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Resistance of Neisseria gonorrhoeae to antibacterial drugs in Ontario.

Observations on multiple resistance of 227 N. gonorrhoeae strains are presented in this paper. These strains were previously isolated from the urogenital area from patients who did not respond to antibacterial drug treatment. The above-mentioned strains were referred to our laboratory for confirmation and for susceptibility testing. All the N. gonorrhoeae strains showed resistance in vitro to penicillin concentrations between 0.5-2.0 i.u./mi. In addittion to penicillin resistance, 83.7% showed resistance to cephaloridine, 72.2% to kanamycin, 58.1% to spiramycin, 51.5% to erythromycin, 41.4% to sulphadiazine, 37.0% to tetracycline, 29.9% to ampicillin and 25.1% to spectinomycin.

Ampicillin↗

[Combination of novoimanine with antibiotics with a different mechanism of action].

Ampicillin, kanamycin, fusidic acid and rifocin significantly increased the effect of novoimanin on Staph. aureus 209. Histon F1 and spectinomycin did not influence the effect of novoimanin. Inefficiency of novoimanin combination with histon F1 provided a supposition that their effect may be directed to the same cell structures and most probably to the membranes. This was confirmed by the data of electron microscopy. The most effective combinations were recommended for the studies on their possible clinical use.

Ampicillin↗

National gonorrhea therapy monitoring study: adverse drug reactions.

The Center for Disease Control and cooperating clinics monitored adverse drug reactions in 6,969 patients who were treated for suspected uncomplicated gonorrhea with one of the four 1972 United States Public Health Service (USPHS) recommended regimens and returned for reexamination. Of those patients receiving the aqueous procaine penicillin G (APPG)-probenecid regimen, 2.0% had at least one adverse reaction and 0.18% experienced procaine reactions. No life-threatening reactions occurred. The overall reaction rates for the ampicillin-probenecid, tetracycline and spectinomycin regimens were 0.62%, 5.9%, and 0.61%, respectively. Our findings document the relative safety of the USPHS recommended regimens.

Drug Administration Schedule↗

Therapeutic regimens for anorectal gonococcal infection in males.

Anorectal gonococcal infection is particularly prevalent in women and homosexual men. Although the currently recommended Public Health Service therapeutic regimens for uncomplicated gonorrhea appear to be effective also for anorectal gonorrhea in women, their efficacy for anorectal infection in men has not been adequately evaluated. We report a case of gonococcal proctitis in a homosexual man that did not respond to therapy with ampicillin plus probenecid and tetracycline, but subsequently responded to spectinomycin therapy. Currently available therapeutic regimens for anorectal gonococcal infection in males are reviewed.

Adult↗

[Therapy of acute gonorrhea].

Since the appearance of totally resistant, penicillinase producing gonococci, penicillin should no longer be considered first choice in the treatment of acute gonorrhea. In order to limit further extension of resistant strains, thiamphenicol (Urfamycin 2,5 p.o. or 0,75 i.m.) or spectinomycin (Trobicin 2,0 i.m.) are suggested as replacements for penicillin.

Acute Disease↗

[Immunosuppressive activity of several drugs and their effect on antibody formation in pullorum disease].

Furazolidon given alone or in combination with chloramphenicol, with spectinomycin, with gentamycin or with sodium arsenilate as well as chlorpyrazine, applied alone, suppress the clinical manifestation of pullorum disease in birds both in the experimental and in the spontaneous outbreak of the disease. These medicinal drugs lower the production of agglutinins in birds--mostly the combination furazolidon+chloramphenicol, followed by furazolidon+sodium arsenilate. The same combinations do not prove essentially effective in influencing the development of the morphologic lesions and do not fully exempt the body from the causative agent of pullorum disease.

Agglutinins↗

Antimicrobial susceptibility among Neisseria gonorrhoeae in New Zealand in 2002.

