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[In vitro evaluation of susceptibility to selected antibiotics of strains of staphylococcus aureus isolated from purulent skin changes].

Resistance to antibiotics of Staphylococcus aureus strains isolated from purulent skin changes during the years 1987-1991 was investigated. The antibiogram was performed by the disc-diffusion method. Susceptibility to penicillin, ampicillin, cloxacillin, gentamicin, doxycycline, erythromycin, tetracycline, and lincomycin was determined. In investigated material during years 1987-1991 high percentage of resistant strains was found in the case of penicillin (from 70% to 66.2%), cloxacillin (66.6%-86.4%) and tetracycline (50%-66.2%). High and rising in time percentage of strains resistant to ampicillin, erythromycin and cephradine was also found. Increase of resistance was also observed with gentamicin (1987--7.1%, 1991--27%) and doxycycline++ (1987--12.7%, 1989--35.3%, 1991--17.6%), while resistance to lincomycin was keeping on a generally equal level within 20% (1987) to 26% (1991). In 1991 susceptibility of 42 strains of Staphylococcus aureus was tested to cefamandole, cefoperazone, cefotaxime, ceftriaxone, cefuroxime, amikacin and netilmicin. No resistant strains to these antibiotics were found.

Bacterial Typing Techniques↗

[Antibiotic sensitivity of streptococci of the A, B, C and G serogroups isolated in 1987-1990].

Antibiotic susceptibility of 1114 cultures of beta-hemolytic streptococci belonging to serogroups A, B, C and G was tested. The cultures were isolated from healthy and diseased children and adults. Group A, C and G streptococci were shown to be highly susceptible to beta-lactams, erythromycin, lincomycin, chloramphenicol and ristomycin. Erythromycin, lincomycin, ristomycin and ampicillin (a beta-lactam) proved to be the most active antibiotics against group B streptococci. Streptococci of the four groups had low susceptibility to tetracycline and especially gentamicin. The different antibiotic susceptibility of the streptococcal cultures isolated from the diseased and healthy children and adults is discussed.

Adult↗

[Large variation in the treatment of foot infections in diabetic patients in The Netherlands].

OBJECTIVE: To determine the treatment of foot infections in patients with diabetes mellitus and the implementation of the Dutch consensus guidelines. DESIGN: Questionnaire. SETTING: Nationwide. METHOD: To 180 internists and paediatricians were sent a letter explaining the objective of the survey and a questionnaire. After two months an identical questionnaire was sent, with the request to return it when the first questionnaire had not been returned yet. RESULTS: Seventy-three questionnaires (40%) were returned of which 63 were evaluable. The main reason for hospitalisation was the threat of limb loss (90%). Most patients presenting with superficial wound infections were treated with local surgical procedures (90%); however, 16% of the responders considered hospitalisation indicated. If osteomyelitis was present 81% of the responders would hospitalize the patient. Antibiotic treatment was instituted by 93%. In all, 11 different antibiotics were used. Of antibiotic combinations the combination of penicillin and lincomycin was used most frequently and the recommended combination of aminoglycoside and lincomycin least. The main reason for using a combination of antibiotics was presence of polymicrobial flora (93%). CONCLUSION: We conclude that treatment of diabetic foot is still very diverse in spite of the consensus guidelines.

Anti-Bacterial Agents↗

Anticoccidial activity of eight compounds in domestic mink.

Eight compounds were tested for anticoccidial activity in 44 domestic mink (Mustela vision). A treatment group consisted of 4 mink exposed to 2 inoculumns of sporulated oocysts on day 0 and day 22 of the experiments. Each inoculum contained 2,000 Isospora laidlawi, 2,000 Eimeria vision, and 2,000 Eimeria sp. One compound was administered to each treatment group; a control of 4 juvenile mink and a control group of 4 adult mink were designated. All treatments were given each day for 30 days after the initial exposure, except lincomycin which was administered for 14 days. In juvenile mink (3 to 4 months old), amprolium at dose level of 0.012% and sulfaquinoxaline at dose level of 0.024% in the water inhibited almost all of the oocyst production when compared with that of the control group. Lincomycin injected at dose level of 5 mg/day/mink was ineffective in suppressing oocyst production. In adult mink (2 to 4 years) monensin sodium at dose level of 0.012% a commercial antiobiotic-sulfonamide mixture at dose level of 0.49%, and lasalocid solium at dose level of 0.01% in the feed inhibited almost 100% oocyst production. Lasalocid sodium at dose level of 0.10% in the feed was lethal to 3 to 4 mink. Sulfamethazine at dose level of 0.014% and sulfathiazole at 0.014% in the feed had limited anticoccidial activities.

