tetracycline and Diarrhea

Lactobacillus reuteri ATCC 55730 has been shown to provide a moderate clinical effect in the treatment of acute gastroenteritis (AGE) in children. However, as the L. reuteri ATCC 55730 strain was found to carry potentially transferable resistance traits for tetracycline and lincomycin, it was replaced by a new strain, L. reuteri DSM 17938, without unwanted plasmid-borne antibiotic resistance. Bioequivalence of the two strains has been suggested. We aimed to systematically evaluate data on the effectiveness of L. reuteri DSM 17938 and the original strain, L. reuteri ATCC 55730, in the treatment of AGE in children. The Cochrane Library, MEDLINE, and EMBASE databases, reference lists, and abstract books of major scientific meetings were searched in August 2013, with no language restrictions, for relevant randomised controlled trials (RCTs). Two RCTs (n=196) that evaluated L. reuteri DSM 17938 and three RCTs (n=156) that evaluated L. reuteri ATCC 55730, which involved hospitalised children aged 3 to 60 months, met the inclusion criteria. Compared with placebo or no treatment, DSM 17938 significantly reduced the duration of diarrhoea (mean difference -32 h, 95% confidence interval (CI): -41 to -24) and increased the chance of cure on day 3 (relative risk: 3.5, 95% CI: 1.2 to 10.8, random effects model). Similar results were obtained with the original strain, L. reuteri ATCC 55730. In conclusion, in hospitalised children, use of both strains of L. reuteri reduced the duration of diarrhoea, and more children were cured within 3 days. Data from outpatients and countryspecific cost-effectiveness analyses are needed. Given the limited data and the methodological limitations of the included trials, the evidence should be viewed with caution.

Topics: Anti-Bacterial Agents; Child, Preschool; Diarrhea; Drug Resistance, Multiple, Bacterial; Feces; Gastroenteritis; Humans; Infant; Limosilactobacillus reuteri; Lincomycin; Probiotics; Tetracycline

Infectious diarrhea is an important disease in the elderly. Some basic principles have been outlined, as follows. In the elderly: Infectious diarrhea is an underappreciated health problem. There is a higher mortality rate and case-fatality rate compared with younger persons. Infectious diarrhea is most often associated with group settings (e.g., nursing homes and skilled nursing facilities) or antibiotic use. Infectious diarrhea may be associated with abnormal immune function (i.e., immunosenescence). Certain bacterial infections are commoner (e.g., C. difficile, E. coli O157:H7, and Salmonella). Some infections behave differently (e.g., Salmonella). Prompt and adequate rehydration measures are crucial. The institution of appropriate contact isolation and infection control measures is crucial in group settings.

Topics: Aged; Anti-Bacterial Agents; Bacterial Infections; Diarrhea; Escherichia coli; Fluid Therapy; Humans; Immune System; Nursing Homes; Salmonella; Shigella sonnei; Tetracycline

Topics: Administration, Topical; Animals; Clindamycin; Cricetinae; Diarrhea; Drug Eruptions; Enterocolitis, Pseudomembranous; Erythromycin; Humans; Ointments; Skin Pigmentation; Tetracycline

Topics: Anti-Infective Agents, Urinary; Antidiarrheals; Chloramphenicol; Chlorpromazine; Cholera; Diarrhea; Drug Combinations; Enterotoxins; Escherichia coli; Escherichia coli Infections; Fluid Therapy; Furazolidone; Humans; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Water-Electrolyte Balance

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Clindamycin; Colitis; Colonic Diseases; Diarrhea; Enterocolitis, Pseudomembranous; Female; Humans; Lincomycin; Male; Middle Aged; Tetracycline

Topics: Anti-Bacterial Agents; Carbenicillin; Clindamycin; Diarrhea; Enterocolitis, Pseudomembranous; Erythromycin; Humans; Legionnaires' Disease; Lung Diseases; Male; Methicillin; Penicillin Resistance; Prostatitis; Staphylococcal Infections; Staphylococcus aureus; Streptococcus pneumoniae; Tetracycline; Urethritis; Vancomycin

Topics: Africa, Western; Animals; Bicarbonates; Child; Chlorides; Cholera; Diarrhea; Dogs; Enterotoxins; Europe; Feces; Glucose; Humans; Intestinal Absorption; Intestinal Diseases; Intestinal Mucosa; Isotonic Solutions; Potassium; Sodium; Tetracycline; Water-Electrolyte Balance

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Arthritis; Diagnosis; Diarrhea; Humans; Lipodystrophy; Pathology; Tetracycline; Whipple Disease

Topics: Anti-Bacterial Agents; Chloramphenicol; Dehydration; Diarrhea; Gastroenteritis; Humans; Kanamycin; Methicillin; Neomycin; Penicillin G; Polymyxins; Sepsis; Shock, Septic; Streptomycin; Sulfisoxazole; Tetracycline

Vibrio cholerae O139 synonym Bengal, recognized in 1993, is the second member in the list of about 200 serogroups of V. cholerae with epidemic and pandemic potential. Although replacement of fluids and electrolytes remains the cornerstone in the management of cholera, antimicrobial therapy can significantly shorten the duration of diarrhoea, and reduce stool volume and requirements ofrehydration fluids. The role of antimicrobial therapy on the natural course of the disease caused by this relatively new pathogen has not been systematically assessed. A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the efficacy of tetracycline in the treatment of adults with severe cholera due to V. cholerae O139 Bengal. Forty-three adult males with severe cholera were randomly allocated to receive either 500 mg of tetracycline (n=21) or placebo (n=22) for three consecutive days. Demographic and clinical characteristics of these patients on admission were comparable. Tetracycline therapy was associated with significantly reduced total median (inter-quartile range) stool volume [216.48 (90.18-325.22) mL/kg vs 334.25 (215.12-537.64) mL/kg; p=0.001], higher rates of clinical cure (81% vs 27%; p<0.001), and shorter median (inter-quartile range) duration of diarrhoea [32 (24-48) hours vs 80 (48-104) hours; p<0.001]. The mean +/- (SD) requirement of intravenous fluid was not significantly different between the two groups [146.42 +/- 42.12 mL/kg vs 150.44 +/- 27.21 mL/kg; p=0.70]. The median (inter-quartile range) duration of faecal excretion of V. cholerae O139 was significantly shorter in the tetracycline group than the placebo group [1(1-2) day vs 5 (3-6) days; p<0.001]. The results of the study indicate that tetracycline therapy is clinically useful in the treatment of severe cholera due to V. cholerae O139 Bengal.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cholera; Dehydration; Diarrhea; Double-Blind Method; Fluid Therapy; Humans; Male; Middle Aged; Tetracycline; Time Factors; Vibrio cholerae

The metronidazole resistance of Helicobacter pylori strains has increased rapidly.. To evaluate the efficacy and safety of new 1-week regimens containing ranitidine bismuth citrate, furazolidone and either amoxicillin or tetracycline.. One hundred and twenty patients with H. pylori-positive inactive duodenal ulcer or non-ulcer dyspepsia diagnosed by endoscopy were recruited randomly to receive one of two regimens for 7 days: ranitidine bismuth citrate, 350 mg b.d., furazolidone, 100 mg b.d., and either amoxicillin, 1000 mg b.d. (n=60), or tetracycline, 500 mg b.d. (n=60). H. pylori infection was identified by rapid urease testing and histology. 13C-Urea breath test was performed to evaluate the cure of H. pylori infection at least 4 weeks after completion of triple therapy.. The eradication rates of H. pylori by ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline regimens were 82% and 85% (P > 0.05), respectively, by intention-to-treat analysis, and 85% and 91% (P > 0.05), respectively, by per protocol analysis. Adverse effects were mild in both ranitidine bismuth citrate-furazolidone-amoxicillin and ranitidine bismuth citrate-furazolidone-tetracycline groups.. One-week regimens containing ranitidine bismuth citrate, furazolidone and amoxicillin or tetracycline are well tolerated and effective for the eradication of H. pylori.

Topics: Adolescent; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents, Local; Anti-Ulcer Agents; Bismuth; Diarrhea; Dizziness; Double-Blind Method; Drug Therapy, Combination; Exanthema; Female; Furazolidone; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Penicillins; Prospective Studies; Pruritus; Ranitidine; Tetracycline; Treatment Outcome; Vomiting

The best regimen for the treatment of Helicobacter pylori infection has yet to be defined. Four-day quadruple therapy with tetracycline, metronidazole, bismuth, and a proton pump inhibitor has been shown to obtain a very high cure rate. However, the fact that it must be taken four times daily may interfere with compliance. The objective of the study was to test the efficacy and tolerability of a new 4-day therapy with 4 drugs taken every 12 hours to cure H. pylori infection. Patients and Methods. Fifty-six consecutive patients with peptic ulcer disease and H. pylori infection were treated with an oral 4-day course with omeprazole (20 mg/12 hours), clarithromycin (500 mg/12 hours), amoxicillin (1 g/12 hours) and tinidazole (500 mg/12 hours). Efficacy of the treatment was determined at least 2 months after therapy either by biopsy (in the case of gastric ulcer) or by 13C-urea breath test. A second breath test was performed at least 6 months after therapy.. Two patients were lost to follow-up. Forty-nine of the remaining 54 patients were cured at the first control [intention-to-treat cure rate: 87.5% (CI 95% 75-94%); per protocol cure rate: 90.7% (CI 95% 81-98%)]. Forty-three of these 49 cured patients returned for a second 13C urea breath-test at 6-12 months. Two of them were not cured, giving a long-term cure rate of 85.5% per protocol and 73.2% by intention-to-treat. Compliance was good, although 25 patients had mild side effects.. This particular four-day therapy is well tolerated, easy to follow, and achieves an acceptably high cure rate.

Topics: Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Clarithromycin; Diarrhea; Drug Administration Schedule; Drug Therapy, Combination; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Nausea; Omeprazole; Organometallic Compounds; Patient Compliance; Pilot Projects; Tetracycline; Time Factors; Tinidazole; Treatment Outcome

Tetracycline and niacinamide were administered in combination to 19 atopic dogs to determine their effectiveness in controlling pruritus. The pruritus was controlled successfully in only one dog. One dog experienced diarrhea that was severe enough to warrant stopping the medication.

Topics: Animals; Anti-Bacterial Agents; Diarrhea; Dog Diseases; Dogs; Drug Therapy, Combination; Hypersensitivity, Immediate; Niacinamide; Pruritus; Tetracycline; Treatment Outcome

Antibiotic treatment appears to shorten the duration of diarrhea and eradicate Vibrio cholerae. The objective of this study was to compare the efficacy of tetracycline with norfloxacin therapy in patients (adults and children) with acute severe watery diarrhea caused by VC 01 and VC 0139. Patients (adults and children) with acute severe watery diarrhea admitted to Bamrasnaradura Infectious Disease Hospital, Thailand were randomized to receive either tetracycline (500 mg qid in adults and 12.5 mg/kg qid in children) or norfloxacin (400 mg bid in adults and 7.5 mg/kg bid in children) for 3 days each. The duration of diarrhea and the fecal shedding were comparable between two groups. Thirteen cases were treated with tetracycline and twelve cases with norfloxacin. The results showed the mean duration of diarrhea in tetracycline-treated and norfloxacin-treated groups were 1.31 and 1.25 days, respectively. The mean fecal shedding in tetracycline-treated and norfloxacin-treated group were 1.38 and 1.33 days, respectively. However, there were no statistically significant differences between two groups of both comparisons (p > 0.05). All isolates (VC 01 and VC 0139) in this study were susceptible to both antibiotics. Tetracycline therapy is as good as norfloxacin therapy for quick recovery and time for bacterial eradication in patients with acute severe watery diarrhea caused by Vibrio cholerae. Children aged less than 8 years should not use tetracycline therapy because of its toxic effects.

Topics: Adolescent; Adult; Age Factors; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Child; Child, Preschool; Cholera; Diarrhea; Female; Humans; Infant; Male; Middle Aged; Norfloxacin; Tetracycline; Vibrio cholerae

Peptic ulcer patients need to be treated with antimicrobials to cure Helicobacter pylori infection. Seven-day quadruple therapy is the regimen with the highest cure rates. An ultra-short quadruple therapy was evaluated prospectively.. Forty-six consecutive H. pylori positive patients (33 had proven ulcer disease) were prescribed lansoprazole 30 mg b.d. on days 1-4, and on day 4 they received in addition tripotassium dicitrato bismuthate 120 mg, tetracycline 250 mg and metronidazole 250 mg at 09.00, 11.00, 13.00, 15.00, 17.00, 19.00, 21.00, 23.00 hours. Repeat endoscopy with biopsies for CLOtest, Giemsa stain and culture was carried out 6 weeks later.. Follow-up was complete. Overall cure rate (all three biopsy-based tests negative) was 26/46 (57%; 95% CI: 41-71%). Antibiotic sensitivity was available in 42. Thirty-nine carried a metronidazole sensitive strain and 23/39 (59%) were cured, three carried a resistant strain and therapy failed in all. Three out of four in whom susceptibility was unknown were cured. Metronidazole resistance was induced in 8 out of 16 with a sensitive strain. Only one patient (3%) reported severe side effects.. This convenient quadruple regimen showed that a short contact time is sufficient to kill H. pylori in vivo. Since 57% of patients are cured with a 14-h treatment, a slightly longer treatment duration may increase the cure rate to above 90%.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Ulcer Agents; Bismuth; Diarrhea; Drug Therapy, Combination; Dyspepsia; Endoscopy, Gastrointestinal; Enzyme Inhibitors; Female; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Metronidazole; Middle Aged; Omeprazole; Organometallic Compounds; Peptic Ulcer; Prospective Studies; Proton Pump Inhibitors; Tetracycline

New treatments for malaria are urgently needed in areas such as Thailand where highly drug-resistant strains of Plasmodium falciparum are prevalent. Mefloquine is rapidly losing efficacy and conventional doses of halofantrine are infective. We therefore used pharmacokinetic stimulation to design an extended-dose halofantrine regimen and tested it in 26 soldiers stationed along the Thai-Cambodian border. Halofantrine was given after meals as three doses of 500 mg each at 4-hr intervals on the first day, followed by 500 mg a day for six days (total dose 4.5 g). Twenty-six soldiers treated with quinine-tetracycline for seven days (Q7T7) served as controls. There were no significant differences in efficacy between halofantrine and Q7T7 (P > 0.1) as assessed by cure rate (92% versus 85%), mean parasite clearance time (82 hr versus 81 hr), or mean fever clearance time (93 hr versus 99 hr). Halofantrine was better tolerated than Q7T7. The side effects score was lower (2 versus 11; P < 0.001), there were less days on which side effects occurred (2.0 days versus 5.5 days; P < 0.001), and fewer patients had adverse effects on every treatment day (4% versus 42%; P < 0.01). High-dose halofantrine is as effective and better tolerated than quinine-tetracycline for multidrug-resistant falciparum malaria.

Topics: Adult; Animals; Chi-Square Distribution; Diarrhea; Dizziness; Drug Resistance; Drug Therapy, Combination; Humans; Malaria, Falciparum; Male; Mefloquine; Phenanthrenes; Plasmodium falciparum; Quinine; Tetracycline; Thailand; Vomiting

To evaluate two triple-therapy (TT) regimens of colloidal bismuth subcitrate (CBS), metronidazole, and tetracycline HCl in eradicating Helicobacter pylori, with particular attention to the frequency of resulting adverse effects of the two therapies.. A prospective, randomized controlled trial was conducted in patients with symptoms of dyspepsia who were positive for H. pylori. Subjects received a 14-day course of either 4 x/day therapy of CBS (108 mg), tetracycline HCl (500 mg), and metronidazole (250 mg), or 5 x/day therapy of CBS (108 mg), tetracycline HCl (250 mg), and metronidazole (200 mg). H. pylori status was determined endoscopically by urease test, histology, and culture. Standard questionnaires were administered to determine compliance to treatment and side effects of therapy.. H. pylori was eradicated in 196/213 (92%) patients in the 4 x/day group and 202/210 (96%) in the 5 x/day group (p = 0.07). Side effects were significantly less frequent and less severe in the 5 x/day group (p < 0.01).. We conclude that a lower dose, 5 x/day triple therapy treatment of H. pylori is equally efficacious to the standard 4 x/day therapy, but is accompanied by fewer and milder adverse effects.

Topics: Abdominal Pain; Anti-Bacterial Agents; Constipation; Diarrhea; Drug Administration Schedule; Drug Therapy, Combination; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Nausea; Organometallic Compounds; Patient Compliance; Prospective Studies; Tetracycline; Vomiting

To compare the efficacy of a single dose of doxycycline (200 or 300 mg) with the standard multiple doses of tetracycline in patients with cholera.. Randomised double blind controlled trial. Patients were given a single 200 mg dose of doxycycline, a single 300 mg dose of doxycycline, or multiple doses of tetracycline (500 mg, six hourly intervals).. Hospital in Bangladesh treating diarrhoea.. 261 Patients aged over 15 admitted to the hospital with severe dehydration due to acute watery diarrhoea associated with Vibrio cholerae. All vibrios isolated from the stools and rectal swabs of patients, including those patients with prolonged excretion of vibrios, were sensitive to tetracycline. The stools of all patients at admission were negative for shigella and salmonella.. All patients received rapid intravenous acetate solution for the first four hours after admission to hospital. They were then entered in the study and randomised. Oral rehydration was started immediately after the intravenous treatment. If signs of severe dehydration reappeared during oral treatment patients were given rapid intravenous acetate solution until dehydration was fully corrected.. Stool output in first 24 hours and till diarrhoea stopped, total intake of oral rehydration fluid, duration of diarrhoea, and excretion of vibrio after receiving antibiotic treatment.. The median stool outputs during the first 24 hours (275 ml/kg body weight) and till diarrhoea stopped (296 ml/kg body weight) were significantly higher in patients receiving 200 mg doxycycline as a single dose than in patients receiving either standard tetracycline (242 ml/kg body weight and 254 ml/kg body weight) or 300 mg doxycycline (226 ml/kg body weight and 255 ml/kg body weight). Similarly, median consumption of oral rehydration solution (18.45 l) was significantly higher in patients receiving 200 mg doxycycline than in patients receiving either 300 mg doxycycline (16.10 l) or standard tetracycline (14.80 l). Almost equal numbers of patients in each group required unscheduled intravenous acetate solution to correct dehydration during antibiotic treatment. Patients treated with doxycycline (low or high dose), however, had more prolonged excretion of bacteria.. A single 300 mg dose of doxycycline is as effective as the standard multiple dose tetracycline treatment for cholera in terms of stool output, duration of diarrhoea, vomiting, and requirement for oral rehydration solution.

