Antibiotic therapy for Klebsiella pneumoniae bacteremia: Implications of production of extended-spectrum beta-lactamases

The prevalence of extended-spectrum beta-lactamase (ESBL) production by Klebsiella pneumonia approaches 50% in some countries, with particularly high rates in eastern Europe and Latin America. No randomized trials have ever been performed on treatment of bacteremia due to ESBL-producing organisms; existing data comes only from retrospective, single-institution studies. In a prospective study of 455 consecutive episodes of Klebsiella pneumoniae bacteremia in 12 hospitals in 7 countries, 85 episodes were due to an ESBL-producing organism. Failure to use an antibiotic active against ESBL-producing K. pneumoniae was associated with extremely high mortality. Use of a carbapenem ( primarily imipenem) was associated with a significantly lower 14-day mortality than was use of other antibiotics active in vitro. Multivariate analysis including other predictors of mortality showed that use of a carbapenem during the 5-day period after onset of bacteremia due to an ESBL-producing organism was independently associated with lower mortality. Antibiotic choice is particularly important in seriously ill patients with infections due to ESBL-producing K. pneumoniae.

Frequency band selection of radars for buried object detection

Choice of the operational frequency is one of the most responsible parts of any radar design process. Parameters of radars for buried object detection (BOD) are very sensitive to both carrier frequency and ranging signal bandwidth. Such radars have a specific propagation environment with a strong frequency-dependent attenuation and, as a result, short operational range. This fact dictates some features of the radar's parameters: wideband signal-to provide a high range resolution (fractions of a meter) and a low carrier frequency (tens or hundreds megahertz) for deeper penetration. The requirement to have a wideband ranging signal and low carrier frequency are partly in contradiction. As a result, low-frequency (LF) ultrawide-band (UWB) signals are used. The major goal of this paper is to examine the influence of the frequency band choice on the radar performance and develop relevant methodologies for BOD radar design and optimization. In this article, high-efficient continuous wave (CW) signals with most advanced stepped frequency (SF) modulation are considered; however, the main conclusions can be applied to any kind of ranging signals.