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Proficiencies of three anaerobic culture systems for recovering periodontal pathogenic bacteria.

Anaerobic culture is employed routinely in the primary isolation of periodontal pathogenic bacteria. However, little or no data exist on the relative abilities of the Coy anaerobic chamber (Coy Laboratory Products, Grass Lake, Mich.), the GasPak (Becton Dickinson Microbiology Systems, Cockeysville, Md.), and the AnaeroPack (Mitsubishi Gas Chemical America, Inc., New York, N.Y.) systems to grow important periodontal species, including Porphyromonas gingivalis, Prevotella intermedia/nigrescens, Bacteroides forsythus, Eubacterium species, Campylobacter species, Fusobacterium species, and Peptostreptococcus micros. A total of 78 specimens from advanced periodontitis lesions were collected anaerobically, plated on enriched blood agar medium, and incubated at 35 degrees C for 5 to 7 days in each anaerobic culture system. The three culture systems were equally efficient in isolating Porphyromonas gingivalis and Prevotella intermedia/nigrescens. The Coy anaerobic chamber yielded the highest proportional recoveries of Campylobacter (P = 0.0001; nonparametric analysis of variance) and Eubacterium (P = 0.009). The Coy anaerobic chamber and the GasPak system demonstrated higher proportional recoveries of Bacteroides forsythus (P = 0.0006) and Peptostreptococcus micros (P = 0.0001) than the AnaeroPack system. The AnaeroPack system was most efficient in growing Fusobacterium species (P = 0.0001). Overall, the Coy anaerobic chamber and the GasPak system showed the highest proportional recoveries of putative periodontal pathogens, but the recoveries by the various anaerobic test systems varied considerably from sample to sample.

Adult↗

Quantitative microbiological study of human carious dentine by culture and real-time PCR: association of anaerobes with histopathological changes in chronic pulpitis.

The bacteria found in carious dentine were correlated with the tissue response of the dental pulps of 65 teeth extracted from patients with advanced caries and pulpitis. Standardized homogenates of carious dentine were plated onto selective and nonselective media under anaerobic and microaerophilic conditions. In addition, real-time PCR was used to quantify the recovery of anaerobic bacteria. Primers and fluorogenic probes were designed to detect the total anaerobic microbial load, the genera Prevotella and Fusobacterium, and the species Prevotella melaninogenica, Porphyromonas endodontalis, Porphyromonas gingivalis, and Micromonas (formerly Peptostreptococcus) micros. The pulpal pathology was categorized according to the cellular response and degenerative changes. Analysis of cultured bacteria showed a predominance of gram-positive microorganisms, particularly lactobacilli. Gram-negative bacteria were also present in significant numbers with Prevotella spp., the most numerous anaerobic group cultured. Real-time PCR analysis indicated a greater microbial load than that determined by colony counting. The total number of anaerobes detected was 41-fold greater by real-time PCR than by colony counting, while the numbers of Prevotella and Fusobacterium spp. detected were 82- and 2.4-fold greater by real-time PCR than by colony counting, respectively. Real-time PCR also identified M. micros, P. endodontalis, and P. gingivalis in 71, 60, and 52% of carious samples, respectively. Correlation matrices of the real-time PCR data revealed significant positive associations between M. micros and P. endodontalis detection and inflammatory degeneration of pulpal tissues. These anaerobes have been strongly implicated in endodontic infections that occur as sequelae to carious pulpitis. Accordingly, the data suggest that the presence of high levels of these bacteria in carious lesions may be indicative of irreversible pulpal pathology.

Bacteria, Anaerobic↗

Prevalent bacterial species and novel phylotypes in advanced noma lesions.

