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PubMed1983

[Statistical observation of urinary tract infections by Serratia marcescens].

Recently, in many institutions, Serratia marcescens has been isolated more frequently. Therefore, we made a statistical analysis of S. marcescens infections. S. marcescens was isolated from the urine of 327 of the 1,773 patients admitted to our Department between 1975 and 1981. S. marcescens was the most frequently isolated organism in the urine of both inpatients and outpatients all of the 7 years. S. marcescens was often isolated in patients with some underlying disease, elderly patients or postoperative patients, in which case the individual defense mechanism protecting the patient from infections is often low. Because 276 of the patients who had S. marcescens infection had urethral indwelling catheters, S. marcescens infection may be nosocomial. The most effective antibiotic against S. marcescens was chloramphenicol followed by amikacin, sulfamethoxazole-trimethoprim, and fosfomycin. The effectiveness of gentamycin, dibekacin and kanamycin was not as high as expected.

Adolescent↗
PubMed1983

[Chemotherapy for bacterial infections in renal transplantation and recent antibacterial agents].

Intraoperative wound infection and postoperative pulmonary and urinary tract infections are the major problems that face the transplant surgeon today. These infections are the major cause of the mortality after renal transplantation. Almost any microorganism could be causative. But, in this paper, only bacterial infections will be discussed. Prophylaxis of intraoperative infection is the same as that used for general surgery. In addition, one of the major defects in the recipient is defective renal function, resulting in general weakness. The use of broad-spectrum antibacterial agents (eg, cefmetazole etc.), effective against many different bacteria from gram-positive cocci to gram negative rods, administered to these patients will produce dramatic results. Aminoglycosides are nephrotoxic and should not be given to the patients having renal failure. Piperacillin or the third generational cephems (ceftizoxime, latamoxef , cefotaxime, cefmenoxime, ceftriaxon and ceftazidime) are the drugs of choice for postoperative infections, especially for urinary tract infections. Pseudomonas aeruginosa should be treated with cefsulodin, cefoperazone, or cefpiramide by the intravenous route. After chemotherapeutic and antibiotic therapy sterilizes the urine, this should be followed by suppressive therapy with quinolone- carboxylic acid (pipemidic acid, norfloxacin, enoxacin and DL-8280), combinations of sulfamethoxazole and trimethoprim, sulfonamides, or fosfomycin for many weeks or months. In chronic antimicrobial suppression treatment, half-doses should be given at bedtime.

Aminoglycosides↗
PubMed1983

[Effect of multiresistance on the minimal inhibitory concentration of N-formimidoyl thienamycin and 6 comparing substances against P. aeruginosa and 4 Enterobacteriaceae species].

The minimal inhibitory concentrations (MICs) of multiresistant strains of P. aeruginosa and four species of Enterobacteriaceae were compared with those of more sensitive ones in N-f-thienamycin and six other antibiotics. The greatest difference between these two differently resistant bacterial populations was found in cefoperazone and the beta-lactamase-instable piperacillin. The latter was used for comparison purposes. The activity of cefsulodin was distinctly reduced in multiresistant strains of P. aeruginosa. Cefotaxime and lamoxactam displayed slightly elevated MICs in multiresistant strains. In N-f-thienamycin a significant difference between the multiresistant and the more sensitive population could not be verified (p greater than 0.05). In this regard it resembles fosfomycin. beta-lactam antibiotics could be ranked by means of correlation analysis of their MICs. Using piperacillin as a reference antibiotic the following order of succession could be arranged according to correlation coefficients in P. aeruginosa: cefoperazone, cefsulodin, lamoxactam, cefotaxime and N-f-thienamycin. For the Enterobacteriaceae species some antibiotics could not be evaluated in this test. Moreover, it was recognized that there was an obvious correlation between the activities of lamoxactam and cefotaxime in P. aeruginosa (r = 0.81) and E. coli (r = 0.80). A correlation was also observed between those of cefsulodin and cefoperazone in P. aeruginosa (r = 0.75). Lower correlation coefficients were seen in N-f-thienamycin with cefoperazone, piperacillin and cefsulodin in P. aeruginosa and with cefoperazone in Klebsiella spec.. Notwithstanding, strains resistant to cefsulodin and cefoperazone were inhibited by concentrations less than or equal to 8 micrograms/ml of N-f-thienamycin. These results showed that in N-f-thienamycin, cefotaxime and lamoxactam multiresistance has only a minimal influence on the MICs of the species of Enterobacteriaceae examined. For therapeutic considerations concerning multiresistance the small differences recognized among these three antibiotics might be without significance. However, N-f-thienamycin was distinctly more active in multiresistant strains of P. aeruginosa than the other beta-lactam antibiotics tested.

