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Bacteria, bile, and the small bowel.

Microbial populations of the small bowel and bile salt metabolism were studied in 15 patients with lesions of the stomach and small intestine. These types of microorganism could be correlated with the site and extent of stasis in the small bowel and the presence of a normally functioning stomach. The presence of obligate anaerobes (bacteroides) and free bile acids could be correlated with areas of stagnation. When these abnormalities were detected throughout the small bowel, steatorrhoea was also noted. However, bacteroides and free bile acids in localized regions of either proximal or distal small bowel were generally associated with normal faecal fat excretion. Vitamin B(12) malabsorption appeared to be related to the total number of bacteria colonizing the small bowel rather than to any specific type of microorganisms. The effect of antibiotics on intestinal function and bacteriology was studied in three patients. In one patient, the broad-spectrum antibiotic tetracycline was effective in eradicating an abnormal bacterial flora. In the other two, lincomycin, which is specifically effective in eradicating the anaerobic flora, restored intestinal function to normal.

Adult↗

Stagnant loop syndrome in patients with continent ileostomy (intra-abdominal ileal reservoir).

Intestinal absorption and bacteriology of the ileal contents were compared in seven patients with continent ileostomy and seven patients with conventional ileostomy. The absorption of vitamin B12 was reduced in five patients with continent ileostomy and subnormal in two patients with conventional ileostomy. Steatorrhoea was present in four patients with continent and one patient with conventional ileostomy. Increased concentrations of total anaerobic bacteria and Bacteroides were found in the ileum of the patients with continent ileostomy. After an oral dose of (1-14C) glycocholic acid there was no difference in the faecal excretion of radioactivity, whereas the 14CO2-expiration was increased in two patients with continent ileostomy. In four patients with continent ileostomy and malabsorption of B12, there was evidence of a stagnant loopsyndrome as oral lincomycin treatment resulted in increased absorption of B12 decreased excretion of faecal fat, and decreased concentrations of Bacteroides in the ileum.

Adult↗

The antibiotic susceptibility of Mycoplasma hominis.

Mycoplasma hominis is now recognized as a human pathogen, but little information regarding its antibiotic susceptibility is available. We therefore tested the susceptibility of 49 isolates of M. hominis to 16 antibiotics. Penicillin-like drugs and erythromycin showed no activity whatsoever. Tetracycline and lincomycin were the most active drugs, with chloramphenicol, kanamycin, and streptomycin showing some inhibitory activity. The distinctions between metabolic inhibition, growth inhibition, and mycoplasmacidal endpoints are discussed and defined.

Anti-Bacterial Agents↗

Lack of evidence for mutation to erythromycin resistance in clinical strains of Staphylococcus aureus.

The properties of 100 erythromycin resistant strains of Staphylococcus aureus obtained from clinical material have been compared with the properties of mutants selected in vitro for resistance to erythromycin. The properties, including inducibility of the resistance and cross-resistance to spiramycin and lincomycin, of the two groups of isolates were always different. The risk that staphylococci will mutate to erythromycin resistance during therapy with this antibiotic is remote.

Drug Resistance, Microbial↗

Cultural diagnosis of gonorrhoea with modified New York City (MNYC) medium.

A simply prepared modified New York City medium, designated MNYC was compared with Thayer Martin (TM) medium for the cultural diagnosis of gonorrhoea. MNYC medium contained lincomycin, commercial gonococcal base and lysed whole blood, whereas the original New York City medium contained fresh horse plasma and haemoglobin solution, a basal medium prepared from basic ingredients and vanocmycin. Using MNYC medium gonococci were cultured from 96.1% of men and 100% of women with gonorrhoea (positive film and/or culture) compared with only 77.6% and 69% respectively using TM medium. There were no patients positive by culture on TM medium but negative by culture on MNYC medium. The proportion of men with positive films but negative culture was reduced from 17.1% on TM medium to 3.9% on MNYC medium. There were no women with positive films but negative cultures on MNYC medium compared with 19% on TM medium. MNYC medium is recommended as a simply prepared and highly efficient medium for the cultural diagnosis of gonorrhoea.

Bacteriological Techniques↗

Efficacy of tilmicosin in treatment of pulmonary infections in calves.

