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PubMed1989

[Effectiveness of ClNa-esculin broth for the rapid identification of the Enterococcus genus].

The efficacy of the ClNa-esculine broth for the rapid identification (2 hours) of the species of the genus Enterococcus was evaluated and compared with the conventional biochemical methods requiring an incubation of 18-24 hours. Out of the 274 evaluated strains, 171 were positive for this investigation; 160 of them corresponded to Enterococcus spp (100%). The sensitivity of the test was 100%, the specificity 99.1%, the positive predictive value 99.3% and the negative predictive value 100%.

Culture Media↗
PubMed1989

Hospital-acquired urinary tract infection.

From 16,534 admissions, 60 patients, 4 days to 15 years of age, with one or more hospital-acquired urinary tract infections were identified during a 5-year period by a prospective surveillance system. The patient charts were subsequently reviewed to characterize the population at risk for such infections and to describe the course and consequences of these infections. Infections in individual patients ranged from one to greater than 50. The hospital-acquired urinary tract infection rate for the study period was 14.2 infections per 1,000 admissions. In the patients in whom all urinary tract infections were well documented, the following characteristics were defined: (1) 92% (97 of 105) of the infections occurred in catheterized patients; (2) almost half (49 of 105) of the infections occurred in patients exposed to only intermittent catheterization; (3) 28% (29 of 105) of the infections were asymptomatic; (4) fever was the most frequent finding in the symptomatic patients and occurred in 66% (60 of 105); (5) pyuria was found in only 51% (35 of 69) of the urinalyses performed at diagnosis; (6) 85% (89 of 105) of the infections were single-organism infections; (7) 82% (101 of 123) of the causative organisms were Escherichia coli, Pseudomonas sp, coagulase-negative staphylococci, Enterococcus spp, Klebsiella spp, or Enterobacter sp. The urinary tract infections in the 60 patients were not complicated by bacteremia, and no direct relationship between the infections and the minimal mortality in our patients could be established.

Adolescent↗
PubMed1988

Cefpodoxime proxetil, its in vitro antibacterial activity, affinity to bacterial penicillin-binding proteins, and synergy of bactericidal activity with serum complement and mouse-cultured macrophages.

Cefpodoxime proxetil (CS-807) is an orally active prodrug of an oxime-type cephem antibiotic. The MIC60 values of cefpodoxime (R-3746) the active form of CS-807, were 3.13, 6.25, 0.05, 0.38, 0.2, 0.1, 3.13, 3.13, 6.25, 6.25, 0.1 and 12.5 micrograms/ml against S. aureus, coagulase-negative staphylococci, S. pneumoniae, E. coli carrying R plasmids, P. vulgaris, P. rettgeri, C. freundii, S. marcescens, A. calcoaceticus, P. cepacia, ampicillin-resistant H. influenzae and B. fragilis, respectively. Its activity was stronger than that of cefaclor and ampicillin. R-3746 manifested little activity against P. aeruginosa, methicillin-resistant S. aureus, and Enterococcus spp. R-3746 showed stronger binding affinity than cefaclor with the PBP2 of S. aureus, PBPs 1a, 1bs, 2 and 3 of E. coli, PBPs 1b, 1c and 3 of P. rettgeri, and the PBP3 of P. aeruginosa than cefaclor. Synergy of the bactericidal effect between R-3746 and serum complement was moderate, although the cells of E. coli NIHJ-JC2 and S. aureus 209P were well engulfed and rapidly digested by mouse-cultured macrophages in the presence of greater than 1/8 MIC of R-3746. Good clinical efficacy can be expected of CS-807 provided its pharmacokinetics prove to be good.

Bacteria↗
PubMed1984

Aztreonam versus cefamandole in the treatment of urinary tract infections.

