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The in vitro activity of BMS-284756, a new des-fluorinated quinolone.

The in vitro activity of BMS-284756 (previously T-3811ME), a des-fluoro(6) quinolone, was investigated and compared with those of six other antimicrobial agents. Susceptibility tests were performed on 919 Gram-positive, Gram-negative (including nine quinolone-resistant Escherichia coli) and anaerobic bacteria, three Chlamydia isolates and four Mycobacteria spp. BMS-284756 was marginally less active against the Enterobacteriaceae, but was the most active quinolone against staphylococci, enterococci and peptostreptococci. Against Streptococcus pneumoniae, BMS-284756 and gemifloxacin were more active than other quinolones. The MIC(90) of BMS-284756 was > or = 2 mg/L for the following bacteria: E. coli (MIC(90) 16 mg/L), Acinetobacter spp. (8 mg/L), Pseudomonas aeruginosa (64 mg/L) and Enterococcus faecium (4 mg/L). The MIC of BMS-284756 for Mycobacterium spp. was within one dilution of the MIC of ciprofloxacin. BMS-284756 was markedly more active than ciprofloxacin against the Chlamydia isolates tested.

Anti-Bacterial Agents↗

In-vitro microbiological assessment of a new penem, Men 10700.

The in-vitro antibacterial activity of Men 10700, a novel penem, has been compared with that of ritipenem, ciprofloxacin, amikacin, cefotaxime and co-amoxiclav against 539 strains taken from 17 genera. Men 10700 was most active against staphylococci and streptococci (MIC90 < 0.5 mg/L), slightly less active against Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Citrobacter spp., Moraxella catarrhalis and peptostreptococci (MIC90 0.5-2 mg/L), moderately active against Enterococcus faecalis, members of the tribe Proteae, Serratia marcescens, Acinetobacter spp., clostridia and Bacteroides spp. (MIC90 4-16 mg/L), and inactive against Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Enterococcus faecium. Its antibacterial spectrum is thus slightly less broad than that of imipenem, but it compares favourably with an oral third-generation cephalosporin. Men 10700 was more active than ritipenem against many species, especially Enterobacter spp. and Citrobacter spp.

Anti-Bacterial Agents↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1989). II. Background of patients].

Clinical background was investigated on 1,197 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during the period from June, 1989 to May, 1990. 1. Distribution of sex and age A majority of female patients with UTIs accounted for a twenties and thirties. The proportion of male patients with UTI has increased with age, accounting for majority in patients 70 years or older. 2. Distribution of infection types and age Most cases among twenties or thirties were uncomplicated UTIs. Fifties and older cases were most frequent in complicated UTIs. 3. Distribution of isolated bacteria and age Escherichia coli was most frequent on the whole, followed by Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus spp. and Klebsiella spp.. E. coli had declined with age, and on the other hand, E. faecalis and P. aeruginosa had increased with age. 4. Administration of antibiotics and pathogens isolated from UTIs. In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 439 to 4. Before an administration of antibiotics, E. coli was mainly detected, but after an administration of antibiotics, E. coli has decreased into two strains. After administration of antibiotics, pathogens of complicated UTIs, without indwelling catheter, have decreased from 324 to 19: E. coli has decreased from 86 to 2, but E. faecalis, Staphylococcus spp., Enterobacter spp. and P. aeruginosa have increased. Pathogens of complicated UTIs with indwelling catheter, have decreased from 156 to 14 after administration of antibiotics, and mainly isolated pathogens were E. faecalis and P. aeruginosa.

Adolescent↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1992). III. Secular changes in susceptibility].

Susceptibilities of Enterococcus faecalis, Staphylococcus aureus, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa and Serratia spp. isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June 1992 to May 1993 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. The susceptibilities of E. faecalis isolated from uncomplicated UTIs to quinolones has decreased. As for S. aureus, Citrobacter spp., Enterobacter spp., P. mirabilis and Serratia spp., which were detected very few in 1989, 1990, 1991 and 1992, their susceptibilities were not observed an obvious change. E. coli, all strains were highly susceptibilities to latamoxef and cefozopran. And the susceptibilities of E. coli isolated from uncomplicated UTIs and complicated UTIs without indwelling catheter to minocycline has decreased in 1991, but they has been indicated a trend of recovery in 1992. The difference in according UTI's classification of the susceptibilities of Klebsiella spp. to minocycline in 1991 has not recognized in 1992. And the susceptibilities of Klebsiella spp. isolated from complicated UTIs without indwelling catheter to quinolones has decreased. The susceptibilities of P. aeruginosa isolated from complicated UTIs to quinolones has been indicated a trend of recovery. These data should be considered in clinical treatment of various urinary tract infections.

