scholarly journals Ability of Microorganisms, Causing Respiratory Infections in Children, to Form Biofilms in vitro

2021 ◽  
Vol 6 (1) ◽  
pp. 177-183
Author(s):  
H. O. Isaieva ◽  
◽  
M. M. Mishyna ◽  
Y. A. Mozgova ◽  
M. O. Gonchar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Respiratory Tract ◽  
Optical Density ◽  
Respiratory Diseases ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Gram Positive ◽  
Gram Negative ◽  
Tract Infections

The purpose of the study was to detect ability to form biofilms by microorganisms that cause respiratory tract infections. Materials and methods. The study involved 97 strains of microorganisms. Microorganisms were isolated from children with respiratory tract infections. All strains, isolated from patients, were able to form biofilms. There were 44 strains of S. aureus (from patients with pneumonia – 13 strains, from patients with other respiratory diseases – 31), 34 strains of S. pneumoniae (pneumonia – 27 strains, other respiratory diseases – 7), 13 strains of K. pneumoniae (pneumonia – 6 strains, other respiratory diseases – 7), 6 strains of P. aeruginosa (pneumonia – 5 strains, other respiratory diseases – 1). Children were treated at the pulmonary department and intensive care unit in Kharkiv Regional Children's Clinical Hospital. Results and discussion. The optical density of primary biofilms formed by Gram-positive microorganisms was 1.33±0.24 Units of OD, and their secondary biofilms was 0.32±0.10 Units of OD. In patients with pneumonia optical density of primary biofilms of Gram-positive microorganisms was 1.48±0.21 Units of OD and of secondary biofilms was 0.30±0.08 Units of OD. Optical density of primary biofilms of Gram-positive microorganisms in patients with other respiratory infections was 1.18±0.15 Units of OD, of secondary biofilms was 0.35±0.12 Units of OD. The optical density of primary biofilms formed by Gram-negative microorganisms was 2.01±1.03 Units of OD, optical density of secondary biofilms was 1.06±0.42 Units of OD. In patients with pneumonia optical density of primary biofilms of Gram-negative microorganisms was 2.57±0.87 Units of OD, of secondary biofilms was 1.21±0.50 Units of OD. Optical density of primary biofilms of Gram-negative microorganisms in patients with other respiratory infections was 1.24±0.66 Units of OD, of secondary biofilms was 0.84±0.11 Units of OD. Conclusion. Gram-negative microorganisms in general formed more massive biofilms compared with Gram-positive microorganisms. Among all microorganisms P. aeruginosa formed the thickest primary and secondary biofilms. Strains of P. aeruginosa isolated from patients with pneumonia formed the thickest primary and secondary biofilms. Strains of S. aureus isolated from patients with other respiratory infections formed most massive primary biofilms, strains of K. pneumoniae formed the hardest secondary biofilms in this group

scholarly journals In Vitro Activities of Peptide Deformylase Inhibitors against Gram-Positive Pathogens

2002 ◽  
Vol 46 (4) ◽  
pp. 1117-1118 ◽  
Author(s):  
R. Wise ◽  
J. M. Andrews ◽  
J. Ashby
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Active Agent ◽  
Peptide Deformylase ◽  
Gram Positive ◽  
Similar Activity ◽  
Amoxicillin Clavulanate ◽  
Tract Infections

ABSTRACT The activities of six peptide deformylase (PDF) inhibitors against 107 respiratory tract pathogens were studied and compared to those of ciprofloxacin and amoxicillin-clavulanate. Against Streptococcus pneumoniae, BB-83698 and BB-83815 were the most active PDF inhibitors (MIC at which 90% of the organisms tested were inhibited [MIC90], 0.25 μg/ml). Five of the agents showed similar activity against Moraxella catarrhalis (MIC90, 0.12 μg/ml). All PDF inhibitors were less active against Haemophilus influenzae; BB-3497 was the most active agent (MIC90, 2 μg/ml). Five agents were studied against Chlamydia spp. and showed activity similar to that of ciprofloxacin (MIC, 0.5 to 4 μg/ml). This study demonstrates that PDF inhibitors have the potential to be developed for the treatment of respiratory tract infections.