The in vivo efficacy and safety of aztreonam compared to that of cefamandole was randomly and prospectively studied in the treatment of 30 patients suffering from recurrent urinary tract infections with a patient ratio of 2 aztreonam to 1 cefamandole. The mean age was 51.6 +/- 15.4 and 59.8 +/- 13 years respectively. Both antibiotics were given at a dose of 1 g, 8 hourly i.m. for 7-13 days. Sixty-seven percent versus 70% of the patients given aztreonam and cefamandole respectively were suffering from upper urinary tract infections. X ray abnormalities predisposing to relapse or reinfections were present in 88% vs 80% of the patients, while all patients had typical symptoms of urinary tract infections, with high fever (greater than or equal to 38.5 degrees C) reported in 70% and 60% of the patients in the two treatment groups respectively. Escherichia coli and Proteus mirabilis were the predominant isolates in urine cultures. During treatment all patients responded favourably both clinically and bacteriologically, while after a 6-week follow-up 20% versus 30% relapsed clinically with 15% vs 30% bacteriologic relapses in the two groups, but only in patients suffering from upper urinary tract infections. No development of bacterial resistance was observed in the relapses, while mainly Enterococcus spp was implicated in reinfections. No appreciable side effects of toxicity were observed. It was concluded that aztreonam is a promising new antibiotic that deserves further clinical trials in systemic infections.

Adolescent↗
PubMed1995

[Escherichia coli, other Enterobacteriaceae and additional indicators as markers of microbiologic quality of food: advantages and limitations].

The 93/43 European Union directive assigns to the food and catering industries the main responsibility for an integrated safety and quality assurance strategy in the food chain. Relying on hazard analysis, followed by design and adoption of control of all critical points and practices ("HACCP"). Hiatus-free compliance with such HACCP-based Codes of Good Practices is to be assessed by monitoring, recording results on process performance charts and gauging such data against experimentally established, attainable and maintainable references ranges ("standards"). Marker microorganisms are a major analytical tool for validating compliance in the sense of the EU directive. They should be expertly chosen amongst microbes usually present in food so that their, whose presence in quantities exceeding predetermined levels point to a lack of microbiological integrity of a food product. This may encompass (i) the potential presence of taxonomically, physiologically and ecologically related pathogens, markers are called index organisms; or else (ii) a lack of process integrity; in this case, markers are termed indicator organisms. The classical index organism was E. coli, introduced in the 1980's to monitor drinking water supplies. It is still used as an appropriate marker to assess the bacteriological safety of raw foods. In the 1920's the coli-aerogenes ("coliform") group was adopted as an indicator to validate the adequate processing, i.e. pasteurization of dairy products. Since the 1950's the entire Enterobacteriaceae taxon is preferred for the latter purpose because it is better defined in determinative sense and includes more organisms of significance. In some food and water supplies, processed for safety, more vigorous or more resistant organisms than the Gram-negative rods are reliable supplementary markers. These include Enterococcus spp., spores of the Clostridium genus, and bacteriophages of E. coli and Bacteroides fragilis mimicking the fate of enteric viruses under particular ecological conditions. Population surveys conducted by the authors provided ranges for epsilon-factors. Those factors were defined as the proportion between colony forming units (cfu) numbers of index organisms and the pathogenic agent to whose potential occurrence they are expected to point. Epsilon factor values obtained for thermotropic Enterobacteriaceae in relation to Salmonella spp. allow the calculation of the probability that the pathogen has been reliably eliminated by the processing of initially contaminated raw materials, when cfu's of the marker organisms remain below a reference range previously fixed.

Enterobacteriaceae↗
PubMed1994

[Therapy and prevention of infective endocarditis].

Antibiotic therapy has improved infective endocarditis prognosis. The observance of general rules to choose the more suitable antibiotic drugs, as regard to their effectiveness, pharmacodynamic peculiarities and use, is mandatory. If the infection is due to antibiotic resistant microorganisms, microbiological analyses to estimate the bactericidal effect of the antibiotics, must be carried out. Resistance to penicillins, oligopeptides and aminoglycosides makes endocarditis produced by Enterococcus spp difficult to treat. The identification of patients at risk for infective endocarditis after surgical and invasive instrumental procedures, allows to introduce antibiotic prophylaxis regimens which can reduce the probability of acquiring the disease.

Anti-Bacterial Agents↗
PubMed1994

Endemic necrotizing enterocolitis: lack of association with a specific infectious agent.

