Antibiotic Resistance Is Selected Primarily in Our Patients

The potential for bacterial resistance probably existed prior to the arrival of humans on earth and bacterial populations isolated before the antibiotic era surely contained antibiotic-resistant organisms. Antibiotic resistance has undergone an explosive development following the introduction of antibiotics in medical practice and in agriculture, and there is no doubt that the higher prevalence of bacterial resistance is closely related to human activities. Strict infection control policies limit the risk of patient-to-patient transmission of resistant as well as susceptible bacteri

Treatment failures of cefotaxime and latamoxef in meningitis caused by Enterobacter and Serratia spp

Despite the apparent success of several new cephalosporins in the treatment of Gram-negative bacterial meningitis, four treatment failures with cefotaxime or latamoxef were encountered (two caused by Enterobacter and two by Serratia spp.). In-vitro parameters of susceptibility of these clinical isolates were compared with those of a meningeal Ent. cloacae isolate from a successfully treated patient. The MIC and MBC values, degrees of inoculum effect, and amounts of β-lactamase produced correlated poorly with the observed clinical outcome. However, the extent to which an isolate was killed by the cephalosporin used for treatment, in a 6-h in-vitro incubation, showed good correlation. We suggest that such a test should be used to predict clinical outcome of therapy because the other parameters such as the MIC and MBC values are not sufficiently discriminator

The Relationship Between Influenza Vaccine-Induced Specific Antibody Responses and Vaccine-Induced Nonspecific Autoantibody Responses in Healthy Older Women

The effect of aging on human humoral immunity was investigated by studying in vivo the relationship between influenza specific antibody responses and nonspecific vaccine-induced autoantibody responses in 32 independent, well-nourished older women volunteers (mean age 86 yr, range 74-97) and 23 young women volunteers (mean age 34 yr, range 23-46). Anti-influenza A/Taiwan/I/86(HINI) antibody titers were determined by a hemagglutination inhibition test (HI-test), and serum anti-dsDNA antibodies were measured by ELISA prior to, 15, and 30 days after influenza vaccination. The mean postvaccination fold increase (FI) of the anti-influenza antibody response was significantly lower in elderly individuals as compared to younger individuals. In contrast, the mean anti-dsDNA autoantibody level measured 30 days after vaccination was significantly increased in older volunteers as compared to younger ones. There was a significant negative correlation between the level of the FI of the anti-influenza antibody response and the anti-dsDNA antibody response (r =−.441, p < .01). Our results suggest that the altered influenza specific antibody response was associated with an age-related increase in autoimmunity in aging individual

Effects of the peroxisome proliferator-activated receptor (PPAR)-γ agonist pioglitazone on renal and hormonal responses to salt in diabetic and hypertensive individuals

Aims/hypothesis: Glitazones are powerful insulin sensitisers prescribed for the treatment of type 2 diabetes. Their use is, however, associated with fluid retention and an increased risk of congestive heart failure. We previously demonstrated that pioglitazone increases proximal sodium reabsorption in healthy volunteers. This study examines the effects of pioglitazone on renal sodium handling in individuals prone to insulin resistance, i.e. those with diabetes and/or hypertension. Methods: In this double-blind randomised placebo-controlled four-way crossover study, we examined the effects of pioglitazone (45mg daily during 6weeks) or placebo on renal, systemic and hormonal responses to changes in sodium intake in 16 individuals, eight with type 2 diabetes and eight with hypertension. Results: Pioglitazone was associated with a rapid increase in body weight and an increase in diurnal proximal sodium reabsorption, without any change in renal haemodynamics or in the modulation of the renin-angiotensin aldosterone system to changes in salt intake. A compensatory increase in brain natriuretic peptide levels was observed. In spite of sodium retention, pioglitazone dissociated the blood-pressure response to salt and abolished salt sensitivity in salt-sensitive individuals. Conclusions/interpretation: Pioglitazone increases diurnal proximal sodium retention in diabetic and hypertensive individuals. These effects cause fluid retention and may contribute to the increased incidence of congestive heart failure with glitazones. Trial registration:: ClinicalTrial.gov NCT01090752 Funding:: Hypertension Research Foundation Lausann

