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[PMID]:29274210
[Au] Autor:Bamba S; Zoungrana J; Nikièma Z; Sondo AK; Ndiaye JL; Bretagne S
[Ad] Endereço:Laboratory of Parasitology-Mycology, Higher Institute of Health Sciences, Polytechnic University, Rue Alwata Diawara, Bobo-Dioulasso, BP 1091, Burkina Faso
[Ti] Título:Impact of alternative treatment approach for cerebral toxoplasmosis among HIV/AIDS patients from a resource-poor setting in Burkina Faso
[So] Source:Ann Parasitol;63(3):173­181, 2017.
[Is] ISSN:2299-0631
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Cerebral toxoplasmosis is caused by the protozoan Toxoplasma gondii because of reactivation of latent tissue cysts in the Acquired Immunodeficiency Syndrome (AIDS) patients with severe immunosuppression. The objective of this study was to evaluate the benefit of co-trimoxazole in presumptive and prevention of cerebral toxoplasmosis in Human Immunodeficiency Virus (HIV)/AIDS patients at Bobo-Dioulasso Hospital in Burkina Faso from June 2012 to October 2014. ELISA and ELFA were performed on serum for the quantitative determination of IgG and IgM anti-T. gondii, respectively. The seroprevalence of toxoplasmosis was 29.3%. No IgM antibodies for T. gondii were found. Six patients with Toxoplasma-specific antibodies presented cerebral toxoplasmosis. All patients were infected by HIV-1 with the median of CD4+ T lymphocytes at 141 cells/µl. No patient was under antiretroviral therapy. No case of cerebral toxoplasmosis was noted in patients receiving co-trimoxazole in prevention. Presumptive treatment of cerebral toxoplasmosis with co-trimoxazole was effective in all patients with a significant clinical improvement in 83.3%. These results attest the benefit of cotrimoxazole in cerebral toxoplasmosis treatment in countries where drug resources are limited when sulfadiazine is not available. Ours finding highlight the importance of establishing toxoplasmosis chemoprophylaxis to HIV with severe immunosuppression patients and positive Toxoplasma serology.
[Mh] Termos MeSH primário: Infecções por HIV/complicações
Toxoplasmose Cerebral/complicações
Toxoplasmose Cerebral/tratamento farmacológico
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/economia
Antibacterianos/uso terapêutico
Burkina Faso/epidemiologia
Estudos Transversais
Feminino
Infecções por HIV/epidemiologia
Seres Humanos
Imunoglobulina G/sangue
Imunoglobulina M/sangue
Masculino
Meia-Idade
Fatores Socioeconômicos
Toxoplasmose Cerebral/sangue
Toxoplasmose Cerebral/epidemiologia
Combinação Trimetoprima e Sulfametoxazol/economia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Immunoglobulin G); 0 (Immunoglobulin M); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171224
[St] Status:MEDLINE
[do] DOI:10.17420/ap6303.103


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[PMID]:29311456
[Au] Autor:Uchiyama M; Ueno M; Takamatsu Y; Matsuo K; Imakyure O; Kamimura H
[Ad] Endereço:Department of Pharmacy, Fukuoka University Hospital.
[Ti] Título:[A Survey of the Adverse Effects and Influence of Concomitant Drugs for Methotrexate Intrathecal Administration].
[So] Source:Yakugaku Zasshi;138(1):111-115, 2018.