The purpose of this study was to determine the bacterial diversity in advanced noma lesions using culture-independent molecular methods. 16S ribosomal DNA bacterial genes from DNA isolated from advanced noma lesions of four Nigerian children were PCR amplified with universally conserved primers and spirochetal selective primers and cloned into Escherichia coli. Partial 16S rRNA sequences of approximately 500 bases from 212 cloned inserts were used initially to determine species identity or closest relatives by comparison with sequences of known species or phylotypes. Nearly complete sequences of approximately 1,500 bases were obtained for most of the potentially novel species. A total of 67 bacterial species or phylotypes were detected, 25 of which have not yet been grown in vitro. Nineteen of the species or phylotypes, including Propionibacterium acnes, Staphylococcus spp., and the opportunistic pathogens Stenotrophomonas maltophilia and Ochrobactrum anthropi were detected in more than one subject. Other known species that were detected included Achromobacter spp., Afipia spp., Brevundimonas diminuta, Capnocytophaga spp., Cardiobacterium sp., Eikenella corrodens, Fusobacterium spp., Gemella haemoylsans, and Neisseria spp. Phylotypes that were unique to noma infections included those in the genera Eubacterium, Flavobacterium, Kocuria, Microbacterium, and Porphyromonas and the related Streptococcus salivarius and genera Sphingomonas and TREPONEMA: Since advanced noma lesions are infections open to the environment, it was not surprising to detect species not commonly associated with the oral cavity, e.g., from soil. Several species previously implicated as putative pathogens of noma, such as spirochetes and Fusobacterium spp., were detected in at least one subject. However, due to the limited number of available noma subjects, it was not possible at this time to associate specific species with the disease.

Adolescent↗

Survival of anaerobic bacteria in common laboratory diluents.

The survival of six species of anaerobic bacteria was studied in simple or commercially available diluents. Bacteroides fragilis and Fusobacterium nucleatum showed excellent survival in all diluents including distilled water. Fusobacterium mortiferum survived well in all diluents except water and water supplemented with 0.1% gelatain. Clostridium perfringens survived best in phosphate-buffered saline with gelatin. Peptococcus asaccharolyticus required gelatin added to the basic diluent, and Streptococcus intermedius showed excellent survival only in minimal essential medium with gelatin. These diluents could provide effective and economical alternatives to more complex and costly diluents often used in work with anaerobic bacteria.

Anaerobiosis↗

The bacteriology of the supragingival plaque of child dental patients in Kuwait.

OBJECTIVE: To investigate the bacterial flora of the gingival plaques of pediatric dental patients in order to establish baseline data for future studies on the complex microbiota of the oral cavity of this group of child dental patients. SUBJECTS AND METHODS: Forty subjects, aged 3-12 years, were enrolled and investigated after informed consent was obtained. During the patients' first visit to the dental clinic supragingival plaque samples were collected from the gingival area of buccal and lingual tooth surfaces of all primary and permanent molar teeth using sterile curettes. Serially diluted samples were inoculated onto a set of selective and nonselective media and then incubated at the appropriate atmospheric conditions and temperatures. Representative colonies of isolates were identified by standard methods, including hemolytic characteristics on blood agar and profiling on API 20S and API 20A as appropriate. RESULTS: A total of 183 isolates (123 aerobes and 60 anaerobes) were recovered from the 40 patients with a mean count of 3 per sample of aerobes compared to 1.5 per sample for the anaerobes. Streptococcus sanguis was the predominant aerobic species (23.6%) isolated from 29 (72.5%) of the 40 patients, followed by Streptococcus mitis, 19.5 and 60%, Streptococcus salivarius, 17.1 and 52.5% and Streptococcus mutans, 17.1 and 52.5%. The frequency of isolation of anaerobic bacteria was Prevotella spp. 50% from 30 (75%) of the 40 patients, Fusobacterium spp., 18.3 and 27.5%, Bacteroides spp., Porphyromonas spp. and Peptostreptococcus spp., 6.7 and 10%, 6.7 and 10%, and 5 and 7.5%, respectively. Prevotella intermedia was the single most common species. CONCLUSION: The results show that there were more aerobic/facultative anaerobic bacteria than the obligate anaerobes in the dental plaque of the pediatric dental patients in Kuwait. The high prevalence of the pioneering streptococci as well as black-pigmented Prevotella spp. and Fusobacterium spp. indicates that the dental plaques of the children were in the developing stage, a precursor to the development of periodontal diseases.

