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Biomedical subjects

F L Sapico

Publications and source records attributed to F L Sapico.

At least 37 records · Page 2Linked to original sources
PubMed1984

Anaerobic bacteria isolated from foot infections in diabetic patients: in vitro susceptibility to nine antibiotics.

Twenty-nine isolates of anaerobic bacteria from foot infections in diabetic patients were tested, using the agar dilution method, for in vitro susceptibility to nine antimicrobial agents. Imipenem and metronidazole showed excellent activity; clindamycin and chloramphenicol were next in terms of efficacy. Cefoxitin and moxalactam demonstrated good activity, although three isolates of the Bacteroides fragilis group were resistant to moxalactam. Penicillin G, cefotaxime, and cefoperazone showed poor activity against the B fragilis group but were quite active against other anaerobes. Among the newer beta-lactam antibiotics studied, imipenem, cefoxitin and, to a lesser extent, moxalactam appear promising for clinical use as anti-anaerobic antibiotics in the treatment of foot infections in diabetic patients.

Anti-Bacterial Agents↗
PubMed1982

Temperature effect on the susceptibility of methicillin-resistant Staphylococcus aureus to four different cephalosporins.

Forty isolates of methicillin-resistant Staphylococcus aureus were tested for in vitro susceptibility to cephalothin, cefamandole, cefotaxime, and moxalactam, using the disk diffusion and microbroth dilution methods at incubation temperatures of 30 and 35 degrees C. Resistance to all four antibiotics was more clearly evident at an incubation temperature of 30 degrees C.

Cephalosporins↗
PubMed1982

In vitro susceptibility of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains to N-formimidoyl thienamycin.

A total of 82 clinical isolates of methicillin-resistant Staphylococcus aureus and 21 isolates of methicillin-susceptible S. aureus were studied for in vitro susceptibility to N-forminidoyl thienamycin at incubation temperatures of 30 and 35 degrees C. The disk diffusion test results were correlated with the macrobroth dilution test by means of the error rate-bounded method of analysis. Both methicillin-susceptible and (to a lesser degree) methicillin-resistant strains were generally susceptible to the antibiotic as judged from their minimum inhibitory concentrations. The discrepancy between in vitro results obtained at 30 and at 35 degrees C was not very remarkable. However, tolerance of N-formimidoyl thienamycin was observed in 37% of methicillin-resistant strains and 24% of methicillin-susceptible strains at an incubation temperature of 30 degrees C; at 35 degrees C, the values were 54% (methicillin-resistant strains) and 14% (methicillin-susceptible strains).

Anti-Bacterial Agents↗
PubMed1982

Methicillin-resistant-Staphylococcus aureus colonization and infection in a rehabilitation facility.

Methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in a rehabilitation hospital (Rancho Los Amigos Hospital [RLAH]) were studied from October 1977 to May 1980. Eighty-four episodes of MRSA colonization or infection were observed in 81 patients (attack rate, 0.44 per 100 admissions). The MRSA was considered to have been acquired at RLAH in 65% of the episodes and from transferring hospitals in 34%. The infection rate was 35% among MRSA-colonized patients, and only one death was attributed to MRSA infection. Colonization for more than 100 days occurred most frequently in wounds and anterior nares. All but two of the MRSA isolates were resistant to aminoglycosides, and 80% of those typed belonged to phage type 83A. The patients were allowed to continue participation in rehabilitation programs. Spread of the MRSA occurred in wards where intensive medical and nursing care was being practiced. There was no evidence of MRSA spread in the services with less intense medical and nursing care and where physical and occupational therapy was continued. Patients in a rehabilitation hospital with MRSA colonization may receive intensive physical and occupational therapy as long as special precautions are observed to prevent MRSA spread.

Adolescent↗
PubMed1982

Failure of rifampin to eradicate methicillin-resistant Staphylococcus aureus colonization.

Four patients with methicillin-resistant Staphylococcus aureus (MRSA) carriage in one body site each (urine, anterior nares, throat, or wound) received 300 mg of oral rifampin twice daily for ten days. Treatment did not eradicate MRSA carriage in any patient, and three of the posttherapy isolates were highly resistant to the drug. Rifampin by itself does not appear to be an effective drug for the eradication of MRSA carriage.