[Is] ISSN:1347-5231
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:In general, the intraventricular administration of cytotoxic antitumor drugs provides a high drug concentration in the cerebrospinal fluid with a reduced risk of systemic adverse reactions. Methotrexate (MTX) high-dose therapy requires close monitoring when performed in combination with trimethoprim-sulfamethoxazole (ST) therapy and proton pump inhibitor (PPI) and nonsteroidal anti-inflammatory drug administration for excretion delay and toxicity enhancement. While the frequency of systemic side effects is thought to be low with intrathecal administration, such effects do rarely but occasionally occur. We must consider drug interactions with combination therapy as a potential factor inducing such effects. We examined the patients who received MTX intrathecal administration at Fukuoka University Hospital from January 2013 to December 2014 with respect to the onset of side effects and combination therapy. MTX intrathecal administration was performed a total of 79 times in 27 patients. In five of these 27 patients, MTX intrathecal administration was performed twice a week, and hematotoxicity and non-hematotoxicity developed in two patients in whom ST was also administered. On the other hand, even if ST and/or PPI was administered, no side effects were observed in the patients administered levofolinate.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Antibacterianos/efeitos adversos
Antimetabólitos Antineoplásicos/administração & dosagem
Antimetabólitos Antineoplásicos/efeitos adversos
Metotrexato/administração & dosagem
Metotrexato/efeitos adversos
Combinação Trimetoprima e Sulfametoxazol/administração & dosagem
Combinação Trimetoprima e Sulfametoxazol/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Anti-Inflamatórios não Esteroides/administração & dosagem
Anti-Inflamatórios não Esteroides/efeitos adversos
Esquema de Medicação
Interações Medicamentosas
Quimioterapia Combinada
Feminino
Seres Humanos
Injeções Espinhais
Masculino
Meia-Idade
Inibidores da Bomba de Prótons/administração & dosagem
Inibidores da Bomba de Prótons/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Antimetabolites, Antineoplastic); 0 (Proton Pump Inhibitors); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1248/yakushi.17-00122


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[PMID]:29429508
[Au] Autor:Ezzedine K
[Ad] Endereço:Service de dermatologie, hôpital Henri-Mondor et EpiDermE, EA 7379, université Paris-Est Créteil Val-de-Marne, 94010, Créteil, France. Electronic address: haled.ezzedine@aphp.fr.
[Ti] Título:[What's new in dermatological therapy?]
[Ti] Título:Quoi de neuf en thérapeutique dermatologique ?.
[So] Source:Ann Dermatol Venereol;143 Suppl 3:S37-S42, 2016 Dec.
[Is] ISSN:0151-9638
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Over the last year there has been major publications related to therapeutic trials in infectious dermatology, not only with regard to Herpes zoster subunit vaccine but also for the treatment of uncomplicated abscesses or scabies. In addition, biological treatments continue to be on the forefront, not only in the treatment of psoriasis but also in other chronic inflammatory dermatologic diseases such as atopic dermatitis and hidradenitis suppurativa, two diseases that significantly impact quality of life and for which there are to date, few therapeutic alternatives in moderate to severe forms. In addition, the treatment of cyclin-resistant papulopustular rosacea was also the subject of a large French controlled randomized controlled trial that could modify our therapeutic approach by the use of isotretinoin. Finally, the prevention of rashes induced by erlotinib with oral doxycyline is also part of this 2016 "what's new in dermatological therapeutics".
[Mh] Termos MeSH primário: Dermatopatias/tratamento farmacológico
[Mh] Termos MeSH secundário: Adalimumab/uso terapêutico
Antibacterianos/uso terapêutico
Anti-Inflamatórios/uso terapêutico
Anticorpos Monoclonais/uso terapêutico
Fármacos Dermatológicos/uso terapêutico
Dermatologia
Cloridrato de Erlotinib/uso terapêutico
Vacina contra Herpes Zoster
Seres Humanos
Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico
Isotretinoína/uso terapêutico
Piperidinas/uso terapêutico
Inibidores de Proteínas Quinases/uso terapêutico
Pirimidinas/uso terapêutico
Pirróis/uso terapêutico
Dermatopatias/diagnóstico
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents); 0 (Antibodies, Monoclonal); 0 (Dermatologic Agents); 0 (Herpes Zoster Vaccine); 0 (Interleukin 1 Receptor Antagonist Protein); 0 (Piperidines); 0 (Protein Kinase Inhibitors); 0 (Pyrimidines); 0 (Pyrroles); 0 (SAR231893); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination); 87LA6FU830 (tofacitinib); DA87705X9K (Erlotinib Hydrochloride); EH28UP18IF (Isotretinoin); FYS6T7F842 (Adalimumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


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[PMID]:28449385
[Au] Autor:Ruzagira E; Baisley K; Kamali A; Biraro S; Grosskurth H; Working Group on Linkage to HIV Care
[Ad] Endereço:London School of Hygiene and Tropical Medicine, London, UK.