Topics: Adolescent; Adult; Cholera; Diarrhea; Double-Blind Method; Doxycycline; Female; Fluid Therapy; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Tetracycline; Time Factors

A double blind study of daily doxycycline (100 mg) vs. weekly mefloquine (250 mg) was performed on United States soldiers training in Thailand to assess the effect of doxycycline malaria prophylaxis on the incidence of gastrointestinal infections. During a 5 week period, 49% (58/119) of soldiers receiving doxycycline and 48% (64/134) of soldiers receiving mefloquine reported an episode of diarrhea. Infection with bacterial enteric pathogens was identified in 39% (47/119) of soldiers taking doxycycline and 46% (62/134) of soldiers taking mefloquine. Forty-four percent (59/134) of soldiers receiving mefloquine and 36% (43/119) of soldiers receiving doxycycline were infected with enterotoxigenic Escherichia coli (ETEC), while 9% (12/134) of soldiers receiving mefloquine and 4% of soldiers receiving doxycycline were infected with Campylobacter. Side effects from either medication were minimal. After 5 weeks in Thailand, the percent of non-ETEC strains resistant to greater than or equal to 2 antibiotics increased from 65% (77/119) to 86% (95/111) in soldiers on mefloquine and from 79% (84/106) to 93% (88/95) in soldiers on doxycycline. Doxycycline prophylaxis did not prevent or increase diarrheal disease in soldiers deployed to Thailand where ETEC and other bacterial pathogens are often resistant to tetracyclines.

Topics: Adolescent; Adult; Animals; Bacterial Infections; Campylobacter; Cryptosporidium; Diarrhea; Double-Blind Method; Doxycycline; Drug Resistance, Microbial; Escherichia coli; Gastrointestinal Diseases; Humans; Malaria; Male; Mefloquine; Military Personnel; Random Allocation; Tetracycline; Thailand

To evaluate single doses of 400 mg of furazolidone and 1 g of tetracycline given orally to patients with diarrhea due to Vibrio cholerae, we studied 87 adults in a randomized, double-blind, placebo-controlled trial. All patients received intravenous fluids for rehydration and no other drugs. The total volumes of stool (mean +/- standard deviation) during a 6-day period after treatment were significantly smaller in the tetracycline group (10.5 +/- 8.6 liters) than in the furazolidone group (20.9 +/- 15.9 liters) and the placebo group (19.1 +/- 10.5 liters) (P less than 0.01). The duration of diarrhea and volumes of intravenous fluids were also significantly reduced in the tetracycline group (P less than 0.05). However, there were no differences between the furazolidone and the placebo groups with regard to stool volume, intravenous fluid, and duration of diarrhea. Within 48 h of treatment, tetracycline significantly reduced the number of patients with positive stool cultures for V. cholerae (37%) compared with furazolidone treatment (96%) and the placebo (97%) (P less than 0.001). Although the tetracycline group had a significantly higher incidence (61%) of bacteriologic relapse (negative stool cultures on days 2 and 3, followed by positive cultures afterward) compared with that in the furazolidone group (40%) and the placebo group (33%), this was not associated with clinical relapse. There were no differences between the furazolidone and placebo groups with regard to any of the bacteriologic responses examined. These data indicate that a single dose of 1 g of tetracycline is effective in the treatment of cholera, but it is asymptomatic bacteriologic relapse. A single dose of 400 mg of furazolidone is not therapeutically effective in cholera.

Topics: Adult; Cholera; Diarrhea; Double-Blind Method; Feces; Furazolidone; Humans; Randomized Controlled Trials as Topic; Tetracycline

A randomised clinical trial was carried out to explore the efficacy of single dose tetracycline therapy in cholera. One hundred and eighteen adult patients were assigned to receive either tetracycline in a single 1 g, or a single 2 g dose, or tetracycline 500 mg every six hours four times, or no antibiotics as controls. The means of total liquid stool volumes after treatment were lower in the single 1 g dose group (168.0 +/- 20.9 ml/kg), in single 2 g dose group (229.5 +/- 45.6 ml/kg), and multiple dose group (214 +/- 28.5 ml/kg), than in the control group (499.1 +/- 56.5 ml/kg) (p less than 0.05). Similarly, the means of durations of diarrhoea and intravenous fluid requirements were significantly lower in the single dose and multiple dose tetracycline groups, than in the controls (p less than 0.05). The mean durations of excretion of Vibrio cholerae were significantly shortened from 3.9 +/- 0.2 days in the control group to 1.9 +/- 0.2 days in single 1 g dose, to 2.2 +/- 0.4 days in single 2 g dose and 1.3 +/- 0.1 days in multiple dose groups, respectively (p less than 0.05). Three patients in the single 1 g dose group and two patients in single 2 g dose group had clinical relapses with excretion of V cholerae during the relapses, but this was not significantly more frequent than that in the multiple dose group (p greater than 0.05). These findings suggest that although multiple dose tetracycline therapy remains the best choice, a single dose of either 1 g or 2 g tetracycline appears to be a reasonable alternative for the treatment of cholera as an adjunct to rehydration therapy.

Topics: Adult; Cholera; Clinical Trials as Topic; Diarrhea; Dose-Response Relationship, Drug; Drug Administration Schedule; Feces; Female; Humans; Male; Middle Aged; Random Allocation; Recurrence; Tetracycline; Vibrio cholerae

To evaluate the antisecretory activity of berberine sulfate (BS), we studied 165 adult patients with acute diarrhea due to enterotoxigenic Escherichia coli (ETEC) and Vibrio cholerae in randomized controlled trials. In patients with ETEC diarrhea who received 400 mg of BS in a single oral dose, the mean stool volumes were significantly less than those of the controls during three consecutive 8-hr periods after treatment (P less than .05). At 24 hr after treatment, significantly more patients who were treated with BS and had ETEC diarrhea stopped having diarrhea as compared with the controls (42% vs 20%, P less than .05). In patients with cholera who received 400 mg of BS, the mean 8-hr stool volume during the second 8-hr period after treatment declined to 2.22 liters, which was significantly less than the 2.79 liters found in the controls (P less than .05). However, patients with cholera who received 1200 mg of BS plus tetracycline did not have significant reduction in stool output compared with patients who received tetracycline alone. No side effects of BS were noted. These results indicated that BS is an effective and safe antisecretory drug for ETEC diarrhea, whereas the activity against cholera is slight and not additive with tetracycline.

Topics: Adult; Bacterial Toxins; Berberine; Berberine Alkaloids; Cholera; Clinical Trials as Topic; Diarrhea; Drug Therapy, Combination; Enterotoxins; Escherichia coli; Escherichia coli Infections; Escherichia coli Proteins; Humans; Male; Random Allocation; Tetracycline

The efficacy of erythromycin base (E-Mycin tablets, 333 mg) and the efficacy of tetracycline hydrochloride (Panmycin tablets) were compared in this double-blind, randomized study. Two hundred patients with moderate to moderately severe acne vulgaris were randomly assigned to the study. One hundred patients received 1 gm of erythromycin base by mouth per day for 4 weeks, followed by 333 mg/day for 8 weeks, plus placebo for tetracycline. The second group of patients received 1 gm of tetracycline by mouth per day for 4 weeks, followed by 500 mg/day for 8 weeks, plus placebo for erythromycin. Both drugs reduced acne severity to the same extent. Pustules, papules, and open comedo counts decreased significantly over the 12-week period. Seventy-seven percent of the erythromycin-treated patients and 89% of the tetracycline-treated patients stated that their acne was markedly improved or improved by week 12. Most of the side effects in patients treated with erythromycin were gastrointestinal symptoms. Among the side effects in patients treated with tetracycline were Candida vaginitis in one patient and pseudotumor cerebri in one patient.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Erythromycin; Female; Humans; Nausea; Pregnancy; Tetracycline

Four hundred adults presenting with acute watery diarrhoea were entered into a randomised, placebo controlled, double blind clinical trial of berberine, tetracycline, and tetracycline and berberine to study the antisecretory and vibriostatic effects of berberine. Of 185 patients with cholera, those given tetracycline or tetracycline and berberine had considerably reduced volume and frequency of diarrhoeal stools, duration of diarrhoea, and volumes of required intravenous and oral rehydration fluid. Berberine did not produce an antisecretory effect. Analysis by factorial design equations, however, showed a reduction in diarrhoeal stools by one litre and a reduction in cyclic adenosine monophosphate concentrations in stools by 77% in the groups given berberine. Considerably fewer patients given tetracycline or tetracycline and berberine excreted vibrios in stools after 24 hours than those given berberine alone. Neither tetracycline nor berberine had any benefit over placebo in 215 patients with non-cholera diarrhoea.

Topics: Acute Disease; Adult; Berberine; Berberine Alkaloids; Cholera; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Random Allocation; Tetracycline

The clinical characteristics of disease due to enterotoxigenic Escherichia coli (ETEC) were determined in 88 adult males admitted to a hospital in Dacca, Bangladesh, with moderate to severe dehydration. Persons infected with ETEC strains producing both heat-labile toxin (LT) and heat-stable (ST) toxin had more dehydration and acidosis, longer duration of illness, and greater stool volume than persons infected with strains producing only ST. Tetracycline therapy, evaluated in 63 cases, resulted in slightly earlier termination of illness in patients with LT-ST strains but had no effect on illness in the patients with ST strains. In both groups of patients tetracycline shortened the duration of excretion of organisms. Because of its limited effectiveness and the generally excellent response of ETEC diarrhea to rehydration therapy alone, tetracycline is not warranted for use in treatment of ETEC diarrhea in adults in this population.

Topics: Adult; Bangladesh; Clinical Trials as Topic; Diarrhea; Escherichia coli; Escherichia coli Infections; Feces; Follow-Up Studies; Humans; Male; Microbial Sensitivity Tests; Rotavirus; Salmonella; Shigella; Tetracycline; Vibrio

A comparative study was undertaken in Indonesia to assess the effect of antibiotic therapy in the treatment of acute diarrheal disease in infants. 120 children, age 2-60 months, suffering form acute gastroenteritis with varying degrees of dehydration who were treated at the Gadjah Mada University Hospital in Yogyakarta, Indonesia, between August and December 1975, were included in the study. Approximately 1/2 the group was treated with antibiotics; the other 1/2 was not. Both groups received oral rehydration therapy. No significant differences were found between the 2 groups as to duration of the diarrhea and duration of hospitalization. It is concluded that antibiotics are not generally indicated in cases of acute diarrheal disease. The only requirements in treatment seems to be maintenance of the fluid electrolyte balance.

Topics: Child, Preschool; Chloramphenicol; Chlortetracycline; Diarrhea; Female; Humans; Infant; Male; Tetracycline

The severity of diarrhea and nutritional status were measured in a prospective study of 97 patients hospitalized with cholera in Dacca, Bangladesh. Ninety-five percent of both adults and children were below their respective medians in weight as related to height; greater than 15% of each group showed second-degree protein-calorie malnutrition. Duration of diarrhea, but no volume of stool per hour, was prolonged by 30%-70% in those adults and children suffering from more severe malnutrition. The increased stool loss was unrelated to antibiotic usage, to presence of intestinal parasites, or to the refeeding diet given. It is suggested that the prolongation of diarrhea represents the continued effect of cholera toxin that is irreversibly bound to intestinal mucosal cells, the replacement of which would be retarded under conditions of poor nutrition.. This study investigates the severity of cholera as related to status of protein-calorie nutrition in both tetracycline-treated and non-antibiotic-treated male patients (n=97) at the Cholera Research Hospital in Dacca, Bangladesh during the cholera epidemic of October through December 1974. Stool and urine samples were analyzed. 54 of the patients were severely dehydrated (plasma specific gravity, 1.034) and 43 were moderately dehydrated (plasma specific gravity, 1.030-1.034). Results show that 95% of both adults and children patients were below their median in weight as related to height and that more than 15% of each group showed 2nd degree protein-calorie malnutrition. Prolongation of diarrhea was marked in all patients. 30 to 70% increase in duration of diarrhea was seen in patients with severe malnutrition. Increased stool loss was not associated with antibiotic usage, presence of intestinal parasites, or to refeeding diet given. The findings show that malnutrition enhances risk of infection and particularly of diarrheal illness, which in turn produces more profound malnutrition. Increased stool losses and prolonged diarrhea in malnourished patients may result in large increases in fluid, electrolyte and nursing needs.

Topics: Bangladesh; Body Height; Body Weight; Child; Child, Preschool; Cholera; Diarrhea; Humans; Infant; Intestinal Mucosa; Male; Protein-Energy Malnutrition; Tetracycline; Toxins, Biological; Vibrio cholerae

Topics: Bronchitis; Chronic Disease; Clinical Trials as Topic; Diarrhea; Escherichia coli; Female; Gastrointestinal Diseases; Haemophilus influenzae; Humans; Male; Minocycline; Staphylococcus; Streptococcus; Suppuration; Tetracycline; Tetracyclines

Topics: Adult; Ampicillin; Bacterial Infections; Cholestyramine Resin; Clinical Trials as Topic; Diarrhea; Feces; Humans; Placebos; Tetracycline; Time Factors; Vietnam

Topics: Adolescent; Adult; Aged; Child; Cholera; Clinical Trials as Topic; Costs and Cost Analysis; Diarrhea; Feces; Folic Acid Antagonists; Humans; Middle Aged; Placebos; Pyrimidines; Sulfadimethoxine; Sulfamethoxazole; Tetracycline; Vibrio

Topics: Clinical Trials as Topic; Diarrhea; Humans; Male; Methacycline; Nausea; Protein Binding; Tetracycline; Time Factors; Urethritis

Seventy-nine patients with chronic bronchitis were randomly allotted to four treatment regimens-placebo throughout the winter months for five years; tetracycline for the first two winters and placebo for the next three; placebo for the first two winters and tetracycline for the next three; and tetracycline for five winters. In addition all groups recevied a five-day course of tetracycline for any acute exacerbation. There was a significant reduction in the number of exacerbations among the more susceptible patients-that is, those who suffered more than one exacerbation each winter. Though the average decline in F.E.V.(1) over the five-year period was less in the treated groups this was not statistically significant. There was no significant difference between the groups in respect of lung volumes, diffusing capacity, and blood gases.

Topics: Adult; Bronchitis; Chronic Disease; Clinical Trials as Topic; Diarrhea; Diffusion; Humans; Male; Middle Aged; Placebos; Respiratory Function Tests; Seasons; Smoking; Spirometry; Sputum; Tetracycline; Weather

Topics: Anti-Bacterial Agents; Clinical Trials as Topic; Diarrhea; Erythromycin; Haemophilus influenzae; Humans; Injections, Intramuscular; Intestinal Absorption; Lincomycin; Male; Mycoplasma; Nausea; Neisseria gonorrhoeae; Neisseria meningitidis; Staphylococcus; Streptococcus; Streptococcus pneumoniae; Tetracycline

A controlled comparison of furazolidone and tetracycline in the treatment of cholera indicates that, in either dosage used, furazolidone reduced total stool volume by 50% and duration of diarrhoea by 40%. These results are comparable to those achieved with tetracycline, which was given in presently recommended dosage. Both furazolidone and tetracycline significantly reduced the rate of stool output within 18 to 24 hours of starting antibiotic treatment. Furazolidone was significantly less effective than tetracycline in rapidly and consistently terminating vibrio excretion. One convalescent carrier of cholera vibrios was identified among control patients; none was identified among patients treated with either tetracycline or furazolidone. All Vibrio cholerae strains tested were sensitive to tetracycline and furazolidone, but larger concentrations of the latter were required to achieve inhibition of growth. It is concluded that tetracycline remains the antibiotic of choice in cholera but that furazolidone would be a useful adjunct to cholera therapy when tetracycline is unobtainable or if strains of V. cholerae with clinically significant resistance to tetracycline should be encountered.

Topics: Adult; Cholera; Clinical Trials as Topic; Diarrhea; Feces; Furazolidone; Humans; Male; Middle Aged; Tetracycline; Time Factors; Vibrio

In a multicentre, double-blind, controlled trial of tetracycline plus nystatin (Mysteclin) and tetracycline, 111 patients with respiratory infections received one or other drug for a period of 10 days.The incidence of gastrointestinal symptoms was high in both groups before treatment began, and somewhat higher in the Mysteclin group than in the tetracycline group. After 10 days' treatment 50% of the patients in the Mysteclin group had symptoms, a mean of 1.44 each, compared with 34% of the patients in the tetracycline group, with a mean of 1.47 symptoms each; the difference between the two groups is not significant (P>0.05). The incidence of Candida albicans in the stools at 10 days in the Mysteclin group (9.1%) was significantly lower than that in the tetracycline group (37.1%), but this was not reflected in any reduction in the frequency of gastrointestinal symptoms.

Topics: Candida; Clinical Trials as Topic; Diarrhea; Feces; Female; Gastrointestinal Diseases; Humans; Male; Middle Aged; Nystatin; Pruritus; Respiratory Tract Infections; Sex Factors; Tetracycline

Antibacterial resistance is a growing concern worldwide, including in Mozambique. Diarrhea is an important cause of mortality in Mozambique, yet few local studies have reported on the resistance of bacterial pathogens in this context. Therefore, this study aims to characterize antibiotic susceptibility patterns of Salmonella, Shigella and Campylobacter spp. among patients with diarrhea, including those who are HIV-infected and-uninfected.. We conducted antibiotic susceptibility testing on 157 stool isolates recovered from 129 patients aged between 0 and 80 years with diarrhea, including HIV infected (n = 68) and-uninfected individuals (n = 61), assisted at two health centers in Maputo city. The isolates comprised of 99 Salmonella, 45 Shigella and 13 Campylobacter strains. The Kirby-Bauer disk diffusion method was used on Mueller-Hinton II agar for Salmonella and Shigella spp., while Mueller-Hinton II agar with 5% defibrinated sheep blood was used for Campylobacter spp. We tested six antibiotics listed on the national essential medicines list, including ciprofloxacin, erythromycin, azithromycin, trimethoprim-sulfamethoxazole, gentamicin, and tetracycline.. All isolates were resistant to at least one antibiotic. A high percentage of Salmonella spp. isolates were found to be resistant to trimethoprim-sulfamethoxazole (89.9%, n = 89), erythromycin (88.9%, n = 88) and tetracycline (76.8%, n = 76). In addition, 86.6% (n = 39) and 68.9% (n = 31) of Shigella isolates were resistant to trimethoprim-sulfamethoxazole and tetracycline, respectively. The majority of Campylobacter isolates (92.3%, n = 12) were resistant to erythromycin, azithromycin and tetracycline. Multidrug resistance (MDR) was observed in 79.8% of Salmonella spp., 76.9% of Campylobacter spp., and 57.8% of Shigella spp. Drug susceptibility profiles for Salmonella spp. and Campylobacter were similar in both HIV-1 infected and uninfected patients. However, Shigella spp. isolates obtained from patients without HIV infection were significantly more likely to be resistant to erythromycin, azithromycin or to exhibit multidrug resistance than those obtained from patients with HIV-1 infection (p < 0.05). All Shigella spp. and Campylobacter spp. isolates were susceptible to gentamicin.. Our study highlights concerning rates of antibiotic resistance and MDR among diarrheal bacterial pathogens in Mozambique. Further research is needed to understand the impact of HIV, ART therapy and immunosuppression on antibiotic resistance. Urgent interventions are essential to prevent the spread of resistant strains.