Amprolium↗

Drug-induced colitis mimicking an acute surgical condition of the abdomen.

Pseudomembranous colitis secondary to antibiotic therapy has received increasing recognition. During a one-year period, eight of 42 patients with this entity had findings closely resembling an acute surgical condition of the abdomen manifested by fever, leukocytosis, and severe abdominal pain and tenderness. All eight patients received clindamycin and two were also given lincomycin hydrochloride monohydrate. Differentiation from an acute surgical condition of the abdomen was difficult until the characteristic findings of pseudomembranous colitis were noted on proctoscopic examination. Unnecessary celiotomy was averted in all patients. Seven of eight patients responded to discontinuation of the antibiotic and supportive measures; one required a diverting ileostomy. Drug-induced colitis must be an important consideration in any patient recently receiving antibiotics who develops fever, abdominal pain, and diarrhea.

Abdomen, Acute↗

Carbohydrate natural products as a scaffolding for the preparation of potential neuraminidase inhibitors.

Compound 10b, 6-acetamido-6,8-dideoxy-D-erythro-beta-D- galacto-octopyranosyl-1-oxyacetic acid sodium salt, was synthesised by hydrazinolysis of Lincomycin, acetylation of methylthiolincosaminide (MTL) 9a, and by subsequent glycosylation of acetate 9b with methyl glycolate under mild conditions (NIS/TfOH). The methyl ester 10a was hydrolysed by treatment with Amberlite Ira-4OO (OH-) resin and aqueous sodium hydroxide, followed by neutralisation with Dowex-50 W x 8 (H+) resin and lyophilisation to give 10b. This carboxylate may represent the first derivative in a novel series of sialidase inhibitors utilising carbohydrate natural products. The phosphonate 11c, prepared under the same experimental conditions with dibenzyl(hydroxymethyl)phosphonate as acceptor, also displays an inhibitory activity towards Clostridium perfringens sialidase (Ki in mM range as with Neu5Ac).

Acetates↗

Wound infections due to Bacteroides fragilis following intestinal surgery.

Ninety-six wound infections due to Bacteroides fragilis occurring after intestinal surgery are described. Most infections followed appendicectomy or colectomy for diverticulitis. B. fragilis was isolated in pure growth from 47 per cent of infections, and in mixed culture the other common bacteria were Klebsiella spp., Escherichia coli and Enterobacter spp. Fifty-three per cent of the infections responded rapidly to either non-specific measures or antibiotic therapy, but 47 per cent of patients developed complications, usually abscess formation. The successful isolation of bacteroides from clinical material requires special precautions. The specimen for bacteriological examination must be sent to the laboratory in a transport medium which maintains an anaerobic environment and the culture techniques must include a selective agar for the isolation of anaerobic bacteria. The role of antibiotic therapy in preventing postoperative wound infection after intestinal surgery is discussed. Bacteroides has an unusualy pattern of antibiotic susceptibility and it is essential that an effective antibiotic such as lincomycin is included in the treatment of infection originating from the intestinal tract.

Abscess↗

The treatment of acute abscesses by incision, curettage and primary suture under antibiotic cover.

One hundred and fifty consecutive acute abscesses have been treated by incision, curettage and primary suture under antibiotic cover. The antibiotic used in this series was lincomycin 600 mg i.m. with premedication and clindamycin 150 mg 6-hourly for 4 days postoperatively (children and infants received smaller doses). Similar results for the rate of healing were achieved in all groups of abscesses. A case is made for the use of the technique of incision, currettage and primary suture with antibiotic covere for acute abscesses as an alternative to conventional methods of treatment.

Abscess↗

Determination of clindamycin in animal plasma by high-performance liquid chromatography combined with electrospray ionization mass spectrometry.

