scholarly journals Infections of Biliary Tract

2021 ◽  
Author(s):  
Hema Prakash Kumari Pilli ◽  
Vijayalakshmi Payala
Keyword(s):  
Biliary Tract ◽  
Early Identification ◽  
Clinical Symptoms ◽  
The Other ◽  
High Morbidity ◽  
Biliary Surgery ◽  
Death Rates ◽  
Ascending Infection ◽  
Tract Infections ◽  
Predisposing Conditions

Biliary tract infections include cholangitis and cholecystitis. They are associated with high morbidity and mortality in elderly patients with comorbid disease. The most common infecting organisms are Enterobacteriaceae ascending from the gastrointestinal tract, Gram-positive pathogens like Enterococci spp.; the infections are rarely caused by fungi, viruses, and parasites. The prime reason for biliary tract infections is the ascending infection due to the reflux of duodenal contents and also the blood-borne infection or infection spreading through the portal-venous channels. The other predisposing conditions causing biliary tract infections include critical illnesses such as trauma, burns, sepsis, HIV infection, immunosuppression, diabetes, non-biliary surgery, and childbirth. The infection is reduced by β-lactam antibiotics or their derivatives, cephalosporins, carbapenems, fluoroquinolones, etc. Empiric treatment with piperacillin/tazobactam or a cephalosporin with or without metronidazole is recommended for moderate and severe acute cholecystitis irrespective of whether there is growth by culture. Patients with severe cholecystitis are unfortunately difficult to identify properly, both clinically and radiologically, because clinical symptoms are unexpected, and imaging investigations are frequently ambiguous. However, there are significant differences in morbidity and death rates between individuals with mild cholecystitis and those with severe cholecystitis. Preventing related consequences requires early identification and effective therapy of individuals at risk of severe cholecystitis.

scholarly journals Biliary tract infections and their Microbiological Spectrum- A study from coastal region of Southern India

Infectio ◽  
2019 ◽  
Vol 23 (3) ◽  
pp. 253 ◽  
Author(s):  
Ballal Mamatha ◽  
Padmaja Ananth Shenoy ◽  
Gabriel Sunil Rodrigues ◽  
Suganthi Martena Devadas ◽  
Vignesh Shetty ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Biliary Tract ◽  
Antimicrobial Therapy ◽  
High Rate ◽  
High Morbidity ◽  
Care Hospital ◽  
College Hospital ◽  
Tract Infections ◽  
Aerobic And Anaerobic ◽  
Bile Samples

Objective: Biliary tract infections include cholangitis and cholecystitis. They are associated with high morbidity and mortality in elderly patients with co-morbid disease. The present study was undertaken to determine the microbial aetiology causing biliary tract infections and also to study their antimicrobial resistance profile.Materials & methods: A retrospective study was conducted from January 2011 to December 2016 at the Enteric Diseases Division, Kasturba Medical College Hospital, Manipal. Patients with biliary tract infections admitted in tertiary referral health care hospital, Manipal were included for the study. Aerobic and anaerobic bacteriological and fungal aetiology of biliary tract infections were recorded along with their antimicrobial resistance profile.Results: Out of 307 bile samples sent for aerobic culture and susceptibly testing 187 (60.91%) were positive for culture, of which Escherichia coli (44.4%) was the predominant aetiology followed by Klebsiella pneumoniae (27.3%). Among the 14 samples sent for anaerobic culture, 5 (35.75%) specimens showed growth, of which Bacteroides fragilis group was found to be the predominant anaerobe. Among the 201 bacterial pathogens tested for their antimicrobial susceptibility, 108 (53.73%) isolates were resistant, out of which 9 were PDR Enterobacteriaceae with 12 ESBL strains. All the Candida species were susceptible to fluconazole with the exception of C. glabrata and C. krusei. All the anaerobic isolates were found to be susceptible to Metronidazole.Conclusions: The high rate of bacterial infection particularly gram-negative bacteria was recorded. It is necessary that antimicrobial therapy be initiated when culture or the clinical conditions reports caution. Routine aerobic and anaerobic culturing of bile samples with biliary tract infections are imperatively necessary. With the emergence of multidrug resistant pathogens and change in the microbiological spectrum of biliary tract infections, there is a need for the empirical antimicrobial therapy in every clinical setting.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

scholarly journals Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuyun Li ◽  
Dongming Wang ◽  
Lili Zhi ◽  
Yunmei Zhu ◽  
Lan Qiao ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Allergic Asthma ◽  
Respiratory Tract Infections ◽  
Allergen Immunotherapy ◽  
Clinical Symptoms ◽  
Influenza Season ◽  
The Body ◽  
History Of ◽  
Tract Infections ◽  
Stage 1

