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PubMed2003

The etiology of urinary tract infection: traditional and emerging pathogens.

The microbial etiology of urinary infections has been regarded as well established and reasonably consistent. Escherichia coli remains the predominant uropathogen (80%) isolated in acute community-acquired uncomplicated infections, followed by Staphylococcus saprophyticus (10% to 15%). Klebsiella, Enterobacter, and Proteus species, and enterococci infrequently cause uncomplicated cystitis and pyelonephritis. The pathogens traditionally associated with UTI are changing many of their features, particularly because of antimicrobial resistance. The etiology of UTI is also affected by underlying host factors that complicate UTI, such as age, diabetes, spinal cord injury, or catheterization. Consequently, complicated UTI has a more diverse etiology than uncomplicated UTI, and organisms that rarely cause disease in healthy patients can cause significant disease in hosts with anatomic, metabolic, or immunologic underlying disease. The majority of community-acquired symptomatic UTIs in elderly women are caused by E coli. However, gram-positive organisms are common, and polymicrobial infections account for up to 1 in 3 infections in the elderly. In comparison, the most common organisms isolated in children with uncomplicated UTI are Enterobacteriaceae. Etiologic pathogens associated with UTI among patients with diabetes include Klebsiella spp., Group B streptococci, and Enterococcus spp., as well as E coli. Patients with spinal cord injuries commonly have E coli infections. Other common uropathogens include Pseudomonas and Proteus mirabilis.Recent advances in molecular biology may facilitate the identification of new etiologic agents for UTI. The need for accurate and updated population surveillance data is apparent, particularly in light of concerns regarding antimicrobial resistance. This information will directly affect selection of empiric therapy for UTI.

Aged↗

PubMed2000

Identification of corynebacterium bovis and other coryneforms isolated from bovine mammary glands.

Bovine mastitis remains the most economically important disease in dairy cows. Corynebacterium bovis, a lipid-requiring Corynebacterium spp., is frequently isolated from the milk of infected mammary glands of dairy cows and is associated with reduced milk production. A total of 212 coryneform bacteria isolated from the milk of dairy cows were obtained from mastitis reference laboratories in the United States and Canada. All isolates had been presumptively identified as Corynebacterium bovis based on colony morphology and growth in the presence of butterfat. Preliminary identification of the isolates was based on Gram stain, oxidase, catalase, and growth on unsupplemented trypticase soy agar (TSA), TSA supplemented with 5% sheep blood, and TSA supplemented with 1% Tween 80. Of the 212 isolates tested, 183 were identified as Corynebacterium spp. based on preliminary characteristics. Of the strains misidentified, one was identified as a yeast, two as Bacillus spp., 11 as Enterobacteriaceae, 18 as staphylococci, one as a Streptococcus spp., and one as an Enterococcus spp. Eighty-seven coryneforms were selected for identification to the species level by direct sequencing of the 16S rRNA gene, the Biolog system and the API Coryne system. Fifty strains were identified as C. bovis by 16S rRNA gene similarity studies: the Biolog and API Coryne systems correctly identified 54.0 and 88.0% of these strains, respectively. The other coryneforms were identified as other Corynebacterium spp., Rhodococcus spp., or Microbacterium spp. These data indicate that the coryneform bacteria isolated from bovine mammary glands are a heterogeneous group of organisms. Routine identification of C. bovis should include Gram-stain, cell morphology, catalase production, nitrate reduction, stimulated growth on 1% Tween 80 supplemented media, and beta-galactosidase production as the minimum requirements.

Animals↗

PubMed1986

[Severe infections associated with chronic lymphoid leukemia. 159 infectious episodes in 60 patients].

