Microbiology of cysts/abscesses of Bartholin's gland: review of empirical antibiotic therapy against microbial culture.

Bartholin's glands are prone to obstruction at their opening into the vestibule, forming cysts which could be infected to become gland abscess. In our unit, treatment of Bartholin's abscess is usually surgical. In addition to surgical treatment, antimicrobial agents are often administered before microbial culture results are known. In this study, we aimed to determine the most common pathogens in Bartholin's glands abscess in our local population so that empiric antimicrobial therapy, if required, could be correctly directed. Among the 78 cases reviewed, there was positive microbial culture in 73.9%. Bartholin's abscess was commonly caused by opportunistic organisms, either as single agents or polymicrobial infections. Aerobic organisms were the commonest with coliforms being the most common bacteria. No cases of N. gonorrhoea or C. trachomatis were encountered. Flucloxacillin as a single agent was the most frequently prescribed antibiotic. Poly-pharmacy was common practice. It was concluded that whether adjuvant antibiotic therapy is necessary following surgical treatment of Bartholin's abscess is still controversial. Where antibiotics are required, the optimal initial therapy is not known. As poly-microbial infections are common, a broad spectrum agent like co-amoxiclav may be suitable for empirical treatment until culture results are known.

Measurement of protein flux with positron emission tomography in neonates.

AIM: To determine whether abnormal transvascular protein flux can be measured with positron emission tomography (PET) in neonates with respiratory distress syndrome (RDS). METHODS: Fourteen infants with normal gas exchange (non-RDS group) underwent one PET measurement and 12 infants with RDS (the RDS group) underwent two measurements of protein flux, as determined by the pulmonary transcapillary escape rate for 68Gallium labelled transferrin (PTCER). RESULTS: The mean PTCER for the RDS infants (132 +/- 39 10(-4)/min) was significantly greater than that for infants without RDS (75 +/- 27 10(-4)/min). PTCER did not change between measurements in the infants with RDS, including five who received and responded to surfactant replacement between the two scans. CONCLUSIONS: Increased transvascular flux of large molecular weight proteins complicates RDS in preterm infants. PET provides a tool with which to evaluate the processes that contribute to pulmonary dysfunction in neonates.