AbstractTo describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.

scholarly journals The prevalence of the iutA and ibeA genes in Escherichia coli isolates from severe and non-severe patients with bacteremic acute biliary tract infection is significantly different

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mahoko Ikeda ◽  
Tatsuya Kobayashi ◽  
Fumie Fujimoto ◽  
Yuta Okada ◽  
Yoshimi Higurashi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Tract Infection ◽  
Biliary Tract ◽  
Iron Acquisition ◽  
Tertiary Care ◽  
Care Hospital ◽  
Biliary Tract Infection ◽  
E Coli ◽  
Severe Group ◽  
Tract Infections

Abstract Background Although Escherichia coli is the most frequently isolated microorganism in acute biliary tract infections with bacteremia, data regarding its virulence are limited. Results Information on cases of bacteremia in acute biliary tract infection in a retrospective study was collected from 2013 to 2015 at a tertiary care hospital in Japan. Factors related to the severity of infection were investigated, including patient background, phylogenetic typing, and virulence factors of E. coli, such as adhesion, invasion, toxins, and iron acquisition. In total, 72 E. coli strains were identified in 71 cases, most of which primarily belonged to the B2 phylogroup (68.1%). The presence of the iutA gene (77.3% in the non-severe group, 46.4% in the severe group, P = 0.011) and the ibeA gene (9.1% in the non-severe group, and 35.7% in the severe group, P = 0.012) was significantly associated with the severity of infection. Among the patient characteristics, diabetes mellitus with organ involvement and alkaline phosphatase were different in the severe and non-severe groups. Conclusions We showed that bacteremic E. coli strains from acute biliary tract infections belonged to the virulent (B2) phylogroup. The prevalence of the iutA and ibeA genes between the two groups of bacteremia severity was significantly different.

Biliary tract infections treated with ciprofloxacin

Infection ◽  
1993 ◽  
Vol 21 (4) ◽  
pp. 262-264 ◽  
Author(s):  
G. N. Karachalios ◽  
G. Zografos ◽  
V. Patrikakos ◽  
D. Nassopoulou ◽  
K. Kehagioglou
Keyword(s):  
Biliary Tract ◽  
Tract Infections

Clinical symptoms, underlying pathogenesis, and the prospect of tailored therapies have all benefited from genetic discoveries in Parkinson's disease

2021 ◽  
Author(s):  
Moataz Dowaidar
Keyword(s):  
Clinical Trials ◽  
Clinical Symptoms ◽  
The Other ◽  
Patient Classification ◽  
Medium Term ◽  
Disease Modifying Drugs ◽  
Disease Biology ◽  
Targeted Treatments ◽  
Disease Modifying ◽  
Underlying Pathogenesis

Clinical symptoms, underlying pathogenesis, and the prospect of tailored therapies have all benefited from genetic discoveries in Parkinson's disease.Even as our understanding of disease biology improves, there are still knowledge gaps that must be filled in the future. Reliable biomarkers that uniquely recapitulate pathophysiological aspects are necessary for patient classification and medication response tracking. Genetic testing is essential in 'idiopathic' or 'sporadic' PD patients to identify those who would benefit from genotype-driven treatment. Genotype-dependent segmentation of research participants will broaden the possible usefulness of targeted treatments. Biomarker-assisted clinical trials will benefit tremendously from new adaptable designs. Recent breakthroughs in genotype-driven therapy, on the other hand, should deliver considerable benefits for Parkinson's patients in the medium term and lead to the development of the first disease-modifying drugs.

scholarly journals Rapid Detection and Evaluation of Clinical Characteristics of Emerging Multiple-Drug-Resistant Gram-Negative Rods Carrying the Metallo-β-Lactamase GeneblaIMP

1998 ◽  
Vol 42 (8) ◽  
pp. 2006-2011 ◽  
Author(s):  
Yoichi Hirakata ◽  
Koichi Izumikawa ◽  
Toshiyuki Yamaguchi ◽  
Hiromu Takemura ◽  
Hironori Tanaka ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Rapid Detection ◽  
Clinical Characteristics ◽  
The Other ◽  
Resistant Bacteria ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Gram Negative ◽  
Multiple Drug Resistant ◽  
Tract Infections