Anti-Bacterial Agents↗
PubMed1982

[Combinations of mezlocillin with other antibiotics. A review of in vitro laboratory studies (author's transl)].

Thirteen publications concerning combinations of mezlocillin with other antibiotics are reviewed, with special attention to antibiotics at present available in France. A fairly large number of different methods were used by the authors, making a comparative study extremely difficult. Most studies dealt with mezlocillin-aminoglycoside combinations against enterobacteriacaea and Pseudomonas aeruginosa : the effect was predominantly synergistic, but a few antagonistic effects are reported. The results on other groups of bacteria and with other antibiotics are more scattered. It was sometimes useful to combine mezlocillin with a cephalosporin. A synergistic effect with fosfomycin was found against Serratia.

Anti-Bacterial Agents↗
PubMed1984

[Septic granulomatosis in adults].

Chronic granulomatous disease is a usually X-linked disorder of granulocyte bacterial killing. At least 8 variants can be distinguished biochemically. Two male patients aged 20 and 24 years with a relatively benign clinical course are presented. A partial defect of the membrane-bound cytochrome b-245 with a residual bactericidal capacity was detected in both. Due to continuous antibacterial prophylaxis (trimethoprim/sulfamethoxazol) and treatment of infections with intracellularly accumulating agents (e.g. rifampicin, fosfomycin, clindamycin), even patients with complete defects of bacterial killing can reach adulthood today. Physicians and surgeons should be aware of this disorder, which is no longer a "fatal granulomatous disease of childhood".

Adult↗
PubMed1983

[Clinical evaluation of antibiotics in gynecologic infections].

The clinical effects of antibiotics (lincomycin, cefotaxime, ceftizoxime, piperacillin, fosfomycin, cefmenoxime, cefotetan, cefbuperazone, cefpiramide and ceftazidime) were evaluated in gynecologic infections. 1. A total of 161 patients with gynecologic infections was treated with each antibiotic and an overall response rate was 150/161 (93.2%). The efficacy rate was 72/78 (92.3%) in intrauterine infection, 29/31 (93.5%) in uterine adnexitis, 22/25 (88.0%) in intrapelvic infection and 27/27 (100%) in external genital infection. 2. Each antibiotic proved bacteriologically effective in 94.3% of the patients with simple intrauterine infection, in 84.0% of patients with mixed intrauterine infection, in 100% of 6 patients with uterine adnexitis, in 100% of 11 with intrapelvic infection and in 100% of 25 with external genital infection. There were 160 isolated organisms with clinical effective rate of 93.8%. Eleven (6.8%) of 161 patients had infections caused by anaerobic bacteria and all of them showed clinical response to therapy.

Anti-Bacterial Agents↗
PubMed1983

[In vitro study of the stability of reduced intraerythrocyte glutathione against a group of drugs frequently used during the neonatal period].

Authors have studied in 32 samples of cord blood (normal newborns and normal births) the stability of glutathione reduced form (GSH) in human erythrocytes opposite to ten drugs (gentamicin, cephazolin, amikacin, carbenicillin, amoxicillin, benzodiacepine, metil-prednisolone, phenilbarbituric acid, fosfomycin, trimethroprim-sulphamethoxazole) using it at similar concentration to the highest haemotic levels that are obtained in the newborn with therapeutic doses. They showed that these drugs have not an effect on stability of GSH. For this reason is very unprobable that these drugs are cause of haemolitic crisis in the newborn. In the another hand, they suggest the use co-trimoxazole in the newborn always, in correct doses.

