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PubMed1993

[The role anaerobes in dermatitis digitalis et interdigitalis in cattle].

Altogether 52 tissue samples and swabs from the corium of the claw of diseased cattle were investigated. Microbiological examinations revealed the presence of 11 strictly anaerobic bacterial strains that belonged to the species Peptococcus asacharolyticus, Pc. sacharolyticus, Peptostreptococcus anaerobius, Bacteroides asacharolyticus and B. melaninogenicus. The remaining isolates were classified as Bacteroides, Fusobacterium, Streptococcus and Clostridium. In the above-mentioned strains observations of their biochemical, morphological and enzymatic properties (Tab. I) were carried out. Their resistance to antibiotics was evaluated from the qualitative viewpoint (Tab. II). Capillary isotachophoresis was used to determine the amounts of volatile fatty acids that developed during glucose fermentation (Tab. III). In the single clinical samples the above-mentioned strains occurred as association of microorganism. The anaerobic genera Bacteroides and Fusobacterium were found in 52% of the samples (Bacteroides sp. and Fusobacterium sp. were recorded in 25% and 12% of the samples, respectively, whereas in 15% of the samples both species occurred). According to our results the etiology of dermatitis digitalis et interdigitalis is closely connected with the incidence of anaerobes. Of the latter, those belonging to the genera Bacteroides and Fusobacterium are of major importance.

Animals↗
PubMedDate not supplied

[On the acute respiratory infections of anaerobes bacteria: clinical, bacteriological and therapeutic results (author's transl)].

In order to isolate and identify aerobe and obligate anaerobe (O.A.) bacteria investigations were carried out on 11 patients with acute respiratory tract infections (7 of them severely ill and hospitalized in an Intensive Care Unit). O.A. species were isolated in 7 subjects, in all cases in mixed culture (from 2 to 5 species per sample), including also potentially pathogenic aerobe bacteria (Pseudomonas aeruginosa, Klebsiella pneumoniae, etc). On the 24 strains of O.A. bacteria identified, M.I.C. was determined for penicillin, clindamycin, chloramphenicol, and thiamphenciol. The data obtained have been compared with the M.I.C. of 28 strains isolated from uro-gynecological infections. The strains isolated from the respiratory tract presented a sensitivity spectrum to antibiotic similar to those isolated from the urogenital tract. Chloramphenicol and thiamphenicol inhibited growth in 100% of the cases at concentrations equivalent or inferior to plasma levels obtained with normal therapeutical doses; clindamycin was active at lower concentrations but not on all the strains isolated (3 Bacteroides, 1 Fusobacterium sp., 1 Peptococcus sp. were resistent). Penicillin G was active on 21 out of 25 Gram-positive strains, but only on 7 out 26 Gram-negative bacilli. In view of these results the difficulty of obtaining a correct etiologic diagnosis and the consequent use of a correct antibiotic therapy are discussed. The usefulness of the association of different antibiotics is suggested.

Adolescent↗
PubMed1993

[Bite wound infections: study of 22 hospitalized patients].

BACKGROUND: To study the characteristics of bite wounds with unfavorable evolution, developing infectious complications that requires hospital admission. METHODS: The data from 22 patients admitted to the Ciudad Sanitaria Vall d'Hebron hospital for the above mentioned reason over the last 5 years were reviewed. RESULTS: The patients (8 males, 8 females and 6 children) were bitten by 10 dogs, 6 cats, and 6 men with predominance of the wound site being in the upper limb (10) followed by the lower limbs (6), head or face (5) and exceptionally on the breast (1). The most frequent clinical manifestation was abscess and/or cellulitis (13) and adenopathies or lymphangitis (4); 5 patients presented osteoarticular involvement including 3 bone fractures due to human aggression. With regard to the etiology of infection, the common bucal flora bacteria were isolated in all the cases; Pasteurella multocida in 15/16 animal bites, Eikenella corrodens associated to streptococcus in 5/6 human bites, Fusobacterium spp. (5), Bacteroides spp. (3) and Peptococcus sp. (1). The most frequently administered antibiotics were gentamycin (15), penicillin (13), cloxacillin (5) and clindamycin (4). The evolution was favorable, although slow in many cases, with sequelae in 3 patients. CONCLUSIONS: It is very difficult to foresee in which cases infectious complications will develop in bite wounds. According to the authors' experience, in the case of deep wounds the bacteria implied come from the mouth of the aggressor. Careful cleansing, rapid administration of an adequate antibiotic and clinical control being the most recommendable procedure.