[Ti] Título:Linkage to HIV care after home-based HIV counselling and testing in sub-Saharan Africa: a systematic review.
[So] Source:Trop Med Int Health;22(7):807-821, 2017 07.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Home-based HIV counselling and testing (HBHCT) has the potential to increase HIV testing uptake in sub-Saharan Africa (SSA), but data on linkage to HIV care after HBHCT are scarce. We conducted a systematic review of linkage to care after HBHCT in SSA. METHODS: Five databases were searched for studies published between 1st January 2000 and 19th August 2016 that reported on linkage to care among adults newly identified with HIV infection through HBHCT. Eligible studies were reviewed, assessed for risk of bias and findings summarised using the PRISMA guidelines. RESULTS: A total of 14 studies from six countries met the eligibility criteria; nine used specific strategies (point-of-care CD4 count testing, follow-up counselling, provision of transport funds to clinic and counsellor facilitation of HIV clinic visit) in addition to routine referral to facilitate linkage to care. Time intervals for ascertaining linkage ranged from 1 week to 12 months post-HBHCT. Linkage ranged from 8.2% [95% confidence interval (CI), 6.8-9.8%] to 99.1% (95% CI, 96.9-99.9%). Linkage was generally lower (<33%) if HBHCT was followed by referral only, and higher (>80%) if additional strategies were used. Only one study assessed linkage by means of a randomised trial. Five studies had data on cotrimoxazole (CTX) prophylaxis and 12 on ART eligibility and initiation. CTX uptake among those eligible ranged from 0% to 100%. The proportion of persons eligible for ART ranged from 16.5% (95% CI, 12.1-21.8) to 77.8% (95% CI, 40.0-97.2). ART initiation among those eligible ranged from 14.3% (95% CI, 0.36-57.9%) to 94.9% (95% CI, 91.3-97.4%). Additional linkage strategies, whilst seeming to increase linkage, were not associated with higher uptake of CTX and/or ART. Most of the studies were susceptible to risk of outcome ascertainment bias. A pooled analysis was not performed because of heterogeneity across studies with regard to design, setting and the key variable definitions. CONCLUSION: Only few studies from SSA investigated linkage to care among adults newly diagnosed with HIV through HBHCT. Linkage was often low after routine referral but higher if additional interventions were used to facilitate it. The effectiveness of linkage strategies should be confirmed through randomised controlled trials.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antirretrovirais/uso terapêutico
Aconselhamento/métodos
Infecções por HIV/diagnóstico
Infecções por HIV/tratamento farmacológico
Serviços de Assistência Domiciliar
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
[Mh] Termos MeSH secundário: África ao Sul do Saara
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Retroviral Agents); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12888


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[PMID]:29255545
[Au] Autor:Simieneh A; Hailemariam M; Amsalu A
[Ad] Endereço:Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Ethiopia.
[Ti] Título:HIV screening among TB patients and level of antiretroviral therapy and co-trimoxazole preventive therapy for TB/HIV patients in Hawassa University Referral Hospital: a five year retrospective study.
