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Biomedical subjects

C N Baker

Publications and source records attributed to C N Baker.

At least 37 records · Page 2Linked to original sources

Campylobacter butzleri sp. nov. isolated from humans and animals with diarrheal illness.

Seventy-eight aerotolerant Campylobacter isolates were characterized phenotypically and by DNA hybridization (hydroxyapatite method at 50 and 65 degrees C). Two DNA relatedness groups were found. (i) Sixty-four strains belonged to aerotolerant Campylobacter DNA hybridization group 2. These organisms were isolated from humans, primarily with diarrheal illness, and animals on several continents. Strains were aerotolerant at 30 and 36 degrees C and catalase negative or weakly catalase positive, grew in media containing glycine and on MacConkey agar, were susceptible to nalidixic acid, and were resistant to cephalothin. The name Campylobacter butzleri sp. nov. is proposed for this group. (ii) DNA hybridization group 1 consisted of the type strain of Campylobacter cryaerophila and 13 additional strains isolated from 10 animals outside the United States and from three humans within the United States. This group was genetically diverse; five strains were closely related to the type strain of C. cryaerophila (DNA hybridization group 1A), and eight strains were more closely related to one another (DNA hybridization group 1B). Strains in DNA hybridization group 1B were phenotypically diverse, with two of eight strains resembling C. cryaerophila. The seven strains from DNA hybridization groups 1A and 1B which resembled C. cryaerophila and the C. cryaerophila type strain were aerotolerant only at 30 degrees C and catalase positive, did not grow in glycine or on MacConkey agar, were generally susceptible to nalidixic acid, and were resistant to cephalothin. The remaining six strains of DNA hybridization group 1B phenotypically resembled C. butzleri; however, they were generally catalase positive and susceptible to nalidixic acid and cephalothin. DNA hybridization group 1B is not designated as a separate species at this time since it cannot, with certainty, be separated genetically from C. cryaerophila or phenotypically from C. butzleri.

Animals↗

Comparison of the E Test to agar dilution, broth microdilution, and agar diffusion susceptibility testing techniques by using a special challenge set of bacteria.

The E Test (AB Biodisk, Solna, Sweden) is a new method for performing antimicrobial susceptibility tests. It consists of an impervious carrier (5- by 50-mm strip) with a predefined antimicrobic gradient which is placed on an inoculated agar plate and processed like a disk diffusion test. Results are generated directly as MICs from a continuous concentration gradient covering 15 twofold dilutions, and MICs are read where the edge of the inhibition zone intersects the strip. We compared the E Test with disk diffusion, broth microdilution, and agar dilution tests by using a challenge set of 195 gram-positive and gram-negative bacteria for 14 antimicrobial agents. Also, disk diffusion, broth microdilution, and agar dilution tests were compared with each other. All test method comparisons gave greater than 94% agreement for the category of susceptibility. The E Test category agreement with disk diffusion and broth microdilution was 95.1%, and with agar dilution it was 95.2%. The E Test results were as reliable as the results obtained by the standard antimicrobial susceptibility testing methods.

Agar↗

Infection caused by Francisella philomiragia (formerly Yersinia philomiragia). A newly recognized human pathogen.

We evaluated the clinical characteristics of patients with Francisella philomiragia (formerly Yersinia philomiragia) isolated from normally sterile sites. Isolates from 14 patients were received by the Centers for Disease Control between 1975 and 1987: 9 were from blood; 2 from lung biopsies; and 1 each from pleural, peritoneal, and cerebrospinal fluid. Underlying problems included chronic granulomatous disease in 5 patients, near-drowning in 5, and a myeloproliferative disease in 2. All 13 patients for whom records were available had a febrile syndrome compatible with bacterial infection. Pneumonia and fever-bacteremia were the commonest clinical syndromes reported. In 7 cases, F. philomiragia was the only sterile-site isolate, and the clinical syndrome did not resolve without appropriate antibiotics. Familiarity with this organism is important because of its ability to cause serious disease in chronic granulomatous disease and near-drowning patients. Further study may yield new insights into pathogenic and host defense mechanisms.

Adolescent↗

Relationship between in vitro susceptibility test results for chloramphenicol and production of chloramphenicol acetyltransferase by Haemophilus influenzae, Streptococcus pneumoniae, and Aerococcus species.