scholarly journals DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN

2020 ◽  
Vol 7 (1) ◽  
pp. 39-45
Author(s):  
M. Mishyna ◽  
M. Gonchar ◽  
O. Logvinova ◽  
H. Isaieva ◽  
M. Basiuk
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Acute Bronchitis ◽  
Community Acquired Pneumonia ◽  
Gram Positive ◽  
Gram Negative ◽  
Nasal Swabs ◽  
Causative Agents ◽  
Tract Infections

DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN. Mishyna М., Gonchar M., Logvinova O., Isaieva H., Basiuk M. The study aimed to investigate prevalence of microorganisms depending on the site of isolation and disease. The study involved 48 children aged 1 year to 17 years. Acute bronchitis (54, 17%), community-acquired pneumonia (CAP) (33, 33%), bronchial asthma (12, 50%) were diagnosed. Were isolated 173 strains of microorganisms. Gram-positive microorganisms were detected 106 strains (61, 3%), Gram-negative microorganisms - 49 strains (28, 3%), fungi - 18 strains (10, 4%). We investigated 100 samples from nose (nasal swabs), pharynx (throat swabs) and sputum. In 83 cases were isolated Gram-positive microorganisms, in 36 cases were isolated Gram-negative microorganisms, in 18 cases - fungi. Analysis reviled that Staphylococcus aureus most often isolated from patients with acute bronchitis; Gram-negative microorganisms most often detected from throat swabs, comparing with microorganisms detected from nose swabs and sputum. Keywords: microorganisms, biofilms, respiratory diseases, children.   Анотація ПОШИРЕНІСТЬ ЗБУДНИКІВ ІНФЕКЦІЙ ДИХАЛЬНИХ ШЛЯХІВ У ДІТЕЙ. Мішина М.М, Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Метою дослідження було вивчити переважання умовно-патогенних мікроорганізмів, які викликають захворювання органів дихання у дітей, в залежності від місця виділення та захворювання. У дослідженні було 48 дітей у віці від 1 року до 17 років. Пацієнти були з такими діагнозами: гострі бронхіти (54, 17%), негоспітальні пневмонії (33, 33%), бронхіальна астма (12, 50%). Було виділено 173 штама умовно-патогенних мікроорганізмів. Грампозитивних мікроорганізмів було виділено 106 штамів (61, 3%), грамнегативних мікроорганізмів – 49 штамів (28, 3%), грибів – 18 штамів (10, 4%). Було досліджено 100 зразків з зіву, носу, мокротиння. Грампозитивні мікроорганізми були виділені з 83 зразків, грамнегативні – з 36 зразків, гриби – з 18 зразків. Проведене дослідження довело, що Staphylococcus aureus найчастіше виділявся у пацієнтів з гострими бронхітами. Грамнегативні мікроорганізми частіш за все виділялись зі зразків із зіву в порівнянні з мазками з носу та мокротинням. Ключові слова: мікроорганізми, біоплівки, захворювання органів дихання, діти.   Абстракт РАСПРОСТРАНЕННОСТЬ ВОЗБУДИТЕЛЕЙ ИНФЕКЦИЙ ДЫХАТЕЛЬНЫХ ПУТЕЙ У ДЕТЕЙ. Мішина М.М., Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Целью исследования было изучить преобладание условно-патогенныхмикроорганизмов, вызывающих заболевания органов дыхания у детей, в зависимости от места забора материала и заболевания. Исследование включало 48 детей в возрасте от 1 года до 17 лет. Пациенты находились с такими заболеваниями: острые бронхиты (54, 17%), внегоспитальные пневмонии (33, 33%), бронхиальная астма (12, 50%). Всего было выделено 173 штамма условно-патогенных микроорганизмов. Грамположительных микроорганизмов было выделено 106 штаммов (61, 3%), грамотрицательных микроорганизмов – 49 штаммов (28, 3%), грибов – 18 штаммов (10, 4%). Было исследовано 100 образцов из зева, носа, мокроты. Грамположительные микроорганизмы были выделены из 83 образцов, грамотрицальные – из 36 образцов, грибы – из 18 образцов. В ходе исследования было доказано, что Staphylococcus aureus чаще всего выделялся от пациентов с острыми бронхитами. Грамотрицательные микроорганизмы чаще всего выделялись из мазков из зева по сравнению с мазками из носа и мокротой. Ключевые слова: микроорганизмы, биопленки, заболевания органов дыхания, дети.