[So] Source:Pan Afr Med J;28:75, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Introduction: Initiation of antiretroviral therapy (ART) and co-trimoxazole preventive therapy (CPT) is recommended for tuberculosis (TB)/human immunodeficiency virus (HIV) co-infected patients to prevent opportunistic infection. The aim of this study was to assess the prevalence of HIV among TB patients and initiation of ART and provision of CPT for TB/HIV co-infected patients in Hawassa university referral hospital. Methods: A five year document review was done on 1961 TB patients who are registered at TB clinic of Hawassa university referral hospital from September 2009 to august 2014. Data were collected using checklist. Data analysis was done by using SPSS version 20 software. Bivariate and multivariate logistic regression analysis was used to determine the predictors of TB/HIV co-infection. Results: Among 1961 TB patients diagnosed in the hospital, 95% (1765) were screened for HIV. Of these, 13.9% (246) were HIV positive. Out of 246 TB/HIV co-infected patients 31.7% (78/246) and 37.4% (92/246) were enrolled to start ART and CPT respectively. Roughly the trends of TB/HIV co-infection decreased with increased linkage to CPT, while linkage to ART was not regular across the year. The rate of TB/HIV co-infection was significantly associated with type of TB. Conclusion: Although, trend of HIV among TB patients has decreased across the year, only a minority of co-infected patients was linked to start ART and CPT. Therefore, screening of all TB patients for HIV and linkage of co-infected patients to HIV care to start ART and CPT should be strengthened in-line with the national guidelines.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Infecções por HIV/diagnóstico
Programas de Rastreamento/métodos
Tuberculose/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Coinfecção/tratamento farmacológico
Coinfecção/epidemiologia
Etiópia/epidemiologia
Feminino
Infecções por HIV/tratamento farmacológico
Infecções por HIV/epidemiologia
Hospitais Universitários
Seres Humanos
Lactente
Recém-Nascido
Modelos Logísticos
Masculino
Meia-Idade
Prevalência
Estudos Retrospectivos
Combinação Trimetoprima e Sulfametoxazol/administração & dosagem
Tuberculose/tratamento farmacológico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.28.75.11977


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[PMID]:29048966
[Au] Autor:Linnemayr S; Huang H; Luoto J; Kambugu A; Thirumurthy H; Haberer JE; Wagner G; Mukasa B
[Ad] Endereço:Sebastian Linnemayr, Jill Luoto, and Glenn Wagner are with the RAND Corporation, Santa Monica, CA. Haijing Huang is with the Pardee RAND Graduate School, Santa Monica. Andrew Kambugu is with Infectious Diseases Institute and Makerere University, Kampala, Uganda. Harsha Thirumurthy is with Department
[Ti] Título:Text Messaging for Improving Antiretroviral Therapy Adherence: No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults.
[So] Source:Am J Public Health;107(12):1944-1950, 2017 Dec.
[Is] ISSN:1541-0048
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To assess the effectiveness of Short Message Service (SMS) reminder messages on antiretroviral and cotrimoxazole prophylaxis adherence among HIV-positive youths as well as the relative effectiveness of SMS with and without a response option. METHODS: Eligible HIV-positive patients aged 15 to 22 years at 2 HIV clinics in Kampala, Uganda, participated in a year-long parallel individual-randomized controlled trial and were assigned in a 1-to-1-to-1 ratio to a weekly SMS message group, weekly SMS message with response option group, or a usual-care control group. RESULTS: We enrolled 332 participants. Electronically measured mean adherence was 67% in the control group, 64% in the 1-way SMS group (95% confidence interval [CI] = 0.77, 1.14), and 61% in the 2-way SMS group (95% CI = 0.75, 1.12) in an intent-to-treat analysis. Results for secondary outcomes and complete-case analysis were similarly statistically insignificant across groups. CONCLUSIONS: Despite previous evidence that interventions using SMS reminders can promote antiretroviral therapy adherence, this study shows that they are not always effective in achieving behavior change. More research is needed to find out for whom, and under what conditions, they can be beneficial. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00830622.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Soropositividade para HIV/tratamento farmacológico
Adesão à Medicação
Sistemas de Alerta
Mensagem de Texto
[Mh] Termos MeSH secundário: Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle
Adolescente
Antibacterianos/uso terapêutico
Feminino
Seres Humanos
Análise de Intenção de Tratamento
Masculino
Avaliação de Resultados (Cuidados de Saúde)
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
Uganda
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-HIV Agents); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.2105/AJPH.2017.304089


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[PMID]:28991913
[Au] Autor:Montalto GJ; Sawe FK; Miruka A; Maswai J; Kiptoo I; Aoko A; Oreyo C; Obiero E; Korir S; Bii SK; Song KX; Kunz AN
[Ad] Endereço:Division of Adolescent Medicine, Department of Pediatrics, Naval Medical Center San Diego, San Diego, California, United States of America.
[Ti] Título:Diagnosis disclosure to adolescents living with HIV in rural Kenya improves antiretroviral therapy adherence and immunologic outcomes: A retrospective cohort study.