Gram-negative rods (GNR) carrying the transferable carbapenem resistance gene blaIMP, includingPseudomonas aeruginosa and Serratia marcescens, have been isolated from more than 20 hospitals in Japan. Although the emergence of such multiple-drug-resistant bacteria is of utmost clinical concern, little information in regard to the distribution ofblaIMP-positive GNR in hospitals and the clinical characteristics of infected patients is available. To address this, a system for the rapid detection of theblaIMP gene with a simple DNA preparation and by enzymatic detection of PCR products was developed. A total of 933 ceftazidime-resistant strains of GNR isolated between 1991 and 1996 at Nagasaki University Hospital, Nagasaki, Japan, were screened for theblaIMP gene; 80 isolates were positive, including 53 P. aeruginosa isolates, 13 other glucose-nonfermenting bacteria, 13 S. marcescens isolates, and 1 Citrobacter freundii isolate. Most of the patients from whom blaIMP-positive organisms were isolated had malignant diseases (53.8%). The organisms caused urinary tract infections, pneumonia, or other infections in 46.3% of the patients, while they were just colonizing the other patients evaluated. It was possible that blaIMP-positive P. aeruginosa strains contributed to the death of four patients, while the other infections caused by GNR carryingblaIMP were not lethal. DNA fingerprinting analysis by pulsed-field gel electrophoresis suggested the cross transmission of strains within the hospital. The isolates were ceftazidime resistant and were frequently resistant to other antibiotics. Although no particular means of pathogenesis ofblaIMP-positive GNR is evident at present, the rapid detection of such strains is necessary to help with infection control practices for the prevention of their dissemination and the transmission of the resistance gene to other pathogenic bacteria.

Coagulopathy with the use of hetastarch in the treatment of vasospasm

1995 ◽  
Vol 82 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Eric R. Trumble ◽  
J. Paul Muizelaar ◽  
John S. Myseros ◽  
Sung C. Choi ◽  
Brian B. Warren
Keyword(s):  
Volume Expansion ◽  
Clinical Symptoms ◽  
Standard Of Care ◽  
The Other ◽  
Appropriate Use ◽  
Content Type ◽  
Prevention And Treatment ◽  
Plasma Protein Fraction ◽  
Clinically Significant ◽  
Fine Print

✓ The use of colloid agents to achieve hypervolemia in the prevention and treatment of postsubarachnoid hemorrhage (post-SAH) vasospasm is included in the standard of care at many institutions. Risk profiles are necessary to ensure appropriate use of these agents. In a series of 85 patients with recent aneurysmal SAH, 26 developed clinical symptoms of vasospasm. Fourteen of the 26 were treated with hetastarch for volume expansion while the other 12 received plasma protein fraction (PPF). Clinically significant bleeding pathologies were noted in six patients who received hetastarch as a continuous intravenous infusion. Hetastarch increased partial thromboplastin time from a mean of 23.9 seconds to a mean of 33.1 seconds (p < 0.001) in all patients who received infusions of this agent, while no effect was noted in the 12 patients who received PPF infusions. No other coagulation parameters were altered. This study shows an increase in coagulopathy with the use of hetastarch as compared with the use of PPF for the treatment of postaneurysmal vasospasm.

scholarly journals The Molecular Epidemiology and Clinical Phylogenetics of Rhinoviruses among Paediatric Cases in Sydney, Australia.

2020 ◽  
Author(s):  
Dillon Adam ◽  
Xin Chen ◽  
Matthew Scotch ◽  
C. Raina MacIntyre ◽  
Dominic Dwyer ◽  
...  
Keyword(s):  
Disease Severity ◽  
Respiratory Tract Infections ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Epidemiological Evidence ◽  
Treatment Practices ◽  
Phylogenetic Methods ◽  
Significant Burden ◽  
Tract Infections ◽  
Sydney Australia

Background Rhinoviruses (RV) represent the most common aetiological agent of all acute respiratory tract infections across all age groups and a significant burden of disease among children. Recent studies have shown that RV-A and RV-C species are associated with varying degrees of disease severity and clinical symptoms. Methods In this study, we uncovered potential associations between RV species and subtypes, and clinical disease severity using a matched dataset of 52 RV isolates sampled from children (<18 years) in Sydney, Australia between 2006 and 2009 using epidemiological and phylogenetic methods. Results We found that RV-C was significantly more likely to be isolated from paediatric cases under two years of age compared to RV-A, although no significant differences in recorded symptoms were observed. Significant phylogenetic-trait associations between age and the VP4/VP2 capsid protein phylogeny suggests age-specific variations in infectivity among subtypes might also be possible. Conclusions This study adds to the growing body of epidemiological evidence concerning RV. Improving surveillance and testing for RV, including routine whole genome sequencing may improve our understanding of the varied diseashe outcomes of RV species and subtypes. Future studies could aim to identify specific genetic markers associated with age-specific infectivity of RV which could inform treatment practices and public health surveillance of RV.

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