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PubMed1991

[Sensitivity of bacteria of the genus Acinetobacter to antibiotics and ofloxacin].

Between 1989-1989 276 strains of Acinetobacter genus were isolated which contained: Acinetobacter calcoaceticus subsp. anitratus (n = 167), Acinetobacter calcoaceticus subsp. Iwoffi (n- = 83), Acinetobacter haemolyticus (n = 26). Their sensitivity to aminoglycoside antibiotics, beta-lactams, tetracyclines, chloramphenicol, colistin, and ofloxacin was tested. More than 90% of strains were sensitive to colistin and ofloxacin. The sensitivity to remaining antibiotics differentiated depending on species. Acinetobacter anitratus were highly resistant to Ist and IInd generation of cephalosporins, and moreover to penicillins, tetracyclines, and chloramphenicol. Cephalosporins of IIIrd generation were active against 70% of strains with exception of cefoperazone what was also the case for representatives of aminoglycosides as netilmicin and amikacin. Strains of Acinetobacter Iwoffi were in majority sensitive to all antibiotics with exception of cephalothin, cephradine and cefoperazone. More than 90% of Acinetobacter haemolyticus strains were sensitive to gentamicin, carbenicillin, azlocillin, ceftriaxone, cefotaxime and tetracyclines.

Acinetobacter↗
PubMed1991

Determination of the synergy of antibiotic combinations by an overlay inoculum susceptibility disc method.

A method involving an overlay inoculum agar and antibiotic susceptibility discs in the determination of synergy of gentamicin and disc antibiotics against clinical isolates of Pseudomonas aeruginosa has been described. Gentamicin combinations with carbenicillin showed synergism against all test isolates. Combinations containing fosfomycin had indifferent effects. Netilmicin, ceftriaxone and ampicillin, respectively, produced interisolate variations in the synergy of their combinations with gentamicin. In all cases synergy was determined on the basis of correlations between inhibition zone diameter (IZD) increments and fractional inhibitory concentration (FIC) indices. An IZD increment of 19% or more predominantly corresponded with synergy. Cases showing less than 19% increase in IZD produced additive effects, while cases showing no variations in IZD had indifferent effects.

Anti-Bacterial Agents↗
PubMed1991

[Beta-lactam and aminoglycoside resistant phenotypes in enterobacteria isolated in pediatrics].

Beta-lactams and aminoglycosides are widely used in the therapy of serious Gram negative infections in pediatrics. In order to survey acquired resistance, the phenotype of resistance to beta-lactams and aminoglycosides were characterized for 260 strains of enterobacteriaceae among the mainly isolated species in pediatrics. These phenotypes were established according to the results of the disk susceptibility tests for beta-lactams respectively ampicillin, ticarcillin, cefaloridin and cefotaxim, and aminoglycosides, streptomycin (S), gentamicin (G), tobryamycin (T), amikacin (A), and netilmicin (N). 49% of E. coli and 73% of P. mirabilis strains were resistant to 3 beta-lactams (RRRS). 72% of Salmonella spp. strains were resistant to 4 beta-lactams (RRRR). For the majority of strains, the mainly observed resistance phenotype to aminoglycosides was streptomycin resistance excepted for Salmonella spp., which was S + KGTNA. The high level of acquired resistance to beta-lactams and aminoglycosides among Enterobacteriaceae with the selection of multiresistant strains would be explained by the wild use of cefotaxim and amikacin in pediatrics.

Aminoglycosides↗
PubMed1991

Clinical implications of multi-drug resistance in the intensive care unit.

A prospective in vitro survey of Gram-negative isolates obtained from patients hospitalized in intensive care units in 10 Boston teaching hospitals was undertaken to document current susceptibility patterns and analyze patterns of cross-resistance. One thousand and five isolates were obtained, 18% were pseudomonas, 18% Escherichia coli, 13% klebsiella, and 22% were in the enterobacter, citrobacter, serratia group. Cross-resistance among beta-lactams and beta-lactamase inhibitors was common for species with a potential to produce the type I inducible beta-lactamase (p less than 0.01). In contrast, resistance to imipenem was not associated with cross-resistance. Ciprofloxacin and netilmicin also remained active. Clinical observations of the development of cross-resistance to the beta-lactams in enterobacter and citrobacter infections in four patients (two bacteremias and two wound infections) seen in one institution confirm these in vitro findings. Unanswered questions remain regarding the frequency of beta-lactam cross-resistance, the most likely sites of occurrence and the overall clinical significance. Clinicians should be aware of the potential selection of type-I beta-lactamase hyperproducers by the use of second or third generation cephalosporins or related beta-lactam agents.

