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PubMed2003

Antimicrobial effects of glass ionomer cements containing bioactive glass (S53P4) on oral micro-organisms in vitro.

The antimicrobial effects of two glass-ionomer cements (GICs), GC Fuji II and Fuji II LC, mixed with different amounts (0 wt%, 10 wt% and 30 wt% of the total powder weight) of bioactive glass (BAG), S53P4, on Streptococcus mutans and Candida albicans were studied in vitro. The growth inhibition was tested using agar diffusion. The materials were also studied in a liquid media. The effect of the material extracts on acid production was studied using cell suspensions. The antimicrobial activity of the materials was examined by incubating the cell suspensions with the material powder. In the agar diffusion test, only the GICs containing 30 wt% BAG inhibited the growth of S. mutans. When the materials were tested in culture medium, no inhibitory effects on S. mutans were detected. The only materials to inhibit acid production of S. mutans were the GIC extracts without added BAG. Furthermore, they also had antibacterial activity against S. mutans when tested as powders. We found very few effects of the tested materials on C. albicans. The only material with an antimicrobial effect on C. albicans was BAG when incubated in a suspension with C. albicans. This is the first time that this effect has been demonstrated for C. albicans. By adding BAG to GICs the structure of the material becomes more brittle than the structure of GICs without BAG. Thus, in addition to the composition of the tested materials, their structure may also have influenced the results. In summary, commercially available GICs and GIC disks containing 30 wt% of BAG exerted antibacterial effects on S. mutans. BAG exerted antimicrobial effects on both S. mutans and C. albicans.

Acids↗
PubMed1985

In vitro susceptibilities of isolates from patients with Branhamella catarrhalis pneumonia compared with those of colonizing strains.

Branhamella catarrhalis has recently been recognized as an opportunistic respiratory pathogen. We tested 10 isolates recovered from patients with documented B. catarrhalis pneumonia and 15 colonizing isolates for their susceptibility to 19 antimicrobial agents and for their ability to produce beta-lactamase. Eight of ten disease isolates and 12 of 15 colonizing isolates produced a detectable beta-lactamase. The isolates that were negative for beta-lactamase were susceptible to all agents tested, including penicillin G. Although all strains were found to be susceptible to the majority of the newer agents by broth dilution testing, the most active new semisynthetic penicillin was azlocillin (MIC that inhibited 90% of strains, 0.5 micrograms/ml), and moxalactam had the greatest potency among the cephalosporins (MIC that inhibited 90% of strains, 0.06 micrograms/ml). Members of the first- and second-generation cephalosporins had only moderate activity. All disease isolates were susceptible to the aminoglycosides and to trimethoprim-sulfamethoxazole and resistant to vancomycin. The antibiotic susceptibilities of the disease isolates were not different from those of the colonizing strains. The results of standardized disk diffusion testing did not correlate well with those of dilution testing for penicillin or ampicillin. However, disk diffusion testing did predict susceptibility adequately for the remainder of the antibiotics tested.

Aminoglycosides↗
PubMed2001

Contemporary assessment of antimicrobial susceptibility testing methods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines.

The emergence of infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter spp. has necessitated the search for alternative parenteral agents such as the polymyxins. The National Committee for Clinical Laboratory Standards (NCCLS) documents do not currently provide interpretative criteria for the testing of the polymyxins, colistin and polymyxin B. Therefore, an evaluation of the antimicrobial activity of colistin and polymyxin B was initiated using 200 bloodstream infection pathogens collected through the SENTRY Antimicrobial Surveillance Program. All susceptibility tests were performed according to the NCCLS recommendations. Polymyxin B and colistin displayed a nearly identical spectrum of activity, exhibiting excellent potency against P. aeruginosa (MIC(90), 2 microg/ml) and Acinetobacter sp. (MIC(90), 2 microg/ml). In contrast, they showed limited activity against some other nonfermentative bacilli such as Burkholderia cepacia (MIC(90), >/=128 microg/ml). Excellent correlation was achieved between broth microdilution and agar dilution tests (r = 0.96 to 0.98); 94.3% of the results were +/-1 log(2) dilution between the methods used for both compounds. At a resistance breakpoint of >/=4 microg/ml for both agents, unacceptable false-susceptible or very major errors were noted for colistin (5%) and polymyxin B (6%). Modified zone criteria for colistin (</=11 and >/=14 mm) and polymyxin B (</=10 and >/=14 mm) were suggested, but some degree of error persisted (>/=3.5%). It is recommended that all susceptible disk diffusion results be confirmed by MIC tests using the preferred reference NCCLS method. The quality control (QC) ranges listed in the product package insert require an adjusted range by approximately 3 mm for both NCCLS gram-negative quality control strains. This evaluation of in vitro susceptibility test methods for the polymyxin class drugs confirmed continued serious testing error with the disk diffusion method, the possible need for breakpoint adjustments, and the recalculation of disk diffusion QC ranges. Clinical laboratories should exclusively use MIC methods to assist the therapeutic application of colistin or polymyxin B until disk diffusion test modifications are sanctioned and published by the NCCLS.