scholarly journals 1609. Epidemiology and Susceptibility to Imipenem/Relebactam of Gram-Negative Pathogens from Patients with Lower Respiratory Tract Infections – SMART United States 2017-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S799-S799
Author(s):  
Sibylle Lob ◽  
Meredith Hackel ◽  
Katherine Young ◽  
Mary Motyl ◽  
Daniel F Sahm
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Surveillance Program ◽  
Lower Respiratory Tract Infections ◽  
Independent Contractor ◽  
Gram Negative ◽  
The Us ◽  
Tract Infections

Abstract Background Relebactam (REL) inhibits class A and C β-lactamases and was approved in the US combined with imipenem (IMI) and cilastatin for complicated urinary tract and intraabdominal infections. Using isolates collected as part of the global SMART surveillance program in the US, we evaluated the activity of IMI/REL against gram-negative pathogens (GNP) from patients with lower respiratory tract infections (LRTI), including a comparison of isolates from ICU and non-ICU wards. Methods In 2017-2018, 27 US hospitals each collected up to 100 consecutive aerobic or facultative GNP from LRTI patients per year. MICs were determined using CLSI broth microdilution and breakpoints. Results Among 3878 GNP isolates from LRTI, the most common species collected were P. aeruginosa (Psa, 33.3%), K. pneumoniae (10.9%), E. coli (10.4%), and S. marcescens (6.9%). Susceptibility of GNP is shown in the table. IMI/REL inhibited 93% of Psa and Enterobacterales, which included 174 isolates of Morganellaceae that are not expected to be susceptible to IMI or IMI/REL. S. marcescens also showed low susceptibility to IMI, with improved but still reduced activity upon addition of REL. IMI/REL inhibited 83% of all GNP combined, 7-18 percentage points higher than the comparator β-lactams. Of the tested comparators, only amikacin exceeded the activity of IMI/REL. Only Psa showed substantial differences in susceptibility between isolates from ICU (n=486) and non-ICU wards (n=611), with 63.4% and 70.2%, respectively, susceptible to IMI, 71.6/78.7% to cefepime, and 64.2/73.3% to piperacillin/tazobactam (P/T). Susceptibility to IMI/REL was high in both settings (91.4/93.6%). Among Enterobacterales, susceptibility was generally similar in ICU and non-ICU wards (IMI/REL, 92.5% in both settings; IMI, 86.3 and 87.1%, respectively; cefepime, 89.9/89.0%; P/T, 88.7/87.4%). Table Conclusion Although resistance rates have frequently been reported to be higher in ICU than non-ICU wards, this pattern was seen in the current study only among Psa isolates. IMI/REL showed activity >90% against both Enterobacterales and Psa from both ward types. These in vitro data suggest that IMI/REL could provide an important treatment option for patients with LRTI in the US, including those in ICUs. Disclosures Sibylle Lob, PhD, IHMA (Employee)Pfizer, Inc. (Consultant) Katherine Young, MS, Merck & Co., Inc. (Employee, Shareholder)Merck & Co., Inc. (Employee, Shareholder) Mary Motyl, PhD, Merck & Co, Inc (Employee, Shareholder) Daniel F. Sahm, PhD, IHMA (Employee)Pfizer, Inc. (Consultant)Shionogi & Co., Ltd. (Independent Contractor)

scholarly journals Inhaled Antibiotics for Gram-Negative Respiratory Infections

2016 ◽  
Vol 29 (3) ◽  
pp. 581-632 ◽  
Author(s):  
Eric Wenzler ◽  
Dustin R. Fraidenburg ◽  
Tonya Scardina ◽  
Larry H. Danziger
Keyword(s):  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Systemic Exposure ◽  
Lung Parenchyma ◽  
Gram Negative ◽  
Disease States ◽  
Inhaled Antibiotics ◽  
Gram Negative Organisms ◽  
Tract Infections

SUMMARYGram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects,in vitroand microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena.

scholarly journals BAKTERI AEROB PADA SPUTUM KELOMPOK GERIATRI DENGAN INFEKSI SALURAN PERNAPASAN DI PUSKESMAS RANOTANA WERU

