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Antibiotic therapy for the Bacteroidaceae in post-cesarean section infections.

One hundred patients were treated for postpartum endometritis with ampicillin and clindamycin. Fifty patients were analyzed retrospectively and 50 prospectively for therapeutic response and development of late infectious sequelae. Seventy-eight patients exhibited an acceptable clinical response. One patient developed a wound infection from Staphylococcus aureus, which responded to drainage. The remaining 21 patients responded to the addition of an aminoglycoside. No patient developed a pelvic abscess or septic thrombophlebitis. The therapeutic response of the 2 groups treated with ampicillin and clindamycin is contrasted with the results derived from the traditional antibiotic regimen of a penicillin and an aminoglycoside.

Ampicillin↗

Roles of mucosal bacteria and succinic acid in colitis caused by dextran sulfate sodium in mice.

Intestines of mice with colitis caused by dextran sulfate sodium (DSS) contain more Bacteroidaceae cells than untreated controls. We investigated the roles of intestinal bacteria and succinic acid, a by-product of Bacteroidaceae metabolism, in this model of colitis. CBA/J mice were given 3% DSS in water for 14 days. After mice were anesthetized and killed, concentrations of organic acids in stools from the cecum and colon were measured. The resected rectum and colon were washed with sterile saline; some specimens were incubated with imipenem in saline for 1 h to kill bacteria on the surfaces and others were not. Their homogenates were cultured anaerobically and aerobically. Separately, 1 mL of 20 mM succinic acid was infused into the rectum of mice, whose anal verge was glued. Animals were anesthetized and killed the next day. The rectum and colon were examined histologically. Concentrations of succinate were higher everywhere in the colon of mice with colitis than in controls. Mice with colitis had more Bacteroidaceae cells, especially B. caccae, than controls. Mice given succinate enemas had focal erosions of the mucosa and edema of the submucosa. Succinic acid, produced abundantly by members of the family Bacteroidaceae, especially B. caccae, may be the ulcerogenic agent in DSS colitis.

Acetates↗

Controlled evaluation of the effect of atmosphere of incubation on detection of bacteremia and fungemia in supplemented peptone broth.

To evaluate the role of atmosphere of incubation in the detection of clinically important bacteremia and fungemia in adults, we compared the yield of microorganisms from 10,541 paired 5-ml samples of blood incubated aerobically and anaerobically. The medium, supplemented peptone broth (SPB) with 0.03% sodium polyanetholesulfonate, and the ratio of blood to broth (1:10) were the same for all cultures. Only cultures with adequate blood samples (greater than or equal to 80% of stated volume) were compared statistically. More fungi (P less than 10(-7) ) grew in continuously vented bottles of SPB. Aerobic incubation also favored (P less than 0.01) isolation of Neisseria gonorrhoeae and Eubacterium; more than 80% of these bacterial organisms were detected only in vented bottles. Anaerobic incubation (plugged venting units) did not significantly favor the isolation of any genus of microorganisms, although an estimated 11% more Bacteroidaceae grew in the unvented bottle of SPB. By comparison of our data with published results for other media, we conclude that the need for both aerobic and anaerobic incubation of blood cultures is dependent upon the medium used and the microorganisms likely to be encountered. Vented incubation of blood cultured in SPB is crucial for detection of fungi and some bacteria. Routine use of an unvented bottle of SPB may not be worthwhile for patients in whom Bacteroidaceae cause bacteremia infrequently. However, when Bacteroidaceae are suspected as the cause of sepsis, use of an unvented bottle of SPB is prudent.

Bacteria↗

Effect of dietary short-chain fructooligosaccharides on the cecal microflora in gastrectomized rats.

Total gastric resection is known to lead to changes in the microflora in the whole gastrointestinal tract. Dietary short-chain fructooligosaccharides (Sc-FOS) have been shown to also induce a change in the microflora in the large bowel by promoting an increase in the numbers of Bifidobacterium and Lactobacillus which have beneficial effects on the host. In the present study, 4-week-old male Sprague-Dawley rats received total gastrectomy or laparotomy, and each of these surgically treated groups was randomly divided into two experimental diet groups and given a 7.5% Sc-FOS diet or control diet. Enumeration and identification of the cecal bacteria was performed by using selective and non-selective media. In the gastrectomized rats, the total bacterial count, and the counts of Bacteroidaceae and Enterobacteriaceae were higher than those in the sham-operated rats. Sc-FOS promoted an increase in the numbers of Bifidobacterium and Lactobacillus, In the rats fed on the Sc-FOS diet, the predominant type of bacteria was Lactobacillus and in the rats fed on the control diet, it was Bacteroidaceae irrespective of gastrectomy. We confirmed that both gastrectomy and dietary Sc-FOS changed the composition of cecal microflora in the rats. Dietary Sc-FOS in the gastrectomized rats increased the proportions of Lactobacillus relative to other types of bacteria to levels similar to those seen in healthy normal rats, and decreased the proportion of Bacteroidaceae.

