BACKGROUND/AIMS: We evaluated the clinical features of ciprofloxacin-resistant Proteus mirabilis bacteremia and risk factors for ciprofloxacin resistance. METHODS: From October 2000 to July 2009, 37 patients with clinically significant P. mirabilis bacteremia were identified and data from patients with ciprofloxacin-resistant and ciprofloxacin-susceptible P. mirabilis bacteremia were compared. RESULTS: The most common underlying diseases were neurologic disease (37.8%) and solid tumors (29.7%). The most common site of infection was the urinary tract (35.1%). Ten of the 37 patients (27.0%) were infected with ciprofloxacin-resistant isolates, and univariate analysis revealed a significant relationship between ciprofloxacin-resistant P. mirabilis bacteremia and neurologic disease, recent operation, L-tube insertion, percutaneous tube use, and extended-spectrum beta-lactamase (ESBL) production (all p < 0.05). ESBL was detected in six of 10 (60%) ciprofloxacin-resistant isolates, while only three of 27 (11%) ciprofloxacin-susceptible isolates produced ESBL (p = 0.005). In a logistic regression analysis, ESBL production remained a significant factor associated with ciprofloxacin resistance, after adjusting for other variables. CONCLUSIONS: These data indicate a close association between ciprofloxacin resistance and ESBL-production in P. mirabilis bacteremia. This association is particularly troublesome because the therapeutic options for serious infections caused by ESBL-producing P. mirabilis are severely restricted.
Adult ; Aged ; Anti-Infective Agents/*pharmacology ; Bacteremia/*drug therapy ; Ciprofloxacin/*pharmacology ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Proteus Infections/*drug therapy ; Proteus mirabilis/*drug effects/enzymology ; Risk Factors ; beta-Lactamases/*biosynthesis

The aim of this study was to demonstrate and assess C-reactive protein (CRP) changes in dogs with induced bacterial cystitis with or without antibiotics. We also evaluated availability of CRP levels to serve as an indicator for monitoring or diagnosing bacterial cystitis. Serial CRP concentrations in dogs with induced bacterial cystitis were higher than those of controls (p < 0.001). CRP concentrations peaked on day 7 and gradually decreased thereafter. In the treatment group, CRP concentrations decreased after medication compared to the untreated group (p = 0.032). CRP levels had a linear correlation with urine white blood cell counts among all groups (r = 0.837, p < 0.001, n = 140). Compared to the negative urine culture group, dogs with positive urine culture results had higher CRP concentrations (median 43.8 mg/L vs. 5.9 mg/L; p < 0.001). Area under the receiver operating characteristic curve was 0.955; when cut-off value was 12.2 mg/L, CRP measurements were found to have a sensitivity of 92.3% and specificity of 86.4%. This result indicates that rapid increases of CRP occurred after inducing bacterial cystitis and CRP may be a useful indicator for monitoring or diagnosing canine bacterial cystitis together with sediment urinalysis and urine bacterial culture.
Amoxicillin-Potassium Clavulanate Combination/therapeutic use ; Animals ; Anti-Bacterial Agents/therapeutic use ; C-Reactive Protein/genetics/*metabolism ; Cystitis/metabolism/*veterinary ; Dogs ; Gene Expression Regulation/*physiology ; Inflammation/*metabolism ; Male ; Proteus Infections/drug therapy/metabolism/microbiology/*veterinary ; Proteus mirabilis

Anti-Bacterial Agents ; therapeutic use ; Ceftazidime ; therapeutic use ; Cross Infection ; drug therapy ; epidemiology ; microbiology ; Escherichia coli Infections ; epidemiology ; Gentamicins ; therapeutic use ; Humans ; India ; epidemiology ; Klebsiella Infections ; epidemiology ; Microbial Sensitivity Tests ; Proteus Infections ; epidemiology ; Pseudomonas Infections ; epidemiology ; Retrospective Studies ; Urinary Tract Infections ; drug therapy ; epidemiology ; microbiology

OBJECTIVETo compare the antibacterial effects of Huangqin-Tang with its metabolites produced by intestinal flora.

METHODThe antibacterial tests in vitro and in vivo were performed by agar dilution method and lethal protection of animal respectively.

RESULTHuangqin-Tang and its metabolites had antibacterial action on bacteria in vitro, however the antibacterial activity of metabolites of Huangqin-Tang on Salmomella, Dysentery bacillus and Proteus in vitro was stronger than Huangqin-Tang. The metabolites of Huangqin-Tang had protective effect on the animals infected by Staphylococcus aureus and Escherichia coli respectively from death, but Huangqin-Tang had no lethal protection action.

CONCLUSIONThe antibacterial effects of metabolites of Huangqin-Tang in vitro and in vivo are stronger than that of Huangqin-Tang, which shows that intestinal flora play a very important role in antibacterial effects of Huangqin-Tang.

Animals ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Escherichia coli Infections ; drug therapy ; Feces ; microbiology ; Intestines ; microbiology ; Male ; Mice ; Phytotherapy ; Plants, Medicinal ; chemistry ; Proteus ; drug effects ; Salmonella ; drug effects ; Shigella dysenteriae ; drug effects ; Staphylococcal Infections ; drug therapy