Topics: Agar; Animals; Anti-Bacterial Agents; Azithromycin; Bacteria; Campylobacter; Diarrhea; Drug Resistance, Bacterial; Drug Resistance, Multiple; Erythromycin; Gentamicins; HIV Infections; Microbial Sensitivity Tests; Mozambique; Salmonella; Sheep; Shigella; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Clostridioides difficile is a bacterium that causes antibiotic-associated infectious diarrhea and pseudomembranous enterocolitis. The impact of C. difficile infection (CDI) in China has gained significant attention in recent years. However, little epidemiological data are available from Chongqing, a city located in Southwest China. This study aimed to investigate the epidemiological pattern of CDI and explore the drug resistance of C. difficile isolates in Chongqing.. A case-control study was conducted to investigate the clinical infection characteristics and susceptibility factors of C. difficile. The features of the C. difficile isolates were evaluated by testing for toxin genes and using multi-locus sequence typing (MLST). The susceptibility of strains to nine antibiotics was determined using agar dilution technique.. Out of 2084 diarrhea patients, 90 were tested positive for the isolation of toxigenic C. difficile strains, resulting in a CDI prevalence rate of 4.32%. Tetracycline, cephalosporins, hepatobiliary disease, and gastrointestinal disorders were identified as independent risk factors for CDI incidence. The 90 strains were classified into 21 sequence types (ST), with ST3 being the most frequent (n = 25, 27.78%), followed by ST2 (n = 10, 11.11%) and ST37 (n = 9, 10%). Three different toxin types were identified: 69 (76.67%) were A. The strains identified in Chongqing, Southwest China, exhibited high genetic diversity. Enhance full awareness of high-risk patients with HA-CDI infection, particularly those with gastrointestinal and hepatocellular diseases, and emphasize caution in the use of tetracycline and capecitabine. These findings suggest that a potential epidemic of CDI may occur in the future, emphasizing the need for timely monitoring.

Topics: Anti-Bacterial Agents; Case-Control Studies; China; Clostridioides; Clostridioides difficile; Clostridium Infections; Diarrhea; Humans; Microbial Sensitivity Tests; Multilocus Sequence Typing; Tertiary Care Centers; Tetracycline; Tigecycline

Analyze the frequency of diarrheagenic Escherichia coli (DEC) pathotypes and their antimicrobial resistance profiles among children aged <15 years with diarrhea in four Mozambican provinces.. A cross-sectional hospital-based surveillance program of diarrhea was implemented in Maputo, Sofala, Zambézia, and Nampula. A single stool sample was collected from each child from May 2014 to May 2017. Culture methods and biochemical characterization were performed to detect E. coli strains. DEC pathotypes were determined by conventional polymerase chain reaction targeting specific virulence genes. Antimicrobial susceptibility was assessed by the Kirby-Bauer method.. From 723 specimens analyzed by culture, 262 were positive for E. coli. A total of 208 samples were tested by polymerase chain reaction for DEC identification, of which 101 (48.6%) were positive for a DEC pathotype. The predominant pathotypes were enteroaggregative (66.3%, 67/101), enteropathogenic (15.8%, 16/101), enterotoxigenic (13.9%, 14/101), and enteroinvasive E. coli (4.0%, 4/101). No Shiga toxin-producing E. coli was identified. Regardless of the province, the most frequent pathotype was enteroaggregative E. coli. Isolated DEC presented high frequency of resistance to ampicillin (97.8%), tetracycline (68.3%), chloramphenicol (28.4%), nalidixic acid (19.5%), and gentamicin (14.4%).. Children with diarrhea in Mozambique had DEC and higher resistance to ampicillin and tetracycline.

Topics: Ampicillin; Anti-Bacterial Agents; Child; Cross-Sectional Studies; Diarrhea; Escherichia coli; Escherichia coli Infections; Humans; Mozambique; Tetracycline

Worldwide, the emergence of diarrhoea-causing multi-drug resistant (MDR) bacteria has become a crucial problem in everyday life. Tetracycline (TC) is a bacteriostatic agent that has a wide spectrum of antibacterial activity. One potential strategy to enhance the penetration and antibacterial activity of antibiotics is the use of nanotechnology. In this context, this study dealt with the synthesis of TC loading in biocompatible magnesium oxide nanoparticles (MgONPs), its characterization, and the potency of killing against diarrhoea-causing MDR bacteria E. coli and S. flexneri. TC loaded- MgONPs (MgONPs-TC) were characterized by DLS, SEM-EDS, UV-vis spectroscopy, and FTIR techniques with adequate physical properties. Antibacterial and antibiofilm studies indicate that this nanoparticle successfully eradicated both planktonic and sessile forms of those bacteria. It also significantly reduced the production of bacterial EPS, different levels of antioxidant enzymes, and induced reactive oxygen species (ROS) in the bacterial cell as a mode of antibacterial action. In particular, MgONPs-TC were efficient in reducing the colonization of MDR E. coli and S. flexneri in the C. elegans model. Therefore, all these data suggest that MgONPs-TC are a highly promising approach to combating diseases associated with diarrhoea-causing MDR bacteria in the medical field with limited health care budgets.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Caenorhabditis elegans; Diarrhea; Escherichia coli; Magnesium Oxide; Microbial Sensitivity Tests; Nanoparticles; Tetracycline

Inappropriate use of antibiotics, especially for treatment of self-limiting infections remains one of the major drivers of antibiotic resistance (ABR). Community pharmacists can contribute to reducing ABR by ensuring antibiotics are dispensed only when necessary.. To assess community pharmacists' management of self-limiting infections.. A purposive sample of 75 pharmacies participated in the study. Each pharmacy was visited by an investigator and a trained simulated patient who mimicked symptoms of common cold and acute diarrhoea, respectively. Interactions between the simulated patient and pharmacist were recorded by the investigator in a data collection form after each visit. Descriptive statistical analysis was carried out. Ethics approval was obtained from the state Ministry of Health Research Ethics Committee.. For common cold, 68% (51/75) of pharmacists recommended an antibiotic. Azithromycin, amoxicillin/clavulanic acid, and sulphamethoxazole/trimethoprim (43%, 24%, 20%, respectively) were the most frequently dispensed agents. For acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic, while 15% dispensed more than one antibiotic. The most frequently dispensed agent was metronidazole (82%), which was dispensed in addition to amoxicillin or tetracycline among pharmacists who dispensed more than one agent. In both infection scenarios, advice on dispensed antibiotics was ofered in 73% and 87% of the interactions, respectively.. This study shows high rate of inappropriate antibiotics dispensing among community pharmacists. There is need for improved awareness of antibiotic resistance through continuing education and training of community pharmacists. Furthermore, the inclusion of antibiotic resistance and stewardship in undergraduate pharmacy curriculum is needed.

Topics: Amoxicillin; Anti-Bacterial Agents; Common Cold; Community Pharmacy Services; Diarrhea; Humans; Inappropriate Prescribing; Metronidazole; Nigeria; Patient Simulation; Pharmacists; Tetracycline

Campylobacter resistance to antimicrobial agents is regarded as a major concern worldwide. The aim of this study was to investigate the expression of the CmeABC efflux pump and the RAPD-PCR pattern in drug-resistant Campylobacter isolates.. A total of 283 stool specimens were collected from children under the age of five with diarrhea. The minimum inhibitory concentration (MIC) of tetracycline and ciprofloxacin was determined by broth microdilution method and E-test, respectively. Detection of tetracycline and ciprofloxacin determinants was done by amplification of tetO gene and PCR-sequencing of the gyrA gene. The cmeABC transcriptional expression was analyzed by Real-time (RT)-PCR. Clonal correlation of resistant strains was determined by RAPD-PCR genotyping.. Out of 283 fecal samples, 20 (7.02%) samples were positive for Campylobacter spp. Analysis of duplex PCR assay of the cadF gene showed that 737 and 461 bp amplicons were corresponding to Campylobacter jejuni and Campylobacter coli, respectively. All of the 17 phenotypically tetracycline-resistant Campylobacter isolates harbored the tetO gene. Also, four phenotypically ciprofloxacin-resistant Campylobacter isolates had a point mutation at codon 257 of the gyrA gene (ACA to ATA; Thr > Ile). High-level expression of the cmeA gene was observed in ciprofloxacin-resistant and high-level tetracycline-resistant Campylobacter isolates, suggesting a positive correlation between the cmeA gene expression level and tetracycline resistance level. Moreover, a statistically significant difference was observed in the cmeA gene expression between ciprofloxacin-resistant and ciprofloxacin-susceptible strains, which signifies the crucial contribution of the efflux pump in conferring multiple drug resistance phenotype among Campylobacter spp. RAPD analysis of Campylobacter isolates exhibited 16 different patterns. Simpsone`s diversity index of RAPD-PCR was calculated as 0.85, showing a high level of homogeneity among the population; however, no clear correlation was detected among tetracycline and/or ciprofloxacin resistant isolates.. Significant contribution of the CmeABC efflux pump in conferring high-level resistance to tetracycline and ciprofloxacin was observed in C. jejuni and C. coli clinical isolates. The resistant phenotype is suggested to be mediated by CmeABC efflux pumps, the tetO gene, and point mutation of the gyrA gene. Genotyping revealed no clonal correlation among resistant strains, indicating distinct evolution of tetracycline and ciprofloxacin resistant genotypes among the isolates.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Campylobacter coli; Campylobacter jejuni; Ciprofloxacin; Diarrhea; DNA, Bacterial; Drug Resistance, Bacterial; Feces; Humans; Membrane Transport Proteins; Microbial Sensitivity Tests; Random Amplified Polymorphic DNA Technique; Tetracycline

Topics: Anti-Bacterial Agents; Azithromycin; Campylobacter; Campylobacter jejuni; Ciprofloxacin; Diarrhea; Drug Resistance, Bacterial; Erythromycin; Humans; Microbial Sensitivity Tests; Tetracycline

We reported earlier about nano-formulation of tetracycline through its entrapment within calcium-phosphate nano-particle (CPNP) and about killing of pathogenic bacterium Shigella flexnari 2a, resistant to tetracycline (and 9 other antibiotics), by the nanonized antibiotic (Tet-CPNP). Here, we report on therapeutic role of Tet-CPNP against deadly diarrheal disease 'shigellosis' in mice, caused by Shigella infection. Our findings revealed that occurrence of mushy-stool excretion, colon-length shortening, weight-loss and bacterial colonization in gastrointestinal tract of mice due to shigellosis was significantly reduced by Tet-CPNP treatment. Histo- and immuno-logical studies showed that changes in morphology and level of inflammatory cytokines TNF-α, IL-1β and IFN-γ in intestinal tissue of Shigella-infected mice were reverted to almost normal features by Tet-CPNP treatment. Bulk tetracycline had no anti-shigellosis action. Thus, nanonization of tetracycline rejuvenated the old, cheap, broad-spectrum antibiotic from obsolescence (due to resistance generation), making it highly beneficial for diarrhea-prone developing countries with limited health-care budgets.

Topics: Animals; Calcium Phosphates; Colon; Colony Count, Microbial; Cytokines; Diarrhea; Drug Resistance, Multiple, Bacterial; Dysentery, Bacillary; Mice, Inbred BALB C; Nanoparticles; Particle Size; Shigella flexneri; Tetracycline

This study was aimed at investigating the occurrence and genetic mechanisms of resistance to ciprofloxacin, tetracycline and erythromycin in clinical isolates of Campylobacter jejuni recovered from human cases of acute gastroenteritis in Turkey.. MIC values of each antibiotic were determined with the epsilometer test (E-test). Resistance genes/mutations were first screened by PCR and analysed by subsequent DNA sequencing.. From a total of 152 C. jejuni isolates tested, 113 (74.3%), 38 (25%) and 9 (5.9%) were found to be resistant to ciprofloxacin, tetracycline and erythromycin, respectively. Sequence analysis of ciprofloxacin-resistant isolates showed that all resistant strains (n=113) carried Thr-86-Ile substition in the gyrA gene, which is the most frequently observed mutation in fluoroquinolone-resistant Campylobacter. All of the tetracycline-resistant isolates (n=38) carried the tetO gene. All of the erythromycin-resistant isolates (n=9) harboured the point mutation A2075G in the 23S rRNA gene, which is the most common mutation conferring macrolide resistance in C. jejuni.. The phenotypic susceptibility testing results were found to agree well with those obtained by genetic detection methods for the C. jejuni isolates tested. The findings of this study showed a very high level of resistance to ciprofloxacin and to a lesser extent to tetracycline while resistance to erythromycin remained at a low level. Thus, erythromycin may be considered as the first choice for treatment of Campylobacter infections in this geographical region when indicated.

Topics: Anti-Bacterial Agents; Campylobacter Infections; Campylobacter jejuni; Ciprofloxacin; Diarrhea; Disk Diffusion Antimicrobial Tests; DNA, Bacterial; Drug Resistance, Bacterial; Erythromycin; Feces; Gastroenteritis; Humans; Microbial Sensitivity Tests; RNA, Bacterial; RNA, Ribosomal, 23S; Tetracycline; Turkey

Topics: Anti-Bacterial Agents; Campylobacter Infections; Campylobacter jejuni; Child; Child, Preschool; Ciprofloxacin; Cross-Sectional Studies; Diarrhea; DNA, Bacterial; Drug Resistance, Bacterial; Erythromycin; Female; Flagellin; Gastroenteritis; Genotype; Humans; Infant; Iran; Macrolides; Male; Microbial Sensitivity Tests; Quinolones; RNA, Ribosomal, 23S; Tetracycline

This paper describes for the first time the isolation of Streptococcus lutetiensis in a cat with intestinal lymphoma. The Streptococcus bovis group has undergone significant taxonomic changes over the past two decades and, in 2002, Poyart et al. described two distinct novel species within the genus Streptococcus: Streptococcus lutetiensis and Streptococcus pasteurianus. The bovis group streptococci include commensal species and subspecies or opportunistic pathogens of humans and animals. The cat was referred to the Veterinary Teaching Hospital, University of Bologna for chronic diarrhoea associated with fresh blood. A diagnosis of intestinal lymphoma was advanced. S. lutetiensis was accidentally isolated from the faeces of the cat and identified through MALDI-TOF and 16s rRNA sequencing. The Kirby-Bauer test revealed that the isolate was resistant to enrofloxacin, erythromycin, clindamycin, marbofloxacin and tetracycline. The detection of S. lutetiensis in cat faeces might suggest that it could be a normal inhabitant of cat intestinal tract or that it could be involved in the manifestation of intestinal diseases. Since bacteria belonging to the S. bovis group are considered emerging pathogens, additional research is required to evaluate the role of S. lutetiensis in cats and its role in the transmission of antimicrobial resistance. SIGNIFICANCE AND IMPACT OF THE STUDY: In this study the isolation of Streptococcus lutetiensis from a cat with intestinal lymphoma was described for the first time. An antimicrobial susceptibility test performed by means of the disc diffusion method revealed that the isolate was resistant to enrofloxacin, erythromycin, clindamycin, marbofloxacin and tetracycline. Nowadays the ecological or pathogenetic role of S. lutetiensis in the gut of animals remains unclear but, even if its role as commensal bacterium was confirmed, the presence of multi-resistant S. lutetiensis in cat gut could favour the transmission of antimicrobial resistance to other bacteria.

Topics: Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Clindamycin; Diarrhea; Disk Diffusion Antimicrobial Tests; Drug Resistance, Multiple, Bacterial; Erythromycin; Feces; Female; Fluoroquinolones; Intestinal Neoplasms; Intestines; Lymphoma; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Streptococcal Infections; Streptococcus; Tetracycline

This study was conducted to test the distribution of diarrheagenic Escherichia coli (DEC) associated genes in fecal isolates from diarrheic yaks of a high remote region of China. Briefly, we obtained 203 fecal samples from diarrheic adult yaks and E. coli strains were isolated and identified via standard methods The antibiotic sensitivity of isolates was determined via disk diffusion method and polymerase chain reaction (PCR) was used to detect the DEC virulence associated genes. Results of the current study showed a high rate of resistance to tetracycline (93.6%) and low rate of resistance to ofloxacin (16.7%) antibiotics. Meanwhile, five different diarrheagenic associated virulence traits were detected including; EAEC (11.80%), EHEC (25.62%), EIEC (17.18%), EPEC (36.92%) and ETEC (11.36%). Moreover, E. coli isolates were positive for all tested DEC associated virulence genes ranging from 1.48% to 33%. Additionally, four isolates were positive for more than one virulence genes. In conclusion, our investigation showed a relatively low number of E. coli virulence genes isolated from diarrheic Tibetan yaks, which could be attributed to the high altitude induced harsh environmental conditions that may not help in the growth and survival of pathogenic organisms. In addition, this study highlights the high level of antibiotic resistance in yaks, therefore; preventive measures should be taken to monitor the antibiotic usage in Tibet region of China.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; China; Diarrhea; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Feces; Ofloxacin; Polymerase Chain Reaction; Prevalence; Tetracycline; Tibet; Virulence

Topics: Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; Central African Republic; Child; Diarrhea; Drug Resistance, Bacterial; Dysentery, Bacillary; Feces; Female; Fluoroquinolones; Humans; Male; Middle Aged; Serogroup; Shigella; Shigella dysenteriae; Shigella flexneri; Shigella sonnei; Tetracycline; Young Adult

Salmonella and Shigella remain the major contributors to acute enteric infections and diarrhoea. Hence, the objective of this study was to isolate and determine the antimicrobial susceptibility pattern of Shigella and Salmonella species from children with acute diarrhoea in Mekelle Hospital and Semen Health Center.. A cross sectional study was conducted among 260 children with acute diarrhoea from November 2011 to March 2012 in Mekelle, Ethiopia. Stool specimen was collected from all study participants who presented with acute diarrhoea. Microscopy, culture and confirmatory identification were done by the pattern of biochemical reactions using a standard bacterial identification system (API 20E, BioMerieux, Marcy-l'Etoile, France) and polyvalent (Poly O and H) antiseras for Salmonella species and Vi for S.typhi. Isolated colonies were assessed for antimicrobial susceptibility profile using disk diffusion method. Data was entered and analyzed using SPSS version 16.0 software.. Out of the 260 study participants, 145(55.8%) were males while 115(44.2%) were females. The majority of the patients (44.2%) were of children under five years old. A total of 120 enteropathogens were isolated. The frequency of isolation was 19(7.3%), 18(6.9%) and 83(31.9%) for Salmonella species, Shigella species and intestinal parasites respectively. Most of the Shigella isolates were resistant to ampicillin (88.9%), Tetracycline (77.8), cotrimoxazole (55.6%) and chloramphenicol (55.6%). Among the Salmonella isolates, the highest resistance was observed to ampicillin (89.5%), Tetracycline (89.5%), chloramphenicol (78.9%) and cotrimoxazole (57.9%). Multi-drug resistance was noted in 19(100%) and 16(88.9%) of Salmonella and Shigella species respectively.. Shigella and Salmonella are still challenging pathogens in children < 5 years of age. High antibiotic resistance was observed among both isolates to ampicillin, tetracycline, chloramphenicol and cotrimoxazole.