Drug Stability↗
PubMed1980

[Influence of antibiotics on leukocyte migration].

Polymorphonuclear granulocytes play an important role in the immediate unspecific host response, and a depression of their functions can be found in many patients with severe or recurrent infections. Therefore administration of drugs causing such impairment in PMN function may be regarded as an additional risk for negative side effects to the patient. In our report the influence of 13 antibiotics--amphotericin B, ampicillin, tauglicolcillin, amoxicillin, cloxacillin, dicloxacillin, cephaloridine, cefalexin, cefuroxime, chloramphenicol, gentamicin, rifamycin, fosfomycin--on the granulocyte spontaneous and induced migration is investigated under in vitro experimental conditions. Human PMN preincubated with the antibiotics appropriately brought to the desired concentrations (therapeutic dose, 1/10 and 10X) in Hepes-Medium 199-water solution pH 7.2, were washed three times and tested for spontaneous and induced migration under agarose. Our experiments demonstrate that amphotericin B, cefalexin, cephaloridine, cefuroxime, chloramphenicol, dicloxacillin, gentamicin and rifamycin can inhibit in vitro human PMN chemotaxis and/or random migration. Inhibition of intracellular respiratory enzyme synthesis, presence of inactive metabolites of the drug, alterations of cyclic AMP and GMP or of the membrane bound divalent cations can be responsible of the phenomenon.

Anti-Bacterial Agents↗
PubMed1993

Effects of twenty-three drugs on the metabolism of FK506 by human liver microsomes.

We investigated the effects of 23 drugs on the metabolism of FK506 by human liver microsomes. Acyclovir, amphotericin B, cefixime, cefotaxime, ciprofloxacin, cyclosporin A, diltiazem, enoxacin, erythromycin, ethinyl estradiol, fluconazole, fosfomycin, kanamycin, lincomycin, loxoprofen, minocyclin, nifedipine, nilvadipine, norethindrone, ofloxacin, phenobarbital, prednisolone, or rifampicin was added to the reaction media at equimolar or at ten times an excess molar ratio of the substrate concentration; their effects on FK506 metabolism were examined. Drugs known to be the substrate of cytochrome P-450 3A inhibited the metabolism of FK506, and among the drugs tested, the inhibition by cyclosporin A and nifedipine was the strongest.

Anti-Infective Agents↗
PubMed1995

[Comparative susceptibility of Ochrobactrum anthropi, Agrobacterium tumefaciens, Alcaligenes faecalis, Alcaligenes denitrificans subsp. denitrificans, Alcaligenes denitrificans subsp. xylosidans and Bordetella bronchiseptica against 35 antibiotics including 17 beta-lactams].

Ochrobactrum anthropi, formerly known as "Achromobacter sp." or CDC group Vd has been isolated from water, hospital environment (antiseptic solutions, dialysis fluids ... ). O. anthropi is a Gram negative, motile, strictly aerobic, oxydase positive and non-fermentative bacteria with a strong urease activity. The susceptibility of 13 strains of O. anthropi was determined by agar diffusion method and compared to those of type strains of Agrobacterium tumefaciens, Alcaligenes faecalis, Alcaligenes denitrificans subsp. denitrificans, Alcaligenes denitrificans subsp. xylosoxydans and Bordetella bronchiseptica. The MICs of 20 antimicrobial agents confirmed the distinct phenotype susceptibility of O. anthropi. All the strains of O. anthropi are sensitive to imipenem, amikacin, gentamicin, netilmicin, nalidixic acid, pefloxacin, ciprofloxacin, tetracyclin, colistin, sulphonamides and rifampicin and resistant to ampicillin, amoxycillin + clavulanic acid, ticarcillin, mezlocillin, cefuroxime, cefamandol, cefoxitin, cefotaxime, cefoperazon, ceftazidime, cefsulodin, aztreonam, streptomycin, kanamycin, pipemidic acid, chloramphenicol, erythromicin, pristinamycin, trimethoprim and fosfomycin. O. anthropi is implicated in nosocomial infections. O. anthropi was the species with the greatest resistance to beta-lactamins.

