ABSTRACT
A prospective study conducted in a Thai general practice clinic demonstrated a high prevalence (91.3%) of inappropriate empirical antibiotic use in women with uncomplicated cystitis and 42.6% Escherichia coli fluoroquinolone resistance. An annual update of antimicrobial resistance surveillance data of uropathogens may permit targeted treatment of patients in hospital care.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cystitis/drug therapy , Drug Resistance, Bacterial , Enterobacteriaceae Infections/drug therapy , Inappropriate Prescribing , Staphylococcal Infections/drug therapy , Adolescent , Adult , Anti-Bacterial Agents/adverse effects , Cystitis/epidemiology , Cystitis/microbiology , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/microbiology , Escherichia coli/drug effects , Female , Fluoroquinolones/administration & dosage , Fluoroquinolones/adverse effects , Fluoroquinolones/pharmacology , Fluoroquinolones/therapeutic use , Humans , Microbial Sensitivity Tests , Middle Aged , Prospective Studies , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Thailand/epidemiology , Young AdultSubject(s)
Diarrhea/etiology , Exanthema/etiology , Shock, Septic/diagnosis , Shock, Septic/pathology , Skin/pathology , Strongyloidiasis/diagnosis , Strongyloidiasis/pathology , Aged, 80 and over , Asian People , Biopsy , Diarrhea/pathology , Exanthema/pathology , Fatal Outcome , Histocytochemistry , Hospitalization , Humans , Male , Strongyloidiasis/complicationsSubject(s)
Diarrhea/etiology , Exanthema/etiology , Shock, Septic/diagnosis , Shock, Septic/pathology , Skin/pathology , Strongyloidiasis/diagnosis , Strongyloidiasis/pathology , Aged, 80 and over , Asian People , Biopsy , Diarrhea/pathology , Exanthema/pathology , Fatal Outcome , Histocytochemistry , Hospitalization , Humans , Male , Strongyloidiasis/complicationsSubject(s)
Central Nervous System Helminthiasis/diagnosis , Central Nervous System Helminthiasis/pathology , Sparganosis/diagnosis , Sparganosis/pathology , Sparganum/isolation & purification , Animals , Anthelmintics/administration & dosage , Asian People , Brain/diagnostic imaging , Brain/pathology , Central Nervous System Helminthiasis/diagnostic imaging , Central Nervous System Helminthiasis/therapy , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neurosurgical Procedures/methods , Praziquantel/administration & dosage , Sparganosis/diagnostic imaging , Sparganosis/therapy , Spine/diagnostic imaging , Spine/pathology , Treatment OutcomeSubject(s)
Central Nervous System Helminthiasis/diagnosis , Central Nervous System Helminthiasis/pathology , Sparganosis/diagnosis , Sparganosis/pathology , Sparganum/isolation & purification , Animals , Anthelmintics/administration & dosage , Asian People , Brain/diagnostic imaging , Brain/pathology , Central Nervous System Helminthiasis/diagnostic imaging , Central Nervous System Helminthiasis/therapy , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neurosurgical Procedures/methods , Praziquantel/administration & dosage , Sparganosis/diagnostic imaging , Sparganosis/therapy , Spine/diagnostic imaging , Spine/pathology , Treatment OutcomeABSTRACT
Anti-interferon (IFN)-γ autoantibodies are increasingly recognized as a cause of adult-onset immunodeficiency and increased risk for infections with intracellular pathogens. We report on disseminated Talaromyces (Penicillium) marneffei and Mycobacterium abscessus infection in a 72-year-old, human immunodeficiency virus noninfected, Thai man with anti-IFN-γ autoantibody. The patient was successfully treated with antimicrobial therapy and rituximab to control B cell-derived autoantibodies.
Subject(s)
Acinetobacter Infections/prevention & control , Cross Infection/prevention & control , Developing Countries , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae Infections/prevention & control , Gram-Positive Bacterial Infections/prevention & control , Infection Control/methods , Acinetobacter Infections/epidemiology , Acinetobacter Infections/microbiology , Acinetobacter Infections/transmission , Acinetobacter baumannii , Carbapenem-Resistant Enterobacteriaceae , Cross Infection/epidemiology , Cross Infection/microbiology , Cross Infection/transmission , Disease Outbreaks , Endemic Diseases , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae Infections/transmission , Gram-Positive Bacterial Infections/epidemiology , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/transmission , Humans , Infection Control/standards , Retrospective Studies , Thailand/epidemiology , Vancomycin-Resistant EnterococciABSTRACT
Data for treatment and outcomes of extensively drug-resistant Acinetobacter baumannii (XDR-AB) pneumonia are limited. A retrospective cohort study of 236 adult patients with XDR-AB pneumonia was conducted between January 2009 and December 2012. The median age of subjects was 70 years (range 17-95 years), 53% were male, 55% had ventilator-associated pneumonia and 42% had been admitted to the intensive care unit. All XDR-AB isolates were susceptible only to tigecycline and colistin; 52 (22%) of the 236 subjects did not receive an agent active against XDR-AB, with an associated 28-day survival of 0%. Colistin-based two-drug combination treatment was prescribed to 166 subjects (70%); regimens included (i) colistin and high-dose sulbactam (n=93); (ii) colistin and tigecycline (n=43); and (iii) colistin and high-dose prolonged infusion of a carbapenem (n=30). The 28-day survival rate and mean length of hospital stay were not statistically different between these three regimens (65%, 53% and 60% and 39, 39 and 38 days, respectively). Predictors of mortality included Acute Physiology and Chronic Health Evaluation (APACHE) II score [adjusted odds ratio (aOR)=1.11; P<0.001 for each point increase], duration from infection onset to receipt of active regimen (aOR=1.01; P=0.002 for each hour delay), underlying malignancy (aOR=3.46; P=0.01) and chronic kidney disease (aOR=2.85; P=0.03). These findings suggest that the three colistin-based two-drug combination regimens may be treatment options for XDR-AB pneumonia.