nystatin-a1 and Enterobacteriaceae-Infections

113 patients being treated for acute non-lymphoblastic leukaemia were investigated to determine the effect of suppression of body microbial flora on prevention of infection. They were randomly allocated to a control group or a group which received non-absorbed antibiotics by mouth and topical applications of cutaneous and mucosal antiseptic preparations. The group receiving oral non-absorbed antibiotics had significantly few infections, fewer deaths from infection, fewer pyrexial episodes, and consequently received less systemic antibiotic therapy than the controls.

Topics: Acute Disease; Administration, Oral; Administration, Topical; Adolescent; Adult; Antineoplastic Agents; Bacterial Infections; Bacteroides Infections; Chlorhexidine; Colistin; Drug Combinations; Enterobacteriaceae Infections; Framycetin; Humans; Leukemia; Nystatin; Remission, Spontaneous; Sepsis; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections

Eighty-three patients with 117 episodes of candidemia were reviewed to examine the clinically significant variables and the results of treatment for this problem. Mortality was 52%. Patients who had bacteremia either synchronously or metachronously in association with Candida species had poorer survival rates. Staphylococcal and enterococcal species were the most frequently associated bacteria. Patients with Candida parapsilosis had better survival rates than patients with other species. Portals of entry for fungemia were catheters, wounds, the urinary tract, and the peritoneal cavity, but were undefined in 54% of patients. Antifungal chemotherapy could not be identified as affecting the outcome in these patients. It is suggested that candidemia in most patients represents a failure of host defense, and that septicemia of either bacteria or fungi may arise from the gastrointestinal tract in critically ill, immunocompromised patients.

Topics: Adolescent; Adult; Aged; Amphotericin B; Candidiasis; Child; Enterobacteriaceae Infections; Female; Humans; Immunocompetence; Male; Middle Aged; Nystatin; Sepsis; Staphylococcal Infections

Although previous reports have implicated Shigella flexneri in resistant or chronic cases of vulvovaginitis in children, no authors have described the clinical findings of this condition. The report presents four cases of persistent vulvovaginitis in prepubertal Indian girls from different reservation communities in Arizona. S. flexneri was isolated in pure culture from the vaginal discharge of each patient. All four cases were characterized by a prolonged vaginitis with a bloody, purulent discharge which responded poorly or not at all to various topical modes of therapy for nonspecific vaginitis. Three cases cleared completely when treated with orally given ampicillin for one week. The striking similarity of these cases suggests that chronic Shigella vulvovaginitis is a recognizable clinical entity and should be considered in the differential diagnosis of persistent vaginitis in children, especially in those from communities where Shigella is endemic.

Topics: Ampicillin; Arizona; Child; Child, Preschool; Enterobacteriaceae Infections; Estrogens; Female; Humans; Indians, North American; Nitrofurantoin; Nystatin; Shigella flexneri; Sulfisoxazole; Sulfonamides; Vulvovaginitis