Topics: Acute Disease; Adolescent; Ampicillin; Anti-Bacterial Agents; Child; Child, Preschool; Chloramphenicol; Cross-Sectional Studies; Diarrhea; Dysentery, Bacillary; Ethiopia; Feces; Female; Hospitals; Humans; Infant; Male; Microbial Sensitivity Tests; Pediatrics; Salmonella; Salmonella Infections; Shigella; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Enterotoxigenic Escherichia coli (ETEC) is one of the major causes of infectious diarrhea in developing countries. This study aimed to characterize the prevalence and phenotypic and genotypic features of ETEC isolates from Shenzhen, China.. ETEC isolates were obtained from acute diarrheal patients and evaluated for enterotoxin, classical colonization factors (CFs), serotypes, antimicrobial susceptibility, and multilocus sequencing typing (MLST).. A total of 168 (1.3%) ETEC strains were isolated from 13,324 diarrheal outpatients during 2009 and 2014. A vast majority of ETEC-infected patients (82.1%) belonged to the age ranging 20-59 years and only six patients were children aged <5 years. Heat-stable toxin (ST) was most frequently detected (81.5%), followed by heat-labile toxin (LT) (13.1%). One or multiple colonization factors (CFs) were identified in 91 ETEC strains (54.2%). The most frequently detected CF was CS6 (with or without other CFs) (84/91), followed by CS21 (14/91). The most common serotype was O159:H34 (n = 36), followed by O148:H28 (n = 25) and O27:H7 (n = 17). High resistant rate was observed to nalidixic acid (77.4%), cephalothin (41.7%), ampicillin (34.5%), and tetracycline (21.4%). Antimicrobial resistance profiles differed among different serogroups. Sequence type (ST) 10 complex, integrated with connected ST218, ST48, ST4, and ST1312 subgroups, covered 73 (43.5%) isolates.. ETEC isolates in Shenzhen of China appeared highly diverse, yet some isolates belonged to well-defined clonal groups sharing a unique set of virulence factors, serotypes, and MLST sequence types. Facing the challenge of ETEC antigenic diversity and geographic variation, novel molecules and/or classical antigens designed by novel strategies might contribute to ETEC vaccine development.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ampicillin; Anti-Bacterial Agents; Bacterial Toxins; Cephalothin; Child; Child, Preschool; China; Diarrhea; DNA, Bacterial; Drug Resistance, Multiple, Bacterial; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Female; Genes, Bacterial; Genotyping Techniques; Humans; Infant; Male; Middle Aged; Multilocus Sequence Typing; Nalidixic Acid; Tetracycline; Young Adult

Topics: Administration, Intravaginal; Adult; Aged; Anti-Bacterial Agents; Body Piercing; Campylobacter Infections; Campylobacter jejuni; Cellulitis; Ciprofloxacin; Communicable Diseases; Cyanosis; Diarrhea; Dietary Fiber; Drug Therapy, Combination; Estrogens; Female; Helicobacter Infections; Humans; Lyme Disease; Male; Metronidazole; Middle Aged; Otitis; Penicillin V; Phenazopyridine; Proton Pump Inhibitors; Tetracycline; Tick Bites; Travel-Related Illness; Urinary Tract Infections; Young Adult

Diarrhoeagenic Escherichia coli (DEC) pathotypes are among the most common bacterial causes of morbidity and mortality in young children. These pathogens are not sought routinely and capacity for their detection is limited in Africa. We investigated the distribution and dissemination of DEC in 126 children paired with their mothers in a Nigerian community.. A total of 861 E. coli were isolated from 126 children with diarrhoea and their mothers. Antimicrobial susceptibility of each isolate was determined by Kirby-Bauer disc diffusion technique. All the isolates were screened for DEC markers by multiplex PCR. Genetic relatedness of DEC strains was determined by flagellin typing and Insertion element 3 (IS3)-based PCR.. DEC were identified from 35.7% of individuals with the most common pathotype being shiga toxin-producing E. coli (42, 16.7%). Identical pathotypes were found in 13 (10.3%) of the mother-child pairs and in three of these strains from mothers and their children showed identical genetic signatures. Over 90% of DEC isolates were resistant to ampicillin, sulphonamide, tetracycline, streptomycin or trimethoprim, but only 9 (7.2%) were ciprofloxacin resistant. The data suggest that healthy mothers are asymptomatic reservoirs of multiply-resistant strains that are pathogenic in their children and there are instances in which identical strains are found in mother-child pairs.

Topics: Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; Child, Preschool; Ciprofloxacin; Diarrhea; Diarrhea, Infantile; Disk Diffusion Antimicrobial Tests; DNA Transposable Elements; Escherichia coli; Escherichia coli Infections; Female; Humans; Infant; Infant, Newborn; Middle Aged; Mothers; Multiplex Polymerase Chain Reaction; Nigeria; Tetracycline; Young Adult

Diarrhea is the second most common cause of death among children less than 5 years of age worldwide. The etiological agents of diarrhea in the southeast coastal area of China were studied from July 2009 to December 2014.. A total of the 2318 patients were enrolled in this study and examined for the presence of viruses, bacteria, and parasites. Multiplex real-time PCR was used for the detection of diarrheagenic Escherichia.coli (DEC). DEC strains were tested for susceptibility to a panel of 20 antibiotics using the Kirby-Bauer disc-diffusion method.. Of the 2318 children with diarrhea, 962 (41.5 %) were positive for at least one pathogen. Rotavirus, human calicivirus (HucV), and DEC were predominant, with detection rates of 19.1 % (443), 17.7 % (411), and 7.6 % (177), respectively. The prevalences of various pathogens in patients of different ages and in different seasons were not the same. The resistance rates of 177 strains of DEC to ampicillin, tetracycline, and cefazolin were 93.2 %, 60.0 %, and 57.7 %, respectively.. Rotavirus, HucV, and DEC were the main pathogens associated with diarrhea in Zhejiang, China. DEC possessed high levels of antibiotic resistance. Increased monitoring of etiological agents of diarrhea is necessary.

Topics: Ampicillin; Anti-Bacterial Agents; Caliciviridae Infections; Child, Preschool; China; Diarrhea; Disk Diffusion Antimicrobial Tests; Escherichia coli; Escherichia coli Infections; Female; Humans; Infant; Male; Population Surveillance; Prevalence; Real-Time Polymerase Chain Reaction; Rotavirus; Rotavirus Infections; Seasons; Tetracycline

This study was conducted to determine the prevalence of virulence genes, serogroups, antimicrobial resistance and phylogenetic groups of Escherichia coli strains isolated from diarrheic and healthy camel calves in Tunisia. From 120 fecal samples (62 healthy and 58 diarrheic camel calves aged less than 3 months), 70 E. coli isolates (53 from diarrheic herds and 17 from healthy herds) were examined by PCR for detection of the virulence genes associated with pathogenic E. coli in animals. A significantly greater frequency of the f17 gene was observed in individual camels and in herds with diarrhea, this gene being found in 44.7% and 41.5% of isolates from camels and herds with diarrhea versus 22.5% and 11.7% in camels (p=0.05) and herds without diarrhea (p=0.02). The aida, cnf1/2, f18, stx2 and paa genes were found only in isolates from camels with diarrhea, although at a low prevalence, 1.8%, 3.7%, 1.8%, 3.7% and 11.3%, respectively. Prevalence of afa8, cdtB, eae, east1, iroN, iss, kpsMTII, paa, sfa, tsh and papC genes did not differ significantly between herds with or without diarrhea. Genes coding for faeG, fanC, f41, estI, estII, CS31a and eltA were not detected in any isolates. All isolates were sensitive to amikacin, chloramphenicol, ciprofloxacin, gentamicin and ceftiofur and the highest frequency of resistance was observed to tetracycline, and ampicillin (52.8% and 37.1% respectively). The phylogenetic groups were identified by conventional triplex PCR. Results showed that E. coli strains segregated mainly in phylogenetic group B1, 52.8% in diarrheic herds and 52.9% in healthy herds.

Topics: Animals; Anti-Bacterial Agents; Camelus; Ciprofloxacin; Diarrhea; Drug Resistance, Multiple, Bacterial; Escherichia coli; Escherichia coli Infections; Escherichia coli Proteins; Feces; Genotype; Phylogeny; Polymerase Chain Reaction; Prevalence; Tetracycline; Tunisia; Virulence Factors

This study was designed to characterize a collection of 60 enteropathogenic Escherichia coli (EPEC) isolates from diarrheic feces of patients in the Ribeirão Preto metropolitan area regarding different phenotypic and molecular features. We examined antibiotic resistance profiles, occurrence of virulence factors-encoding genes, intimin subtypes and the correlation of serotypes among typical (tEPEC) and atypical (aEPEC) EPEC isolates. The results demonstrated that atypical EPEC was more heterogeneous than typical EPEC concerning the characteristics investigated and 45.2% do not belong to classical EPEC serogroups. Intimin subtype β was the most frequent among the EPEC isolates (46.7%), being detected in both tEPEC and aEPEC. The majority of aEPEC isolates presented localized adherence-like (LAL) pattern to HEp-2 cells, although aEPEC isolates displaying diffuse adherence (DA) or non-adherent were also detected. High prevalence of antimicrobial resistance was found for ampicillin, cephalothin, sulfonamide and tetracycline. In general, tEPEC isolates were more resistant to the antimicrobials tested than aEPEC isolates.

Topics: Ampicillin; Anti-Bacterial Agents; Bacterial Adhesion; Brazil; Cell Line; Cephalothin; Child, Preschool; Diarrhea; Drug Resistance, Multiple, Bacterial; Enteropathogenic Escherichia coli; Escherichia coli Infections; Feces; Female; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Serotyping; Sulfonamides; Tetracycline; Virulence Factors

Shigella species are a common cause of bacterial diarrhea worldwide and the disease is characterized by seasonality. Shigella has been encountered by widespread resistance to commonly used antibiotics which is a serious concern. The aim of this study was to analyze the epidemiological relatedness of Shigella strains isolated from children during one year period by PFGE method and to investigate antimicrobial resistance determinants and cassettes among Shigella species. The occurrence of Shigella spp. in the present study was 1.32% during the study period and the majority of cases (56 (80%)) were occurred during autumn while Shigella sonnei was the most prevalent species identified. Multi-drug resistance phenotype was seen in 98.5% of total isolates with SXT(r)/TE(r)/TMP(r) resistance pattern. Among the 70 Shigella spp. analyzed in this study, 16 isolates were positive for class I integron (int1(+)) with two types of gene cassette arrays (dfrA17/aadA5 and dfrA7).The class 2 integron was more frequently detected among the isolates (85.71%) with dfrA1/sat1/aadA1 (10%) and dfrA1/sat1 (75.71%) gene cassettes. The tetA and tetB determinants were observed in 75.7% and 21.42% of Shigella isolates and tet(A) was the foremost in S. sonnei and Shigella flexneri population. In this study 5 tetracycline resistant isolates had no tetracycline resistance gene (A-D) and no association was recognized between the value of MIC against tetracycline and the tet genes content of isolates. Fifty three of total Shigella isolates (75.7%) showed an identical PFGE patterns. Seven PFGE clusters observed in our study were composed of members with one to three band variations, which is indicative of closely related isolates. The major cluster (cluster C) constituted 75.7% of total isolates, all of which (except eight isolates) consonantly showed identical class 2 integron of 1500 bp which strongly suggests the dissemination of a single S. sonnei clone among the pediatric population in 2012 autumn in Tehran, Iran, in comparison with the equal data from the comparable time period from recent years.

Topics: Anti-Bacterial Agents; Child, Preschool; Diarrhea; Drug Resistance, Bacterial; Dysentery, Bacillary; Genes, Bacterial; Genotype; Humans; Iran; Microbial Sensitivity Tests; Molecular Typing; Shigella sonnei; Tetracycline

A total of 121 Campylobacter isolates from 4,788 humans with gastroenteritis were identified and characterized by biochemical detection methods, polymerase chain reaction, and multilocus sequence typing (MLST). These samples were obtained during a 3-year period, from January 2007 to December 2009, using the National Notifiable Diseases Surveillance System at the Research Institute of Public Health and Environment in Seoul Metropolitan, Korea. Antimicrobial susceptibilities of the bacterium were also determined with the agar dilution method. All 121 isolates were identified as Campylobacter jejuni, with all (100%) of them having two virulence genes (ceuE and cadF) and a toxin gene (cdtB). Twenty-three different sequence types (STs), including 9 new STs, were determined by MLST. The most prevalent ST and clonal complex (CC) observed in this study were ST-45 (28.9%) and ST-45 CC (53.7%), respectively. Percentages of antimicrobial-resistant isolates were 1.9% for ampicillin, 0.8% for chloramphenicol, 24% for ciprofloxacin, 46.3% for enrofloxacin, 0.8% for erythromycin, 6.6% for gentamicin, and 46.3% for tetracycline. This study demonstrated that the majority of the Campylobacter isolates obtained from human samples in Korea were C. jejuni with ST-45 CC, which has been detected mainly in broilers worldwide, and all strains with new STs were uniformly resistant to enrofloxacin and tetracycline. This study indicates that broilers may be a breeding ground for bacteria as well as an important potential source of human campylobacteriosis.

Topics: Animals; Anti-Bacterial Agents; Campylobacter Infections; Campylobacter jejuni; Diarrhea; Drug Resistance, Multiple, Bacterial; Enrofloxacin; Fluoroquinolones; Gastroenteritis; Humans; Microbial Sensitivity Tests; Multilocus Sequence Typing; Polymerase Chain Reaction; Republic of Korea; Tetracycline; Virulence

The in vitro activity of mastoparan-AF, an amphipathic antimicrobial peptide isolated from the hornet venom of Vespa affinis, alone and in combination with various clinically used antibiotics, was investigated against 21 Escherichia coli isolates/strains. Most E. coli isolates tested were detected containing multiple-antimicrobial resistance genes. Antimicrobial activity of mastoparan-AF was measured by MIC, MBC, time-kill kinetic assay and chequerboard titration method. Mastoparan-AF exhibited potent antimicrobial activity against most multiple-antibiotic-resistant E. coli isolates at the concentrations ranging from 4 to 16 μg/ml. Combination studies showed that mastoparan-AF acts synergistically with certain antibiotics, i.e., cephalothin or gentamicin, against some multiple-antibiotic-resistant E. coli isolates. In conclusion, mastoparan-AF alone or in combination with other antibiotics could be promising as alternatives for combating multiple-antibiotic-resistant E. coli in future clinical applications.

Topics: Amino Acid Sequence; Ampicillin; Animals; Anti-Bacterial Agents; Antimicrobial Cationic Peptides; Cephalothin; Chloramphenicol; Diarrhea; Drug Resistance, Multiple, Bacterial; Drug Synergism; Escherichia coli; Escherichia coli Infections; Genes, Bacterial; Gentamicins; Microbial Sensitivity Tests; Neomycin; Sus scrofa; Swine; Swine Diseases; Tetracycline; Wasp Venoms

Clostridium difficile is the main cause of antibiotic associated diarrhea. In the past decade, the number of C. difficile patients has increased dramatically, coinciding with the emergence of two PCR ribotypes 027 and 078. PCR ribotype 078 is also frequently found during C. difficile outbreaks in pigfarms. Previously, the genome of the PCR ribotype 078 strain M120, a human isolate, was described to contain a unique insert of 100 kilobases.. Analysis of this insert revealed over 90 open reading frames, encoding proteins originating from transposons, phages and plasmids. The insert was shown to be a transposon (Tn6164), as evidenced by the presence of an excised and circularised molecule, containing the ligated 5'and 3'ends of the insert. Transfer of the element could not be shown through filter-mating experiments. Whole genome sequencing of PCR ribotype 078 strain 31618, isolated from a diarrheic piglet, showed that Tn6164 was not present in this strain. To test the prevalence of Tn6164, a collection of 231 Clostridium difficile PCR ribotype 078 isolates from human (n = 173) and porcine (n = 58) origin was tested for the presence of this element by PCR. The transposon was present in 9 human, tetracycline resistant isolates, originating from various countries in Europe, and none of the pig strains. Nine other strains, also tetracycline resistant human isolates, contained half of the transposon, suggesting multiple insertion steps yielding the full Tn6164. Other PCR ribotypes (n = 66) were all negative for the presence of the transposon. Multi locus variable tandem repeat analysis revealed genetic relatedness among transposon containing isolates. Although the element contained several potential antibiotic resistance genes, it did not yield a readily distinguishable phenotype.. Tn6164 is a newly described transposon, occurring sporadically in C. difficile PCR ribotype 078 strains. Although no transfer of the element could be shown, we hypothesize that the element could serve as a reservoir of antibiotic resistance genes for other bacteria. Further research is needed to investigate the transfer capabilities of the element and to substantiate the possible role of Tn6164 as a source of antibiotic resistance genes for other gut pathogens.

Topics: Animals; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Diarrhea; DNA Transposable Elements; DNA, Bacterial; Genomic Islands; Humans; Open Reading Frames; Polymorphism, Genetic; Ribotyping; Swine; Tetracycline; Tetracycline Resistance

Topics: Anti-Bacterial Agents; Cholera; Diarrhea; Feces; Humans; India; Microbial Sensitivity Tests; Population Surveillance; Prevalence; Risk Factors; Tetracycline; Tetracycline Resistance; Vibrio cholerae O1

The antimicrobial susceptibility and mechanisms of resistance of 109 Shigella and 40 Salmonella isolates from children with diarrhea in southern Mozambique were assessed. The susceptibility to seven antimicrobial agents was tested by disk diffusion, and mechanisms of resistance were searched by PCR or colorimetric method. A high proportion of Shigella isolates were resistant to chloramphenicol (Chl) (52%), ampicillin (Amp) (56%), tetracycline (Tet) (66%), and trimethoprim-sulfamethoxazole (Sxt) (84%). Sixty-five percent of the isolates were multidrug resistant. Shigella flexneri isolates were more resistant than those of Shigella sonnei to Amp (66% versus 0.0%, P < 0.001) and Chl (61% versus 0.0%, P < 0.001), whereas S. sonnei isolates presented higher resistance to Tet than S. flexneri isolates (93% versus 64%, P = 0.02). Resistance among Salmonella isolates was as follows: Tet and Chl, 15% each; Sxt, 18%; and Amp, 25%. Only 3% of Salmonella isolates were resistant to nalidixic acid (Nal), and none to ciprofloxacin or ceftriaxone (Cro). Among Salmonella isolates, multiresistance was found in 23%. Among Shigella isolates, antibiotic resistance was related mainly to the presence of oxa-1-like beta-lactamases for Amp, dfrA1 genes for Sxt, tetB genes for Tet, and Chl acetyltransferase (CAT) activity for Chl. Among Salmonella isolates, resistance was conferred by tem-like beta-lactamases for Amp, floR genes and CAT activity for Chl, tetA genes for Tet, and dfrA1 genes for Sxt. Our data show that Shigella isolates are resistant mostly to the most available, inexpensive antibiotics by various molecular mechanisms but remain susceptible to ciprofloxacin, Cro, and Nal, which is the first line for empirical treatment of shigellosis in the country.