Bacteria, Aerobic↗

A multicentre study to evaluate the effect of sulbactam/ampicillin combination on anaerobic micro-organisms.

Ampicillin combined with the beta-lactamase inhibitor sulbactam was compared with ampicillin alone, cefoxitin and metronidazole against 569 clinical strains of anaerobic organisms. The strains included 289 species of Bacteroides, 160 strains of Clostridium and 120 strains of various species of Streptococcus/Peptostreptococus, Fusobacterium, Veillonella, Eubacterium, Bifidobacterium, Actinomyces and Propionibacterium. Sulbactam/ampicillin was as effective as cefoxitin and metronidazole against all anaerobic species tested, inhibiting more than 90% of strains at the breakpoints (16, 32 and 32 mg/l, respectively). Sulbactam/ampicillin was also significantly more active than ampicillin against strains of Bacteroides, the minimal inhibitory concentration being at least four-fold lower. In contrast, the activity of the combination did not differ from that of ampicillin alone against Fusobacterium species and Gram-positive rods and cocci.

Ampicillin↗

Comparative in vitro activity of PH-027 versus linezolid and other anti-anaerobic antimicrobials against clinical isolates of Clostridium difficile and other anaerobic bacteria.

PH-027 is a new 5-triazole oxazolidinone synthesized in our laboratories, which shows strong activity against gram-positive aerobic bacteria including clinical isolates. The objective of this study was to investigate the in vitro activity of this compound in comparison with linezolid and other antibiotics against gram-positive and gram-negative anaerobes. The in vitro activity of PH-027 in comparison with those of linezolid and other antimicrobial agents was evaluated against 201 clinical isolates of gram-positive and gram-negative anaerobic bacteria by agar dilution and Etest methods. PH-027 showed excellent activity, with minimum inhibitory concentrations (MIC) in the range of 0.12-4.0 microg/ml against all isolates; MIC90s being 4.0, 1.0, 2.0, 2.0 and 2.0 microg/ml against Clostridium difficile, Peptostreptococcus spp., Bacteroides fragilis, Prevotella bivia and Fusobacterium spp. respectively. In comparison, linezolid had MIC in the range of 0.5-4.0 microg/ml against all isolates, with MIC90s of 2.0, 4.0, 4.0, 4.0 and 2.0 microg/ml against the same set of bacteria respectively. PH-027 demonstrated excellent in vitro activity that is superior to linezolid against Peptostreptococcus spp., B. fragilis and P. bivia. However, against C. difficile and Fusobacterium spp, PH-027 and linezolid showed comparable in vitro activity. Against all anaerobes, metronidazole, PH-027 and, to a lesser extent, linezolid had the most potent activity. From the results of in vitro susceptibility testing, both linezolid and PH-027 show promise in the treatment of anaerobic infections.

Acetamides↗

Constitutive beta-glucosidases hydrolyzing ginsenoside Rb1 and Rb2 from human intestinal bacteria.

When ginsenoside Rb1 and Rb2 were anaerobically incubated with human intestinal microflora, these ginsenosides were metabolized to 20-O-beta-D-glucopyranosyl-20(S)-protopanaxadiol (compound K) and 20(S)-protopanaxadiol. Several kinds of intestinal bacteria hydrolyzed these ginsenosides. Eubacterium sp., Streptococcus sp. and Bifidobacterium sp., which more potently hydrolyzed gentiobiose than sophorose, metabolized ginsenoside Rb1 to compound K via ginsenoside Rd rather than gypenoside XVII. However, Fusobacterium K-60, which more potently hydrolyzed sophorose than gentiobiose, metabolized to compound K via gypenoside XVII. Ginsenoside Rb2 was also metabolized to compound K via ginsenoside Rd or compound O by human intestinal microflora. Eubacterium sp., Streptococcus sp. and Bifidobacterium sp. metabolized ginsenoside Rb2 to compound K via ginsenoside Rd rather than compound O. Fusobacterium K-60 metabolized ginsenoside Rb2 to compound K via compound O.