We conducted a comprehensive analysis of bacterial, parasitic and viral agents present in stool samples of 23 necrotizing enterocolitis cases and 23 matched and 10 random controls. Enterococcus spp., Staphylococcus epidermidis, and Escherichia coli were the most common aerobic bacterial species isolated. Astrovirus was identified in a stool sample from one control. Eight infants were bacteremic; in 7 of 8 the same organism was also present in the stool. No one bacterial species or strain (as identified by plasmid profile analysis) was associated with occurrence of illness. Plasmid analysis further suggested that each infant was colonized with his or her own distinctive aerobic bacterial flora. With the exception of isolates from two control patients which hybridized with a probe for diffuse adherence, no diarrheagenic E. coli was identified. Five (45%) of 11 case infants were colonized with coagulase-negative staphylococci (all S. epidermidis) that produced delta-hemolysin in vitro, as compared with 13 (87%) of 15 control infants. Necrotizing enterocolitis was not associated with an increased ability to ferment carbohydrate, as measured by in vitro beta-galactosidase activity. Our data do not support the hypothesis that endemic necrotizing enterocolitis in our institution is caused by a single infectious agent, nor was there evidence that previously proposed virulence mechanisms such as production of delta-hemolysin or increased in vitro carbohydrate fermentation play a critical role in disease occurrence.

Bacteriological Techniques↗
PubMed1994

[Current state of causative bacteria in infections diseases and trends in resistance to antimicrobial agents].

The current state of causative bacteria in infectious diseases and the trends in resistance to antimicrobial agents were mentioned. The commonest micro-organisms isolated from the blood and intravascular catheter tips were CNS, S. aureus and C. albicans. Significant urine culture isolates were E. coli and other enterobacteriaceae in uncomplicated UTI, and Enterococcus spp. and Pseudomonas spp. in complicated UTI with a urinary catheter. In respiratory tract infections (RTIs), H. influenzae, S. pneumoniae, B. catarrhalis, S. aureus and P. aeruginosa, were common causative organisms. Community-acquired pneumonia was mainly caused by H. influenzae, S. pneumoniae and B. catarrhalis. In common with hospital-acquired pneumonia, P. aeruginosa, S. aureus and enterobacteriaceae were the frequent microorganisms isolated. In anaerobic infections, the most common micro-organisms were B. fragilis and other B. fragilis group isolated from intra-abdominal focus of post operative patients. The trends in the antimicrobial susceptibility of isolates of common bacteria over a period of 5 years (1988-1992) have been monitored. The proportion of isolates of S. aureus resistant to CEZ, CMZ, FMOX, IPM or MINO has increased. There was no trend towards increased resistance among isolates of P. aeruginosa except for CBPC. The incidence of resistance to PCG, ABPC, EM and LMOX increased in isolates of S. pneumoniae and that of resistance to PIPC, CMZ, LMOX and IPM increased in those of B. fragilis group.

Anti-Bacterial Agents↗
PubMed1994

[Infection in patient with malignant disease].

The rate of infection in patients with malignant disease was significantly high than that of patients with benign disease. Enterococcus spp. was the most predominant organism isolated from patients with malignant disease, followed by Staphylococcus spp., Pseudomonas spp., Enterobacter spp. and Klebsiella spp. in order. From patients with benign disease, E. coli was the most predominant organism, followed by Gram negative anaerobes, and Klebsiella spp.. The rate of postoperative infection in the patients with malignant biliary disease was significantly high than that without a risk factor. The rates of bacterial isolation from intraoperative bile culture and wound swab were significantly higher in patient with malignant disease. These findings suggest that the utmost care should be exercised in patients with malignant disease in order to prevent intraoperative contamination with prophylactic antibiotic therapy covering the bacteria isolated from the bile.

Aged↗
PubMed1994

[Antibiotic activities of cefpirome against fresh clinical isolates resistant to multiple drugs].

Using multiple drug-resistant clinical isolates isolated since September 1992, minimum inhibitory concentrations (MICs) of cefpirome (CPR) were determined. Several control drugs were also used, and these MIC-determinations were made to determine the antibiotic activity of CPR. The obtained results are summarized as follows: 1. Antibiotic activities of CPR against methicillin-resistant Staphylococcus spp., Enterococcus faecalis, and benzylpenicillin-insensitive or resistant Streptococcus pneumoniae showed that expanded antibacterial spectrum of CPR and its enhanced antibiotic action against Gram-positive bacteria. We suggest that among the existing fourth-generation cephem antibiotics, CPR is "characteristically strong against Gram-positive bacteria". 2. Strong antibiotic activities of CPR were recognized against bacteria of family Enterobacteriaceae that were resistant to the third-generation cephems. The strong antibiotic activities appeared to be due to CPR's stability and decreased affinity for beta-lactamase. 3. Antibacterial spectrum of CPR was expanded against non-glucose fermented Gram-negative bacilli including Pseudomonas aeruginosa. It appears that this expansion of antibacterial spectrum is due to CPR's affinities for a wide range of penicillin-binding proteins as well as its improved permeability into tissues.

