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PubMed2004

[Clinical and bacteriological substantiation of the use of cefoperazone/sulbactam in complex therapy of patients with pyo-destructive forms of lower respiratory tract infection (LRTI)].

Antibacterial therapy is the most important component of the complex management of pyo-destructive forms of LRTI. Since the microbial flora is rather variable and polymorphous, antibiotics used in the treatment of LRTI should be active against both aerobic (especially gramnegative) and anaerobic pathogens. The aim of the study was to prove, on the basis of the bacteriological and clinical findings, the validity of the use of cefoperazone/sulbactam (CS), the only inhibitor-protected cephalosporin, for the monotherapy of patients with LRTI. The trial enrolled 32 patients (29 males and 3 females) with various forms of LRTI, including 22 patients with destructive pneumonia, 8 patients with acute and chronic lung abscesses and 2 patients with lung gangrene. Complications of the main disease such as empyema, bronchopleural fistula, pyopneumothorax and hemoptysis in 63.5% of the patients were recorded. To verify the microbiological diagnoses, bacteriological assay of the sputum, endobronchial secretion or the contents of the abscess and pleural cavities was performed. The main component of the complex conservative treatment was the monotherapy with CS administered intravenously in an average daily dose of 5.9+/-1.59 g divided into 2 portions. The maximum daily dose for the patients with lung gangrene was 12 g. The bacteriological efficacy was evaluated by the ESCMID (1993) criteria. The clinicoroentgenologic efficacy was estimated by regression of the main signs of LRTI. The pathogens of LRTI were isolated and identified in 87.5% of the patients. Nonsporulating anaerobic bacteria such as Prevotella spp., Bacteroidesfragilis, Fusobacterium spp., Peptococcus spp. and Peptostreptococcus spp. were isolated from 24 (75%) of them. AD the anaerobic organisms proved to be susceptible to CS (100%). As for the aerobic organisms, 85.5% of them was susceptible to CS. The clinical effect of the antibacterial therapy in 29 (90.6%) patients was registered. In 20 patients (64.5%) both clinical and roentgenologic cure was shown. The lethal outcome in 1 patient (3.1%) was stated.

Anti-Bacterial Agents↗
PubMed1992

[Bacteriology of chronic maxillary sinusitis].

132 patients with chronic maxillary sinusitis were included in this bacteriological study of the intrasinus exudate obtained by a radical antrostomy or antral puncture. We found 78.3% aerobes, 21.7% anaerobes, 51.5% gram positive and 48.5% gram negative micro-organisms, but no fungi in 120 cultures. The commonest aerobic species was Haemophylus (20%), whereas Peptococcus and Bacteroides were the commonest anaerobes (10%).

Adolescent↗
PubMed1979

[Clinical experience of cefoxitin in the field of obstetrics and gynecology (author's transl)].

Cefoxitin was given to the 7 patients of infections in the field of obstetrics and gynecology, and the following results were obtained: 1) The clinical response was excellent in 2 patients, good in 4 and poor in 1 patient with the efficacy rate of 85.7%. Out of the 4 patients resistant to the previous therapy with other antibiotics, 3 patients responded to cefoxitin, and all the 3 patients of anaerobic infections responded satisfactorily to cefoxitin. 2) Microorganisms isolated were 2 strains each of E. coli and Staphylococcus aureus, 3 strains of Peptococcus and 1 strain of Eubacterium lentum. All the 8 strains isolated were sensitive to cefoxitin. As to bacteriological response, all the strains isolated were eradicated except 1 strain of Staphylococcus aureus which recurred on the 9th day after completion of the therapy with the eradication rate of 87.5%. 3) No subjective nor objective side effects were noted. Especially, the elevated GOT and GPT observed on a patient complicated with hepatitis prior to the initiation of cefoxitin treatment were found to be normal upon completion of the treatment.

Abdominal Muscles↗
PubMed2006

[Characteristics of war wound infection].