Haemophilus influenzae, Streptococcus pneumoniae, and Aerococcus species were tested for susceptibility to chloramphenicol by standard broth microdilution and disk-diffusion methods. MICs and zone diameter breakpoints were correlated with production of chloramphenicol acetyltransferase (CAT). A comparison of MICs and zone diameters indicated that the interpretative criteria for H. influenzae and S. pneumoniae should be an MIC of less than or equal to 4 micrograms/ml or a zone diameter greater than or equal to 25 mm for susceptible strains and an MIC of greater than or equal to 8 micrograms/ml or a zone diameter of less than or equal to 20 mm for resistant strains; for Aerococcus species, interpretative criteria should be an MIC of less than or equal to 8 micrograms/ml or a zone diameter of greater than or equal to 20 mm for susceptible strains and an MIC of greater than or equal to 32 micrograms/ml or a zone diameter of less than or equal to 12 mm for resistant strains. All but four strains of H. influenzae and one strain of S. pneumoniae that were resistant to chloramphenicol by these criteria produced CAT. For Aerococcus species, however, chloramphenicol-resistant strains were negative for CAT as determined by a commercially available disk test. When comparing susceptibility results with CAT production, thiamphenicol was a better indicator of the presence of the enzyme than chloramphenicol and may be useful in assaying resistance to chloramphenicol.

Chloramphenicol↗

Antimicrobial activity of LY164846, a new oral cephalosporin, and recommendations for disk diffusion tests.

LY164846 is a new oral cephalosporin with a limited spectrum of antimicrobial activity that includes staphylococci (other than methicillin-resistant), streptococci (other than enterococci), Haemophilus influenzae (beta-lactamase-negative and beta-lactamase-positive), Branhamella catarrhalis (beta-lactamase-negative and beta-lactamase-positive), and Neisseria species (beta-lactamase negative and beta-lactamase-positive). The tentative recommendations for susceptibility breakpoints are less than or equal to 4 micrograms/ml and greater than or equal to 19 mm for susceptible, 8 micrograms/ml and 15-18 mm for intermediate, and greater than or equal to 16 micrograms/ml and less than or equal to 14 mm for resistant.

Cephalosporins↗

Campylobacter hyointestinalis associated with human gastrointestinal disease in the United States.

Campylobacter hyointestinalis was isolated from stool specimens of four persons, all of whom were experiencing nonbloody, watery diarrhea. The youngest (8 months of age) and the oldest (79 years of age) individuals were females, and the other two were homosexual men. C. hyointestinalis was the only clinically significant pathogen isolated from stool specimens for three of the individuals. In case 3 (involving a 37-year-old homosexual man), Entamoeba histolytica and Shigella sonnei were also present in the stool. The identification of all C. hyointestinalis strains was made biochemically and confirmed by DNA hybridization. This study documented the isolation of C. hyointestinalis from four patients with diarrhea, and our findings suggest that the clinical significance of Campylobacter species must be expanded to include C. hyointestinalis as a potential cause of human gastrointestinal disease.

Adult↗

Evaluation of the MicroScan antimicrobial susceptibility system with the autoSCAN-4 automated reader.

The American MicroScan (American MicroScan, Mahwah, N.J.) identification and antimicrobial susceptibility system consists in part of an automated reading system (autoSCAN-4) with data management capabilities. We evaluated the system with 404 gram-negative and 170 gram-positive facultative anaerobic and aerobic bacteria. We compared MicroScan results read automatically and visually with each other and with the results obtained by the reference method (read visually). The overall agreement within +/- 1 log2 dilution was 94.3% when the MicroScan system (read automatically) was compared with the reference method (read visually), 96.4% when MicroScan panels (read visually) were compared with reference panels, and 97.4% when the autoSCAN-4 automated reading was compared with the visual reading of the MicroScan panels. Total discrepancies (susceptibility interpretation category changes) for the MicroScan system compared with the reference method were 7%, with 6.2% considered a minor discrepancy. The autoSCAN-4 and the complete MicroScan system yielded accurate results compared with the reference method.

Anti-Bacterial Agents↗

Antimicrobial susceptibility testing of Francisella tularensis with a modified Mueller-Hinton broth.

A modified Mueller-Hinton broth was developed to perform antimicrobial susceptibility tests on Francisella tularensis. Adequate growth of the organism was obtained within 24 h of inoculation, and MICs could be read at that time. We tested 15 selected strains of F. tularensis and five reference quality control strains in this medium with 36 antimicrobial agents. The MICs of the aminoglycosides and tetracycline increased 1 to 3 dilutions in this medium compared with those in the usual medium, but the other antimicrobial agents were not consistently affected by the medium. Even though the medium caused an increase in MICs, the aminoglycosides and tetracyclines remained very active in vitro against F. tularensis. Other antimicrobial agents effective in vitro were chloramphenicol, erythromycin, ceftazidime, moxalactam, cefotaxime, ceftriaxone, and Sch 29482 (a cephalosporin).

Anti-Bacterial Agents↗

autoSCAN-4 system for identification of gram-negative bacilli.