Anti-Bacterial Agents↗
PubMed2026

Mechanisms of cefiderocol resistance in carbapenem-resistant Acinetobacter baumannii: a Swiss 2023-2025 collection.

OBJECTIVES: The numbers of infections caused by carbapenem-resistant Acinetobacter baumannii (CRAB) are increasing globally and present a significant burden on healthcare systems. This study describes the CRAB isolates received at the Swiss National Reference Centre for Emerging Antibiotic Resistance (NARA) over a 3-year period, from January 2022 to December 2025, and aimed to characterize the prevalence and mechanisms of FDC resistance. METHODS: Two-hundred and thirty-four non-duplicate CRAB isolates were submitted to NARA over the study period from hospitals and laboratories across Switzerland. Susceptibility testing was performed by disk diffusion and broth microdilution, according to EUCAST methodology. Whole-genome sequencing was performed on 11 isolates. ADC alleles were cloned into vector pVRL1 and transformed into Escherichia coli Top10. RESULTS: All isolates exhibited resistance to the carbapenems, and most were resistant to cephalosporins. Most isolates harboured an acquired class D carbapenemase, most frequently OXA-23 (181/234; 77.4%). One quarter of isolates were resistant to cefiderocol (FDC), exhibiting MICs ranging from 4->32 mg/L. Whole genome sequencing analyses, performed on 11 FDC-resistant isolates, identified that FDC resistance was due a combination of mechanisms including NDM and PER-production, mutations within the iron transporters, piuA and pirA, and the overexpression of ADC variants. CONCLUSIONS: This study showed that OXA-23 was the dominant mechanism of carbapenem-resistance in CRAB in Switzerland. Almost one quarter of CRAB isolates were resistant to "last resort" antimicrobial, FDC. The mechanisms of FDC resistance identified in this study emphasise that resistance to this antimicrobial is often complex and multifactorial, requiring high-resolution methods, including WGS, to identify.

Acinetobacter baumannii↗
PubMed2004

Comparison of the susceptibilities of Burkholderia pseudomallei to meropenem and ceftazidime by conventional and intracellular methods.

The effect of the two antibiotics ceftazidime and meropenem on a collection of 46 Burkholderia pseudomallei isolates representing clinical and environmental sources across northern Australia was investigated by using a series of in vitro test methods. The susceptibility testing methods used included Kirby-Bauer disk diffusion, Etest MIC, broth microdilution MIC, and a modification of the microdilution method in which Acanthamoeba cells were added to simulate the effect of a professional phagocytic cell on test outcome. In a semiquantitative validation coculture series, the majority of bacteria were intracellular up to a multiplicity of infection of 10 bacteria to one ameba. The optical density and bacterial count (log10 CFU/ml) correlated across the range tested (r2 = 0.77; P < 0.0001). Susceptibility test results were compared against clinical outcomes. The MICs of ceftazidime were consistently higher than those of meropenem by all three methods. The MICs of both agents were significantly higher when Acanthamoeba trophozoites were added to the broth microdilution method. Conventional and intracellular MIC results were consistent for clinical isolates from the Western Australian outbreak cluster despite the wide variety of clinical outcomes. Further development of the intracellular MIC method is expected to help assess the efficacy of antimicrobial agents on this bacterial species in an intracellular setting.

Acanthamoeba↗
PubMed2007

Activity of dalbavancin tested against Staphylococcus spp. and beta-hemolytic Streptococcus spp. isolated from 52 geographically diverse medical centers in the United States.