4-Quinolones↗

Characterization and partial purification of a bacteriocin produced by Leuconostoc carnosum LA44A.

Twenty Leuconostoc strains isolated from vacuum packaged Vienna-type sausages were screened for antagonistic activity against various Gram-positive organisms (including Listeria spp.). One of the three strains exhibiting inhibitory activity was chosen for further investigation. This strain was identified as Leuc. carnosum and the inhibitory substance produced was named carnosin. Carnosin was inactivated by trypsin but not by catalase or other non-proteolytic enzymes tested. Carnosin retained activity after heating at 100 degrees C for 20 min, whereas heating at 121 degrees C for 15 min resulted in complete loss of activity. Carnosin was active at pH values ranging from 2 to 9. Carnosin activity was not detectable until cells were in the late log-phase of growth. At low temperatures (4 degrees C), higher cell densities were required before carnosin activity could be detected. Carnosin was active against various lactic acid bacteria, Enterococcus faecalis and Enterococcus faecium and against Listeria spp. Difficulties in purification were reduced by growing Leuc. carnosum in a modified MRS medium, having 50% of the normal peptone concentration and no Tween or meat extract. Sodium dodecyl sulphate polyacrylamide gel electrophoresis of partially purified carnosin indicated that it has a molecular mass between 2510 and 6000 Da. Yet, retention of activity after exhaustive dialysis suggested a molecular mass > 14kDa. It is hypothesized that carnosin forms large active complexes which can be dissociated to small (active) components.

Bacteriocins↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2003). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from 565 patients diagnosed as urinary tract infections (UTIs) in 14 institutions in Japan were collected between August 2003 and July 2004. The susceptibilities of these bacteria to various antimicrobial agents were examined. The bacteria were divided into 2 groups consisting of uncomplicated UTIs and complicated UTIs (with and without indwelling catheter) based on their isolation origins. The results were compared with those obtained between 1994 and 2002. The drug sensitivity of S. aureus in this year was similar to those in up to the previous years and S. aureus showed the best susceptibility to vancomycin. The drug sensitivity of E. faecalis in this year also was similar to those in up to the previous years. The drug sensitivity of E. coli in this year was generally good except penicillins and was similar to those in up to the previous years. Among cephems, cefozopran (CZOP) and cefpirome (CPR) showed the highest potency activity (MIC90: < or = 0.125 microg/mL). An antibacterial activity of cefotiam (CTM) was stable for 10 years and was fine (MIC0: < or = 0.5 microg/mL). The sensitivity of E. coli to carbapenems and carumonam (CRMN) also was good like to CZOP. The sensitivity of the complicated UTIs group to quinolones, however, has decreased after 2000 and it was suggested that the resistance to the drug has developed. Kiebsiella spp. showed a decrease in the susceptibility to some of cephems. The drugs indicating a big decrease in the sensitivity were cefazolin, CTM, cefaclor, and cefpodoxime. Imipenem, carbapenems, also indicated a decrease in the sensitivity. The susceptibility of the strain to the other drugs was similar to that in up to the previous years. Among them, CZOP maintained good susceptibility (MIC90: > or = 0.125 microg/mL against uncomplicated UTIs, 0.25 microg/mL against complicated UTIs) like meropenem. The drug sensitivity of P. aeruginosa was generally low and was not much different from that in up to the previous years.

Anti-Infective Agents↗

The effect of a probiotic Enterococcus faecium product in diets of healthy dogs on bacteriological counts of Salmonella spp., Campylobacter spp. and Clostridium spp. in faeces.

