Search PubMed⌕ Search

Biomedical subjects

C V Sanders

Publications and source records attributed to C V Sanders.

At least 55 records · Page 3Linked to original sources
PubMed1987

RO23-6240, a new orally absorbed quinolone: in vitro comparison with other broad-spectrum oral antimicrobial agents and imipenem.

A total of 626 clinical isolates were tested for their susceptibility to RO23-6240 and other broad-spectrum antimicrobial agents. RO23-6240 showed good activity against strains of Enterobacteriaceae, Acinetobacter, and P. aeruginosa. RO23-6240 MIC90s ranged from 0.032 to 4 micrograms/ml for these strains. RO23-6240 also showed good activity against staphylococci, both methicillin-susceptible and -resistant strains. The activity in vitro of RO23-6240 was comparable with that of norfloxacin and ofloxacin, and more active than imipenem, trimethoprim-sulfamethoxazole, cefaclor, and amoxycillin/clavulanate potassium. As with the other quinolones tested, increases in inoculum size produced moderate increases in the MICs and MBCs of RO23-6240.

Anti-Bacterial Agents↗
PubMed1987

Antibiotic- and method-dependent variation in susceptibility testing results of Bacteroides fragilis group isolates.

The susceptibilities of 36 isolates of the Bacteroides fragilis group to ceftizoxime, cefoxitin, clindamycin, and metronidazole were determined by using the National Committee for Clinical Laboratory Standards agar dilution reference method and a broth microdilution method using anaerobe, brucella, Schaedler, and brain heart infusion broths. MICs that were greater than or equal to fourfold higher or lower than those of the reference method were considered significant. Major and minor discrepancies in susceptibility interpretation (SI) were also noted. Ceftizoxime showed the greatest number of variations and SI discrepancies. In 72% of the cases, MICs in broth were greater than or equal to fourfold lower than those obtained by the reference method, resulting in 33% of the major and 22% of the minor discrepancies in SI. A total of 53% of the isolates were resistant to ceftizoxime by the reference method, but only 11 to 17% were resistant in the various broths. Significant variations in MICs of cefoxitin occurred in 19 to 22% of the isolates; 17 to 19% of the isolates showed major discrepancies and 31 to 58% showed minor discrepancies in SI. A total of 58% of the isolates were resistant to cefoxitin by the reference method, but only 19 to 28% were resistant in the various broths. Significant variations with clindamycin in broths ranged from 32 to 53% and resulted in 3 to 8% of the isolates showing major discrepancies and 33 to 44% showing minor discrepancies in SI. Metronidazole yielded significant variations in MICs in 6 to 28% of the isolates, but no major or minor SI discrepancies were noted. This study indicates that significant differences in susceptibility results, which appear to be method related, can result when isolates of the B. fragilis group are tested. Therefore, studies correlating in vitro results, determined by various methods, to clinical outcome are essential.

Bacteroides↗
PubMed1987

Localized and systemic infection due to Vibrio species.

Many important species have been added to the genus Vibrio in the past several years. Vibrios have been associated with a wide variety of clinical syndromes ranging from mild gastroenteritis to life-threatening cellulitis. Most Vibrio infections follow consumption of raw shellfish or exposure to sea water. Although much has been learned about these organisms in the past several years, additional information is needed concerning pathogenesis, diagnosis, treatment, and prevention of Vibrio infections.

Humans↗
PubMed1987

Macronodular lesions associated with Staphylococcus aureus bacteremia. A condition that resembles a 'lymphocutaneous' syndrome.

A 54-year-old man, diagnosed as having Wegener's granulomatosis and treated with a regimen of cyclophosphamide and prednisone and hemodialysis, was found to have Staphylococcus aureus in blood, urine, and pus that were removed from the infected area. He had unusual macronodular lesions of the skin that resembled the lymphocutaneous syndrome. These lesions resolved with antibiotic therapy. To our knowledge, this condition has not been described previously.

