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Abdallah ATH, Abdelkhalig RE, Hamid E, Ahmed A, Siddig EE. Unusual manifestation of cystic mycetoma lesions: A case report. Clin Case Rep 2023; 11:e8054. [PMID: 37854263 PMCID: PMC10580693 DOI: 10.1002/ccr3.8054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023] Open
Abstract
Key Clinical Message This case presents an atypical cystic presentation of mycetoma without sinuses or discharge. Awareness of these variations is crucial for accurate diagnosis and timely intervention, highlighting the need for healthcare professionals to consider diverse manifestations of mycetoma. Abstract Mycetoma is a chronic and debilitating infectious disease characterized by localized swellings and granulomatous lesions. It primarily affects individuals in tropical and subtropical regions and is caused by certain fungi or bacteria. While mycetoma typically presents with sinuses and discharge, this case report presents a unique cystic presentation without these features. The patient, a 12-year-old female from Sudan, presented with a painless swelling on the dorsum of her right foot. Physical examination revealed a round, non-tender, and fluctuant mass. Histopathological examination confirmed actinomycetoma caused by Streptomyces somaliensis. The patient was successfully treated with a combination of antibiotherapy. This atypical presentation underscores the need for healthcare professionals to consider uncommon variations of mycetoma for accurate diagnosis and management.
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Affiliation(s)
| | | | - Elwasila Hamid
- Consultant Surgeon, Rufa'a Teaching HospitalAlbutana UniversityRufaSudan
| | - Ayman Ahmed
- Institute of Endemic diseasesUniversity of KhartoumKhartoumSudan
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- University of BaselBaselSwitzerland
| | - Emmanuel Edwar Siddig
- ErasmusMC, University Medical Center RotterdamDepartment of Medical Microbiology and Infectious DiseasesRotterdamthe Netherlands
- Faculty of Medical Laboratory sciencesUniversity of KhartoumKhartoumSudan
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Combe M, Cherif E, Blaizot R, Breugnot D, Gozlan RE. What about Current Diversity of Mycolactone-Producing Mycobacteria? Implication for the Diagnosis and Treatment of Buruli Ulcer. Int J Mol Sci 2023; 24:13727. [PMID: 37762030 PMCID: PMC10531242 DOI: 10.3390/ijms241813727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
The identification of an emerging pathogen in humans can remain difficult by conventional methods such as enrichment culture assays that remain highly selective, require appropriate medium and cannot avoid misidentifications, or serological tests that use surrogate antigens and are often hampered by the level of detectable antibodies. Although not originally designed for this purpose, the implementation of polymerase-chain-reaction (PCR) has resulted in an increasing number of diagnostic tests for many diseases. However, the design of specific molecular assays relies on the availability and reliability of published genetic sequences for the target pathogens as well as enough knowledge on the genetic diversity of species and/or variants giving rise to the same disease symptoms. Usually designed for clinical isolates, molecular tests are often not suitable for environmental samples in which the target DNA is mixed with a mixture of environmental DNA. A key challenge of such molecular assays is thus to ensure high specificity of the target genetic markers when focusing on clinical and environmental samples in order to follow the dynamics of disease transmission and emergence in humans. Here we focus on the Buruli ulcer (BU), a human necrotizing skin disease mainly affecting tropical and subtropical areas, commonly admitted to be caused by Mycobacterium ulcerans worldwide although other mycolactone-producing mycobacteria and even mycobacterium species were found associated with BU or BU-like cases. By revisiting the literature, we show that many studies have used non-specific molecular markers (IS2404, IS2606, KR-B) to identify M. ulcerans from clinical and environmental samples and propose that all mycolactone-producing mycobacteria should be definitively considered as variants from the same group rather than different species. Importantly, we provide evidence that the diversity of mycolactone-producing mycobacteria variants as well as mycobacterium species potentially involved in BU or BU-like skin ulcerations might have been underestimated. We also suggest that the specific variants/species involved in each BU or BU-like case should be carefully identified during the diagnosis phase, either via the key to genetic identification proposed here or by broader metabarcoding approaches, in order to guide the medical community in the choice for the most appropriate antibiotic therapy.
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Affiliation(s)
- Marine Combe
- ISEM, Université de Montpellier, CNRS, IRD, 34095 Montpellier, France; (E.C.); (D.B.); (R.E.G.)
| | - Emira Cherif
- ISEM, Université de Montpellier, CNRS, IRD, 34095 Montpellier, France; (E.C.); (D.B.); (R.E.G.)
| | - Romain Blaizot
- Service de Dermatologie, Centre Hospitalier Andrée Rosemon, Cayenne 97306, French Guiana;
| | - Damien Breugnot
- ISEM, Université de Montpellier, CNRS, IRD, 34095 Montpellier, France; (E.C.); (D.B.); (R.E.G.)
| | - Rodolphe Elie Gozlan
- ISEM, Université de Montpellier, CNRS, IRD, 34095 Montpellier, France; (E.C.); (D.B.); (R.E.G.)
