Ciprofloxacin can prevent fever in neutropenic patients with acute lymphoblastic leukemia during the induction phase of chemotherapy with good tolerance and no serious side effects. Due to the selective pressure of intestinal flora resistance to ciprofloxacin, the long-term effectiveness needs further investigation.
Certain fecal microbial counts were higher in rural children compared with urban children in South East Asia. Several contrasting home environmental conditions and practices were also identified. These may serve as a basis for future investigation of lifestyle factors underlying the global gradient of the increasing trends of allergic diseases.
ABSTRACT:The incidence of multidrug-resistant Acinetobacter baumannii (MDR A. baumannii) is increasing worldwide and is leading to therapeutic problems. We investigated the in vitro activities of cefoperazone/sulbactam, colistin, imipenem, and rifampicin alone and in double combinations against 100 A. baumannii isolates from patients at Songklanagarind Hospital in Songkhla Province, Thailand. The E-test method was used to determine antimicrobial susceptibility, the minimal inhibitory concentration (MIC) and for antimicrobial combination testing. A. baumannii isolates were susceptible to colistin (97%), cefoperazone/sulbactam (69%), imipenem (45%), and rifampicin (13%). Fifty-nine percent of them were MDR A. baumannii. Colistin was superior to cefoperazone/sulbactam, rifampicin and imipenem against MDR A. baumannii and the MIC50, MIC90 of colistin were 0.75 and 1 µg/ml, respectively. Non-MDR A. baumannii isolates were susceptible to cefoperazone/sulbactam (100%), colistin (95%), imipenem (93%) and rifampicin (2%). Combinations of cefoperazone/sulbactam plus colistin or rifampicin, imipenem plus colistin or rifampicin and colistin plus rifampicin showed indifferent effects against most MDR isolates. Of all the antimicrobial combinations tested, cefoperazone/sulbactam plus rifampicin produced the highest percentages (42%) of synergy, partial synergy, and additive results. The activity rate of cefoperazone/sulbactam against MDR A. baumannii was higher when combined with rifampicin than colistin. Thus colistin had the greatest activity against most MDR and non-MDR A. baumannii isolates among all of the antibiotics tested. Cefoperazone/sulbactam and imipenem showed good activity against non-MDR isolates, and cefoperazone/sulbactam combined with rifampicin may be useful in treating infections caused by MDR isolates.
ObjectiveTo determine the relationship between plasma zinc values and the severity of dengue viral infection (DVI) and DVI-caused hepatitis.MethodsA prospective cohort study was conducted during 2008–2010 in hospitalized children aged <15 years confirmed with DVI. Complete blood count, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and zinc values (mcg/dL) were determined twice: first during the toxic phase (Zn1) and secondly two weeks after recovery (Zn2).Results39 patients were enrolled with a mean age of 9.7±3.7 years, and 15/39 diagnosed with dengue shock syndrome (DSS). Zn1 values were lower than Zn2 values [median (IQR): 46.0 (37.0, 58.0) vs 65.0 (58.0, 81.0) mcg/dL, respectively, p <0.01]. Zn1 but not Zn2 values had a negative correlation with AST and ALT (rs = −0.33, p = 0.04 and rs = −0.31, p = 0.05, respectively). Patients with DSS had lower Zn1 but not Zn2 values compared with non-DSS patients [median (IQR) Zn1, 38.0 (30.0, 48.0) vs 52.5 (41.2, 58.7), p = 0.02; Zn2, 61.0 (56.0, 88.0) vs 65.0 (59.5, 77.5), respectively, p = 0.76]. Zn1 values showed a decreasing trend across increasing dengue severity groups (p = 0.02). Age <5 years and DVI-associated diarrhea were associated with low Zn1.ConclusionChildren who had a higher grade of dengue disease severity and liver cell injury had lower Zn1 values. Low Zn1 values were probably caused by loss from diarrhea and from zinc translocating to liver cells.
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