[So] Source:PLoS One;12(10):e0183180, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND & AIMS: Emphasis on adolescent HIV has increased worldwide as antiretroviral treatment has greatly extended life expectancies of HIV-positive children. Few evidence-based guidelines exist on the optimal time to disclose to an adolescent living with HIV (ALHIV); little is known about the medical effects of disclosure. This study looked to determine whether disclosure is associated with improved medical outcomes in ALHIV. Prior work has tended to be qualitative, cross-sectional, and with an emphasis on psychosocial outcomes. This paper addresses the adolescent cohort retrospectively (longitudinally), building upon what is already known about disclosure. METHODS: Retrospective, longitudinal clinical record reviews of ALHIV seen at Kericho District Hospital between April 2004 and November 2012 were performed. Patient demographics and clinical outcomes were systematically extracted. The student's t-test was used to calculate changes in mean CD4 count, antiretroviral therapy (ART), and cotrimoxazole adherence pre- vs. post-disclosure. Linear regression modelling assessed for trends in those clinical outcomes associated with age of disclosure. RESULTS: Ninety-six ALHIV (54 female, 42 male) were included; most (73%) entered care through the outpatient department. Nearly half were cared for by parents, and 20% experienced a change in their primary caregiver. The mean time in the study was 2.47 years; mean number of visits 10.97 per patient over the mean time in the study. Mean disclosure age was 12.34 years. An increase in mean ART adherence percentage was found with disclosure (0.802 vs. 0.917; p = 0.0015). Younger disclosure age was associated with significantly higher mean CD4 counts over the course of the study (p = 0.001), and a nonsignificant trend toward a higher mean ART adherence percentage (p = 0.055). CONCLUSION: ART adherence and improved immunologic status are both associated with disclosure of HIV infection to adolescent patients. Disclosure of an HIV diagnosis to an adolescent is an important means to improve HIV care.
[Mh] Termos MeSH primário: Antirretrovirais/uso terapêutico
Infecções por HIV/tratamento farmacológico
Infecções por HIV/psicologia
Cooperação do Paciente
Revelação da Verdade
[Mh] Termos MeSH secundário: Adolescente
Anti-Infecciosos/uso terapêutico
Contagem de Linfócito CD4
Criança
Estudos Transversais
Feminino
HIV/isolamento & purificação
Infecções por HIV/diagnóstico
Infecções por HIV/epidemiologia
Seres Humanos
Quênia/epidemiologia
Masculino
Relações Profissional-Paciente
Estudos Retrospectivos
População Rural
Resultado do Tratamento
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Anti-Retroviral Agents); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183180


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[PMID]:28913903
[Au] Autor:Krzysciak P; Chmielarczyk A; Pobiega M; Romaniszyn D; Wójkowska-Mach J
[Ad] Endereço:Department of Mycology, Jagiellonian University Medical College, Krakow, Poland.
[Ti] Título:Acinetobacter baumannii isolated from hospital-acquired infection: biofilm production and drug susceptibility.
[So] Source:APMIS;125(11):1017-1026, 2017 Nov.
[Is] ISSN:1600-0463
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:Acinetobacter baumannii cause opportunistic nosocomial infections and is often multidrug resistant. It has ability to form biofilm. The possession of drug resistance mechanism and ability of biofilm formation seems to be the different way to enhancement of viability in stressful environment. In this study, we evaluate relation between these two factors. The biofilm formation was investigated in M63 medium with casein in microtiter plates, and the drug susceptibility was performed by disk diffusion methods. We found that 80-98% strains formed a biofilm. Strains showing sensitivity to amikacin and tobramycin from ICU produced more biofilm than strains showing resistance to these antibiotics. Ceftazidime-sensitive strains formed a smaller biofilm than resistant. The logistic regression shows association between drug resistance and strains originating from ICU. In case of ceftazidime, strong biofilm formation and descending from ICU reduced the likelihood of drug sensitivity. For other drugs such as aminoglycosides, fluoroquinolones, trimethoprim/sulfamethoxazole, and tetracycline, we found opposite relation (but it was not statistically significance). However, generally it seems that strong biofilm producers from ICUs are often more susceptible to antibiotics. This situation can be explained by the fact that bacteria protected in biofilm do not need mechanisms responsible for resistance of planktonic cells.