Topics: Anti-Bacterial Agents; Child, Preschool; Diarrhea; Drug Resistance, Bacterial; Humans; Infant; Infant, Newborn; Microbial Sensitivity Tests; Polymorphism, Restriction Fragment Length; Salmonella; Shigella

We applied a previously reported method to clarify whether a multidrug-resistant Shigella colonizes in a south Asian country. At Kansai Airport Quarantine Station, stool samples were collected from overseas travelers who reported a history of diarrhea. Shigella strains were isolated, ranging from 53 to 106 (average, 82.4) isolates/year (2001-2005), and almost 80% of the isolates were Shigella sonnei. The most frequent country of origin was India. Strains from the country of the most frequent origin were studied by antimicrobial susceptibility testing. Resistance to tetracycline, sulfamethoxazole-trimethoprim and nalidixic acid was observed at the highest frequency: in 23 of the 25 strains isolated in 2001, 5 of the 13 strains isolated in 2002, and 16 of the 19 strains isolated in 2005. Strains showing the most prevalent multidrug-resistance pattern were analyzed by pulsed-field gel electrophoresis (PFGE). The PFGE profiles showed that 27 of the 44 strains isolated in 2001, 2002, and 2005 were identical in PFGE pattern, as determined using two restriction enzymes. We concluded that a multidrug-resistant Shigella sonnei colonizes in a south Asian country.

Topics: Anti-Bacterial Agents; Diarrhea; DNA, Bacterial; Drug Resistance, Multiple, Bacterial; Dysentery, Bacillary; Electrophoresis, Gel, Pulsed-Field; Humans; India; Japan; Nalidixic Acid; Quarantine; Seroepidemiologic Studies; Shigella sonnei; Tetracycline; Time Factors; Travel; Trimethoprim, Sulfamethoxazole Drug Combination

Diarrhea is the gastrointestinal disease most frequently encountered in captive rhesus macaques. The precise pathogenic mechanisms underlying chronic diarrhea in nonhuman primates are not well understood, but a persistent inflammatory component has been implicated strongly. This study evaluated the inflammatory changes in the colon of macaques with diarrhea and assessed the efficacy of a 10-d course of tylosin in a cohort of 21 animals with chronic diarrhea. Stool quality was evaluated daily, and fecal consistency was scored. Colonoscopies were performed; biopsy samples were characterized histologically and assayed for expression of TNFalpha mRNA. Blood samples collected pre-, mid-, and post-treatment were assayed for C-reactive protein (CRP). The results indicated that 63% of the animals receiving tylosin showed improvement in stool quality, compared with 10% in the sham-treated group. Histologically, 82% of animals in the tylosin-treated group had a reduction in the severity of colonic lesions post-treatment, compared with 40% of animals in the sham group. The amount of TNFalpha mRNA before treatment did not differ from that afterward in either tylosin- or sham-treated animals. CRP levels serially decreased in tylosin-treated monkeys; the average post-treatment CRP value for tylosin-treated animals was 11.96 +/- 3.86 microg/ml compared with 26.48 +/- 4.86 microg/ml for sham-treated controls. In conclusion, tylosin significantly improved the fecal consistency score, significantly decreased colonic inflammation, and significantly decreased serum CRP levels post-treatment in rhesus macaques with chronic diarrhea.

Topics: Animals; Anti-Bacterial Agents; C-Reactive Protein; Chronic Disease; Colonoscopy; Cytokines; Diarrhea; Disease Models, Animal; Dog Diseases; Dogs; Feces; Gene Expression Regulation; Macaca mulatta; Metronidazole; Prednisone; Primate Diseases; RNA, Messenger; Tetracycline; Tumor Necrosis Factor-alpha; Tylosin

A randomized intervention study was conducted to determine if discontinuing use of calf milk replacer medicated with oxytetracycline results in increased tetracycline susceptibility in Salmonella and Campylobacter spp. and Escherichia coli in dairy calves over a 12-month period. Dairy herds with enteric bacteria with known low tetracycline susceptibility were enrolled for the study. Fecal samples from preweaned calves and environmental samples were collected from eight dairy herds in Michigan and New York State. Samples were collected monthly for 3 months prior to and 12 months after four of the eight herds discontinued medicated milk replacer feeding. Salmonella and Campylobacter spp. and E. coli were isolated, and antimicrobial susceptibility testing was conducted using automated broth microdilution. A total of 804 intervention and 1,026 control calf fecal samples and 122 intervention and 136 control environmental samples were collected for testing. No differences in owner-reported morbidity and mortality between treatment groups were seen. The intervention was significantly associated with increasing tetracycline susceptibility in E. coli and Salmonella. Tetracycline susceptibility increased in intervention herds for the first 3 months after switching to nonmedicated milk replacer but declined in subsequent months. Discontinuing the practice of feeding medicated milk replacers to calves increased tetracycline susceptibility in E. coli and Salmonella on dairy farms, without increasing cattle disease, but declines in effectiveness after 3 months suggest that other factors contribute to decreasing susceptibility on the farm.

Topics: Animal Husbandry; Animals; Anti-Bacterial Agents; Campylobacter; Cattle; Cattle Diseases; Dairying; Diarrhea; Drug Resistance, Bacterial; Escherichia coli; Feces; Microbial Sensitivity Tests; Milk; Neomycin; Oxytetracycline; Salmonella; Tetracycline; Weaning

Campylobacter jejuni and Campylobacter coli are frequent causes of bacterial gastroeneritis in humans worldwide. Campylobacteriois is usually a self-limiting disease and therapy with antibiotics is required in severe clinical infections. The objective [corrected] of this study was to determine the antibiotic resistance of C. jejuni and C. coli isolated from humans with diarrhea during 2005-2006 in Bielsko-Biala region in Poland. The MICs of ciprofloxacin, tetracycline, erythromycin, gentamicin and ampicillin were determined by the E-test method. It was observed that 23 % and 6% C. jejuni isolates were resistant to two and three antibiotics, respectively. All isolates of Campylobacter sp. were sensitive to erythromycin and gentamicin. From the 69 C. jejuni strains 58% were resistant to ciprofloxacin, 23% to tetracycline and 17% to ampicillin. From the 8 C. coli strains all were resistant to ciprofloxacin, 62,5% to ampicillin and 12,5% to tetracycline.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Campylobacter coli; Campylobacter Infections; Campylobacter jejuni; Ciprofloxacin; Diarrhea; Disk Diffusion Antimicrobial Tests; Drug Resistance, Multiple, Bacterial; Erythromycin; Gentamicins; Humans; Microbial Sensitivity Tests; Poland; Tetracycline

The enterotoxigenic Escherichia coli (ETEC) strain Ec2173, causing post weaning diarrhoea in swine, harbours six plasmids ranging from 13 to 200 kb in size. The heat stable toxin genes sta, stb and a tetracycline resistance gene were located on a self conjugative 120-kb plasmid, called pTC. In the cloned ColE1 type origin of replication of pTC a deletion was detected compared to other ColE1 replicons affecting the replication modulator gene rom. Epidemiological studies on ETEC isolates showed that pTC-like plasmids are widely distributed among porcine ETEC strains; thus representing an example of co-evolution of antibacterial resistance and virulence in pathogenic E. coli.

Topics: Animals; Conjugation, Genetic; Diarrhea; Enterotoxins; Escherichia coli; Escherichia coli Infections; Fimbriae, Bacterial; Fluorine Radioisotopes; Plasmids; Replication Origin; Swine; Swine Diseases; Tetracycline; Virulence; Weaning

One hundred forty-seven Campylobacter were isolated using 3,204 samples taken from sporadic diarrheic patients from January 2001 to December 2003. The detection rate of Campylobacter in 16 to 30 year old patients (12.9%, 83/641) was significantly higher than that in patients less than 16 years of age, 5%, (29/1,155) (p < 0.001) and more than 30 years of age, 2.5% (35/1,408) (p < 0.001), respectively. The highest detection rate was obtained from the stool of males in the 16 to 30 year old range during the months from May to August, 26% (32/123). If the minimal inhibitory concentration (MIC) breakpoint for resistance of gentamicin (GM), erythromycin (EM), ciprofloxacin (CPFX), tetracycline (TC) were defined tentatively > or = 16 microg/ml, > or = 16 microg/ml, > or = 2 microg/ml, > or = 16 microg/ml, the resistant rate would be 0.0%, 0.0%, 22.0%, 42.8% in C. jejuni, 0.0%, 62.5%, 62.5%, 87.5% in C. coli, respectively. All the Campylobacter isolates were susceptible to GM. Three of the 8 C. coli isolates were multi-resistant in EM, CPFX, and TC. Five highly EM resistant strains with an MIC of > or = 512 microg/ml did not show any zone around the EM disk; 7 susceptible strains with an MIC of less than 16 microg/ml showed = zones of 24mm to 36mm and revealed a good correlation with the Etest method and the agar dilution method. Between the two time periods of January 2001-June 2002 and July 2002-December 2003, the resistant rate of CPFX in C. jejuni decreased from 27.5% to 15.5%, however, that was not significant decrease (p = 0.133).

Topics: Adolescent; Adult; Anti-Bacterial Agents; Campylobacter coli; Campylobacter jejuni; Ciprofloxacin; Diarrhea; Drug Resistance, Bacterial; Drug Resistance, Multiple; Erythromycin; Female; Gentamicins; Humans; Male; Microbial Sensitivity Tests; Tetracycline

Drug resistance trends were investigated for 271 Vibrio cholerae O1 (V.c O1) and 401 V. cholerae non-O1 (V.c non-O1) strains isolated from mainly imported diarrheal cases during 1981-2001 in Japan. The results of drug resistance test using 8 drugs (CP, TC, SM, KM, ABPC, ST, NA, and NFLX) showed that 34.7% of the V. c O1 strains and 15.7% of V.c non-O1 strains were multi-drug or mono-drug resistant. The incidence of drug resistant strains has increased since 1991, and it has been remarkable in V.c O1 strains that increased from 1.2% in 1981-1985 to 70.8% in 1996-2001. The drug resistance patterns of the resistant strains classified into 6 types in V.c O1 and 21 types in V.c non-O1. The prevalent patterns recognized were SM (75.5%), CP.TC.SM.ST (10.6%) and CP.SM.ST (8.5%) in V.c O1, and SM (25.4%) and ABPC (25.4%) in V.c non-O1. Ten V.c O1 strains (3.7%) and 10 V.c non-O1 strains (2.5%) were multi-drug resistant including TC. Among those, 13 strains were isolated from travelers who returned to Japan from Thailand. One V.c O1 strain (0.4%) and 6 V.c non-O1 strains (1.5%) were NA high-resistant and fluoroquinolones low-sensitive. Among those, 4 strains were isolated from travelers who returned to Japan from India.

Topics: Diarrhea; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Tetracycline; Tetracycline Resistance; Travel; Vibrio cholerae; Vibrio cholerae O1

Clostridium difficile and Clostridium perfringens are anaerobic, Gram-positive bacilli that are common causes of enteritis and enterotoxemias in both domestic animals and humans. Both organisms have been associated with acute and chronic large and small bowel diarrhea, and acute hemorrhagic diarrheal syndrome in the dog. The objective of this study was to determine the in vitro antimicrobial susceptibilities of canine C. difficile and C. perfringens isolates in an effort to optimize antimicrobial therapy for dogs with clostridial-associated diarrhea. The minimum inhibitory concentrations (MIC) of antibiotics recommended for treating C. difficile (metronidazole, vancomycin) and C. perfringens-associated diarrhea in the dog (ampicillin, erythromycin, metronidazole, tetracycline, tylosin) were determined for 70 canine fecal C. difficile isolates and 131 C. perfringens isolates. All C. difficile isolates tested had an MIC of or=256 microg/ml for both erythromycin and tylosin. A third C. perfringens isolate had an MIC of 32 microg/ml for metronidazole. Based on the results of this study, ampicillin, erythromycin, metronidazole, and tylosin appear to be effective antibiotics for the treatment of C. perfringens-associated diarrhea, although resistant strains do exist. However, because there is limited information regarding breakpoints for veterinary anaerobes, and because intestinal concentrations are not known, in vitro results should be interpreted with caution.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Clostridium perfringens; Diarrhea; Dog Diseases; Dogs; Erythromycin; Metronidazole; Microbial Sensitivity Tests; Tetracycline; Tylosin

To study the efficacy of tetracycline (or doxycycline) and nicotinamide in the treatment of less extensive bullous pemphigoid.. An open trial of 11 patients with bullous pemphigoid. Treatment was initiated with tetracycline 1.5-2 g/day and nicotinamide 1.5-2 g/day and gradually tapered down. Doxycycline was substituted for tetracycline in patients who could not tolerate tetracycline due to gastrointestinal side effects or headache.. 6 out of 11 patients achieved complete response (> 90% decrease in lesions) while another 2 had partial response (50-90% decrease in lesions).. Tetracycline/doxycycline and nicotinamide is a useful alternative treatment for localized bullous pemphigoid, especially in those whose concurrent medical illnesses preclude the use of systemic corticosteroids.

Topics: Aged; Anti-Bacterial Agents; Complement C3; Diarrhea; Doxycycline; Drug Combinations; Female; Fluorescent Antibody Technique, Indirect; Follow-Up Studies; Headache; Humans; Immunoglobulin G; Male; Niacinamide; Pemphigoid, Bullous; Recurrence; Remission Induction; Skin; Tetracycline; Vomiting

Exposure of a group of horses to tetracycline-contaminated feed resulted in acute colitis and subsequent death in one horse and milder diarrhea in 3 others. The most severely affected animal demonstrated clinical and pathological findings typical of colitis X. The other herdmates responded well to administration of zinc bacitracin.

Topics: Acute Disease; Animal Feed; Animals; Anti-Bacterial Agents; Colitis; Diarrhea; Fatal Outcome; Food Contamination; Horse Diseases; Horses; Male; Tetracycline

Topics: Amoxicillin; Antacids; Anti-Bacterial Agents; Anti-Ulcer Agents; Clarithromycin; Diarrhea; Drug Interactions; Drug Resistance, Microbial; Duodenal Ulcer; Helicobacter Infections; Helicobacter pylori; Histamine H2 Antagonists; Humans; Metronidazole; Misoprostol; Peptic Ulcer; Proton Pump Inhibitors; Salicylates; Salicylic Acid; Sucralfate; Tetracycline

The rectal swabs of diarrhoeic and apparently healthy non-diarrhoeic dogs presented to a Small Animal Clinic were cultured for Escherichia coli, Salmonella and Campylobacter and the enteropathogens were characterized. Overall, of 130 dogs divided equally into two groups consisting of 65 diarrhoeic and 65 non-diarrhoeic dogs, 99 (76.2%), 6 (4.6%) and 18 (13.8%) were positive for E. coli, Salmonella and Campylobacter, respectively. The differences were statistically significant (P < or = 0.05; chi 2). The prevalences of the enteropathogens in diarrhoeic and non-diarrhoeic dogs were not statistically significant (P > or = 0.05; chi 2). Diarrhoea was significantly (P < or = 0.01; chi 2) more prevalent in dogs less than 6 months of age and 7 months to 1 year old than in dogs older than 1 year. The prevalences of Salmonella, E. coli and enteropathogenic E. coli (EPEC) strains were not significantly (P > or = 0.05; chi 2) associated with age but the prevalence of Campylobacter infection was significantly (P < or = 0.01; chi 2) higher in dogs less than 1 year old (25.0%) than in older dogs (5.4%). Of 99 E. coli strains tested, three (3.0%), four (4.0%), five (5.1%) and 20 (20.2%) were haemolytic, non-sorbitol fermenters, verocytotoxigenic (VT) and EPEC strains, respectively. Resistance to tetracycline (59.6%) and ampicillin (50.5%) was most prevalent and significantly (P < or = 0.01; chi 2) higher than to six other antimicrobial agents.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Campylobacter Infections; Diarrhea; Dog Diseases; Dogs; Drug Resistance, Microbial; Escherichia coli Infections; Female; Male; Penicillins; Prevalence; Salmonella Infections, Animal; Tetracycline; Trinidad and Tobago

The authors describe the case of a fifty-nine-year-old white man, previously in good health, who initiated his present illness with acute episode of enterocolitis characterized by mild fever and, in the next eight hours, twenty-four episodes of watery diarrhea, nausea and vomiting, as well as generalized sweating and severe weakness secondary to hypovolemia and electrolyte disorder. These complications were corrected in seventy-two hours in the intensive care unit. Two days later, when the patient was stable hemodynamically, under cardiac monitoring and with normal laboratory studies including serum electrolytes, he developed electrocardiographic changes characterized by trifascicular block (prolonged P-R interval, complete right bundle branch block [CRBBB] and left posterior hemiblock [LPH]) with a cardiac rate of thirty beats per minute, for which a temporary pacemaker was inserted. Endomyocardial biopsy showed histopathologic signs of myocarditis and the immunologic study of the cardiac tissue revealed positive polymerize chain reaction (PCR+) with the presence of antitoxine choleric antibodies (AcTCA). After three weeks, the same conduction disturbances remained, for which a permanent pacemaker was inserted. On top of intravenous fluid replacement and electrolyte supplements, the patient was managed with tetracycline 2 g a day for one week and sulfamethoxazole-trimethoprim 800/160 mg a day for two weeks. The purpose of this study is to present a rare and very well-documented myocarditis by cholera in a patient with enteric disease, in whom several cardiac complications occurred.

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Bradycardia; Bundle-Branch Block; Cholera; Diarrhea; Electrocardiography; Enterocolitis; Humans; Male; Middle Aged; Myocarditis; Nausea; Pacemaker, Artificial; Polymerase Chain Reaction; Sweating; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio cholerae; Vomiting

Vibrio cholerae O139 Bengal has recently emerged as a cause of epidemic cholera in Asia. To evaluate clinical and immunologic responses to infection, V. cholerae O139 Bengal AI1837 was administered to healthy adult North American volunteers. Two of 4 persons ingesting 10(4) cfu became ill (incubation period, 48 h; mean diarrheal stool, 1873 g), as did 7 of 9 persons receiving 10(6) cfu (incubation period, 28 h; mean diarrheal stool, 4548 g). Ill volunteers did not demonstrate a vibriocidal antibody response to the challenge strain or other V. cholerae. Three months later, volunteers were rechallenged with the homologous O139 Bengal strain. Only 1 of 6 persons who had been ill on initial challenge had diarrhea, compared with 11 of 13 controls (P = .01; protective efficacy = 80%). V. cholerae O139 Bengal can cause severe diarrhea typical of cholera, with clinical characteristics and a dose-response similar to those seen with V. cholerae O1 El Tor. A moderately high level of protection against subsequent disease is provided by initial clinical infection.