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Şenel A, Öztürkmen Y, Eren M, Carkci E, Circi E, Kanay E, Açıkgöz İ. Factors Influencing the Clinical Outcomes of Two-Stage Re-Implantation in Patients With Periprosthetic Joint Infection After Total Knee Arthroplasty. Cureus 2023; 15:e42566. [PMID: 37637597 PMCID: PMC10460261 DOI: 10.7759/cureus.42566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Infection is one of the most distressing complications of total knee arthroplasty (TKA), requiring a long treatment process and may negatively affect patient satisfaction. All surgeons aim to achieve infection-free survival, painless, functional, and stable knee after treatment of periprosthetic joint infection (PJI) with two-stage revision treatment. Many factors play a role in determining clinical outcomes. We aimed to evaluate the factors influencing the clinical outcomes of patients undergoing two-stage revision knee arthroplasty for PJI. Methods Forty-nine patients were retrospectively evaluated. Forty-four patients met the inclusion criteria. Spacer types, growth rates in culture, types and amount of antibiotics added to the cement, and intervals between stages were evaluated. Pre- and post-treatment infection parameters, changes in the range of motion (ROM), clinical and functional (C&F) Knee Society Score (KSS) results, and complications were also studied. Results After a mean follow-up of 48.8 ± 16.5 months, re-infection was detected in five out of 44 patients (10.4%). No significant difference was noted regarding C&F KSS when comparing time intervals between the two stages, whether they were shorter or longer than 10 weeks. However, better ROM results were obtained in patients with less than 10 weeks between stages. The relationship between spacer type, ROM, and C&F KSS was not found to be significant. Particularly, the addition of 4g of teicoplanin to the cement shortened the time between the two stages. Conclusion C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels can be considered safe parameters for diagnosis, reimplantation timing, and follow-up. The use of dynamic spacers or reimplantation performed within 10 weeks after the first stage is associated with better ROM outcomes. Additionally, the addition of teicoplanin to the cement shortened the duration of antibiotic therapy.
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Affiliation(s)
- Ahmet Şenel
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Yusuf Öztürkmen
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Murat Eren
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Engin Carkci
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Esra Circi
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Enes Kanay
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - İlhan Açıkgöz
- Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
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Correa Bonito A, Cerdán Santacruz C, Di Martino M, Blanco Terés L, Gancedo Quintana Á, Martín-Pérez E, Biondo S, García Septiem J. Treatment for acute uncomplicated diverticulitis without antibiotherapy: systematic review and meta-analysis of randomized clinical trials. Int J Surg 2023; 109:1412-1419. [PMID: 37026842 PMCID: PMC10389615 DOI: 10.1097/js9.0000000000000307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/15/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Use of antibiotics in selected cases of acute uncomplicated diverticulitis (AUD) has recently been questioned. OBJECTIVE The aim of this study is to examine the safety and efficacy of treatment regimens without antibiotics compared with that of traditional treatments with antibiotics in selected patients with AUD. DATA SOURCES PubMed, Medline, Embase, Web of Science, and the Cochrane Library. METHODS A systematic review was performed according to PRISMA and AMSTAR guidelines by searching through Medline, Embase, Web of Science, and the Cochrane Library for randomized clinical trials (RCTs) published before December 2022. The outcomes assessed were the rates of readmission, change in strategy, emergency surgery, worsening, and persistent diverticulitis. STUDY SELECTION RCTs on treating AUD without antibiotics published in English before December 2022 were included. INTERVENTION Treatments without antibiotics were compared with treatments with antibiotics. MAIN OUTCOME MEASURES The outcomes assessed were the rates of readmission, change in strategy, emergency surgery, worsening, and persistent diverticulitis. RESULTS The search yielded 1163 studies. Four RCTs with 1809 patients were included in the review. Among these patients, 50.1% were treated conservatively without antibiotics. The meta-analysis showed no significant differences between nonantibiotic and antibiotic treatment groups with respect to rates of readmission [odds ratio (OR)=1.39; 95% CI: 0.93-2.06; P =0.11; I2 =0%], change in strategy (OR=1.03; 95% CI: 0.52-2,02; P =0.94; I2 =44%), emergency surgery (OR=0.43; 95% CI: 0.12-1.53; P =0.19; I2 =0%), worsening (OR=0.91; 95% CI: 0.48-1.73; P =0.78; I2 =0%), and persistent diverticulitis (OR=1.54; 95% CI: 0.63-3.26; P =0.26; I2 =0%). LIMITATIONS Heterogeneity and a limited number of RCTs. CONCLUSIONS Treatment for AUD without antibiotic therapy is safe and effective in selected patients. Further RTCs should confirm the present findings.
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Affiliation(s)
| | | | | | - Lara Blanco Terés
- General and Digestive Surgery Service, Hospital Universitario de La Princesa, Madrid
| | | | - Elena Martín-Pérez
- General and Digestive Surgery Service, Hospital Universitario de La Princesa, Madrid
| | - Sebastiano Biondo
- General and Digestive Surgery – Colorectal Unit, Bellvitge University Hospital, Barcelona, Spain
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Timpau AS, Miftode RS, Costache II, Petris AO, Miftode IL, Gheorghe L, Timpau R, Miftode ID, Prepeliuc CS, Coman I, Anton-Paduraru DT, Tuchilus C, Miftode EG. An Overview of the Impact of Bacterial Infections and the Associated Mortality Predictors in Patients with COVID-19 Admitted to a Tertiary Center from Eastern Europe. Antibiotics (Basel) 2023; 12. [PMID: 36671345 DOI: 10.3390/antibiotics12010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
1. BACKGROUND Literature data on bacterial infections and their impact on the mortality rates of COVID-19 patients from Romania are scarce, while worldwide reports are contrasting. 2. MATERIALS AND METHODS We conducted a unicentric retrospective observational study that included 280 patients with SARS-CoV-2 infection, on whom we performed various microbiological determinations. Based on the administration or not of the antibiotic treatment, we divided the patients into two groups. First, we sought to investigate the rates and predictors of bacterial infections, the causative microbial strains, and the prescribed antibiotic treatment. Secondly, the study aimed to identify the risk factors associated with in-hospital death and evaluate the biomarkers' performance for predicting short-term mortality. 3. RESULTS Bacterial co-infections or secondary infections were confirmed in 23 (8.2%) patients. Acinetobacter baumannii was the pathogen responsible for most of the confirmed bacterial infections. Almost three quarters of the patients (72.8%) received empiric antibiotic therapy. Multivariate logistic regression has shown leukocytosis and intensive care unit admission as risk factors for bacterial infections and C-reactive protein, together with the length of hospital stay, as mortality predictors. The ROC curves revealed an acceptable performance for the erythrocyte sedimentation rate (AUC: 0.781), and C-reactive protein (AUC: 0.797), but a poor performance for fibrinogen (AUC: 0.664) in predicting fatal events. 4. CONCLUSIONS This study highlighted the somewhat paradoxical association of a low rate of confirmed infections with a high rate of empiric antibiotic therapy. A thorough assessment of the risk factors for bacterial infections, in addition to the acknowledgment of various mortality predictors, is crucial for identifying high-risk patients, thus allowing a timely therapeutic intervention, with a direct impact on improving patients' prognosis.