A method for the quantification of clindamycin in animal plasma using high-performance liquid chromatography combined with electrospray ionization mass spectrometry (LC/ESI-MS/MS) is presented. Lincomycin is used as the internal standard. The sample preparation includes a simple deproteinization step with trichloroacetic acid. Chromatographic separation is achieved on an RP-18 Hypersil column using gradient elution with 0.01 M ammonium acetate and acetonitrile as mobile phase. Good linearity was observed in the range 0-10 microg ml(-1). The limit of quantification of the method is 50 ng ml(-1) and the limit of detection is 1.3 ng ml(-1). The method was shown out to be of use for pharmacokinetic studies of clindamycin formulations in dogs.

Animals↗

Hypersecretion of mucus glycoprotein by the gallbladder epithelium in experimental cholelithiasis.

In three models of cholelithiasis (dihydrocholesterol-fed rabbits, cholesterol-cholic acid-fed mice, and Lincomycin-treated guinea pigs), the quantity and chemical composition of gallbladder epithelial mucin have been studied using (1) a spectrum of histochemical glycoprotein stains, and (2) biochemical extraction, purification and analysis of the carbohydrate components of epithelial mucin. Despite the diverse mechanism of stone induction and difference in stone composition, a common pattern of response by the epithelial mucin was observed in all three models. There was a quantitative increase in epithelial mucus production at a time before stones were formed and this increase persisted till stones were formed. There was no difference, qualitatively, between mucus produced by normal and stone-forming gallbladders.

Animals↗

Enhanced levels of biochemical markers for cobalamin deficiency in totally gastrectomized rats: uncoupling of the enhancement from the severity of spongy vacuolation in spinal cord.

The totally gastrectomized (TGX) rat is a new experimental model for studying the pathogenesis of cobalamin (Cbl)-deficient myelopathy, i.e., subacute combined degeneration, total gastrectomy (TG) serving as a surgical paradigm of human pernicious anemia. We determined the serum levels of some biochemical indicators of Cbl deficiency in TGX rats at 2 to 10 months after TG. Methylmalonic acid (MMA) rose within 2 months and progressively increased thereafter until the end of the investigation period. 2-Methylcitric acid (MCA) rose significantly by 6 months and showed a further increment 4 months later. Homocysteine was only clearly elevated much later than the serum MMA, i.e., 10 months after the operation. The concentrations of MMA, MCA, and cystathionine were increased in kidney, liver, and spinal cord (SC) of TGX rats at 10 months. Chronic treatment of TGX rats with Cbl greatly decreased the serum levels of all the metabolic indicators of Cbl deficiency. Chronic peroral administration of the antibiotic lincomycin to TGX rats in an attempt to suppress the enteric flora markedly decreased serum MMA levels. Only Cbl, however, given either for the first 2 months after TG or for the third and fourth postoperative months (i.e., after SC abnormalities had already appeared) significantly decreased the severity of spongy vacuolation in SC white matter, although not completely preventing or repairing the neuropathological damage. Therefore, neither the early impairment in TGX rats of the Cbl-dependent methylmalonyl-coenzyme A mutase reaction nor the more delayed impairment of the Cbl-dependent methionine synthase step, as reflected by changes in serum metabolite levels, seems to be causally related to the TG-induced spongy vacuolation in SC white matter.

5-Methyltetrahydrofolate-Homocysteine S-Methyltran↗

Effects of the combination antibiotic--EDTA-Tris in the treatment of chronic bovine endometritis caused by antimicrobial-resistant bacteria.

The combined effects of the uterine infusion of EDTA-Tris solution and antibiotics have been evaluated in 75 cases of slight, moderate or severe bovine endometritis which did not respond to local routine antimicrobial therapy. Antibiotic-resistant bacteria were isolated from uterine swabs. The cows were divided into three groups on the basis of the severity of endometritis and treated with 100 ml of sterile EDTA-Tris solution (250 mM EDTA and 50 mM tris, pH 8) and the same antibiotic used in the first unsuccessful treatment (oxytetracycline, enrofloxacin, lincomycin-spectinomycin or amikacin). Control groups consisting of six animals treated with antibiotic alone were used. Clinical evaluations performed 2, 15, 21, 42 and 63 days after treatment revealed good therapeutic results, as 53 cows showed a complete recovery with renormalization of the subsequent oestrus cycle. Artificial insemination was followed by pregnancy in about 90% of treated cows. In control animals the second treatment performed using only the antibiotic gave variable and unsatisfactory results, particularly in animals affected by severe endometritis.