Dalbavancin is a lipoglycopeptide antimicrobial agent with a potency significantly better than that of vancomycin when tested against staphylococci and streptococci. These two pathogens are common causes of skin and skin structure infections (SSSIs), and dalbavancin has been approved for the treatment of moderate to severe SSSIs. This study generated susceptibility data for staphylococci and beta-hemolytic streptococci from 52 U.S. medical centers that locally tested dalbavancin, vancomycin, and other antimicrobial class representatives to assess the potency of dalbavancin and the overall contemporary activities of commonly prescribed agents. Locally generated data showed that oxacillin-resistant staphylococci (57.0% overall) had slightly higher dalbavancin MIC(90) values (0.19 microg/ml) than oxacillin-susceptible strains (0.125 microg/ml). This potency was 8- to 16-fold greater than that for vancomycin. beta-Hemolytic streptococci had MIC(90) values ranging between 98% against staphylococci. Erythromycin resistance was high for staphylococci (30.6 to 94.1%) with inducible clindamycin resistance rates of 26.0% and 55.0% for oxacillin-susceptible and -resistant Staphylococcus aureus, respectively. Beta-hemolytic streptococci had a 20.2% erythromycin resistance rate and a 60% inducible clindamycin resistance rate but were highly susceptible to other tested agents. Etest reading errors were apparent and skewed results towards slightly higher dalbavancin MICs, requiring further education on how to interpret Etest method results for this compound. Current disk diffusion breakpoint criteria for oxacillin susceptibility for S. aureus showed a very-major-error rate of 2.3% and only a 0.9% minor-error rate when cefoxitin was used to predict oxacillin susceptibility. Dalbavancin demonstrated excellent potency and activity (100% susceptibility at proposed breakpoints) against common causes of SSSI pathogens in this U.S. multicenter study sample.

Anti-Bacterial Agents↗
PubMedDate not supplied

Antimicrobial susceptibility pattern of Neisseria gonorrhoeae isolated at the Jos University Teaching Hospital, Jos, Central Nigeria.

Widespread, inadequate and inappropriate treatment of gonococcal infections are facilitating antibiotic resistance in Jos Nigeria. We present an antimicrobial susceptibility pattern of Neisseria gonorrhoeae strains in this study. Thirty-one strains of Neisseria gonorrhoeae were isolated by inoculating swabs onto prewarmed heated blood agar and Thayer Martins medium and incubated overnight at 35 to 37 degrees C. The isolates were then screened for antimicrobial susceptibility by the disk diffusion method. About 93.6% were susceptible to azithromycin, 90.3% to ciprofloxacin, 87.1% to ceftriaxone, 80.7% and 64.3% to erythromycin and ofloxacin respectively. Less than half were each susceptible to spectinomycin (38.7%) and gentamicin (32.8%), while 12.9% and 4.6% were susceptible to tetracycline and penicillin respectively. These findings suggest that gentamicin, tetracycline and penicillin may not be recommended in this environment for treating gonococcal infections. Azithromycin, ciprofloxacin and ceftriaxone are the suggested alternatives. Prompt diagnosis, treatment and indeed continued surveillance are hereby recommended for an effective management of gonococcal infections.

Anti-Bacterial Agents↗
PubMed1987

Regression analysis, proposed interpretative zone size standards, and quality control guidelines for a new macrolide antimicrobial agent, A-56268 (TE-031).

A-56268 is a 6-O-methyl derivative of erythromycin A which has a spectrum of activity similar to that of erythromycin and is 1 log2 dilution more potent than erythromycin against most organisms that have been tested. The correlation of zone size diameters and MICs of A-56268 for 461 strains of bacteria isolated from clinical specimens was investigated. Based on anticipated levels in human serum of 2 micrograms/ml, 15-microgram disks have been recommended with zone size standards of greater than or equal to 15 mm for susceptibility (MIC correlate, less than or equal to 2.0 micrograms/ml) and less than or equal to 11 mm for resistance (MIC correlate, greater than or equal to 8 micrograms/ml). Selection of these tentative breakpoints resulted in no very major errors (false susceptible), a major error (false resistant) rate of 0.22%, and an acceptable minor error (intermediate) rate of 2.82%. MIC ranges and zone diameter limits for quality control organisms used in the standardized agar dilution and disk diffusion susceptibility tests with A-56268 are given.

Clarithromycin↗
PubMed2005

Trends in linezolid susceptibility patterns in 2002: report from the worldwide Zyvox Annual Appraisal of Potency and Spectrum Program.

