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Frequent antibiotic prescriptions for urinary infections (UI) promote the development and spread of antibiotic resistance. In order to identify effective antibiotics for the first line treatment of UI at the Galaţi Infectious Diseases Hospital, we performed a retrospective study based on disk diffusion antibiotic sensitivity testing on bacterial strains from urine cultures. Urine samples were collected from hospitalized patients admitted with symptomatic UI during 2010. In total, 659 records were found of certified bacteriological UI, of which 82% were caused by Enterobacteriacea. Escherichia coli isolates were the most commonly encountered species of Enterobacteriaceae (83%). The median age of the patients with urinary E. coli was 48 [3; 87], sex ratio M/F= 56/399 and 9.8% of patients were HIV positive. Using the Carmeli scoring system for antibiotic resistance risk, we found that 86% of the E. coli isolates were community acquired infections. High level of resistance was evident for Ampiciline at 85%, Neoxazole at 54,6%, TMP-SMX at 45,6% and AmoxiClavulanate at 40,2%. The best sensitivity was obtained with 3rd generation cephalosporins and carbapenemes. The incidence of ESBL-positive strains was 7.4% (34/421). No ESBLpositive strain was identified in community acquired UI (Carmeli score 1). In conclusion, it is strongly recommended that the first line of antibiotic therapy at the Gala ţi Infectious Diseases Hospital should involve 3rd generation cephalosporins, while carbapenems should be reserved to patients with a Carmeli score of 2 or 3.
Nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels present in many regions of the central nervous system (CNS) and the peripheral nervous system. The neuronal nicotinic acetylcholine receptors, being situated at the level of different neurotransmission pathways, participate in the function of many cerebral activities.
Palliative procedures are those usually used in the treatment of metastatic limb sarcoma. However given the impressive results obtained with hyperthermic isolated limb perfusion (ILP), we tested the feasibility of isolated lung perfusion (ILuP), using the same regimen. Three patients with multiple metastases from limb sarcoma were included in this study.Newsflash
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