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Travellers' diarrhoea (TD) is a condition affecting a large number of persons going to Africa, Asia or Latin America. The aetiology varies but is dominated by bacterial enteropathogens. Clinically TD is a self-limiting disease but a considerable proportion of those afflicted become incapacitated for one day or longer. Antibiotic prophylaxis of TD has been proven to be effective in trials comparing doxycycline, trimethoprim, co-trimoxazole, mecillinam, ciprofloxacin or norfloxacin to placebo. With all of those except ciprofloxacin and norfloxacin, selection of resistant Enterobacteriaceae in the faecal flora has been a major problem. In addition, co-trimoxazole has been found to cause high frequencies of adverse reactions. It is quite clear that, to avoid overuse of antibiotics and unnecessary side effects, prophylaxis of TD must be restricted to risk groups, e.g. patients with immunodeficiencies, reduced gastric acidity, inflammatory bowel diseases or serious diseases which may be worsened by TD. In other individuals going to areas with high incidences of TD short-term self-treatment seems to be a better alternative to prophylaxis. Both for prophylaxis and self-treatment, a fluoroquinolone with documented activity against TD seems to be well advised.
The risk of urinary tract infection in diabetic patients is higher and the etiology and the antibiotic resistance of uropathogens have been changing over the past years.
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A fluoroquinolone-susceptible strain was exposed to norfloxacin in vitro. Selected mutants were sequentially exposed to norfloxacin, and this procedure was repeated. For 11 mutants, minimum inhibitory concentrations (MICs) of antimicrobial agents were determined, and mutations in the region corresponding to the quinolone resistance-determining region (QRDR) of the Escherichia coli gyrA gene and the analogous region of the parC gene were analyzed.
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Ciprofloxacin is a new 6-fluoro-7-piperazino-4-quinolone that is highly active against a broad array of microbial pathogens. Minimal inhibitory concentrations (MICs) of ciprofloxacin are generally below 0.5 micrograms/ml for Hemophilus, Neisseria, and Enterobacteriaceae and are 1.0 microgram/ml or less for many non-fermentative gram-negative bacteria. Most staphylococci, including strains resistant to methicillin, are inhibited by 1.0 microgram/ml or less of ciprofloxacin, whereas streptococci are somewhat less susceptible. Obligate anaerobes are generally not susceptible to ciprofloxacin at concentrations below 1.0 microgram/ml. The antimicrobial potency of ciprofloxacin is twofold to fourfold greater than that of norfloxacin and is considerably greater than that of cephalosporins and aminoglycosides in tests with most gram-negative bacteria. Factors diminishing the in vitro activity of ciprofloxacin include acidic pH, high levels of magnesium ions, and an inoculum size of 10(7) colony-forming units/ml or greater. Ciprofloxacin is bactericidal at concentrations near its MIC for most bacteria. In vivo tests with experimentally induced infections in animals confirm the potency of ciprofloxacin. Doses required to protect 50 percent of animals from death are generally less than 2.0 mg/kg for gram-negative infections and range from 0.7 to 7.0 mg/kg for staphylococcal infections. The antimicrobial spectrum and potency of ciprofloxacin demonstrated in these preclinical studies make this quinolone a promising new antimicrobial agent.
Clerodane diterpene 16α-hydroxycleroda-3,13(14)-Z-dien-15,16-olide (CD) from leaves of Polyalthia longifolia (Sonn.) Thwaites (Annonaceae) as RAM will be useful in improving the current treatment strategies for staphylococcal infections.
A process involving the use of membrane bioreactor seeded with aerobic granular sludge (GMBR) was applied to the treatment of sewage containing pharmaceuticals and personal care products (PPCPs). The removal effects of five kinds of medicines in the reactor were investigated, and the microbial communities were constructed by polymerase chain reaction and denaturing gradient gel electrophoresis. We also determined the effects of different sludge retention and hydraulic retention times (SRT and HRT, respectively) and influent organic loading on GMBR's efficiency in processing sewage containing PPCPs. The removal effects of the GMBR on five PPCPs varied. Using the GMBR, the removal rates of prednisolone, naproxen and norfloxacin were 98.56, 84.02 and 87.85%, respectively. The removal rates of sulfamethoxazole and ibuprofen were 77.83 and 63.32%, respectively. In the system, PPCP drugs had relatively less effect on microbial diversity. A certain succession was observed in the structural variation of microbial species in the GMBR. Microorganisms that can degrade PPCPs gradually accumulated, and antibiotic-resistant microorganisms, such as Firmicutes sp., Aeromonas sp. and Nitrospira sp., served a key function in the treatment of sewage containing antibiotics. Long SRT and HRT during the GMBR process can facilitate the removal of most PPCPs. The system efficiently removed PPCPs at high influent organic loading.
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The minimum inhibitory concentrations (MICs) of 15 chemotherapeutic agents were tested against 146 Lactococcus garvieae strains isolated from 1999 to 2006 in Japan. The agents used included chloramphenicol, ciprofloxacin, erythromycin (EM), enoxacin, fleroxacin, florfenicol, kanamycin, lincomycin (LCM), norfloxacin, oxolinic acid, orbifloxacin, ofloxacin, benzylpenicillin, streptomycin and tetracycline (TC). Of the tested strains, 46 showed high levels of resistance to EM, LCM and TC. Twelve of these strains were detected to be carrying transferable R-plasmids using a conjugation experiment and, using Southern hybridization, were shown to have the same structure as the R-plasmid. The remaining 34 resistant strains had a similar DNA structure to that of the R-plasmid as confirmed by polymerase chain reaction (PCR) using primers designed from sites in the transferable R-plasmid. The EM and TC resistance genes were classified into the ermB and tetS groups using PCR. We also detected gyrA and/or parC mutants that are highly resistant to old and new generation quinolones. This study revealed that transferable R-plasmids encoding EM, LCM and TC are widely distributed and are conserved regardless of the area and/or time of collection.
The present study was conducted to detect aerobic causative agents of urinary tract infection (UTI) and their antibiogram pattern. This study was carried out in the Department of Microbiology, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India. A total of 1,109 clean catched midstream urine samples were collected, out of which 459 (40.4%) samples grew potential pathogens causing UTI. Escherichia coli were the predominant 334 (72.8%) bacterial pathogen followed by Klebsiella species 66 (14.4%), non lactose fermenters 19 (4.1%), Pseudomonas species 16 (3.5%) and others. Most of the strains of E. coli were resistance to Ciprofloxacin whereas sensitive to Aminoglycoside. Most of the urinary isolates showed high degree of resistance to Tetracycline, Norfloxacin and Cotrimoxazole. Gentamycin was the drug of choice for most of the strains.