Adult↗
PubMed1991

[Antimicrobial susceptibilities of clinical isolates of Morganella-proteus-providencia group of bacteria].

We examined in vitro susceptibilities of 3,109 isolates belonging to 5 species of Proteeae to 2 penicillins, 5 cephems and 2 aminoglycosides. The isolates were collected from 69 hospital laboratories throughout Japan between 1986 and 1988. Minimal inhibitory concentrations were determined using the agar dilution method with inoculation of 10(8) cells/ml of bacteria. Proteus mirabilis had marked susceptibilities to the penicillins and cephems tested. Proteus vulgaris and Morganella morganii were similar in their susceptibilities to ampicillin (ABPC), piperacillin (PIPC), cefazolin (CEZ), cefotiam (CTM), latamoxef, gentamicin (GM) and netilmicin (NTL), but M. morganii was slightly more resistant to cefmetazole and ceftizoxime (CZX) than P. vulgaris. Providencia rettgeri also had a susceptibility pattern similar to that of P. vulgaris, except that P. rettgeri showed higher resistances to CZX, GM and NTL. Providencia stuartii had a very similar susceptibility pattern to P. rettgeri, but P. stuartii was much more resistant to GM and NTL than the latter. Some major differences on susceptibilities were clearly evident among the 5 species of Proteeae tested. Notable species-specific differences included higher susceptibilities of P. mirabilis to ABPC, PIPC, CEZ and CTM than others and stronger resistances of P. rettgeri and P. stuartii to GM and NTL.

Ampicillin↗
PubMed1990

[Antibiotic sensitivity of enteropathogenic strains of Escherichia coli isolated from children with diarrhea].

Enteropathogenic E. coli strains (n = 120), isolated from faeces in 1988-1989, were sensitive to cefotaxime and ceftriaxone (100%) and to colistin, amikacin, cefoperazone, cefuroxime, cefamandole, netilmicin, gentamicin, tobramycin and neomycin (94.2-99.2%). These strains were resistant to ampicillin (55.6%) and carbenicillin (52.5%). It was found that E. coli strains of serotype 018:K76 were resistant mainly to ampicillin and carbenicillin, whereas E. coli strains of serotype 0119:K69 were resistant mainly to tetracyclines and carbenicillin.

Anti-Bacterial Agents↗
PubMed1990

Impact of the antibiotic dosage schedule on efficacy in experimental endocarditis.

The animal model of endocarditis provides a reliable and reproducible model of acute infection and appears appropriate for studying the parameters involved in the in vivo efficacy of antibiotic therapy. The following points are discussed: (i) beta-lactam antibiotics exhibit a time-dependent bactericidal effect which explains the importance of t1/2 beta in the determination of dosing intervals and the need for large unitary doses for increasing efficacy through extending the period of serum levels greater than MIC (ii). The impact of unitary doses and dosing intervals of aminoglycosides on their in vivo synergism with beta-lactams has been investigated in Escherichia coli and streptococcal infections. Once- daily dosing of netilmicin appears very synergistic with ceftriaxone on E. coli, and the aminoglycoside has a significant dose effect. Conversely, divided doses are necessary to exhibit full synergistic effect with penicillin G on E. faecalis. Different patterns of in vivo synergism can therefore be individualized (iii). The rapid bactericidal effect of quinolones and their in vivo post-antibiotic effect allowing large intervals between doses have been investigated with ciprofloxacin (iv). The importance of t1/2 beta on the in vivo effect of glycopeptides is illustrated by data comparing teicoplanin and vancomycin. It is concluded that in vitro killing rate within 3 h is the major factor interfering with the dose interval, followed by t1/2 beta which is of major importance for those drugs whose bactericidal effect is time-dependent. These parameters appear to have a similar importance in experimental endocarditis to that in other experimental models. However, infected vegetations represent a particular focus of infection incorporating heterogeneity of antibiotic distribution, high density of bacteria and reduced metabolic activity of microorganisms. These factors may explain the lack of in vivo postantibiotic effect observed with some antibiotics, correspondingly shorter dosage intervals in endocarditis than in other types of infections and a need for high unitary doses.

Animals↗
PubMed1990

Simplified monitoring of aminoglycoside treatment.

