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[Experimental research on microbiological profile of josamycin. II: Findings on the phenomenon of resistance in comparison with other macrolides].

The interactions between josamycin, other macrolides and lincomycin have been considered as far as the microbic resistance phenomenon is concerned, in relation to Staph. aureus strains. It has been possible to give rise to resistance to josamycin as well as to erythromycin even though the daily average increase is far lower for josamycin. Subinhibitory concentrations of josamycin have not provoked resistance in relation to other macrolides while this phenomenon has been observed as far as the use of erythromycin is concerned.

Drug Resistance, Microbial↗

Infection in vascular prosthesis.

1. The method of protected coagulum has withstood the test of time for three decades and, as confirmed by the literature, its principle has been in recent years increasingly applied in the form of single-dose perioperative administration of antibiotics. 2. The method has proved its value in vascular prosthesis as blood coagula are the source of morphogenesis of the vascular wall in prosthesis. 3. In 1 657 patients undergoing arterial reconstructive procedures the method reduced infection rate of 0.9%. 4. There is experimental evidence that, given in therapeutically active doses, tobramycin, lincomycin and cephazolin form protected coagula with prolonged antibiotic action.

Animals↗

[Combination of antibiotics and sodium nucleinate in the therapy of an experimental mixed infection due to pyogenic bacteria].

Mice were infected wtih a mixed culture of pathogenic Staphylococcus and Pseudomonas aeruginosa. The doses of sodium nucleinate were titrated. When used for prophylactic and treatment-prophylactic purposes, these doses did not change the antiinfection resistance of the animals. The doses of tetracycline and lincomycin combination (lincotetrin) having no therapeutic effect on repeated use of the combination were also chosen. It was shown that the combined use of the antibiotics and sodium nucleinate in the above doses promoted a significant increase in the animal survival rate while the drugs used alone did not promote any increase in the survival of the mice. The decrease in the death rate of the animals was observed both with the parenteral and the oral use of sodium nucleinate.

Animals↗

[The treatment of periodontal diseases with the preparation Linco-HAP].

Hydroxyapatite paste with lincomycin (linco-HAP) was for the time used for the treatment of such a prevalent disease as periodontitis. A follow-up of 380 patients demonstrated a positive therapeutic effect of this complex expressed in reduction of the depth of periodontal pouches and inflammation arrest, thus appreciably shortening the treatment duration.

Adult↗

Mode of action of bottromycin A2. Release of aminoacyl- or peptidyl-tRNA from ribosomes.

Bottromycin A2 inhibited MS2 phage RNA-dependent protein synthesis as well as polyuridylic acid-(poly(U))- or polyadenylic acid (poly(A))-dependent polypeptide synthesis. When the ribosomal complex with N-acetyl-[14C]phenylalanyl-tRNA (N-acetyl-[14C]Phe-tRNA) at the A site was subjected to bottromycin A2, the release of N-acetyl-[14C]Phe-tRNA was observed while no release of N-acetyl-[14C]Phe-tRNA from the donor site was observed, indicating that the action of bottromycin A2 is specific to the A site of ribosomes. Due to bottromycin's capacity to release [14C]Phe-tRNA or N-acetyl-[14C]Phe-tRNA from the ribosomal acceptor site (A site), bottromycin A2 inhibited the nonenzymatic binding of N-acetyl-[14C]Phe-tRNA and elongation factor T (EF-T)-dependent binding if the concentration of EF-Tu-GTP-[14C]Phe-tRNA ternary complex was low. Our data are consistent with the possibility that the inhibition of overall polypeptide synthesis by bottromycin A2 is at least partly due to bottromycin A2's activity to release aminoacyl- or oligopeptidyl-tRNA from ribosomes. Among 10 antibiotics tested, bottromycin A2 and lincomycin released aminoacyl-tRNA from ribosomes.

Anti-Bacterial Agents↗

[Virus-induced dyslipidemias as possible risk factors in the development of somatic diseases].

Experimental and clinical studies showed a number of virus infections to be accompanied by lipidemic disorders. Experimentally, dyslipidemias were found in tick-borne encephalitis (TBE) in mice, rotavirus infection in rabbits, and amyotrophic leukospongiosis in guinea pigs. The possibility of correcting the virus-induced lipidemic disorders with an antiviral drug, lincomycin, was demonstrated in TBE in mice. Dynamic study of the lipidemic status of patients with virus hepatitis A revealed marked dyslipidemia of the atherogenic type which was stable and persisted up to the time of clinical recovery. The data obtained supplement the current concepts concerning the pathogenesis of virus infections.