Topics: Adult; Antibodies, Bacterial; Cholera; Diarrhea; Feces; Humans; Immunity, Active; Tetracycline; Vibrio cholerae

Topics: Diarrhea; Humans; Microbial Sensitivity Tests; Tetracycline; Tetracycline Resistance; Vibrio cholerae

The incidence of Plesiomonas shigelloides among diarrhoeal patients attending the Dhaka Treatment Centre of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) from January through December 1987, has been reported. Using bile peptone broth (pH 8.8) as an enrichment medium and Salmonella-Shigella agar to isolate the organism, P. shigelloides was isolated from 838 (6.4%) of 13,142 patients, 523 (4.0%) of whom had no other pathogen isolated. The percentage of isolation was higher from stool (9.2%) than from rectal swab (5.9%) specimens (P < 0.005). The incidence of P. shigelloides was higher among male (64.0%) than female (36.0%) patients (P < 0.005). Isolation was highest among children less than five years. P. shigelloides was isolated most often in March (11.0%) and September (7.7%), indicating two seasonal peaks of incidence before and after the monsoons. All the strains were uniformly sensitive to chloramphenicol, furazolidon, gentamicin and trimethoprim-sulfamethoxazole. Sensitivity of the organism to ampicillin and tetracycline was 27.0% and 89.0%, respectively. This indicates that P. shigelloides may be an important agent of diarrhoea in our patient population.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Ampicillin; Bangladesh; Child; Child, Preschool; Chloramphenicol; Diarrhea; Feces; Female; Furazolidone; Gentamicins; Humans; Infant; Male; Middle Aged; Plesiomonas; Prevalence; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Under combat conditions infectious disease can become a major threat to military forces. During Operation Desert Shield, there were numerous outbreaks of diarrhea among the U.S. forces. To evaluate the causes of and risk factors for diarrheal disease, we collected clinical and epidemiologic data from U.S. troops stationed in northeastern Saudi Arabia.. Between September and December 1990, stool cultures for enteric pathogens were obtained from 432 military personnel who presented with diarrhea, cramps, vomiting, or hematochezia. In addition, a questionnaire was administered to 2022 soldiers in U.S. military units located in various regions of Saudi Arabia.. A bacterial enteric pathogen was identified in 49.5 percent of the troops with gastroenteritis. Enterotoxigenic Escherichia coli and Shigella sonnei were the most common bacterial pathogens. Of 125 E. coli infections, 39 percent were resistant to trimethoprim-sulfamethoxazole, 63 percent to tetracycline, and 48 percent to ampicillin. Of 113 shigella infections, 85 percent were resistant to trimethoprim-sulfamethoxazole, 68 percent to tetracycline, and 21 percent to ampicillin. All bacterial isolates were sensitive to norfloxacin and ciprofloxacin. After an average of two months in Saudi Arabia, 57 percent of the surveyed troops had at least one episode of diarrhea, and 20 percent reported that they were temporarily unable to carry out their duties because of diarrheal symptoms. Vomiting was infrequently reported as a primary symptom, but of 11 military personnel in whom vomiting was a major symptom, 9 (82 percent) had serologic evidence of infection with the Norwalk virus.. Gastroenteritis caused by enterotoxigenic E. coli and shigella resistant to a number of drugs was a major problem that frequently interfered with the duties of U.S. troops during Operation Desert Shield.

Topics: Adolescent; Adult; Ampicillin; Diarrhea; Drug Resistance, Microbial; Dysentery, Bacillary; Escherichia coli; Escherichia coli Infections; Feces; Gastroenteritis; Humans; Male; Middle Aged; Military Personnel; Norwalk virus; Saudi Arabia; Shigella sonnei; Surveys and Questionnaires; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Vomiting; Warfare

Sequential stool cultures submitted for routine culture were screened for the presence of CDC group DF-3. Of 690 specimens, 11 (1.6%) yielded moderate to heavy growth of DF-3. Information on the 11 patients from whom these specimens were obtained showed that 4 had a history of prolonged diarrheal disease that resolved after specific therapy to eradicate DF-3, while for the other 7 patients no clear role could be established. Microbiological characterization of the stool isolates and 10 CDC strains of DF-3 suggested the presence of two subtypes within the group. Antibiotic susceptibility studies showed DF-3 to be relatively resistant to a wide variety of antibiotics.

Topics: Adolescent; Adult; Aged; Bacterial Proteins; Bacterial Toxins; Campylobacter coli; Campylobacter jejuni; Diarrhea; Doxycycline; Drug Resistance, Microbial; Feces; Female; Gram-Negative Facultatively Anaerobic Rods; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Tetracycline

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Animals; Clavulanic Acids; Diarrhea; Drug Combinations; Drug Therapy, Combination; Escherichia coli; Escherichia coli Infections; Injections, Intramuscular; Remission Induction; Sulfadiazine; Swine; Swine Diseases; Tetracycline; Time Factors; Trimethoprim

Topics: Acute Disease; Adolescent; Anti-Infective Agents; Bacteria; Bacterial Infections; Chloramphenicol; Diarrhea; Feces; Female; Humans; Male; Norfloxacin; Quinolones; Randomized Controlled Trials as Topic; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

The susceptibility to chloramphenicol, clindamycin, erythromycin, rifampicin and tetracycline of 308 isolates of Clostridium difficile from various origins was determined by a disc diffusion susceptibility testing and the results were compared with the serogroup of the strains. For the five antimicrobials, there was a clear-cut separation between susceptible and resistant strains. Some correlation between resistance and serogroup was found. Almost all of the 161 isolates of serogroups A, F, G, H and X were susceptible to all antibiotics. The 32 toxigenic isolates of serogroup C were characterized by a typical resistance pattern which could be used for typing purposes. Other serogroups showed variable patterns. The review of 64 cases of antibiotic associated diarrhoea showed that these differences in susceptibility could have clinical implications: all seven cases due to clindamycin were caused by a clindamycin resistant strain of serogroup C, whereas cases associated with other antibiotics were distributed among various serogroups.

Topics: Anti-Bacterial Agents; Bacterial Typing Techniques; Chloramphenicol; Clindamycin; Clostridium; Diarrhea; Drug Resistance, Microbial; Erythromycin; Humans; Rifampin; Tetracycline

The aetiological role of salmonella in acute diarrhoeal illness in infants aged between 4 weeks and 7 years admitted to the Mosul Paediatric Hospital (North Iraq) was studied. Patients consisted of 63 males and 48 females. Almost all (18) salmonella positive cultures were isolated from patients under 2 years old who comprised 84 (75.6%) of the total sample. A wide variety of species of salmonella were found with Salm. typhimurium and Salm. worthington predominating. Most of the strains were sensitive to chloramphenicol and tetracycline. This study emphasizes the importance of high rates of Salmonella spp. as potential causes of diarrhoeal disease in infancy and children.. The etiologic role of salmonella in acute diarrheal illness in 111 children 4 weeks-7 years of age admitted to North Iraq's Mosul Pediatric Hospital was investigated. 75% of all children with diarrhea were under 2 years of age; 29% of them were under 6 months and 45% were under 18 months. 57% of the children were male; 43% were female. Rectal swab analysis revealed a high rate of isolation of salmonella serotypes in this random sample--17 children (15%). Salmonella typhimurium and worthington predominated. 72% of the salmonella strains were sensitive to chloramphenicol and 61% were responsive to tetracycline. The majority of salmonella-positive cultures were isolated from children under 1 year of age. Only 1 child who was solely breastfed was infected with salmonella, confirming the protective role of this infant feeding practice. Since 45% of the children in this study with negative stool cultures for salmonella had been treated for diarrhea and vomiting before admission, it is likely that the rate of salmonella infection in the sample is an underestimate of its true prevalence in this population.

Topics: Child; Child, Preschool; Chloramphenicol; Diarrhea; Diarrhea, Infantile; Female; Gastroenteritis; Humans; Infant; Iraq; Male; Rectum; Salmonella; Salmonella Infections; Serotyping; Tetracycline

We identified Campylobacter jejuni infections in four patients infected with the human immunodeficiency virus (HIV); three had persistent and severe C. jejuni infections. Multiple isolates obtained from each patient had the same biochemical and serotypic characteristics, indicating recurrent infection rather than reinfection with unrelated strains. Serum antibody responses to C. jejuni group antigens by enzyme-linked immunosorbent assay were markedly impaired in the three patients with persistent infection compared with forty-two immunocompetent C. jejuni-infected controls and with the HIV-infected patient who readily cleared the organism. One patient was bacteremic; his blood isolate was killed by normal serum but was resistant to his own serum, whereas a simultaneous stool isolate of a different serotype was sensitive. Failure of two patients to eradicate the organism and long-term administration of erythromycin therapy led to the in-vivo development of resistance to this antibiotic, which is most frequently used to treat C. jejuni infections.

Topics: Acquired Immunodeficiency Syndrome; Adult; Aged; Antibodies, Bacterial; Campylobacter fetus; Campylobacter Infections; Diarrhea; Drug Resistance, Microbial; Erythromycin; Humans; Immunoglobulin A; Male; Recurrence; Tetracycline

A gram-negative bacteria designated DF-3 was cultured on multiple occasions from stool samples of a patient with common variable hypogammaglobulinemia and chronic diarrhea. Antibiotic therapy resulted in elimination of the organism and resolution of the patient's symptoms. DF-3 has not been linked previously to human disease; because of its fastidious growth characteristics and unique isolation requirements, it may be a rarely identified cause of diarrhea and other gastrointestinal symptoms in immunocompromised patients.

Topics: Agammaglobulinemia; Aged; Bacterial Infections; Diarrhea; Female; Gastrointestinal Diseases; Gram-Negative Anaerobic Bacteria; Humans; Tetracycline

A conjugative R-plasmid PE004, Inc F11, conferring resistance to ampicillin, tetracycline, streptomycin, kanamycin and trimethoprim was obtained from an E. coli serotype 026 isolate from the stool of a child with acute diarrhoea. The R-plasmid PE004 also co-transfers an enteropathogenicity antigen without the production of enterotoxins or manifestation of invasiveness. It is not yet known whether this transferable antigen mediates enterocyte damage with consequent diarrhoea. The R-plasmid was of molecular weight 2.4 megadaltons (3.7 kilobase) with a transfer frequency of 6 x 10(-4) cfu/ml E. coli J53-1. The uncontrolled mediation with antibiotics in cases of acute diarrhoea could select gut bacteria not only possessing R-plasmids conferring resistance to several antibiotics but with associated undesirable extrachromosomal genes.

Topics: Acute Disease; Ampicillin; Child; Diarrhea; DNA, Bacterial; Escherichia coli; Escherichia coli Infections; Feces; Genes, Bacterial; Humans; Kanamycin; R Factors; Streptomycin; Tetracycline; Trimethoprim

Of 28 healthy, nondiarrheal, colostrum-fed neonatal calves, 22 developed diarrhea after they were given (orally) for 3 to 5 days maximally recommended doses of chloramphenicol, neomycin, ampicillin, or tetracycline. Ampicillin-, neomycin-, or tetracycline-treated calves had significantly (P less than 0.05) decreased and delayed glucose absorption during oral glucose tolerance tests. Chloramphenicol-treated calves had significantly (P less than 0.05) higher base-line plasma glucose concentrations during the non-test period and had no significant increase in blood glucose concentrations during the tolerance tests compared with those in control calves.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Blood Glucose; Blood Proteins; Cattle; Cattle Diseases; Chloramphenicol; Diarrhea; Glucose Tolerance Test; Hematocrit; Lactates; Malabsorption Syndromes; Male; Neomycin; Potassium; Sodium; Tetracycline

The annual economic burden of diarrhoea in four subdistricts in Indonesia averaged $2.27 per child aged under 5 years when health centre, hospital, and private expenditures were all considered. The community itself spent $1.03 per child or 46% of the total; 96% of community payments went to the private sector, and 4% were for fees at government health centres and hospitals. The widespread availability of oral rehydration therapy has led to only partial abandonment of ineffective or marginally effective medications; non-rehydration medications amounted to 44% of total treatment expenditures. Most medication costs were for antimicrobial agents, such as tetracycline in the government sector and iodochlorhydroxyquin in the private sector. If the use of tetracycline at health centres could be restricted to 10% of episodes treated instead of the present 88%, their costs could be reduced by 50%.. The annual economic burden of diarrhea in 4 subdistricts in Indonesia averaged $2.27/child under age 5 when health center, hospital, and private expenditure were all considered. The community itself spent $1.03/child or 46% of the total; 96% of community payments went to the private sector, and 4% were for fees at government health centers and hospitals. The widespread availability of oral rehydration therapy has led to only partial abandonment of ineffective or marginally effective medications; nonrehydration medications amounted to 44% of total treatment expenditures. Most medication costs were for antimicrobial agents, such as tetracycline in the government sector and iodochlorhydroxyquin in the private sector. If the use of tetracycline in health centers could be restricted to 10% of the episodes treated instead of the present 88%, their costs could be reduced by 50%.

Topics: Child; Child, Preschool; Costs and Cost Analysis; Diarrhea; Electrolytes; Fluid Therapy; Health Expenditures; Health Services; Humans; Indonesia; Infant; Tetracycline

We studied the plasmid and antibiotic resistance characteristics of 35 strains of Enterobacteriaceae recovered from faecal specimens of children with diarrhoea in Central General Hospital, Bandung, Indonesia. Twenty three Escherichia coli, three Providencia, three Proteus, three Klebsiella, two Enterobacter and one Citrobacter were examined. All strains were multiply resistant, many carrying six to nine antibiotic resistances. Most of these resistances were transferable to a laboratory E. coli strain and were carried on large-sized plasmids. All recently-described tetracycline resistance determinants (Classes A----D) were represented; the most common was the Class B, or TN10 type. The TEM-1 beta-lactamase was detected in 17 out of 21 ampicillin-resistant strains examined. The OXA-1, PSE-1, and SHV-1 enzymes were also found. Of 23 plasmids tested, all could be classified into one of eight different incompatibility groups: IncFII, IncN, IncB, IncF1, IncI1, IncI2, IncH2 and IncT. These studies demonstrate the existence of large multiresistant transferable plasmids representing common incompatibility groups and bearing common tetracycline and ampicillin resistance determinants in enteric strains isolated from children hospitalized in Indonesia.

Topics: beta-Lactamases; Child; Conjugation, Genetic; Diarrhea; DNA Replication; Drug Resistance, Microbial; Enterobacteriaceae; Humans; Indonesia; Microbial Sensitivity Tests; Penicillin Resistance; R Factors; Tetracycline

Jejunal diverticulosis, a marker of disordered small intestinal motility, presents varied clinical manifestations. It is important to consider this disorder in elderly patients with unexplained abdominal discomfort accompanied by signs of intermittent small bowel obstruction and malabsorption. Diagnosis can be made by a small bowel follow-through x-ray film obtained as part of the evaluation of diarrhea and obstructive symptoms. Medical therapy is helpful in controlling diarrhea and anemia, while surgical therapy can give excellent results in treating complications or refractory symptoms.

Topics: Aged; Anemia; Antacids; Diagnosis, Differential; Diarrhea; Diverticulum; Humans; Jejunal Diseases; Male; Metoclopramide; Middle Aged; Tetracycline

Cefaclor and tetracycline were compared in a single-blind study designed to treat patients with acute bacterial bronchitis and acute exacerbations of chronic bronchitis. Twenty-five pathogens (including 19 of Haemophilus influenzae and four of Streptococcus pneumoniae) were obtained from sputum samples of 48 patients. No pathogen could be cultured from the sputum of 23 patients. All of these pathogens were susceptible to cefaclor, while 12 (63%) of the 19 H influenzae isolates and three of the four S pneumoniae isolates were resistant to tetracycline. When the susceptibility of the 25 isolates to other commonly used antibacterials was tested, 18 isolates of H influenzae were resistant to erythromycin and one was resistant to ampicillin. (One H influenzae isolate was not tested for erythromycin susceptibility.) The four isolates of S pneumoniae were susceptible to erythromycin and ampicillin. Satisfactory results were achieved in 21 of the 23 patients receiving cefaclor. After four to six days of cefaclor therapy, the other two patients were diagnosed as having bronchopneumonia, and parenteral antibiotic therapy was instituted. Of the 25 patients assigned to the tetracycline regimen, three with resistant H influenzae had unsatisfactory clinical responses and required parenteral antibiotic therapy for recovery. Although patients were randomly assigned to therapy, only three of the 16 patients infected with tetracycline-resistant organisms were assigned to the tetracycline group, and all three failed to respond to treatment. Had the patients been more evenly distributed according to susceptibilities, it is possible that more treatment failures would have occurred in the group receiving tetracycline.

Topics: Adult; Aged; Bronchitis; Cefaclor; Cephalexin; Diarrhea; Drug Eruptions; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Middle Aged; Pneumococcal Infections; Random Allocation; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Conjugation, Genetic; Diarrhea; Drug Resistance, Microbial; Escherichia coli; Escherichia coli Infections; Feces; Oxytetracycline; Streptomycin; Sulfonamides; Tetracycline

Fabry's disease is a rare, sex-linked disorder of glycolipid metabolism. We describe a patient with watery diarrhea, early satiety, and asymptomatic cholelithiasis. The jejunal aspirate demonstrated bacterial overgrowth; sigmoidoscopy showed rectal angiokeratoma corpora diffusum. The gastric emptying rate measured with 99mTc-sulfur colloid was markedly prolonged and the fasting gastrin was elevated at 276 pg/ml. The (14C)glycocholate breath test demonstrated a markedly elevated peak at 4 h, associated with an increased fecal bile acid loss of 0.82 g/day. Oral cholecystogram showed a solitary radiolucent stone in a functioning gallbladder. The bile acid pool size and lithogenic index were normal. Light microscopy of small bowel and rectal biopsy specimens revealed normal surface epithelium, but enlarged and vacuolated ganglion cells in Meissner's plexus. Electron microscopy showed laminated and amorphous osmiophilic deposits within ganglion cells of the submucosal plexus, within smooth muscle cells of the muscularis mucosae, and within endothelial cells lining arterioles, venules, and capillaries, but not in autonomic nerve fibers or enterocytes. The diarrhea and early satiety responded promptly to metoclopramide and to tetracycline. The early satiety was likely on the basis of delayed gastric emptying due to deposition of sphingolipid within ganglion cells of the autonomic nervous system; the diarrhea was likely on the basis of intestinal stasis with bacterial overgrowth and bile salt wastage.