4-Quinolones↗
PubMed1995

Yersinia enterocolitica O:3. Antimicrobial resistance patterns, virulence profiles and plasmids.

Antimicrobial resistance patterns (ARP), virulence profiles and plasmids in clinical isolates of Yersinia enterocolitica serotype O:3 were studied. The ARP was tested using the disk method. All strains were susceptible to amoxicillin/clavulanic acid, cefoxitin, fosfomycin, gentamicin, kanamycin, neomycin, tetracycline, nalidixic acid, norfloxacin, ciprofloxacin and trimethoprim. All of them presented resistance to ampicillin, all with the exception of one to cephalotin, differing in resistance or susceptibility to chloramphenicol, streptomycin (Sm), sulfadiazine (Sd) and cotrimoxazole. Due to these differences they were grouped into 8 ARP. Twenty-nine strains carried plasmids and were grouped into 5 plasmid profiles. All strains carrying 42 MDa plasmids were positive for virulence tests (calcium dependence, crystal violet binding, Congo red binding and autoagglutination). No correlation between ARP and plasmid profile was found, although small plasmids of 6.5 and 4.1 MDa mediated resistance to Sm-Sd, as was shown by transformation to Escherichia coli strains. DNAs from plasmids were analyzed by restriction enzymes. All 42 MDa plasmids showed identical EcoRI and HindIII profiles. The two 6.5 MDa plasmids showed identical BglII, AvaI and SalI restriction profiles and the four 4.1 Mda plasmids also yielded restriction profiles similar to each other, but different from the 6.5 ones.

Anti-Bacterial Agents↗
PubMed1995

[Modification of vancomycin nephrotoxicity by other antibiotics in rats].

Vancomycin (VCM) was intravenously administered to rats for 14 days at doses of 150 mg/kg/day and 250 mg/kg/day alone or in combination with 1,000 mg/kg/day of latamoxef (LMOX), flomoxef (FMOX) or cefpirome (CPR) or 250 mg/kg/day of fosfomycin (FOM), and the influences of combined antibiotics on the VCM-induced renal damage were studied. The renal impairment caused by VCM alone was, morphologically, demonstrated mainly as regeneration of tubular epithelium: slight regeneration was observed in a half of rats administered 150 mg/kg/day and slight to extensive regeneration in all the rats administered 250 mg/kg/day. Clinical examinations found apparent increases in urinary LDH and MDH activities in rats administered 250 mg/kg/day, thus showing a good correlation with renal pathological changes. In addition, increase in kidney weight and increase in urinary NAG activity were noted, while changes in plasma urea-N and creatinine were mild, and gamma-GTP activity and protein in urine could not be used as a parameter of the renal impairment. The slight renal impairment as noted in rats administered VCM 150 mg/kg/day alone was not observed at all when LMOX or FMOX was administered concomitantly, and less pronounced even when FOM was administered concomitantly. When CPR was administered concomitantly, the changes were the same as those observed with VCM alone. The renal impairment in rats administered VCM 250 mg/kg/day was apparently less severe when combined with LMOX, FMOX and FOM than that in rats administered VCM alone, and this was supported by apparent reduction of clinical examination values as the parameter of VCM-induced nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Everninomicin, a new oligosaccharide antibiotic: its antimicrobial activity, post-antibiotic effect and synergistic bactericidal activity.

Antimicrobial activity of everninomicin (SCH) 27899) in comparison with two glycopeptides (vancomycin, teicoplanin) and six beta-lactam agents was evaluated against recent clinical isolates of Gram-positive bacteria. Everninomicin showed the highest activity against the species tested and MICs90% of everninomicin against Streptococcus pneumoniae, Streptococcus pyogenes, Enterococcus faecalis, Enterococcus faecium and Clostridium difficile were 0.1, 0.1, 0.2, 0.39, 0.1 microgram/ml, respectively. MICs90% of everninomicin against methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) were 0.78 microgram/ml. Laboratory induced resistance to everninomicin in strains of S. aureus and E. faecalis occurred in a stepwise manner and at a very slow rate. Post-antibiotic effect against strains of S. aureus and E. faecalis were 1.8 and 2.6 h, respectively, and a little longer than that of vancomycin. Adherence to glass surface of an MRSA strain was strongly repressed by the addition of sub MIC of everninomicin in combination with fosfomycin.