Adult↗
PubMed1993

[Gardnerella vaginalis in infections of reproductive organs].

The study was aimed at multidirectional studies on bacteria isolated from smears from vagina and cervix uteri in 226 patients with inflammatory states of their reproductive organs. Most frequently isolated aerobic bacteria were Gram-negative--27%, mainly E. coli, and Enterococcus faecalis--in 18% of cases. Anaerobic bacteria were isolated in 81% of cases: Gardnerella vaginalis was isolated in 28% and Lactobacillus in 53% of cases. Other anaerobic bacteria were: Peptococcus asaccharolyticus (15.5%), Streptococcus sp. (15.9%), and Bacteroides melaninogenicus (14.1%). Gardnerella vaginalis was most frequently found in chronic cases of vaginosis (41.7%). All strains of G. vaginalis were susceptible to cefotaxime, while 15-40% of them were resistant to gentamycin, tetracycline and metronidazole.

Chronic Disease↗
PubMed1993

A review of commonly prescribed oral antibiotics in general dentistry.

The microflora associated with odontogenic infections are typically mixed and of indigenous origin. Streptococcus, peptostreptococcus, peptococcus, fusobacterium, bacteroides, and actinomyces species are the principle microflora isolated from these infections. Penicillin V (phenoxymethyl penicillin) remains the antimicrobial of choice for the initial empirical treatment of odontogenic infections. This agent is safe, highly effective and inexpensive. Amoxicillin has little indication for the routine treatment of odontogenic infections. However, it is the agent of choice for endocarditis prophylaxis, as it produces higher serum levels than penicillin V. Erythromycin may be used for mild, acute odontogenic infections in penicillin-allergic patients. The high incidence of gastrointestinal disturbances and superinfection commonly associated with the ingestion of tetracycline limits its role in general dental practice. Tetracycline may be considered as an alternative therapy for penicillin-allergic patients over the age of 13 who cannot tolerate erythromycin. Clindamycin is very effective against all odontogenic pathogens, but its potential gastrointestinal toxicity relegates it to third- or even fourth-line therapy in general dentistry. Although metronidazole displays excellent activity against anaerobic gram-negative bacilli, it is only moderately effective against facultative and anaerobic gram-positive cocci, and should not be used alone in the treatment of acute odontogenic infections.

Administration, Oral↗
PubMed1977

[Susceptibility to Thiamphenicol and Chloramphenicol of Anaerobic Bacteria (author's transl)].

The in vitro susceptibility to thiamphenicol and chloramphenicol of 272 anaerobes, most of which were recent clinical isolated, was determined by broth dilution tests, With chloramphenicol, 133 anaerobic gram-negative non-sporing rods (48 Bacteroides fragilis, 13 B. thetaiotaomicron, 14 B. oralis, 16 Sphaerophorus varius etc.) had MIC values of 0.03 through 16 microng/ml. Very similar results (MIC, 0.06-16 microng/ml) were obtained with thiamphenicol. In concentrations of 4 microng/ml or less chloramphenicol inhibited 90.2% and thiamphenicol 78.95% of the strains. Strains with only moderate sensitivity to both antibiotics (MIC, 8 or 16 microng/ml) belonged to B. fragilis or other Bacteroides species. Members of the Fusobacterium and Sphaerophorus group were susceptible to less than or equal to 2 microng chloramphenicol/ml and less than or equal to 4 microng thiamphenicol/ml respectively. With both antibiotics, 102 strains of gram-positive non-sporing anaerobes (P. acnes, Peptostreptococcus spp., Peptococcus spp.) were susceptible to less than or equal to 8 microng/ml. Of 37 Clostridium isolates, 35 (belonging to C. perfringens, C. septicum, C. cadaveris etc.) were inhibited by concentrations of 8 microng/ml or less of chloramphenicol and thiamphenicol. Only one strain each of C. perfringens and Clostridium sp. had an MIC of 16 microng thiamphenicol/ml. Accordingly, resistance to thiamphenicol or chloramphenicol was not observed. A standardized monodisk agardiffusion test was performed on 40 Bacteroidaceae, 18 Peptococcaceae and 20 C, (P.) acnes strains. Only a poor correlation was observed between MIC and zone size for thiamphenicol and chloramphenicol. Therefore, inhibition zone diameter measurement cannot be regarded as a reliable method to detect chloramphenicol or thiamphenicol resistance in anaerobes. Thiamphenicol, which is virtually as active against anaerobes as chloramphenicol but lacks serious toxicity, may well play an important role in the therapy of various anaerobic infections.

