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Biomedical subjects

L B Guze

Publications and source records attributed to L B Guze.

At least 37 records · Page 2Linked to original sources
PubMed1981

Rifampin, ampicillin, streptomycin, and their combinations in the treatment of enterococcal pyelonephritis in rats.

The activities of ampicillin, rifampin, streptomycin, and their combinations were evaluated in vitro against Streptococcus faecalis strain GK and in vivo in rats with an established pyelonephritis resulting from challenge with this same enterococcus. In vitro synergy was demonstrated between all combinations. Comparison of the log colony-forming units of S. faecalis recovered per gram of kidney tissue showed that all treated groups had significant lower numbers than controls (P less than 0.001). Ampicillin plus streptomycin or ampicillin alone was superior to rifampin alone or rifampin plus streptomycin at each interval (P less than 0.001). There was no significant difference between ampicillin and rifampin plus ampicillin. The disparity between in vitro and in vivo results again raises some doubts as to the relevance of in vitro observations to clinical outcome.

Administration, Oral↗
PubMed1981

Properties of binding of Escherichia coli endotoxin to various matrices.

Binding of Escherichia coli O127:B8 endotoxin to a variety of resins and column materials was investigated by measuring the beta-hydroxy myristic acid content (a major component of the lipid A moiety) of endotoxin after hydrolysis by selected ion-monitoring gas chromatography-mass spectrometry. More than 80% of the endotoxin was bound to hydroxylapatite, polystyrene, Dowex 1-X2, and charcoal. The binding of endotoxin to these materials was markedly reduced by the addition of normal or delipidated serum. Phenyl- and octyl-Sepharose bound 56 and 50% of the endotoxin from saline solutions, respectively. Their percent binding was increased significantly in 1 M ammonium sulfate solutions, indicating hydrophobic interactions between endotoxin and phenyl- and octyl-Sepharose. Only 5% of the endotoxin was bound to plastic polymer PSI-HAP-100 beads, and no binding was observed with concanavalin A- and heparin-Sepharose. Study of the in vitro binding of endotoxin to the above material in the presence of serum suggests that the use of these materials in removing circulating endotoxin in vivo is limited.

Charcoal↗
PubMed1981

Therapy of experimental infective endocarditis due to antibiotic-tolerant Lactobacillus plantarum-bactericidal synergy of penicillin plus gentamicin. Correlation of in vitro susceptibility studies with in vivo efficacy.

Infective aortic valve endocarditis (IE) was induced in 40 rabbits with a penicillin (PNC)-tolerant, gentamicin (GM)-resistant strain of Lactobacillus plantarum; this isolate was synergistically killed in vitro by PNC + GM. The in vivo relevance of the in vitro observations was examined by determining the rates of eradication of endocardial L. plantarum by PNC versus PNC + GM. Mean vegetation L. plantarum titers were significantly lower (p less than 0.05) in PNC + GM treated rabbits versus both PNC-treated and control rabbits by 48 h of therapy. Also, PNC + GM more rapidly sterilized vegetations as compared to controls (p less than 0.025) and PNC-treated rabbits (p less than 0.05). Thus, in vivo antibiotic efficacy paralleled in vitro bactericidal studies, and may partially explain the relatively refractory nature of lactobacillary IE in humans treated with single beta-lactam antibiotics.

Animals↗
PubMed1981

Neurological disease associated with Mycoplasma pneumoniae pneumonitis: demonstration of viable Mycoplasma pneumoniae in cerebrospinal fluid and blood by radioisotopic and immunofluorescent tissue culture techniques.

Several neurologic syndromes (including Guillain-Barré) complicated Mycoplasma pneumoniae pneumonitis in a young man. At onset of neurologic disease, buffy coat and cerebrospinal fluid cultures on inert media were negative for M. pneumoniae. However, metabolically active mycoplasma were identified in both body fluids by enhanced uptake of 14C-uracil versus 3H-uridine, with marked reduction in normal uridine-to-uracil uptake ratios (> 1000:1) in tissue culture. Uridine-to-uracil ratios were 8.5:1 and 15:1 for buffy coat and cerebrospinal fluid, respectively. Indirect fluorescent antibody (FA) studies confirmed the species as M. pneumoniae. In convalescence, uridine-to-uracil ratios and FA studies of buffy coat normalized, indicating clearance of M. pneumoniae from blood. Cell lines inoculated with "convalescent" cerebrospinal fluid showed slightly increased uracil uptake, slightly decreased uptake ratios, and persistent FA staining of approximately 5% of cells, indicating incomplete clearance of M. pneumoniae. Immune complexes were undetectable in either buffy coat or spinal fluid. This indicates that certain M. pneumoniae-associated neurologic disorders may be related to direct neural infection and not immunologically mediated as has been suggested.