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Villy Tompodung
Keyword(s):  
Bacillus Subtilis ◽  
Respiratory Tract ◽  
Elderly People ◽  
Respiratory System ◽  
Proteus Mirabilis ◽  
Respiratory Tract Infections ◽  
Gram Positive ◽  
Sample Distribution ◽  
Gram Negative ◽  
Tract Infections

Abstract: Respiratory system disorder has been considered one of the most frequent reason why a person go to a doctor. Infection is one of the causes of the disturbance in respiratory system. Geriatric is the group of elderly people at the age of above 60 years old. The risk of suffering from respiratory tract infections increased for elderly people. The goal of this research is to determine the sputum pattern of the geriatric group suffering respiratory system infection. This research used descriptive prospective method. Twenty samples was included in the research that met the inclusion criteria. Bacteria identification was done through culture media. The sample distribution according to gender; 10 male (63%) and 6 female (38%). This research shows a negative result for the 20 samples through the examination of Acid-fast Bacilli (AFB). This research found that the cause of respiratory system infection of the geriatric group through gram staining are: gram negative on 7 sample (39%), gram positive on 7 sample (39%), and 4 sample for both gram negative and positive (22%). The gram positive bacteria consist of: Streptococcus spp (8 sample; 34.78%), Bacillus subtilis (1 sample; 4,35%), and Lactobacillus (2 sample; 8.70%). Five species of gram negative are: Citrobacter freundii (1 sample; 4.35%), Proteus mirabilis (5 sample; 21.74%), and Seratia marcescens (3 sample; 13.04%). This research concludes that the most frequent causes of Respiratory tract infections(RTI) found in the geriatric group of Ranotana Weru Community Health Centre is Streptococcus spp, and men experienced more respiratory tract infections compared with women. Keywords :Geriatric, RTI, Aerobic Bacteria.   Abstrak: Gangguan pada sistem pernapasan merupakan salah satu keluhan tersering yang menyebabkan seseorang datang memeriksakan diri pada dokter. Infeksi merupakan salah satu penyebab seseorang mengalami gangguan pada sistem pernapasan.Geriatriadalahkelompok lanjut usia dimanaseseorang  telah mencapai usia 60 (enam puluh) tahun keatas. Resiko menderita infeksi saluran pernapasan meningkat terutama pada usia lanjut. Tujuan penelitian ini yaitu untuk mengetahui pola bakteri pada sputum kelompok geriatri dengan infeksi saluran pernapasan. Penelitian ini menggunakan metode deskriptif prospektif. Sampel penelitian berjumlah 20 sampel yang telah memenuhi kriteria inklusi. Identifikasi bakteri dilakukan dengan menggunakan media kultur. Distribusi sampel penelitian berdasarkan jenis kelamin didapatkan hasil 10 orang (63%) pria dan 6 orang (38%) wanita. Hasil penelitian menunjukkan 20 sampel negatif pada pemeriksaan Basil Tahan Asam (BTA). Penelitian ini menunjukkan penyebab infeksi saluran pernapasan pada geriatrimelaluipewarnaan gramyaitubakteri gram negatif7 sampel (39%), bakteri gram positif 7 sampel (39%) dan 4 sampel (22%) yang terdapatbakteri gram positifdannegatif. Bakteri gram positifterdiridari 3 spesiesyaituStreptococcus spp(8 sampel; 33,33%), Bacillus subtilis(1 sampel;4,17%) dan Lactobacillus(2 sampel; 8,33%). Lima spesies bakteri gram negatif yaitu Citrobacterfreundii(1 sampel; 4,17%), Diplococcusgram negatif(1 sampel; 4,17%), Klebsiela pneumonia (1 sampel; 4,17%), Proteus mirabilis(5 sampel; 20,83%) dan Seratia marcescens (3 sampel; 12,50%). Kesimpulan pada penelitian ini didapatkan bakteri penyebab terbanyak infeksi saluran pernapasan pada geriatri adalah Streptococcus spp. dan pria lebih banyak mengalami infeksi saluran pernapasan di bandingkan dengan wanita. Kata kunci : Geriatri, Sputum, Bakteri .

scholarly journals Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Lei ◽  
Lisong Yang ◽  
Cheong Tat Lou ◽  
Fan Yang ◽  
Kin Ian SiTou ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Pediatric Patients ◽  
Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Viral Etiology ◽  
Upper Respiratory ◽  
Syncytial Virus ◽  
Tract Infections

Abstract Background Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. Methods A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. Results Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. Conclusions This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.