AIM: To estimate the prevalence of antimicrobial resistance among Neisseria gonorrhoeae, and to determine whether the increase in ciprofloxacin resistance observed in Auckland in 2001 had occurred in other parts of the country. METHODS: The antimicrobial susceptibility of N. gonorrhoeae (isolated in New Zealand over a 4-month period between April and August 2002) was tested at either LabPlus, Auckland District Health Board, or at ESR, using the same agar dilution method. RESULTS: The prevalence of resistance to the antimicrobials tested was: ceftriaxone, 0%; ciprofloxacin, 6.8%; penicillin, 9.0%; spectinomycin, 0%; and tetracycline, 27.8%. There were few statistically significant geographical differences in resistance within New Zealand. Gonococcal infections acquired in Asia were more likely to be ciprofloxacin and penicillin resistant than infections acquired in New Zealand. CONCLUSIONS: Ciprofloxacin resistance among N. gonorrhoeae in New Zealand has reached a level where this antibiotic is no longer the most appropriate first-line treatment. In fact, ceftriaxone should now be considered the most reliable option for the treatment and control of gonorrhoea in New Zealand, particularly in the Northland/Auckland region.

Adolescent↗

[Interaction of aminoglycosides and the other antibiotic on selected bacterial strains].

The aim of this study was to analyse the activity interaction of aminoglycosides (gentamicin, kanamycin, streptomycin and dihydrostreptomycin) when combined with other antibiotics (lincomycin, benzylpenicillin, amoxicillin, cephalexin, spectinomycin and erythromycin), on selected clinical bacterial strains. The checkerboard method has been selected from the traditional assays for the measurement of antibiotic interaction. Checkerboard results for all strains demonstrated synergism for nine cases (9/112--8%). Additive effects were predominant--73/112--65.2%. In 12.5% neutral effects were shown, but in 11.6% of combinations FIC indexes were not possible to calculate, because of the resistance of clinical strains to the highest concentration of at least one antibiotic. The best results were achieved for combinations of dihydrostreptomycin with procaine penicillin because of higher number of cases synergy effect was observed. Antagonism of aminoglycosides and beta-lactams in case of gentamicin and amoxicillin for E. coli and E. cloacea strains were shown. Potential activity for combination of streptomycin and erythromycin was shown.

Aminoglycosides↗

[Gonococcal pharyngitis in a woman with genital gonorrhea].

Gonococci were isolated from pharyngeal swabs in a woman suffering from genital gonorrhoea. She admitted orogenital contact at her most recent intercourse. A single dose treatment with spectinomycin cured the genital and pharyngeal infections.

Adult↗

Susceptibility-resistance pattern of Neisseria meningitidis isolated in the province of Ontario, Canada.

A total of 522 N. meningitidis cultures isolated from different sources (cerebrospinal fluid, sputum, blood, naso-pharyngeal, uro-genital area, eye and rectal samples) between the years 1976-1977 in Ontario, were tested for their susceptibility pattern to 8 antibacterial drugs. Among the 522 cultures, 24.8% showed resistance to sulfadiazine (10-100 micrograns/ml) and all N. meningitidis cultures (100%) were resistant to spectinomycin (15 micrograms/ml); this feature could be used as one of the confirmation tests for N. meningitidis, especially with the strains which cause difficulty in identification and/or confirmation. Among the N. meningitidis cultures, 3.2% yielded maltose negative results in CTA sugars (cystine trypticase agar) and were also susceptible to sulfadiazine (10 micrograms/ml).

Anti-Bacterial Agents↗

Antibiotic susceptibility patterns of Neisseria gonorrhoeae isolates in Port Elizabeth.

