ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718534

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryOne hundred seventy six consecutive, non-duplicate pneumococcal isolates from clinical specimens collected from November 1994 through February 1995 in nine general hospitals throughout Belgium were tested for theirin vitrosusceptibilities to penicillin, ampicillin, amoxycillin with and without clavulanate, cefaclor, cefuroxime, cefonicid, cefprozil, cefpodoxime, cefotaxime, imipencm, tetracycline, and erythromycin by means of the NCCLS microdilution test. The overall rate of decreased susceptibility to penicillin was 12.5%, including 6.3% of intermediately and 6.3% of fully resistant isolates. Penicillin, ampicillin amoxycillin, amoxycillin/clavulanate, cefuroxime, cefotaxime and imipenem had the highest activity on a weight basis (MIC50<0.008 ng/ml), followed by cefpodoxime and erythromycin (MIC50 of 0.015 ng/ml), cefprozil and tetracycline (MIC50 of 0.12 ng/ml), and eventually, cefaclor and cefonicid (MIC50 of 0.5 ng/ml). Aggregate rates of susceptible plus intermediately resistant isolates at NCCLS-recommended breakpoints, i.e. overall percentages of isolates likely to respond to increased antibiotic dosesin vivo(except for meningitis), were 100.0% for imipencm and cefotaxime, 98.9% for amoxycillin with and without clavulanate, 93.8% for penicillin, and 90.9% for cefuroxime. Overall rates of susceptibility to erythromycin and tetracycline amounted to 78.4% and 72.7%, respectively. MIC values of all (i-lactams increased with those of penicillin. Ampicillin was equally active as penicillin against isolates with reduced susceptibility to the latter (MIC90 of 2 ng/ml); imipencm, cefotaxime, and amoxycillin with and without clavulanate however, were more active (MIC90 3, 1, and 1 doubling dilution, respectively, below that of penicillin), while cefpodoxime, cefuroxime, cefprozil, cefonicid, and cefaclor on the other hand, were less active (MIC90, 1, 1, 2, 5, and 5 doubling dilutions, respectively, above that of penicillin). In conclusion, the present data confirm that pneumococcal resistance to penicillin has increased in Belgium, suggest that resistance to erythromycin may have stabilised, and reveal an unexpectedly high rale of resistance to tetracycline. Imipencm was the most active antibiotic tested overall, and amoxycillin with or without clavulanate the most active oral antibiotic, with activity almost similar to that of cefotaxime.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718535

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummarySince 1992, the Belgian network for the surveillance of nosocomial infections runs a system of voluntary surveillance of surgical wound infections, including the perioperative antibiotic prophylaxis patterns. From 1992 to 1995, the global rate of prophylaxis was 71%, calculated on 44,728 interventions from 72 hospitals, but in 11.4% of operations for which prophylaxis is indicated, it was not given. On the other hand, prophylaxis was prescribed in 55.6% of operations where it was not indicated. At least 4 out of 10 courses were inappropriate with respect to indication, duration or day of administration. Fifteen percent of all courses exceeded 2 days (28% in genitourinary surgery, and 20% in abdominal surgery). In orthopedic surgery, recommended indications were not followed in 42% of operations.To improve the prescribing of antibiotic prophylaxis in Belgium, local surveillance of prophylaxis patterns and the implementation of guidelines describing good practices should be priorities at the hospital level. At the national level, recommendations about the indications for prophylaxis should be updated and disseminated.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718536

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryThe authors report 3 cases of thromboembolic splenic infarction due to atherosclerosis of the thoracic aorta and the splenic artery. On this occasion, a retrospective analysis of 64 splenic infarcts showed that, in contrast to the literature, the leading aetiology in our series consisted of haematologic disorders (50%), followed by cardiovascular diseases (29%) and by digestive disorders (20%). Mean age was 58±17 years and 50% of the patients were aged below 60 years. Hospital mortality rate was high (34%) but not directly related to splenic infarction, suggesting that splenic infarction often occurs in the setting of severe underlying diseases. Splenic infarct is part of the differential diagnosis of the left upper quadrant pain and can also mimic renal disorders. Laboratory values may show an inflammatory syndrome and an increase in serum lactate deshydrogenase. Diagnosis is often made by CT scan and can be confirmed by a selective spleen scintigraphy. Transocsophageal echocardiography is essential in the detection of cardiac and thoracic aorta embolic material.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718537

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryThe authors report the case of a 67-year-old woman, with mitral valve prolapse, for more than 20 years. She recently complained of attacks of syncope and clinical ventricular tachycardia; ventricular fibrillation was induced during programmed stimulation. The patient seemed to be at high risk for sudden cardiac death, and was therefore treated with an automatic implantable defibrillator. The pathophysiology and risk factors of sudden cardiac death in mitral valve Prolapse are discussed.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718538

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryA 32-year-old Italian man developed fever and general malaise 3 weeks after arrival in Zaire. Malaria was diagnosed by a thick blood film, but consequent treatment with quinine was unsuccessful. After repatriation, the diagnosis of early stage sleeping sickness was established. Treatment with eflornithine (Ornidyl®) resulted in complete recovery.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718539

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummarySpinal epidural absccss is an uncommon site of infection, resulting in back pain, fever, weakness and loss of sensibility. These signs should suggest the diagnosis, and quick confirmation by MRI should be performed.Immediate surgical decompression and antibiotherapy is necessary, because this is the base of a possible successful functional recovery. Empiric therapy consisting of high dose of penicillinase-resistant antibiotics is advised because most often an epidural absccss is caused byStaphylococcus aureus.However, because other bacteria can be involved, an aminoglycoside or a cephalosporin should be added to the empiric treatment, until the results of the cultures arc known.When diagnosis and therapy are delayed, permanent paralysis and death are common.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718540

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718541

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor