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Is ciprofloxacin active against clinically important anaerobes?

The comparative activity of ciprofloxacin against 272 clinical isolates and reference strains of anaerobes was determined by an agar dilution method. The majority of strains of Bacteroides fragilis and clostridia were resistant (MIC greater than 2 mg/l). The effect of pH, inoculum size and medium composition was also studied; the activity of ciprofloxacin was decreased at acid pH and by increasing inoculum size but was unaffected by the composition of the test media. Ciprofloxacin should not be used for the treatment of anaerobic infections because of its limited in-vitro activity against these organisms.

Anti-Bacterial Agents↗

Assessment of the pathogenicity of bacterial species isolated from acute dentoalveolar abscesses.

The pathogenicity of 20 strains belonging to nine bacterial species isolated from acute dentoalveolar abscesses was assessed individually and in two species combinations by subcutaneous inoculation of mice. Infections were produced by all the bacteria although variations were seen both in the type of lesion produced and the subsequent recovery of viable bacteria. Anaerobic gram-negative bacilli were recovered more often (p less than 0.05) at high concentrations (10(6)-10(9) cfu/ml) and produced a localised abscess with peripheral necrosis more frequently (p less than 0.001) than either Streptococcus milleri or anaerobic gram-positive cocci. Lesions induced by a combination of bacteria comprising anaerobic gram-negative bacillus and any other species yielded both strains at high concentration more often (p less than 0.001) than a combination comprising anaerobic gram-positive cocci and S. milleri. It is concluded that anaerobic gram-negative bacilli are major pathogens in acute dentoalveolar abscesses.

Acute Disease↗

The clinical importance of gram-positive anaerobic cocci isolated at St Bartholomew's Hospital, London, in 1987.

The clinical importance of the gram-positive anaerobic cocci (GPAC) isolated in 1987 at St Bartholomew's Hospital, London, is assessed. Of about 800 anaerobic isolates, 209 (27%) were GPAC, of which 67 (32%) were from abscesses and 22 (11%) were in pure growth. Four species comprised 77% of the 168 isolates available for study: Peptostreptococcus magnus (55 isolates, 33%), P. micros (23, 14%), P. asaccharolyticus (24, 14%) P. asaccharolyticus (24, 14%) and P. anaerobius (27, 16%). Different species were associated with different sites, from P. magnus (usually skin-associated sites; normally cultured with aerobes, infrequently with other anaerobes), P. asaccharolyticus (distributed widely) and P. anaerobius (usually genitourinary and gastrointestinal; always below the diaphragm) to P. micros (always deep sites with other anaerobes). P. magnus was isolated from 15 abscesses and was obtained in pure culture from 11 specimens, six of them abscesses developing from infected sebaceous cysts. P. micros was usually isolated from soft tissue abscesses, never from the skin, and with a characteristic mixed flora consisting of "Streptococcus milleri" and anaerobic gram-negative rods. P. heliotrinreducens was a rare isolate from similar specimens. P. asaccharolyticus was cultured from a wide variety of sites, typically mixed with both aerobes and anaerobes, and frequently from abscesses. Most isolates of P. anaerobius came from gastrointestinal or female genitourinary specimens, never from above the diaphragm and rarely from the skin; cultures were usually heavily mixed. Isolates of P. vaginalis and the "bGAL" group made up 11% of str ains and were usally cultured from superficial sites, P. vaginalis often from post-operative wound infections with Staphylococcus aureus.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗

The influence of a diet rich in wheat fibre on the human faecal flora.

The effect on the faecal flora of adding wheat fibre to a controlled diet in four healthy volunteers for a 3-week period has been observed. No change in the concentration of the bacteria in the bacterial groups counted was found, although there was a slight increase in total output associated with increased faecal weight. The predominant organisms in all subjects were non-sporing anaerobes, but the dominant species in each subject was different and was unaffected by changing the diet. Similarly, the concentration of faecal beta-glucuronidase detected in two subjects was unaltered and the concentration of clostridia able to dehydrogenate the steroid nucleus found in one subject was unaltered. It is suggested that the faecal microflora is not primarily controlled by the presence of undigested food residues in the large bowel.

