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Non-gonococcal urethritis/cervicitis (NGU) is now the most common sexually transmitted infection that is possible to treat. Mycoplasma genitalium is a microorganism about to be established as an aetiological agent of NGU and upper genital infection.
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This study assessed the characteristics of pathogens identified in clinical isolates from patients with urinary tract infection (UTI) and their in vitro sensitivity to commonly used antibiotics in the clinical setting in China.
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There are various approaches to control trachoma. These include the elimination of the ocular strains of Chlamydia trachomatis that cause the disease and to decrease the spread of infection by other measures such as fly control. Here, we examined how these two are related (i.e., how treating children with antibiotics affects carriage of Chlamydia by flies). Flies were collected in villages that had received mass oral azithromycin distribution and were compared with flies in untreated villages. Polymerase chain reaction (PCR) was performed to detect chlamydial DNA on the flies. Conjunctival swabs were also taken to assay for chlamydial prevalence in the children. Chlamydia was found on 23% of the flies in the untreated villages but only 0.3% in treated villages. Prevalence of trachoma in children proved to be an excellent predictor of the prevalence on flies (correlation coefficient, 0.89). Thus, treating children with antibiotics may drastically reduce the role of flies as a vector.
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In Japan, The Mycobacteriosis Research Group at the Japanese National Chest Hospitals has continuously made the clinico-epidemiological study of nontuberculous mycobacteriosis (NTM) since early 1970s. The prevalence rate was determined as 0.82, 0.91, 1.22, 1.74 and 2.43 per 100,000 population per year in 1971, 1975, 1980, 1985 and in 1990 respectively. The newest datum in 1997 was 3.52. These data indicates the prevalence rate has continuously increased and became 3.8 times than 25 years ago. While on the other hand, the prevalence rate of lung tuberculosis has decreased from 133.1 to 15.2, becoming one nines in the same period. The numbers of newly detected patients of lung mycobacteriosis in 1996 were also studied at 12 hospitals in Kinki district. The rate of NTM was 16.6% in 4 sanatorium hospitals, being about the same to the datum of The Mycobacteriosis Research Group. The rate of NTM in 8 general hospitals was surprisingly high, 40.0%. The 70% of NTM patients were infected with Mycobacterium avium complex (MAC). The 24% were with M. kansasii, and the only 6% were with other miscellaneous species. That is, the about one thirds or more of total NTM patients were female MAC desease patients, another one thirds or less were male MAC patients, and the more than 90% of M. kansasii patients (about one fourth of total patients) were male. These 3 groups took the most part of NTM patients. The rate of female MAC patients with small non-cavitary lesion without underlying diseases showed a tendency to increase, and the rate of male MAC patients with cavitary lesions with underlying lung or systemic diseases decreased. In 1997, American Thoracic Society (ATS) published the official statement about the diagnosis and treatment of NTM disease. The table-1 in that statement showed the new criteria for diagnosis of NTM pulmonary disease. It is useful for precise diagnosis of lung NTM disease, and the old criteria made by The Mycobacteriosis Research Group of the Japanese National Chest Hospitals is also useful for rough diagnosis. In the ATS statement, for adult HIV-negative MAC patients, minimum three drug regimen of clarithromycin (or azithromycin), rifabutin (or rifampin) and ethambutol, with intermittent streptomycin which is option for extensive disease, is recommended. This regimen is the same that most of the Japanese specialists for NTM disease recommended. The follow-up study of 47 Japanese MAC patients treated by the regimen contained clarithromycin with other anti-tuberculous drugs revealed that 80% of cases converted into bacilli negative and that the regimen had durable effect for at least 24 months. The resectional surgery may be considered for localized disease, and supportive nutritional treatment must also be considered for the MAC patients to whom the drug therapy was not effective, as if for the tuberculosis patients of multi-drug resistant.
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One hundred adult patients with acute sinusitis were included in an open, randomized study. Clinical diagnosis of sinusitis was confirmed by nasal endoscopy, sinus radiography, and (when possible) by culture of sinus aspirate. Patients were randomized to receive azithromycin (500 mg once daily for 3 days) or amoxicillin/clavulanate (625 mg every 8 hours for 10 days).