An experiment was conducted to determine the effects of a probiotic on selected faecal bacteria of healthy dogs under different feed and environmental conditions. For the study 12 dogs kept in households were used for an 18-day supplementation with a patented commercially available strain of E. faecium NCIB 10415 (Enteroferm). In order to minimize losses the probiotic product was orally applicated once a day before meals at a dose of 2 g per dog (9.2 x 10(9) CFU). The faeces were collected before the beginning of the supplementation and at the end of the 18-day application period. In order to exclude contamination, all faeces were taken rectally. Before and at the end of the experimental period total Salmonella spp., Campylobacter spp. and Clostridium spp. counts were determined in fresh faeces using selective media. It was demonstrated that the 18-day application of the probiotic E. faecium product induced modifications on the gastrointestinal microflora in all dogs. While Salmonella spp. and Campylobacter spp. counts were in majority of the dogs higher than before the application. Clostridium spp. counts were significantly reduced in 10 of 12 dogs. According to the guidelines for the evaluation of the efficiency of microorganisms in dogs a relevant efficacy effect was supported by this data. However, a beneficial effect of the probiotic product on healthy dogs remains questionable.

Administration, Oral↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2004). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as urinary tract infections (UTIs) in 14 institutions in Japan were collected between August 2004 and July 2005. The susceptibilities of these bacteria to various antimicrobial agents were measured. The bacteria were divided into 2 groups consisting of uncomplicated UTIs and complicated UTIs (with and without indwelling catheter) based on their isolation origins. The results were compared with those obtained between 1995 and 2003. The drug sensitivity of S. aureus in this year was similar to those in up to the previous year and S. aureus showed the best susceptibility to vancomycin (VCM) and arbekacin (ABK). The drug sensitivity of E. faecalis in this year also was similar to those in up to the previous year. The susceptibility of E. coli to cephems in this year was generally good and was similar to those in up to the previous year. MIC90 of cefozopran (CZOP) was the most stable and 0.125 microg/mL or less since 1995. The susceptibility of E. coli to cefpirome (CPR) and cefotiam (CTM) also was good but to cefaclor (CCL), cefixime (CFIX), and cefpodoxime (CPDX) was largely decreased in complicated UTI groups. The sensitivity of E. coli to carbapenems also was good but to carumonam (CRMN) tended to decrease. The susceptibility of E. coli to quinolones, however, has largely changed and has decreased since 2003 in uncomplicated UTIs and 2000 in complicated UTIs. That was suggested the development of the resistance to the drug. The susceptibility of Klebsiella spp. to cefazolin (CEZ), CTM, CCL, CPDX, and cefditoren (CDTR) decreased in the previous year and recovered to the year before the previous year in this year. The susceptibility of Klebsiella spp. to other cephems was stable since 1995, especially against CZOP, the highest sensitivity (MIC90: < or = 0.125 microg/mL) was maintained. The susceptibility of Klebsiella spp. to carbapenems and CRMN also was good. The susceptibility of Klebsiella spp. to aminoglycosides was lower than to CZOP but was stable since 1995. The susceptibility of P. aeruginosa was generally low and has largely changed against the majority of the agents since 1995. The susceptibility of P. aeruginosa isolated from uncomplicated UTIs has largely changed against ceftazidime (CAZ), cefsulodin (CFS), CZOP, imipenem (IPM), meropenem (MEPM), aztreonam (AZT), CRMN, gentamicin (GM), and tobramycin (TOB). The susceptibility of P. aeruginosa isolated from complicated UTIs has largely changed against CSF, CZOP, MEPM, GM, and ciprofloxacin (CPFX). The susceptibility of P. aeruginosa isolated from complicated UTIs has been stable against amikacin (AMK). For annual changes in MIC50, TOB and IPM had a relatively stable and high activity (MIC50: 0.5-2 microg/mL).