A production model of the autoSCAN-4 system (American MicroScan, Inc., Mahwah, N.J.) was tested with not more than 11 strains each of 73 groups or species of gram-negative bacilli from various Centers for Disease Control culture collections. The strains included typical and atypical strains of enteric fermenters, nonenteric fermenters, and nonfermenters. The autoSCAN-4 system identified 95.3% of all 405 cultures accurately: 95.4% of 307 members of the family Enterobacteriaceae, 96.6% of 29 nonenteric fermenters, and 94.2% of 69 nonfermenters. Manual readings of the same trays provided essentially the same results, with a maximum change of only +1.6% identification accuracy of members of the Enterobacteriaceae. These data were obtained by all required additional tests, including serology and computer consultation when indicated. Only 19 of the cultures tested were misidentified. These were distributed randomly throughout the various groups and species except that Edwardsiella tarda was usually missed because of poor H2S reactions in the test medium. Of six Yersinia enterocolitica isolates, two were not identified. Only one nonenteric fermenter, a Pasteurella sp., and four nonfermenters (three Pseudomonas sp. and one Centers for Disease Control group Ve-2) were misidentified.

Bacteriological Techniques↗

Influence of growth medium on the in vitro activities of second- and third-generation cephalosporins against Streptococcus faecalis.

The influence of culture medium of the MICs of eight cephalosporins for 45 strains of Streptococcus faecalis was investigated. The MICs of cephalothin, cefamandole, and cefoperazone were not substantially influenced by the type of culture medium used. In contrast, MICs of cefuroxime, ceftizoxime, cefotaxime, cefmenoxime, and ceftriaxone varied markedly with both the commercial brand and the blood content of the broth used. The use of Mueller-Hinton broths (from Oxoid Ltd., GIBCO Diagnostics, and Difco Laboratories) supplemented with 5% lysed sheep blood frequently resulted in MICs that were greater than or equal to 16 times lower than the MICs obtained with these same broths without blood. Similar, but less marked, patterns were observed when supplemented and unsupplemented brain heart infusion and Sceptor broths were used. The influence of the broth on MICs suggests a complex interaction between some cephalosporins, medium components, and organisms. The cephalosporins that were affected by media share an identical moiety at the 7-acyl position (cefuroxime is slightly different), but this structure is not shared by those cephalosporins that were not affected. This commonality in structure at the 7-acyl position may be partially responsible for the observed results.

Animals↗

Inoculum standardization in antimicrobial susceptibility testing: evaluation of overnight agar cultures and the Rapid Inoculum Standardization System.

Using the Rapid Inoculum Standardization System [RISS; Minnesota Mining & Manufacturing Co. (3M Co.)], we investigated the use of overnight agar cultures in the preparation of inocula for disk diffusion and microdilution susceptibility tests and compared our results with susceptibility results obtained with the standard methods. The 3M system consists of an inoculation wand, with which a reproducible number of bacteria can be removed from an agar plate, and a diluent in which to suspend the organisms. We used 25 gram-positive cocci, 75 enteric and nonfermentive gram-negative bacilli, and 40 more fastidious bacteria (Haemophilus, Neisseria, and pneumococci) for the evaluation. The geometric mean inoculum size for all organisms tested was 9.7 X 10(7) CFU/ml by the standard method and 1.1 X 10(8) CFU/ml for the RISS. The categories of susceptibility obtained by both methods in the disk diffusion tests were comparable, as were the minimal inhibitory concentrations. We recommend that the use of overnight agar cultures and the use of the RISS to prepare inocula for susceptibility tests be acceptable alternative procedures in the standard methods for susceptibility tests.

Agar↗

Medium-dependent zone size discrepancies associated with susceptibility testing of group D streptococci against various cephalosporins.

Mueller-Hinton (MH) agar media from various commercial sources, either supplemented or not supplemented with 5% sheep blood, were studied to determine their effect on disk diffusion susceptibility testing results obtained with 90 strains of group D streptococci and four cephalosporins. The cephalosporins investigated included cephalothin, cefamandole, moxalactam, and cefotaxime. Results showed that a number of Streptococcus faecalis and Streptococcus faecium strains were susceptible to cephalothin, cefamandole, and cefotaxime, but the number varied with both the commercial source and blood content of the MH medium used. Regardless of the MH medium used, none of the S. faecalis or S. faecium strains were found to be susceptible to moxalactam. The apparently medium-associated variations in the number of strains susceptible to cephalothin, cefamandole, and cefotaxime were largely due to minor discrepancies (one result being intermediate) among the various types of MH media used. However, major discrepancies (one result being resistant and the other susceptible or vice versa) were observed when S. faecalis strains were tested against cefotaxime. These major discrepancies were associated with both the commercial source of the MH medium and the blood content of the medium.

Cephalosporins↗

Tentative interpretive standards for agar disk diffusion antimicrobial susceptibility testing of cefoperazone.