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Blachez M, Boussier J, Mariani P, Caula C, Gaschignard J, Lefèvre-Utile A. Detection of enterovirus in cerebrospinal fluids without pleocytosis in febrile infants under 3 months old reduces antibiotherapy duration. Front Pediatr 2023; 11:1122460. [PMID: 36925668 PMCID: PMC10011150 DOI: 10.3389/fped.2023.1122460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/31/2023] [Indexed: 03/18/2023] Open
Abstract
Background Infants under 3 months old with fever often receive empirical antibiotic treatment. Enterovirus is one of the leading causes of infection and aseptic meningitis but is not systematically screened. We aimed to evaluate enterovirus positive RT-PCR proportion in cerebrospinal fluid (CSF) with no pleocytosis and its impact on antibiotic treatment duration. Methods During the enterovirus endemic season, from 2015 to 2018, we retrospectively studied infants under 3 months old, consulting for fever without cause, with normal CSF analysis, and receiving empirical antibiotic treatment. Clinical and biological data were analyzed, notably enterovirus RT-PCR results. The primary outcome was the duration of antibiotic therapy. Results 92 patients were recruited. When tested, 41% of infants were positive for enterovirus, median antibiotic duration was reduced in enterovirus positive in comparison to negative patients with respectively 1.9 [interquartile range (IQR), 1.7-2] vs. 4.1 [IQR, 2-6], p < 0.001. No clinical nor biological features differed according to the enterovirus status. Conclusion In this population, enterovirus positive CSF are frequent despite the absence of pleocytosis. However, its research was not guided by clinical or biological presentations. Systematic and routine use of enterovirus RT-PCR during enterovirus season, regardless of CSF cell count, could reduce the prescription of antibiotics in febrile infants under 3 months old without clinical orientation.
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Affiliation(s)
- Marion Blachez
- General Pediatrics and Pediatric Emergency Department, Saint Camille Hospital, Bry-sur-Marne, France
| | - Jeremy Boussier
- Sorbonne Université, La Pitié Salpêtrière Hospital, Paris, France
| | - Patricia Mariani
- Assistance Publique Hôpitaux de Paris (APHP), Laboratory of Microbiology, Robert Debré Hospital, Université de Paris, Paris, France
| | - Caroline Caula
- Assistance Publique Hôpitaux de Paris (APHP), Pediatric Emergency Department, Robert Debré Hospital, Université de Paris, Paris, France
| | - Jean Gaschignard
- General Pediatrics and Pediatric Emergency Department, Nord-Essonne Hospital Group, Longjumeau, France.,INSERM, UMR1137 - IAME, Université de Paris, Paris, France
| | - Alain Lefèvre-Utile
- Assistance Publique-Hôpitaux de Paris (APHP), General Pediatric and Pediatric Emergency Department, Jean Verdier Hospital, Bondy, France.,INSERM U976 - Human Systems Immunology and Inflammatory Networks, Saint Louis Research Institute, Université de Paris, Paris, France
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Chiș AA, Rus LL, Morgovan C, Arseniu AM, Frum A, Vonica-Țincu AL, Gligor FG, Mureșan ML, Dobrea CM. Microbial Resistance to Antibiotics and Effective Antibiotherapy. Biomedicines 2022; 10:biomedicines10051121. [PMID: 35625857 PMCID: PMC9138529 DOI: 10.3390/biomedicines10051121] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
Currently, the efficacy of antibiotics is severely affected by the emergence of the antimicrobial resistance phenomenon, leading to increased morbidity and mortality worldwide. Multidrug-resistant pathogens are found not only in hospital settings, but also in the community, and are considered one of the biggest public health concerns. The main mechanisms by which bacteria develop resistance to antibiotics include changes in the drug target, prevention of entering the cell, elimination through efflux pumps or inactivation of drugs. A better understanding and prediction of resistance patterns of a pathogen will lead to a better selection of active antibiotics for the treatment of multidrug-resistant infections.
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Acar E, Bezirgan U. A rare cause of osteomyelitis of distal phalanx: Candida lusitaniae. Jt Dis Relat Surg 2021; 32:556-559. [PMID: 34145840 PMCID: PMC8343857 DOI: 10.52312/jdrs.2021.79490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/08/2020] [Indexed: 11/25/2022] Open
Abstract
Osteomyelitis of the phalanx caused by Candida species are rare. A 49-year-old female patient was admitted to an external center with a splinter injury of the third phalanx of the middle finger of her left hand about 45 days ago. She was referred to our clinic with persistent pain and discharge, despite four-week antibiotherapy. Debridement and curettage were performed and partial excision of the distal phalanx at an appropriate level was done. Her complaints gradually resolved postoperatively with prescribed antibiotics for the pathogen identified as Candida lusitaniae based on the intraoperative cultures. At her three-month follow-up visit, treatment yielded near-excellent results. To the best of our knowledge, this is the first case of osteomyelitis of the distal phalanx caused by Candida lusitaniae in the literature, highlighting the importance of definitive diagnosis and pathogen-specific treatment, rather than empirical treatment, to achieve favorable results with cure.