Anti-Bacterial Agents↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2002). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as urinary tract infections (UTIs) in 13 institutions in Japan were supplied between August 2002 and July 2003. The susceptibilities of these bacteria to various antimicrobial agents were examined. The bacteria were divided into 2 groups consisting of uncomplicated UTIs and complicated UTIs (with and without indwelling catheter) based on their isolation origins. The results were compared with those obtained between 1993 and 2001. The drug sensitivity of S. aureus in this year was similar to those in up to the previous year and S. aureus showed the best susceptibility to vancomycin. The drug sensitivity of E. faecalis in this year also was similar to those in up to the previous year. The drug sensitivity of E. coli in this year was generally good except penicillins and was similar to those in up to the previous year. Among cephems, cefozopran (CZOP) and cefpirome (CPR) showed the highest potency (MIC90: < or = 0.125 microg/mL). An antibacterial activity of cefotiam (CTM) was similar to it in 10 years ago and was fine (MIC90: < or = 1 microg/mL). The sensitivity of E. coli to carbapenems and carumonam (CRMN) also was good like to CZOP. However, the sensitivity of the complicated UTIs group to quinolones decreased after 2000 and was suggested to develop the resistance to the drug. The drug sensitivity of Klebsiella spp. in this year also was similar to those in up to the previous year. The bacteria showed good susceptibility (MIC: < or = 0.125 microg/mL) to cefmenoxime (CMX), CPR, cefixime (CFIX), flomoxef (FMOX), and CZOP among cephems. The drug sensitivity of P. aeruginosa was generally low. Most of the bacteria were little sensitive to cephems except CZOP and ceftazidime (CAZ). The sensitive bacteria to CZOP and ceftazidime (CAZ) were observed to be 26.8% (15/56 strains) and 39.3% (22/56 strains) in complicated UTIs group, respectively. The sensitivity profile of P. aeruginosa to the other tested drugs was not much different from that in up to the previous year. However, the sensitivity of the bacteria to carbapenems tended to decrease after 2000, and the low sensitive strains (MIC: > or = 256 microg/mL) were detected at 22.2% (2/9 strains) in the uncomplicated UTIs group and 3.6% (2/56 strains) in the complicated UTIs group.

Anti-Bacterial Agents↗

Classification and risk-factor analysis of infections in a surgical neonatal unit.

BACKGROUND/PURPOSE: Nosocomial infection may result in significant morbidity in surgical neonates. Traditionally, nosocomial infections are classified using time cut-off points. Gastrointestinal carriage of microorganisms has not been used as a criterion for classifying infection in surgical neonates. The aims of the study were to (1) determine the overall infection rate, (2) distinguish between nosocomial and community acquired infections using a 48-hour postadmission cutoff and the carrier state criterion, and (3) determine risk factors for clinical infection. METHODS: A 1-year prospective observational cohort study was undertaken in a regional neonatal surgical unit between 1997 and 1998. All infants residing for >/=3 days in the unit were included in the study (n = 167). Patient demographics, including illness severity (PRISM score), were recorded for all infants. Surveillance throat and rectal swabs were obtained on admission and twice weekly thereafter to determine carrier status. Carriage was defined as isolation of the same microorganism from at least 2 consecutive surveillance samples. Infective episodes were diagnosed if a clinical diagnosis of local or general inflammation was microbiologically proven. RESULTS: A total of 167 infants responsible for 174 admissions were studied. Median gestational age was 38 weeks (range, 24 to 42), median birth weight was 3 kg (range, 1 to 3.6), median age on admission was 8 days (range, 0 to 142), median length of hospital stay was 8 days (range, 3 to 95). The diagnoses were gastrointestinal disorders (n = 96), abdominal wall defects (n = 22), neural tube defects and hydrocephalus (n = 17), thoracic disorders (n = 16), urologic disorders (n = 12), and abdominal tumours (n = 4). Twenty-five infants had 33 episodes of infection giving an overall infection rate of 14.9%. The predominant infecting organism was Stapylococcus aureus (n = 11); others were enterococcus, coagulase negative staphylococcus, Candida spp, Gram-negative bacilli, and anaerobes. A total of 27 of 33 infective episodes were caused by microorganisms carried by the infants on admission (primary endogenous). Only 6 children had "true" nosocomial infections. Using a traditional 48 hour cutoff, 87% of the infections were classed as nosocomial. Birth weight, presence of central venous line, PRISM score, and length of stay were identified as significant risk factors for developing clinical infection. CONCLUSIONS: (1) Carriage allowed us to identify the true nosocomial infection rate (microorganisms acquired in the unit), which was only 18%. In contrast, using a traditional 48 hour cutoff, 87% of the infections would have been classed as nosocomial and warranted unnecessary cross-infection investigations. (2) The results of this study confirm that birth weight, illness severity (PRISM score), presence of central venous catheter, and length of hospital stay were independent risk factors associated with clinical infection in surgical neonates.