Oxazolidinones have become reliable clinical and candidate antimicrobial agents to be utilized for infections caused by multidrug-resistant Gram-positive cocci, especially vancomycin-resistant enterococci and methicillin-resistant staphylococci. However, mutational resistance of the ribosomal target has been described for several species. Longitudinal surveillance remains necessary to monitor for this evolving linezolid resistance pattern. A survey of linezolid and several comparison Gram-positive focused agents was initiated in 2002 (7971 strains, >99.0% compliance) for 54 participating sites in the United States, Canada, Europe (6 nations), Latin America (2 nations), and the Asia Pacific (2 nations). The 5 and 25 sites in Canada and the United States, respectively, submitted 200 strains each to a central laboratory for organism identification/confirmation and reference MIC processing. The 10 remaining nations had 200 strain samples from 1 to 4 separate institutions. Linezolid resistance (MIC >/= 8 microg/mL) was confirmed by alternative susceptibility testing methods (Etest, AB BIO Disk, Solna, Sweden; disk diffusion method) and target mutation characterization by PCR and sequence analysis. Linezolid activity against the 6 major organism groups did not vary between geographic areas. A total of 98.1% of linezolid MIC values were between 0.5 and 2 microg/mL, and only 0.5% of results were at 4 microg/mL, which included 32 Staphylococcus aureus (0.9%) and 5 (0.5%) enterococcal isolates. Linezolid resistance was detected in only 4 isolates (0.05%): 1 each Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, and a viridans group Streptococcus. All 4 isolates had a G2576U mutation in the 23S rRNA target. Linezolid activity as outlined by these Zyvox Annual Appraisal of Potency and Spectrum (ZAAPS) Program results demonstrate sustained, near complete activity against contemporary Gram-positive isolates on 4 monitored continents and in centers utilizing oxazolidinones. Rare linezolid-resistant strains were identified in the United States only (0.05% resistance overall).

Acetamides↗
PubMedDate not supplied

[Distribution and diversity of conjugative plasmids among some multiple antibiotic resistant E.coli strains isolated from river waters].

In natural bacterial communities the microbial structure and functions are subjected to dynamic environmental and genetic adaptation. Plasmid-mediated horizontal genes transfer has a major impact on the adaptability of bacteria, exemplified by the interspecific and intergeneric transfer of antibioresistance genes in a variety of aquatic media. The high incidence of resistant bacteria has been documented for fresh waters, marine waters and chronically polluted waters. The aim of this study was to establish the distribution and diversity of plasmids and to study the transfer of plasmids harboring multiple antimicrobial-resistance determinants (R plasmids) belong to 12 multiple antibiotic resistant E. coli strains isolated from river waters. Antimicrobial resistance patterns were performed for aminoglycosides (gentamycin, kanamycin), beta-lactams (ampicillin), cephalosporins (ceftazidime and cefotaxime), tetracycline, nalidixic acid and chloramphenicol by disk diffusion method following NCCLS recommendations. Minimum inhibitory concentrations (MICs) were performed using dilution method in Mueller-Hinton broth with a 0.06-64 micrograms/ml concentration range for all antimicrobials and bacterial inoculum corresponding to 0.5 standard of the McFarland scale. For the data analysis NCCLS breakpoints for resistance and sensitivity were used. Bacterial plasmid isolation was performed by an alkaline lysis method. Genetic characterization was performed by agarose gel electrophoresis and spectrophotometric analysis. R-plasmid transfer frequencies were estimated by conjugation of drug-resistant E. coli strains used as donors with E. coli DH5 alpha F recipient marked with chromosomal resistance to nalidixic acid (Nal). The drug resistance markers possessed by a particular donor strain were sequentially used to screen for R+ transconjugants by incorporation the particular drug in the selective media. All E. coli strains are multiple antibiotic resistant, 65% of them being resistant to all 8 antibiotics tested. Plasmid profile analysis revealed the presence of several plasmids ranging from 3.8 kpb to more than 50 kpb. All aquatic R+ strains transferred two or more of their resistance markers to E. coli DH5 alpha F, transfer of resistance to ampicillin and tetracycline being the most frequent and having a frequency of 10(-4) or greater (expressed as transconjugants/donor). The phenotypic data shows the frequency and dynamic flow of multiple antibioresistant E. coli strains in aquatic media. Electrophoretic patterns analysis reflects the high incidence and diversity of plasmids in aquatic E. coli strains. Plasmid-harboring E. coli strains transferred antibiotic resistance and, hence, possessed conjugative R plasmids. Of these, 80% transferred drug resistance at a frequency of about 10(-4).