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Affiliation(s)
- Erdinc Acar
- Department of Orthopedics and Traumatology, Hand and Upper Extremity Surgery Division, Ankara City Hospital, Ankara, Turkey
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Basso A, Moerman F, Ronsmans C, Demarche M. Necrotizing myositis case report and brief literature study. Acta Clin Belg 2020; 75:424-428. [PMID: 31268407 DOI: 10.1080/17843286.2019.1637388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Necrotizing myositis is an extremely rare soft tissue infection, mainly caused by Group A Streptococci. Although its presentation is nonspecific and seems harmless, it quickly leads to death in almost all cases. Therefore, diagnosis and treatment of necrotizing myositis are considered as medical emergencies. The 27 years old patient we report benefited from early diagnosis and care. Necrotic tissues were surgically removed 24 hours after the appearance of the first clinical signs. Intravenous antibiotherapy as well as immunoglobulin therapy were also given on the first day. Starting from this clinical case, we present a brief explanation of the pathogenesis, the key clinical features and appropriate tools for diagnosis. Then, adequate antibiotherapy, role of immunoglobulin therapy and interest of hyperbaric oxygenotherapy will be discussed.
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Affiliation(s)
- Arthur Basso
- Otorhinolaryngology-Head and Neck Surgery resident, University hospital, Liège, Belgium
| | - Filip Moerman
- Infectious diseases specialist, Citadelle Hospital, Liège, Belgium
| | | | - Martine Demarche
- General and pediatric surgery, Citadelle Hospital, Liège, Belgium
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Zhong Y, Pouliot M, Downey AM, Mockbee C, Roychowdhury D, Wierzbicki W, Authier S. Efficacy of delayed administration of sargramostim up to 120 hours post exposure in a nonhuman primate total body radiation model. Int J Radiat Biol 2020; 97:S100-S116. [PMID: 32960660 DOI: 10.1080/09553002.2019.1673499] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/09/2019] [Accepted: 09/18/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND High dose ionizing radiation exposure is associated with myelo-depression leading to pancytopenia and the expected clinical manifestations of acute radiation syndrome (ARS). Herein, we evaluated the efficacy of sargramostim (Leukine®, yeast-derived rhu GM-CSF), with regimens delivered at 48, 72, 96, or 120 h after radiation exposure. METHODS A randomized and blinded nonhuman primate (NHP) study was conducted to assess the effects of sargramostim treatment on ARS. NHPs were exposed to total body radiation (LD83/60 or lethal dose 83% by Day 60) and were randomized to groups receiving daily subcutaneous dosing of sargramostim starting from either 48, 72, 96, or 120 h post-irradiation. Additionally, separate groups receiving sargramostim treatment at 48 h post-irradiation also received prophylactic treatment with azithromycin. Sargramostim treatment of each animal continued until the preliminary absolute neutrophil count (ANC) returned to ≥1000/μL post-nadir for three consecutive days or the preliminary ANC exceeded 10,000/μL, which amounted to be an average of 15.95 days for all treatment groups. Prophylactic administration of enrofloxacin was included in the supportive care given to all animals in all groups. All animals were monitored for 60 days post-irradiation for mortality, hematological parameters, and sepsis. RESULTS Delayed sargramostim treatment at 48 h post-irradiation significantly reduced mortality (p = .0032) and improved hematological parameters including neutrophil but also lymphocyte and platelet counts. Additional delays in sargramostim administration at 72, 96, and 120 h post-irradiation were also similarly effective at enhancing the recovery of lymphocyte, neutrophil, and platelet counts compared to control. Sargramostim treatment also improved the survival of the animals when administered at up to 96 h post-irradiation. While sargramostim treatment at 48 h significantly reduced mortality associated with sepsis (p ≤ .01), the additional prophylactic treatment with azithromycin did not have clinically significant effects. CONCLUSION In a NHP ARS model, sargramostim administered starting at 48 h post-radiation was effective to improve survival, while beneficial hematological effects were observed with sargramostim initiated up to 120 h post exposure.
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Panduru M, Epure AM, Cimpoca B, Cozma C, Giuca BA, Pop A, Pop G, Simon LG, Robu M, Panduru NM. Antibiotics administration during last trimester of pregnancy is associated with atopic dermatitis - a cross-sectional study. Rom J Intern Med 2020; 58:99-107. [PMID: 32229683 DOI: 10.2478/rjim-2020-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Studies regarding antibiotics administration during pregnancy and atopic dermatitis (AD) in children are only few. In this context, the objective of our study was to investigate the potential association between the timing of intrauterine exposure to antibiotics or prenatal antibiotic administration in general and AD occurrence in children. METHODS This was a cross-sectional study in 1046 subjects. The exposure to antibiotics during pregnancy was initially evaluated using simple logistic regressions. Then, each period of antibiotics administration was adjusted with the other periods of antibiotics exposure (model 1) and with the other variables associated with AD in our database (model 2). RESULTS In simple logistic regression analysis, the administration of antibiotics during pregnancy, as a whole period, presented a trend of association with AD (OR = 1.28, %CI: 0.99 - 1.65). When we analyzed antibiotic administration during each trimester of pregnancy, only antibiotherapy during the 3rd trimester was associated with AD (OR = 2.94, %CI: 1.21 - 7.12). After adjusting with all the other important risk factors associated with AD in the database, antibiotics administration during the 3rd trimester of pregnancy was still independently associated with AD (OR=2.64, %CI: 1.01 - 6.91). CONCLUSION Antibiotic administration during the 3rd trimester of pregnancy was independently associated with AD in children.
