Summary:The safety and efficacy of early bacterial prophylaxis with piperacillin-tazobactam were prospectively evaluated in 51 autologous peripheral blood stem cell transplantation (PBSCT) recipients. The results were compared with those obtained in 51 control patients receiving oral fluoroquinolones in a retrospective matched-pair control study. Overall, 76% of the study group and 98% of the control group developed at least one febrile episode during neutropenia (P ¼ 0.002). Time from neutropenia to the first febrile episode (FFE) was significantly longer in the study group than in the control group (P ¼ 0.04). Once a febrile episode appeared, the duration of fever was significantly longer in cases than in controls (median of 5 and 2 days respectively, Po0.001), and led to a more frequent use of empirical amphotericin B (AmB), not statistically significant (P ¼ 0.13). However, the total time of antibiotic administration was significantly greater in the control than in the study group (P ¼ 0.05). The duration of AmB treatment shows a trend toward a longer duration in the control than in study group (P ¼ 0.2). Overall, 86% of the Gram-positive bacteremia and 85% of the Gram-negative bacteria were susceptible to the tested antibiotics. Our study suggests that a subgroup of patients could benefit from prophylaxis with piperacillintazobactam without increasing toxicity or bacterial resistance. Bone Marrow Transplantation (2005) 36, 59-65.
We report the case of a 25-year-old, HIV-positive patient (group IV, A, C2 clinical stage) with a widespread dermatophyte infection. He was a male gypsy with a known history of intravenous drug abuse. After an episode of cerebral toxoplasmosis for which he was treated with systemic steroids (because of cerebral oedema) he developed, over 16 days, a remarkably extensive ringworm of the trunk due to an unusual zoophilic dermatophyte, Microsporum (Trichophyton) gallinae. Human infection with this dermatophyte species is unusual: there are as few as seven proven reported cases, all of whom had localized lesions. This is the first widespread and severe case reported in man and also the first reported from Spain.
The in vitro activity of several beta-lactam agents, macrolides, and cotrimoxazole was investigated against 53 Streptococcus pneumoniae isolates recovered from healthy children. The rates of resistance to penicillin or amoxicillin, cefaclor, and cefuroxime were 30%, 51%, and 37%, respectively. No cefotaxime-resistant isolates were found. Rates of resistance to erythromycin, clarithromycin, and cotrimoxazole were 22.6%, 13.2%, and 83%, respectively. Pneumococci with divergent antimicrobial susceptibility profiles (susceptible or moderately resistant vs. resistant isolates) coexisted in 32% samples, with divergencies more often involving beta-lactam agents and/or macrolides. In five of these samples, isolates belonged to different serotypes.
Apocynin has been widely used as an inhibitor of the nicotinamide adenine dinucleotide phosphate oxidase (NADPH-oxidase) system and shows promise as an anti-inflammatory drug. Diapocynin, the dimeric product generated by the oxidation of apocynin in the presence of myeloperoxidase (MPO), is supposed to be its active form. In this study, diapocynin has been chemically synthesized and its activity on several inflammatory mediators in LPS-stimulated RAW 264.7 macrophages and its anti-inflammatory effect on ulcerative colitis induced by dextran sodium sulfate (DSS) in mice analyzed. We found that diapocynin showed higher inhibitory activity than apocynin. The dimer reduced ROS production, TNF-α, IL-6, and IL-1β levels and inhibited iNOS and COX-2 expression as well as decreased NO and PGE production induced in LPS-stimulated RAW 264.7 cells. The anti-inflammatory molecular mechanism of diapocynin was associated with the suppression of NF-κB activation. However, these results were not paralleled by in vivo studies. Oral administration of apocynin and diapocynin (100 mg/kg) three times a week exhibited similar protections against experimental inflammatory bowel disease induced by DSS; therefore, apocynin should not be considered a prodrug. However, it should be taken into account that the dimer is more potent because its dose (0.3 mmol/kg) is half that of apocynin.
Outer membrane protein (OMP) profiles of 122 Pseudomonas aeruginosa isolates recovered from the blood of bacteremic patients were analyzed to relate alterations in the expression of OMPs with porin activity to resistance to imipenem, ceftazidime, and ciprofloxacin. Imipenem-resistant isolates lacked or expressed reduced amounts of porin OprD. In contrast, alterations of OMP profiles were absent in most ceftazidime-resistant isolates. Six of 12 ciprofloxacin-resistant isolates had normal OMP profiles. The remaining isolates showed alterations in the expression of either OprC, OprF, or OprD. In addition, imipenem- and ceftazidime-resistant isolates displayed a beta-lactamase activity compatible with that of a group 1 chromosomal cephalosporinase.
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