Trimethoprim in the Treatment of Urinary Infections in Hospital

Success in the cure of urinary infections of hospital patients was compared for five-day courses of sulphamethoxazole alone, sulphamethoxazole plus one-tenth its weight of trimethoprim, and sulphamethoxazole plus one-fifth its weight of trimethoprim (Septrin). The cure rates were 65%, 84%, and 92% respectively. Fifty-four per cent. of 111 patients had urinary tract abnormalities. Forty-three per cent. of the causative organisms were sulphonamide-resistant in vitro. There were no major side-effects, though two patients had pruritus or a rash.The degree of potentiation of sulphamethoxazole activity by one-fifth the weight of trimethoprim was so great that its cure rate of infections due to sulphonamide-resistant organisms exceeded that of sulphamethoxazole alone used in infections due to sulphonamide-sensitive organisms. The degree of synergism between trimethoprim and sulphamethoxazole demonstrated in vitro against urinary organisms was directly related to the cure rate of the combination.     

R Factors in Hospital Infection

In order to assess the clinical importance of R factors 524 “coliform” infections were studied in a general hospital. Of these, 95 were caused by Pseudomonas aeruginosa. Among the remaining 429, 43% were caused by drug-resistant enterobacteria; resistance was frequently multiple and determined by transmissible R factors. Choice of therapy was thus limited but in every case at least one antibiotic, effective in vitro, was still available.     

脑出血合并医院感染42例临床分析

目的：探讨脑出血患者医院感染的易感因素及其预防措施。方法：回顾性调查、分析291例脑出血患者的临床资料。结果：291例脑出血患者合并医院感染42例,发病率为14.93%,明显高于平均医院感染发病率。结论：脑出血病人医院感染发病率与医院感染危险因素呈明显的正相关性。机体免疫功能低下是其主要因素,长期卧床,侵入性操作与长期使用抗菌药物也是不容忽视的重要因素。预防措施应注意保护和提高患者机体免疫功能,严格执行无菌操作和消毒隔离制度,合理使用抗菌药物,并实施科学的护理。     

Bacteroides Infection among Hospital Patients

In an 18-month period a total of 118 isolates of Bacteroides species, mainly Bacteroides fragilis, were grown from 112 hospital patients with various conditions. The infections were severe and were associated with serious operations such as intestinal surgery for carcinoma and postpartum hysterectomy. Blood cultures were often found to be positive too late in the course of infection for prompt and successful antibiotic therapy to be given. All the Bacteroides species tested were sensitive to clindamycin and co-trimoxazole. We suggest that clindamycin should be added to an empirical antibiotic regimen for the treatment of patients prone to the infection.