Bacterial infections

Harrison's Internal Medicine Chapter 127. Treatment and Prophylaxis of Bacterial Infections Treatment and Prophylaxis of Bacterial Infections: Introduction The development of vaccines and drugs that prevent and cure bacterial infections was one of the twentieth century's major contributions to human longevity and quality of life. Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide. Used appropriately, these drugs are lifesaving.

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Duration of Therapy and Treatment Failure Until recently, there was little incentive to establish the most appropriate duration of treatment; patients were instructed to take a 7- or 10-day course of treatment for most common infections. A number of recent investigations have evaluated shorter durations of therapy, especially in patients with communityacquired pneumonia. Table 127-10 lists common bacterial infections for which treatment duration guidelines have been established or for which there is sufficient clinical experience to establish treatment durations.

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Status of the Host Various host factors must be considered in the devising of antibacterial chemotherapy. The host's antibacterial immune function is of importance, particularly as it relates to opsonophagocytic function. Since the major host defense against acute, overwhelming bacterial infection is the polymorphonuclear leukocyte, patients with neutropenia must be treated aggressively and empirically with bactericidal drugs for suspected infection (Chap. 82). Likewise, patients who have deficient humoral immunity (e.g.

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Bacterial infections and antibiogram in device associated infections in MICU, ICU of hospital. The study was carried during the period of Jan 2017 to Dec 2017 in Bacteriology section department of Microbiology in Government Medical College and hospital Aurangabad. 530 samples received from patients of ICU and MICU of hospital for culture and sensitivity. Out of which 330/530 (62%) samples were from endotracheal secretions suspected of pneumonia and 90/530 (17%) were Urine samples and 75/530 (14%) were blood samples. Samples were processed identified by different biochemical reactions.

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Serious bacterial infections (SBI) are a significant cause of mortality worldwide. Parental concern and clinician’s gut feeling that there is something wrong has been associated with increased likelihood of developing SBI in primary care studies.

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Infectious diseases in children living in resource-limited settings are often presumptively managed on the basis of clinical signs and symptoms. Malaria is an exception. However, the interpretation of clinical signs and symptoms in relation to bacterial infections is often challenging, which may lead to an over prescription of antibiotics when a malaria infection is excluded.

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Prevalence and pathomorphology of bacterial infection of the liver and kidneys was studied in swine population from postmortem carcasses of pigs in the Department of Veterinary Pathology, College of Veterinary science, Assam Agricultural University (AAU), Khanapara, Guwahati-22.A total of 21(48.8%) liver and 9(20.9%) kidney samples were found to be positive for the presence of bacterial infection out of 43 samples examined during the study. Bacteria isolated were mainly Streptococcus spp. (10.5%), Staphylococcus spp. (6.97%), Micrococcus spp. (1.16%), E. coli (11.6%), Klebsiella spp. (2.

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Bacterial infection of the bronchial tree is common in persistent preschool wheezers and provides a possible explanation for non response to ICS therapy. Non-typeable H. influenzae seems to be the predominant pathogen involved, followed by S. pneumoniae and M. catarrhalis.

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C-reactive protein (CRP) is widely used to detect bacterial infection in children. We investigated the impact of CRP test results on decision-making and summarized the evidence base (EB) of CRP testing.

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Globally, possible serious bacterial infection [PSBI] is a cause for about 600,000 newborn deaths per year. To decrease the burden of this infection, a community-based management newborn PSBI when referral to hospital is not possible has been on implementation. Studies showed gaps in the service utilization and this study was aimed at exploring its barriers and facilitators.

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Site of Infection The location of the infected site may play a major role in the choice and dose of antimicrobial drug. Patients with suspected meningitis should receive drugs that can cross the blood-CSF barrier; in addition, because of the relative paucity of phagocytes and opsonins at the site of infection, the agents should be bactericidal. Chloramphenicol, an older drug but occasionally useful in the treatment of meningitis, is bactericidal for common organisms causing meningitis (i.e.

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Principles of Antibacterial Chemotherapy The choice of an antibacterial compound for a particular patient and a specific infection involves more than just a knowledge of the agent's pharmacokinetic profile and in vitro activity.

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Adverse Reactions Adverse drug reactions are frequently classified by mechanism as either dose-related ("toxic") or unpredictable. Unpredictable reactions are either idiosyncratic or allergic. Dose-related reactions include aminoglycoside-induced nephrotoxicity, linezolid-induced thrombocytopenia, penicillin-induced seizures, and vancomycin-induced anaphylactoid reactions. Many of these reactions can be avoided by reducing dosage in patients with impaired renal function, limiting the duration of therapy, or reducing the rate of administration.

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Inhibition of Cell-Wall Synthesis One major difference between bacterial and mammalian cells is the presence in bacteria of a rigid wall external to the cell membrane. The wall protects bacterial cells from osmotic rupture, which would result from the cell's usual marked hyperosmolarity (by up to 20 atm) relative to the host environment. The structure conferring cell-wall rigidity and resistance to osmotic lysis in both gram-positive and gram-negative bacteria is peptidoglycan, a large, covalently linked sacculus that surrounds the bacterium.

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Inhibition of Protein Synthesis Most of the antibacterial agents that inhibit protein synthesis interact with the bacterial ribosome. The difference between the composition of bacterial and mammalian ribosomes gives these compounds their selectivity. Aminoglycosides Aminoglycosides (gentamicin, kanamycin, tobramycin, streptomycin, neomycin, and amikacin) are a group of structurally related compounds containing three linked hexose sugars. They exert a bactericidal effect by binding irreversibly to the 30S subunit of the bacterial ribosome and blocking initiation of protein synthesis.

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Distribution To be effective, concentrations of an antibacterial agent must exceed the pathogen's MIC. Serum antibiotic concentrations usually exceed the MIC for susceptible bacteria, but since most infections are extravascular, the antibiotic must also distribute to the site of the infection. Concentrations of most antibacterial agents in interstitial fluid are similar to free-drug concentrations in serum.

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(BQ) Part 1 of the document Transplant infections presents the following contents: Introduction to transplant infections, risks and epidemiology of infections after transplantation, specific sites of infection, bacterial infections.

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The primary objective of this study was to report on the diagnostic accuracy of point-of-care testing (POCT) for procalcitonin (PCT) in identifying invasive bacterial infections in young infants. Invasive bacterial infection was defined as the isolation of a bacterial pathogen in blood or cerebrospinal fluid culture.

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Skin infections are most common in dogs, especially pugs are more prone due to its folded skin nature. A Pug of 3 years age weighing around 10 kgwas brought to the Veterinary Clinical Complex, Rajendranagar, Hyderabad with the complaint of alopecia, pruritus, decrease in the appetite and erythematous lesions all over the body. Detailed clinical examination revealed mild increase in temperature (102.50 F) and normal heart rate, pulse and respirations. Skin scrapings and bacterial cultural examination revealed mixed infection of Demodicosis and Staphylococcal pyoderma.

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Neonatal sepsis still remains a significant cause of morbidity and mortality in the newborn, particularly in preterm, low birth weight infants. Despite advances in neonatal care, overall case-fatality rates from sepsis may be as high as 50%. Clinical signs of bacterial infection are vague and non-specific, and up to now there exists no easily available, reliable marker of infection despite a large bulk of studies focussing on inflammatory indices in neonatology. Every neonatologist is faced with the uncertainty of under- or over- diagnosing bacterial infection.

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