This retrospective hospital study concerns 159 infectious episodes observed in 60 patients with chronic lymphoid leukaemia (CLL) staged A, B or C on first admission. The most frequent site of infection was pulmonary (33%), followed by ENT and stomatological infections (15%), septicaemia (9%), urinary and genital tracts infections (9%), herpes virus infections (9%), skin and soft tissue purulent sepsis (8%), digestive tract (3%) and meningeal (1%) infections and isolated fever (8%). Seventy nine bacteria were isolated, including 35 Gram-positive cocci (Staphylococcus spp. 12, Streptococcus spp. 13, D. pneumoniae 5, Enterococcus spp. 5), 43 Gram-negative bacilli (Enterobacteriaceae 36, Pseudomonas spp. 5, Haemophilus influenzae 2) and 1 M. tuberculosis. The other documented infections were: candidiasis 11, viral infections 19 (including 17 of the herpes group) and 2 parasitoses (1 pneumocystosis, 1 toxoplasmosis). Sixteen patients died of toxic -infectious shock (9 cases, including 1 meningitis) or pneumonia (7 cases, including one chicken-pox). Stage C leukaemia and granulopenia (less than 1 X 10(9) PN/l) were associated with significantly more frequent and severe infections.

Adult↗

PubMed2003

Bacteria recovered from teeth with apical periodontitis after antimicrobial endodontic treatment.

UNLABELLED: Chávez de Paz LE, Dahlén G, Molander A, Möller A, Bergenholtz G. Bacteria recovered from teeth with apical periodontitis after antimicrobial endodontic treatment. International Endodontic Journal, 36, 500-508, 2003. AIM: To determine whether there is a pattern for certain bacteria to remain after chemo-mechanical treatment of root canals in teeth with apical periodontitis. METHODOLOGY: Consecutive root-canal samples of 200 teeth receiving root-canal treatment, referred from general practitioners and endodontic specialists for analyses of cultivable microbes, were studied prospectively. To be included, samples had to be taken at a treatment session subsequent to the one at which endodontic therapy was initiated. All samples were from teeth that either presented with clinical or radiographic evidence of apical periodontitis or both. Bacteriological findings were linked to clinical and radiographic parameters including status of the root canal prior to treatment, namely, vital pulp, necrotic pulp or root filled. RESULTS: A total of 248 strains were isolated from 107 teeth giving bacterial growth. Gram-positives predominated (85%). Lactobacillus spp. (22%), nonmutans streptococci (18%), and Enterococcus spp. (12%) were the most common isolates. Gram-negative anaerobes were relatively sporadic. Large radiographic bone lesions, persistent pain and use of intracanal calcium hydroxide dressing correlated with bacterial presence (P < 0.05). CONCLUSIONS: Once established, nonmutans streptococci, enterococci and lactobacilli appear to survive commonly following root-canal treatment of teeth with clinical and radiographical signs of apical periodontitis.

Adolescent↗

PubMed1988

Occurrence of the Campylobacter resistance gene tetO in Enterococcus and Streptococcus spp.

The distribution of nucleotide sequences related to tetK, tetL, tetM, and tetO was studied by dot blot hybridization in 178 strains of Streptococcus and Enterococcus spp. that were resistant to tetracycline. The tetO gene, which is responsible for tetracycline resistance in Campylobacter spp., was detected in six Streptococcus strains and two Enterococcus strains, in which it was borne by similar plasmids. This observation confirms our previous proposal that tetO originated in gram-positive cocci. tetM, the most prevalent resistance gene, was present alone in 109 strains and associated with tetL in 33 strains in which the two genes contributed cooperatively to high-level tetracycline resistance. tetL was present alone in five Enterococcus strains, and tetK was detected in a single Streptococcus strain. The existence of 22 strains that did not hybridize to the probes suggest that tetracycline resistance in streptococci and enterococci involves additional gene classes as well.

Campylobacter↗

PubMed1991

Oral associated bacterial infection in horses: studies on the normal anaerobic flora from the pharyngeal tonsillar surface and its association with lower respiratory tract and paraoral infections.