Cefoperazone is a new cephalosporin with a very wide spectrum of activity, including activity against Pseudomonas aeruginosa. It has less activity on enterococci and Acinetobacter. Of the 459 selected bacterial strains tested in this study, only 1.5% (7 strains and 6 genera) had minimum inhibitory concentrations of greater than or equal to 128 micrograms/ml. For a minimum inhibitory concentration breakpoint of less than or equal to 32 micrograms/ml (susceptible), we recommend that the disk diffusion test be done with a 75-micrograms disk and breakpoints of greater than or equal to 18 mm for susceptible, 15 to 17 mm for intermediate, and less than or equal to 14 mm for resistant. Diffusion tests using these criteria yielded only 1.1% very major or major errors.

Acinetobacter↗

Antibacterial activity of fortimicin A compared with those of five other aminoglycosides, and factors affecting susceptibility tests.

Fortimicin A, a pseudodisaccharide aminoglycoside, was found to have broad-spectrum activity against most clinically important aerobic and facultatively anaerobic bacteria, except Pseudomonas aeruginosa, some other Pseudomonas species, and streptococci. It was comparable to amikacin in its level of activity (minimum inhibitory concentrations) and spectrum of activity (except for the lack of activity on P. aeruginosa). Fortimicin A was bactericidal and was affected by cations when tested against P. aeruginosa. Minimum inhibitory concentrations were affected by the inoculum used in the susceptibility test. The drug was resistant to most aminoglycoside-inactivating enzymes, but probably is not active against permeability mutants.

Aminoglycosides↗

Synergism, killing kinetics, and antimicrobial susceptibility of group A and B streptococci.

The susceptibility of 110 group A and 179 group B streptococci to 25 antimicrobics was tested by broth microdilution and agar disk diffusion tests. Representative strains were used in killing kinetics, penicillin-gentamicin synergy, and minimal bactericidal concentration tests. Group A streptococci were more susceptible than group B streptococci to 17 of the 25 antimicrobics tested. Group A and B streptococci were killed at the same rate if the amount of penicillin used was equivalent to their respective penicillin minimal inhibitory concentrations. Synergism was demonstrated for both group A and B streptococci when penicillin was used at concentrations equal to each respective minimal inhibitory concentration and subinhibitory concentration of gentamicin. This synergy could be demonstrated best using minimal bactericidal concentrations obtained by culturing 3- and 6-h cultures from the microdilution checkerboard tests rather than from 24-h subcultures. A greater synergistic effect was achieved by adding penicillin first and then adding gentamicin rather than in the reverse order, or simultaneously.

Anti-Bacterial Agents↗

In vitro antimicrobial activity of cefoperazone, cefotaxime, moxalactam (LY127935), azlocillin, mezlocillin, and other beta-lactam antibiotics against Neisseria gonorrhoeae and Haemophilus influenzae, including beta-lactamase-producing strains.

Minimum inhibitory concentrations and agar disk diffusion tests were determined on clinical isolates of beta-lactamase-positive and beta-lactamase-negative Neisseria gonorrhoeae and Haemophilus influenzae with the newer beta-lactam antibiotics, cefoperazone, cefotaxime, moxalactam (LY127935), azlocillin, mezlocillin, and piperacillin, and with seven older beta-lactam antibiotics. All the drugs were active against beta-lactamase-negative strains of N. gonorrhoeae and H. influenzae. The drug most active against beta-lactamase-positive N. gonorrhoeae was cefotaxime, followed closely by cefoperazone, moxalactam, piperacillin, and mezlocillin. The drugs most active against beta-lactamase-positive strains of H. influenzae were cefotaxime, moxalactam, cefoperazone, and cefamandole.

Azlocillin↗

Comparison of in vitro activity of Sch 21420, a gentamicin B derivative, with those of amikacin, gentamicin, netilmicin, sisomicin, and tobramycin.

Sch 21420 is a new aminoglycoside synthesized from gentamicin B. Susceptibility tests with Sch 21420, amikacin, gentamicin, netilmicin, sisomicin, and tobramycin were performed on a variety of bacterial species including 44 with known mechanisms of resistance to aminoglycosides. Sch 21420 and amikacin had similar effects on all except Haemophilus influenzae and Neisseria species, which were more susceptible to amikacin. Except with some strains of Serratia marcescens, the drugs used were bactericidal. Sch 21420 and amikacin were more stable than the other four aminoglycosides in the presence of the inactivating enzymes produced by some strains. Strains which were very resistant to Sch 21420 and emikacin either were permeability mutants or produced AAC (6')-I inactivating enzyme. The effect of cations on the susceptibilities of these strains to Sch 21420 and amikacin was seen mostly with Pseudomonas aeruginosa and to Sch 21420 with Acinetobacter. Cations did not affect the susceptibilities of other Pseudomonas species, Enterobacteriaceae, Staphylococcus aureus, or Streptococcus faecalis to Sch 21420 or amikacin.

Amikacin↗