Aminoglycosides are effective but toxic antibiotics. They are usually administered by repeated daily injections with the dosage adjusted according to twice-weakly monitoring of serum concentrations. A recent study involving 60 patients with severe infections proposed simplified administration and monitoring of aminoglycosides. The patients were randomly treated with either gentamicin or netilmicin given by once daily or thrice daily injections. No difference was found in efficacy or in toxicity between the various groups. In drugs excreted by glomerular filtration, the daily dose should be proportional to renal clearance. This we assessed by aminoglycoside clearance, calculated from trough and peak concentrations of the drug in serum. We also estimated creatinine clearance by a simple equation derived from the knowledge that the urinary excretion of creatinine is proportional to the muscle mass, decreasing with age. For women, creatinine clearance (ml/min) should be [150.age (years)].body weight (kg)/serum creatinine (mumol/l). For men less than 70 years, the figure 150 should be substituted by 170, and at 70 years or older, by 160. We used 51Cr-EDTA clearance as an independent arbiter to decide which mode was best suited for monitoring aminoglycoside therapy. The results showed that estimated creatinine clearance corresponded better to 51Cr-EDTA clearance than did aminoglycoside clearance based on assay of serum concentrations (correlation coefficients for patients with single-dose treatment 0.81 vs. 0.72). In the study we monitored aminoglycoside treatment in the conventional manner according to the patient's weight and adjusted the dose after assay of the drug's serum concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Antibacterial activity of carumonam and cefpirome on hospital strains resistant to gentamicin and cephalothin: comparison with other beta-lactam antibiotics, new fluoroquinolones, aminoglycosides and other antibiotics].

The antibacterial in vitro activity of carumonam, a new monobactam, and cefpirome, a new cephalosporin, was studied on 483 hospital strains resistant to gentamicin and cephalothin, in comparison with amikacin, azlocillin, aztreonam, cefmenoxim, cefoperazone, cefotaxim, cefsulodin (for Pseudomonas), ceftazidime, ceftriaxone, cefuroxim, chloramphenicol, ciprofloxacin, doxycycline, enoxacin, netilmicin, norfloxacin, pefloxacin, piperacillin, rifampicin, tobramycin and trimethoprim. In general the two compounds have a very good in vito activity on Enterobacteriaceae but are less active on non-fermenting microorganisms. For the Enterobacteriaceae the minimal inhibitory concentrations 90% for carumonam was less than or equal to 1.1 mg/l excepted for Enterobacter spp. (43,6 mg/l) and M. morganii (56.8 mg/l) . All the Enterobacteriaceae are susceptible to cefpirome (minimal inhibitory concentrations 90% less than or equal to 5.3 mg/l). The activity of carumonam and cefpirome on Enterobacteriaceae is comparable with that of the third generation cephalosporins. Carumonam is more active than cefpirome and other beta-lactams, ceftazidime excepted, on Pseudomonas aeruginosa and Pseudomonas spp. On the other hand, both compounds reveal to have only a low activity on the other non-fermenters which minimal inhibitory concentrations 90% values of 115.4 mg/l for carumonam and 32.0 mg/l for cefpirome.

Aminoglycosides↗
PubMed1990

[In vitro susceptibility of Escherichia coli and Klebsiella sp. to antibiotics].

A nationwide susceptibility survey of clinical isolates of Escherichia coli and Klebsiella pneumoniae initiated in 1980 was continued for the 8th consecutive year. A total of 4,421 strains of E. coli and 2,825 strains of K. pneumoniae isolated mainly from urine, sputum and pus, were obtained from 69 hospitals throughout Japan during the 2 years (1986-1987). MICs were determined using the agar plate dilution method (Mueller-Hinton agar, BBL) with inoculation of 10(8)CFU/ml bacteria. Antibiotics tested in this survey were 2 penicillins, 7 cephems and 2 aminoglycosides. Most of the strains of the two species of bacteria were susceptible to ceftizoxime (CZX), cefotetan (CTT), latamoxef (LMOX), cefotiam (CTM) and cefmetazole (CMZ) and also gentamicin (GM) and netilmicin (NTL) were active against both species of bacteria. About 90% of the E. coli strains were inhibited at a concentration of 0.20 micrograms/ml of CZX, 0.39 micrograms/ml of LMOX, 0.78 micrograms/ml of CTT, 1.56 micrograms/ml of CTM or NTL, or 3.13 micrograms/ml of CMZ or GM. Most of the strains were resistant to ampicillin (ABPC) and piperacillin. For the strains of K. pneumoniae, similar results were obtained. Yearly changes in susceptibility of E. coli and K. pneumoniae were not obvious with ABPC, cefazolin, CMZ or GM. No significant differences were observed during 1986-1987 in susceptibilities of the isolates of both species of bacteria due to different clinical specimens. These results suggest that the 2nd and the 3rd generation cephems and aminoglycosides, alone or in combination, may be efficacious in treating infections due to E. coli and K. pneumoniae.