Cephalosporins↗
PubMed1993

Cefdinir: in vitro activity study and effect of human serum.

The in-vitro activity of cefdinir (Cl-983, FK482), an orally absorbed aminothiazole cephalosporin, was compared with that of penicillin, ampicillin, amoxycillin, amoxycillin/clavulanic acid (2/1), cefaclor, cefuroxime, cefixime, cefotaxime, vancomycin and erythromycin against 370 clinical isolates of Gram-negative and Gram-positive bacteria. Cefdinir was highly active against Staphylococcus aureus and S. epidermidis, inhibiting 90% of the strains at doses of 0.25 and 0.5 mg/l respectively. However, cefdinir was not active against methicillin-resistant S. aureus (range 16- > 128 mg/l). The respiratory pathogens Moraxella catarrhalis, Streptococcus pneumoniae, and S. pyogenes were also susceptible (MIC90 < or = 0.5 mg/l), but against Enterococcus spp. cefdinir displayed no useful activity. The common members of the family Enterobacteriaceae were susceptible (MIC90 < or = 1 mg/l), but those possessing chromosomal beta-lactamases were more resistant (MIC90 2-8 mg/l). The presence of human serum had little effect on MICs of cefdinir. These results indicate that cefdinir exhibited a wide spectrum for an oral cephalosporin and support its possible clinical use against susceptible pathogens in infections of the skin, soft tissue, respiratory and urinary tracts.

Anti-Bacterial Agents↗
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↗
PubMed2001

Prevalence of glycopeptide and aminoglycoside resistance in Enterococcus and Listeria spp. in low microbial load diets of neutropenic hospital patients.

Low microbial load diets for patients with haematological malignancy were examined for enterococci and listeria using pre-enrichment, enrichment and selective plating. Enterococci were highly prevalent and their ecology diverse; 100/211 samples yielded 132 isolates made up of 67 strains distinguishable by PFGE. Listeria monocytogenes was not found. Screening of enterococci for antibiotic resistance showed low level vancomycin resistance (6-12 microg/ml) in six isolates of E. gallinarum and high level streptomycin resistance (> or = 1000 microg/ml) in eight isolates from various foods. No strains showing high level glycopeptide or gentamicin resistance were found. The high prevalence of enterococci in food processed for safety indicates a possible route for the acquisition of antibiotic-resistant strains by vulnerable hospital patients.

Aminoglycosides↗
PubMed2002

Proficiency of Italian clinical laboratories in detecting reduced glycopeptide susceptibility in Enterococcus and Staphylococcus spp. using routine laboratory methodologies.