Antineoplastic Agents↗

PCR for the detection of Streptobacillus moniliformis.

Streptobacillus moniliformis is a Gram-negative bacterium found in various laboratory animal species and is the cause of rat bite fever and Haverhill fever in man. In order to evaluate a polymerase chain reaction (PCR) for the detection of this zoonotic bacterium in animal tissues a set of primers was designed based on the DNA base sequence of part of the 16S rRNA gene from 11 S. moniliformis strains. The PCR detected as few as 2-6 copies of S. moniliformis DNA. A 296 bp DNA fragment was amplified from S. moniliformis strains from rodents, humans and turkeys. Amplicons of about the same size were obtained from Fusobacterium necrogenes and Sebaldella (Bacteroides) termitidis but Bfa I treatment of these amplicons did not result in the S. moniliformis specific 130 bp DNA fragment. The in silico evaluation of 14 additional Fusobacterium spp. and 12 unculturable phytoplasmas indicated that none is likely to give rise to confusing amplicons or DNA fragments. The PCR detected S. moniliformis infection in all four orally- and four intravenously-infected C57BL/6 mice and the bacterium was cultured from all but one mouse. The PCR detected S. moniliformis infection in all 12 orally-infected WU rats, and in five of eight rats exposed to natural infection. Enzyme linked immunosorbent assay (ELISA) and PCR were equally successful in detecting infection in rats but S. moniliformis was not detected by using culture.

Animals↗

Oral flora of mongrel and beagle dogs with periodontal disease.

The plaque flora was studied in adult mongrel and beagle dogs with periodontal disease. Gingival plaque from maxillary premolars was removed and cultured on various growth media. The flora in all dogs was composed of mostly anaerobic gram negative rods. Bacteroides asaccharolyticus was found in the highest proportion of plaque samples from mongrel dogs, and decomposed hydrogen peroxide suggesting catalase activity. Fusobacterium nucleatum was found in higher proportion in the plaque of beagle dogs as compared to B. asaccharolyticus. With the increasing numbers of obligative anaerobic gram negative organisms such as B. asaccharolyticus, the proportions of Streptococcus, Enterococcus and Staphylococcus decreased in the dogs with periodontal disease. The salivary flora was different from the plaque flora of the dogs with periodontal disease. It was constant regardless with the disease. The salivary flora of beagle dogs with the healthy gingiva was different from that of mongrel dogs. Enterococcus, Lactobacillus, Eubacterium and black-pigmented Bacteroides (BPB, mainly B. asaccharolyticus) were higher proportion in the flora of beagle dogs as compared to mongrel dogs, while Fusobacterium, Enterobacteriaceae, yeast and molds were lower in the flora. The results reveal that B. asaccharolyticus and F. nucleatum are common pathogens and uniquely contribute to the development of gingival inflammation in dog.

Animals↗

Effect of periodontal status of rotary electric toothbrushes vs. manual toothbrushes during periodontal maintenance. II. Microbiological results.