Two hundred and seventy bacterial isolates were obtained from the pharyngeal tonsillar surface of 12 normal horses and 98 obligatory anaerobic bacteria were characterised. Of these, 57 isolates belonging to 7 genera (Peptostreptococcus (1); Eubacterium (9); Clostridium (6); Veillonella (6); Megasphera (1); Bacteroides (28); Fusobacterium (6)) were identified, and 16 of these were identified to species level (P. anaerobius (1); E. fossor (9); C. villosum (1); B. fragilis (1); B. tectum (2); B. heparinolyticus (2)). Three hundred and twenty isolates were obtained from 23 samples from horses with lower respiratory tract (LRT) or paraoral (PO) bacterial infections. Of the 143 bacteria selected for detailed characterisation, obligate anaerobes accounted for 100 isolates, facultative anaerobes for 42 isolates and obligate aerobes for one isolate. Phenotypic characterisation separated 99 of the isolates into 14 genera. Among the obligately anaerobic species, Gram-positive cocci including P. anaerobius comprised 25% of isolates, E. fossor 11% and other Gram-positive rods (excluding Clostridium sp.) 18% of isolates. The Gram-negative rods comprised B. fragilis 5%, B. heparinolyticus 5%, asaccharolytic pigmented Bacteroides 3% and other Bacteroides 13%, while a so-far unnamed species of Fusobacterium (7%), and Gram-negative corroding rods (3%) were isolated. Among the facultatively anaerobic isolates, S. equi subsp. zooepidemicus accounted for 31% of isolates, followed by Pasteurella spp. 19%, Escherichia coli 17%, Actinomyces spp. 9%, Streptococcus spp. 9%. Incidental facultative isolates were Enterococcus spp. 2%, Enterobacter cloaceae 2%, Actinobacillus spp. 2% and Gram-negative corroding rods 5%. On the basis of the similarities (as determined by DNA hybridization data and/or phenotypic characteristics) of some of the bacterial species (e.g. E. fossor and B. heparinolyticus) isolated from both the normal pharyngeal tonsillar surfaces and LRT and PO diseases of horses, it is considered that the most likely source of bacteria involved in these disease processes is flora from the oral cavity.

Animals↗

PubMed1993

Antimicrobial activity and spectrum of rifaximin, a new topical rifamycin derivative.

Rifaximin, a rifamycin derivative, was evaluated in vitro to assess its spectrum and potency against a wide variety of bacteria, yeasts, viruses, and parasites. High concentrations of rifaximin were often used to reflect topically achieved levels since this compound is poorly absorbed by oral route. Like rifampin, rifaximin possessed best activity against Staphylococcus spp. (MIC50 < or = 0.015 microgram/ml), Streptococcus spp. (MIC50s, < or = 0.03-0.12 microgram/ml), Enterococcus spp. (MIC50s, 0.25-2 micrograms/ml), Bacillus cereus (MIC50, 0.06 microgram/ml), Moraxella catarrhalis (MIC50, < or = 0.03 microgram/ml), and Haemophilus influenzae (MIC50, 0.25 microgram/ml). Rifaximin demonstrated potential use as a topical agent for bacterial vaginosis by inhibiting Bacteroides bivius-disiens, Gardnerella vaginalis, Lactobacillus spp., and Mobiluncus spp. strains (all MICs < or = 1 microgram/ml). Strains of Haemophilus ducreyi and Neisseria gonorrhoeae (MIC50s, 0.25 microgram/ml) were also inhibited. However, some organisms associated with genital tract infections were rifaximin resistant, for example, Candida spp., herpes virus, mycoplasmas, Trichomonas vaginalis, and Ureaplasma urealyticum. Clinical trials appear warranted using rifaximin topical concentrations that will minimize mutations to rifamycin resistance.

Administration, Topical↗

PubMed2000

Evaluation of the intestinal microflora in the rat model for esophageal adenocarcinoma.