Adult↗
PubMed1982

Severe vertebral osteomyelitis in patients with spinal cord injury.

Four patients with spinal cord injury (SCI) experienced severe and unusual clinical manifestations of vertebral osteomyelitis. The main feature of the illness was the development of extensive disease below the level of the SCI. Large paravertebral abscesses pointing to the skin developed in three patients. The fourth patient was seen initially with a persistent draining sinus on a previous nephrectomy incision site before the condition was diagnosed. All four patients underwent surgical debridement of infected bone together with antibiotic therapy. Vertebral osteomyelitis should be considered in patients with SCI and sepsis of uncertain origin.

Abscess↗
PubMed1982

Infective endocarditis due to anaerobic and microaerophilic bacteria.

Seven cases of infective endocarditis (IE) due to anaerobic or microaerophilic bacteria were seen in a period of 42 months at Rancho Los Amigos Hospital (Downey, California), representing 10.6 percent of the total number of 66 cases that carried the diagnosis of IE. Five of the 66 patients had polymicrobial endocarditis. Three of five patients with polymicrobial endocarditis had at least one anaerobic or microaerophilic microorganism isolated from the blood, and all five patients practiced intravenous drug abuse. Six of the seven patients with anaerobic or microaerophilic IE were women. The three patients who had anaerobic Gram-negative bacillary endocarditis were drug abusers. None of the isolated organisms were Bacteroides fragilis. The following heart valves were involved in the seven patients with anaerobic or microaerophilic IE: tricuspid (three), mitral (two), aortic (one) and tricuspid plus aortic (one). Three of the seven patients had preexistent valvular disease, and two required tricuspid valvulectomy. Only one patient had serious systemic embolism (cerebral), but all four drug abusers had septic pulmonary embolism. All seven patients recovered with appropriate antimicrobial therapy.

Adult↗
PubMed1981

Temperature effect on cephalothin sensitivity of methicillin-resistant Staphylococcus aureus.

Nineteen methicillin-resistant Staphylococcus aureus isolates from clinical specimens were tested for cephalothin sensitivity by disk diffusion and tube-dilution methods using incubation temperatures of 35 C and 30 C. Resistant colonies were observed to grow within the zones of antibiotic inhibition for 17 of the 19 isolates at 30 C but not at 35 C incubation. Twenty control strains known to be methicillin-sensitive did not show these resistant colonies at 30 C. Five of the methicillin-resistant isolates were sensitive, one of intermediate sensitivity to cephalothin, and the rest were resistent by tube-dilution testing at 35 C. At 30 C, however, two isolates were of intermediate sensitivity, and the rest were resistant to cephalothin by tube-dilution testing. These observations strongly suggest that the 30 C incubation temperature is more reliable in detecting in-vitro resistance of methicillin-resistant strains of Staphylococcus aureus to cephalothin in agar as well as in liquid media.

Cephalothin↗
PubMed1981

Cryptococcal intracerebral mass lesions: the role of computed tomography and nonsurgical management.

Cephalic computed tomography (CT) is a sensitive technique for defining certain intracerebral diseases. Four patients with cryptococcosis were evaluated with cephalic computed tomography over 3 years. All had focal, intracerebral "contrast-enhanced" lesions consistent with cryptococcal mass lesions, confirmed histopathologically in two. An analysis of 55 cases of cryptococcal intracerebral mass lesions from the literature showed that 18% of patients with these lesions associated with cryptococcal meningitis did not have specific symptoms or signs of focal intracerebral disease or increased intracranial pressure. We therefore recommend that patients with cryptococcal meningitis, regardless of localizing symptoms or signs, be considered for cephalic CT evaluation to ascertain the presence of mass lesions. Three patients in this report were treated with systemic antifungal medication without surgery. Decreased size or disappearance of these lesions was seen on sequential CT scan in all patients. We conclude that selected patients with cryptococcal intracerebral mass lesions may be managed successfully with systemic antifungal therapy alone.

Adolescent↗
PubMed1980

Short-course aminoglycoside therapy in patients with spinal cord injury. Standard dose versus low dose.