Anti-Bacterial Agents↗
PubMed1989

In vitro antimicrobial activity and susceptibility testing of ofloxacin. Current status.

The fluoroquinolone, ofloxacin, exhibits a broad antibacterial spectrum. Based on our data and a review of the literature, ofloxacin inhibited essentially 100 percent of staphylococci, including oxacillin-resistant strains, Haemophilus influenzae, Neisseria spp. and Branhamella catarrhalis. Ninety-five percent of Enterobacteriaceae were susceptible to ofloxacin. Pseudomonas aeruginosa and enterococci were less susceptible: 79 and 63 percent, respectively, were susceptible (minimal inhibitory concentration [MIC], less than or equal to 2.0 micrograms/ml); 15 and 25 percent, respectively, were intermediate (MIC, 4 micrograms/ml); 3 and 6 percent, respectively, were resistant (MIC, more than or equal to 4 micrograms/ml). Clostridium spp., including Clostridium difficile, were resistant to ofloxacin, but other anaerobic species, including the Bacteroides fragilis group (over 90 percent) were either susceptible or intermediate to ofloxacin. Ofloxacin is bactericidal; minimal bactericidal concentrations of ofloxacin rarely exceed the MICs by one doubling concentration. A modest inoculum effect has been observed with ofloxacin: MICs with inocula of 10(7) colony-forming units/ml are often two- to fourfold higher than those with inocula of 5 x 10(5) colony-forming units/ml. Susceptible organisms exposed serially to increasing concentrations of nalidixic acid developed increasing resistance to not only nalidixic acid, but also to all other quinolones, including ofloxacin. Correlations of disk diffusion inhibitory zone diameters using the 5-micrograms ofloxacin disk with ofloxacin MICs have been performed, and the disk diffusion zone diameter breakpoints recommended are: susceptible, greater than or equal to 16 mm; intermediate, 13 to 15 mm; resistant, less than or equal to 12 mm. Quality control parameters also are summarized.

Bacteria↗
PubMed2004

Reemergence of macrolide resistance in pharyngeal isolates of group a streptococci in southwestern Pennsylvania.

We previously reported on the emergence of macrolide-resistant pharyngeal isolates of group A streptococci (GAS) in our community. The purpose of the present study was to track longitudinal trends in macrolide resistance in these isolates in southwestern Pennsylvania. Testing for susceptibility to erythromycin and clindamycin was performed for all pharyngeal GAS isolates recovered at the Children's Hospital of Pittsburgh and a local pediatric practice between September 2001 and May 2002. Macrolide resistance phenotypes and genotypes were determined by double-disk diffusion and PCR, respectively. Strain relatedness was determined by field inversion gel electrophoresis and emm gene sequence typing. A total of 708 isolates of GAS were recovered during the study period; 68 (9.6%) were macrolide resistant, while all isolates were sensitive to clindamycin. The monthly prevalence of macrolide resistance ranged from 0 to 41%. Only 21 of 573 (3.7%) strains recovered from September 2001 through March 2002 were macrolide resistant. A sudden increase in the rate of macrolide resistance (47 of 135 isolates [35%]) was seen in April and May 2002. Sixty-two isolates demonstrated the M phenotype (resistance to macrolide antibiotics), and six isolates demonstrated the MLS(B) phenotype (resistance to most macrolide, lincosamide, and streptogramin B antibiotics); these isolates were confirmed to be mef(A) and erm(A), respectively. Three unique mef(A) clones and four unique erm(A) clones were identified among the resistant isolates. The MIC at which 50% of isolates are inhibited (MIC(50)) for the mef(A) strains was 16 micro g/ml, while the MIC(50) for erm(A) strains was 8 micro g/ml. The finding of high levels of macrolide resistance among pharyngeal isolates of GAS for a second successive year in our community raises the concern that this problem may be more common in the United States than was previously appreciated. Longitudinal surveillance of isolates from multiple centers is needed to define the prevalence of antimicrobial agent-resistant GAS in the United States.