OBJECTIVE: To survey the antibiotic susceptibility of Neisseria gonorrhoeae isolates. DESIGN: This was a cohort analytical study. SETTING: Three clinics serving different areas in Port Elizabeth. Outcome measures. Prevalence of antibiotic-resistant N. gonorrhoeae isolates. RESULTS: Twenty-one of the 35 isolates (60%) were resistant to ciprofloxacin, while 28 (80%) showed resistance to erythromycin, 17 (48.6%) to penicillin, 3 (8.6%) to doxycycline, 11 (31.4%) to spectinomycin and 33 (94.3%) to tetracycline. CONCLUSION: To ensure effective treatment of gonorrhoea, continued surveillance of antimicrobial susceptibility is necessary.

Adolescent↗

[Production of Brassica olereceae (+Arabidopsis thaliana) and Brassica napus cell lines resistant to spectinomycin/streptomycin as a result of plastome genetic transformation].

Plastid genetic transformation has been performed using both the PEG-treatment of protoplasts of somatic hybrids of B. oleracea carrying A. thaliana chloroplasts and the particle bombardment of regenerable calluses of B. napus sv. Westar. The chloroplast transformation vector pCB040 carried resistance (aadA) gene flanked by rapeseed plastid DNA sequences to target its insertion between the trnV-rps7 fragments. Selection of transplastomic cell lines has been performed according to their ability to grow on the medium supplied with spectinomycin and streptomycin in high concentrations. Antibiotic resistant cell lines have been obtained using the both transformation methods. The presence of the aadA gene in the A. thaliana and B. napus plastomes was confirmed by PCR analysis for two cell lines of B. oleracea (+ A. thaliana) and three lines of B. napus.

Arabidopsis↗

Prevalence of resistance of N. gonorrhoeae to penicillin and three other antibiotics in a rural area in Kenya.

Of 90 isolates of Neisseria gonorrhoeae in a rural area in Kenya, 44 (48.9%) produced beta-lactamase (penicillinase). Testing for susceptibility of 35 penicillinase producing N. gonorrhoeae (PPNG) strains to four antibiotics yielded the following results: 16 (45.7%) showed a decreased susceptibility to tetracycline; six (17.1%) showed resistance, probably plasmid mediated; 10 (28.6%) had intermediate susceptibility to gentamicin; one (2.9%) was resistant; and two (5.7%) isolates were resistant to cefotaxime. 16 (57.1%) of 28 non PPNG strains showed a decreased susceptibility to penicillin; 10 (35.7%) were resistant. Nine (32.1%) of 28 non-PPNG isolates showed intermediate susceptibility to tetracycline; one (3.6%) was resistant. Eight of non PPNG isolates (28.6%) showed decreased susceptibility to gentamicin. These results imply that penicillin and tetracycline should be abandoned as primary therapy. For the time being, thiamphenicol and spectinomycin seem to be good alternatives. The observation of cefotaxime resistance in N. gonorrhoeae in a rural area implies a warning concerning future possibilities for use of third generation cephalosporins.

Drug Resistance, Microbial↗

[Penicillinase-producing strains of N. gonorrhoeae (PPNG) in the Zurich area, 1981-1988: incidence, antibiotic sensitivity and plasmid profile (3)].

During the period 1981 to 1988 2688 strains of N. gonorrhoeae from patients with gonorrhea were investigated at the Department of Dermatology. Zürich University Hospital. The frequency of gonorrhea decreased by 86% (from 566 in 1981 to 76 in 1988). The proportion of PPNG strains varied between 3.5% and 6.5% until 1986 and increased to 20% in 1988. If chromosomal penicillin resistant strains are included, in 1988 25% of all isolated N. gonorrhoeae strains were resistant to penicillin. Until 1984 West African and South East Asian countries were almost exclusively the source of the PPNG strains. In 1988 our PPNG strains were acquired in all five continents. Since 1985 roughly 20% of the PPNG infections have been acquired in Zurich. 95 out of 125 PPNG strains between 1981 and 1988 were examined for plasmids. 85 out of 95 PPNG strains contained the 4.4-MD plasmid ("Asia plasmid") and 8 out of 95 the 3.2-MD plasmid ("Africa plasmid"), while 63 out of 95 PPNG strains additionally contained the 24,6-MD transfer plasmid. Antibiotic resistance was as follows: all PPNG strains were resistant to penicillin (MIC greater than 1 microgram/ml). 80% to 100% were resistant to tetracycline (MIC greater than 1 microgram/ml), and 100% were sensitive to spectinomycin (MIC less than 30 micrograms/ml) and to thiamphenicol (MIC less than 2 micrograms/ml) respectively.

