Clinical and microbiological profile of urinary tract infection at a tertiary-care center in Lebanon.

We compared community-acquired urinary tract infection (UTI) with hospital-acquired UTI at the American University of Beirut Medical Center. Escherichia coli was the most frequently isolated organism. Hospital-acquired E.

Ventilator-associated pneumonia at a tertiary-care center in a developing country: incidence, microbiology, and susceptibility patterns of isolated microorganisms.

Objective: Ventilator-associated pneumonia (VAP) complicates the course of up to 24% of intubated patients. Data from the Middle East are scarce. The objective of this study was to evaluate the incidence, microbiology, and antimicrobial susceptibility patterns of isolated microorganisms in VAP in a developing country.

Brucella pelvic tubo-ovarian abscess mimicking a pelvic malignancy.

A 57-y-old woman presented with recurrent abdominal and pelvic pain of 6 months' duration with low-grade fever. A computed tomographic scan indicated an ovarian tumor. Laparotomy revealed a pelvic abscess.

Endemic gastrointestinal anthrax in 1960s Lebanon: clinical manifestations and surgical findings.

Anthrax is an ancient disease caused by the gram-positive Bacillus anthracis; recently, it has gained much attention because of its potential use in biologic warfare. Anthrax infection occurs in three forms: cutaneous, inhalational, and gastrointestinal. The last type results from ingestion of poorly cooked contaminated meat.

Azithromycin-induced rash in infectious mononucleosis.

Antibiotic-induced skin eruption in the setting of infectious mononucleosis is a common and well-documented clinical scenario. The skin lesions are non-specific and the mechanisms causing them are unclear. Several reports have described this entity with different antibiotic classes, mainly penicillins.

Infective endocarditis at a tertiary care centre in Lebanon: predominance of streptococcal infection.

Objectives: Infective endocarditis (IE) remains a disease associated with high morbidity and mortality. Many epidemiological studies have been reported worldwide; however, data from the Middle East is scarce. Most studies have recently shown a trend towards increasing incidence of Staphylococcus aureus endocarditis and decreasing prevalence of rheumatic heart disease as a predisposing condition.

Susceptibility of bacterial isolates to cefepime in comparison to other broad spectrum antimicrobial agents at a tertiary care center in Lebanon.

Newly introduced antimicrobial agents have to be evaluated to establish their current activity and susceptibility data base against microorganisms for future comparison. Cefepime is a fourth generation cephalosporin that was recently introduced in Lebanon but no background susceptibility data is available for it in this country. We prospectively analyzed the antimicrobial susceptibility pattern of the bacterial isolates from the American University of Beirut Medical Center to a number of broad spectrum antimicrobial agents and compared it to the susceptibility of cefepime.

Campylobacter fetus pericarditis in a patient with beta-thalassemia: case report and review of the literature.

A case of pericardial effusion due to Campylobacter fetus in a patient with thalassemia is presented. The patient failed to respond to ceftriaxone and clarithromycin despite in vitro susceptibility, but improved after pericardiectomy and ampicillin. Pericarditis due to C.

Safety of aerosolized amphotericin B lipid complex in lung transplant recipients.

Background: Fungal infections remain an important cause of morbidity and mortality in lung transplant recipients. Aerosolized amphotericin B lipid complex (ABLC) may be more efficacious than conventional amphotericin B in the prevention of fungal infections in animal models, but experience with aerosolized ABLC in humans is lacking.

Methods: We conducted a prospective, noncomparative study designed to evaluate safety of aerosolized ABLC in lung or heart-lung transplant recipients.

Ramichloridium mackenziei brain abscess: report of two cases and review of the literature.

We report two cases of brain abscesses caused by Ramichloridium mackenziei, a neurotropic dematiaceous fungus that seems to be geographically restricted to the Middle East. One of the patients had chronic myelomonocytic leukemia but did not receive any chemotherapeutic agents. The other patient was a normal host.

Febrile neutropenia in cancer patients in a tertiary care medical center in Lebanon: microbial spectrum and outcome.

We prospectively analyzed the episodes of febrile neutropenia at the American University of Beirut Medical Center. One hundred and four episodes were studied in 64 patients over a period of 15 months: 81 (78%) with leukemia, 11 (10.5%) with lymphoma, 3 (2.

Antibiotic prophylaxis.

The use of antibiotic prophylaxis has long been established to prevent the development of invasive infections. In many settings, it is currently considered to be the standard of care to administer antibiotics prior to surgical procedures. The aim is to decrease the load of organisms at the site of manipulation and therefore minimize the appearance of local as well as distant infection.

Current status and changing trends of antimicrobial resistance in Lebanon.

Antimicrobial resistance among microorganisms has been on the rise worldwide including Lebanon. Several surveillance programs have been initiated to monitor the patterns of resistance due to the deleterious consequences on patients management. Thus, knowledge about the local antimicrobial resistance patterns is essential for epidemiologic aspects as well as clinical practice.

Drug-resistant Streptococcus pneumoniae in the Lebanon: implications for presumptive therapy.

A total of 50 consecutive clinical isolates of Streptococcus pneumoniae, collected between 1996 and 1998, were tested against six antimicrobial agents using the E-test. The percentages of fully resistant (R) and intermediately-R strains, respectively, were: benzyl penicillin 18 and 38%, amoxycillin-clavulanate 6 and 12%, cefuroxime 22 and 16%, ceftriaxone 2 and 16%, and clarithromycin 10%. Fully and or intermediately multidrug-resistance (two or more drugs) was seen in 44% of the isolates, 18% being fully resistant.

Mycoplasma hominis pneumonia complicating bilateral lung transplantation: case report and review of the literature.

Mycoplasma hominis is a commensal of humans. The organism has been predominantly associated with infections of the genitourinary tract. Extragenital infections have been described in neonates, in women during the postpartum period, and in immunocompromised patients.

Infections in patients with cystic fibrosis following lung transplantation.

Background: There is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation.

Methods: We undertook a retrospective review of the results of lung transplantation for patients with cystic fibrosis (CF) at Duke University Medical Center.

Results: As of May 1996, 21 patients with CF underwent bilateral lung transplantation.

A case of disseminated infection with Nocardia brasiliensis in a lung transplant recipient.

Background: Infection with Nocardia species is an increasingly recognized complication of solid organ transplantation. Nocardia asteroides accounts for most transplant-related nocardiosis, while Nocardia brasiliensis rarely causes infection in organ transplant recipients.

Methods: We describe a case of disseminated infection with N brasiliensis in a single-lung transplant recipient who also had concomitant infections with viral and fungal organisms.

Fungal infections in lung and heart-lung transplant recipients. Report of 9 cases and review of the literature.

We reviewed the pattern and incidence of fungal infections in patients undergoing lung and heart-lung transplantation at Duke University Medical Center from September 1992 until August 1995, and present here 9 illustrative cases. Of the 73 lung and heart-lung transplant recipients studied, 59 (81%) had positive fungal cultures at some point after transplantation. The cases presented here illustrate that lung transplant recipients are predisposed to a wide variety of fungal infections.

Cytomegalovirus infection following liver transplantation: review of the literature.

Cytomegalovirus (CMV) remains a major cause of problems following solid organ transplantation, accounting for a significant increase in morbidity and affiliated costs. Infection with CMV following orthotopic liver transplantation (OLT) is commonly seen as a result of marked cell-mediated immunosuppression and is an independent risk factor for opportunistic and fungal infections. The role of CMV infection in acute cellular or chronic rejection remains unclear.