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Augustin P, Tanaka S, Tran-Dinh A, Parenti Ribeiro L, Arapis K, Grall N, Al Qarni A, Montravers P. Outcome and Adequacy of Empirical Antibiotherapy in Post-Operative Peritonitis: A Retrospective Study. Surg Infect (Larchmt) 2019; 21:284-292. [PMID: 31770083 DOI: 10.1089/sur.2019.120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Empirical antibiotherapy (EA) should target all bacteria in post-operative peritonitis (PP). Nevertheless, recent studies failed to prove a link between adequacy of EA and prognosis of PP. We sought to confirm this loss of association between adequate EA and prognosis and to analyze the evolution of patients' characteristics and antimicrobial strategies. Methods: This is was retrospective study. Patients with a positive fungal culture were excluded. The cohort was divided into two time periods. Data of survivors and non-survivors were compared within each time period. Differences between the two periods were assessed. A multivariable analysis searched for parameters associated with a higher hospital mortality rate. Results: Two hundred fifty-one patients were included, with 92 patients in the first period (P1) and 152 patients in the second period (P2). Inadequate EA was associated with a worse outcome only in P1. The multivariable analysis in the whole cohort showed that inadequate EA was associated with a higher mortality rate. When the differences noticed between the two periods were entered in the model (presence of resistant gram-positive cocci and EA comprising glycopeptides), inadequate EA was no longer associated with worse outcome. In P1, the most severe patients had more resistant bacteria, hence, had a higher rate of inadequate EA. This artifact disappeared in P2, during which broader antibiotherapies with triple EA were more often prescribed for the most severe patients. Conclusion: This study showed that the link between inadequate EA and outcome of patients with PP was at least partly artifactual in older studies.
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Affiliation(s)
- Pascal Augustin
- Département d'Anesthésie et Réanimation, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Sebastien Tanaka
- Département d'Anesthésie et Réanimation, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alexy Tran-Dinh
- Département d'Anesthésie et Réanimation, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Lara Parenti Ribeiro
- Service de Chirurgie digestive, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Kostantinos Arapis
- Service de Chirurgie digestive, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Nathalie Grall
- Laboratoire de Microbiologie, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Adel Al Qarni
- Département d'Anesthésie et Réanimation, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Philippe Montravers
- Département d'Anesthésie et Réanimation, Groupe Hospitalier Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Press Sorbonne Cité, Paris, France.,INSERM UMR 1152, Paris, France
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Duchatelet S, Join-Lambert O, Delage M, Miskinyte S, Guet-Revillet H, Lam T, Coignard-Biehler H, Ungeheuer MN, Chatenoud L, Lortholary O, Nassif X, Hovnanian A, Nassif AS. Remission of chronic acne fulminans and severe hidradenitis suppurativa with targeted antibiotherapy. JAAD Case Rep 2019; 5:525-528. [PMID: 31205996 PMCID: PMC6558272 DOI: 10.1016/j.jdcr.2019.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sabine Duchatelet
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Olivier Join-Lambert
- Laboratoire de Microbiologie, Hôpital Necker Enfants Malades, Paris, France.,Physiopathologie des Infections Systémiques, Institut Necker-Enfants Malades, Paris, France.,CHU de Caen, Laboratoire de Microbiologie, Caen, France.,Groupe de Recherche sur l'Adaptation Microbienne, Caen, France.,Normandy University, Normandy, France
| | - Maïa Delage
- Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Snaigune Miskinyte
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Hélène Guet-Revillet
- Laboratoire de Microbiologie, Hôpital Necker Enfants Malades, Paris, France.,Physiopathologie des Infections Systémiques, Institut Necker-Enfants Malades, Paris, France
| | - Thi Lam
- Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Hélène Coignard-Biehler
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker Enfants Malades, Paris, France
| | | | - Lucienne Chatenoud
- Laboratoire d'immunologie, Hôpital Necker Enfants Malades, Paris, France
| | - Olivier Lortholary
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker Enfants Malades, Paris, France
| | - Xavier Nassif
- Laboratoire de Microbiologie, Hôpital Necker Enfants Malades, Paris, France.,Physiopathologie des Infections Systémiques, Institut Necker-Enfants Malades, Paris, France
| | - Alain Hovnanian
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University Paris Descartes - Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Necker Enfants Malades, Paris, France
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14
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Grammatico-Guillon L, Shea K, Jafarzadeh SR, Camelo I, Maakaroun-Vermesse Z, Figueira M, Adams WG, Pelton S. Antibiotic Prescribing in Outpatient Children: A Cohort From a Clinical Data Warehouse. Clin Pediatr (Phila) 2019; 58:681-690. [PMID: 30884973 DOI: 10.1177/0009922819834278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To characterize antibiotic (ab) prescriptions in children. METHODS Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication. RESULTS A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections. DISCUSSION A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
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Affiliation(s)
- Leslie Grammatico-Guillon
- 1 Boston University, Boston, MA, USA.,2 Teaching Hospital of Tours, University of Tours, Tours, France
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15
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Calis H, Guler Y, Sengul S, Karabulut Z. The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure. Int Wound J 2019; 16:974-978. [PMID: 30938077 DOI: 10.1111/iwj.13130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 11/28/2022] Open
Abstract
Pilonidal sinus disease is a common disorder. We aimed to evaluate the effects of perioperative antibiotherapy on surgical site infections in pilonidal sinus patients who were treated with rhomboid excision with Limberg transposition procedure. A total of 104 patients between 18 and 40 years of age (52 males, 52 females) were included in the study. The patients were divided into two groups and evaluated because of the administration of perioperative antibiotherapy. On the 10th-day, first-month, and third-month follow ups, the status of the wound was recorded. No significant difference was found between the ages, gender distribution, and smoking. Wound dehiscence rate was higher in the non-antibiotic group on the 10th-day, first-month, and third-month follow up, whereas the rate of superficial infection was higher in the antibiotic group. None of the patients had any signs of recurrence. Antibiotic administration did not provide a significant advantage in terms of wound healing, surgical site infection, and recurrence. We think that perioperative antibiotherapy, except for patients with immunosuppression, diffuse cellulitis, or a major coexisting disease who were treated with rhomboid excision with Limberg transposition procedure, does not have any effect on healing surgical site infections and delaying early recurrence.
