Leptospirosis in Egypt: Is It the Tip of an Iceberg?

Sherbini, Azza El

doi:10.1086/521945

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…There was no other significant variability among the human clinical strains for the other antimicrobials. Leptospirosis has recently received attention in Egypt as an important etiology of acute febrile illness, especially in those patients who present with acute hepatitis (9,21). It is unclear why the doxycycline and tetracycline MICs are higher for the isolates from Egypt, although it has been reported that many patients with acute febrile illness in this region are empirically diagnosed with typhoid and are treated with either ampicillin or tetracycline (9).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibilities of Geographically Diverse Clinical Human Isolates ofLeptospira

Ressner

Griffith

Beckius

et al. 2008

Antimicrob Agents Chemother

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Although antimicrobial therapy of leptospirosis has been studied in a few randomized controlled clinical studies, those studies were limited to specific regions of the world and few have characterized infecting strains. A broth microdilution technique for the assessment of antibiotic susceptibility has been developed at Brooke Army Medical Center. In the present study, we assessed the susceptibilities of 13 Leptospira isolates (including recent clinical isolates) from Egypt, Thailand, Nicaragua, and Hawaii to 13 antimicrobial agents. Ampicillin, cefepime, azithromycin, and clarithromycin were found to have MICs below the lower limit of detection (0.016 g/ml). Cefotaxime, ceftriaxone, imipenem-cilastatin, penicillin G, moxifloxacin, ciprofloxacin, and levofloxacin had MIC 90 s between 0.030 and 0.125 g/ml. Doxycycline and tetracycline had the highest MIC 90 s: 2 and 4 g/ml, respectively. Doxycycline and tetracycline were noted to have slightly higher MICs against isolates from Egypt than against strains from Thailand or Hawaii; otherwise, the susceptibility patterns were similar. There appears to be possible variability in susceptibility to some antimicrobial agents among strains, suggesting that more extensive testing to look for geographic variability should be pursued.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibilities of Geographically Diverse Clinical Human Isolates ofLeptospira

Ressner

Griffith

Beckius

et al. 2008

Antimicrob Agents Chemother

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“…Leptospirosis is a worldwide zoonosis [ 10 , 11 ] and has been reported in most parts of the world, including North America (USA [ 8 , 12 , 13 ]), Europe (Germany [ 14 ], The Netherlands [ 15 ], Portugal [ 16 , 17 ], Greece [ 18 ], Serbia [ 19 ], Turkey [ 20 , 21 ]), The Middle East (Israel [ 22 , 23 ]), Central and South America (Brazil [ 4 , 24 , 25 ], Cuba [ 26 ], Nicaragua [ 27 ], Trinidad and Tobago [ 28 ], West Indies [ 29 ]), Asia (India [ 30 , 31 ], Thailand [ 32 ], Indonesia [ 3 ]), Africa (Egypt [ 33 , 34 ], Nigeria [ 35 , 36 ], South Africa [ 37 ]), Australia [ 38 ], and New Zealand [ 39 , 40 ]. Leptospirosis is characterized by great clinical variability, ranging from a mild flu-like illness to life-threatening multiorgan failure.…”

Section: Discussionmentioning

confidence: 99%

Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients

Velissaris

Καρανικόλας

Flaris

et al. 2012

Critical Care Research and Practice

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Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee. Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors. Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings.

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Leptospirosis in Egypt: Is It the Tip of an Iceberg?

Cited by 2 publications

References 5 publications

Antimicrobial Susceptibilities of Geographically Diverse Clinical Human Isolates ofLeptospira

Antimicrobial Susceptibilities of Geographically Diverse Clinical Human Isolates ofLeptospira

Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients

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