Animals↗

Qualitative and quantitative differences in normal vaginal flora of conventionally reared mice, rats, hamsters, rabbits, and dogs.

We examined quantitatively the vaginal flora of conventionally reared mice, rats, hamsters, rabbits and dogs, species that are widely used as laboratory animals. Vaginal specimens were examined according to the method of analyzing intestinal flora (Mitsuoka's procedure). The total number of bacteria (aerobes and anaerobes) and the prevalence of specific bacteria were determined. The total number of bacteria was highest during estrus and lowest during diestrus or anestrus in mice, rats, hamsters, and dogs. The most predominant bacteria during estrus were streptococci in mice; gram-negative rods (GNR), streptococci, and members of the family Bacteroidaceae in rats; GNR, Bacteroidaceae and gram-positive anaerobic cocci in hamsters, and Bacteroidaceae in dogs. The increase in the total number of bacteria during estrus was caused by an increase of predominant bacteria in the vagina. Aerobes were more predominant than anaerobes in mice, and number of aerobes was comparable to that of anaerobes in rats and dogs. On the other hand, in hamsters, anaerobes were more predominant than aerobes and the total number of bacteria was highest among the laboratory animals (mice, rats, hamsters, rabbits, and dogs). However, in rabbits, bacteria were not isolated from about 90% of the vaginal specimens. Rabbits do not have cyclic reproductive stages and are usually in precoital status in the laboratory. In precoital rabbits, vaginal epithelium manifests few signs of secretion. Therefore, we suspect that the vaginal environment in precoital rabbits is comparable to that during diestrus or anestrus in mice, rats, hamsters, and dogs. These results suggest that the vaginal flora of laboratory animals is influenced by the estrous cycle, and probably by mucous secretion. Our data imply that vaginal flora differ among laboratory animals species, and researchers need to take into consideration the estrous cycle of laboratory animals when studying their vaginal flora.

Animals↗

Normal vaginal flora in chimpanzees (Pan troglodytes): qualitative and quantitative study.

Lactobacilli are the predominant microorganisms in the vaginal flora of human beings, and are known to play an important role in protecting them from genital infections. On the other hand, the composition of the vaginal flora differs among laboratory animal species, and lactobacilli are not the predominant vaginal microorganism in many laboratory animals. We speculated that the vaginal flora of chimpanzees would be more similar to those of human beings than to those of other animal species, because chimpanzees are phylogenetically close to human beings, and their reproductive physiology is similar to that of human beings. To clarify our speculation, we examined the development of the vaginal flora in chimpanzees (Pan troglodytes). Streptococci, lactobacilli, and members of the family Bacteroidaceae were the most predominant bacteria in the vagina of mature chimpanzees (9 to 22 years old). During development of the vaginal flora of chimpanzees, the total number of bacteria increased with age and reached a plateau just before sexual maturity (5 to 7 years of age; juvenile period). Lactobacilli were already one of the predominant bacteria before sexual maturity. In mature chimpanzees, the total number of bacteria (aerobes and anaerobes) in the vagina was highest during the swelling phase of the menstrual cycle. During the swelling phase in mature chimpanzees, streptococci, lactobacilli, and Bacteroidaceae were the most frequently isolated (100%) organisms, and the total number of organisms recovered from vaginal specimens from these three groups was the highest. In mature chimpanzees in which the number of bacteria was the highest, lactobacilli were the predominant bacteria. Taken together, these results suggest that these three bacterial groups (streptococci, lactobacilli, and Bacteroidaceae) are indigenous to the vagina of chimpanzees, and chimpanzees would be the most suitable laboratory animals for studying the role of lactobacilli in the vagina of human beings.

Age Factors↗

Indirect fluorescent antibody procedure for the rapid detection and identification of Bacteroides and Fusobacterium in clinical specimens.