Adult↗

Effect of eight growth media upon fermentation profiles of ten anaerobic bacteria.

A study was made of the influence of eight growth media upon the fermentation end-product patterns obtained with ten species of anaerobes. Acidic and neutral end-products of fermentation were analysed by gas chromatography and the results were examined statistically by computer. Differences in end-product profile were at least as great between different media used to grow a single anaerobic species, as between different anaerobes grown in a single type of medium. When individual fermentation end-products produced by a single anaerobe species were examined statistically significant differences were found between different media for individual end-products. It is concluded that standardisation of growth medium is essential in diagnostic laboratories concerned with identification of anaerobes with the aid of gas chromatography.

Anaerobiosis↗

Screening for bacterial vaginosis and cervicitis aimed at preventing premature delivery.

OBJECTIVE: We performed screening and treatment of bacterial vaginosis and cervicitis during pregnancy for prevention of premature delivery. The incidence and the etiology of lower genital tract infections and premature delivery were examined to elucidate the effectiveness and problems of this trial. METHODS: Three hundred sixty-five pregnant women who attended the obstetrical outpatient clinic in our hospital were included as subjects. The screening was done at prenatal-care visits around the 10th, 20th, and 30th gestational weeks. RESULTS: Fifty-eight women were diagnosed as bacterial vaginosis and 54 women were successfully treated. Thirty-five women were diagnosed as cervicitis and all were cured. Nine women (2.5%) delivered before the 37th gestational week and 1 women delivered before the 35th gestational week because of cervical incompetence. CONCLUSIONS: The treatment of bacterial vaginosis and cervicitis may prevent microbes in the lower genital tract from penetrating the intrauterine cavity and thereby reduce the incidence of premature delivery.

Adolescent↗

Qualitative and quantitative changes of the vaginal microbial flora during the menstrual cycle.

Knowledge of the normal vaginal microbial flora is essential in understanding the etiology of female genital tract infections. This study was done to investigate both qualitative and quantitative differences that occur during the menstrual cycle. We studied 34 reproductive age women longitudinally. Quantitative cultures were obtained during menses and following the cessation of menses. A greater variety of organisms were found during menstruation. The effect was not selective with respect to aerobes or anaerobes. The total number of bacteria between the two culture periods did not change significantly.

Adult↗

Comparison of methods for isolation of anaerobic bacteria from clinical specimens.

Five different anaerobic culture methods and several different media were compared for their ability to recover anaerobes from clinical specimens. Specimens were obtained from patients with documented infections, avoiding contamination with normal flora, and immediately placed in an anaerobic transporter. Each specimen was cultured by all methods and on all the various media. The comparative data indicate that anaerobic jars (GasPak and evacuation-replacement types) are just as effective in the recovery of clinically significant anaerobes as the more complex roll-tube and chamber methods employing prereduced media. Liquid media were disappointing as a "back-up" system but chopped-meat glucose was superior to two thioglycolate formulations. Growth of all anaerobes was poorer on selective media, but these media were very helpful in the workup of specimens containing mixed growth of anaerobic and facultative organisms. A variety of different anaerobes was isolated, but no very fastidious or extremely oxygen-sensitive organisms were recovered. This suggests that such organisms may not play a significant role in causing clinical infections.

Abscess↗

Human fecal flora: the normal flora of 20 Japanese-Hawaiians.

Quantitative and qualitative examination of the fecal flora of 20 clinically healthy Japanese-Hawaiian males was carried out by using anaerobic tube culture techniques. Cultural counts were 93% of the microscopic clump counts. Isolated colonies were selected in a randomized manner to give an unbiased sampling of the viable bacterial types. Each isolate was characterized for species identification. From a total of 1,147 isolates, 113 distinct types of organisms were observed. Statistical estimates indicate that these types account for 94% of the viable cells in the feces. The quantitative composition of the flora of this group of people, together with differential characteristics of previously unreported species, is presented for those kinds of bacteria which each represented at least 0.05% of the flora.