The efficacy of tilmicosin in the treatment of respiratory infections in calves was evaluated. According to a randomised block design, 58 calves with naturally occurring respiratory infections were treated with one of the following products: a single subcutaneous injection of tilmicosin (10 mg/kg liveweight) or daily intramuscular injections of 5 mg lincomycin and 10 mg spectinomycin/kg liveweight, for a minimum of three days. Both treatment groups initially showed similar clinical signs and their initial responses to the treatments were good. However, the tilmicosin treated calves improved more rapidly. Significantly greater improvements (P less than or equal to 0.05) were observed in their demeanour and appetite during the first 10 days after treatment began, and in their respiratory condition between five and 10 days after treatment began.

Animals↗

Sensitivity of strains of Serpulina hyodysenteriae isolated in Hungary to chemotherapeutic drugs.

The sensitivity of 332 strains of Serpulina hyodysenteriae isolated in Hungary between 1978 and 1992 was tested against seven chemotherapeutic drugs frequently used for the treatment of swine dysentery, and the changes in the patterns of resistance were also monitored. All the strains remained sensitive to carbadox, with minimum inhibitory concentrations (MIC) of only 0.05 to 0.40 microgram/ml at present. The susceptibility of the strains to dimetridazole has gradually decreased, but about half of the strains are still sensitive, with large numbers of "moderately sensitive' strains; the MIC values varied within wide limits (0.1 to 50 micrograms/ml). Most of the strains were resistant to tylosin, with MIC values from 0.1 to 100 micrograms/ml. The number of strains resistant to lincomycin has gradually increased, but about half of the strains remain sensitive; the MIC values ranged from 0.2 to 100 micrograms/ml. Recently, tiamulin has proved the most effective antibiotic, but some resistant strains have already emerged (MIC values 0.05 to 50 micrograms/ml). Monensin was good for the prevention of swine dysentery, but resistance may evolve quickly; the MIC values ranged from 0.4 to 25 micrograms/ml. For sedecamycin, the MIC values (6.25 to 100 micrograms/ml) were much higher than expected.

Animals↗

Treatment of clinical mastitis: two intramammary formulations compared.

Two hundred cases of mild clinical mastitis were treated on two farms using two intramammary preparations in quick release bases. One preparation contained penicillin and streptomycin, the other contained lincomycin, neomycin and prednisolone. Fifty-eight per cent of cases were clinically and bacteriologically cured using the first preparation; and 61 per cent of cases, with a similar range of organisms, using the second. The main infections were Streptococcus uberis and coliform; all but three of the infections were sensitive in vitro to one or both of the antibiotics in the preparations. On the farm with 100 cows, 69 per cent of cases were cured, while only 52 per cent were cured on the farm with 300 cows. It is suggested that it is more difficult to detect and treat cases in the larger herd. A number of reservations about the interpretation of the results are discussed.

Animals↗

Enhanced fluid transport across gallbladder mucosa in experimental cholelithiasis.

Fluid transport of the gallbladder has been studied in two models of experimental cholelithiasis: dihydrocholesterol-induced gallstones in the rabbit and lincomycin-induced gallstones in the guinea pig. Using the noneverted explained gallbladder of the rabbit and the guinea pig, the transport of luminal to serosal fluid has been quantitated before, during, and after stone formation. The everted gallbladder preparation of the rabbit has also been used to measure fluid transport before and during gallstone formation. In both models, an increased fluid transport was observed in the phase of gallstone induction and a return to normal after stones were formed. This abnormality preceded the appearance of conventional histological features of cholecystitis. There was also a coincidental increase in glycoprotein production from and cell proliferation of the gallbladder epithelium. This enhancement of fluid transfer may play a contributing role in the genesis of gallstones.

Animals↗

Human respiratory tract infections with mycoplasmas and their in vitro susceptibility to tetracyclines and some other antibiotics.

