New antimicrobics for the pediatrician.
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Examples are presented to demonstrate that in-vitro determinations of the minimal inhibitory concentration of antibiotics do not take into account factors of presumable in-vivo significance: pH and divalent cations in the medium, protein binding of antimicrobials, and the bacterial inoculum effect.
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The biotic elimination of Salmonella typhimurium in coastal sea water is primarily caused by protozoa. The elimination is usually faster in summer than in winter and in the vicinity of waste water outlets partially faster than in coastal areas with less contamination. When the rate of elimination is measured twice in succession in the same sample (primary/secondary culture) the second reduction is considerably faster. This activation is attributed to the multiplication of protozoa (predator-prey-effect). The activation is also possible through E. coli in concentrations such as those found in waste from sewage treatment plants or by Salmonella typhimurium themselves and vice versa. After 12 hours incubation the number of E. coli in the primary culture was still about 58% of the original quantity and 12 hours after a renewed inoculation in the secondary culture only 1%. When salmonella were added to the primary culture it was already impossible to detect E. coli after 12 hours in the secondary culture. Salmonella showed comparable tendencies, although the elimination of salmonella was clearly slower than the elimination of E. coli even after activation with salmonella. In the primary culture E. coli is already recultivatable in a smaller quantity than salmonella. Furthermore the addition of Cycloheximide to the secondary culture provides a considerably better protection for salmonella than for E. coli, so that it can be assumed that other or additional factors are involved in the elimination of E. coli.