The Antibiotic Susceptibility Patterns of Uropathogenic Escherichia Coli, With Special Reference to the Fluoroquinolones.

The antibiotic susceptibility patterns of uropathogenic Escherichia coli, with special reference to the fluoroquinolones.

J Clin Diagn Res. 2013 Jun; 7(6): 1027-30
Shariff V A AR, Shenoy M S, Yadav T, M R

Context: The emergence of drug resistance to trimethoprim-sulfamethoxazole, the penicillins, cephalosporins, and fluoroquinolones by Uropathogenic Escherichia coli (UPEC) has limited the options for selecting the appropriate antibiotic for the treatment of urinary tract infections. Aims: The The E. coli isolates, which were obtained from the culture of urine samples,were studied for their antibiotic resistance patterns, with special reference to the antimicrobial activity of the fluoroquinolones and the production of the extended spectrum ?-lactamases. (ESBL), Settings and Design: This was a hospital based, prospective study which was done for a period of eighteen months. Material and Methods: This study was done by using the standard culture techniques for urine samples, the modified Kirby-Bauer disk diffusion method for the antibiotic susceptibility testing and the disk diffusion method to confirm the ESBL production by the clinical isolates of E. coli in urine. The sensitivity pattern was correlated with the clinical condition and the presence of the risk factors. The statistical analysis which was used: The statistical analysis was done by using the proportions of sensitive, resistant and intermediates. Descriptive statistics like the total, mean and percentage were done by using the Statistical Package for the Social Sciences (SPSS), version 15.0. Results: The hospital isolates showed high degrees of resistance to the penicillins, cephalosporins, nalidixic acid and the fluoroquinolones, with 59% of the isolates being ESBL producers. Conclusions: The incidence of the multidrug resistant strains of Escherichia coli has been steadily increasing over the past few years. The knowledge on the resistance pattern of the bacterial strains in a geographical area will help in guiding the appropriate and the judicious use of antibiotics. Also, the formulation of an appropriate hospital antibiotic policy will go a long way in controlling these infections. HubMed – drug

The microbial colonization profile of respiratory devices and the significance of the role of disinfection: a blinded study.

J Clin Diagn Res. 2013 Jun; 7(6): 1021-6
Jadhav S, Sahasrabudhe T, Kalley V, Gandham N

Introduction: Approximately 10-40% of all the nosocomial infections are pulmonary, which lead to grave complications. Elderly, debilitated, or critically ill patients are at a high risk. The respiratory care equipments which include ventilators, humidifiers, nebulizers may have been identified as the potential vehicles which cause major nosocomial infections if they are colonized by fungi or bacteria. Aim: To determine the rate of colonization by bacteria and fungi of the oxygen humidifier chambers of the portable cylinders and central lines at our hospital. The Hudson’s chambers of nebulizers were also studied for the same. Methods: Swab samples were obtained from the equipments by using sterile cotton swabs on a tuesday, as these chambers were usually cleaned on every Saturday. Spot samples were taken from the ICUs, wards, the casualty and OPDs on a single day. Air samples were also obtained on the same day to determine whether the fungal spore load in the inhaled room air was normal or high. We performed a disinfection with 70% ethanol after cleaning these devices. Results: 53/70 (75.71%) samples showed fungal growth; out of which, 23/33 (69.70%) were from the ICU, 24/30(80%) were from the wards and 6/7 (85.71%) were from the OPDs. 23/30 (76.66%) swabs from the central line humidifiers, 18/23(78.26%) swabs from the O2 cylinder humidifiers and 8/17 (47.5%) swabs from the nebulizers grew bacteria. Of the total 61(87.14%) bacterial isolates, 42(68.85%) were gram negative bacteria and 19(31.14%) were gram positive cocci. Out of the 42 gram negative bacteria, 17 were multi-drug resistant like ESBL producers ie. Pseudomonas spp. (6) Acinetobacter spp.(4), Klebseilla pneumoniae (4), E.coli (2) and Stenotrophomonas maltophila (1). Our findings (before disinfection) showed that the colonization rate for fungi was 75% and that for bacteria, it was 87%. After the 70% ethanol disinfection and strict compliance with the hand hygiene, the colonization rates reduced significantly. The fungal colonization rate was reduced and only 15% fungi grew after the disinfection, while only 12% bacterial colonization rate was found. Conclusion: This study indicates a potential in-hospital source of allergens and infections. The oxygen and nebulizer chambers need to be cleaned more frequently with disinfectants, to control the possible nosocomial infections. HubMed – drug

Intravenous infusion of magnesium sulphate during subarachnoid anaesthesia in hip surgery and its effect on postoperative analgesia: our experience.

Transl Med UniSa. 2013 Jan; 5: 18-21
Pastore A, Lanna M, Lombardo N, Policastro C, Iacovazzo C

The treatment of degenerative hip joint disease involves modern operative techniques and the use of prosthetic devices individualized on each patient. Being a surgery of considerable importance, great attention is always given by the anaesthesiologist to postoperative analgesia. In general, our goal is to limit the doses of NSAIDs, known to be associated with haemostasis interference and alteration of gastrointestinal apparatus; component of our baseline analgesic protocols after arthroplasty is morphine given parenterally. In order to steadily improve analgesic techniques, which directly impact on patient outcome, we experimented the use of a continuous infusion of magnesium sulphate during subarachnoid anaesthesia. Magnesium sulphate is the drug of choice in case of eclampsia, and pre-eclampsia (for the risk of evolution in eclampsia). According to the most recent findings, this drug has also analgesic properties: its use as an adjunct to analgesia is based on a non-competitive antagonism towards the NMDA receptor and on the blocking of calcium channels: these properties prevent the mechanisms of central sensitization due to nociceptive stimulation of peripheral nerves. HubMed – drug

1,4-dihydropyridines: the multiple personalities of a blockbuster drug family.

Transl Med UniSa. 2012 Sep; 4: 12-26
Cataldi M, Bruno F

More than 40 years after their introduction in therapy, 1,4-dihydropyridines (DHPs) are still amongst the most prescribed drugs in the world. Though they all share a similar mechanism of action blocking L-type voltage-gated Ca(2+) channels, DHPs differ in crucial pharmacological properties like tissue selectivity and cardiodepressant activity. This review examines how changes in the DHP structure can modify the pharmacological properties of these drugs and how some of these chemical manipulations have been exploited to obtain clinically more effective molecules. Special emphasis is given to the evidence that L-type Ca(2+) channels are an heterogeneous family and that DHPs with different pharmacological properties differ in their affinity for the different isoforms of this class of channels. Data showing that DHP pharmacological heterogeneity could be in part dependent on the interaction of some of these molecules with ion channels different from the L-type Ca(2+) channels is reviewed as well. HubMed – drug

Drug and Alcohol Treatment at Duffy’s in Napa Valley, CA
Guests and counselors discuss treatment at Duffy’s Napa Valley Rehab. Andrew: The most important thing that I learned here was what I needed to do with the t…