Joseph R. Lentino

Therapy of Serious Skin and Soft Tissue Infections with Ofloxacin Administered by Intravenous and Oral Route

We evaluated the safety and efficacy of ofloxacin administered both by the intravenous route and orally in 26 men with serious skin and soft tissue infection. Twenty-one patients completed antimicrobial therapy and were fully evaluable. Of these, 18 were judged to be cured, while 3 failed therapy either during or within 2 weeks after completion of therapy. Overall, Staphylococcus aureus was the most commonly isolated pathogen and was found to be susceptible to ofloxacin in 12 of 14 patients. Two patients, 1 with a tolerant isolate of S. aureus, the other patient with a resistant isolate of S. aureus, responded clinically to ofloxacin therapy; a third patient with an initially ofloxacin-sensitive isolate failed therapy, and on subsequent culture an ofloxacin-resistant S. aureus was isolated. Ofloxacin was well tolerated and efficacious in the treatment of skin and soft tissue infections including those caused by staphylococci and streptococci.

Jaundice associated with nonhepaticStaphylococcus aureus infection

SummaryA previously healthy young man developed jaundice early in the course of a febrile illness caused by an unrecognized deep-seatedStaphylococcus aureus abscess. The serum bilirubin level peaked 11 days before the abscess was discovered and drained. During this time the bilirubin level returned to normal, circulating immune complexes were detected, and the serum free teichoic acid antibody titer was elevated. Indirect immunofluorescent staining of liver tissue for teichoic acid revealed 2+ nuclear fluorescence of the hepatocytes. These findings suggested that circulating free teichoic acid was deposited in the liver and may have had an endotoxin-like effect in the hepatocytes. With the appearance of specific antibody in the serum, circulating teichoic acid was neutralized and further hepatic injury ceased.

Seroprevalence of HTLV-I/II and HIV-1 Infection Among Male Intravenous Drug Abusers in Chicago

Summary:We surveyed for serologie evidence of either HIV-1 or HTLV-I/II infection in 387 male veterans who entered into an inpatient drug treatment center. Serum was obtained after receiving written informed consent. Serum specimens were tested by enzyme-linked immunosorbent assay for antibody to HIV-1 and for antibody to HTLV-I/II; sera that were repeatedly reactive were then tested by Western blot (HIV-1/HTLV-I/II) and radioimmunoprecipitation assay (HTLV-I/II). Sixty-five of 387 (16.79%) patients were tested and confirmed as positive for HTLV-I/II only antibodies and 30 of the 387 (7.75%) were positive for HIV-1 only antibodies. An additional nine patients (2.32%) were seropositive for antibodies to both viruses. A statistically significant difference in the CD4/CD8 lymphocyte ratio was associated with HIV-1 sero-positivity. HTLV-I/II seropositivity was strongly associated with black race, age, and duration of i.v. drug use, but not with sexual intercourse as determined by lifetime history of number of sexual partners, incidence of sexually transmitted diseases, type of drug used, or needle-sharing practices.

The Effectiveness and Safety of Oral Linezolid as Primary or Secondary Treatment of Bloodstream Infections: A Retrospective Observational Analysis

Abstract: The aim of this study was to determine the effectiveness and safety of oral linezolid as treatment of primary or secondary bloodstream infection. A retrospective observational analysis was completed on all patients who received at least 7 days of oral linezolid between June 2000 and December 2002. Twenty-four patients received 25 courses of oral linezolid for bloodstream infections. Microbiologic cure was documented in 21 (84%) of 25 patients who received at least 7 days of therapy. The most common adverse event was thrombocytopenia (13%). Orally administered linezolid offers the clinician an alternative to parenteral therapy for serious gram-positive coccal infections. A wide margin of safety was noted when therapy was limited to a mean of 14 days.