War wounds are the most complex type of non-targeted injuries due to uncontrolled tissue damage of varied and multifold localizations, exposing sterile body areas to contamination with a huge amount of bacteria. Wound contamination is caused by both the host microflora and exogenous agents from the environment (bullets, cloth fragments, dust, dirt, water) due to destruction of the host protective barriers. War wounds are the consequence of destructive effects of various types of projectiles, which result in massive tissue devitalization, hematomas, and compromised circulation with tissue ischemia or anoxia. This environment is highly favorable for proliferation of bacteria and their invasion in the surrounding tissue over a relatively short period of time. War wounds are associated with a high risk of local and systemic infection. The infection will develop unless a timely combined treatment is undertaken, including surgical intervention within 6 hours of wounding and antibiotic therapy administered immediately or at latest in 3 hours of wound infliction. Time is a crucial factor in this type of targeted combined treatment consisting of surgical debridement, appropriate empirical antimicrobial therapy, and specific antitetanic prophylaxis. Apart from exposure factors, there are a number of predisposing factors that favor the development of polymicrobial aerobic-anaerobic infection. These are shock, pain, blood loss, hypoxia, hematomas, type and amount of traumatized tissue, age, and comorbidity factors in the wounded. The determinants that define the spectrum of etiologic agents in contaminated war wounds are: wound type, body region involved, time interval between wounding and primary surgical treatment, climate factors, season, geographical area, hygienic conditions, and patient habits. The etiologic agents of infection include gram-positive aerobic cocci, i. e. Staphylococcus spp, Streptococcus spp and Enterococcus spp, which belong to the physiological flora of the human skin and mucosa; gram-negative facultative aerobic rods; members of the family Enterobacteriacea (Escherichia coil, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter cloacae), which predominate in the physiological flora of the intestines, transitory flora of the skin and environment; gram-negative bacteria, i. e. Pseudomonas aeruginosa, Serratia marcescens, Acinetobacter calcoaceticus - A. baumanii complex; environmental bacteria associated with humid environment and dust; anaerobic gram-positive sporogeneous rods Clostridium spp, gram-negative asporogeneous rods Bacteroides spp and gram-positive anaerobic cocci; Peptostreptococcus spp and Peptococcus spp. The latter usually colonize the intestine, primarily the colon, and the skin, while clostridium spores are also found in the environment. Early empirical antibiotic therapy is used instead of standard antibiotic prophylaxis. Empirical antimicrobial therapy is administered to prevent the development of systemic infection, gas gangrene, necrotizing infection of soft tissue, intoxication and death. The choice of antibiotics is determined by the presumed infective agents and localization of the wound. It is used in all types of war wounds over 5-7-10 days. The characteristics of antibiotics used in war wounds are the following: broad spectrum of activity, ability to penetrate deep into the tissue, low toxicity, long half-life, easy storage and application, and cost effectiveness. The use of antibiotics is not a substitution for surgical treatment. The expected incidence of infection, according to literature data, is 35%-40%. If the time elapsed until surgical debridement exceeds 12 hours, or the administration of antibiotics exceeds 6 hours of wound infliction, primary infection of the war wound occurs (early infection) in more than 50% of cases. The keys for the prevention of infection are prompt and thorough surgical exploration of the wound, administration of antibiotics and antitetanic prophylaxis, awareness of the probable pathogens with respect to localization of the wound, and optimal choice of antibiotics and length of their administration.

Bacterial Infections↗
PubMedDate not supplied

In vitro inhibition of growth of neisseria gonorrhoeae by genital microorganisms.

The ability of microorganisms present in titers of over 10(5)/ml in the vaginal or cervical secretions to inhibit growth of N. gonorrhoeae in vitro was tested. Study of a strain of N. gonorrhoeae against 77 microorganisms demonstrated that most strans of S. epidermidis, S. aureus and the one "Gaffkya anaerobia" interfered with the growth of the N. gonorrhoeae. A minority of strains of S. viridans, Neisseria, Candida and Bifidobacterium demonstrated interference. No strains of enterococcus, diptheroids, aerobic Lactobacillus, Peptostreptococcus, Peptococcus, anaerobic Lactobacillus or Veillonella demonstrated interference.

Bacteria↗
PubMed1991

Two-dimensional NMR investigation of iron-sulfur cluster electronic and molecular structure of oxidized Clostridium pasteurianum ferredoxin. Interpretability of contact shifts in terms of cysteine orientation.