Anaerobiosis↗

Growth curves of anaerobic bacteria in solid media.

Simple pour plate and spectrophotometric techniques for the evaluation of growth curves of several anaerobic bacteria on solid media are described. Three basic patterns of anaerobic growth were observed. The curves obtained were very reproducible when studied on separate occasions. The curves obtained by spectrophotometric measurement were comparable to those obtained by the pour plate method, especially when a large bacterial inoculum was used. Limitations in the interpretation of the results are discussed. The methods and principles reported could provide the basis for the determination of bacterial growth on solid media using other organisms and different experimental conditions.

Agar↗

Susceptibility of brain to aerobic, anaerobic, and fungal organisms.

The utility of an experimental animal model is dependent on its ability to simulate the actual clinical situation. With a stereotaxic injection procedure, the susceptibility of rat brain to the spectrum of organisms commonly associated with human brain abscess was determined. Two strains of Escherichia coli were more infective than Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pyogenes. Even between the E. coli strains it was possible to document significant differences in degree of infectivity. The E. coli strain with the K-1 capsular polysaccharide was significantly more infective than the E. coli strain without the capsular polysaccharide. The brain was also susceptible to Candida albicans, but at a level higher than any of the aerobic bacteria examined. Brain infection could not be created when microaerophilic or obligately anaerobic organisms alone were injected.

Animals↗

Total synthesis of acetate from CO 2 . V. Determination by mass analysis of the different types of acetate formed from 13 CO 2 by heterotrophic bacteria.

Mass analysis was used to determine the amount of acetate which is totally synthesized from (13)CO(2) during fermentations by Clostridium formicoaceticum, C. acidiurici, C. cylindrosporum, Butyribacterium rettgeri, and Diplococcus glycinophilus. In the fermentation of fructose by C. formicoaceticum, 27% of the acetate was found to be totally synthesized from CO(2), and the remaining acetate was unlabeled, having been formed from fructose. Evidence is presented that the purine-fermenting organisms, C. acidiurici and C. cylindrosporum, totally synthesized about 9% of the acetate from CO(2), and that the methyl group of an additional 9% was formed from CO(2). The remaining acetate was formed from the carbons of the purine and not via CO(2). It has been postulated that the fermentation of the purines and synthesis of acetate from CO(2) both occur via derivatives of tetrahydrofolate. Evidence is presented that a compartmentalization of these folate intermediates is required if both the purine degradation and the CO(2) utilization involve identical intermediates. Neither B. rettgeri nor D. glycinophilus incorporated sufficient (13)CO(2) into acetate to allow determination of the types of acetate by mass analysis, although they did incorporate labeled (14)CO(2) in both positions of acetate.

Acetates↗

Distribution of xanthine oxidase and xanthine dehydrogenase specificity types among bacteria.

A diverse collection of xanthine-metabolizing bacteria was examined for xanthine-, 1-methylxanthine-, and 3-methylxanthine-oxidizing activity. Both particulate and soluble fractions of extracts from aerobically grown gram-negative bacteria exhibited oxidation of all three substrates; however, when facultative gram-negative bacteria were grown anaerobically, low particulate and 3-methylxanthine activities were detected. Gram-positive and obligately anaerobic bacteria showed no particulate activity or 3-methylxanthine oxidation. Substrate specificity studies indicate two types of enzyme distributed among the bacteria along taxonomic lines, although other features indicate diversity of the enzyme within these two major groups. The soluble and particulate enzymes from Pseudomonas putida and the enzyme from Arthrobacter S-2 were examined as type examples with a series of purine and analogues differing in the number and position of oxygen groups. Each preparation was active with a variety of compounds, but the compounds and position attacked by each enzyme was different, both from the other enzymes examined and from previously investigated enzymes. The soluble enzyme from Pseudomonas was inhibited in a competitive manner by uric acid, whereas the Arthrobacter enzyme was not. This was correlated with the ability of Pseudomonas, but not Arthrobacter, to incorporate radioactivity from [2-14C]uric acid into cellular material.

Actinomycetales↗