An indirect fluorescent antibody (IFA) technique was evaluated as a procedure for rapid detection and identification of members of the Bacteroidaceae. Antisera were prepared against 31 members of this family, including species of Bacteroides and Fusobacterium commonly isolated from human infections. The antisera had demonstrated species and/or subspecies specificity. Thirty clinical specimens were studied. Of 13 specimens yielding Bacteroidaceae, for which antisera were available, 23 were presumptively diagnosed by IFA to contain subspecies of B. fragilis and/or Fusobacterium species. Of 17 specimens yielding negative culture results, two were positive by IFA on direct smear. Frequently the in vivo morphology of cells detected in direct smears by this procedure closely mimicked that of cellular debris, tissue cells, and leukocytes. Polyvalent antisera pools facilitated use of the IFA procedure as a practical tool for rapid diagnosis of infections involving the Bacteroidaceae.

Animals↗

Methodological implications of testing anaerobe susceptibility to cephalosporins (cefazolin, cefamandole, cefoxitin).

By simultaneously performing broth dilution, agar dilution, and agar diffusion tests with Bacteroidaceae and Peptococcaceae, the influence of methodology upon the outcome of susceptibility testing to cefazolin, cefamandole and cefoxitin was studied. With beta-lactamase positive and negative Bacteroidaceae, the results of the broth dilution and agar dilution tests were in good agreement for cefoxitin. However, when tested with cefaxolin and cefamandole, beta-lactamase positive Bacteroides strains had mostly high broth dilution MICs and relatively low agar dilution MICs. The statistical analysis of the relationship between zone size and broth dilution or agar dilution MICs frequently showed lack of stochastic linearity or relatively low correlation coefficients.

Bacteroidaceae↗

Microbial findings of deep peri-implant bone defects.

The objective of this study was to examine inflammatory tissue in deep peri-implant bone pockets (> 5 mm) for anaerobic bacteria colonization. The peri-implant inflammatory tissue of bone defects from 12 edentulous patients with 18 unsuccessful implants (IMZ type) was removed after surgical opening of the defects. After grinding the tissue with glass beads in nutrient solution, an aliquot of the suspension was plated and incubated on appropriate culture media. The quantitative and qualitative distribution of bacteria as a function of the tissue dry weight was determined (cell count/mg dry weight). The mean total cell count was 67 x 10(3) cells/mg dry weight. The following bacteria dominated: species of the family Bacteroidaceae (Prevotella intermedia, Prevotella buccae, Prevotella oralis, Prevotella melaninogenica, Prevotella denticola); Actinobacillus actinomycetemcomitans; Fusobacterium nucleatum; Capnocytophaga spp; and Eikenella corrodens. Bacteroidaceae and Actinobacillus actinomycetemcomitans were found particularly frequently. The increased colonization of these bacteria in deep peri-implant bone pockets is consistent with the currently held view of advanced periodontal lesions, whereby certain pathogens grow at a disproportionate rate in comparison with the total bacteria count under specific circumstances.

Aged↗

Quantitative bacteriology of the vaginal flora in vaginitis.

Vaginal flora was studied quantitatively in 29 sexually active women, 16 to 33 years of age, to define the role of C. vaginale in vaginitis. Seventeen were asymptomatic and 12 complained of symptoms of vaginitis. Seven asymptomatic women had scant secretions: four of these seven had C. vaginale at log10 6 to 9 CFU per milliliter, none of whom had "clue" cells; none had trichomonas or candida; six had lactobacilli at log10 7 to 9.7 per milliliter; only one had Bacteroidaceae at greater than log10 5 per milliliter. Ten asymptomatic women had easily collectable secretions; eight of 10 had C. vaginale at log10 6.5 to 9.6 per milliliter, three of whom had "clue" cells; four had trichomonas and none candida; nine had Lactobacilli at log10 7 to 9.3 per milliliter; four had Bacteroidaceae at greater than log10 5 per milliliter. Twelve had vaginitis: five of 12 had C. vaginale at log10 7.9 to 11 per milliliter, one of whom had "clue" cells; nine had either trichomonas or candida or both and three had no pathogen, including C. vaginale; 10 had Lactobacilli at log10 7 to 10 per milliliter; six had Bacteriodaceae at greater than log10 5 per milliliter. Three had "clue" cells in absence of C. vaginale.

Adolescent↗

Production of amylase by the intestinal microflora in cultured freshwater fish.