Arteriovenous Shunt, Surgical↗
PubMed1986

Variation in the potentiation of beta-lactam antibiotic activity by clavulanic acid and sulbactam against multiply antibiotic-resistant bacteria.

Using a broth microdilution method, we studied 120 strains of beta-lactamase-producing clinical isolates to determine the potentiating effect of clavulanic acid and sulbactam (both beta-lactamase inhibitors) on the antibacterial activity of a variety of beta-lactam antibiotics. All antibiotics were tested alone and in combination with each inhibitor simultaneously using low (10(5) cfu/ml) and high (10(7) cfu/ml) inocula. Against the strains of Escherichia coli and Haemophilus influenzae the addition of both inhibitors significantly potentiated the activity of most antibiotics at the low inoculum. At the high inoculum, however, this effect was abrogated against E. coli and most strains of H. influenzae. Antibiotic activity was significantly enhanced by the inhibitors at both inoculum sizes with Bacteroides fragilis. Antibiotic resistance of Pseudomonas aeruginosa was little affected by the inhibitors. Among methicillin-resistant staphylococci, antibiotic potentiation by the inhibitors was more significant for Staphylococcus aureus than the coagulase-negative staphylococci.

Anti-Bacterial Agents↗
PubMed1986

Managing sepsis--a common cause of geriatric death.

Consider where the patient acquired the infection--in the community or the hospital. Gram-negative sepsis that develops after admission to a hospital or extended-care facility is likely to be caused by multiply-resistant organisms. Lack of fever does not reliably exclude sepsis in elderly patients. Among 27 afebrile patients found to have bacteremia-fungemia, diagnosis was made in one-third only after blood cultures were drawn, and almost one-half were already receiving antibiotics.

Aged↗
PubMed1985

Safety and effectiveness of ticarcillin plus clavulanic acid in the treatment of community-acquired acute pyelonephritis in adult women.

An open study was conducted to evaluate the safety and effectiveness of ticarcillin plus clavulanic acid in the treatment of 18 adult women with community-acquired Escherichia coli acute pyelonephritis. Eleven of the 18 patients had a history of urinary tract infections, primarily acute pyelonephritis. Six patients had blood culture results positive for E. coli in addition to positive urine culture results. Ticarcillin plus clavulanic acid was administered as the 3.2 g formulation to 11 patients and as the 3.1 g formulation to the other seven. The mean duration of treatment was 9.2 days. Five of the 18 (28 percent) patients had clinical and bacteriologic cures; there were 11 (69 percent) relapses or reinfections and two (11 percent) clinical failures. Adverse reactions (all reversible) were reported in 11 (61 percent) patients, the most frequent of which was phlebitis. These results should prompt further investigation into the treatment of acute pyelonephritis with ticarcillin plus clavulanic acid versus other antibiotics.

Acute Disease↗
PubMed1985

Comparison of the activities of coumermycin, ciprofloxacin, teicoplanin, and other non-beta-lactam antibiotics against clinical isolates of methicillin-resistant Staphylococcus aureus from various geographical locations.

One hundred clinical isolates of methicillin-resistant (Metr) Staphylococcus aureus from five different geographical origins were tested for their susceptibility to 12 non-beta-lactam antibiotics by the broth microdilution technique recommended by the National Committee for Clinical Laboratory Standards. Coumermycin and rifampin showed the highest activity with of MIC90s of 0.032 micrograms/ml for each compound. No resistance was found to coumermycin, whereas a single Metr S. aureus strain was found to be resistant to rifampin. Ciprofloxacin, vancomycin, and teicoplanin were the next most active compounds with MIC90s of 0.25, 0.5, and 0.5 micrograms/ml, respectively. Norfloxacin was less active, with an MIC90 of 1.0 micrograms/ml. Amikacin was the most active aminoglycoside tested, whereas high levels of resistance were found to tobramycin and gentamicin. Doxycycline and chloramphenicol showed variable results. Geographical variations in results were seen with doxycycline, chloramphenicol, and aminoglycosides. Kill-curve studies showed that coumermycin, ciprofloxacin, teicoplanin, vancomycin, and rifampin were highly bactericidal; more than 90% of the inoculum was killed within 8 h.