Surgically induced duodenal reflux results in cancer development in the rat esophagus. One proposed mechanism of carcinogenesis relies on the production of carcinogens in the presence of bacterial overgrowth. Against this background, intestinal microflora in the rat jejunum was analyzed before and after reflux-inducing surgery. Total gastrectomy and esophagojejunostomy were performed on Sprague-Dawley rats to produce esophageal reflux of duodenal juice (n = 12). Three days before surgery they were randomized into three groups: animals which received tap water; animals which received acidified water at pH 1.8; and animals subjected to oral decontamination with triple antibiotics. During surgery and at autopsy after 2 weeks, intestinal juice was aspirated and analyzed immediately for bacterial content. The physiologic microflora of the rat jejunum contained Lactobacillus spp. and Bacteroides spp., both of which were resistant to the antibiotic regimen. Bacterial overgrowth with fecal bacteria was found following surgery. Acidified water did not alter the intestinal microflora. Triple antibiotics eliminated Escherichia coli and Proteus spp. and reduced the concentration of Enterococcus spp. Bacterial overgrowth by bacteria of the fecal flora occurs in the rat model of esophageal adenocarcinoma with the potential to catalyze the production of carcinogens.

Adenocarcinoma↗

PubMed1989

In-vitro activity of meropenem against clinical isolates in a multicentre study in Italy.

A multicentre in-vitro study was undertaken to evaluate the susceptibility of bacterial pathogens isolated in different Italian hospitals to meropenem. A total of 1399 aerobic and 452 anaerobic strains was analysed. Comparative agents were imipenem, cefotaxime, ceftazidime, ceftriaxone, piperacillin, ciprofloxacin, gentamicin, amikacin, plus vancomycin when appropriate. The MIC ranges (mg/l) of meropenem were: 0.015-2 for Klebsiella spp., Proteus spp., Morganella morganii and Providencia spp.; less than 0.008-1 for Escherichia coli; 0.016-32 for Serratia spp.; 0.03-2 for Enterobacter spp. and Citrobacter spp.; 0.03- greater than 128 for Acinetobacter anitratus; 0.03-32 for Pseudomonas spp.; less than 0.008-0.5 for Haemophilus spp. and Neisseria spp.; 0.015-64 for Staphylococcus spp.; 0.06- greater than 128 for Enterococcus spp.; less than 0.008-0.25 for Streptococcus spp.; 0.016-8 for Fusobacterium spp.; 0.03-8 for Bacteroides spp.; less than 0.06-0.5 for anaerobic Gram-positive cocci; 0.08-2 for Clostridium spp. Meropenem exhibited superior antibacterial activity against the aerobic and anaerobic strains tested when compared to the other beta-lactam drugs. The new carbapenem was as active as ciprofloxacin and more active than imipenem and the aminoglycosides against Enterobacteriaceae and Ps. aeruginosa. It was also more active than ciprofloxacin against most strains of Gram-positive cocci. Meropenem was slightly less potent than imipenem against staphylococci and enterococci, with the exception of oxacillin-susceptible Staph. aureus against which meropenem and imipenem exhibited similar antibacterial activity.

Aminoglycosides↗

PubMed2025

Multidrug resistance and recurrence in urinary bacteraemia among cancer patients.

BACKGROUND: Urinary tract infections (UTI) in oncological patients can lead to bacteraemia (bUTI), increasing morbidity and mortality. This study assessed the characteristics, outcomes and recurrence of bUTI in oncological patients. METHODS: A retrospective cohort study was conducted at Hospital Clinic, Barcelona, from 2008 to 2019. All episodes of bUTI in oncological patients were analysed. Multivariable regression models identified independent risk factors for multidrug-resistant (MDR) Gram-negative bacilli (GNB), recurrent bUTI and related mortality. RESULTS: A total of 561 bUTI episodes were identified in 478 oncological patients. Urinary tract involvement due to neoplasm was present in 62.2%, and 59.4% had urinary tract instrumentation. Prior UTI-related admission without bacteraemia was reported in 63.8%. Following bUTI, oncological treatment was delayed in 47% and stopped in 33.6% of cases. GNB caused 87.3% of episodes, with Escherichia coli and Klebsiella spp. being the most common pathogens. Enterococcus spp. and Pseudomonas aeruginosa were frequent, particularly in patients with urinary instrumentation. MDR-GNB caused 19.6% of episodes, and 23.4% of cases received inappropriate empirical antibiotic therapy (IEAT). Recurrent bUTI occurred in 14.0% of patients. A simple predictive score efficiently identified patients at high risk of recurrence. Thirty-day mortality was 15.3%, and bUTI-related mortality was 10.7%, with absence of fever, septic shock and carbapenemase-producing Enterobacterales linked to higher related mortality. CONCLUSION: bUTI in oncological patients is predominantly caused by GNB, with high rates of MDR isolates and high mortality. IEAT is common, and recurrence is significant, highlighting the need for targeted preventive strategies and optimized empirical therapy.