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Affiliation(s)
- Hasan Calis
- Department of General Surgery, Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey
| | - Yilmaz Guler
- Department of General Surgery, Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey
| | - Serkan Sengul
- Department of General Surgery, Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey
| | - Zulfikar Karabulut
- Department of General Surgery, Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey
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16
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Czerżyńska M, Sacharczuk J, Mleczko M, Skalski JH, Mroczek T. The effect of prenatal diagnosis on antibiotic therapy in neonates with hypoplastic left heart syndrome. Antibiotics in prenatally diagnosed patients with HLHS. Folia Med Cracov 2019; 59:35-44. [PMID: 31659347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Hypoplastic left heart syndrome (HLHS) is a congenital heart anomaly that is diagnosed prenatally or postnatally. The prenatal diagnosis leads to limiting the rate of systemic complications in the preoperative period due to optimization of the early therapeutic management. OBJECTIVE The objective of the study is to determine the effect of prenatal diagnostic management of HLHS on the condition of newborns and the frequency of antibiotherapy employment prior to the first stage of surgical treatment. METHODOLOGY The study included 95 children with HLHS operated on in the years 2014-2016. The cohort was divided into two groups: newborns with a prenatally diagnosed heart defect (50 children - 52.6%) and neonates with the defect diagnosed after birth (45 children - 47.4%). The data of the patients were analyzed based on their medical records. RESULTS The mean age of the children upon admission was 3.86 days in the group of patients with the prenatally diagnosed heart defect (PreHLHS) and 7.41 days in the group of newborns without the prenatal diagnosis (PostHLHS) (p = 0.001). In 60% of the PreHLHS group patients (30/50), at least one antibiotic was administered, while in the PostHLHS group, antibiotherapy was employed in 93.3% (42/45) cases (p = 0.001). Bacteriological tests demonstrated pathogen growth in 33 children (36% and 33.3%, respectively), what accounted for 34.7% of the entire cohort. On the average, the first antibiotic was introduced on the 6.55th day of life in the PreHLHS group and on the 2.73th day in the PostHLHS group (p = 0.005). The most profound differences in antibiotic employment involved aminoglycosides. The aforementioned type of antibiotic medications was administered to 6% of the children with the prenatal diagnosis and to 17.8% of the children diagnosed postnatally (p = 0.042). CONCLUSIONS Preoperative antibiotherapy in children with HLHS was employed more frequently than it would be indicated by microbiology tests results. Antibiotics were observed to be introduced more commonly and earlier in the newborns with the postnatally diagnosed congenital heart defect.
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Affiliation(s)
- Magdalena Czerżyńska
- Department of Pediatric Cardiac Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Poland
| | - Julita Sacharczuk
- Department of Pediatric Cardiac Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Poland
| | - Mateusz Mleczko
- Department of Pediatric Cardiac Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Poland
| | - Janusz H Skalski
- Department of Pediatric Cardiac Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Poland
| | - Tomasz Mroczek
- Department of Pediatric Cardiac Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Poland.
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17
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de Pablo E, Fernández-García R, Ballesteros MP, Torrado JJ, Serrano DR. Nebulised antibiotherapy: conventional versus nanotechnology-based approaches, is targeting at a nano scale a difficult subject? Ann Transl Med 2017; 5:448. [PMID: 29264365 DOI: 10.21037/atm.2017.09.17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Nebulised antibiotics offer great advantages over intravenously administered antibiotics and other conventional antibiotic formulations. However, their use is not widely standardized in the current clinical practice. This is the consequence of large variability in the performance of nebulisers, patient compliance and a deficiency of robust preclinical and clinical data. Nebulised antibiotherapy may play a significant role in future pulmonary drug delivery treatments as it offers the potential to achieve both a high local drug concentration and a lower systemic toxicity. In this review, the physicochemical parameters required for optimal deposition to the lung in addition to the main characteristics of currently available formulations and nebuliser types are discussed. Particular attention will be focused on emerging nanotechnology based approaches which are revolutionizing inhaled therapies used to treat both infections and lung cancer. Promising carriers such as Trojan-Horse microparticles, liposomes, polymeric and lipid nanoparticulate systems have been investigated and proposed as viable options. In order to achieve site-specific targeting and to optimize the PK/PD balance critical nanoscale design parameters such as particle size, morphology, composition, rigidity and surface chemistry architecture must be controlled. Development of novel excipients to manufacture these nanomedicines and assessment of their toxicity is also a keystone and will be discussed in this review.
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Affiliation(s)
- Esther de Pablo
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain
| | - Raquel Fernández-García
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain
| | - María Paloma Ballesteros
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain.,Instituto Universitario de Farmacia Industrial (IUFI), Facultad de Farmacia, Universidad Complutense de Madrid, Avenida Complutense, Madrid, Spain
| | - Juan José Torrado
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain.,Instituto Universitario de Farmacia Industrial (IUFI), Facultad de Farmacia, Universidad Complutense de Madrid, Avenida Complutense, Madrid, Spain
| | - Dolores R Serrano
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain.,Instituto Universitario de Farmacia Industrial (IUFI), Facultad de Farmacia, Universidad Complutense de Madrid, Avenida Complutense, Madrid, Spain
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18
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Bugeaud J, Colombat P, Vallet N, Hardouin C, Thibault N. [Infections of implantable ports in haematology patients]. Rev Infirm 2017; 66:41-43. [PMID: 28865699 DOI: 10.1016/j.revinf.2017.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
From 2010 to 2015, a study analysed the infections of implantable ports in haematology patients. Communication, collaboration and diligence were some of the main issues raised.
