Objective: To investigate clinical and laboratory features of patients with Influenza A H1N1 virus infection hospitalized during 2009/2010 pandemic. Methods: Prospective observational study comparing clinical and laboratory characteristics of Influenza A H1N1 positive and negative patients with influenza-like illness (ILI). Results: From October 21, 2009 to February 14, 2010 196 ILI patients were admitted, of which 66 tested positive for Influenza A H1N1. The patients with H1N1 infection were younger (43 years vs. 65 years; P ( 0.01), more patients were pregnant (P ( 0.01), had allergies (P ( 0.05) or, asthma (P ( 0.01). H1N1 positive patients were more often febrile (91% vs. 72.9%; P ( 0.01) and had a higher prevalence of headache (31.8% vs. 18.5%; P ( 0.05). Lower values of C-reactive protein (88 pg/dl vs. 126 pg/dl; P ( 0.01), procalcitonine (0.42 microg/l vs. 3.98 microg/l; P ( 0.05), leukocyte count (7.4*10(9)/l vs. 11.7*10(9)/l; P ( 0.01) and higher values of troponin (0.162 micro/l vs. 0.146 microg/l; P ( 0.01) were found in H1N1 positive patients. More bacterial infections were found in H1N1 negative group(68.8% vs. 89.2%; P ( 0.05). Conclusion: In this study patients infected with Influenza A H1N1 differed from H1N1 negative ILI patients in several clinical and laboratory characteristics. The same was observed also by other investigators. The results of the study suggest some other specific features, such as a higher incidence of headache and higher values of troponin in Influenza A H1N1 infected patients.
COBISS.SI-ID: 28873945
Daptomycin is a lipopeptide antibiotic with a unique mechanism of action on Gram-positive bacteria. It is approved for treatment of skin and soft-tissue infections with Gram-positive bacteria, bacteraemia and right-sided infectiveendocarditis caused by Staphylococcus aureus. Diminishing susceptibility of S. aureus to daptomycin during treatment of complicated infections and clinical failure have been described. Combinations of daptomycin with other antibiotics including gentamicin, rifampin, beta-lactams, trimethoprim/sulfamethoxazole (TMP-SMX), or clarithromycin present a new approach for therapy. In vitro and animal studies have shown that such combinations may, in some cases, be superior to daptomycin monotherapy. In this paper we focus on the antibiotic combinations for complicated S. aureus infections.
COBISS.SI-ID: 28314073
Vancomycin is a glycopeptide antibiotic used for treatment of infections caused by methicillinresistant Staphylococcus aureus (MRSA). During the last decade there have been reports of glycopeptide-resistant strains of Staphylococcus aureus. In some cases there are heterogenous populations of glycopeptide-susceptible and resistant strains which cannot be differentiated by standard clinical microbiology methods, but cause treatment failure and cross-resistance to other antibiotics. In order to improve clinical successanddiminish the occurence of resistance, vancomycin trough concentrations of 15-20 mg/L have been recommended. With such high trough concentrations there have been warnings and doubts about the nephro-and ototoxicity of vancomycin. The review article describes new guidelines for therapeutic monitoring of vancomycin concentrations and the scientific background of the amendments. We discuss the pharmacokinetic and pharmacodynamic characteristics of vancomycin, its toxicity and the problem ofresistance.
COBISS.SI-ID: 28773849
Lactococcus garvieae is usually an animal pathogen. Only a few cases of infections in humans have been described. We describe a case of an elderly patient with prosthetic heart valves with a septicaemia without infective endocarditis, and with a favourable clinical course.
COBISS.SI-ID: 28874201