Humans↗

PubMed2003

Rapid detection of meat spoilage by measuring volatile organic compounds by using proton transfer reaction mass spectrometry.

The evolution of the microbial spoilage population for air- and vacuum-packaged meat (beef and pork) stored at 4 degrees C was investigated over 11 days. We monitored the viable counts (mesophilic total aerobic bacteria, Pseudomonas spp., Enterobacteriaceae, lactic acid bacteria, and Enterococcus spp.) by the microbiological standard technique and by measuring the emission of volatile organic compounds (VOCs) with the recently developed proton transfer reaction mass spectrometry system. Storage time, packaging type, and meat type had statistically significant (P < 0.05) effects on the development of the bacterial numbers. The concentrations of many of the measured VOCs, e.g., sulfur compounds, largely increased over the storage time. We also observed a large difference in the emissions between vacuum- and air-packaged meat. We found statistically significant strong correlations (up to 99%) between some of the VOCs and the bacterial contamination. The concentrations of these VOCs increased linearly with the bacterial numbers. This study is a first step toward replacing the time-consuming plate counting by fast headspace air measurements, where the bacterial spoilage can be determined within minutes instead of days.

Bacteria↗

PubMed1974

Comparison of macroscopic, microscopic, and radiometric examinations of clinical blood cultures in hypertonic media.

Clinical blood cultures were collected in the Bactec 8A flask (Johnston Laboratories, Cockeysville, Md.) and examined macrosopically, microscopically, and radiometrically in an effort to determine which approach produced the fastest detection time. Of 360 blood cultures found to contain organisms by subculture, 334 were first detected by Bactec, 98 by macroscopic examination, and 68 by microscopic examination. Examination times were at 4, 8, 16, 24, 36, and 48 h after collection of the specimen. Sixteen hours after specimen collection, microscopic examination had detected 31 positive cultures, macroscopic examination had detected two positive cultures, and Bactec had detected 160 positive cultures. By the end of the first 24 h of incubation, Bactec had detected 313 (93%) of those cultures eventually found to be positive. Although Bactec produced the fastest detection time in an overwhelming majority of the cultures, it failed to detect three of three Candida spp. cultures, three of five Bacteroides spp. cultures, and six of 32 Enterococcus spp. cultures during the first 48 h of incubation.

Bacteriological Techniques↗

PubMedDate not supplied

[Increasing trend of antimicrobial drug-resistance in organisms causing bacteremia at a tertiary-care hospital: 1995 to 2000].

We described the trends of drug-resistant organisms isolated in blood cultures from patients detected in a teaching hospital from 1995 to 2000. We found an increase in the number of clinical isolates of Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter spp, Serratia spp, Staphylococcus aureus, S. epidermidis and Enterococcus spp, resistant to antibiotics commonly used to treat infections caused by these organisms. The frequency of gram-negative bacilli resistant to third-generation cephalosporins and quinolones increased during the period of study, and in 2000 more than 20% of the isolates were resistant. In contrast, the frequency of resistance to aminoglycosides and carbapenems was less than 20%. The frequency of resistant staphylococci increased exuberantly fifty fold to quinolones and five fold to oxacillin during the study period, therefore in 2000, 26.1% of S. aureus isolates and 61% of S. epidermidis were resistant to oxacillin. The frequency of resistant enterococci also increased, and in 2000, 50% were resistant to ampicillin, and 37.5% to gentamicin. The increase of drug resistant organisms isolated in blood had a direct impact in the empirical treatment of severely infected patients in our hospital. It is important to continuously supervise antibiotic use, and to adopt more strict control measures to decrease the frequency of infections caused by drug resistant organisms.