Aminocoumarins↗
PubMed1985

Cefamandole and cefoxitin.

Cefamandole and cefoxitin, introduced only 7 years ago, are now the most commonly prescribed parenteral antibiotics in the United States. These drugs are similar to the first-generation cephalosporins in toxicity, but their in-vitro spectrum of activity is greater. Their serum half-lives are longer than those of cephalothin and cephapirin but shorter than that of cefazolin. Although cefamandole has been recommended in empiric therapy for patients with community-acquired pneumonia and as a prophylactic agent for patients having various surgical procedures, other regimens are less expensive and just as effective. Cefamandole should not be used to treat intra-abdominal, enterobacter, or ampicillin-resistant Haemophilus influenzae infections. Cefoxitin is effective in the treatment and prevention of mixed aerobic-anaerobic skin and soft-tissue, intra-abdominal, gynecologic, and penicillinase-producing, spectinomycin-resistant Neisseria gonorrhoeae infections. Cefoxitin represents a greater advance than cefamandole in our continuing search for safe and more effective antimicrobial agents.

Bacteria↗
PubMed1985

Accidental administration of hepatitis B immune globulin to a patient positive for hepatitis B surface antigen.

Approximately 24 hours after receiving hepatitis B immune globulin (HBIG), a renal transplant surgeon developed localized urticaria at the site of injection followed by generalized urticaria and angioedema, which resolved after administration of corticosteroids but recurred ten days later. Blood drawn from the surgeon prior to his receiving the HBIG injection was positive for hepatitis B surface antigen (HBsAg). We believe that the adverse reaction may have been caused by HBsAg-HBIG immune complexes. This case illustrates the necessity for knowing the results of hepatitis serology before injection of HBIG is given in high risk individuals. It also re-emphasizes the value of periodic screening for hepatitis B in such persons and the need for hepatitis B vaccine.

Angioedema↗
PubMed1984

Comparison of the activities of penicillin G and new beta-lactam antibiotics against clinical isolates of Bacteroides species.

MICs were determined for 218 clinical isolates of Bacteroides by a broth microdilution method. Imipenem was the most active antibiotic tested. Azlocillin, mezlocillin, and cefoxitin had comparable activities, with resistance among members of the B. fragilis group and B. capillosus. Ceftizoxime was the most active cephalosporin tested. Members of the B. fragilis group showed high levels of resistance to cefotetan and ceftazidime. Resistance to penicillin G varied from 0 to 14%.

Anti-Bacterial Agents↗
PubMed1984

Comparison of rapid identification assays for Staphylococcus aureus.

A total of 137 strains of Staphylococcus species were blindly tested by four rapid serological assays, and the results were compared with those of the tube coagulase assay. For the S. aureus isolates, the Sero-STAT Staph assay gave six false-negative results, four of which were for methicillin-resistant strains. The Accu -Staph, Staphylatex , and Staphyloslide assays identified all the coagulase-positive strains as Staphylococcus aureus. Among the coagulase-negative staphylococci, false-positive results were seen with strains of S. capitis. S. saprophyticus, and S. cohnii. The overall accuracy of the kits compared with the tube coagulase test ranged from 95.1 to 100%.

Bacteriological Techniques↗
PubMed1984

In vitro synergy and potentiation between cefotaxime and desacetylcefotaxime against clinical isolates of Bacteroides.