OBJECTIVE: To assess the ability of 59 clinical microbiology laboratories distributed throughout Italy to correctly identify and detect reduced susceptibility to glycopeptides in staphylococci and VanA-, VanB- or VanC-mediated glycopeptide resistance in enterococci. METHODS: Eight test strains comprising three staphylococci (S. aureus ATCC 29212 and two vancomycin-intermediate S. haemolyticus [11105301, 10030683Y]) and five enterococci (E. faecalis ATCC 29212, E. faecalis ATCC 51299 VanB, E. faecium AIB40 VanA, E. faecalis V583 VanB and E. gallinarum AIB39 VanC1) were distributed to 59 Italian clinical microbiology laboratories. Each isolate was blind-coded, and laboratories were instructed to identify the strains and test isolates for susceptibility to teicoplanin and vancomycin using their standard methods. Results were assessed against consensus test results obtained by a reference laboratory. In addition, to complement data interpretation, laboratories were asked to provide retrospective routine test results from their respective hospitals. RESULTS: All 59 laboratories participating in the study completed the susceptibility testing and provided data for analysis. A total of 53 laboratories provided retrospective routine data. Overall, laboratories were able to identify isolates to the genus level successfully. E. gallinarum and S. haemolyticus posed problems for species identification, with only 40.6 and 71.2%, respectively, of results reported correctly; most incorrect results were reported as 'other species'. For enterococcal test strains, VanA phenotypes were detected correctly by 96.6% of laboratories; VanB by 30.5% (E. faecalis ATCC 51299) and 88.1% (E. faecalis V583); and VanC1 by 67.8%. For staphylococcal test strains, 28.8% (S. haemolyticus 11105301) and 23.7% (S. haemolyticus 10030683Y) of the laboratories were able to detect reduced susceptibility to vancomycin. Errors in detecting vancomycin resistance in VanB and VanC1 enterococci were made with all methods, most noticeably by disk diffusion users. For staphylococci, most errors in reporting vancomycin-intermediate resistance occurred with disk diffusion and Vitek (software version 5.04) users. Overall, considerably fewer errors occurred with the detection of teicoplanin resistance, especially for staphylococci. For 1999, routine results show that 41/1749 (2.4%) of E. faecium, 220/11 180 (2.0%) of E. faecalis, 29/24 927 (0.12%) of S. aureus and 54/22 102 (0.24%) of coagulase-negative staphylococci were reported as resistant to vancomycin. CONCLUSION: Italian laboratories are able to identify staphylococci and enterococci adequately, although all methodologies used have problems in identifying E. gallinarum and coagulase-negative staphylococci to the species level. While VanA phenotypes were efficiently detected, problems were experienced in detecting VanB and VanC phenotypes. The majority of laboratories were unable to detect reduced vancomycin susceptibility in staphylococci adequately, especially with disk diffusion and older Vitek systems. Teicoplanin appeared useful as a marker for detecting vancomycin resistance, particularly with disk diffusion. Should enterococcal VanB or staphylococcal glycopeptide-intermediate phenotypes become prevalent in Italy, it is likely that they would be under-detected. New systems under development, such as Vitek2, should improve this situation.

Anti-Bacterial Agents↗
PubMed1987

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1985). II. Background of patients].

We have investigated relationships between patients' backgrounds and isolates from urinary tract infections in reference to various conditions, such as sexes, age distribution by sex, species of causative organisms by sex, age distribution according to species and types of infections, species and infections before and after treatment with antibacterial agents, and species and detected places. As for the relationship between sexes and types of infections, although simple urinary tract infections were consistently found at about 20% in men and at about 80% in women between 1981 and 1983, these infections were seen at 24.4% in men and at 75.6% in women in 1984, and at 26.6% and at 73.4% in 1985, indicating slight decreases in the ratio of women. By contrast, complex urinary tract infections were found in men at about 60-70% from 1981 up to 1985, regardless of the presence or absence of indwelling catheter. There were no noticeable changes according to age during this 5-year period in incidences of infections including simple urinary tract infection and complex urinary tract infection with or without indwelling catheter. Thus, backgrounds of patients with urinary tract infections, including sex, age and simple or complex infections, were fairly consistent throughout this period, while there were relatively large changes in species of isolates. Enterococcus faecalis was isolated at about 8% of both men and women in 1982 and 1983, but its isolation rates were increased to 22.5% of men and 17.9% of women in 1984. In 1985 this species was isolated in 14.9% of men and 7.6% of women, and in 11.2% of all patients. Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp. and Enterococcus spp. were detected at rates of 3.2%, 8.1%, 0.7% and 1.0%, respectively, and 24.2% of isolated strains were Gram-positive organisms. When species of isolates before treatment with antibacterial agents and their isolation rates were analyzed, it was found that the isolation rate of E. faecalis increased dramatically in 1983, and that this tendency was still seen in 1984. The isolation rate of Gram-positive organisms was 25% in 1984 and 24.3% in 1985. Escherichia coli was consistently isolated at about 40%, but, as far as simple urinary tract infections are concerned, its isolation rate decreased by about 10% in 1985, compared to 1982 and 1983. These results suggested that causative organisms for simple urinary tract infections became similar to those for complex urinary tract infections. In other words, isolates obtained from complex urinary tract infections before treatment were similar to those of simple infections.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗
PubMed2001

Plasmid and chromosomal basis of tolerance to cadmium and resistance to antibiotics in normal bovine duodenal bacterial flora.

