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Biomedical subjects

I Brook

Publications and source records attributed to I Brook.

At least 109 records · Page 6Linked to original sources
PubMed1996

Pyomyositis in children, caused by anaerobic bacteria.

The author describes the microbiology and clinical features of six pyomyositis infections in children, which yielded anaerobic bacteria. Anaerobic bacteria alone were recovered in four instances, and they are mixed with facultative bacteria in two. There were 15 bacterial isolates (13 anaerobic, 2 facultative). The bacteria were Peptostreptococcus sp (5 isolates), Bacteroides fragilis (3), Clostridium sp (2), Fuso-bacterium nucleatum (1), Prevotella sp (1), Bateroides sp (1), Streptococcus pyogenes (1), and Escherichia coli (1). Recent trauma or injury had occurred in five cases; three such injuries were from penetrating objects. This study highlights the potential importance of anaerobic bacteria in children with pyomyositis.

Abscess↗
PubMed1996

Microbial dynamics of persistent purulent otitis media in children.

Repeated aspirations (for a period of 36 to 55 days) of the exudate through an open perforation were performed in seven children with acute otitis media that did not respond to antimicrobial therapy. Penicillin-resistant organisms were present in all but one of the first two aspirates. Failure to respond to antimicrobial therapy was associated with the emergence of resistant anaerobic and aerobic bacteria in the third and fourth cultures. The infection was cured in all instances after administration of antimicrobial agents effective against these bacteria.

Adolescent↗
PubMed1996

Prophylaxis with amoxicillin or sulfisoxazole for otitis media: effect on the recovery of penicillin-resistant bacteria from children.

The rate of recovery of oropharyngeal penicillin-resistant Streptococcus pneumoniae and aerobic and anaerobic beta-lactamase-producing bacteria (BLPB) from children who received a 4- to 6-month course of prophylaxis with amoxicillin or sulfisoxazole for otitis media was investigated monthly over 9 months. The BLPB recovered were Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, pigmented Prevotella species, and Fusobacterium species. The recovery rate for all penicillin-resistant S. pneumoniae isolates and BLPB increased only after administration of amoxicillin. Before amoxicillin was administered, six BLPB isolates were recovered from four of the children who were to be given this drug (20%). The number of BLPB recovered increased gradually until all of these patients were found to be colonized with BLPB; five (25%) of these patients were found to be colonized with penicillin-resistant S. pneumoniae after 5 months of prophylaxis. Three to five months after amoxicillin prophylaxis was discontinued, the number of BLPB recovered gradually declined; only three children (15%) remained colonized with BLPB, and none remained colonized with penicillin-resistant S. pneumoniae. These data illustrate that amoxicillin prophylaxis induces an increase in the number of penicillin-resistant bacteria in the oropharynx.

Amoxicillin↗
PubMed1996

Microbiology of subperiosteal orbital abscess and associated maxillary sinusitis.

Aspirate of pus from eight subperiosteal orbital abscesses (SPOAs) and their corresponding infected sinuses were studied for aerobic and anaerobic bacteria. Polymicrobial flora was found in all instances, and the number of isolates varied from two to five. Anaerobes were recovered from all specimens. The predominant isolates were Peptostreptococcus spp, Prevotella spp, Fusobacterium spp, Staphylococcus aureus, and microaerophilic streptococci. Concordance in the microbiological findings between SPOA and the infected sinus was found in all instances. However, certain organisms were only present at one site and not the other. Fourteen beta-lactamase-producing organisms were present in nine specimens. These data confirm the importance of anaerobic bacteria in sinusitis and demonstrate their predominance in the associated SPOA.

Abscess↗
PubMed1996

Immune response to Fusobacterium nucleatum and Prevotella intermedia in patients with infectious mononucleosis.

The role of four oral flora organisms (Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans) was investigated in 22 patients with infectious mononucleosis. Immunoglobulin-G class antibody titres to these organisms were measured by enzyme-linked immunosorbent assay. Serum levels in the patients were determined at day 1 and 42-56 days later. Significantly higher antibody levels to F. nucleatum and Pr. intermedia were found in the second serum sample of patients as compared to their first sample. The elevated antibody levels to F. nucleatum and Pr. intermedia, known oral pathogens, suggest a potential pathogenic role for these organisms in the pharyngo-tonsillitis associated with infectious mononucleosis.

Adolescent↗
PubMed1996

Isolation of non-sporing anaerobic rods from infections in children.