We compared the use of a rotary electric toothbrush with conventional toothbrushing for their effectiveness in modulating the subgingival microbiota. Forty subjects who had received periodontal treatment for moderate to advanced periodontitis and were on 3-month periodontal maintenance were divided into two equal groups matched for age and sex. One group used only the rotary tooth cleaner and the other group used conventional toothbrushing, dental floss, and toothpicks for 12 months. Subgingival plaque samples (two sites per patient) were taken from 10 subjects per group at baseline, 6 months, and 12 months and analyzed for percentage of obligate anaerobes and colony-forming units of black-pigmented Bacteroides, Fusobacterium, Actinomyces, Streptococcus, and Veillonella spp. The percentage of spirochetes and motile rods was determined by darkfield microscopy. Results showed that levels of obligate anaerobes, Fusobacterium, and Actinomyces and percentage of spirochetes and motile rods decreased significantly (P less than 0.05), while levels of Streptococcus spp. increased (P less than 0.05) for both groups. However, there was no significant difference between the two groups, indicating that the rotary tooth cleaner and conventional toothbrushing are equally effective in controlling gingivitis and fostering a less pathogenic microflora.

Adult↗

Studies of the subgingival microflora in patients with acquired immunodeficiency syndrome.

Two unique forms of periodontal disease, HIV-gingivitis and HIV-periodontitis, have been described in patients with Acquired Immunodeficiency Syndrome (AIDS). In order to determine the bacterial species associated with periodontitis in AIDS patients, the predominant cultivable microflora was examined in 21 subgingival plaque samples from 11 AIDS patients with periodontitis. The presence of putative periodontal pathogens including Actinobacillus actinomycetemcomitans, Bacteroides intermedius, Porphyromonas gingivalis (formerly B. gingivalis), and Wolinella recta was examined by immunofluorescence in 128 subgingival dental plaque samples from 50 AIDS patients including 32 patients with periodontitis. Of 666 bacterial strains isolated from the 21 subgingival plaque samples, Streptococcus sanguis II was the most frequently recovered species comprising 18.5% of the total number of isolates followed by Lactobacillus acidophilus (12.2%), Porphyromonas gingivalis (12%), Fusobacterium nucleatum (11.4%), Staphylococcus epidermidis (8.7%), Actinomyces naeslundii (7.5%), and Actinomyces viscosus (4.7%). Fusobacterium nucleatum was the most prevalent species and was found in 76% of the sites and 91% of the patients. Enteric species including Enterococcus avium and Enterococcus faecalis, Clostridium clostridiiforme and Clostridium difficle as well as Klebsiella pneumoniae also were recovered. Immunofluorescence assays detected similar carriage rates of A. actinomycetemcomitans, B. intermedius, and P. gingivalis in both gingivitis patients and periodontitis patients, while four times more periodontitis patients demonstrated W. recta. Subgingival yeast was a frequent finding in these AIDS patients, present in 62% of the subjects and 55% of the sites. This study indicates that subgingival plaque in AIDS patients with periodontitis can harbor high proportions of the same periodontal pathogens as are associated with periodontitis in non-HIV infected subjects as well as high proportions of opportunistic pathogens.

Acquired Immunodeficiency Syndrome↗

Microbiological study of HIV-related periodontitis.

The subgingival microbiota in 14 persons with HIV-periodontitis was examined. Subgingival plaque samples were collected with paper points, transported in VMGA III, and plated on anaerobic enriched brucella blood agar and various selective media. HIV-periodontitis sites revealed Actinobacillus actinomycetemcomitans, Wolinella recta, Peptostreptococcus micros, and Bacteroides intermedius, each averaging 7% to 16% of the cultivable subgingival flora in positive patients. High levels of spirochetes also were detected in diseased sites with phase-contrast microscopy. Low levels of Candida albicans or enteric Gram-negative rods were recovered in the subgingival flora in 7 HIV-periodontitis patients or Bacteroides fragilis, Fusobacterium necrophorum, Fusobacterium varium, and Eubacterium aerofaciens were recovered in 8 patients. These findings suggest that the major components of the subgingival microbial flora in HIV-periodontitis are similar to those associated with adult periodontitis in systemically healthy persons. However, HIV-periodontitis lesions also may contain organisms which are rarely found in common types of periodontitis. The etiological significance of specific periodontal organisms in HIV-periodontitis awaits further longitudinal study.