Anti-Bacterial Agents↗
PubMed1996

[Diagnosis and treatment of local forms of surgical anaerobic non-clostridial infection].

145 patients with such kind of surgical infection have been taken to clarify the cause of it. Aerobic agents were the cause in 16.6% and anaerobic nonclostridial agents--in 33.1% of all cases. The mixed flora was the cause in 44.1%. The most important place among anaerobic nonclostridial infections belongs to bacteroids (38.3%), peptostreptococcus (27.3%) and the peptococcus (17.2%). One must use wide-spectrum antibiotic for a treatment of a such kind of infection tiel the usults of microbiological test are known and only then one can use group-specific antibiotics.

Bacteria, Aerobic↗
PubMed1995

[Aerobic and anaerobic bacterial flora in acute abdominal illnesses].

366 specinmens taken from patients suffering from acute abdominal illnesses who had undergone operations were examined. Bacterial pathogens were isolated from 318 specimens. Aerobic bacteria were isolated from 53.8% specimens. Anaerobic bacteria were isolated from 12.6% specimens. Mixed bacterial flora were isolated from 33.6% specimens. Among aerobic bacteria E. coli and Streptococcus faecalis were most often isolated. Among anaerobic bacteria Bacteroides fragilis, Peptostreptococcus spp. and Peptococcus spp. were most often seen.

Abdomen, Acute↗
PubMed1996

Surgical treatment of subdural empyema: a critical review.

Between 1990 and 1992 six cases of subdural empyema were surgically treated at the Neurosurgical Division of Emergency Department of Cardarelli Hospital in Naples. Three cases were associated with paranasal sinusitis and three cases with otitis media. Headache and fever were the presenting symptoms in all cases; in only two cases they were associated with seizures and altered mental status. CT scans showed convexity low density collections in five cases and multilocalized pus collection in one; concurrent paranasal or mastoid infections were visualized as well. The organisms responsible for the subdural empyema were Peptococcus in four cases, Streptococcus and anaerobius in the other two cases. In five cases surgical treatment consists in pus drainage by selective burr hole and placement of a subdural small silicon tube for local antibiotic therapy. In one case with a loculated diffuse empyema, craniotomy was performed in order to provide a better access to all the localizations. In all cases drainage of the wound and intravenous antibiotic therapy were used. Paranasal sinus drainage or mastoidectomy performed by the otolaryngologist when a localized collection of pus was present, grave a quicker regression of symptoms. A full recover of the original neurological status was achieved in all cases; a 20 months mean followup confirms the results.

Adolescent↗
PubMed1996

[Occurrence of non-spore forming anaerobic bacteria in the upper airways of patients with chronic obstructive pulmonary disease].

The aim of this study was to assess the occurrence of anaerobic non-sporeforming bacteria upper airways flora in the exacerbation of COPD. Sputum from 35 COPD patients was sent to the laboratory in sterile, filled with CO2 containers and cultured under anaerobic conditions. In all patients bacteriological tests were positive. The most common anaerobic bacteria were as follows: Peptostreptococcus - in 28 pts, Fusobacterium - in 27 pts, Bacteroides - in 26 pts and Prevotella in 24. Less common were: Propionibacterium, Actinomyces, Eubacterium, Porphyromonas and Peptococcus. The susceptibility to most common antimicrobial agents was evaluated. All anaerobic bacteria show a significant sensitivity to amoxicillin either with clavulanic acid or ampicillin with sulbactam. Gram-positive rods were resistant to metronidazole and tinidazole.

Adult↗
PubMed1996

[The study of drug resistance in aerobic and anaerobic bacterial flora to selected antibacterial drugs].

