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Biomedical subjects

R Auckenthaler

Publications and source records attributed to R Auckenthaler.

At least 109 records · Page 6Linked to original sources

In-vitro activity of newer quinolones against aerobic bacteria.

Nalidixic and five newer 4-quinolones, ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin were tested against 576 recent clinical aerobic bacterial isolates. The 4-quinolones were regularly active (MIC90 less than 4 mg/l) against the following bacteria: Staphylococcus aureus, S. epidermidis, S. saprophyticus, different Enterobacteriaceae, Haemophilus influenzae, Campylobacter jejuni, Pseudomonas aeruginosa, Agrobacter spp., Aeromonas spp., Plesiomonas spp., Neisseria meningitidis. Other bacteria were usually intermediately susceptible or resistant: different streptococci, Listeria monocytogenes, Nocardia asteroides, P. maltophilia, Achromobacter xylosoxydans and Alcaligenes denitrificans. Ciprofloxacin was the most potent compound, followed by ofloxacin and pefloxacin, norfloxacin and enoxacin being less active. All the 4-quinolones were much more active than nalidixic acid. The MBC/MIC ratios of the 4-quinolones were between 1 and 2 with a majority of strains, and between 2 and 3 with Streptococcus agalactiae, Str. faecalis and L. monocytogenes. A two- to eight-fold increase of MIC was observed by increasing the inoculum 10,000-fold with most of the strains tested. Susceptible bacterial population of Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and P. aeruginosa contained more clones resistant to nalidixic acid (10(4) to 10(8) at four times the MIC) than to 4-quinolones (10(5) to 10(9) at four times the MIC). Supplementing the media with MgSO4 produced smaller inhibition zone diameters with a disc diffusion method than those obtained with non-supplemented agar, with all quinolone or strains. Less regular effect, or no effect was obtained after supplementation with ZnSO4 or Ca(NO3)2.

Anti-Bacterial Agents↗

[Peridural anesthesia in obstetrics: impact on the lower urinary tract].

The results of non-invasive urodynamic examinations (urinary flow rates and ultrasound determination of residual urine in the bladder) and of urinary bacteriology were studied 4 or 5 days after delivery in 305 patients. The method of delivery and other clinical and obstetric parameters that could influence lower urinary tract function have been considered. The numbers of urines that contain bacteria in quantities of more than 10(5)/ml are significantly raised as compared with the control group after spontaneous delivery under continuous epidural analgesia (15% as compared with 4.5% - p less than 0.01). Continuous epidural anaesthesia increases the risk of urinary tract infection and is significantly associated with a prolongation of labour as well as an frequency of catheterisations as well as episodes of urinary retention. This compromises the likelihood of starting normal micturition after delivery.

Adult↗

Throat cultures for group A beta-hemolytic Streptococcus. Importance of anaerobic incubation.

The bacteriologic detection of group A Streptococcus in pharyngitis is vital in everyday practice to prevent serious potential sequelae. The purposes of this study were to determine whether throat cultures should be incubated in anaerobic atmosphere and whether an increased recovery rate could be obtained by stabbing of the plates (partial anaerobiosis) and by using a sulfamethoxazole-trimethoprim disk to enhance growth and identification. We examined 243 throat cultures, in duplicate, which were incubated in room air and in anaerobiosis (carbon dioxide, 10%). We found that, in aerobic incubation, the recovery rate of group A streptococci was 5.7%; in anaerobic incubation it was 19.8%. Stabbing of the agar to create a partial anaerobiosis was useless. When directly placed on the plate, the sulfamethoxazole-trimethoprim disk facilitated the identification of beta-hemolysis areas. To achieve maximum detection of group A streptococci in specimens obtained from the throats of infected children, we found that anaerobic incubation should be used.

Anaerobiosis↗

Antibiotic prophylaxis in large bowel surgery: results of a controlled clinical trial.