Amikacin↗

Characterization of the antibiotic resistance plasmid ERL1 from Streptococcus pyogenes.

The streptococcal plasmid ERL1 determining inducible resistance to erythromycin, lincomycin, and staphylomycin S was isolated by dye-buoyant density centrifugation and shown to have a molecular weight of about 17.5 Mdal, as revealed by sedimentation through neutral sucrose gradients. In SM60 cells entering the stationary phase its covalently closed circular form was present to the extent of 5 copies per chromosomal genome equivalent, ERL1 was subject to the DNA restriction and modification mechanism discovered in strain 56188. It did not appear to exercise restriction of phage DNA but mediated a partial release of the restricted growth of A25.

DNA, Bacterial↗

[Release of antibiotics from bone cement and penetration to infected cortical bone (author's transl)].

Addition of antibiotics to bone cement is used more and more in orthopedics and traumatology. Indications are discussed: 1. infection prophylaxis in replacement arthroplasty, 2. therapy and recidive prophylaxis in infected arthroplasty, 3. therapy of chronic osteomyelitis. Our own experiments show release of antibiotics from bone cement Palacos and penetration into cortical bone after experimental osteomyelitis. Carbenicillin and Cephalotin show high level of concentration for 2 weeks, after 3 weeks there is no concentration evident. Lincomycin and Gentamycin in the first days show high tissue levels, after decrease and increase again after second week. Gentamycin was examined during 10 months showing high levels after this time.

Animals↗

Secretion of staphylocoagulase be Staphylococcus aureus: the role of a cell-bound intermediate.

A cell-bound staphylocoagulase could be detected in chemostat cultures of Staphylococcus aureus 104 under magnesium-and oxygen-limited growth conditions. A distribution study revealed that 81% of the enzyme was membrane-bound and could be optimally released by Triton X-100. The remaining part was located in the periplasmic space and was released during protoplasting of organism. From inhibition studies with cerulenin, quinacrine, lincomycin an chloramphenicol, it was concluded that the cell-bound form was precursor in the secretion of extracellular staphylocoagulase. The involvement of a lipid intermediate/exoprotein-releasing protease system in the secretion of staphylocoagulase, and of exoproteins in general, is discussed.

Cell Membrane↗

In vitro activity of antibiotics against Ureaplasma urealyticum and Chlamydia trachomatis strains from patients with nongonococcal urethritis.

The activity of minocycline, doxycycline, tetracycline, erythromycin, mepartricin and lincomycin against 35 freshly isolated Ureaplasma urealyticum strains was tested. Doxycycline was the most active. Twelve strains were resistant to minocycline and four of these were sensitive to erythromycin. Mepartricin showed no activity against the organisms at a concentration of 10 micrograms/ml. The susceptibility of 30 low-laboratory-passage Chlamydia trachomatis strains against tetracycline and erythromycin was tested. A variable degree of sensitivity to tetracycline and erythromycin was found, the median MIC values being 0.13 micrograms/ml and 0.025 micrograms/ml respectively. No resistant Chlamydia trachomatis strain was found.

Anti-Bacterial Agents↗

[Distribution of species of Moraxella and moraxella-like organisms in the nasopharynx of healthy human adults (author's transl].

By means of a lincomycin containing selective medium, gram-negative, oxidase-positive, non-motile, non-saccharolytic, penicillin-sensitive rods have been isolated from 24 of 165 healthy adults (13,9%). Three strains were lost, 7 strains were Moraxella osloensis (4,2%), 12 strains were Neisseria elongata (7,3%) and 2 strains were considered to be a subspecies of N. elongata (1.2%). By agglutination and immunodiffusion could be demonstrated that N. elongata is a serologically heterogenous species. The nasopharynx seems to represent the natural habitat of M. osloensis and N. elongata.

Adult↗