Adult↗

[Sensitivity of pathogens of post-ventilation pneumonia in newborns to antibacterial drugs].

The majority of the enteric bacteria and aerobic and anaerobic cocci causing postventilation pneumonia in newborns were susceptible to gentamicin, carbenicillin, ampicillin and cephalosporins. The strains of Pseudomonas aeruginosa were mainly susceptible to gentamicin and carbenicillin. Bacteroides were susceptible to metronidazole, ceftazidime and lincomycin. 70.8 per cent of the causative agents of the pneumonia were polyresistant to at least 6 antibiotics.

Anti-Bacterial Agents↗

[The modern approach to the treatment of periodontitis].

For the treatment of patients with chronic and exacerbated periodontitis trichopol and lincomycin were used as well-known effective antibacterial drugs in anaerobic non-clostridial infection. Zinc-eugenol paste was added. The results were favourable.

Bacteria, Anaerobic↗

Induction of mutations in antibiotic-producing microorganisms by fast neutrons from the U-120 cyclotron.

The purpose of this study was to investigate the activity of fast neutrons from a U-120 cyclotron in the induction of mutations in streptomycetes, resulting in strains with enhanced antibiotic production. Three streptomycete strains producing the antibiotics: lincomycin, moenomycin, and demethylchlorotetracycline were used. Correlation between the survival rate of spores of the examined strains and neutron dose was determined. Several morphological and physiological features (particularly production of antibiotics for 1543 variants derived from the parent strains) and their distribution within the population were also studied. The survival rate of the streptomycetes spores after irradiation with fast neutrons was found to be an individual strain property. Several variants with considerably increased antibiotic yield were isolated. The results are compared with those obtained after treatment with other mutagens. Several variants of one of the strains with a strongly enhanced antibiotic yield (200--220%) were isolated. No such variants were found after UV irradiation.

Demeclocycline↗

Triadic nose drops in the treatment of chronic sinusitis.

Thirty patients with chronic sinusitis have been treated with triadic nose drops consisting of ephedrine, dexamethason and lincomycin. Twenty three cases were cured, five cases improved and there was no effect in two cases. This study suggests that triadic nose drops are beneficial in chronic sinusitis. The pathogenesis and treatment of chronic sinusitis is discussed.

Administration, Intranasal↗

Chronic Q fever.

Sixteen cases of chronic Q fever are described. In eight there was a history of exposure to infection from farms or farm products. All had valvular heart disease, involving the mitral valve in nine and the aortic valve in seven. Infection occurred on a prosthetic valve in two patients. Arterial embolism was common. Venous thrombosis occured in three patients, and pulmonary embolism occurred in three other patients. Complement fixing antibodies to phase 1 antigen were found in a titre of 1:200 or greater in all except two patients. In one of these post-mortem examination revealed rickettsial bodies in mitral valve vegetations, and in the other Coxiella burneti was isolated from heart valve tissue. The majority presented with infective endocarditis but two presented primarily with liver disease. All patients had evidence of liver involvement and in one this led to death from cirrhosis. Abnormal tests of liver function, particularly hyperglobulinaemia, raised alkaline phsophatase and abnormal bromsulphthalein retention were found in all patients. Hepatic histology was abnormal in all eight patients in whom it was studied. The commonest features were mononuclear cell infiltration of the portal tracts and prominence of the sinusoidal Kupffer cells. Patchy focal necrosis of parenchymal cells, granulomata, fatty change, and eosinophilia of the sinusoidal walls were also noted in several patients and cirrhosis developed in one. Six patients had a purpuric rash, and in 12 there was thrombocytopenia. It is suggested that the presence of hepatomegaly and liver involvement and thrombocytopenia may help to differentiate Q fever endocarditis from bacterial endocarditis. Raised serum IgM and IgA levels occured frequently, but with only a moderate dominance of IgM. Sheep cell agglutination and latex fixation tests for rheumatoid factor were occasionally positive. Several features of the disease suggest the possibility that immune-complex mechanisms may play a role in chronic Q fever. Treatment was with prolonged courses of tetracycline usually combined with lincomycin. Seven patients underwent valve replacement surgery for haemodynamic reasons. Five patients died; two from heart failure, one from cirrhosis, one seven days after valve replacement and one from intraperitoneal haemorrhage following percutaneous liver biopsy. Three patients have survived for more than five years, and another six for more than three and a half years after diagnosis. Of these nine patients, three received medical therapy alone and six required valve replacement as well. Antibiotics have been discontinued in four patients who have had valve surgery and three others. Six patients had received antibiotics for continuous periods varying from 29-62 months. In the period after stopping therapy varying from 15-21 months, no relapse has occured. A seventh patient, who had received antibiotics for four months prior to valve replacement, has survived 43 months after the withdrawal of antibiotics...