A broth microdilution checkerboard system was used to determine the activity of cefotaxime (CTX) and desacetylcefotaxime (des-CTX), alone and in combination, against 92 clinical isolates of Bacteroides species. Overall, CTX was only marginally more active than the metabolite. Resistance to both compounds was found among B. fragilis group, B. disiens, B. bivius, and B. capillosus. The combination of CTX with des-CTX resulted in a marked reduction of the MICs greater than or equal to fourfold for 82% of the strains tested. In addition, complete or partial synergy was noted with the combination against 85% of the strains tested. The ratio of CTX to des-CTX at the inhibitory endpoints varied widely, but in 75% of the cases it was 2:1 to 1:2 parts CTX to des-CTX.

Bacteroides↗
PubMed1983

Vibrio vulnificus infection. Case report and update since 1970.

Vibrio vulnificus infections is being reported with increasing frequency in coastal regions of the United States. Raw seafood consumption, particularly raw oysters, and wounds acquired in a marine environment predispose to infection. Patients with advanced liver disease are at increased risk of developing septicemia. V. vulnificus is a virulent pathogen producing significant morbidity and mortality; its virulence relates in part to the production of exotoxin. Skin lesions occur early in the clinical course of infection and provide means of specific diagnosis. The patient and the consulting physician are well served by the dermatologist capable of recognizing this infectious disease.

Anti-Bacterial Agents↗
PubMed1983

Comparative clinical trial of imipenem-cilastatin (N-formimidoyl-thienamycin-dehydropeptidase inhibitor) and cefazolin.

One hundred and eighty-six patients were randomized to receive either imipenem-cilastatin (94 patients) or cefazolin (92 patients). Imipenem-cilastatin (250 mg 6 hourly iv) or cefazolin (1000 mg 6 hourly iv) were given for 5 to 14 days. An assessment of efficacy could be made in 141 patients, 72 of whom received imipenem-cilastatin and 69 of whom received cefazolin. Reasons for exclusion included failure to isolate a causative organism (20 patients), less than 5 days of treatment (16 patients), inadequate follow up or culture (5 patients), concomitant administration of another antibiotic (1 patient), and resistance to the study drug (3 patients, all of whom were in the cefazolin group). No isolates resistant to imipenem were found. Sites of infection included skin and soft tissue (91 patients), lower respiratory tract (21 patients), urinary tract (16 patients), bone and joint (8 patients), primary bacteraemia (4 patients) and miscellaneous other sites (1 patient). Bacteria isolated included Staphylococcus aureus (65 patients), group A streptococcus (42 patients), Escherichia coli (17 patients), other Gram-negative bacilli (37 patients), anaerobic bacteria (34 patients) and other bacteria. Imipenem was more active than cephalothin in vitro against pathogenic bacteria isolated from evaluable patients. Cure or improvement was seen in 68 of the 72 imipenem-cilastatin patients (94%) and in 68 of the 69 cefazolin patients (99%). Relatively few abnormal laboratory tests and adverse experiences were noted, and there were no differences in this between the two treatment groups. We concluded that imipenem-cilastatin is safe at the dose used. It is as effective as cefazolin in mild to moderate infections caused by common pathogens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Susceptibility of anaerobic bacteria to beta-lactam antibiotics and beta-lactamase production.

We examined the susceptibility of various anaerobes to four beta-lactamase susceptible (ampicillin, amoxycillin, cyclacillin, and penicillin G) and two beta-lactamase resistant (moxalactam, and N-F-thienamycin) beta-lactam antibiotics and measured beta-lactamase production. Members of the Bacteroides groups were most resistant to the six antibiotics. N-F-thienamycin was the most effective antimicrobial agent against all the test strains, moxalactam the next most effective, and penicillin G the least. Beta-lactamase production was mainly confined to Bacteroides species. Cephalosporinase was the most common beta-lactamase produced; penicillinase was detected less often. About two thirds of the penicillin-resistant isolates produced cephalosporinase. N-F-thienamycin and moxalactam were the most active agents against those anaerobes that were resistant to many beta-lactam antibiotics.

Amoxicillin↗