The aim of the study to determine the resistance to certain antibacterial drugs of the aerobic and anaerobic bacterial flora isolated from patients operated on for acute abdominal infections. The resistance was investigated by the disc diffusion method. Among the isolated aerobes Enterobacteriaceae, Enterococcus spp, Pseudomonas spp. Staphylococcus spp were most frequent, and in the group of anaerobes the most frequent were Bacteroides spp, Peptostreptococcus spp and Peptococcus spp. The sensitivity to ciprofloxacin, gentamicin and cefoperazone was tested in 492 aerobic strains, and the sensitivity of cefuroxime was tested in 387 strains. In the group of anaerobes the sensitivity to ciprofloxacin and cefoperazone was tested in 239 strains, and in 187 and 176 strains the sensitivity to cefuroxime and metronidazole respectively was tested. Only 94 aerobic strains and 32 anaerobic strains were additionally tested for augmentin, ceftriaxone, ceftazidime, imipenem, clindamycin and doxycycline. Imipenem was found to be the most active drug against aerobic and anaerobic bacteria. Clindamycin showed a very high activity against anaerobes but was significantly less active against aerobes. Only a small proportion of the tested aerobic strain (11.2%) were resistant to ciprofloxacin, while most anaerobic strains (66.5) were resistant to this antibiotic. Metronidazole was active against about 100% of anaerobes. Augmentin had a high activity against gram-positive cocci and was less active against gram-negative rods and anaerobes. A high proportion of aerobic and anaerobic strains were resistant to ceftriaxone, ceftazidime, cefuroxime and doxycycline. Gentamicin showed a sufficient activity against the tested aerobic strains (33.9% were resistant).

Abdomen↗
PubMed1997

[Anti-anaerobic activity of carbapenems].

The critical concentrations of sensitivity and resistance for meropenem versus anaerobic bacterias were analyzed. It is demonstrated the meropenem is a powerful inhibitor of the microorganisms of the Bacteroides groups (MIC90 < 1 mg/l), Prevotella > Porphyromonas, Fusobacterium, Veillonella, Clostridium perfringens is inhibited at a MIC < 0.06 mg/l. The MIC of meropenem versus C. difficile is 2 mg/l. They are also highly susceptible to the Propionibacterium, Peptostreptococcus and Peptococcus type microorganisms. Meropenem is comparable to imipenem and is more active than piperacillin, metronidazole and clindamycin. The mechanism of action and acquisition of resistance versus meropenem is evaluated and discussed. The percentage of highly resistant strains (MIC > 256 mg/l) isolated in the Hospital Gregorio Marañón in Madrid (Spain) is low (1.2%). The influence of pH on the in vitro activity of the carbapenémicos is also analyzed providing experimental data suggesting that meropenem maintains its bactericide activity more effectively in low pH conditions (5.6). Finally, the authors analyze the literature and the evidence reported regarding the use of meropenem in clinical practice, as a treatment of intraabdominal infections with a clinical response of 91%-100% and bacteriologic efficacy of 84%-95%.

Bacteria, Anaerobic↗
PubMed1997

[Two stages reimplantation for infection after knee arthroplasty. Apropos of a series of 29 cases].

PURPOSE OF THE STUDY: The purpose of this work was to precise diagnosis and treatment of infected total knee arthroplasty with two stage reimplantation. MATERIAL: 29 infected total knee arthroplasties were operated between 1984 and 1994 and included in this study (mean F.U. 3.5 Y). There were 20 females and 9 males, mean age 70 (46-83). The original arthroplasty was done for OA in 28 patients, RA in one. The arthroplasties were: UHK 2, Bicompartmental 2, Tricompartmental 19. 20 TKA were cementless. 14 patients showed one or several risk factors. Infection was diagnosed in 1 of 2 ways: preoperative aspiration or culture of surgical specimen. There were 12 staphylococcus epidermidis, 8 staphylococcus aureus, streptococcus (n = 2) acinetobacter (n = 2), peptococcus (n = 1) pseudomonas (n = 1), gemella morbidellum (n = 1). 6 were non identified. METHOD: The protocol for two stage reimplantation began with components and cement removal. A synovectomy was performed. The knee cavity was filled with antibiotic cement spacer and the wound was closed. The leg was placed in a splint. All patients underwend a continued antibiotic therapy, specific in 20 cases with isolated organisms. A total knee arthroplasty was performed, using a total posterior cruciate substituting prosthesis, 6 to 8 weeks after components removal (2-24). All patients received parenteral antibiotics after reimplantation for not less than 2 months (2-6). RESULTS: Infection was eradicated in 24 cases, 22 in one time, 2 bad second debridement. At last follow-up the average Hungerford score was 75.6/100, the average Knee society knee score was 80 and the average functional score was 70. Mean range of flexion was 95 degrees. 6 patients had recurrent infection and poor result. They underwent arthrodesis. 5 of the 6 patients had solid mature fusion at last follow-up. DISCUSSION: The results of two stage reimplantation for infected total knee replacement showed that this is the method of choice for infection treatment and acceptable function restoration. As other authors, we get a good success rate (82 per cent). Functional result was better with identified microorganisms, but we did not find any correlation with organisms type or infection length. Punction and bone scanning are of great help for diagnosis in difficult chronical cases. Organism identification is fundamental for infection duration. Staphylococcus epidermidis was the most frequent identified organism. New procedures using articulated cement spacer may improve functional results.