Carrier State↗

Genetic basis of tetracycline resistance in urogenital bacteria.

The distributions of the nucleotide sequences related to the tetracycline resistance determinants Tet K, Tet L, Tet M, and Tet O were studied by dot blot hybridization with randomly chosen clinical urogenital tract isolates of viridans group streptococci, Streptococcus agalactiae, Enterococcus faecalis, Gardnerella vaginalis, Lactobacillus spp., Fusobacterium nucleatum, Peptostreptococcus spp., and Veillonella parvula. Among the Peptostreptococcus spp., 79% of the isolates hybridized with one (64%) or more (36%) of the probes for Tet K (27%), Tet L (30%), Tet M (75%) and Tet O (13%). Of the viridans group streptococci, 82% of the strains hybridized with one (34%) or more (66%) of the four probes. The distribution of the four determinants in this group was as follows: Tet K, 36%; Tet L, 31%; Tet M, 43%; Tet O, 61%. Twenty-nine percent of the enterococci and forty-six percent of the group B streptococci hybridized with the probes; however, the Tet K, Tet L, and Tet O determinants were found in only a few strains, while the Tet M determinant predominated. A total of 29% of the F. nucleatum isolates, 55% of the G. vaginalis isolates, and 26% of the V. parvula isolates hybridized with the Tet M determinant. In contrast, 43% of the Lactobacillus spp. hybridized with the Tet O determinant. The data indicate that tetracycline resistance determinants are common to many of the microorganisms isolated from the urogenital tract.

Bacteria↗

Characterization of reutericyclin produced by Lactobacillus reuteri LTH2584.

Lactobacillus reuteri LTH2584 exhibits antimicrobial activity that can be attributed neither to bacteriocins nor to the production of reuterin or organic acids. We have purified the active compound, named reutericyclin, to homogeneity and characterized its antimicrobial activity. Reutericyclin exhibited a broad inhibitory spectrum including Lactobacillus spp., Bacillus subtilis, B. cereus, Enterococcus faecalis, Staphylococcus aureus, and Listeria innocua. It did not affect the growth of gram-negative bacteria; however, the growth of lipopolysaccharide mutant strains of Escherichia coli was inhibited. Reutericyclin exhibited a bactericidal mode of action against Lactobacillus sanfranciscensis, Staphylococcus aureus, and B. subtilis and triggered the lysis of cells of L. sanfranciscensis in a dose-dependent manner. Germination of spores of B. subtilis was inhibited, but the spores remained unaffected under conditions that do not permit germination. The fatty acid supply of the growth media had a strong effect on reutericyclin production and its distribution between producer cells and the culture supernatant. Reutericyclin was purified from cell extracts and culture supernatant of L. reuteri LTH2584 cultures grown in mMRS by solvent extraction, gel filtration, RP-C(8) chromatography, and anion-exchange chromatography, followed by rechromatography by reversed-phase high-pressure liquid chromatography. Reutericyclin was characterized as a negatively charged, highly hydrophobic molecule with a molecular mass of 349 Da. Structural characterization (A. Höltzel, M. G. Gänzle, G. J. Nicholson, W. P. Hammes, and G. Jung, Angew. Chem. Int. Ed. 39:2766-2768, 2000) revealed that reutericyclin is a novel tetramic acid derivative. The inhibitory activity of culture supernatant of L. reuteri LTH2584 corresponded to that of purified as well as synthetic reutericyclin.

Anti-Bacterial Agents↗

[Resistance to antimicrobials and combination therapy assessment in neonatal sepsis].