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Affiliation(s)
- Julie Bugeaud
- Service d'hématologie et thérapie cellulaire, Unité stérile de soins intensifs, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France.
| | - Philippe Colombat
- Service d'hématologie et thérapie cellulaire, Unité stérile de soins intensifs, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France
| | - Nicolas Vallet
- Service d'hématologie et thérapie cellulaire, Unité stérile de soins intensifs, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France
| | - Christelle Hardouin
- Service de néphrologie, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France
| | - Nathalie Thibault
- Service de soins palliatifs, Centre hospitalier de Luynes, 28 avenue du clos Mignot, 37230 Luynes, France
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19
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Ouédraogo AS, Zaré C, Traoré IA, Sanou S, Sanon BG, Ki B, Poda A, Kambou T. Microbiological characteristics of community-acquired peritonitis at Souro Sanou Teaching Hospital of Bobo Dioulasso. Med Sante Trop 2016; 26:203-6. [PMID: 27412980 DOI: 10.1684/mst.2016.0555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to describe the microbiological characteristics of community-acquired peritonitis at the Souro Sanou teaching hospital of Bobo Dioulasso, Burkina Faso. This 10-month prospective study, from July 2012 through May 2013 included all cases of community-acquired peritonitis who underwent surgery at our hospital and had a pus sample taken at that time. Bacteriological analyses were performed according to the hospital laboratory's protocol. The study included 72 patients (45 men and 27 women with a sex-ratio of 1.6). Their mean age was 27.3 years (range: 14 months to 67 years). The analysis of 72 samples of pus enabled confirmation of 39 cases and led to the identification of 53 bacterial strains. The most common families were enterobacteriaceae in 58% and Gram-positive cocci in 36%. The most common enterobacteria species was Escherichia coli (47%) followed by Streptococcus species (22%). The microbiological confirmation of peritonitis was most frequent in the 20-30 year-old age group. These bacteria appeared most susceptible to gentamycin, ceftriaxone, and ciprofloxacin, while we observed resistance to amoxicillin and the combination of clavulanic acid-amoxicillin. These findings suggest that the best probabilistic antibiotic treatment for the peritonitis in our context would combine a third-generation cephalosporin with aminoglycosides, with imidazole to cover potential anaerobic bacteria.
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20
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Tudorașcu DR, Bărbulescu AL, Cârțână ET, Petrescu IO, Ciurea RN, Ciobanu D, Forțofoiu MC, Pădureanu V, Tica OS, Tudorache S, Petrescu F. Study of the Etiological Spectrum of Spontaneous Bacterial Peritonitis in a Group of Patients Suffering from Liver Cirrhosis. Curr Health Sci J 2016; 42:365-71. [PMID: 30581591 DOI: 10.12865/CHSJ.42.04.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 12/09/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Spontaneous bacterial peritonitis (SBP) represents the most severe and common infectious complication in patients suffering from liver cirrhosis. The objectives of the study were the evaluation of the risk factors responsible for the occurrence of the spontaneous bacterial peritonitis in a group of patients suffering from liver cirrhosis, the identification of the bacterial spectrum and assessing the response to antibiotic therapy. Material and method - The studied group included 64 patients suffering from liver cirrhosis, with an episode of SBP, who were admitted to the IInd Medical Clinic of the County Hospital of Craiova, within a period of 24 months. The control group included 61 patients with liver cirrhosis with an episode of decompensation of liver disease. The diagnosis of liver cirrhosis was established by using clinical, biological and imagistic criteria, and the SBP's diagnosis was based on cytological and bacteriological analysis of the ascites fluid. Patients suffering from hepatocellular carcinoma, portal vein thrombosis and other infectious conditions were excluded. The anamnesis, the duration of the disease, the alcohol intake, the complete clinical examination, the clinical, biological and imagistic evaluation were monitored. Results and conclusions - The most frequent etiology of SBP is represented in 67% of the cases by Gram negative germs, and thus, the antibiotic therapy will be orientated against this etiological segment. In what antibiotic sensitivity is concerned, most of the germs were sensitive to third generation cephalosporins, quinolones, carbapenems and vancomycin.
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21
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Mahmoudi A, Maâtouk M. [A rare and fulminant form of gastritis: emphysematous gastritis]. Pan Afr Med J 2016; 22:58. [PMID: 26834911 PMCID: PMC4725653 DOI: 10.11604/pamj.2015.22.58.7910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 09/15/2015] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ammar Mahmoudi
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Mezri Maâtouk
- Service d'Imagerie Médicale, CHU Fattouma Bourguiba de Monastir, Tunisie
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22
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Affiliation(s)
- Ammar Mahmoudi
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Monastir, Tunisie
| | - Abdelaziz Hamdi
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Monastir, Tunisie
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23
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Mahmoudi A, Abdelali M. [A psoas abscess complicating acute appendicitis]. Pan Afr Med J 2015; 22:231. [PMID: 26955420 PMCID: PMC4761250 DOI: 10.11604/pamj.2015.22.231.8201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 10/31/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ammar Mahmoudi
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Monastir, Tunisie
| | - Mabrouk Abdelali
- Service d' Imagerie Médicale, CHU Fattouma Bourguiba de Monastir, Monastir Tunisie
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24
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Serghini I, El Moqqadem A, Bellasri S, Laayoune J, Hamama J, Boughalem M. [Orbital cellulitis complicating acute pansinusitis: report of a case]. Pan Afr Med J 2015; 22:321. [PMID: 26977230 PMCID: PMC4769801 DOI: 10.11604/pamj.2015.22.321.8215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 11/06/2015] [Indexed: 11/30/2022] Open
Abstract
Les cellulites orbitaires sont des affections peu fréquentes. Ces infections peuvent être secondaire à une infection oculaire, péri oculaire ou à une septicémie. L'origine sinusienne reste la plus fréquente. Le risque de graves complications mettant en jeu le pronostic fonctionnel et vital nécessite un diagnostic rapide et une prise en charge précoce. Nous rapportons le cas clinique d'une femme de 70 ans connue diabétique, qui a présenté une cellulite orbitaire secondaire à une pansinusite négligée. Le traitement était à la fois médical et chirurgical: antibiothérapie et drainage. L’évolution a été favorable au bout du septième jour. Nous essayons à travers ce cas clinique de souligner la gravité des infections orbitaires et leurs conséquences dramatiques en cas de retard de prise en charge.