The role played by Mycoplasma pneumoniae and possibly by other species of mycoplasma in respiratory tract infections in man is considered. The in vitro sensitivity of human mycoplasmas, that is, M. hominis, M. fermentans, M. orale type 1, M. pneumoniae, M. salivarium and T-mycoplasmas to different tetracycline analogues and some other antibiotics was determined. The strains tested were often somewhat more susceptible to doxycycline than to methacycline, minocycline and tetracycline, while oxytetracycline, per unit of weight, was in most instances 8-16 times less effective than doxycycline. The difference between the minimum concentrations of the above-mentioned tetracyclines, that inhibited metabolism of M. pneumoniae in liquid medium, and the minimum lethal concentrations of these antibiotics was small. Variation of the inoculum size of this organism had comparatively little effect on the result of the susceptibility tests with doxycycline. The study indicates a cidal rather than static action of doxycycline on M. pneumoniae. This organism as well as T-mycoplasmas were sensitive to low concentrations of erythromycin, while the strains of the other species studied were resistant to even 100 mug/ml of this antibiotic. M. pneumoniae and T-mycoplasmas were resistant to 20-80 mg/ml lincomycin, while the other human mycoplasmas were moderately sensitive. Chloramphenicol and gentamycin were generally less effective, per unit of weight, than the tetracyclines against most of the strains of mycoplasma tested. Some known effects of antibiotic treatment of mycoplasma infections in man are also discussed.

Anti-Bacterial Agents↗

Septicaemia.

Septicaemia still presents a major diagnostic and therapeutic challenge to the clinician. Most cases are hospital-acquiredand the reasons for their increasing prevalence are discussed, with reference to predisposing factors and opportunistic infections. The pathology and bacteriology of proven cases (positive blood cultures) in 1974 in a modern children's and maternity hospital complex are presented. Gram-positive and Gram-negative varieties are compared and the molecular biology and mechansims of endo- and exotoxaemia described. Successful therapy demands correct choice of antibiotic and the development of shock requires skilled supportive measures. For the former a rational scheme is outlined and a plea is made for collection of data for this purpose. Polypharmacy is deprecated and either an aminoglycoside or a cephalosporin forms the mainstay of therapy. The emergence of Bacteroids sp. in cases of abdominal and puerperal sepsis necessitates addition of a lincomycin or metronidazole. Superinfection with systemic candidiasis requires 5-fluorocytosine.

Cefazolin↗

Antibiotic susceptibility of Mycoplasma hyopneumoniae isolated from swine.

The antibiotic susceptibility of thirty-nine strains of Mycoplasma hyopneumoniae isolated from swine between 1970-1981 and 1989-1990 was investigated. From the present results, it is suggested that the susceptibility to chlortetracycline has been decreasing in Japan. On the other hand, all the strains were sensitive to lincomycin, thiamphenicol and macrolides. Newly developed macrolides such as tilmicosin, acetyl-isovaleryl-tylosin and mirosamycin had equal or higher activity than general macrolides.

Animals↗

In vitro susceptibility of Mycoplasma hyosynoviae and M. hyorhinis to antimicrobial agents.

Fifty-four Japanese strains of Mycoplasma hyosynoviae isolated from porkers during 1980 to 1995, and 107 Japanese strains of M. hyorhinis isolated from piglets with respiratory disease during 1991 to 1994 were investigated for the in vitro activities of 13 antimicrobial agents [josamycin, tylosin, spiramycin, kitasamycin, erythromycin, lincomycin (LCM), kanamycin (KM), chloramphenicol (CP), thiamphenicol (TP), tiamulin (TML), oxytetracycline (OTC), chlortetracycline (CTC), and enrofloxacin (ERFX)] by the agar dilution method. Of the drugs tested TML showed the highest activity with minimum inhibitory concentration (MIC) of 0.013 to 0.1 microgram/ m/ (MIC90; 0.05 microgram/ml) against strains of M. hyosynoviae, and 0.2 to 0.78 microgram/ml (MIC90; 0.39 microgram/ml) against strains of M. hyorhinis. ERFX, LCM, most of the 16-membered macrolide antibiotics and tetracyclines also showed low MICs against both mycoplasma species. The susceptibility of KM, CP and TP to the mycoplasmas was considered to be of a secondary grade. Two of 54 strains of M. hyosynoviae, and 11 of 107 strains of M. hyorhinis showed resistance to all 14- and 16-membered macrolide antibiotics tested. Tetracyclines (OTC and CTC) showed a relatively broad MIC distribution from 0.1 to 6.25 micrograms/ml against the M. hyosynoviae strains tested. All of the strains isolated during 1980 to 1984 were susceptible at the concentration of 0.78 microgram/ml or less (MIC90; 0.78 microgram/ml) to OTC and 1.56 micrograms/ml or less (MIC90; 1.56 micrograms/ml) to CTC, while the susceptibility of strains isolated recently, during 1994 to 1995, was more than 0.78 microgram/ml (MIC90; 3.13 micrograms/ml) to OTC, and more than 1.56 micrograms/ml (MIC90; 6.25 micrograms/ml) to CTC.