AIDS-Related Complex↗

Microbial composition and pattern of antibiotic resistance in subgingival microbial samples from patients with refractory periodontitis.

A series of 993 subgingival microbial samples sent to a diagnostic microbiology laboratory included 196 samples that could be identified as compatible with a clinical diagnosis of refractory or recurrent periodontitis. In descending order of prevalence the associated microbiota included Bacteroides forsythus (84%), spirochetes (83%), motile rods (76%), Fusobacterium species (68%), Porphyromonas gingivalis (63%), Campylobacter rectus (47%), Capnocytophaga species (38%), Prevotella intermedia (23%), Peptostreptococcus micros (18%), Actinobacillus actinomycetemcomitans (16%), Candida (14%), enteric rods (9%), Staphylococcus species, not including aureus (5.6%). Eikenella corrodens (3%), Staphylococcus aureus (1.5%), and Enterococcus species (< 1%). Antibiotic resistance to tetracycline, penicillin G, or metronidazole was particularly noticeable for enteric rods, Fusobacterium species, Capnocytophaga species, Staphylococcus, and Actinobacillus actinomycetemcomitans. It was largely absent for Campylobacter rectus. No antibiotic sensitivity data were obtained for Porphyromonas gingivalis or Bacteroides forsythus, as these species were detected by immunofluorescence. The results indicate that a substantial number of microorganisms associated with refractory periodontitis are variably resistant to commonly-used antibiotics. Diagnostic microbiology must be considered an essential adjunct to the therapist faced with periodontal lesions refractory to conventional treatment.

Adult↗

A model of spontaneous periodontitis in the miniature goat.

BACKGROUND: The pathogenesis and progression of periodontal disease have been extensively studied through the use of animal models. However, no animal model has yet been established that is precisely similar to periodontitis in humans. In the present study, we examined the use of Shiba goats as a model for spontaneous periodontitis. METHODS: Thirty-four Shiba goats (seven males and 27 females, aged 10 to 98 months) were used. We examined periodontitis in Shiba goats clinically, histopathologically, and microbiologically. RESULTS: The mean probing depth (PD) of the 68 teeth examined was 2.7 +/- 0.8 mm. The incidences of PD > or =3 and 4 mm were 46.4% and 22.1%, respectively. The incidence of bleeding on probing in 68 sites and in 34 animals was 60.7% and 73.5%, respectively. The formation of vertical alveolar bone defects and downgrowth of gingival epithelial cells were found in the areas of periodontitis. The prevalence of Tannerella forsythensis, Campylobacter rectus, Fusobacterium necrophorum, Fusobacterium nucleatum, and Actinobacillus actinomycetemcomitans in subgingival plaque by polymerase chain reaction was 46.4%, 28.5%, 28.5%, 17.8%, and 3.5%, respectively. These percentages were increased in subgingival plaque from PD > or =3 mm. CONCLUSIONS: The clinical, histopathological, and microbiological features of spontaneous periodontitis in Shiba goats were somewhat similar to those in human periodontitis. Moreover, there are some advantages of using the Shiba goat; the size of the oral cavity is suitable for periodontal treatment, and handling and housing are relatively easy. Therefore, these results suggest that the Shiba goat is a useful animal model for human periodontitis.

Animals↗

[Microbiological evaluation of topical application of the controlled release strips containing ofloxacin (PT-01) in the human periodontal pocket].