From 1974 to 1994, 2033 microbiological specimens from children were submitted for cultures for anaerobic bacteria. Fifty-seven isolates of Bifidobacterium spp. were obtained from 55 (3%) children, 67 isolates of Eubacterium spp. from 65 (3%) children and 41 isolates of Lactobacillus spp. from 40 (2%) children. Most Bifidobacterium isolates were from chronic otitis media, abscesses, peritonitis, aspiration pneumonia and paronychia. Most Eubacterium isolates were from abscesses, peritonitis, decubitus ulcers and bites. Lactobacillus spp. were mainly isolated from abscesses, aspiration pneumonia, bacteraemia and conjunctivitis. Most (> 90%) infections from which these species were isolated were polymicrobial and yielded a mixture of aerobic and anaerobic bacteria. The organisms most commonly isolated with the non-sporing anaerobic gram-positive rods were Peptostreptococcus spp., Bacteroides spp., pigmented Prevotella and Porphyromonas spp., Fusobacterium spp., Staphylococcus aureus and Escherichia coli. Most Bacteroides spp. and E. coli were isolated from intra-abdominal infection and skin and soft tissue infection around the rectal area, whereas most Prevotella, Porphyromonas and Fusobacterium isolates were from oropharyngeal, pulmonary and head and neck sites. The predisposing conditions associated with the isolation of non-sporing anaerobic gram-positive rods were previous surgery, malignancy, steroid therapy and immunodeficiency. Antimicrobial therapy was given to 149 (83%) of the 160 patients, in conjunction with surgical drainage or correction of pathology in 89 (56%).

Actinomycetales Infections↗
PubMed1996

Microbiology of the transition from acute to chronic maxillary sinusitis.

Repeated aspirations of sinus secretions by endoscopy was performed in five patients over a period of 34-50 days and, ultimately, surgical drainage was done in three who presented with acute maxillary sinusitis that did not respond to antimicrobial therapy and became chronic. The aspirates were cultured for aerobic and anaerobic bacteria. Most of the bacteria isolated from the first culture were aerobic or facultative bacteria: Streptococcus pneumoniae (three isolates), Haemophilus influenzae non-type-b (two) and Moraxella catarrhalis (one). Three of these cultures yielded bacteria that were resistant to the antimicrobial agents prescribed for treatment. Failure to respond to therapy was associated with the emergence of resistant aerobic and anaerobic bacteria in subsequent aspirates. These organisms included Fusobacterium nucleatum, pigmented Prevotella and Porphyromonas spp. and Peptostreptococcus spp. Eradication of the infection was achieved in all instances following the administration of antimicrobial agents effective against these bacteria, and in three instances by surgical drainage. This study illustrates the microbial dynamics of maxillary sinusitis that did not respond to antimicrobial therapy.

Acute Disease↗
PubMed1996

In-vitro effects of penicillin and clindamycin on the expression of Streptococcus pneumoniae capsule.

The effects of subinhibitory concentrations of penicillin or clindamycin were evaluated in 20 isolates of Streptococcus pneumoniae that were fully susceptible to penicillin and in 20 isolates that were of intermediate resistance. All isolates were capsulate and susceptible to clindamycin. After incubation in one-half of the MIC of clindamycin, 17.5% of isolates retained a capsule, compared to 87.5% after incubation with one-half of the MIC of penicillin. Clindamycin appears to be superior to penicillin in reducing the expression of the capsule by S. pneumoniae.

Anti-Bacterial Agents↗
PubMed1996

Microbiology of infected atopic dermatitis.

BACKGROUND: Bacterial infections occur frequently in lesions of atopic dermatitis (AD). The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD. METHODS: A retrospective review was carried out of clinical and microbiology laboratory records and of data obtained from patients with secondarily infected AD lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria. RESULTS: Bacterial growth was noted in 41 specimens. Aerobic or facultative anaerobic bacteria only were present in 15 patients (36%), anaerobic bacteria only in eight (20%), and mixed anaerobic-aerobic flora was present in 18 (44%). Seventy-two isolates were recovered (1.8 per specimen), 34 aerobic or facultative bacteria, 35 strict anaerobes, and three Candida sp. The predominant aerobic and facultative bacteria were Staphylococcus aureus (12 isolates), Group A beta hemolytic streptococcus in five isolates, and Escherichia coli in four. The predominant anaerobes were Peptostreptococcus spp. (13 isolates), pigmented Prevotella and Porphyromonas spp. in eight, and Fusobacterium spp. in four isolates. Single bacterial isolates were recovered in 14 patients (34%), seven of which were S. aureus. Twenty-one of the organisms isolated from 16 patients (39%) produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric gram-negative rods and Bacteroides fragilis group predominated in lesions on legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Porphyromonas and Fusobacterium spp. were most frequently recovered in lesions of the finger, scalp, face, and neck. CONCLUSIONS: The polymicrobial etiology of secondarily infected AD lesions and the association of bacterial flora with the anatomic site of the lesions are demonstrated.