Topics: Adult; Bile; Biopsy; Cholelithiasis; Diarrhea; Fabry Disease; Gastric Emptying; Humans; Jejunum; Male; Metoclopramide; Rectum; Satiation; Tetracycline

An 83-year-old male presented with chronic diarrhea and protein malnutrition associated with Plesiomonas shigelloides overgrowth in the small intestine. This overgrowth was related to achlorhydria and small-bowel diverticula. Tests for heat-labile and heat-stable enterotoxin were negative on the P. shigelloides isolated from both the small bowel aspirate (3 x 10(8) bacteria per ml) and the patient's stool. The patient responded satisfactorily to tetracycline, to which this unusual isolate was susceptible in vitro. The ability to correctly identify and determine the antimicrobial susceptibility of P. shigelloides in the setting of small-bowel overgrowth will help determine appropriate therapy.

Topics: Achlorhydria; Aged; Chronic Disease; Diarrhea; Diverticulum; Feces; Humans; Intestine, Small; Male; Microbial Sensitivity Tests; Protein Deficiency; Tetracycline; Vibrionaceae

During an epidemic of cholera, vaccination has limited applicability in controlling its spread. It has been seen that one out of every five to 10 V. cholerae-infected people develops diarrhoea severe enough to require hospital treatment. Most health authorities are concerned with this severely ill group in whom the majority of deaths occur. During the cholera epidemic of 1975 in Dacca two doses of tetracycline were administered to all family contacts of index cases. The control group of cholera cases did not receive the drug. The families were re-visited after 10-12 days and history of any diarrhoea and hospitalization was obtained. It was found that the subsequent diarrhoea or cholera cases occurring among the cholera contacts within 10-12 days were not different between the treated (13.5%) and the untreated (14.4%) groups. The occurrence of severe cases requiring hospitalization was, however, significantly reduced in the treated group (8.0% to 4.5%). In view of the emergence of V. cholera strains resistant to tetracycline, antibiotic sensitivity testing of epidemic strains would be needed before use of tetracycline for protecting cholera contacts as an immediate control measure.

Topics: Adolescent; Adult; Bangladesh; Child; Child, Preschool; Cholera; Diarrhea; Disease Outbreaks; Female; Humans; Infant; Male; Tetracycline

Topics: Bile Acids and Salts; Deoxycholic Acid; Diarrhea; Feces; Female; Humans; Lithocholic Acid; Middle Aged; Tetracycline

Topics: Adult; Ampicillin; Chloramphenicol; Diarrhea; Enterobacteriaceae; Escherichia coli; Feces; Hospitalization; Humans; Klebsiella; Microbial Sensitivity Tests; Patient Admission; Patient Discharge; Penicillin Resistance; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Asia, Eastern; Bacteria; Cholera; Diarrhea; Doxycycline; Drug Resistance, Microbial; Gonorrhea; Humans; Infection Control; Male; Minocycline; Mucous Membrane; R Factors; Tetracycline; United States

Diagnosis of enterotoxigenic Escherichia coli diarrhea was made in 109 adult males with an acute dehydrating cholera-like syndrome in Dacca, Bangladesh, by testing 10 colonies isolated from admission stool specimens for production of heat-labile and heat-stable toxins. Toxin testing of one colony yielded a diagnosis in 92% of the cases, testing of two colonies yielded a diagnosis in 95% of the cases, testing of a pool of 5 colonies yielded a diagnosis in 95% of the cases, and testing of a pool of 10 colonies yielded a diagnosis in 96% of the cases. From stool cultures obtained on subsequent days, toxin testing of individual colonies and pools revealed diminished efficacy of pooling with decreasing numbers of enterotoxin-positive isolates in the pool. To detect the presence of enterotoxigenic E. coli in stools, toxin testing of 5 individual isolates and a pool of 10 colonies was found to be almost as effective as the testing of 10 individual isolates.

Topics: Bacteriological Techniques; Bangladesh; Diagnosis, Differential; Diarrhea; Enterotoxins; Escherichia coli; Escherichia coli Infections; Feces; Humans; Male; Tetracycline

Topics: Diarrhea; Humans; Tetracycline; Travel

Experiments were conducted to study transfer of an enterotoxin (Ent) plasmid from a porcine enteropathogenic Escherichia coli to an E coli K12 strain in the intestine of newly weaned pigs. The Ent plasmid carried genes for resistance to tetracycline, streptomycin, and sulfonamides, thereby permitting a selection for tetracycline-resistant exconjugants in the feces of the pigs. In vivo transfer of the Ent plasmid was demonstrated to occur when the pigs were given large oral inocula of donor and recipient cultures, 1 hour apart. Differences in extent of transfer were not detected in pigs given antibiotic-free feed compared with littermates on feed containing oxytetracycline at 50 g/ton. In one experiment, tetracycline-resistant Ent- exconjugants were found which appeared to have received an R plasmid from an enteropathogenic type of E coli resident in the intestine.

Topics: Animals; Diarrhea; Drug Resistance, Microbial; Enterotoxins; Escherichia coli; Escherichia coli Infections; Feces; Intestines; Oxytetracycline; Plasmids; R Factors; Swine; Swine Diseases; Tetracycline

Three patients developed severe, incapacitating diarrhea after antibiotic administration. Presenting features included abdominal discomfort, hematochezia, and hypokalemia from voluminous diarrhea. Roetgenographic studies in 1 patient were normal and proctoscopic examinations in 2 patients failed to show antibiotic-associated colitis. Stool cultures were negative. Despite cessation of antibiotics and symptomatic therapy, the diarrhea continued. After the administration of oral tetracycline, the diarrhea stopped without recurrence even after the tetracycline was discontinued. These clinical results suggest that patients with antibiotic-associated diarrhea may benefit from tetracycline when standard medical therapy fails.

Topics: Administration, Oral; Aged; Ampicillin; Anti-Bacterial Agents; Cephalexin; Cephalothin; Clindamycin; Diarrhea; Female; Gentamicins; Humans; Middle Aged; Neomycin; Tetracycline

Topics: Administration, Oral; Anti-Bacterial Agents; Diarrhea; Humans; Tetracycline

Topics: Animals; Antibodies; Cattle; Cattle Diseases; Diarrhea; Drug Resistance, Microbial; Escherichia coli; Escherichia coli Infections; Streptomycin; Sulfonamides; Tetracycline

Topics: Aged; Diarrhea; Escherichia coli; Female; Humans; Jejunum; Malabsorption Syndromes; Staphylococcus aureus; Tetracycline

The case history of a 52-year-old male with weight loss, steatorrhea and arthritis is presented. During clinical pathological conference, Whipple's disease was strongly suggested. The diagnosis could be proved morphologically. Antibiotic therapy with tetracycline 1 g daily for three months caused a prompt improvement. Small bowel biopsy showed disappearance of PAS-containing macrophages.

Topics: Body Weight; Carcinoma, Squamous Cell; Diarrhea; Head and Neck Neoplasms; Humans; Malabsorption Syndromes; Male; Middle Aged; Tetracycline; Whipple Disease

Out of 8 patients with Whipple's disease, 7 had roentgenographic findings consisting of slight dilatation of the small bowel, with thickening of the mucosal folds. The eighth patient had no abnormality on roentgenographic study. This series represents the first in which the roentgenographic changes have been quantitatively assessed. Confirmation of the diagnosis by biopsy is important because antibiotic treatment results in marked improvement both clinically and roentgenographically.

Topics: Adult; Aged; Amenorrhea; Biopsy; Body Weight; Diagnosis, Differential; Diarrhea; Duodenum; Edema; Female; Fever; Follow-Up Studies; Humans; Intestinal Mucosa; Intestine, Small; Jejunum; Joint Diseases; Lymphadenitis; Male; Middle Aged; Pain; Pigmentation Disorders; Purpura; Radiography; Tetracycline; Whipple Disease

Topics: Age Factors; Aged; Arthritis; Diarrhea; Humans; Intestine, Small; Jejunum; Male; Prednisone; Radiography; Tetracycline; Time Factors; Whipple Disease

Whipple's disease is characterized morphologically by macrophages in the small intestine which store PAS-postive material, as well as coarsening and atrophy of the intestinal villi, with pseudocystic cavitations. Without treatment it ends fatally due to irreversible diarrhoea and cachexia. Until 1963, only 90 cases had been diagnosed, most of them at autopsy. Intestinal biopsy has facilitated the diagnosis in life. Treatment with antibiotics results in dramitic improvement and remission for many years. From this an at least partial bacterial cause of the disease has been deducted, but it has not been possible so far to identigy more precisely any causative bacteria. Two cases of Whple's disease with some special features are reported. Both occurred in women (previous reports were almost entirely of men). The severely ill patients were cured by tetracycline within a few weeks and have remained completely well at follow-up examinations. The morphological changes in the intestinal mucosa had partially regressed.

Topics: Adult; Aged; Anti-Bacterial Agents; Atrophy; Biopsy; Diarrhea; Female; Humans; Intestinal Mucosa; Intestine, Small; Macrophages; Male; Middle Aged; Remission, Spontaneous; Sex Factors; Tetracycline; Whipple Disease

Antibiotic therapy has been shown to be of no value in the treatment of the URI--either in shortening the course of the acute illness or in preventing the development of secondary bacterial infections. Patient expense, as well as the threat of adverse reactions, should prohibit the present practice by some of routinely prescribing tetracycline, erythromycin, and ampicillin. Indiscriminate antibiotic therapy cannot substitute for proper diagnostic evaluation of the patient who may have either a bacterial or, far more likely, a viral illness.

Topics: Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Diagnosis, Differential; Diarrhea; Guaiacol; Humans; Mycoplasma Infections; Otitis Media; Penicillin V; Penicillins; Pharyngitis; Prospective Studies; Respiratory Tract Infections; Streptococcal Infections; Sulfonamides; Tetracycline; Vomiting

A disease characterized by segments of ischaemic small intestine has been recognized in norther Thailand over the past decade. The clinical features and appearance of the diseased intestime are described. Most of the patients were treated by surgical resection of the affected bowel. The overall mortality was 14 per cent. Recently, some patients have been successfully treated by non-surgical means. The aetiology of the disease is still unknown.

Topics: Adolescent; Adult; Child; Child, Preschool; Diarrhea; Enteritis; Feces; Female; Gastrointestinal Hemorrhage; Humans; Hydrocortisone; Infant; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Parasite Egg Count; Tetracycline; Thailand

Topics: Animals; Animals, Newborn; Anti-Bacterial Agents; Arthritis, Infectious; Cattle; Cattle Diseases; Cystitis; Diarrhea; Escherichia coli Infections; Female; Foot Diseases; Fusobacterium Infections; Liver Abscess; Mastitis, Bovine; Meningitis; Osteomyelitis; Pasteurella Infections; Pneumonia; Respiratory Tract Infections; Salmonella Infections, Animal; Sheep; Sheep Diseases; Streptococcal Infections; Sulfonamides; Tetracycline; Uterine Diseases

Topics: Animals; Carrier State; Diarrhea; Feces; Female; Horse Diseases; Horses; Intestines; Male; Postoperative Complications; Salmonella Infections, Animal; Salmonella typhimurium; Stress, Physiological; Tetracycline

Three cases of Reiter's disease occurring in boys under the age of 16 are reported. One of these presented with a Salmonella enteritidis diarrhoea. This conforms to the 'dysenteric' form of Reiter's disease usually seen in Europe and rarely reported in England. Another presented with a monarticular arthritis of the knee, and the third has developed a chronic relapsing erosive arthritis as a result of sexually acquired Reiter's disease--an occurrence not previously reported in this age group. We draw attention to the frequency of diarrhoea in these children and the sex incidence of 1 female to 4--5 males, which agrees more with Reiter's disease of dysenteric origin than that acquired venereally.

Topics: Adolescent; Arthritis; Arthritis, Reactive; Diarrhea; Humans; Indomethacin; Male; Phenylbutazone; Salmonella enteritidis; Tetracycline

Idiopathic late-onset immunoglobulin deficiency in a young man was associated with achlorhydria and a severe intestinal malabsorption syndrome that did not respond to conventional therapy. Combined therapy with high doses of prednisone and tetracycline hydrochloride resulted in weight gain, cessation of diarrhea, improved absorption of water, fat, and vitamin B12, and production of gastric acid after stimulation with histamine. Serum immunoglobulin levels, however, did not increase.

Topics: Achlorhydria; Adult; Age Factors; Body Weight; Celiac Disease; Cholecystokinin; Diarrhea; Drug Therapy, Combination; Humans; Immunoglobulin M; Immunologic Deficiency Syndromes; Malabsorption Syndromes; Male; Prednisone; Tetracycline; Vitamin B 12

Topics: Ampicillin; Anti-Bacterial Agents; Carbenicillin; Chloramphenicol; Conjugation, Genetic; Czechoslovakia; Diarrhea; Escherichia coli; Extrachromosomal Inheritance; Female; Humans; Infant, Newborn; Kanamycin; Neomycin; Penicillin Resistance; Salmonella typhimurium; Streptomycin; Sulfonamides; Tetracycline

Topics: Amebiasis; Diarrhea; Entamoeba histolytica; Humans; India; Intestinal Absorption; Metronidazole; Tetracycline; Travel

Two cases of pseudomembranous colitis are presented. The first patient had been treated with novobiocin-tetracycline and penicillin, and two weeks later developed severe fulminating diarrhea with ascites and bilateral pleural effusions which did not respond to intravenous ACTH. Subsequently she underwent subtotal colectomy and made a rapid and complete recovery. The second patient developed severe diarrhea two weeks after a 10-day course of clindamycin. She was treated with intravenous ACTH, oral Lactobacillus and a fecal enema and made a complete recovery.These cases reconfirm the importance of antibiotics as etiologic agents in this disease. They also stress the classic sigmoidoscopic and histologic findings that should facilitate prompt and rapid diagnosis.

Topics: Adolescent; Adrenocorticotropic Hormone; Anti-Bacterial Agents; Ascites; Biological Products; Clindamycin; Colon; Diarrhea; Enema; Enterocolitis, Pseudomembranous; Female; Humans; Lactobacillus; Middle Aged; Novobiocin; Penicillins; Pleural Effusion; Rectum; Tetracycline

Topics: Achlorhydria; Anemia, Megaloblastic; Anorexia Nervosa; Body Weight; Bone Marrow Cells; Celiac Disease; Diarrhea; Gastritis; Hemoglobinometry; Humans; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Vitamin B 12; Zimbabwe

Topics: Animals; Antitoxins; Bacteriological Techniques; Blood Proteins; Cholera; Cross Reactions; Diarrhea; Dogs; Enterotoxins; Escherichia coli; Humans; Intestinal Secretions; Jejunum; Neutralization Tests; Rabbits; Sodium; Temperature; Tetracycline; Time Factors; Vibrio cholerae

Topics: Adult; Aged; Bile Acids and Salts; Celiac Disease; Chemical Phenomena; Chemistry; Cholesterol; Cholestyramine Resin; Cholic Acids; Diarrhea; Feces; Female; Gastrointestinal Motility; Glycocholic Acid; Humans; Intestinal Obstruction; Intestine, Small; Lipid Metabolism; Liver; Malabsorption Syndromes; Male; Middle Aged; Taurocholic Acid; Tetracycline

Seven cases are reported in which drugs of the tetracycline group produced a fall in the glomerular filtration rate. In six patients there was a primary underlying renal disease and renal impairment. All seven patients were made seriously ill by the antibiotic. Two patients required immediate haemodialysis; one died and the other continued on dialysis until transplanted. Another patient initially responded to intravenous fluids and protein restriction but his renal function deteriorated and four months later he began maintenance haemodialysis. Three patients required peritoneal dialysis. The seventh patient responded satisfactorily to conservative management. The medical and medicolegal complications arising from the use of tetracycline in patients with renal disease are discussed. Yet another plea is made that drugs of the tetracycline group other than doxycycline should not be given to patients with chronic renal failure.

Topics: Adult; Aged; Body Weight; Creatinine; Diarrhea; Dietary Proteins; Female; Glomerular Filtration Rate; Humans; Infusions, Parenteral; Kidney Failure, Chronic; Male; Middle Aged; Nausea; Oxytetracycline; Peritoneal Dialysis; Renal Dialysis; Tetracycline; Urea; Vomiting

Topics: Antiprotozoal Agents; Biopsy; Chloroquine; Chronic Disease; Coccidiosis; Diagnosis, Differential; Diarrhea; Diet Therapy; Drug Therapy, Combination; Duodenum; Follow-Up Studies; Humans; Intestinal Diseases, Parasitic; Intestine, Small; Isospora; Jejunum; Malabsorption Syndromes; Male; Metronidazole; Microscopy, Electron; Middle Aged; Nitrofurantoin; Primaquine; Pyrimethamine; Quinacrine; Sulfadiazine; Tetracycline; Time Factors

Sixty-five strains of Yersinia enterocolitica were isolated from stool specimens obtained from 35 patients over a 12-month period. The microbiologic characteristics and drug sensitivities are reported and the clinical patterns of disease associated with the organism are described. Gastroenteritis affecting infants and young children is the most frequent manifestation. The data for 1972 show the same epidemiological trend as in preceding years.

Topics: Adolescent; Bacteriophage Typing; Body Height; Body Weight; Child; Child, Preschool; Chloramphenicol; Diarrhea; Feces; Female; Humans; Infant; Male; Microbial Sensitivity Tests; Pasteurella; Pasteurella Infections; Salmonella Infections; Seasons; Serotyping; Skin Manifestations; Tetracycline

Thirty-four cases of malabsorption are described in young adults after brief periods of overland travel to India. Symptoms included diarrhoea, abdominal distension, and weight loss. Investigation revealed fat, xylose, and vitamin B(12) malabsorption with marked morphological changes in the mucosa. Lower levels of serum folate and vitamin B(12) were observed in those with protracted diarrhoea, but no anaemia developed. Malabsorption may persist for many months after return to the U.K. Most patients responded initially to antibiotics, but some subsequently relapsed. The reasons why these patients developed tropical sprue are discussed.