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Affiliation(s)
- Issam Serghini
- Pôle Anesthésie- Réanimation, Hôpital Militaire Avicenne, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, 40010 Marrakech, Maroc
| | | | - Salah Bellasri
- Service de Radiologie, 5 Hôpital Militaire Guelmim, Maroc
| | | | - Jalal Hamama
- Service de Chirurgie Maxillo-Fasciale et de Stomatologie, 5 Hôpital Militaire Guelmim, Maroc
| | - Mohamed Boughalem
- Pôle Anesthésie- Réanimation, Hôpital Militaire Avicenne, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, 40010 Marrakech, Maroc
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25
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Champeaux C, Raballand E. Craniocerebral gunshot wound in a baby chimpanzee--an uncommon experience of neurosurgical treatment conducted in the Guinean forest. J Med Primatol 2014; 44:49-52. [PMID: 25523755 DOI: 10.1111/jmp.12156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 11/28/2022]
Abstract
An orphan female chimpanzee was wounded by a left craniocerebral gunshot complicated with a right hemiparesis. Local treatment and long-term antibiotherapy failed to lead to healing. A neurosurgical procedure was planned and achieved. She fully recovered, and 2 years after the procedure, there is no evidence of infection.
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Affiliation(s)
- C Champeaux
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
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26
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Hassani FD, El Fatemi N, Moufid F, YassadOudrhiri M, Gana R, El Maaqili R, Bellakhdar F. [Management of encephalic abscess: series of 82 cases]. Pan Afr Med J 2014; 18:110. [PMID: 25404970 PMCID: PMC4232099 DOI: 10.11604/pamj.2014.18.110.2247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 09/29/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Fahd Derkaoui Hassani
- Service de Neurochirurgie, Hôpital Ibn Sina, CHU Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V - Souissi
| | - Nizare El Fatemi
- Service de Neurochirurgie, Hôpital Ibn Sina, CHU Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V - Souissi
| | - Faycal Moufid
- Service de Neurochirurgie de l'Hôpital Farabi, CHU Oujda, Faculté de Médecine de Oujda, Université Mohammed le premier
| | - Mohammed YassadOudrhiri
- Service de Neurochirurgie, Hôpital Ibn Sina, CHU Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V - Souissi
| | - Rachid Gana
- Service de Neurochirurgie, Hôpital Ibn Sina, CHU Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V - Souissi
| | - Rachid El Maaqili
- Service de Neurochirurgie, Hôpital Ibn Sina, CHU Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V - Souissi
| | - Fouad Bellakhdar
- Service de Neurochirurgie, Hôpital Ibn Sina, CHU Rabat, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V - Souissi
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27
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Cocquempot K, Javaudin O, Lerasle P, Aigle L. [Noma in a 4 year-old girl: a case report from Chad]. Med Sante Trop 2014; 24:99-104. [PMID: 24736219 DOI: 10.1684/mst.2014.0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This case report describes a 4-year-old girl in Chad with noma, also called cancrum oris. This acute gangrenous stomatitis has a combined morbidity-mortality rate that can reach 70%. It occurs worldwide but is most common in sub-Saharan Africa in children aged 2 to 16 years. Its pathogenesis is uncertain, but several bacteria including Fusobacterium necrophorum, Prevotella intermedia and Pseudomonas aeruginosa may be responsible for the development of noma, which develops over the oral lesions these bacteria cause. Poverty is its most important risk factor. Due to its rapid course and high lethality, it requires emergency treatment with antibiotics, daily dressing of the lesion, and nutritional rehabilitation. Surgical removal of the remaining necrotic tissue can be followed by reconstructive procedures. Physical and speech therapy should be initiated to prevent functional complications.
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Affiliation(s)
- K Cocquempot
- Service médical base aérienne 113, BP 52, 52113 Saint-Dizier Cedex
| | - O Javaudin
- Institut de recherche biomédicale des armées, Brétigny-sur-Orge
| | - P Lerasle
- Service de biologie, hôpital d'instruction des armées Sainte-Anne, Toulon
| | - L Aigle
- CMA de Calvi, 2e REP, Calvi (Corse)
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28
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Augusto JF, Sayegh J, Croue A, Subra JF, Onno C. Renal transplant malakoplakia: case report and review of the literature. Clin Kidney J 2008; 1:340-3. [PMID: 25983929 PMCID: PMC4421262 DOI: 10.1093/ndtplus/sfn028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 02/21/2008] [Indexed: 12/05/2022] Open
Affiliation(s)
| | - Johnny Sayegh
- Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, F-49933
| | - Anne Croue
- Département de Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, F-49933 , France
| | | | - Céline Onno
- Service de Néphrologie-Dialyse-Transplantation, CHU Angers, Angers, F-49933
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