A two-dimensional NMR study has been carried out on the four-iron clusters of a bacterial oxidized ferredoxin for the purpose of investigating the relationship between contact shift patterns and the orientation of the individual coordinated cysteines. The ferredoxin from Clostridium pasteurianum, CpFdox, was selected because of its extensive sequence homology, and likely close structural similarity, to the crystallographically characterized ferredoxin from Peptococcus aerogenes, Pa Fdox (Adman, E.T., Sieker, L.C., and Jensen, L. H. (1973) J. Biol. Chem. 248, 3987-3996). Rapid data collection rates with minimal but adequate acquisition time allowed the detection of numerous CpFdox cross-peaks from the contact-shifted and strongly relaxed coordinated cysteinyl C beta H protons in the resolved 10-20 ppm window. Relatively strong magnitude COSY cross peaks from the resolved eight cysteinyl C beta H resonance unambiguously locate the geminal C beta H partner for each residue; weaker cross-peaks locate the C alpha Hs from three of the residues. The geminal nature of the magnitude-COSY detected partners to the resolved C beta H peaks is confirmed by strong NOESY cross-peaks. The NOESY spectra, moreover, assign an additional two cysteinyl C alpha H resonances. The present results confirm some previous one-dimensional NOE assignments, revise others, and locate resonances previously undetected (Bertini, I., Briganti, F., Luchinat, C., and Scozzafara, A. (1990) Inorg. Chem. 29, 1874-1880). A striking pairwise pseudo-symmetry in cysteinyl contact shift patterns is observed which is attributed to the previously recognized pseudo-symmetry in the crystal of PaFdox. A detailed analysis of the structural/electronic determinants of the coordinated cysteine C beta H contact shift pattern is made, and the NMR data necessary for unique interpretation are identified. It is shown that analysis of the relaxation properties of cysteine beta-methylene protons provides the stereospecific assignments necessary for comparison of shift ratios with crystallographic structural data. The available structural data on PaFdox (Backes, G., Mino, Y., Loehr, T., Meyer, T., Cusanovich, M., Sweeney, W., Adman, E., and Sanders-Loehr, J. (1991) J. Am. Chem. Soc. 13, 2055-2064) are qualitatively but not quantitatively consistent with the observed cysteinyl contact shift pattern, with the NMR data reflecting more asymmetry than previous studies. A tentative assignment of a single pair of symmetry-related cysteines is proposed.(ABSTRACT TRUNCATED AT 400 WORDS)

Clostridium↗
PubMed1991

[Effects of antibiotics and anti-bacterial components of preparations for local treatment of suppurative wounds on pathogens of odonto- genic infections].

The results of identification and sensitivity assay of 156 strains of pathogens causing odontogenic infections are presented. In the sensitivity assay antibacterial drugs were used. 42.3 percent of the strains were obligate anaerobes belonging to Bacteroides, Fusobacterium, Peptococcus, Peptostreptococcus, Veillonella and Actinomyces. Significant differences in the microbial sensitivity to the drugs used for general and local therapy were detected. There was observed high sensitivity of the obligate anaerobes to gramicidin (0.02 micrograms/ml), nitazol (10 micrograms/ml), levomycetin and tetracycline (60 micrograms/ml). Antiseptics such as dioxidine and chlorhexidine used locally showed satisfactory results. The above mentioned drugs and especially levomycetin were also rather active against facultative organisms in associations of pathogens causing odontogenic infections: Bacillus coagulans, B. licheniformis, Pseudomonas sp., Acinetobacter calcoaceticus, Staphylococcus sp. and Streptococcus sp.

Anti-Bacterial Agents↗
PubMed1991

[Anaerobic infection of burns].

To analyze anaerobic infection 158 specimens were obtained from deep necrotic tissues and exudates under burned subeschar, secretion of eyes and blood. The results showed that more anaerobes were isolated from deep necrotic tissues (46.88%) and smelly exudates of subeschar (38.71%). Most of them were mixed with aerobes (97.1%). In 43 strains of anaerobes, Clostridium accounted for 18 strains (41.86%), and Bacteroides for 17 strains (39.53%). Fusiform nucleatum. Peptococcus, and Veillonell paryula were also differentiated. The recent total detectable rate of anaerobes (38.71%) from burn wounds was higher significantly than that of 1980-1983 (14.7%). It may be due to the exact selection of specimens and modification of cultural medium and equipment.