Telithromycin: The First of the Ketolides

2002 ◽  
Vol 36 (3) ◽  
pp. 452-464 ◽  
Author(s):  
Christopher S Shain ◽  
Guy W Amsden
Keyword(s):  
Respiratory Tract ◽  
Clinical Efficacy ◽  
Respiratory Tract Infections ◽  
Safety Issue ◽  
Qtc Interval ◽  
Phagocytic Cells ◽  
Medline Search ◽  
Atypical Pathogens ◽  
Tract Infections

OBJECTIVE: To review the chemistry, spectrum of activity, pharmacology, clinical efficacy, and safety of telithromycin. DATA SOURCES: A MEDLINE search from 1966 to December 2000 was performed via OVID and PubMed using the following search terms: HMR 3647, HMR3647, Ketek, RU 66647, and telithromycin. An extensive review of retrieved literature, abstracts from international scientific conferences, and minutes from regulatory authority meetings was also performed. DATA EXTRACTION: Medicinal chemistry, in vitro, animal, and human trials were reviewed for information on the antimicrobial activity, clinical efficacy, pharmacology, and safety of telithromycin. DATA SYNTHESIS: Several chemical modifications to the macrolide structure have led to the development of telithromycin, the first ketolide antimicrobial that demonstrates improved activity against penicillin- and macrolide/azalide-resistant Streptococcus pneumoniae due to its unique binding to the ribosomal target site. Although telithromycin may be useful in the treatment of community-acquired respiratory tract infections due to its activity against common typical and atypical pathogens, questions concerning its reliable activity against Haemophilus influenzae need to be addressed. Telithromycin's pharmacokinetics permit once-daily dosing for abbreviated periods and good distribution into lung tissue and phagocytic cells. Clinical and bacteriologic cure rates have been similar to those of comparator agents in human efficacy trials; however, the incidence of adverse gastrointestinal events were generally higher with telithromycin patients. Like other macrolides and many newer fluoroquinolones, telithromycin's ability to prolong the QTc interval is a potential safety issue, especially in elderly patients with predisposing conditions or those who are concurrently receiving drugs that are substrates for CYP2D6 and 3A4. Liver function test elevations demonstrated during clinical trials, although not overtly severe, may warrant monitoring in some patients taking multiple hepatically metabolized/cleared agents. CONCLUSIONS: Telithromycin offers potential advantages over traditional macrolides/azalides for community-acquired respiratory tract infections caused by macrolide-resistant pathogens. Further studies are needed to elucidate its clinical efficacy against H. influenzae, potential drug interactions, and safety in various subpopulations.

Amikacin in Gram-Negative Paediatric Infections

1978 ◽  
Vol 6 (4) ◽  
pp. 257-265
Author(s):  
Hugo Trujillo ◽  
Rafael Manotas ◽  
Jose Ivan Ramirez ◽  
Alvaro Uribe ◽  
Nancy Agudelo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Intestinal Tract ◽  
Cure Rate ◽  
Gram Negative ◽  
Complete Cure ◽  
Tract Infections ◽  
Gastro Intestinal Tract

Amikacin was used in the treatment of various Gram-negative infections in sixty-six children ranging in age from two days to thirteen years. Over 72% of the infections treated were classified as severe and the remainder were moderate. Among infections in which the site of origin was the urinary or gastro-intestinal tract, amikacin achieved thirty-eight (95%) complete or partial cures in forty patients. In respiratory tract infections, amikacin completely or partially cured six (75%) out of eight patients. The remaining eighteen infections involved skin, soft tissue and other miscellaneous categories in which amikacin therapy resulted in seventeen (94%) complete or partial cures. Overall, amikacin achieved fifty-four complete cures and seven clinical or bacteriological cures in sixty-six patients, which represents an 82% complete cure rate and 10% partial cure rate for all the patients in the study.

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