Adolescent↗
PubMed1996

Veillonella infections in children.

From 1974 to 1994, 2,033 specimens from children were submitted for cultures for anaerobic bacteria. Eighty-three Veillonella spp. were recovered from 83 children (4%). Most Veillonella species were recovered from abscesses, aspiration pneumonias, burns, bites, and sinuses. The infections were polymicrobial in 79 (95%) patients, but in 4 (5%) patients, Veillonella species were recovered in pure culture. The predisposing conditions associated with the recovery of these organisms were previous surgery, malignancy, steroid therapy, foreign body, and immunodeficiency. These data illustrate that Veillonella spp. are found infrequently in children, mostly in association with mixed infections, and are recovered mixed with mouth and bowel flora.

Abscess↗
PubMed1996

Microbiology of periapical abscesses and associated maxillary sinusitis.

Aspirate of pus from 5 periapical abscesses of the upper jaw and their corresponding maxillary sinusitis were studied for aerobic and anaerobic bacteria. Polymicrobial flora were found in all instances, where the number of isolates varied from 2 to 5. Anaerobes were recovered from all specimens. The predominant isolates were Prevotella sp., Porphyromonas sp., Fusobacterium nucleatum, and Peptostreptococcus sp. Concordance in the microbiological findings between periapical abscess and the maxillary sinus flora was found in all instances. However, certain organisms were only present at one site and not the other. Five beta-lactamase-producing organisms were present in the five specimens. These data confirm the importance of anaerobic bacteria in periapical abscesses and demonstrate their predominance in maxillary sinusitis that is associated with them.

Adult↗
PubMed1996

Immune response to anaerobic bacteria in patients with peritonsillar cellulitis and abscess.

The role of four oral organisms (Fusobacterium nucleatum. Prevotella intermedia, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans) was investigated in 19 children with peritonsillar abscess, and 17 with peritonsillar cellulitis. Antibody titers to these organisms were measured by enzyme- linked immunosorbent assay in the patient, as well as in 32 control patients. Serum levels in the patients were determined at day 1 and 42-56 days later. Significantly higher antibody levels to F. nucleatum and P. intermedia were found in the second serum sample of patients with peritonsillar cellulitis or abscess, as compared to their first sample or the levels of antibodies in controls. A total of 136 bacterial isolates, 100 anaerobic and 36 aerobic were isolated from the 19 peritonsillar abscesses. Anaerobic bacteria were found in all abscesses, and they were mixed with aerobic bacteria in 5 (26%). F. nucleatum was recovered in 14 (74%) abscesses and P. intermedia was isolated in 13 (68%). The elevated antibody levels to F. nucleatum and P. intermedia, known oral pathogens, suggest a pathogenic role for these organisms in peritonsillar infections.

Abscess↗
PubMed1996

Aerobic and anaerobic microbiology of infected hemorrhoids.

OBJECTIVES: To study the aerobic and anaerobic microbiology of infected hemorrhoids. METHODS: Retrospective review of the clinical microbiology records. RESULTS: Aspirates of pus from infected hemorrhoids in 19 patients showed bacterial growth. Anaerobic bacteria only were recovered in six (32%) specimens, aerobic bacteria only in one (5%), and mixed aerobic and anaerobic bacteria in 12 (63%). Sixty-eight isolates were recovered: 39 anaerobes (2.1 isolates per specimen) and 29 aerobes (1.5 per specimen). The predominant anaerobes were Bacteroides sp. (13 isolates, including 10 Bacteroides fragilis groups) and 13 Peptostreptococcus sp. The predominant aerobes were Escherichia coli (7), Proteus sp. (5), group D streptococci (4), and Pseudomonas sp. (3). CONCLUSIONS: This study highlights the polymicrobial nature and predominance of anaerobic bacteria in infected hemorrhoids.

Adolescent↗
PubMed1996

Microbiology and management of sinusitis.

