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A 4-year-old child with no prior medical history was referred for two painless ulcerative cutaneous nodules. Incubation of samples from the edges of these lesions revealed the presence of acid-alcohol resistant bacilli (AARB), which were shown by PCR to be M. ulcerans, the causative agent in BU. Treatment consisted of levofloxacin (100mg/d) and rifampicin (150mg/d) for 8weeks. After 7days of medical treatment, seven painless nodules appeared on the patient's scalp. Further PCR for these lesions confirmed the presence of M. ulcerans. The same medical therapy was maintained and after 54days of treatment, all lesions had been healed.
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Variation of resistant degree among wards were very obvious and large. We could survey the wards where patient-to-patient transmission of resistant organisms might occur along the moving lines of inpatients. WHONET 5 will be recognized as an analysis and surveillance tool for every infection control team to survey the suspicious wards.
Therapeutic conclusions for staphylococcal implant infections treated with debridement and implant retention can only be drawn from a small series. To this aim, data from patients with implant staphylococcal infections (1998-2006) treated with debridement and implant retention were retrospectively reviewed. Infections were defined by staphylococci isolation (two or more consecutive debridement or three sinus tract discharge samples) along with clinical criteria. Patients received oral levofloxacin plus rifampicin for >or=6 weeks after the resolution of signs/symptoms and C-reactive protein normalisation. Failure was defined as lack of response or recurrence of signs/symptoms and/or sinus tract bacterial isolation during therapy or follow-up and/or implant removal. Twenty-five patients (53.2+/-20.8 years; 48% males) were included, 12 with spinal infections and 13 with limb implant infections. Diagnosis was performed from debridement material (72%) and sinus tract discharge (28%) (11 Staphylococcus aureus and 14 coagulase-negative staphylococci (CoNS)). Time from surgery to symptom onset was higher in CoNS infections compared with S. aureus infections (21.6+/-9.3 days vs. 12.6+/-5.2 days; P=0.007). Seven patients (28%) were failures, with no differences between cured patients with respect to age, sex, infection site, time from surgery to symptom onset, sinus tract diagnosis and aetiology. Longer symptom duration prior to attendance was observed in failures (5.7+/-6.2 months vs. 1.4+/-0.6 months; P=0.04). Levofloxacin plus rifampicin showed efficacy in implant infections, which was higher for short duration of symptoms.
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Aerococcus viridans organisms are gram-positive, usually airborne cocci that are widely distributed in hospital environments. These bacteria have infrequently been encountered as a human pathogen causing bacteremia, endocarditis and urinary tract infections. The clinical significance of these bacteria may be overlooked due to their fastidious growth and often confused with other strains of streptococci.
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The in vitro activity of gemifloxacin (SB-265805) was compared with that of other fluoroquinolones against 302 clinical isolates of Streptococcus pneumoniae, 300 clinical isolates of Haemophilus influenzae and 28 clinical isolates of Moraxella catarrhalis, including multiply resistant strains. Gemifloxacin at 0.12 mg/L inhibited all microorganisms tested. MIC(90) values of gemifloxacin, trovafloxacin, grepafloxacin and levofloxacin against all (630) isolates tested were 0.03, 0.12, 0.12 and 1 mg/L, respectively. MIC(90) values of the same fluoroquinolones against S. pneumoniae were 0.06, 0.25, 0.12 and 1 mg/L, respectively.
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We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment for MRSA infections at any body site? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
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To evaluate the different efficacy and safety to the treatment of bacterial conjunctivitis between the fluoroquinolone antibiotics gatifloxacin and levofloxacin.
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All levofloxacin-resistant isolates were ciprofloxacin resistant (MIC > or = 4 mg/l, FDA breakpoint) and non-susceptible to gatifloxacin (MIC > or = 2 mg/l); 62 were non-susceptible to moxifloxacin (MIC > or = 2 mg/l). Resistant isolates were in 48 (20%) of 238 institutions in 29 states. Three institutions had levofloxacin-resistant isolates in both surveillance studies. Among the resistant isolates were 17 serotypes and 48 different PFGE patterns. Fourteen isolates had PFGE patterns closely related to the Spain(23F)-1 clone; one strain had a PFGE pattern closely related to the French(9V)-3 clone. All levofloxacin-resistant isolates had two or more mutations within the QRDR of parC, parE, gyrA and gyrB.
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A 71-year-old Caucasian woman was admitted to the hospital with right-sided weakness and slurred speech. Glioblastoma multiforme was diagnosed, and resection of the tumor was performed. During the patient's hospitalization, blood and urine cultures were obtained after her temperature rose to 103.3 degrees F. Four blood cultures revealed Klebsiella rhinoscleromatis sensitive to trimethoprim-sulfamethoxazole, levofloxacin, cefazolin, gentamicin, and tetracycline, but resistant to ampicillin. The patient had no recent history of foreign travel. After a 3-week course with levofloxacin, the patient was afebrile, and repeat blood cultures were negative. To our knowledge, this was the first case of K. rhinoscleromatis bacteremia in the United States to be treated successfully with levofloxacin.
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To report five cases with a probable interaction between acenocoumarol and levofloxacin.