aged, with reduced mobility and repeatedly negative urine cultures, 16 (47%) responded to a rapid hydration and 20 mg frusemide administered intravenously with a transient bacterial excretion usually trailing the diuresis. Antibody-coated bacteria were detected in 11 of the 13 Gram-negative isolates tested. Women with urine turning positive had significantly lower glomerular filtration rates and more advanced renal tubular defects than the steadily nonbacteriuric subjects of the same age. Progress to renal insufficiency was somewhat faster and all-causes mortality at 1 year was higher in subjects with urine turning positive. Diuresis bacteriuria originating from the upper urinary tract along with frank bacteriuria may be detected in up to 70% of women in their mid-80s and represents a likely source of the most common infection in man's last period of life.