Female↗

[Action of aminoglycosides on platelet aggregation in vitro].

The authors tested the influence of gentamicin, spectinomycin dihydrostreptomycin on the ADP and epinephrine in vitro induced platelet aggregation. Our aim was to demonstrate if platelet aggregation in vitro had some influences by antibiotics. A reduction in platelet aggregability, strictly dependent from the used antibiotic dose was observed. We have studied platelet function thanks to Born's method, adding to PRP gradual therapeutics doses of antibiotics. The results showed a reduction of platelet function which was dose-depended, and, particularly, gentamicin seemed to be the most effective among aminoglycosides. An interference between these drugs and the ADP and epinephrine binding to specific platelet receptor sites is proposed.

Adenosine Diphosphate↗

[Effects of aminoglycosides on T and B lymphocyte populations: in vitro study].

The authors tested the influence of gentamycin, spectinomycin,and dihydrostreptomycin on the formation of EAChu and EAT rosettes and they have found a significant reduction of the percentage of EAChu rosettes. Probably this reduction is due to an interaction with the receptor sites for the Complement of B lymphocytes and/or an in vitro denaturation Complement.

Adult↗

[Antimycoplasmal activities of ofloxacin and commonly used antimicrobial agents on Mycoplasma gallisepticum].

In vitro activities of ofloxacin (OFLX), a new quinolone derivative, against 29 strains of Mycoplasma gallisepticum was compared with those of 4 commonly used antimicrobial agents, doxycycline (DOXY), tylosin (TS), spectinomycin (SPCM) and thiamphenicol (TP). Antimycoplasmal activities of the drugs were evaluated on the MIC (final MIC) and MPC (minimum mycoplasmacidal concentration) values which were determined by a broth dilution procedure. The following results were obtained. 1. The MIC90s of OFLX and DOXY were both 0.20 micrograms/ml. The MICs of TS were distributed through a wide range (less than or equal to 0.006 - 0.78 micrograms/ml), and its MIC90 was 0.78 micrograms/ml. Of 29 M. gallisepticum strains, 27.6% were recognized as TS-resistant. The MIC90 values of SPCM and TP were 1.56 micrograms/ml and 3.13 micrograms/ml, respectively. The MIC90 of OFLX was equal to that of DOXY and 4- to 16-fold smaller than the values of the other 3 antibiotics. 2. The MPC of OFLX was the lowest among the antibiotics tested, its MPC90 value was 0.39 micrograms/ml and was followed by DOXY (1.56 micrograms/ml). The MPCs of TS were distributed in a wide range (0.012 - 3.13 micrograms/ml), and its MPC90 was 3.13 micrograms/ml. The MPC90 values of SPCM and TP were both 6.25 micrograms/ml. Therefore, the mycoplasmacidal activity of OFLX evaluated with MPC90 values was 4- to 16-fold greater than those of the other 4 antibiotics.

Doxycycline↗

[The sperm compatibility of lincospectin in the framework of the Federal Republic of Germany customary bull sperm preservation methods with the use of a Tris egg yolk thinner (clinical short report)].

Regulations considering the inner-community-exchange of frozen bovine semen prescribe the use of lincomycin and spectinomycin (LINCOSPECTIN) and streptomycin-penicillin as antibiotics in the diluted semen. A susceptibility test with Tris-egg yolk-freezing medium, mostly used in Germany, demonstrated that lincospectin in a concentration of 450 micrograms/ml diluted semen had no detrimental spermatologic effect on sperm function.

Animals↗