The recognition that destructive periodontal diseases may be caused by specific microorganisms has led to an increased interest and usage of antimicrobial agents in periodontal therapy. In this study, the effect of topical application of ofloxacin (OFLX), a synthetic antibiotic, was microbiologically evaluated. The new developed controlled release strips containing OFLX (PT-01), in which there were structurally immediate- and sustained-releasing portions, were applied to the periodontal pockets of 27 adult subjects with periodontitis. Three different sites with a deep probing pocket depth (greater than or equal to 5 mm) were randomly selected in each patient, and were divided into three groups, i.e., PT-01 applied site (T), placebo-applied site (P) and control site (C). Periodontal treatments consisted of oral hygiene instruction and supragingival scaling on day 0 and 7, and subgingival scaling and root planing on day 14. PT-01 was weekly applied on day 0 to 35, and the subgingival plaque samples from each site were collected on day 0, 14, 21 and 42. The dynamics of subgingival microflora was investigated by dark field microscopy for determination of the %s of spirochetes, motile rods and coccoid cells, and anaerobic and aerobic cultivations for the determinations of the total number of subgingival bacteria, black-pigmented Bacteroides (BPB), Fusobacterium species and Actinobacillus actinomycetemcomitans. The results showed that the significant reduction of %s of spirochetes and motile rods and significant increase of % coccoid cells were found in only PT-01 applied sites during first 14 days. In this period, the total number of cultivable bacteria, BPB and Fusobacterium species were also significantly reduced in T sites. While, after subgingival scaling and root planing were performed, significant changes in the proportions and numbers of the subgingival microflora were found in all sites. Especially, PT-01 applied site showed significant improvement in the %s of spirochetes and motile rods as well as the total number of the bacteria. Moreover, the further microbiological determinations of the each isolate revealed that no detectable amounts of A. actinomycetemcomitans could be found from any samples in this study. These results suggested that weekly application of PT-01 in the periodontal pocket could have significant effects on the qualitative and quantitative improvements in the subgingival microflora. It was also suggested that the application of PT-01 might have ameliorating effect as adjuncts of mechanical subgingival plaque control in the periodontal treatment.

Adult↗

Bacteriology of odontogenic apical periodontitis and effect of penicillin treatment.

The microbiology and treatment of apical periodontitis was studied in 62 patients, followed-up for 1 year. The clinical treatment and the radiological technique were standardized. One third of the patients received no systemic antibiotics, one third received phenoxymethylpenicillin for 1 week, and one third for 3 months. On the average, 0-2 facultatively anaerobic and 4-6 anaerobic bacteria were isolated from periapical infections. The genera Bacteroides and Fusobacterium in addition to anaerobic gram-positive cocci were found most frequently. Minimum inhibitory concentrations of benzylpenicillin against 269 strains were tested. 12 strains were resistant at the concentration 2.4 micrograms/ml, including 4 strains of Fusobacterium sp. All patients were free of symptoms 1 month after the admission. Only 1 patient failed to show any progress in radiological healing. No differences between the groups in relation to penicillin therapy were found.

Adult↗

In-hospital anaerobic susceptibility testing: an aid to formulary decision making.

In this study, the susceptibility of 116 recent anaerobic isolates, including the Bacteroides fragilis group (n = 22), Bacteroides spp (n = 65), gram-positive cocci (n = 13), Clostridium spp (n = 10), and Fusobacterium spp (n = 6) were tested by agar dilution against a variety of agents suggested for prophylaxis or therapy. These agents included ampicillin sodium and sulbactam sodium, cefotaxime, cefoxitin, ceftizoxime, clindamycin, imipenem-cilastatin, metronidazole, and ticarcillin and clavulanate potassium. All anaerobes demonstrated 100% susceptibility to imipenem-cilastatin, metronidazole, ampicillin sodium and sulbactam sodium, and ticarcillin and clavulate potassium. Varying degrees of susceptibility (ranging from 60% to 100%) of Bacteroides spp to the selected panel of antibiotics were seen. Fusobacterium spp and the gram-positive cocci were inhibited by all agents tested. Clostridium spp was 90% susceptible to cefoxitin, 80% susceptible to clindamycin, and 100% susceptible to the other six agents. Due to the varying activity of these agents, local susceptibility patterns, antimicrobic spectrum, and cost effectiveness must be considered in the choice of agents used for empiric therapy.

Anti-Bacterial Agents↗