Animals↗

The fractional inhibitory concentration index of antimicrobial agents for bacteria and Mycoplasma isolated from the nasal swabs of cattle with respiratory diseases.

We investigated the effect of thiamphenicol plus lincomycin (TP + LCM) and thiamphenicol plus tylosin (TP + TS) combinations using checker board method on the growth of Pasteurella (P.) multocida, P. haemolytica and Mycoplasma (M.) bovis by calculating the fractional inhibitory concentration index (FIC index). The results showed that the FIC indexes of the TP + LCM combination for P. multocida, P. haemolytica and M. bovis were 0.36 +/- 0.10, 0.72 +/- 0.09 and 0.81 +/- 0.18, respectively. The FIC indexes of the TP + TS combination for P. multocida, P. haemolytica, and M. bovis were 0.79 +/- 0.20, 0.66 +/- 0.11 and 0.32 +/- 0.14, respectively. Thus, these combinations are assumed to have a more synergistic or additive effect on bacteria growth than a single antimicrobial agent.

Animals↗

Antibiotic susceptibility testing of anaerobic bacteria by the standardized disc diffusion method with special reference to bacteroides fragilis.

The susceptibility of 90 strains of Bacteroides fragilis to 16 antibacterial drugs was determined by the agar plate dilution test and the disc diffusion test. Good correlation of results was obtained with the two methods, and regression line analysis could be performed for beta-lactam antibiotics, erythromycin, tetracyclines, lincomycin and clindamycin. Thus the standardized disc diffusion method can be used for susceptibility testing, but only a clear distinction between sensitive and resistant strains can be seen.

Agar↗

Antibiotic susceptibility of Clostridium species isolated from human infections.

In antibacterial susceptibility testing by the agar plate dilution method with 252 strains of Clostridium perfringens, 22 strains of C. novyi type A and 7 of C. novyi type B, with 21 strains of C. bifermentans, 12 strains of C. sordellii and 18 of C. sporogenes, the majority of the strains were inhibited by penicillin G, cephalothin, chloramphenicol, erythromycin, tinidazole and metronidazole. Resistance to lincomycin and clindamycin was noticed among strains of all clostridia species as well as to tetracycline and doxycycline among strains of C. perfringens.

Anti-Bacterial Agents↗

Regression line analysis for five antibiotics with strains of Clostridium species.

The susceptibility of 90 strains of clostridia to 5 antibacterials was determined by the agar plate dilution method and the disc diffusion test. The correlations between minimum inhibitory concentration and inhibition zone were quite acceptable for lincomycin, clindamycin, tetracycline and doxycycline to calculate regression lines by the least square method. The strains showed comparatively wide ranges of susceptibility. For erythromycin, no regression line could be calculated, since all the strains tested were susceptible over a narrow range of concentrations.

Anti-Bacterial Agents↗

Some clinical, immunological and bacteriological observations in a case of pyogenic arthritis due to bacteroides fragilis.

A case of recurrent pyogenic arthritis in a knee joint and abscess formation of the lower limb is described. The infection occurred in a 70-year-old male patient treated with steroids for rheumatoid arthritis. A strain of Bacteroides fragilis was repeatedly isolated both from the knee joint and the abscess. The isolated strain was used as antigen in tube agglutination tests and significant titre changes were observed during the course of the disease. The isolated strain was initially sensitive to doxycycline but developed resistance to this drug during therapy. The sensitivity to lincomycin remained unaffected.

Aged↗