OBJECTIVES: To estimate antibiotic resistance among bacterial strains isolated from patients with neonatal sepsis from January 1994 through December 1998, and to assess the predictive value of the checkerboard method for selecting treatment with combination antibiotic therapy in seriously ill patients. METHODS: The study of strain susceptibility was carried out by microdilution in broth, and the checkerboard method in broth trays was used to assess the efficacy of antibiotic combination therapy. RESULTS: Fifty per cent of the strains of coagulase-negative Staphylococcus spp. and 37% of S. aureus strains, which are the main pathogens involved in neonatal sepsis, were resistant to methycillin. Of these strains, 94.5% were resistant to several antibiotics. Four strains of coagulase-negative Staphylococcus spp. and one strain of Enterococcus faecium were resistant to vancomycin (minimal inhibitory concentration = 128 micro g/mL). We noted a high probability of clinical efficacy (P < 0.01) with antibiotic combinations having a synergistic effect in vitro, whereas antagonic reactions were seen in close association with a highly significant probability of clinical therapeutic failure. DISCUSSION: The main cause of neonatal sepsis in the Neonatal Intensive Care Unit at "América Arias" Hospital in Havana, Cuba, were strains of Staphylococcus resistant to methycillin and other antibiotics. In seriously ill patients (according to policy established at this institution), the first line of treatment is a combination of an aminoglycoside antibiotic and a beta-lactamic antibiotic. This study showed that the clinical efficacy of combination antibiotic therapy is not determined by the resistance pattern of the strain and that good clinical results can be attained, in all likelihood, when a synergistic effect can be shown in vitro.

Aminoglycosides↗

[Nosocomial infections in the intensive care unit of a gynecology clinic].

INTRODUCTION: Nosocomial infections are caused by microorganisms, and they develop 48 hours or more after admission to a hospital. It is considered that these infections are neither manifested nor present during the incubation period at the time of admission. MATERIAL AND METHODS: The objective of our study was to identify the most frequent microorganisms causing nosocomial infections in the Intensive Care Unit of the Institute of Gynecology and Obstetrics. The study included 33 patients, mean age 43.5 +/- 5 years, who were critical cases treated in Intensive Care Unit of the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, in the period 2001 - 2003. All patients were surgically treated, intubated and assisted by mechanical ventilation. RESULTS: The most common causative agents isolated from the endotracheal tube were Staphylococcus aureus, Staphylococcus coagulasa negative and Pseudomonas spp., whereas Escherichia colli and Enterococcus were isolated from the wounds. These are highly resistant strains to antimicrobial agents. DISCUSSION: Two big groups of microorganisms were isolated as causative organisms of nosocomial infections. The first group causes blood stream infections, such as Staphilococcus aureus and coagulasa negative, and the second group causes respiratory infections like Pseudomonas aeruginosa, Klebsiella Enterobacter and Acinetobacter. The mortality and morbidity are very high, up to 40 - 80%. CONCLUSION: We can conclude that invasive diagnostic procedures are causing a high percentage of nosocomial infections. It is of utmost importance to prevent these infections by early use of antibiotics and infection control which depends on the hospital or clinic.

Adult↗

Antimicrobial activity of extracts of local cough mixtures on upper respiratory tract bacterial pathogens.

The punched-hole and the paper disc diffusion methods were used in screening for the antimicrobial activity of six common ingredients used locally in cough mixtures, against the following bacteria: Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus. Enterococcus faecalis, Escherichia coli, Salmonella spp, Salmonella paratyphi, Shigella dysenteria, Shigella sonnei and Candida albicans. The results, evaluated as the diameter of zone of inhibition of microbial growth, showed that lime, garlic onion, onion and honey were active against Staphylococcus aureus, Streptococcus faecalis, Candida albicans, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Salmonella spp and Shigella dysenteriae. Bitter-kola nut extract and palm kernel oil showed no antimicrobial activities against any of the tested organisms. None of the extracts inhibited the growth of Salmonella paratyphi and Shigella sonnei and the most susceptible organisms were Escherichia coli and Salmonella spp.

