Causative agent distribution and antibiotic therapy assessment among adult patients with community acquired pneumonia in Chinese urban population

<p>Abstract</p> <p>Background</p> <p>Knowledge of predominant microbial patterns in community-acquired pneumonia (CAP) constitutes the basis for initial decisions about empirical antimicrobial treatment, so a prospective study was performed during 2003–2004 among CAP of adult Chinese urban populations.</p> <p>Methods</p> <p>Qualified patients were enrolled and screened for bacterial, atypical, and viral pathogens by sputum and/or blood culturing, and by antibody seroconversion test. Antibiotic treatment and patient outcome were also assessed.</p> <p>Results</p> <p>Non-viral pathogens were found in 324/610 (53.1%) patients among whom <it>M. pneumoniae </it>was the most prevalent (126/610, 20.7%). Atypical pathogens were identified in 62/195 (31.8%) patients carrying bacterial pathogens. Respiratory viruses were identified in 35 (19%) of 184 randomly selected patients with adenovirus being the most common (16/184, 8.7%). The nonsusceptibility of <it>S. pneumoniae </it>to penicillin and azithromycin was 22.2% (Resistance (R): 3.2%, Intermediate (I): 19.0%) and 79.4% (R: 79.4%, I: 0%), respectively. Of patients (312) from whom causative pathogens were identified and antibiotic treatments were recorded, clinical cure rate with β-lactam antibiotics alone and with combination of a β-lactam plus a macrolide or with fluoroquinolones was 63.7% (79/124) and 67%(126/188), respectively. For patients having mixed <it>M. pneumoniae </it>and/or <it>C. pneumoniae </it>infections, a better cure rate was observed with regimens that are active against atypical pathogens (e.g. a β-lactam plus a macrolide, or a fluoroquinolone) than with β-lactam alone (75.8% vs. 42.9%, <it>p </it>= 0.045).</p> <p>Conclusion</p> <p>In Chinese adult CAP patients, <it>M. pneumoniae </it>was the most prevalent with mixed infections containing atypical pathogens being frequently observed. With <it>S. pneumoniae</it>, the prevalence of macrolide resistance was high and penicillin resistance low compared with data reported in other regions.</p

Effect of Resveratrol-Based Nutritional Supplement on Choroidal Thickness: A Pilot Study

PurposeThe effect of an oral trans-resveratrol-based supplement (Longevinex®) on choroidal thickness, measured using optical coherence tomography (OCT) enhanced depth imaging, was investigated in a prospective study.Materials and methods34 young, healthy participants were randomly divided into two age- and gender-matched groups. They were then assigned in a randomized fashion to treat with either a trans-resveratrol-based group (Longevinex®, Las Vegas) or placebo. All participants underwent ocular imaging with spectral domain (SD)-OCT (Spectralis; Heidelberg Engineering, Heidelberg) at the baseline and then again 1 h following treatment. The choroidal thickness was measured in a masked fashion at the fovea and at four additional points, located at 500 μm and 1000 μm nasal to the fovea and 500 μm and 1000 μm temporal to the fovea.ResultsIn the resveratrol group, the foveal choroidal thickness at the baseline was 267.73 ± 84.19 μm (mean ± SD); it increased to 284.57 ± 92.39 μm 1 h after drug treatment (p = 0.033). The mean choroidal thickness was also significantly increased at each of the four extrafoveal points (all p &lt; 0.05). In the control group, the mean baseline choroidal thickness at the fovea was 269.73 ± 71.40 μm (mean ± SD) and it was 268.43 ± 70.15 μm (mean ± SD) 1 h after the placebo was administered (p = 0.183); there were also no significant differences in choroidal thickness at the four additional points (all p &gt; 0.05) Conclusion: A significant increase in choroidal thickness following oral administration of a trans-resveratrol-based supplement was observed. There was no change in choroidal thickness in the placebo-treated control group. We speculate that the increased choroidal thickness is the result of choroidal vessel vasodilation