A prospective, randomized clinical trial was undertaken to compare the value of a combination of two antibiotics for the prevention of postoperative septic complications after large bowel surgery. In group I the patients received three doses daily for 2 days of 80 mg gentamicin and 600 mg clindamycin, intravenously. Patients in group II received three doses daily for 2 days of 80 mg gentamicin and 500 mg metronidazole. Antibiotic administration was started in the operating room before the surgical procedure. The two antibiotics were administered by separate venous routes. One hundred and seven patients were allocated to either one of the two groups. Both groups were equally matched for gender, age, and surgical procedure. Bacteriologic specimens were taken in the wound as soon as the peritoneum was closed. They were immediately incubated for identification by aerobic and anaerobic cultures and sensitivity determinations. Cultures of one or more organisms were positive in 63 of 107 specimens. There was no difference between the two groups. No death occurred as a result of intra-abdominal complication, no reoperation was required, and in no case did peritonitis occur. Six wound abscesses and three delayed stitch infections were observed: five in group I and two in group II. Five clinical anastomotic leakages were observed (5.1%): two in group I and three in group II. They did not require treatment and healed spontaneously. Furthermore, five radiologic anastomotic leakages were present in 45 patients who received a control barium enema. No side effects were noted with metronidazole of with clindamycin. No clinical evidence of ototoxicity or nephrotoxicity was observed in patients receiving gentamicin. There is no statistically significant clinical difference between the combination of gentamicin and metronidazole or gentamicin and clindamycin. Both combinations are effective in preventing wound sepsis in large bowel surgery. Metronidazole and clindamycin were equally effective in preventing postoperative anaerobic infections. No resistance of anaerobic organisms to metronidazole was observed.

Aged↗

Lack of in vivo and in vitro bactericidal activity of N-formimidoyl thienamycin against enterococci.

The minimal bactericidal concentrations of N-formimidoyl thienamycin (N-f-thienamycin) against 21 strains of enterococci isolated from patients with infective endocarditis were determined by macro- and microdilution methods. By a macrodilution technique with the minimal bactericidal concentration defined as greater than or equal to 99.9% killing of an initial inoculum, all 21 strains of enterococci were found to have minimal bactericidal concentration/minimal inhibitory concentration ratios of greater than or equal to 32. The mean minimal inhibitory concentration was 1.5 micrograms/ml (range, 0.5 to 4 micrograms/ml), and the minimal bactericidal concentration was greater than or equal to 128 micrograms/ml. The disparity between the results of our study and those published elsewhere, which reported that N-f-thienamycin is bactericidal in vitro against enterococci, may represent the relative insensitivity of the microdilution method in determining greater than or equal to 99.9% killing. The lack of in vitro bactericidal activity of N-f-thienamycin against enterococci was confirmed in vivo in the rabbit model of experimental endocarditis. N-f-Thienamycin was no more effective than penicillin alone in the treatment of experimental enterococcal endocarditis and was less effective than the combination of penicillin and gentamicin. The results indicate that N-f-thienamycin should not be used alone in the treatment of enterococcal endocarditis.

Animals↗

Comparison of recovery of organisms from blood cultures diluted 10% (volume/volume) and 20% (volume/volume).

We compared blood cultures that were diluted 1:5 (20%, vol/vol) and 1:10 (10%, vol/vol) and contained specimens from patients with suspected septicemia. Streptococcus pneumoniae was recovered significantly more frequently from blood cultures diluted 20%, whereas gram-negative bacilli, group D streptococci, Staphylococcus aureus, and Candida spp. were recovered significantly sooner and more frequently from blood cultures diluted 10%. Statistically significant differences in isolation rates, however, represented only a small number of patients for whom the positive cultures affected therapy. We conclude that as long as at least two separate sets of blood cultures are obtained per septic episode from each patient, a 1:5 to 1:10 blood/vented (aerobic) medium ratio provides acceptable results. Nevertheless, the results also demonstrate that blood cultures diluted 10% provided greater and faster yields than those provided by blood cultures diluted 20%.

Bacteriological Techniques↗

In vitro activity of a new semisynthetic cephalosporin: cefoperazone.

Cefoperazone is a new semisynthetic cephalosporin with excellent antibacterial activity. This study included more than 1,500 clinical isolates whose susceptibility to cefoperazone was determined by minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Cefoperazone was highly active against Enterobacteriaceae including indolepositive Proteus, Serratia and Enterobacter sp. Particularly noteworthy was the high activity of cefoperazone against Pseudomonas and Acinetobacter strains, which are usually resistant to first- and second-generation cephalosporins. The activity of cefoperazone against Staphylococcus aureus, Staphylococcus epidermidis, group D streptococci and Haemophilus was also determined. In general, the differences between MIC and MBC were minimal. Additional studies were carried out to determine the effect of inoculum size on cefoperazone activity.

Bacteria↗

[Antibiotics].

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Anti-Bacterial Agents↗

[Drainage and lavage in abdominal surgery: bacteriologic aspects].

The efficiency of draining a purulent collection in the thoracic or abdominal cavity is well known. The actuel knowledge about opsonisation and phagocytosis of pathogenic bacterias offer a new and attractive explanation for this phenomenon. The prophylactic drainage of an uninfected cavity on the other hand has the advantage of eliminating blood and other materials promoting infection. However, the drainage has the inherent risk of a foreign body, obstruction and introduction of an artificial fistula. Therefore it should be inserted for a period as short as possible.

Abdomen↗