Bacteremia↗

PubMed1995

Urinary tract infection at a specialist hospital in Saudi Arabia.

Midstream specimens of urine from inpatients and out patients at King Fahd Specialist Hospital in Buraidah, Saudi Arabia, were collected over a period of 12 months to determine prospectively the frequencies of different causative organisms and their antimicrobial susceptibility. A total of 854 from 4157 specimens (20.54%) gave significant bacterial counts i.e., counts greater than 10(5) organisms per millilitre. Escherichia coli was the commonest organism (50.11%) followed by Klebsiella spp. (28.33%) Pseudomonas spp. (7.84%) and Proteus spp. (4.91%). Other bacterial pathogens were Enterococcus spp. (3.98%), Acinetobacter spp. (1.84%), Staphylococcus aureus (1.63%), Enterobacter spp. (0.35), Staphylococcus epidermidis (0.30%), Haemolytic streptococci B (0.47%) and Salmonella paratyphi A (0.12%). In vitro drug sensitivity tests showed norfloxacin and nalidixic acid to be very effective for most of the strains of the bacterial pathogens. A very high proportion of strains of Escherichia coli (86%) and Klebsiella spp. (94.6%) were found to be resistant to ampicillin.

Drug Resistance, Microbial↗

PubMed2002

Dietary mannan-oligosaccharides and their effect on chicken caecal microflora in relation to Salmonella Enteritidis colonization.

This study first investigates the effects of mash diet, or mash supplemented with either 2.5% mannose-oligosaccharide (MOS) or palm kernel meal (PKM), on the microflora of the hen caecal contents. Second, it investigates the effect of caecal contents of hens (HCC) fed mash or mash supplemented with MOS or PKM on the major microflora groups of chicks, and their inhibitory effect on Salmonella enterica serovar Enteritidis (PT4) colonization. Finally, this study investigates the effect over time of diets supplemented with MOS or PKM on S. Enteritidis colonization and the microflora of chicks. In hens, supplemented diets increased Bifidobacterium spp., while decreasing members of Enterobacteriaceae and Enterococcus spp., compared with the mash diet. Chicks dosed with the HCC showed, on average, increased numbers of anaerobes, while the numbers of aerobes decreased including coliforms and S. Enteritidis compared with controls without HCC. In chicks fed the MOS-supplemented or PKM-supplemented diets, S. Enteritidis colonization decreased over time, compared with mash alone. Four-week-old PKM birds showed an increase in Bifidobacterium spp. and Lactobacillus spp., with a decrease in S. Enteritidis compared with week 2. Generally, the HCC and diets supplemented with MOS or PKM affected the birds intestinal microflora by increasing the Bifidobacterium spp. and Lactobacillus spp., while decreasing the Enterobacteriaceae groups. They also reduced susceptibility in young chickens to colonization by S. Enteritidis.

Animal Feed↗

PubMed2006

Pulmonary disposition of tilmicosin in foals and in vitro activity against Rhodococcus equi and other common equine bacterial pathogens.

The objectives of this study were to determine the serum and pulmonary disposition of tilmicosin in foals and to investigate the in vitro activity of the drug against Rhodococcus equi and other common bacterial pathogens of horses. A single dose of a new fatty acid salt formulation of tilmicosin (10 mg/kg of body weight) was administered to seven healthy 5- to 8-week-old foals by the intramuscular route. Concentrations of tilmicosin were measured in serum, lung tissue, pulmonary epithelial lining fluid (PELF), bronchoalveolar lavage (BAL) cells, and blood neutrophils. Mean peak tilmicosin concentrations were significantly different between sampling sites with highest concentrations measured in blood neutrophils (66.01+/-15.97 microg/mL) followed by BAL cells (20.1+/-5.1 microg/mL), PELF (2.91+/-1.15 microg/mL), lung tissue (1.90+/-0.65 microg/mL), and serum (0.19+/-0.09 microg/mL). Harmonic mean terminal half-life in lung tissue (193.3 h) was significantly longer than that of PELF (73.3 h), bronchoalveolar cells (62.2 h), neutrophils (47.9 h), and serum (18.4 h). The MIC90 of 56 R. equi isolates was 32 microg/mL. Tilmicosin was active in vitro against most streptococci, Staphylococcus spp., Actinobacillus spp., and Pasteurella spp. The drug was not active against Enterococcus spp., Pseudomonas spp., and Enterobacteriaceae.