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Because of the recent resurgence of Group A streptococcal infections and their sequelae and to concerns about Group A streptococcal antimicrobial resistance, 282 isolates from acute pharyngitis and 43 additional isolates from severe, invasive infections were examined for susceptibility to 11 oral antibiotics. M serotypes 1, 2, 3, 4 and 12 accounted for more than one-half of the pharyngeal isolates; M serotypes 1 and 3 accounted for most isolates from severe infections. All 325 isolates were exquisitely susceptible to penicillin (Concentration of antibiotic required to inhibit 90% of isolates, 0.012 micrograms/ml). Only approximately 4% of the tested strains demonstrated an erythromycin minimum inhibitory concentration of 0.5 microgram/ml or greater; the new macrolides, azithromycin and clarithromycin, were similar. The cephalosporins varied somewhat in their ability to inhibit Group A streptococci, but all were effective in vitro. No major differences in minimum inhibitory concentrate were observed between strains associated with severe infections and those from uncomplicated upper respiratory tract infections. On the basis of the 325 isolates examined, we conclude that antimicrobial resistance has not been a factor in the recent resurgence of Group A infections.
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Our findings support the view that minocycline and azithromycin could be useful in many cases of toxoplasmosis. Clinical studies are needed to determinate the relative efficacy and safety of these antibiotics for the treatment of toxoplasmosis in humans.
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Concentrations and percent loadings of pharmaceutically active compounds (PhACs) and other emerging contaminants released from healthcare facilities (2 hospitals and a long-term care facility) to a sewage treatment plant (STP) in a large urban sewershed were evaluated. An additional hospital outside the sewershed was also monitored. Fourteen of the 24 steroids/hormones and 88 of the 117 PhACs and emerging contaminants were detected at least once. Commonly used substances, including cotinine, caffeine and its metabolite 1,7-dimethylxanthine, ibuprofen and naproxen (analgesics), venlafaxine (antidepressant), and N,N-diethyl-meta-toluamide (insect repellant), were detected in all samples at all sites. Concentrations detected in the large specialty hospital outside the sewershed were similar to those within the sewershed. Cytotoxic drugs (tamoxifen and cyclophosphamide) and x-ray contrast media (iopamidol and diatrizoic acid) were infrequently detected in hospital effluents. Analysis for antibiotics indicated that azithromycin, clarithromycin, ciprofloxacin, erythromycin, ofloxacin, and sulfamethoxazole were consistently detected in hospital wastewaters, as was triclosan (antibacterial agent). Fifteen compounds individually contributed greater than 1% to the total PhAC and emerging contaminant load to the STP from the 2 hospitals in the sewershed, and 9 compounds in the STP effluent exceeded ecotoxicological criteria. The present survey demonstrates that point source discharges from healthcare facilities in this sewershed make a small contribution to the overall PhAC and emerging contaminant loading compared with the total concentrations entering the receiving STP.
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To report and discuss a serious cutaneous adverse reaction in a child who was treated with acetaminophen (paracetamol).
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Pseudomonas aeruginosa is an opportunistic pathogen and a leading cause of nosocomial infections. Unfortunately, P. aeruginosa has low antibiotic susceptibility due to several chromosomally encoded antibiotic resistance genes. Hence, we carried out mechanistic studies to determine how azithromycin affects quorum sensing and virulence in P. aeruginosa. lasI and rhlI single and double mutants were constructed. We then undertook a quantitative approach to determine the optimal concentration of azithromycin and culture time that can affect the expression of HSLs. Furthermore, based on the above results, the effect on quorum sensing was analyzed at a transcriptional level. It was found that 2 μg/mL azithromycin caused a 79% decrease in 3-oxo-C12-HSL secretion during cultivation, while C4-HSL secretion was strongly repressed in the early stages. Azithromycin acts on ribosomes; to determine whether this can elicit alternative modes of gene expression, transcriptional regulation of representative virulence genes was analyzed. We propose a new relationship for lasI and rhlI: lasI acts as a cell density sensor, and rhlI functions as a fine-tuning mechanism for coordination between different quorum sensing systems.