An unique presentation of sickle cell disease: pyogenic hepatic abscess.
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Anaerobic bacteria are classified using presence or absence of phospholipase and lipase, among other criteria. Techniques are described for the qualitative and quantitative detection of bacterial esterases (carboxylic ester hydrolase) and lipases (triacylglycerol acyl hydrolase) endo- or -exocellular, using gas liquid chromatographic method. Results with representatives anaerobic species are briefly presented.
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This review is concerned with anaerobic bacteria and antimicrobial susceptibility. Data on the susceptibility to different antimicrobials of anaerobic isolates in Sweden during 1983 is presented. Among the different bacterial groups, Clostridium perfringens, propionibacteria, anaerobic cocci and curved rods were found to be susceptible to beta-lactam antibiotics, clindamycin and chloramphenicol. C. difficile was susceptible to benzylpenicillin and imipenem, but resistant to cefoxitin. Most C. difficile strains were also susceptible to clindamycin and fusidic acid, while all strains were susceptible to metronidazole and vancomycin. The majority of the fusobacteria were susceptible to beta-lactam antibiotics, clindamycin, metronidazole and chloramphenicol. However, some strains were found to be resistant to penicillins. Against the Bacteroides fragilis group, clindamycin, chloramphenicol, metronidazole and imipenem had the best activity, whereas piperacillin and cefoxitin showed good activities. Most Bacteroides non-fragilis strains were susceptible to the antimicrobials tested. However, an increasing number of isolates were found to be resistant especially to penicillins when comparing with data from the last five years.
The identification of anaerobic bacteria to the species level can be a laborious and time consuming procedure. Gas chromatography offers a diagnostic aid, and the advantages of the recently introduced head-space gas chromatography technique are: it is rapid, accurate and easy to perform; it provides more information of differential diagnostic value; and the identification process can be automated by connecting the head-space gas chromatograph to an automatic injection unit and a computer which interprets the chromatograms. The head-space technique may be used for direct analyses of clinical specimens for rapid diagnoses of anaerobic infections.
Compared with second-generation cephalosporins, cefoperazone, a third-generation cephalosporin, has demonstrated an extended antibacterial spectrum. In addition, it has a long serum half-life and requires only twice-a-day administration. In this study, 66 patients with clinically diagnosed obstetric and gynecologic infections were treated with cefoperazone, and 61 were evaluated for efficacy. An overall cure rate of 93% (57 patients) was achieved. In view of the excellent clinical response and convenience of twice-a-day administration, we conclude that cefoperazone is a clinically useful single agent for the initial empirical treatment of patients with obstetric and gynecologic infections.
Twenty-nine isolates of anaerobic bacteria from foot infections in diabetic patients were tested, using the agar dilution method, for in vitro susceptibility to nine antimicrobial agents. Imipenem and metronidazole showed excellent activity; clindamycin and chloramphenicol were next in terms of efficacy. Cefoxitin and moxalactam demonstrated good activity, although three isolates of the Bacteroides fragilis group were resistant to moxalactam. Penicillin G, cefotaxime, and cefoperazone showed poor activity against the B fragilis group but were quite active against other anaerobes. Among the newer beta-lactam antibiotics studied, imipenem, cefoxitin and, to a lesser extent, moxalactam appear promising for clinical use as anti-anaerobic antibiotics in the treatment of foot infections in diabetic patients.