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Incidence of hemolysin, gelatinase, and aggregation substance among enterococci isolated from patients with endocarditis and other infections and from feces of hospitalized and community-based persons.

The presence of hemolysin, gelatinase, and aggregation substance (by use of a probe known to hybridize to most pheromone-responsive plasmids) was determined in 192 isolates of Enterococcus faecalis from patients with endocarditis or other infections and fecal isolates from hospitalized patients or healthy volunteers, and in 86 non-E. faecalis isolates. Hemolysin was more common in nonendocarditis clinical isolates and in hospital fecal isolates (37% and 31%, respectively) than among endocarditis and community fecal isolates (16% and 20%, respectively). Gelatinase and aggregation substance, respectively, were found in 54% and 52% of isolates from endocarditis, in 58% and 72% of isolates from other infections, in 62% and 56% of hospital fecal isolates, and in 27% and 30% of fecal isolates from healthy volunteers. All 86 non-E. faecalis enterococcal isolates were negative for these traits. The absence of hemolysin, gelatinase, or the aggregation substance gene in > 45% of endocarditis E. faecalis isolates suggests that while these traits may play a role in virulence, other properties are also important.

Bacterial Proteins↗

The killing effects of cefathiamidine or ampicillin alone and in combination with gentamicin against enterococci.

The in-vitro activity of cefathiamidine against Streptococcus faecalis and Str. faecium were studied in comparison with other beta-lactams. All the 56 strains of Str. faecalis tested were inhibited by 2 mg/l of cefathiamidine. MICs of ampicillin were twofold higher than those of cefathiamidine and MICs of cephaloridine and cephazolin were 8-16-fold higher. No significant inoculum effect on MICs of cefathiamidine could be seen. Two isolates of Str. faecium showed resistance to the four antibiotics. The MBCs of cefathiamidine and ampicillin for ten strains of Str. faecalis showed that the ratios of MBC/MIC were greater than 64. The rates of killing of Str. faecalis were reduced at concentrations of cefathiamidine and ampicillin greater than the MIC. The most rapid killing was obtained at 2 mg/l cefathiamidine or 4 mg/l of ampicillin. With the addition of 1 mg/l gentamicin this paradoxical bacteriocidal effect was eliminated. Time killing studies showed 99.9% of the cells were killed within 6 h by a combination of aminoglycoside and beta-lactam. The paradoxical bacteriocidal effect of cefathiamidine and ampicillin was also demonstrated on solid media.

Ampicillin↗

Comparative activity of imipenem (N-formimidoyl thienamycin) on enterococci and its interactions with aminoglycosides.

Activity of imipenem (N-formimidoyl thienamycin, ampicillin and vancomycin against 27 Streptococcus faecalis and 5 Str. faecium was determined. Also evaluated were the interactions of imipenem, ampicillin and vancomycin with streptomycin or amikacin or sissomicin. Imipenem showed the most inhibitory activity against Str. faecalis with MIC50 and MIC90 values 0.5 and 2 mg/l respectively, Str. faecium strains were less susceptible to imipenem with MIC50/MIC90 values of 2/16 mg/l. Imipenem showed good bactericidal activity against both groups of strains with MBC50/MBC90 values of 1/4 and 4/16 mg/l respectively. The most favourable interactions (synergy and addition) of imipenem were with streptomycin (72.2%) and sissomicin (53.2%). Combinations containing amikacin were the least favourable. Similar results were obtained with these combinations against Str. faecium.

Amikacin↗