[Mh] Termos MeSH primário: Infecções por Acinetobacter/microbiologia
Acinetobacter baumannii/efeitos dos fármacos
Antibacterianos/farmacologia
Biofilmes/efeitos dos fármacos
Infecção Hospitalar/microbiologia
Plâncton/efeitos dos fármacos
[Mh] Termos MeSH secundário: Infecções por Acinetobacter/tratamento farmacológico
Acinetobacter baumannii/crescimento & desenvolvimento
Acinetobacter baumannii/isolamento & purificação
Idoso
Aminoglicosídeos/farmacologia
Biofilmes/crescimento & desenvolvimento
Cefalosporinas/farmacologia
Infecção Hospitalar/tratamento farmacológico
Meios de Cultura/química
Farmacorresistência Bacteriana Múltipla/fisiologia
Feminino
Fluoroquinolonas/farmacologia
Seres Humanos
Unidades de Terapia Intensiva
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Plâncton/crescimento & desenvolvimento
Plâncton/isolamento & purificação
Combinação Trimetoprima e Sulfametoxazol/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aminoglycosides); 0 (Anti-Bacterial Agents); 0 (Cephalosporins); 0 (Culture Media); 0 (Fluoroquinolones); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170916
[St] Status:MEDLINE
[do] DOI:10.1111/apm.12739


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[PMID]:28850172
[Au] Autor:Zunza M; Gray DM; Young T; Cotton M; Zar HJ
[Ad] Endereço:Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
[Ti] Título:Isoniazid for preventing tuberculosis in HIV-infected children.
[So] Source:Cochrane Database Syst Rev;8:CD006418, 2017 08 29.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tuberculosis (TB) is an important cause of illness and death in HIV-positive children living in areas of high TB prevalence. We know that isoniazid prophylaxis prevents TB in HIV-negative children following TB exposure, but there is uncertainty related to its role in TB preventive treatment in HIV-positive children. OBJECTIVES: To summarise the effects of TB preventive treatment versus placebo in HIV-positive children with no known TB contact on active TB, death, and reported adverse events. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMed, Embase and two trial registers up to February 2017. SELECTION CRITERIA: We included trials of HIV-positive children with and without known TB exposure, randomized to receive TB preventive treatment or placebo. DATA COLLECTION AND ANALYSIS: Two review authors independently used the study selection criteria, assessed risk of bias, and extracted data. We assessed effects using risk, incidence rate and hazard ratios and assessed the certainty of evidence using GRADE. MAIN RESULTS: We included three trials, involving 991 participants, below the age of 13 years, from South Africa and Botswana. Children were randomized to isoniazid prophylaxis or placebo, given daily or three times weekly. The median length of follow-up ranged from 5.7 to 34 months; some were on antiretroviral therapy (ART).In HIV-positive children not on ART, isoniazid prophylaxis may reduce the risk of active TB (hazard ratio (HR) 0.31, 95% confidence interval (CI) 0.11 to 0.87; 1 trial, 240 participants, low certainty evidence), and death (HR 0.46, 95% CI 0.22 to 0.95; 1 trial, 240 participants, low certainty evidence). One trial (182 participants) reported number of children with laboratory adverse events, which was similar between the isoniazid prophylaxis and placebo groups. No clinical adverse events were reported.In HIV-positive children on ART, we do not know if isoniazid prophylaxis reduces the risk of active TB (risk ratio (RR) 0.76, 95% CI 0.50 to 1.14; 3 trials, 737 participants, very low certainty evidence) or death (RR 1.45, 95% CI 0.78 to 2.72; 3 trials, 737 participants, very low certainty evidence). Two trials (714 participants) reported number of clinical adverse events and three trials (795 participants) reported number of laboratory adverse events; for both categories, the number of adverse events were similar between the isoniazid prophylaxis and placebo groups. AUTHORS' CONCLUSIONS: Isoniazid prophylaxis given to all children diagnosed with HIV may reduce the risk of active TB and death in HIV-positive children not on ART in studies from Africa. For children on ART, no clear benefit was detected. .
[Mh] Termos MeSH primário: Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle
Antituberculosos/uso terapêutico
Infecções por HIV/mortalidade
Isoniazida/uso terapêutico
Tuberculose Pulmonar/mortalidade
Tuberculose Pulmonar/prevenção & controle
[Mh] Termos MeSH secundário: Infecções Oportunistas Relacionadas com a AIDS/mortalidade
Fármacos Anti-HIV/uso terapêutico
Antituberculosos/efeitos adversos
Criança
Infecções por HIV/tratamento farmacológico
Seres Humanos
Incidência
Isoniazida/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Combinação Trimetoprima e Sulfametoxazol/efeitos adversos
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
Tuberculose Pulmonar/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-HIV Agents); 0 (Antitubercular Agents); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination); V83O1VOZ8L (Isoniazid)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171029
[Lr] Data última revisão:
171029
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006418.pub3


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[PMID]:28771141
[Au] Autor:Herrera-Heredia SA; Pezina-Cantú C; Garza-González E; Bocanegra-Ibarias P; Mendoza-Olazarán S; Morfín-Otero R; Camacho-Ortiz A; Villarreal-Treviño L; Rodríguez-Noriega E; Paláu-Davila L; Maldonado-Garza HJ; Flores-Treviño S
[Ad] Endereço:1​Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
[Ti] Título:Risk factors and molecular mechanisms associated with trimethoprim-sulfamethoxazole resistance in Stenotrophomonas maltophilia in Mexico.
[So] Source:J Med Microbiol;66(8):1102-1109, 2017 Aug.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Stenotrophomonas maltophilia is a multidrug-resistant opportunistic pathogen causing an increasing number of nosocomial infections. Our aim was to evaluate the risk factors and mechanisms associated with trimethoprim-sulfamethoxazole (SXT) resistance in S. maltophilia infections in Mexico. METHODOLOGY: Clinical isolates and patients' demographic and clinical data were collected from February 2007 to August 2015 in two tertiary-care hospitals in Mexico. Antimicrobial susceptibility and analysis of sul and SmeABC and SmeDEF efflux pump overexpression were performed in all isolates.Results/Key findings. In the 9-year period, 196 patients infected with S. maltophilia were identified. Most patients were male, and the mean age was 46.2 years. The mean Charlson score was 1.42, and the most frequent comorbidities were arterial hypertension (26.7 %), type 2 diabetes (21.2 %) and cerebral infarction (11.6 %). High drug resistance to meropenem (93.4 %), gentamicin (55.1 %), ceftazidime (52.3 %), cefotaxime (51.5 %), amikacin (42.3 %) and cefepime (32.1 %), and lower resistance to ciprofloxacin (26.0 %), SXT (25.0 %), chloramphenicol (14.3 %) and levofloxacin (2.6 %) were detected. SXT resistance was not associated with the sul genes. SmeABC overexpression was associated with gentamicin (P=0.001) and levofloxacin resistance (P=0.041), whereas SmeDEF overexpression was associated with ceftazidime resistance (P=0.003). Prolonged hospitalization (≥15 days) was an independent risk factor for SXT-resistant S. maltophilia infections (OR=3.05; 95 % CI=1.12-8.86; P=0.029). CONCLUSION: Given the high SXT resistance rate, SXT is not an effective first-line therapy for our patients; instead, levofloxacin could be used as an appropriate therapeutic option against S. maltophilia infections.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Farmacorresistência Bacteriana Múltipla
Infecções por Bactérias Gram-Negativas/microbiologia
Stenotrophomonas maltophilia/efeitos dos fármacos
Sulfametoxazol/farmacologia
Trimetoprima/farmacologia
[Mh] Termos MeSH secundário: Adulto
Proteínas de Bactérias/genética
Proteínas de Bactérias/metabolismo
Infecção Hospitalar
Feminino
Infecções por Bactérias Gram-Negativas/tratamento farmacológico
Seres Humanos
Masculino
México
Testes de Sensibilidade Microbiana
Meia-Idade
Stenotrophomonas maltophilia/classificação
Stenotrophomonas maltophilia/genética
Stenotrophomonas maltophilia/isolamento & purificação
Combinação Trimetoprima e Sulfametoxazol
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination); AN164J8Y0X (Trimethoprim); JE42381TNV (Sulfamethoxazole)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000550



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