Topics: Adult; Asia, Western; Biopsy; Body Weight; Celiac Disease; Diarrhea; Fats; Female; Folic Acid; Humans; India; Intestinal Absorption; Jejunum; Malabsorption Syndromes; Male; Tetracycline; Travel; Vitamin B 12; Xylose

Topics: Administration, Oral; Adolescent; Adult; Chlortetracycline; Demeclocycline; Diarrhea; Drug Combinations; Gonorrhea; Humans; Male; Metoclopramide; Microbial Sensitivity Tests; Nausea; Promazine; Recurrence; Tetracycline; Urethritis; Vomiting

Topics: Botulism; Chloramphenicol; Cholera; Clostridium perfringens; Codeine; Diarrhea; Dysentery, Amebic; Dysentery, Bacillary; Escherichia coli Infections; Food; Foodborne Diseases; Humans; Opium; Oxytetracycline; Salmonella Infections; Staphylococcus; Stress, Physiological; Tetracycline; Travel; Virus Diseases

Topics: Acidosis; Administration, Oral; Adolescent; Adult; Aged; Bangladesh; Bicarbonates; Child; Child, Preschool; Cholera; Dehydration; Diarrhea; Female; Glucose; Humans; Infant; Injections, Intravenous; Male; Middle Aged; Refugees; Sodium Chloride; Solutions; Tetracycline; Vomiting; Water-Electrolyte Balance

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Barium Sulfate; Diarrhea; Enema; Enterocolitis, Pseudomembranous; Female; Humans; Lincomycin; Male; Middle Aged; Radiography; Sigmoidoscopy; Streptomycin; Tetracycline

Topics: Adult; Aerospace Medicine; Air Movements; Animals; Child; Chloramphenicol; Cholera; Cholera Vaccines; Diarrhea; Disease Vectors; Humans; Italy; Neomycin; Seasons; Sulfaguanidine; Tetracycline; Vibrio cholerae

Topics: Anti-Bacterial Agents; Chloramphenicol; Colistin; Diarrhea; Dihydrostreptomycin Sulfate; Drug Resistance, Microbial; Escherichia coli; Feces; Furazolidone; Humans; Iran; Microbial Sensitivity Tests; Neomycin; Polymyxins; Salmonella; Salmonella paratyphi A; Salmonella typhi; Salmonella typhimurium; Shigella; Shigella flexneri; Shigella sonnei; Sulfonamides; Tetracycline

Topics: Blind Loop Syndrome; Constipation; Diarrhea; Diverticulum; Duodenal Diseases; Ehlers-Danlos Syndrome; Humans; Ileum; Male; Middle Aged; Mitral Valve Insufficiency; Peptic Ulcer; Streptococcal Infections; Tetracycline

Topics: Achlorhydria; Adult; Aged; Alkalies; Bacterial Infections; Celiac Disease; Diabetes Complications; Diabetic Neuropathies; Diarrhea; Drug Synergism; Female; Humans; Male; Middle Aged; Parasympatholytics; Potassium; Salts; Solutions; Tetracycline

Topics: Biopsy; Body Weight; Calcium; Diarrhea; Female; Folic Acid; Humans; Intestinal Mucosa; Jejunum; Middle Aged; Prednisone; Tetracycline; Vitamins; Whipple Disease

Topics: Adolescent; Adult; Age Factors; Aged; Arthritis; Child; Child, Preschool; Diarrhea; Diet Therapy; Enteritis; Erythema; Erythema Nodosum; Feces; Female; Gastroenteritis; Humans; Infant; Infant, Newborn; Male; Middle Aged; Myocarditis; Pasteurella; Pasteurella Infections; Prognosis; Sex Factors; Sulfonamides; Sweden; Tetracycline

Topics: Bacteriophage Typing; Chloramphenicol; Colicins; Diarrhea; Drug Resistance, Microbial; Feces; Humans; Salmonella; Serotyping; Shigella; Streptomycin; Sulfonamides; Tetracycline; Vibrio

Topics: Animals; Animals, Newborn; Anti-Bacterial Agents; Cattle; Cattle Diseases; Chloramphenicol; Diarrhea; Furazolidone; Immunoglobulins; Male; Neomycin; Streptomycin; Tetracycline

Topics: Acute Kidney Injury; Cholecystitis; Cholera; Dehydration; Diarrhea; Gangrene; Humans; Hyperaldosteronism; Hypokalemia; Parotitis; Respiratory Tract Diseases; Shock; Tetany; Tetracycline; Vibrio cholerae; Water-Electrolyte Balance

Topics: Bicarbonates; Cholera; Diarrhea; Feces; Gastric Acidity Determination; Humans; Infusions, Parenteral; Male; Tetracycline; Vibrio; Water Microbiology

Topics: Adolescent; Adult; Ampicillin; Anemia, Hemolytic; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Diarrhea; Drug Eruptions; Epilepsy; Erythromycin; Female; Hepatic Encephalopathy; Humans; Hyperkalemia; Kanamycin; Lincomycin; Male; Middle Aged; Penicillins; Potassium; Sodium; Tetracycline

Topics: Adult; Balantidiasis; Balantidium; Diarrhea; Humans; Iodoquinol; Male; Tetracycline; Vietnam

Each member of a group of 8 patients with acute cholera was treated with a mixture of four cholera bacteriophage preparations containing over 2 x 10(12) phage particles/ml. These massive doses were intended to kill immediately all vibrios in the intestine by "lysis from without". The numbers of Vibrio cholerae were drastically reduced rapidly. In 4 patients, V. cholerae was completely eliminated from the stools early in the treatment; the total stool volume and after-treatment of diarrhoea were reduced in comparison with a control group but were higher than in a group of patients treated with tetracycline. In the other 4 patients treated with phage, vibrios disappeard more slowly from the stools and there was no apparent clinical effect of the phage. In all the patients treated with phage, the duration of diarrhoea was longer than in patients in a control group who excreted vibrios for a similar length of time although the stool output was similar. This was interpreted as being due to the persistence of vibrios in foci of infection in the upper intestine.It is concluded that treatment of cholera with massive doses of bacteriophage is not as effective as treatment with tetracycline. However, phage can selectively eliminate the majority of vibrios without affecting the other intestinal flora and without any apparent toxic effect on the patient. Phage might therefore be useful as a research tool.

Topics: Acute Disease; Animals; Bacteriophages; Cholera; Diarrhea; Feces; Haplorhini; Humans; Rabbits; Tetracycline; Time Factors; Vibrio

Among 1109 patients with bacteriologically confirmed El Tor cholera admitted to the San Lazaro Hospital, Manila, in 1969, 11 patients continued to excrete vibrios of the same biotype and serotype in stools for more than 1 week in spite of antibiotic treatment.The strains isolated from these patients all belonged to the Ogawa serotype and were all highly resistant to streptomycin and chloramphenicol, and a few of them were resistant also to tetracycline. Other streptomycin-resistant strains of El Tor vibrio were detected, 5 in the Greater Manila area and 1 in Bacolod.The antibiotic-resistant strains showed a high sensitivity to 3 kinds of antimicrobial chemicals, particularly dihydroxymethyl furalazine.Furalazine was given to 33 adults and 15 children with bacteriologically confirmed cholera, and its effect in reducing the duration of diarrhoea and excretion of vibrios was investigated in comparison with the same number of cases treated with chloramphenicol. Furalazine was more effective in reducing the duration of positive stool culture than chloramphenicol, and the two antimicrobial agents were equally effective in decreasing intravenous fluid requirements.Since furalazine was satisfactory in reducing the duration of diarrhoea and excretion of vibrios in stools, and since no resistant strains were found, the drug could be recommended as an alternative to chloramphenicol and tetracycline in the treatment of cholera.

Topics: Adolescent; Adult; Child; Child, Preschool; Chloramphenicol; Cholera; Diarrhea; Drug Resistance, Microbial; Feces; Female; Humans; Male; Microbial Sensitivity Tests; Nitrofurans; Philippines; Tetracycline; Triazines; Vibrio

Tetracycline continues to be an effective antimicrobial agent in the clinical control of cholera but because of its high cost, relatively short shelf-life and recent reports of increased resistance of vibrios to tetracycline in vitro, alternative antimicrobial agents have been tested. Furazolidone, effective against cholera caused by the El Tor biotype in adults, was found to be as effective as tetracycline in reducing the volume and duration of diarrhoea in children with classical cholera and, given over a period of 7 days, only slightly less effective in reducing duration of vibrio excretion.Therapy with an antimicrobial agent over a period of 7 days was associated with a significantly smaller rise in vibriocidal antibody titre (of no clinical significance) in the youngest age-group studied; this was probably due to a diminished antigenic stimulus from the primary infection. Undernourished children showed a poorer response to anti-microbial therapy.The study indicated that furazolidone is a reasonable alternative to tetracycline in the treatment of cholera.

Topics: Antibody Formation; Body Weight; Child; Child, Preschool; Cholera; Diarrhea; Feces; Female; Furazolidone; Humans; Male; Tetracycline; Time Factors; Vibrio

Topics: Adolescent; Adult; Aged; Animals; Antibody Formation; Antitoxins; Cholera; Diarrhea; Disease Reservoirs; Humans; Male; Middle Aged; Rabbits; Tetracycline; Time Factors; Vibrio

Topics: Adolescent; Adult; Anemia; Biopsy; Black People; Diarrhea; Fats; Female; Folic Acid; Humans; Jejunum; Malabsorption Syndromes; Male; Nigeria; Sprue, Tropical; Tetracycline; Xylose

Topics: Administration, Oral; Diarrhea; Gonorrhea; Humans; Male; Nausea; New York City; Tetracycline; United States; Urethritis; Vomiting

Topics: Aged; Ampicillin; Bronchitis; Diarrhea; Gastrointestinal Diseases; Humans; Naphthacenes; Tetracycline

Topics: Acute Disease; Adult; Amebiasis; Biopsy; Chloroquine; Complement Fixation Tests; Diarrhea; Dysentery, Amebic; Humans; Iodoquinol; Liver; Male; Military Medicine; Pain; Tetracycline; United States; Vietnam

Fecal specimens were collected on 22 different Nebraska ranches and at the Department of Veterinary Science from young calves and pigs with neonatal diarrhea. Enterobacteriaceae isolated from these fecal specimens were screened for resistance to tetracycline, streptomycin, sulfamethizole, kanamycin, chloramphenicol, colistin, nitrofurantoin, and nalidixic acid. Of the 92 strains studied, 57 were resistant to one or more of these antimicrobial agents. Resistant strains were obtained from all herds involved in the study. The two most common resistance patterns were tetracycline streptomycin sulfamethizole (22 of 57) and tetracycline (13 of 57). None of the strains were resistant to chloramphenicol, colistin, nitrofurantoin, or nalidixic acid. The 57 resistant strains were studied to determine whether the resistance was transferable. Forty-three of the 57 resistant strains could transfer part or all of their resistance pattern to a drug-sensitive recipient. The 43 R(+) strains were obtained from 17 of the 23 herds studied. Considerable variation was observed between different R(+) strains in the frequency of transfer of resistance to a particular drug. In addition, variation in the frequency of transfer of different resistance determinants in individual R(+) strains was noted.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Chloramphenicol; Colistin; Conjugation, Genetic; Diarrhea; Drug Resistance, Microbial; Enterobacteriaceae; Escherichia; Escherichia coli; Extrachromosomal Inheritance; Kanamycin; Nalidixic Acid; Nitrofurantoin; Proteus; Streptomycin; Sulfamethizole; Swine; Swine Diseases; Tetracycline

Topics: Animals; Animals, Newborn; Bacteria; Corynebacterium; Cricetinae; Diarrhea; Enterobacter; Escherichia coli; Female; Graft vs Host Disease; Intestines; Lactobacillus; Leukopenia; Lymphocytes; Male; Pseudomonas aeruginosa; Rodent Diseases; Rodentia; Staphylococcus; Streptococcus; Sulfaguanidine; Sulfathiazoles; Tetracycline; Thymectomy

Topics: Abdomen, Acute; Adult; Aged; Diarrhea; Diet Therapy; Diverticulum; Dyspepsia; Female; Flatulence; Humans; Intestine, Small; Intestines; Male; Middle Aged; Tetracycline

Topics: Diarrhea; Humans; Malabsorption Syndromes; Nematode Infections; Taiwan; Tetracycline; Thiabendazole; Trichuroidea

Topics: Aged; Anti-Bacterial Agents; Chloramphenicol; Cloxacillin; Diarrhea; Enterobacteriaceae; Erythromycin; Haemophilus; Humans; Lincomycin; Nausea; Neisseria; Staphylococcus; Streptococcus; Streptococcus pneumoniae; Tetracycline

Topics: Anemia; Child; Diarrhea; Enteritis; Humans; Hypothermia; Infections; Kwashiorkor; Nutrition Disorders; Penicillins; Respiratory Tract Infections; Sepsis; Skin Diseases, Infectious; Tetracycline; Urinary Tract Infections

Topics: Adult; Amphotericin B; Diabetes Complications; Diarrhea; Female; Humans; Potassium; Tetracycline

Topics: Biopsy; Chronic Disease; Cobalt Isotopes; Diarrhea; Dietary Proteins; Fats; Feces; Folic Acid; Humans; Ileum; India; Intestinal Mucosa; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Tropical Climate; Vitamin B 12; Xylose

Topics: Adolescent; Agammaglobulinemia; Diarrhea; Giardiasis; Humans; Hyperplasia; Infusions, Parenteral; Intestinal Diseases; Intestine, Small; Jejunum; Lymphatic Diseases; Lymphatic System; Male; Plasma; Quinacrine; Radiography; Tetracycline

Topics: Diarrhea; Humans; Intestinal Absorption; Intestines; Nystatin; Tetracycline

Topics: Animals; Cecum; Chlortetracycline; Colon, Sigmoid; Cricetinae; Diarrhea; Drug Hypersensitivity; Epithelium; Intestine, Large; Necrosis; Oxytetracycline; Tetracycline; Vascular Diseases

Topics: Biopsy; Cholera; Diarrhea; Dysentery, Amebic; Humans; Intestine, Small; Jejunum; Malabsorption Syndromes; Tetracycline; Typhoid Fever

Topics: Adult; Deficiency Diseases; Diarrhea; Diet Therapy; Female; Glucosidases; Glycoside Hydrolases; Humans; Lactose; Sucrase; Sucrose; Tetracycline

Topics: Adult; Ampicillin; Bacteriological Techniques; Cephalothin; Child; Chloramphenicol; Cloxacillin; Diarrhea; Eosinophilia; Erythromycin; Haemophilus influenzae; Humans; Methicillin; Nausea; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine; Penicillin V; Physician-Patient Relations; Pruritus; Respiratory Tract Infections; Skin Diseases; Staphylococcus; Streptococcus; Streptococcus pneumoniae; Sulfonamides; Tetracycline; Urticaria; Vomiting

Topics: Adolescent; Adult; Child; Child, Preschool; Chloroquine; Diarrhea; Diarrhea, Infantile; Dysentery, Amebic; Emetine; Female; Humans; Infant; Male; New Guinea; Tetracycline

Topics: Adult; Diarrhea; Humans; Hypotension; India; Male; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Child; Diarrhea; Diarrhea, Infantile; Humans; Infant; Lymecycline; Lysine; Respiratory Tract Infections; Tetracycline; Toxicology

Topics: Anti-Bacterial Agents; Antidiarrheals; Bismuth; Child; Chloramphenicol; Colistin; Diarrhea; Diarrhea, Infantile; Drug Therapy; Humans; Infant; Lactates; Opium; Protein Synthesis Inhibitors; Tannins; Tetracycline

Topics: Biomedical Research; Cholera; Diarrhea; Humans; India; Leprosy; Research; Tetracycline; Water-Electrolyte Balance

Topics: Anti-Bacterial Agents; Chloramphenicol; Diarrhea; Diarrhea, Infantile; Drug Resistance; Drug Resistance, Microbial; Erythromycin; Penicillins; Staphylococcal Infections; Staphylococcus; Streptomycin; Tetracycline

Topics: Adolescent; Alaska; Anti-Bacterial Agents; Child; Diarrhea; Drug Therapy; Escherichia coli Infections; Fluorescent Antibody Technique; Humans; Infant; Tetracycline; Whooping Cough

Boric acid poisoning in 11 infants, occurring in the newborn nursery as a result of the accidental and inadvertent use of 2.5% boric acid in the preparation of the formulae, is reported. Five of the infants died. All except two exhibited the classical symptomatology of acute boric acid poisoning, namely, diarrhea, vomiting, erythema, exfoliation, desquamation of the skin, and marked central nervous system irritation. Early manifestations of poisoning were nonspecific, and one patient died before skin manifestations were noted. Peritoneal dialysis, instituted in nine cases, was found to be the most effective method of treatment. It is recommended that boric acid, which is of doubtful therapeutic value, should be completely removed from hospitals, dispensaries and pharmacopoeias.

Topics: Acidosis; Anti-Bacterial Agents; Borates; Boric Acids; Color Perception Tests; Dehydration; Diarrhea; Diarrhea, Infantile; Erythema; Exchange Transfusion, Whole Blood; Gastric Lavage; Hypernatremia; Infant; Infant, Newborn; Peritoneal Dialysis; Phenobarbital; Seizures; Tetracycline; Toxicology; Vomiting

Topics: Animals; Anti-Bacterial Agents; Blood Platelets; Bone Marrow Transplantation; Diarrhea; Haplorhini; Lymphocytes; Naphthyridines; Neutrophils; Penicillins; Pharmacology; Radiation Effects; Research; Salmonella Infections; Salmonella Infections, Animal; Salmonella paratyphi A; Salmonella typhi; Tetracycline; Typhoid-Paratyphoid Vaccines

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Bronchial Diseases; Candidiasis; Diarrhea; Lung Diseases; Nausea; Nystatin; Tetracycline; Toxicology; Vomiting

Topics: Anti-Bacterial Agents; Barbiturates; Chloramphenicol; Diarrhea; Diarrhea, Infantile; Diet; Diet Therapy; Humans; Infant; Protein Synthesis Inhibitors; Tetracycline

Topics: Celiac Disease; Diarrhea; Diverticulum; Duodenal Diseases; Escherichia coli Infections; Humans; Intestinal Diseases; Intestines; Sprue, Tropical; Steatorrhea; Tetracycline; Vitamin B 12

Topics: Cardiac Glycosides; Chloramphenicol; Diarrhea; Drug Therapy; Enteritis; Erythromycin; Foodborne Diseases; Humans; Infusions, Parenteral; Tetracycline; Vibrio; Vibrio parahaemolyticus

Topics: Anti-Bacterial Agents; Diarrhea; Diarrhea, Infantile; Oleandomycin; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Chloramphenicol; Diarrhea; Diarrhea, Infantile; Kanamycin; Neomycin; Sulfadimethoxine; Tetracycline

Topics: Anti-Bacterial Agents; Biopsy; Chloramphenicol; Diarrhea; Follow-Up Studies; Humans; Lipodystrophy; Tetracycline; Whipple Disease

Topics: Child; Diarrhea; Feces; Humans; Infant; Micrococcus; Staphylococcal Infections; Staphylococcus aureus; Tetracycline

Topics: Anti-Bacterial Agents; Child; Diarrhea; Humans; Infant; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Child; Diarrhea; Infant; Protein Synthesis Inhibitors; Tetracycline

Topics: Accidents; Anti-Bacterial Agents; Diarrhea; Erythromycin; Humans; Intestinal Obstruction; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Bacterial Infections; Child; Diarrhea; Dysentery; Humans; Infant; Tetracycline

Topics: Anti-Bacterial Agents; Diarrhea; Humans; Incidence; Intestines; Protein Synthesis Inhibitors; Tetracycline