Bacteria, Anaerobic↗
PubMed1990

[Anaerobic bacteria and their role in recurrent tonsillitis].

The presence of anaerobic bacteria in 100 palatal tonsils obtained during the tonsillectomy, was evaluated in quality and in quantity. 17 species of anaerobic bacteria were found. The most frequent were: Bacteroides melaninogenicus, Peptostreptococcus anaerobius, Peptostreptococcus intermedius, Propionibacterium, Veillonella parvula and Peptococcus asaccharolyticus. In most evaluations their density was 10(5)-10(6) in gram of tonsil tissue, sometimes 10(7). Its role in recurrent tonsils infections was discussed.

Adolescent↗
PubMed1990

[Susceptibilities of clinical bacterial isolates to antimicrobial agents. A study mainly focused on imipenem. Research Group for Testing Imipenem Susceptibility on Clinical Isolates].

We investigated susceptibilities of clinical bacterial isolates to imipenem (IPM) and other antimicrobial agents at 459 hospital laboratories throughout Japan from September to December of 1988. In this study, identification and susceptibility testing were performed at each hospital laboratory and the tests were carried out according to the 1-dilution or 3-dilution disc technique in which susceptibilities are classified into 4 grades: , ++, + and -. IPM had significantly high activity against Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Neisseria gonorrhoeae, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter cloacae, Salmonella spp., Citrobacter freundii, Proteus mirabilis, Providencia rettgeri, Acinetobacter calcoaceticus, Moraxella catarrhalis, Alcaligenes spp., Peptococcus spp./Peptostreptococcus spp., Bacteroides fragilis and Bacteroides spp. and should slightly lower activities on coagulase-negative staphylococci (CNS), Enterococcus faecalis, Haemophilus influenzae, Serratia marcescens, Proteus vulgaris, Providencia stuartii and Pseudomonas aeruginosa than on the above mentioned bacteria. In a comparative study on activities of IPM against bacteria from different clinical sources, no remarkable differences were found due to different sources among S. pneumoniae, E. faecalis, H. influenzae, E. coli, K. pneumoniae, E. cloacae, C. freundii, P. mirabilis or A. calcoaceticus, whereas slight differences were found among Staphylococcus aureus, CNS, S. marcescens and P. aeruginosa.

Anti-Bacterial Agents↗
PubMed1990

[A microbiologic study on anaerobic bacteremia after dental extraction].

It has been known for many years that tooth extraction can cause bacterial dissemination into blood stream, that is, bacteremia. Besides endocarditis--causing bacteria, alpha-hemolytic streptococci, anaerobes are involved in the post- extraction bacteremia. They are of clinical importance because they can cause abscesses in the various parenchymatous organs such as the liver, lung, and brain through anachoresis. The purpose of this study is to establish the types of species of anaerobes associated with post--extraction bacteremia, and to give the baseline to the succeeding study of sensitivity tests of various antibiotics, thus clinicians can chose the right ones. 10ml of blood was sampled pre- and post- operatively from 32 patients and incubated in anaerobic chamber. The followings are the results of this study. 1. All the preoperative blood samples showed negative culture. 2. Postoperative blood samples from 8 out of 10 patients (80%) in group 1, from 1 out of 15 (73.3%) in group 2, and 2 out of 7 (28.6%) in group 3 yielded anaerobic and facultative species. 3. Organisms detected were species belonging to the genera Streptococcus, Bacteroides, Actinomyces, Staphylococcus, Peptostreptococcus, Peptococcus, Propionebacterium, Fusobacterium, nonenterococcus, and Corynebacterium.

Bacteria, Anaerobic↗
PubMed1990

In vitro activity of teicoplanin, vancomycin, A16686, clindamycin, erythromycin and fusidic acid against anaerobic bacteria.

