PYREXIAOFUNKNOWNORIGIN.ppt

* Same serotypes seen in the study from Kenya. * In Malawi study chloramphenicol failed to effect a radical cure for NTS bacteremia Fluoroquinolones or Third generation cephalosporins might reduce inpatient mortality and recurrence In affluent countries- long term fluoroquinolone suppressive regimens commonly used to prevent recurrence Bactrim may useful for secondary suppression in areas where susceptibility is high * * * * * * * * * * * * * Lung Involvement in HIV-positive Patients Salmonella Lung Involvement in Patients with HIV Infection. CHEST1997. Retrospective clinical study- studied records of all HIV-infected patients with Salmonella bacteraemia at a university tertiary hospital in Spain from Jan 87 to Dec 95. Findings Lung involvement was frequent Present in 35% of HIV positive patients with NTS bacteraemia 33% of those with lung involvement had definite Salmonella pulmonary infection Predisposing factors for focal disease were not apparent Focal lung involvement with NTS was not associated with worse prognosis 56% of those with lung involvement had Superinfection with other respiratory pathogen 28% PCP 17% pyogenic bacterial infections 11% TB Antimicrobial Susceptibility and Resistance In developed countries there is great concern over development of antimicrobial resistance Increase in fluroquinolone resistance among Salmonellae serotypes Nairobi, Kenya 48%-56% of isolates were resistant to 3 or more of the routinely available antimicrobials Malawi 5% resistant to chloramphenicol 73% resistant to co-trimoxazole 79% resistant to ampicillin 43% resistant to gentamycin 40% resistant to tetracycline Bangui in Central Africa (Kassa-Kelembho et al. Bacteremia in adults admitted to the Department of Medicine on Bangui Community Hospital (Central Africa Republic). Acta Tropica. 2003;89:67-72) 12% resistant to chloramphenicol 75% resistant to co-trimoxazole 80% resistant to amoxicillin 26% resistant to gentamycin 56% resistant to tetracycline 0% resistan