Adult↗

Subtotal colectomy for refractory pseudomembranous enterocolitis.

Pseudomembranous enterocolitis resulting from therapy with antibiotics such as clindamycin and lincomycin hydrochloride monohydrate does not always respond to drug and vigorous medical support. We describe two seriously ill patients who recovered after subtotal colectomy with ileostomy.

Adult↗

[The surgical treatment of jaw cysts using hydroxyapatite with an ultrahigh degree of dispersity].

Ultrahighly dispersed hydroxyapatite, a biochemically active form of hydroxyapatite, stimulates the repair osteogenesis at the early stages. Drugs with ultrahighly dispersed hydroxyapatite: 33% OSTIM-100 paste and its composition with lincomycin Lincogap, which ensures a prolonged release of the antibiotic at the site of implantation, were used for filling the bone cavity formed after cystectomy in 49 patients. In controls (n = 43) the postoperative cavity was filled with blood clot. The results of clinical, x-ray, and radiovisiographic studies indicate that use of the above preparations decreased the incidence of postoperative complications and created the optimal conditions for bone repair at the site of defects of different size. The therapeutic efficacy was the highest when the intervention was preceded by inflammatory symptoms at the site of the cyst.

Adolescent↗

[Antibiotic sensitivity of pathogenic microflora: data of the bacteriological laboratory at the antituberculosis clinic].

A total of 426 cultures for nonspecific organisms, made at the Bacteriological Laboratory of the Antituberculosis Dispensary, were analyzed. Escherichia coli, Streptococcus pyogenes, and Staphylococcus aureus were most common among the isolated pathogens. Evaluation of antibiotic sensitivity by using the disks showed augmentin, cefuroxime axetil, and ciprofloxacin to be most effective. Streptomycin and rifampicin resistance of pathogens was highest. In patients with tuberculosis, the non-tuberculosis flora showed resistance to the drugs widely used in general practice (ampicillin, carbenicillin, oxacillin, lincomycin, erythromycin). Among macrolides, rovamycin was more effective than erythromycin. It is concluded that when wide-spectrum antibiotics are prescribed, new and potent drugs should be used in a tuberculosis hospital.

Amoxicillin-Potassium Clavulanate Combination↗

In vitro antibiotic sensitivity of Pasteurella multocida.

Thirty Pasteurella multocida strains were tested against 19 antibiotics using an agar dilution method. Penicillin G was the single most active agent tested. Anti-staphylococcal penicillins were markedly less inhibitory than penicillin G. Other penicillins including phenoxymethyl penicillin, and tetracyclines, chloramphenicol and cephalosporins all inhibited the organisms in low concentrations. Erythromycin and lincomycins had poor activity against several of the strains. The range of M.I.C.s observed for most antibiotics was narrow but wide variation was seen in zone size when antibiotic disk tests were performed.

Anti-Bacterial Agents↗

In vitro and in vivo comparisons of valnemulin, tiamulin, tylosin, enrofloxacin, and lincomycin/spectinomycin against Mycoplasma gallisepticum.

The minimum inhibitory concentrations (MICs) for valnemulin, tiamulin, enrofloxacin, tylosin, and lincomycin/spectinomycin were determined for a virulent strain of Mycoplasma gallispeticum (MG). At the initial reading, the lowest MICs were seen with valnemulin and tiamulin, followed by tylosin, enrofloxacin, and a relatively high MIC for lincomycin/spectinomycin. At the final reading, at 14 days, a similar pattern was obtained, with valnemulin giving the lowest MIC (< 0.008 mg/ml). The same strain of MG was used to infect groups of 20 2-day-old chicks in two separate experiments. In both, several concentrations of valnemulin and tiamulin and one each of tylosin and enrofloxacin were administered to separate groups in the drinking water. In the second experiment, one group of chicks was given lincomycin/spectinomycin. Each experiment had one infected unmedicated group and an uninfected unmedicated group. Mortality, clinical signs, and gross lesions, in both experiments, were significantly less (P < 0.001) in the uninfected and infected medicated groups (except for the two lowest dosages of valnemulin, lincomycin, and spectinomycin) than in the infected unmedicated groups. Also, the mean body weight gain was greater in the uninfected and infected medicated groups. Among the infected birds, MG was recovered from fewer chicks in the infected medicated groups except for the lowest two dosages of valnemulin. Serologic results were negative for the uninfected groups, and there were fewer positive reactors for the infected medicated groups except for the group treated with lincomycin/spectinomycin. Valnemulin should prove to be a useful addition to the antimicrobials in the control of MG infection in chickens.