Adult↗
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

E. coli adherence to bladder epithelial cells of mice.

Adherence of E. coli to bladder cells was studied by mixing E. coli with cells scraped from the surface of the normal mouse bladder. E. coli adherence to bladder epithelium did not correlate with renal infection, the ability of E. coli to resist phagocytosis, the growth of the strains, the presence of K-antigen or dulcitol fermentation. There was also no correlation with proportion of deaths, motility, or rough mutation. Pili were observed in three of the 22 strains of E. coli and their presence was not associated with increased virulence. In this model of renal infection neither adherence of E. coli to bladder epithelial cells nor the presence of pili were significant virulence factors.

Adhesiveness↗
PubMed1980

Bactericidal synergy between penicillin or ampicillin and aminoglycosides against antibiotic-tolerant lactobacilli.

The bactericidal activities of penicillin G and ampicillin alone were compared with those of their combinations with streptomycin or gentamicin against 17 strains of lactobacilli classified as tolerant to various beta-lactam antibiotics. The penicillin G combinations with streptomycin and gentamicin were synergistic against 17 and 16 of these strains, respectively, whereas the corresponding ampicillin-aminoglycoside combinations were synergistic against 12 and 15 strains, respectively. Importantly, synergy was manifested at concentrations of these antibiotics that are attained in serum after their administration in conventional dose regimens. In no instances were combinations antagonistic. These in vitro observations provide a partial explanation for the favorable results obtained in preliminary clinical evaluations of the benefits of combination regimens in the treatment of lactobacillus infections refractory to single-drug therapy.

Ampicillin↗
PubMed1980

Experimental intraabdominal candidiasis: macroscopic, microscopic and cultural natural history.

We have developed a rabbit model for intraabdominal candidiasis by the intraperitoneal injection of Candida albicans. The most reliable early predictor of induction of disease was positive paracentesis cultures for C. albicans during the 1st week post-inoculation (p.i.). Cultures of mesenteric and renal abscess were mean log 6.20 and 3.18 colony-forming units (CFU) per gram tissue, respectively, 1 week p.i., and remained positive for the 21-day i.p. period. Incidence of hematogenous dissemination, judged by chorioretinal cultures, was 69%. Histopathology of involved organs demonstrated suppurative abscesses at 1 week p.i.; lesions became more granulomatous at 2 and 3 weeks p.i.

Abdomen↗
PubMed1980

Clinical value of teichoic acid antibody titers in the diagnosis and management of the staphylococcemias.

Differentiation of endocarditic from nonendocarditic Staphylococcus aureus (SA) septicemia is prognostically and therapeutically important. A study of 68 cases of either SA or streptococcal sepsis, including 50 cases of SA sepsis of both cardiac and noncardiac origin, was done to determine the presence and titer of serum teichoic acid antibodies (TAA's) by double immunodiffusion. Thirty-seven uninfected controls were also examined. There was no statistical difference in either incidence or peak TAA titers in endocardial versus deepseated, extracardiac SA sepsis. However, in both of these groups, incidence and peak titers were significantly higher than in intravascular catheter-related SA sepsis, streptococcal endocarditis and controls (P<0.05). Peak TAA titers in SA sepsis develop on admission or shortly thereafter (6 to 11 days) and permit early decisions on degree of tissue infection, likelihood of metastatic seeding and necessity for higher-dose, longer-term antibiotic therapy. Cases of catheter-related SA sepsis with no clinical evidence of metastatic SA seeding and with negative or low-titered (1:1) TAA's were classified as superficial sepsis. Treatment consisted of short-term, low-dose antistaphylococcal regimens and catheter removal. In posttherapy follow-up after 6 to 12 weeks, all of the patients were cured and no signs of endocarditis or deepseated SA infection developed.

