ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Candida albicanshas been recognized as the predominant infecting organism in oropharyngeal candidiasis. Yeasts other thanC. albicansare commonly recognized as colonizing the oral cavity but have not been thought to be a significant cause of disease. This review will describe the emergence of yeasts other thanC. albicansas causative pathogens in oropharyngeal candidiasis both as co-infecting organisms withC. albicansand as sole pathogens themselves. Diagnosis and treatment of these emerging infections will also be discussed.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Black moulds are a heterogeneous group of darkly pigmented (dematiaceous) fungi, widely distributed in the environment, that occasionally cause infection in humans. The clinical spectrum of infection includes mycetomas, chromoblastomycosis, sinusitis, and superficial, cutaneous, subcutaneous and systemic phaeohyphomycosis. During the last 2 years, there have been reports of infection caused by black moulds in previously healthy individuals and in immunocompromised patients, including an outbreak of fungemia in hospitalized patients. Molecular analysis of strains obtained from patients and from the environment has suggested a common nosocomial source. In addition, data on antifungal susceptibility tests have become available. Surgical excision and antifungal therapy (usually itraconazole) remain the standard treatment for these infections.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The prevalence of fungal infections has increased significantly over the past few decades.CandidaandAspergillusspp. are the most common fungal pathogens due to recent changes in medical technology. Amphotericin B continues to be the treatment of choice in many severe disseminated mycosis cases, but problems with toxicity, resistance and non-availability of an absorbable oral form are important drawbacks. The azoles offer a less toxic alternative but often they are not as effective as amphotericin B and resistance is an increasing problem. The echinocandins are new active antifungal agents with a novel mechanism of action. During the past year, one agent has been released and two others are undergoing advanced stages of investigation. Although these agents are not the ideal antifungal drug, they do offer new options of therapy.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Recent studies have contributed to our understanding of risk factors for severe and potentially life-threatening infections withCoccidioides immitis, allowing a more rational approach to initiation of antifungal therapy for this infection, as well as determining its intensity and duration. A large randomized trial found that itraconazole and fluconazole had similar efficacies in the treatment of progressive nonmeningeal coccidioidomycosis. An animal model of coccidioidal meningitis suggested potential efficacy of systemically administered liposomal amphotericin B. Investigational agents that have activity againstC. immitisinclude posaconazole, voriconazole, caspofungin, and sordarin derivatives.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Extended-spectrum beta-lactamases mediate resistance to cephalosporin antibiotics and were first discovered in Europe in the early 1980s. They have become a widespread problem, particularly inKlebsiella pneumoniae, but increasingly in non-typhoidSalmonellaspecies. Traditionally, extended-spectrum beta-lactamases have been derivatives of TEM and SHV parent enzymes. The last year, however, has seen an explosion of developments in extended-spectrum beta-lactamases of non-TEM, non-SHV lineage in Europe. The CTX-M type extended-spectrum beta-lactamases have become particularly widespread. At the same time, European clinical microbiology laboratories have become more aware of the pressing need for detection methods given increasing awareness of the lack of reliability of cephalosporins in the treatment of extended-spectrum beta-lactamase producers.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Severe community-acquired pneumonia is a clinical diagnosis with a significant impact on healthcare management around the world, with the highest morbidity and mortality of all of the forms of community-acquired pneumonia. Patients with severe pneumonia usually require intensive care unit management, including vasopressors or mechanical ventilation. Early clinical suspicion and prompt empiric antimicrobial therapies are mandatory in patients with severe pneumonia. A number of recent studies and guidelines addressing these issues have been published, and they will be reviewed in this article.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

There is growing concern about the increasing rates of resistance among human pathogens. These high rates of resistance, which are a consequence of antibiotic misuse, highlight the need for a thorough revision of strategies that deal with the proper use of antibiotics. The so-called ‘optimal use of all antibiotics’, restriction guidelines and use of a combination of antibiotics are well established strategies in most hospitals but new potential strategies, such as dosage optimization and antibiotic cycling, require further study and evaluation. Cycling antibiotic therapy consists of the scheduled replacement of one antibiotic for another, in order to avoid the development of bacterial resistance. Initial studies suggest that this strategy could be useful in reducing the rates of bacterial resistance as well as the incidence of nosocomial infections caused by Gram-negative bacilli in intensive care unit patients. This strategy, however, does not prevent antibiotic misuse and needs to be applied in a complete antibiotic policy program.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The isolation in 1972 of artemisinin by Chinese scientists, and their development of all the derivatives now used in the treatment of malaria today, were of outstanding importance. The results which have accumulated both from the Chinese work and from that subsequently conducted on a worldwide basis provide for a relatively comprehensive understanding of the chemistry, pharmacological profiles, toxicology, metabolism, and effects on the malaria parasite. The optimal regimens for use in the field are also apparent, particularly in combinations with longer half-life quinoline antimalarials. Thus the future use of the artemisinin class of drug appears assured. However, the mechanism of action needs to be clarified. More importantly from a clinical viewpoint, problems inherent in the current derivatives must be addressed, particularly that of neurotoxicity, if new artemisinin derivatives are to be introduced in a normal drug regulatory environment. The application of established principles of modern drug design should indeed allow for the first truly rationally designed, in so far as the target is still unknown, derivatives to come to hand.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID