Infection alerts.
Article Type: Brief article
Subject: Infection (Drug therapy)
Infection (Research)
Antibiotics (Health aspects)
Antibiotics (Research)
Drug resistance in microorganisms (Research)
Pub Date: 05/01/2011
Publication: Name: South African Medical Journal Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 South African Medical Association ISSN: 0256-9574
Issue: Date: May, 2011 Source Volume: 101 Source Issue: 5
Topic: Event Code: 310 Science & research
Product: SIC Code: 2834 Pharmaceutical preparations
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 257352891
Full Text: Antibiotic susceptibility of Esherichia coli has changed in parallel with an increase in organisms expressing beta-lactamase. Practitioners (10) treating uncomplicated urinary tract infections are advised to re-consider an old drug, the urinary antiseptic nitrofurantoin, to which E. coli remains 100% sensitive, as their empiric choice and to cease prescribing trimethoprim-sulphamethoxazole and ampicillin, to which there is now a high level of bacterial resistance. Overuse of the quinolones (ciprofloxacin being the practitioners' favourite) should be avoided, as they must be reserved for second-line antituberculosis therapy.

A shock finding from rural Tugela Ferry in KZN (11) is that patients with HIV-TB co-infection have a 20% methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage rate on admission to the Church of Scotland Hospital; a further 10% of negative carriers at admission become positive on repeat testing, suggesting nosocomial acquisition. Fortunately, most isolates remain sensitive to vancomycin, clindamycin and fusidic acid. Those living with HIV/ AIDS potentially constitute a 'pool' of diverse infection and may represent a source of increasingly resistant organisms, as they tend to receive repeated courses of antibiotics as a variety of infections complicate their course.
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.

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