PURPOSE: The pathophysiology, microbiology, and treatment of acute and chronic sinusitis are reviewed. MATERIALS AND METHODS: The current literature is reviewed. REVIEW: Sinusitis generally develops as a complication of viral or allergic inflammation of the upper respiratory tract. Bacterial pathogens contribute to the inflammatory process-Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are predominant in acute sinusitis, while anaerobic bacteria and Staphylococcus aureus are predominant in chronic sinusitis. Pseudomonas aeruginosa has emerged as a potential pathogen in the immunocompromised patients and in those who have nasal tubes or catheters. Many of these organisms recovered from sinusitis became resistant to penicillins either through the production of beta-lactamase (H. influenzae, M. catarrhalis, S. aureus, Fusobacterium sp., and Prevotella sp.) or through changes in the penicillin-binding protein (S. pneumoniae). The pathogenicity of beta-lactamase-producing bacteria is expressed directly through their ability to cause infections, and indirectly through the production of beta-lactamase. CONCLUSIONS: The indirect pathogenicity is conveyed not only by surviving penicillin therapy, but also by "shielding" penicillin-susceptible pathogens from the drug. The direct and indirect virulent characteristics of these bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections. Proper therapy, with antimicrobial and decongestants combined when indicated with surgical drainage and correction of pathology, constitutes the cornerstone of management of sinusitis.

Acute Disease↗
PubMed1995

Role of bacterial interference and beta-lactamase-producing bacteria in the failure of penicillin to eradicate group A streptococcal pharyngotonsillitis.

OBJECTIVE: To determine the association among bacterial interference and beta-lactamase production and penicillin failure in treating streptococcal pharyngotonsillitis. DESIGN: Fifty-two children who had acute pharyngotonsillitis caused by group A beta-hemolytic streptococci (GABHS) were treated for 10 days with penicillin. Surface tonsillar cultures were obtained before therapy and at 10, 21, and 42 days after termination of therapy. The cultures obtained before and 10 days after completion of treatment were processed for aerobic and anaerobic organisms; the other cultures were processed for GABHS only. RESULTS: Based on eradication of GABHS, 38 patients were in the classification bacteriologic "cure"; 14 were in the classification bacteriologic "failure" after therapy. In the cured group, before therapy alpha-hemolytic streptococci inhibiting their own GABHS were recovered in the cultures of 14 children (37%), and beta-lactamase-producing organisms (BLPB) were detected in the cultures of two children (5%). After therapy, inhibiting alpha-hemolytic streptococci were recovered in 31 cultures (82%), and BLPB were detected in five cultures (13%). In contrast, in the failure group, before therapy alpha-hemolytic streptococci were isolated in one culture (7%) and BLPB were recovered from nine cultures (64%). After therapy, alpha-hemolytic streptococci were recovered in four cultures (29%), and BLPB was recovered in 13 cultures (93%). CONCLUSIONS: These data show that the absence of interfering alpha-hemolytic streptococci and the presence of BLPB is associated with penicillin failure in the treatment of GABHS pharyngotonsillitis.

Adolescent↗
PubMed1995

Clinical features and aerobic and anaerobic microbiological characteristics of cellulitis.

OBJECTIVES: To investigate the aerobic and anaerobic microbiological characteristics of cellulitis and correlate them with the infection site. DESIGN: Of 342 specimens, 64 obtained using needle aspiration and 278 using swabs were studied over 10 years. RESULTS: Bacterial growth was noted in 15 (23%) of the 64 needle aspirates and 259 (93%) of the 278 swab aspirates. The microbial results of the 15 specimens obtained through needle aspiration are separately presented. Aerobic or facultative bacteria only were present in 138 (53%) of swab samples, anaerobic bacteria only in 69 (27%), and mixed aerobic-anaerobic flora in 52 (20%). In total, there were 582 isolates, 247 aerobic or facultative and 335 anaerobic bacteria, with an average of 2.2 isolates per specimen. The predominance of certain isolates in different anatomical sites correlated with their distribution in the normal flora adjacent to the infected site. The highest recovery rates of anaerobes was from the neck, trunk, groin, external genitalia, and leg areas. Aerobes outnumbered anaerobes in the arm and hand. The predominant aerobes were Staphylococcus aureus, group A streptococci, and Escherichia coli. The predominant anaerobes were Peptostreptococcus sp, Bacteroides fragilis group, Prevotella and Porphyromonas sp, and Clostridium sp. Certain clinical findings correlated with the following organisms: swelling and tenderness with Clostridium sp, Prevotella sp, S aureus, and group A streptococci; regional adenopathy with B fragilis group; bulbous lesions with Enterobacteriaceae; gangrene and necrosis with Peptostreptococcus sp, B fragilis group, Clostridium sp, and Enterobacteriaceae; foul odor with Bacteroides sp; and gas in tissues with Peptostreptococcus sp, B fragilis group and Clostridium sp. Certain predisposing conditions correlated with the following organisms: trauma with Clostridium sp; diabetes with Bacteroides sp, Enterobacteriaceae, and S aureus; and burn with Pseudomonas aeruginosa. CONCLUSION: These data highlight the polymicrobial nature of cellulitis.

Adolescent↗