The amylase-producing ability of the intestinal microflora in cultured specimens of ayu, carp, channel catfish, Japanese eel and tilapia was determined. Mean viable counts of aerobes and anaerobes ranged from 1.1 x 10(6) to 3.7 x 10(8) cfu g-1 and from 1.3 x 10(3) to 1.6 x 10(8) cfu g-1, respectively. Aeromonas spp. and Bacteroidaceae were predominant in four to five fish species. Of 206 strains examined, 65 (31.6%) produced > or = 0.01 U amylase ml-1. The percentage of producers differed among families and genera of bacteria and fish species. While 56% of the anaerobes produced amylase, only 20% of the aerobes did. More than 50% of Aeromonas, Bacteroidaceae and Clostridium strains produced amylase efficiently while Acinetobacter, coryneforms, Enterobacteriaceae, Moraxella, Plesiomonas and Streptococcus strains did not. High amylase production (> or = 0.05 U ml-1) was found in 12 strains, 11 from Aeromonas and one Pseudomonas. The percentage of high amylase producers in Japanese eel was lower than the other four fish (2-30%). These results strongly suggest that the amylase produced by the intestinal microflora play an important role in the digestion of starch in freshwater fish to some extent.

Amylases↗

Antibody response to anaerobic bacteria.

Anaerobes, especially the gram-negative non-spore-forming bacilli of the indigenous biota, are recognized as important agents of clinical infection; however, information regarding human antibodies to anaerobes is limited. Sporadic work, employing agglutination, gel diffusion, passive hemagglutination, and immunofluorescence, demonstrated antibody response to various Bacteroidaceae in patients with infections caused by Bacteroides or Fusobacterium. Because of the need for using homologous (autologous) isolates and the apparent antigenic heterogeneity of strains, there has been no general clinical application of these findings. Increased concentrations of antibodies to anaerobic intestinal organisms in chronic inflammatory bowel diseases have been found; however, it is unclear whether these are the effect or cause of these conditions. Natural antibodies to Bacteroidaceae, primarily of the IgM class, are widely distributed in normal humans; thus for serologic diagnosis IgG antibodies should be sought. Radioimmunoassays and various immunoelectorphoretic methods for detection of both antibody and antigen are presently being evaluated for diagnostic use in infections due to anaerobic bacteria.

Antibody Formation↗

A reassessment of the microbial flora of the female genital tract, with special reference to the occurrence of Bacteroides species.

Two hundred and twelve randomly selected vaginal or uterine cervical specimens were investigated for the presence of anaerobic and aerobic bacteria and yeasts. Anaerobes of possible clinical significance, including Bacteroidaceae, Peptococcaceae and clostridia were isolated from 34% of the specimens and were identified to specific or generic level. Among the Bacteroidaceae isolated, B. bivius was the most common, followed by other propionate-negative species. Members of the Bacteroides fragilis group were seldom isolated. Of the aerobic or facultatively anaerobic isolates, enterococci and Escherichia coli were most often found. The results show that clinically significant anaerobes, especially Bacteroides species, are not regular members of the vaginal flora and that the species distribution of anaerobes occurring in the genital tract is significantly different from that of the intestinal tract.

Bacteria↗

Production of chitinase and beta-N-acetylglucosaminidase by intestinal bacteria of Pinnipedian animals.

The chitinase- and beta-N-acetylglucosaminidase(GlcNAcase)-producing ability of intestinal bacteria from Pinnipedian animals was determined using fluorogenic 4-methylumbelliferone glycosides of N-acetylglucosamine oligosaccharides. Intestinal microflora of a single Cape fur seal, three California sea lions and three South American sea lions were characterized by a predominance of isolates of the Bacteroidaceae and Enterobacteriaceae families and the genus Clostridium. Of the 711 isolates tested 26.0, 10.0 and 8.7% could hydrolyse 4-MU(GlcNAc)1, 4-MU(GlcNAc)2 and 4-MU(GlcNAc)3, respectively. This result suggests that beta-GlcNAcase producers occur at a higher density than do chitinase producers. Moreover, beta-GlcNAcase, and to a lesser degree, chitinase seem to be efficiently produced by facultative anaerobes in the Cape fur seal and the California sea lion, and by both facultative and obligated anaerobes in the South American sea lion. To our knowledge, this is the first paper to report that isolates of the family Bacteroidaceae and the genus Streptococcus produce chitinase and/or beta-GlcNAcase.

Acetylglucosaminidase↗