Anti-Bacterial Agents↗
PubMed1980

Oxacillin nephritis.

Acute interstitial nephritis secondary to administration of antibiotics is a well-described entity. Oxacillin, however, has never been directly implicated. An 80-year-old man had a rising creatinine level and eosinophiluria while receiving oxacillin sodium. These findings disappeared when use of the drug was discontinued. We conclude that oxacillin is an additional penicillin that can cause interstitial nephritis.

Aged↗
PubMed1979

Chronic progressive coccidioidal pneumonitis. Report of six cases with clinical, roentgenographic, serologic, and therapeutic features.

Chronic progressive coccidioidal pneumonitis (CPCP) is an uncommon sequela of acute pulmonary coccidiodomycosis. Six recent patients with CPCP are described, most of whom were previously healthy. The clinical presentation was indolent, resulting in long diagnostic delays. Serial chest roentgenograms showed progressive pulmonary infiltration and sputum cultures were persistently positive for Coccidioides immitis. Serum complement fixation (CF) antibody titers were high, with five of six patients having titers greater than or equal to 1:16. No patients had evidence of extrapulmonary coccidioidal spread at time of diagnosis of CPCP, although hematogenous dissemination occurred later in one patient. Five patients received amphotericin B intravenously (greater than or equal to 30 mg/kg total), resulting in rapid clinical and mycologic cure, decline in CF titers, and roentgenographic improvement or stabilization. However, two of these five patients suffered permanent physiologic impairment. One patient refused therapy and remains clinically symptomatic, with chronic positivity of sputum cultures for C immitis and high CF titers.

Adult↗
PubMed1979

Adult bacteremic Haemophilus parainfluenzae infections. Seven reports of cases and a review of the literature.

Seven cases of adult Haemophilus parainfluenzae infections diagnosed by positive blood cultures are compared with cases previously reported in the English literature. Three patients had pneumonia, while the others had epiglottitis with meningitis, pharyngitis, arthritis, and endocarditis, respectively. Nonendocarditic manifestations of adult H parainfluenzae infection were reported in four other cases. In addition to the diseases of our patients, H parainfluenzae also has been isolated from cerebral abscesses. Patients did well with antibiotic therapy and there were no deaths. Patients did well with antibiotic therapy and there were no deaths. Report of antibiotic sensitivity testing of 50 strains disclosed 6% of isolates resistant to ampicillin sodium, with all sensitive to chloramphenicol. If the antibiotic sensitivity of the organism is unknown, then chloramphenicol therapy should be instituted until adequate susceptibility studies have been performed. If the organism is sensitive to ampicillin, then this is the drug of choice.

Adult↗
PubMed1979

Use of circulating immune complex levels in the serodifferentiation of endocarditic and nonendocarditic septicemias.

Distinguishing endocarditic from nonendocarditic septicemias is prognostically and therapeutically important. One hundred two patients with both valvular and nonvalvular sepsis were studied for the presence and quantitation of circulating immune complexes. Ninety per cent of the patients with infective endocarditis versus 50 per cent of septic patients without infective endocarditis had circulating immune complex levels (p less than 0.005). Mean circulating immune complex levels in patients with infective endocarditis were significantly higher than in those without infective endocarditis, 106 +/- 18.58 microgram/ml versus 31 +/- 7.4 microgram/ml (p less than 0.005). Only three of 52 patients without infective endocarditis had circulating immune complex levels greater than 100 microgram/ml, as opposed to 16 of 50 patients with infective endocarditis (p less than 0.005). Similarly, one of 52 patients without infective endocarditis has circulating immune complex levels greater than 200 microgram/ml, as opposed to eight of 50 patients with infective endocarditis (p less than 0.05). In 92 per cent of the patients without infective endocarditis and 76 per cent of those with infective endocarditis peak circulating immune complex levels developed within 14 days after their entry into the study, often on the initial sampling. In febrile, septicemic patients with clinical symdromes nonclassic for endocarditis, measurements of serial circulating immune complex levels may be of adjunctive diagnosis importance. If circulating immune complex levels are undetectable, endocarditis would appear less likely; alternatively, levels above 100 to 200 microgram/ml would suggest a valvular rather than nonvalvular septic focus.

Antigen-Antibody Complex↗