Cadmium (Cd) tolerance and antibiotic resistance was studied in duodenal flora of 20 normal bovine samples. Twelve bacterial isolates (5 Staphylococcus spp, 4 Enterococcus faecalis, 2 Bacillus spp, and a Pseudomonas sp) were grown in Luria broth containing 0.05 to 0.8 mM of cadmium chloride (CdCl). All isolates displayed multiple antibiotic resistance, with 2 Enterococcus strains and Pseudomonas pickettii demonstrating resistance to 12/17 antibiotics tested. With the exception of Staphylococcus sp, all contained plasmid DNA. Curing to remove plasmid DNA determined if Cd tolerance and/or antibiotic resistance was plasmid or chromosomally mediated. None of the bacteria became sensitive to CdCl after curing, suggesting that tolerance was not plasmid-mediated. Six bacteria became sensitive to antibiotics after curing indicating that antibiotic2 resistance was plasmid mediated. Two of these bacteria became sensitive to multiple antibiotics; a Staphylococcus sp became sensitive to ampicillin, ceftiofur and cephalothin, and a Enterococcus strain became sensitive to neomycin, oxacillin, and tiamulin. All of the isolates were probed for the presence of known Cd-resistance genes (cadA, cadC, and cadD). DNA-DNA hybridization revealed cadA- and cadC-related sequences in chromosomal DNA of a Staphylococcus sp, an Enterococcus strain, and in plasmid DNA of another Staphylococcus sp. No cadD-related sequences were detected in any of the 12 isolates even under reduced stringency of hybridization.

Animals↗
PubMed2006

Antimicrobial and toxicological profile of the new biocide Akacid plus.

OBJECTIVES: Akacid plus is a new member of the polymeric guanidine family of disinfectants. It was especially developed to enhance the antimicrobial activity of this class with significantly less toxicity. The in vitro activity of Akacid plus compared with chlorhexidine digluconate and mupirocin was tested against a total of 369 recent clinical isolates. METHODS: The organisms tested by CLSI reference methods included the following: Staphylococcus aureus (98), Staphylococcus epidermidis (9), Bacillus spp. (2), Enterococcus faecalis (32), Klebsiella spp. (45), Enterobacter spp. (20), Escherichia coli (65), Salmonella spp. (6), Shigella spp. (2), Yersinia enterocolitica (1), Acinetobacter spp. (4), Proteus spp. (7), Pseudomonas aeruginosa (59), Stenotrophomonas maltophilia (4), Candida spp. (10) and Aspergillus spp. (7). In vitro selection of resistance to Akacid plus was carried out on 24 strains. Toxicological analyses were also performed. RESULTS: All tested agents were more effective against Staphylococcus spp. and Bacillus spp. than against E. faecalis and Gram-negative bacteria. The MIC90s of chlorhexidine and mupirocin showed a 4-fold and 32-fold increase for methicillin-resistant S. aureus in comparison with methicillin-susceptible strains, while MIC values of Akacid plus were similar for antibiotic-susceptible and multiresistant strains. Bactericidal action of Akacid plus was observed at 1-2x MIC. The in vitro selection of resistance test showed no increase in MIC values of Akacid plus for any isolate after 30 passages. In addition, Akacid plus showed low oral and dermal toxicity. CONCLUSIONS: These preliminary results demonstrate the broad antimicrobial properties of Akacid plus, which makes it a promising tool for topical application in the prophylaxis and treatment of bacterial and fungal infections.

Anti-Bacterial Agents↗
PubMed1998

Bacteriology of burns.

A retrospective study was undertaken at University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, to examine the bacterial isolates from the Burns unit and to determine the antibiograms of the isolates to commonly used antimicrobial agents. A total of 600 pus samples from as many patients received, over a period of 5 years (June 1993-June 1997) yielded 920) isolates. Pseudomonas spp. was the most common (36%) followed by Staphylococcus aureus (19%), Klebsiella spp. (15.54%), Proteus spp. (11.19%), Enterococcus faecalis (8.5%), Escherichia coli (5.10%), Acinetobacter spp. (1.1%), Salmonella senftenberg (0.8%) and other (3%). Pseudomonas spp. was the most susceptible to ceftazidime (83% susceptible) and cefoperazone (82% susceptible), whereas the drugs most effective in other Gram-negative organisms were amikacin, netilmicin and ciproflox. Vancomycin was effective in 100% of Gram-positive organisms. The infection of burn wounds with multiple organisms, with the superadded problem of drug resistance, necessitate the institution of a drug policy by the hospitals for burn patients.

Anti-Bacterial Agents↗