Animals↗

PubMed1994

Clinical comparison of isolator and thiol broth with ESP aerobic and anaerobic bottles for recovery of pathogens from blood.

The recovery of pathogens and the speed of their detection were determined for our conventional blood culture system (an Isolator [Wampole] and a 100-ml Thiol bottle [Difco]) compared with automated ESP aerobic and anaerobic bottles (80 ml each; Difco). Each of the four culture devices was inoculated with approximately 10 ml of blood from symptomatic patients weighing more than 80 lb (ca. 36 kg). From 7,070 sets of cultures for 2,841 patients, 607 clinically significant isolates were recovered: 456 (75.1%) from the Isolator, 353 (58.2%) from Thiol, 377 (62.1%) from ESP aerobic bottles, and 346 (57.0%) from ESP anaerobic bottles. Of the 607 isolates, 149 (24.5%) were detected only with the conventional system (Isolator and/or Thiol), and 65 (10.7%) were detected only with the ESP two-bottle system (P < 0.001). Our conventional system allowed for detection of significantly more isolates of members of the family Enterobacteriaceae (P < 0.001), Staphylococcus aureus (P < 0.01), Staphylococcus spp. (coagulase-negative) (P < 0.01), and Enterococcus spp. (P < 0.05), and ESP facilitated detection of significantly more isolates of S. pneumoniae (P < 0.01). When all four devices in a culture set were positive for the same isolate, no microbial species or group was detected significantly earlier ( > or = 24 h) by either blood culture system. The Isolator contamination rate (4.8%) was > or = 6 times the rate for any of the bottles. Of pathogens detected by the Isolator, 50% were recovered in counts of < or = 1.0 CFU/ml and 18% were recovered only as a single colony. The ESP system offered an automated, less labor-intensive blood culture system for which routine subcultures were not required, but the important considerations of culturing large volumes of blood and of obtaining at least two sets from each patient in our population were reemphasized.

Adolescent↗

PubMed1996

Susceptibility of corneal and conjunctival pathogens to ciprofloxacin.

Ciprofloxacin 0.3% ophthalmic solution has been shown to be effective in the treatment of bacterial keratitis and conjunctivitis, and many physicians use ciprofloxacin as sole therapy in these conditions. In this retrospective study, we found seven of 84 isolates from corneal and conjunctival cultures that were resistant to ciprofloxacin. All of the resistant organisms were gram positive. Six of the isolates (Staphylococcus aureus, Staphylococcus hominis, and four isolates of the Streptococcus viridans group) were from corneal cultures, and one (Staphylococcus aureus) was from a conjunctival culture. Yearly records of systemic isolates from 1988 to 1993 (n = 35,308) demonstrated a statistically significant decrease in susceptibility for several organisms that are common pathogens in the conjunctiva and cornea: Pseudomonas aeruginosa (95-90%, p = 0.001); Staphylococcus aureus (96-87%, p < 0.0001); Staphylococcus spp., coagulase negative (97-81%, p < 0.0001); Enterococcus spp. (92-79%, p < 0.0001); Acinetobacter anitratus (97-77%, p = 0.0006); and Enterobacter cloacae (100-96%, p = 0.03). Although the susceptibility of corneal and conjunctival isolates in this series remained relatively high (91.7%), a much larger series of systemic isolates that are common ocular pathogens revealed a statistically significant increase in resistance to ciprofloxacin over the preceding 5 years.

Anti-Infective Agents↗