The in vitro activity of teicoplanin and A16686, two new glycopeptide antibiotics was determined against 196 isolates of anaerobic bacteria. The activity of teicoplanin and A16686, in comparison with that of vancomycin, clindamycin, erythromycin and fusidic acid was 2 to 16 times higher against the gram positive anaerobes, namely, Propionibacterium acnes, Clostridium perfringens, Clostridium difficile, Clostridium species, Peptococcus species and Peptostreptococcus species. However, Bacteroides fragilis was resistant to teicoplanin and A16686 while Bacteroides melaninogenicus and Bacteroides bivius were found to be sensitive.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Retrograde endoscopic cholangiopancreatography. Incidence of bacteremia].

ERCP like all the endoscopic procedures, implies some risks of complications, between them, infections. Bacteremia may occur in any endoscopic and gastrointestinal procedure. The rate on ERCP is about 0 to 5.6%. In the present investigation we intended to determine the rate of bacteremia produced by ERCP, the organism that cause bacteremia and to correlate ductal pathology, stasis and bacteremia. From May to October 1988, at the Hospital Vargas of Caracas, 22 ERCP were performed in patients that were included for analysis. Haemocultives were taken for aerobics and anaerobics, gems before ERCP, immediately after the cannulation of biliary and/or pancreatic ducts and 5 minutes later after concluding the study. A high incidence of bacteremia was reported, 13.6%, all the previous haemocultives were negative. The positive haemocultives were during the cannulation procedure and no haemocultive after the study was positive. The organism isolate were Peptococcus sacharoliticcus and Staphylococcus epidermidis both of the normal flora of small intestine and the last one on the skin too. There were not relation between the ductal pathology, stasis and bacteremia. Some organisms were related to nosocomial agents, we considered though the disinfection and polishment of the accessories and equipment adequate. It is recommendable to use prophylactic antibiotic in immunosuppressed patients with valvular prosthesis.

Adult↗
PubMed1990

Bacterial flora of the vagina and uterus of healthy cats.

Bacterial culturing was conducted on samples from the reproductive tracts of 53 clinically healthy female cats. Aerobic bacteria were isolated from 52 of 53 vaginal swab samples and from 2 of 29 uterine swab samples. Anaerobic bacteria were detected in 4 of 30 vaginal and 1 of 29 uterine cultures. The aerobic bacteria included species of Acinetobacter, Actinomyces, Corynebacterium, Escherichia, Haemophilus, Klebsiella, Lactobacillus, Staphylococcus, and Streptococcus. Coagulase-negative Staphylococcus, Streptococcus canis, and E coli were the most common organisms and were isolated from 56%, 52%, and 44% of the vaginal samples, respectively. Anaerobes isolated from vaginal samples included 3 species of Bacteroides and 2 isolates of Peptococcus. The single uterine anaerobe isolate was a Lactobacillus sp. The number of bacterial species isolated from each vaginal culture ranged from 1 to 8 (mean, 3). The number of colony forming units tended to vary inversely with the number of bacterial species detected in each sample.

Animals↗
PubMed1990

[A clinical study on ceftazidime in the treatment of intractable respiratory infections].

Ceftazidime (CAZ) was administered to 51 patients (37 males, 14 females) with respiratory infections including severe cases, accompanied by various underlying respiratory diseases. The clinical efficacy and side effects of CAZ were investigated. The mean age and body weight of these 51 cases were 62.6 years and 48.0 kg, respectively. CAZ was administered by intravenous drip infusion (daily dose of 2-4 g) for a mean of 14.7 days to a mean total dose of 56.7 g. Clinical efficacy rates were 64% (18 of 28 cases), 80% (16 of 20 cases) and 67% (2 of 3 cases) for airway and intermediary regional infections, pneumonia (including lung abscess) and pyothorax, respectively. In the bacteriological study, efficacy rates and bacterial eradication rates were 69% and 67%, 33% and 20%, 100% and 100%, and 100% and 100% for infections caused by Pseudomonas aeruginosa (13 cases), Staphylococcus aureus (6 cases), Streptococcus pneumoniae (6 cases) and Klebsiella pneumoniae (4 cases), respectively, and bacterial eradication was achieved in both of 2 cases of Peptostreptococcus anaerobius and 2 cases of Haemophilus influenzae, and 1 case each of Peptococcus sp., Fusobacterium necrophorum and Serratia marcescens. Side effects observed were eruption in 1 case (2%) and elevated GOT, GPT and Al-P values in 1 case (2%), but these cases tended to recover after CAZ treatment was discontinued.