Anti-Infective Agents↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2001). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as urinary tract infections (UTIs) in 10 institutions in Japan were supplied between September and December, 2001. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined, and the results were compared with those obtained between 1992 and 2000. Comparison was made by classifying strains isolated from patients into those in uncomplicated UTIs and those in complicated UTIs (including with or without indwelling catheter). The drug sensitivity of S. aureus in this year was comparable to those in up to the previous year, and S. aureus showed the best susceptibility to vancomycin (VCM). E. faecalis showed good susceptibility to ampicillin and imipenem, and the MIC90s were 2 micrograms/mL. The susceptibility of E. faecalis to VCM was also good. E. coli showed good susceptibility to the drugs except penicillins. Among cephems, the susceptibility to cefozopran (CZOP) was better (MIC90: < or = 0.125 microgram/mL). Just as the last report, the decreases in susceptibility of E. coli to quinolones were also observed in the patients with complicated UTIs. The susceptibility of Klebsiella spp. to all the test drugs did not significantly change in 2001 and was generally good but not to penicillins. Among cephems, Klebsiella spp. showed good susceptibility to flomoxef, cefpirome, cefixime, and CZOP with < or = 0.125 microgram/mL of MIC90s either in uncomplicated or complicated UTIs. Although the drug sensitivity of P. aeruginosa was generally low, the detection of the strains that showed good susceptibility to quinolones and carbapenems (MIC: < or = 0.125-2 micrograms/mL) were relatively frequent.

Anti-Bacterial Agents↗

Antibiotic resistance of urinary pathogens in female general practice patients.

A cross-sectional study was performed to determine the prevalence of antibiotic resistance in women with uncomplicated and complicated lower urinary tract infection (UTI) in Germany. In 36 (of 118 invited) general practices, urine cultures and resistance testing were performed during 4 months on all women presenting with symptoms of UTI. Each patient's symptoms, risk factors and treatment were documented. A total of 445 women were included, and their median age was 53 y. Complicating factors were present in 27% of women. Urine cultures were available for 430 patients. They were sterile in 23%, 53% had 10(5) cfu/ml or more, and 24% had 10(2)-10(4) cfu/ml. E.coli was the most frequent pathogen (68%), followed by Enterococcus faecalis (10%) and Proteus spp. (10%). E.coli resistance levels were 25-40% for amoxicillin, co-amoxiclav, first generation oral cephalosporins, trimethoprim and co-trimoxazole. Nine percent were resistant to fluoroquinolones. E.coli resistance remained low for nitrofurantoin (2%) and third generation oral cephalosporins (3%). Odds for E.coli resistance to most antibiotics were 2-5 times higher in patients with complicating factors, and increased with age. Resistance levels to all common antibiotics were high even in unselected females with UTI in general practices. Older or complicated patients had a significantly higher risk for resistance.

Adolescent↗

[Antibacterial activities of ofloxacin against recent isolates from patients with community-acquired infections].

In order to survey antibacterial activities of ofloxacin (OFLX) against 1,440 bacterial strains isolated from patients with community-acquired infections in 1987 and 1990, minimum inhibitory concentrations (MICs) of the drug as well as those of other new quinolones and oral cephems were determined. The following conclusions were reached. 1. Comparison of the MIC distribution for strains isolated in 1987 with those in 1990 suggested a tendency toward an increase in the frequency of OFLX-resistant isolates with the passage of time of Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Citrobacter spp., Klebsiella ssp., Enterobacter spp., Proteus vulgaris, Morganella morganii, Providencia spp., and Acinetobacter calcoaceticus. Most common elevations of MIC values against these bacteria were observed in MIC80 and MIC90 values, while no significant alteration was observed in MIC50 values. However, MIC50's of OFLX against Serratia marcescens and Pseudomonas aeruginosa were relatively high for strains isolated in both 1987 and 1990. Most of the OFLX-resistant strains of S. aureus seemed to be methicillin-resistant (MRSA). Furthermore, MIC80 of OFLX against coagulase-negative staphylococci was high in strains isolated in both 1987 and 1990. 2. Susceptibility of Streptococcus spp. was evaluated only in strains isolated in 1990. The results were comparable to those reported by others in the early 1980s. 3. Bacteria which showed no or infrequent emergence of OFLX-resistant strains even in 1990 were Proteus mirabilis, Haemophilus influenzae, Neisseria gonorrhoeae, Campylobacter spp. and Peptostreptococcus spp. 4. Recently isolated strains from patients with community-acquired infections showed a tendency toward an increase of the frequency of OFLX-resistant strains among many bacteria. However, the bacteria which contained high percentages of OFLX-resistant strains except for MRSA were so-called less-virulent bacteria, and in the other bacteria elevations of MIC values were only observed in MIC80 and MIC90. These results suggested that OFLX preserved a potent antibacterial activity against bacteria which were major causative pathogens in community-acquired infections.

Bacteria↗