Aged↗
PubMedDate not supplied

Pancreatic fluid collections: diagnostic and therapeutic implications of percutaneous drainage guided by ultrasound.

BACKGROUND/AIMS: The aim of the present study is to assess the usefulness of biochemical and bacteriological analysis of the pancreatic fluid obtained at percutaneous drainage of pancreatic pseudocysts and abscesses guided by ultrasound. METHODOLOGY: The study population was comprised of 65 patients, aged 21-79 years: 18 with abscesses and 47 with pseudocysts. In all cases the etiological factor of pancreatic fluid collections was acute pancreatitis. Microbiological (both of aerobic and anaerobic flora), biochemical (including alpha 2-macroglobulin) and cytological analysis of aspirated fluid was performed. Duration of percutaneous drainage in pseudocysts was 10-40 days (mean 18 +/- 12) and in abscesses 21-56 days (mean 32 +/- 19). RESULTS: Complete resolution of pancreatic fluid collections was obtained in 54 (83%) patients, among them in 40 (85.1%) with pseudocysts and in 14 (77.7%) with abscesses, which was confirmed in follow-up ultrasound and/or computed tomography one year after the catheter was removed. Mild complications of this procedure observed in 17 (26.1%) patients were managed without catheter removal. A variety of organisms were cultured from pancreatic fluid, E. coli being the most prevalent. Enterobacter cloacae, staphylococcus aureus, staphylococcus epidermidis, peptococcus saccharolyticus, propionibacterium acnes and bacteroides fragilis were also isolated. Cytologic analysis of the aspirate revealed no atypical cells. The level of alpha 2-macroglobulin in the pancreatic fluid was significantly higher (p < 0.05) in patients with successful pancreatic drainage as compared to the remaining group. CONCLUSION: Percutaneous drainage represents a safe therapeutic method that also provides additional criteria for the management of patients with pancreatic cystic lesions.

Abscess↗
PubMed1997

[Bacterial flora in chronic purulent maxillary sinusitis].

In the years from 1993 till 1995 there were 132 tests done on occurrence aerobes (oxygen bacteria) and 56 tests on occurrence of anaerobes and fungus in patients with chronic sinusitis. The most common microorganisms among the aerobes was Haemophilus influenzae (23.1%) and Staphylococcus aureus (20.9%). The most common microorganisms among the anaerobes was Peptococcus and Peptostreptococcus (together 57.1%) and from the strains Bacteroides (36.8). The breeded oxygen microorganisms Gr(+) were mostly sensible to clindamycin, cefuroxim and augmentin; Gr(-) organisms to amicacin, gentamycin and cefuroxim. Anaerobes were mostly sensible to metronidazole and clindamycin.

Adult↗
PubMed1997

[A study of anaerobic infection in maxillofacial region].

To analyse the anaerobic infection of maxillofacial surgery and estimate the efficacy of antianaerobic therapy, 45 patients were divided into two groups, tinidazole group and metronidazole group. Bacterial culture was positive before treating in all cases. There were Bacillus Melaniogenicus, Veillonella, Peptococcus and Peptostreptococus, etc. There was excellent efficacy in the treatment of maxillofacial anaerobic infection by tinidazole intravenously. After treatment, the result of bacterial examination was negative. The healing rate was 96.4% in 28 cases which used tinidazol, but 82.4% in control group which used metronidazole. The value of white blood cell and the function of liver and kidney pro- and post-treatment were not significantly different (P < 0.05) by comparision.

Adolescent↗