Anti-Bacterial Agents↗
PubMed1996

Evaluation of 500 gram negative isolates to determine the number of major susceptibility interpretation discrepancies between the Vitek and MicroScan Walkaway for 9 antimicrobial agents.

Although the Vitek and MicroScan Walkaway are two of the most commonly used automated antimicrobial susceptibility test systems, few studies have been performed comparing discrepancies between these systems. In this study, 500 Gram negative clinical isolates were tested against ampicillin, ampicillin/sulbactam, ticarcillin, ticarcillin/clavulanate, imipenem, ciprofloxacin, norfloxacin, mezlocillin, and piperacillin to determine the number of major interpretation discrepancies between the two systems. The 500 isolates consisted of 100 isolates each of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis and Enterobacter species. Each isolate was tested simultaneously in both systems using the same standardized inoculum. Eighty-four major discrepancies occurred, of which 48 were reproducible. The reproducible discrepancy rate, for the 4,500 isolate/antimicrobic combinations tested, was 48 of 4500 (1.06%). The rate for individual antimicrobics varied from 17 of 500 (3.4%) for ampicillin to no discrepancies for ticarcillin or ciprofloxacin. Of the 48 reproducible discrepancies, 44 (92%) were Vitek resistant, MicroScan susceptible. Fifteen (31%) of the Vitek and 21 (44%) of the MicroScan results were confirmed by broth microdilution. Disk diffusion results were in agreement with 15 (31%) of the Vitek and 21 (44%) of the MicroScan results. Twelve (25%) of the broth microdilution and 12 (25%) of the disk diffusion results were intermediate. The broth microdilution and disk diffusion results for the 48 isolates with reproducible discrepancies were in agreement more often with MicroScan. However, there was less very major error comparing the Vitek results for these isolates to the broth microdilution and disk diffusion. Overall, the result of this evaluation indicate that the number of major interpretation discrepancies between the two systems is minimal for the isolate/antimicrobic combinations tested.

Ampicillin↗
PubMed1975

Accuracy of Kirby-Bauer susceptibility tests read at 4, 8, and 12 hours of incubation: comparison with readings at 18 to 20 hours.

Disk diffusion antibiotic susceptibility tests as performed by the hospital diagnostic microbiology laboratory were read at 4, 8, and 12 h of incubation and compared to the traditional 18-h readings. Both the zone size in millimeters and a judgement of susceptible or resistant were recorded by the investigator at each time interval for each drug tested against the various clinical isolates. Considerable variation of zone sizes existed for certain organisms (e.g., staphylococci and Proteus) and certain antibiotics (e.g., trimethoprim-sulfamethoxazole) when zone sizes in millimeters were examined. However, 8 to 60% of isolates demonstrated visible growth at 4 h of incubation and could be placed in susceptible or resistant categories with a fair degree of accuracy (74 to 95% agreement with 18-h readings). By 8 h of incubation, 83 to 100% of the cultures showed visible growth and almost all the organisms had accurate readings (89 to 98% agreement). The ability to determine antimicrobial susceptibility patterns early could influence favorably the prognosis in serious infections.

Bacteria↗
PubMed1984

Feasible method for routine surveillance culturing of stools from neutropenic patients.

This study was undertaken to develop an accurate, yet inexpensive, method for determining whether the bowel of a neutropenic patient is colonized with bacteria resistant to the antimicrobial agents used in empiric therapy. Selective agar media were prepared in which Mueller-Hinton agar or MacConkey agar were supplemented with one of the following antimicrobial agents: carbenicillin (16 micrograms/ml), gentamicin (4 micrograms/ml), or tobramycin (4 micrograms/ml). Moxalactam was incorporated initially at 16 micrograms/ml and subsequently at 8 micrograms/ml. Stools from neutropenic patients and bone marrow transplant recipients were inoculated on these media and on unsupplemented MacConkey agar. All bacteria that grew on the antibiotic-containing media were categorized as resistant to the supplementing drug; failure to detect an organism that did grow on the antibiotic-free MacConkey agar indicated susceptibility. These results were compared with those obtained for all isolates on all media by agar disk diffusion. There were 512 gram-negative enteric isolates from 320 stools obtained from 98 patients. The antibiotic-containing media suppressed the growth of 95% of bacteria that were identified as susceptible by agar disk diffusion. In detecting resistant organisms, the correlation between agar disk diffusion and direct stool screening with Mueller-Hinton agar ranged from 73 to 83%, and on MacConkey agar it ranged from 87 to 97%. The predictive value of a resistant result was 80 to 97% for the four antimicrobial agents when MacConkey agar was used. MacConkey agar performed better than Mueller-Hinton agar because of the greater ease of detecting different bacterial morphotypes. The cost of direct stool screening with antibiotic-supplemented MacConkey agar is approximately half the cost of routine methods of surveillance. Its cost and accuracy make the method a useful adjunct to the routine management of neutropenic patients.

