Fatal septicaemia caused by Aeromonas hydrophila in a patient with cirrhosis.

In this case report from Italy we describe a fatal infection caused by A. hydrophila in a 39 yr old cirrhotic patient. This pathogen was isolated as a pure single culture from the patient's blood sample. The patient died on the second day of hospitalization from overwhelming sepsis. The A. hydrophila isolate was tested for different potential virulence properties, such as invasiveness, adherence, exotoxins production, presence of fimbriae and for the patterns of resistance to a variety of antimicrobial agents. Although, the Aeromonas species are infrequently reported as a cause of human infections, the present case study confirms the capability of these pathogens to induce serious human infections.

[Monotherapy, empirical and targetted, with imipenem-cilastatin in sepsis of bacterial origin]. / La monoterapia, empirica e mirata, con imipenem-cilastatina nelle sepsi ad eziologia batterica.

The authors describe an open study in 22 patients with febrile conditions of unknown origin who were treated with imipenem-cilastatin while waiting for routine laboratory and culture tests. These were done immediately at the patients' entry into hospital, after which imipenem-cilastatin treatment was started immediately, and was subsequently confirmed by the isolates and culture tests. The drug was found to be active and to eradicate the responsible organism in all cases. In addition, it was found to be easy to handle and not to give rise to side-effects or changes in laboratory tests.

Cefoperazone compared with chloramphenicol in the treatment of typhoid fever.

The authors have conducted an open randomized study to compare the clinical efficacy and safety of cefoperazone with those of chloramphenicol in the treatment of typhoid fever. They studied 56 subjects (28 in each group), 36 males and 20 females, whose average age was 25.9 years. The diagnosis of typhoid fever was made when one of the at least three blood cultures performed was positive for Salmonella typhi and in the presence of a 'toxic'-like symptomatology and hyperpyrexia (39 degrees C). Moreover, several stool cultures were done and the signs and symptoms characteristic of the pathology in progress were monitored. Furthermore, the MICs of cefoperazone and chloramphenicol were determined for all the strains of S. typhi isolated in both groups. Cefoperazone was given at the mean dose of 2 g i.v. every 8 h, and chloramphenicol at the dose of 500 mg by oral route every 6 h. The results obtained were assessed statistically (Friedman's test and Fischer's test). The authors conclude that cefoperazone is as active as chloramphenicol, and the importance of this result should not be underestimated.