Adult↗
PubMed1990

Isolation and identification of anaerobic bacteria from ovine foot rot in Spain.

A microbiological study was made of 125 Merino sheep showing clinical signs of foot rot. A total of 435 strictly anaerobic strains were isolated, belonging to the following genera: Bacteroides, Peptostreptococcus, Tissierella, Fusobacterium, Megasphaera, Eubacterium, Acidaminococcus, Clostridium, Peptococcus and Propionibacterium. Of the 35 species obtained, the following were found in more than 10 per cent of animals sampled: Bacteroides nodosus, B putredinis, B buccae, B ruminicola subspecies brevis, Tissierella praeacuta, Peptostreptococcus anaerobius and Megasphaera elsdenii. Six culture media were used for isolation. Agar brucella and agar brucella enriched with G-N anaerobe supplement proved to be the most efficient for isolating anaerobic bacteria.

Animals↗
PubMed1990

[Susceptibilities of clinical bacterial isolates to antimicrobial agents. A study mainly focused on imipenem. Reported by the Research Group for Testing Imipenem Susceptibility on Clinical Isolates].

This study was conducted to investigate susceptibilities of clinical bacterial isolates to imipenem (IPM) and other antibacterial agents at 64 hospital laboratories throughout Japan from September to December of 1988. In this study, identification and susceptibility testing were carried out at each laboratory and the tests were performed according to the disk dilution method recommended by NCCLS in which susceptibilities are classified into "S", "MS", "I" and "R". IPM showed markedly high in vitro activities against Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Enterococcus faecalis, Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter aerogenes, Enterobacter cloacae, Serratia marcescens, Salmonella spp., Citrobacter freundii, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Providencia stuartii, Acinetobacter calcoaceticus, Moraxella (Branhamella) catarrhalis, Alcaligenes spp., Peptococcus spp./Peptostreptococcus spp., Bacteroides fragilis and Bacteroides spp. IPM also had strong activities against Achromobacter xylosoxidans and Pseudomonas aeruginosa, but less active against Flavobacterium spp., E. faecium, coagulase-negative staphylococci (CNS), Staphylococcus aureus and Pseudomonas cepacia. In a study in which activities of IPM against bacteria isolated from different clinical sources were compared, differences in susceptibilities were observed among S. aureus, CNS, A. calcoaceticus and P. aeruginosa, but such differences were not apparent among S. pneumoniae, E. faecalis, H. influenzae, E. coli, K. pneumoniae, E. cloacae, C. freundii, S. marcescens or P. mirabilis.

Bacteria↗
PubMedDate not supplied

Clindamycin versus ampicillin in the treatment of odontogenic infections.

The subjects were 106 patients, aged 14 to 70 years, with acute facial or oral abscesses originating from an odontogenic source. They were randomly assigned to receive 150 mg of clindamycin or 250 mg of ampicillin orally four times daily for seven days. After seven days of treatment, the infections were eradicated in 36 of the 52 clindamycin-treated patients and in 42 of the 54 ampicillin-treated patients, and improved in 16 and 11, respectively. One of the ampicillin group was a treatment failure. Mixed bacterial infections were found in most of the patients; 385 isolates were identified, 167 aerobes and 218 anaerobes. The most common aerobes were Staphylococcus aureus (in 58 patients), Staphylococcus epidermidis (in 47), and Staphylococcus viridans (in 32); the most common anaerobes were species of Peptococcus (in 76), Bacteroides (in 38), and Peptostreptococcus (in 33). No isolates were resistant to clindamycin; nine of 126 aerobes and six of 160 anaerobes were resistant to ampicillin. It is concluded that clindamycin is a safe and effective alternative antibiotic in the treatment of odontogenic infections.

Abscess↗