Twenty-nine patients with spinal cord injury and asymptomatic urinary tract infection were treated with standard or reduced doses of tobramycin and amikacin. The patients received five days of intramuscular antibiotics. Most of the patients in the tobramycin groups had Pseudomonas aeruginosa infection and most of those in the amikacin group had either Proteus rettgeri or Providencia stuartii infections. Only 1 patient had a positive urine antibody coating test. High antibiotic concentrations were demonstrated in the urine of all patients during therapy. Urine cultures were obtained two and seven days after completion of therapy. Forty-eight per cent of the patients were cured, while 31 per cent showed persistence or relapse, and 21 per cent had reinfection with other bacteria. No significant differences in results were observed between the standard-dose and low-dose regimens and between the amikacin and tobramycin groups. The low success rate of the regimens used may indicate the need to evaluate alternative therapeutic regimens to treat urinary tract infections in this special group of patients.

Adult↗
PubMed1980

Quantitative aerobic and anaerobic bacteriology of infected diabetic feet.

Quantitative aerobic and anaerobic cultures of deep tissue were performed on amputated infected lower limbs of 13 diabetic patients immediately after surgery. Dissection was made through intact skin distant from any preexisting ulcer. The results were compared with those obtained from: (i) ulcer swabs (pre- and postamputation), (iii) curettage of the ulcer base, and (iii) needle aspiration after normal saline injection. Anaerobic transport media were used for anaerobic cultures before prompt transfer to the anaerobic chamber. A mean of 4.7 bacterial species per specimen was seen (2.3 aerobes, 2.4 anaerobes). Mean log10 growth per gram of tissue was as follows: (i) aerobes plus anaerobes = 6.99, (ii) aerobes = 6.42, and (iii) anaerobes = 7.65. There was poor concordance between the deep tissue culture results and the results from other modalities of culture collection, though the results from other modalities of culture collection, though the results from curettage and saline aspiration were slightly better than those obtained from ulcer swabs. The most frequently isolated organisms were enterococci, anaerobic streptococci, and species of Proteus, Clostridium, and Bacteroides. When anti-microbial therapy is indicated for this patient population, the possibility of the concomitant presence of aerobes as well as anaerobes should be considered.

Aerobiosis↗
PubMed1976

Aerobic and anaerobic flora in bladder urine of patients with indwelling urethral catheters.

Twenty-five bladder urine specimens from 13 patients with long-standing indwelling catheters were obtained by percutaneous suprapubic needle aspiration to avoid contamination by extraneous flora and cultured aerobically and anaerobically. Twenty different species of organism were isolated from twenty-four positive specimens. The isolates were predominantly gram-negative aerobic or facultatively anaerobic bacilli, with occasional gram-positive aerobic cocci and yeasts. One patient had Clostridium perfringens and a Bifidobacterium and another had Veillonella and two species of Bifidobacterium. Both patients had four concomitant aerobic or facultative bacteria present. Anaerobic bacteria may therefore be found in the bladder urine of some patients with indwelling urethral catheters, but their role in the initiation and perpetuation of urinary tract infection in this setting remains unclear.

Acinetobacter↗
PubMed1972

Standardized antimicrobial disc susceptibility testing of anaerobic bacteria: in vitro susceptibility of Clostridium perfringens to nine antibiotics.

The in vitro susceptibility of 43 strains of Clostridium perfringens to nine antibiotics was determined by a standardized test for rapid-growing anaerobes. Good correlation was established between the agar dilution susceptibility and the disc diffusion susceptibility results. The inhibition zone diameters around the antibiotic discs, however, were generally much smaller than those of gram-negative anaerobes previously studied. All of the strains tested were susceptible in vitro to chloramphenicol, clindamycin, doxycycline, minocycline, penicillin, and vancomycin. Erythromycin showed poor in vitro activity against this organism, with only 7% of the strains susceptible, 72% intermediate in susceptibility, and 21% resistant. In tests of the 43 strains against lincomycin, 58% were susceptible, 32.5% were intermediate in susceptibility, and 9.5% were resistant. Against tetracycline, 37% of the strains were intermediate in susceptibility and the rest were susceptible.

Anaerobiosis↗