Agranulocytosis↗
PubMed1993

Effect of sulbactam on infections caused by imipenem-resistant Acinetobacter calcoaceticus biotype anitratus.

A recent outbreak of multiresistant strains of Acinetobacter calcoaceticus biotype anitratus was observed mostly, but not exclusively, in the surgical intensive care unit in our hospital. Disk diffusion and microdilution susceptibility studies demonstrated resistance to imipenem, all aminoglycosides, and all individual beta-lactam antibiotics. Only ampicillin plus sulbactam, cefoperazone plus sulbactam, and polymyxin produced zone sizes and MICs in the susceptible ranges. Determination of MICs and MBCs demonstrated that sulbactam was the antimicrobial agent responsible for the killing of these organisms. Nine of 10 patients who were infected with imipenem-resistant Acinetobacter strains and received ampicillin plus sulbactam for > 3 days improved clinically, and in many cases organisms were eradicated from the site of isolation.

Acinetobacter Infections↗
PubMed1991

Pseudomonas pseudomallei, a common pathogen in Thailand that is resistant to the bactericidal effects of many antibiotics.

The purpose of this investigation was to identify newer antimicrobial agents that may be useful in the therapy of melioidosis. The in vitro susceptibilities of 199 clinical isolates of Pseudomonas pseudomallei to 22 antibiotics were determined by standard disk diffusion, and those to 13 antibiotics were determined by agar dilution. Over 90% of the isolates were susceptible to imipenem, piperacillin-tazobactam, piperacillin, ceftazidime, ticarcillin-clavulanate, ampicillin-sulbactam, and carumonam by both methods. Standard disk diffusion yielded unacceptably high false-susceptibility results with aztreonam, ciprofloxacin, and temafloxacin. Piperacillin, ceftazidime, imipenem, and ciprofloxacin were not bactericidal for three selected P. pseudomallei strains as determined by time-kill curve methods. Furthermore, addition of ciprofloxacin to piperacillin, ceftazidime, or imipenem did not enhance bactericidal activity. One hundred ninety-four strains showed weak beta-lactamase production that did not increase upon incubation with cefoxitin. These findings suggest that several newer antimicrobial agents may prove useful in the treatment of melioidosis. However, results of susceptibility studies involving P. pseudomallei and newer agents must be interpreted with caution.

Anti-Bacterial Agents↗
PubMedDate not supplied

Antimicrobial properties of self-etching primer-bonding systems.

Self-etching primers are now considered the new generation of dentin bonding systems that modify and incorporate the bacteria-containing smear layer into their bonding mechanism. The antibacterial effects of the self-etching primers Clearfil SE Bond, Mac Bond, Imperva FL Bond, One-Up BondF and Prompt L-Pop were evaluated using the bacteria Streptococcus mutans ATCC25175, Peptostreptococcus anaerobius, Peptostreptococcus prevotii, Peptostreptococcus asaccharolyticus, Lactobacillus acidophilus, Lactobacillus catenaforme, Lactobacillus jensenii, Actinomyces odontolyticus, Porphyromonas endodontalis, Clostridium ramosum, Prevotella oris, Prevotella denticola and Fusobacterium nucleatum, with a disk diffusion method. A single-bottle total-etch dentin adhesive (Excite) was used for comparisons and chlorhexidine (0.2%) was used as the positive control. After incubation, zones of inhibited bacterial growth were observed. One-Up BondF, Prompt L-Pop and Excite showed growth inhibition for all bacterial strains. The bonding agents of Clearfil SE Bond, Mac Bond and Imperva FL Bond were unable to inhibit the growth of Lactobacillus jensenii and Actinomyces odontolyticus, while the primers of these systems produced inhibition halos to all tested microorganisms greater than that of chlorhexidine.

Actinomyces↗