Aminoglycosides↗
PubMed1994

[In vitro synergistic effects of tazobactam/piperacillin with various antibiotics].

We investigated in vitro synergistic effects of tazobactam/piperacillin (TAZ/PIPC), a combination drug of tazobactam (TAZ) and piperacillin (PIPC) in the ratio of 1:4, with several other antibiotics against Pseudomonas aeruginosa, Serratia marcescens and methicillin-resistant Staphylococcus aureus (MRSA). Synergistic effects of TAZ/PIPC with each of tobramycin (TOB), netilmicin (NTL), fosfomycin (FOM), ciprofloxacin, minocycline or cefoperazone were observed against all bacteria tested in the checkerboard dilution method. No antagonistic effect was observed in combination of TAZ/PIPC with other antibiotics. Against P. aeruginosa, a combination of TAZ/PIPC with NTL was the most effective, with an average fractional inhibitory concentration (FIC) index of 0.459. And a combination of TAZ/PIPC with FOM was the most the effective against S. marcescens and MRSA. TAZ/PIPC combined with TOB or FOM showed bactericidal effect against P. aeruginosa No. 11, S. marcescens No. 39 and S. aureus O-62 at concentrations of the drugs that showed only bacteriostatic activity individually. Phase-contrast micrographic observations of P. aeruginosa No. 11 and S. marcescens No. 39 demonstrated that the bacterial cells treated with TAZ/PIPC were in filamentous forms and those treated with TOB or FOM were nearly normal. The combination of TAZ/PIPC with TOB or FOM induced filamentous cells with spheroplast-like structures and lysis. Those results suggest that the combination of TAZ/PIPC with aminoglycosides or FOM were useful in the treatment of infections by P. aeruginosa, S. marcescens and MRSA, especially those caused by beta-lactamase-producing strains.

Drug Synergism↗
PubMed1994

[Clinical analysis of methicillin-resistant Staphylococcus aureus (MRSA) infection].

In 14 patients from which methicillin-resistant Staphylococcus aureus (MRSA) was isolated at the Department of Urology, Tone Chuo Hospital June, 1992 and October, 1993, the site of infection, background of patients, and drug resistance were analyzed. The 14 patients consisted of 11 males and 3 females between 45 and 85 years old with a mean of 71.6 years. The site from which MRSA was isolated was urine in 11, wound in 2, nasal cavity in 1, pharynx in 1, and renal fistula in 1 (detected at 2 or more sites in 2). The underlying condition was prostate hyperplasia in 2, prostate cancer in 4 (after radical prostatectomy in 1, complicated by bladder stone in 1), bladder tumor in 3, (during bladder instillation of BCG in 1), perirenal abscess in 2, renal pelvic tumor in 1, neurogenic bladder in 1, and after Boari's operation in 1. Urethral catheterization had been performed in 3. A fewer of 38 degrees C or above was noted in 3. Mixed infection was observed in 10, and was caused by Escherichia coli in 2, Proteus mirabiris in 1, Candida in 1, Klebsiella in 2, Pseudomonas aeruginosa in 2, and Serratia in 2. Four patients has previously been administered antibiotics, which were third generation cephems in 3 and penicillin in 1. The drug sensitivity was 100% for vancomycin (VCM), 30% for imipenam (IMP), 31% for minomycin (MINO), 31% for amikacin (AMK), and 7% for fosfomycin (FOM). As for chemotherapy, VCM+FOM+sulbactam/cefoperazone were administered to 6, and ceftazidime+ MINO were administered to 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Orbital cellulitis in children].