Animals↗

Antimicrobial resistance of community and hospital acquired Staphylococcus aureus isolates to oxacillin and glycopeptides.

OBJECTIVE: To determine sensitivity pattern of Staphylococcus aureus isolates from the community and hospitals to methicillin, glycopeptides and other antimicrobial agents. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Private Pathology Laboratory in Lahore from January 2001 to April 2002. SUBJECTS AND METHODS: A total of 714 Staphylococcus aureus (S.aureus) isolates from the community and hospital were tested. Community acquired S.aureus strains (n=434) were isolated from specimens like pus from boils/pimples and nasal swabs of patients with asthma attending a local allergy clinic. The hospital acquired S.aureus (n=280) were isolated from specimens like pus from wounds/discharging sinuses, ear swabs, blood and urine. All the isolates were subjected to sensitivity test against Oxacillin, Vancomycin, Teicoplanin, Penicillin, Imipenem, Cefipime and other anti-staphylococcal agents by standard Kirby-Bauer disk diffusion method. Beta lactamase production by all the isolates was also determined by acidimetric test. RESULTS: Significantly higher number of hospital acquired S.aureus isolates (p<0.01) were beta lactamase producing (96.07%) as compared to community acquired (81.79%). Methicillin (Oxacillin) resistance was also higher among hospital strains (31.1%) as compared to community ones (14.1%). No isolate from the community showed resistance to glycopeptides. While 0.3 percent and 0.7 percent of all S.aureus isolates were interpreted as resistant to Vancomycin and Teicoplanin respectively as there was no zone of inhibition. The resistance to these drugs was a bit higher among the MRSA (1.1% and 2.3% respectively). More than 90% of nosocomial MRSA strains were sensitive to Ofloxacin and Fucidic Acid. Resistance to Erythromycin, Lincomycin and Gentamicin was 70.1, 33.3 and 39.1% in that order. In general resistance to different antimicrobial was lower among S.aureus strains of community origin as compared to those of hospital origin. CONCLUSION: Methicillin and multiple drug resistance is quite a significant problem in nosocomial as well as community acquired S.aureus strains. Moreover, it appears that resistance to glycopeptides has also emerged in our nosocomial S. aureus strains. Microbiology laboratories should make efforts not only to regularly screen S.aureus isolates for sensitivity to glycopeptides but also to determine MIC of the isolates.

Cross Infection↗

Community-acquired methicillin-resistant Staphylococcus aureus in children and adolescents: changing trends.

OBJECTIVE: To identify current trends in antibiotic sensitivity patterns of community-acquired methicillin-resistant Staphylococcus aureus (CA MRSA) infections of the head and neck in children and adolescents and evaluate outcomes after therapy. DESIGN: Retrospective review of cases consisting of a medical record review with telephone follow-up. SETTING: Two tertiary university medical referral centers. PATIENTS: Pediatric patients (age <18 years). MAIN OUTCOME MEASURES: Number of cases, sensitivities of cultured organisms, treatments used, and outcome of treatments. RESULTS: Seven patients were identified with CA MRSA in a 4-month period. Superficial abscesses (3 patients [43%]) and suppurative lymphadenitis (3 patients [43%]) were the most common causes. An erythromycin-resistant, clindamycin-sensitive pattern was observed in 6 (86%) of the 7 isolates. All infections resolved with prescribed treatments; there were no complications. CONCLUSIONS: A high prevalence of erythromycin-resistant, clindamycin-sensitive CA MRSA was noted. This new resistance pattern is indicative of inducible macrolide-lincomycin-streptogramin-B resistance. Basic science data suggest that these strains of bacteria could develop resistance to clindamycin during therapy despite appearing susceptible on initial laboratory testing. In our small series, clindamycin was used alone and effectively in 2 such cases. This appears to support its continued use as initial, empiric therapy in suspected cases of CA MRSA.

Adolescent↗