CARP MYOGENS OF WHITE AND RED MUSCLES. GROSS ISOLATION ON SEPHADEX COLUMNS OF THE LOW-MOLECULAR-WEIGHT COMPONENTS AND EXAMINATION OF THEIR PARTICIPATION IN ANAEROBIC GLYCOGENOLYSIS

1. The combined low-molecular-weight protein components of the myogens from carp white and red muscles [about 30% (w/w) of the myogen proteins] have been isolated by gel filtration on Sephadex G-75 columns. 2. The presence in this fraction from myogen of white muscle of the three main electrophoretic components previously isolated has been confirmed, and the low molecular weight of the fourth component has been definitely established. 3. The exclusive presence of this fourth component in the myogen of red muscle, apart from myoglobin, has also been demonstrated. 4. Glycogenolysis experiments in vitro have shown that the low-molecular-weight protein fraction from carp myogen does not contain enzymes from the Embden–Meyerhof chain

Female sex hormones, salt, and blood pressure regulation

There are gender-associated differences in blood pressure (BP) in humans, with men having higher BP than age-matched pre-menopausal women and being at greater risk for cardiovascular and renal diseases. The mechanisms responsible for the gender differences in BP control and regulation are not clear, although there is some evidence that interactions between sex hormones and the kidneys could play a role. However, the response to salt in pre- and post-menopausal women, and in particular the influence of exogenous and endogenous female sex hormones on renal hemodynamics and tubular segmental sodium handling, have been poorly investigated. Recently we have shown that both endogenous and exogenous female sex hormones markedly influence the systemic and renal hemodynamic response to salt. We have found that BP in young normotensive women, regardless of oral contraceptive use, is rather insensitive to salt. However, the renal hemodynamic and the tubular responses to salt vary significantly during the normal menstrual cycle and with the administration of oral contraceptives. Furthermore, after the menopause, BP tends to become salt sensitive, a pattern that could be due to aging as well as to the modification of the sex hormone profile. These observations provide new insights pertaining to potential mechanisms explaining the lower incidence of cardiovascular disease and progression of renal disease in pre-menopausal women (which tend to disappear with the menopause); these observations also emphasize the importance of considering more carefully the phase of the menstrual cycle whenever conducting physiologic studies in women and enrolling women in clinical studies. Finally, increased salt sensitivity in menopausal women strongly encourages the use of diuretics

Persistence of Resistant Staphylococcus epidermidis after Single Course of Clarithromycin

Short course of antimicrobial therapy can select resistant bacteria that persist for 4 years or longer

The Impact of Membrane Lipid Composition on Macrophage Activation in the Immune Defense against Rhodococcus equi and Pseudomonas aeruginosa

Nutritional fatty acids are known to have an impact on membrane lipid composition of body cells, including cells of the immune system, thus providing a link between dietary fatty acid uptake, inflammation and immunity. In this study we reveal the significance of macrophage membrane lipid composition on gene expression and cytokine synthesis thereby highlighting signal transduction processes, macrophage activation as well as macrophage defense mechanisms. Using RAW264.7 macrophages as a model system, we identified polyunsaturated fatty acids (PUFA) of both the n-3 and the n-6 family to down-regulate the synthesis of: (i) the pro-inflammatory cytokines IL-1β, IL-6 and TNF-α; (ii) the co-stimulatory molecule CD86; as well as (iii) the antimicrobial polypeptide lysozyme. The action of the fatty acids partially depended on the activation status of the macrophages. It is particularly important to note that the anti-inflammatory action of the PUFA could also be seen in case of infection of RAW264.7 with viable microorganisms of the genera R. equi and P. aeruginosa. In summary, our data provide strong evidence that PUFA from both the n-3 and the n-6 family down-regulate inflammation processes in context of chronic infections caused by persistent pathogens