BACKGROUND: Because the potential for complications is great, orbital cellulitis must be recognized promptly and treated aggressively. POPULATION AND METHODS: The files of 38 children admitted from 1988 to 1993 because of orbital or periorbital cellulitis were retrospectively analyzed. Clinical findings included fever, edema, pain, rhinorrhea, conjunctivitis, limitation of eye movement, loss of vision and ophthalmoplegia. All patients had hemogram, ionogram, blood cultures, search for soluble antigens in blood and/or urine, C-reactive protein measurement; they also had roentgenographic examination of the sinuses, orbital ultrasonography and/or CT scan in patients with retroseptal cellulitis. All patients were given systemic antibiotic therapy. RESULTS: Thirty-five patients had preseptal and three retroseptal cellulitis. Preseptal cellulitis was associated to sinusitis in 17 patients, to ocular infection in 11 (seven conjunctivitis and four dacryocystitis), to an infected wound in six. Seventy-three per cent of the patients with ocular infection were less than 2 years of age with a significant preponderance of girls (64%). The three cases of retroseptal cellulitis were associated to sinusitis. Orbital echography was performed in five cases, permitting to recognize the three cases of retroseptal cellulitis that was confirmed by CT scan. Twenty-five of the 38 children were given oral antibiotics during the days preceding admission, explaining the relative rarity of positive bacteriological findings (seven cases). Thirty-five of the 38 children were given IV cefotaxime + fosfomycin, associated to netromycin in 16 cases. Mean duration of treatment was 3 days (range: 1-7). IV antibiotherapy was followed by oral amoxicillin-clavulanic acid administration in 25 patients and pristinamycin in 11. CONCLUSIONS: Orbital cellulitis in children, more frequently preseptal, have a good prognosis under adapted antibiotherapy. A retroseptal cellulitis requires multidisciplinary management because of the risk of extension of infection from the orbit to the eye and/or into the cranial cavity.

Anti-Bacterial Agents↗
PubMed1994

[Therapy for HAM/TSP and AIDS].

(1) We evaluated efficacy of several treatments for HTLV-I-associated myelopathy (HAM) on the basis of our study on 254 HAM patients and of literature review. Improvement of motor disability more than fair response was obtained as follows: 82% in prednisolone, 69% in interferon-alpha, 92% in fosfomycin, 82% in high-dose vitamin C, 72% in blood purification therapy, 70% in heparin, 59% in salazosulfapyridine, 56% in thyrotropin-releasing hormone, 55% in erythromycin, 50% in mizoribine. (2) In the absence of clear guideline, the efficacy of zidovudine in the AIDS dementia complex has been demonstrated. There are also efficacy of amytriptylinein controlling HIV headache, corticosteroid in mononeuritis multiple and inflammatory myositis, hydrocortisone in autonomic neuropathy and plasmapheresis in distal sensory neuropathy respectively. Otherwise, it is emphasized that ddI, ddC and d4T have peripheral neuropathy as major, dose related side effect.

AIDS Dementia Complex↗
PubMed1994

[A survey of Staphylococcus aureus for typing and drug-resistance in various areas of Japan during 1992 and 1993].

Data on Staphylococcus aureus strains isolated at various areas in Japan during 1992 and 1993 were collected and analysed. Among 7,033 strains examined, 60.3% were methicillin-resistant S. aureus (MRSA), 86% of which were isolated from inpatients. MRSA were isolated most often (38%) from departments of internal medicine, followed by departments of surgery (13%). The most frequent source of MRSA was sputa (38%), followed by pus (18%). As for coagulase types, 69% of MRSA were Type II and next most frequent was Type VII (24%). Among MSSA strains, Type VII (35%) and Type III (32%) were the most frequent. Frequencies of beta-lactamase-producing strains were 68% in MRSA and 59% in MSSA. More than 80% of MRSA strains were resistant to beta-lactams. The frequencies of resistance to fosfomycin, ofloxacin, minocycline and gentamicin were 88%, 72%, 19% and 66%, respectively. Less than 3% of MRSA strains were resistant to arbekacin or vancomycin.

Anti-Bacterial Agents↗