Ampicillin↗
PubMed1990

[Typical nosocomial infection with an unusual cause: Hafnia alvei. Report of 2 cases and literature review].

The route of infection and the course of two typical nosocomial infections are described in two patients infected with a rare gram-negative bacterium. Both patients underwent cardiovascular surgery. They were placed close to each other in the intensive care unit for several days and suffered from pneumonia and from wound infection respectively. In both patients bacterial culture grew Hafnia alvei. Successful antibiotic treatment was achieved with Netilmicin and Imipenem. Urinary tract, respiratory tract and wound infections are the most frequent nosocomial infections according to the literature. Risk factors are duration of stay in the intensive care unit, shock, poor general condition and advanced age.

Aged↗
PubMed1990

In vitro drug susceptibility of Mycobacterium other than tubercle bacilli.

MOTT were isolated from clinical specimens from the Division of Mycobacteriology, Department of Microbiology, Siriraj Hospital, Mahidol University, and also from natural sources, namely water and soil in the Bangkok area from January to December, 1987. The strains isolated were as follows: 30 M. fortuitum fortuitum, 5 M. fortuitum peregrinum 3 M. fortuitum 3 rd. biovariant complex, 3 M. chelonae chelonae, 7 M. chelonae abscessus. Of these, 5 strains were isolated from clinical specimens and the other 43 were from the environment. The pattern of drug susceptibility to antituberculous and antimicrobial agents revealed that they were resistant to antituberculous agents but susceptible to aminoglycosides (which contain a central ring of 2-deoxystreptamine) such as amikacin (83% of cultures), netilmicin (83%), gentamicin (77%) and kanamycin (75%). Some strains were sensitive to tetracyclines (35%), but all were resistant to penicillins and cephalosporins.

Anti-Bacterial Agents↗
PubMed1990

[Rapid evaluation of the effectiveness of antibacterial drugs in experimental tularemia].

Rapid estimation of the protective effect of antibacterial drugs on Fransiella tularensis for not more than 2 days was shown possible in experiments on albino mice infected with tularemia. High efficacy of aminoglycosides (kanamycin, gentamicin, streptomycin, amikacin, netilmicin, tobramycin, sagamycin, ribostamycin and sisomicin), tetracyclines (tetracycline, doxycycline, minocycline and methacycline), rifampicin, phosphomycin and oxolinic acid was determined with the recommended rapid method. Amoxycillin, ampicillin, piperacillin, carbenicillin, erythromycin, levomycetin, cefradine, cefmetazole, cefatrizine, cefoxitin, cefsulodin and bactrim (biseptol) proved to be inefficient against the tularemia causative agent.

Animals↗
PubMed1990

[Antibacterial activity of various antibacterial agents against methicillin-resistant Staphylococcus aureus, and difference in antibacterial activity between aminoglycosides by coagulase type. Comparison of isolates obtained in the period from 1982 to 1986 and isolates in recent 6 months].

The sensitivity of methicillin-resistant Staphylococcus aureus (MRSA) isolated in our hospital during the period from November 1988 through April 1989 to various antibacterial agents was examined. Isolates were obtained from blood (4 isolates), sputum (40), bile (1), ascites (1) and urine (4). All isolated MRSA were resistant to cefazolin, cefmetazole, cefuzonam, flomoxef, and tobramycin. More than 80% of the isolates were resistant to fosfomycin and amikacin. 60% were resistant to ofloxacin (OFLX). 46% were sensitive to minocycline. 50% or more of the isolates were sensitive to gentamicin (GM), dibekacin (DKB) and astromicin (ASTM). 88% were sensitive to netilmicin. All the isolates were sensitive to vancomycin and arbekacin. The incidence of OFLX-resistant isolates was increased compared with the results of the previous study. Most of the isolates were coagulase type II. GM, ASTM and DKB were less active against type IV isolates, but they had sufficient antibacterial activity against the type II isolates.

Aminoglycosides↗
PubMed1990

[Measurement of MICs on 16 antimicrobial agents for freshly isolated methicillin-resistant Staphylococcus aureus strains].

MICs of 16 antimicrobial agents including a newly synthesized aminoglycoside antibiotic, arbekacin (HBK), were determined against methicillin-resistant Staphylococcus aureus (MRSA) strains which had been isolated since 1988 from patients with refractory infections. 1. The proportion of highly methicillin-resistant strains was large, especially among those isolated from blood and respiratory tract. 2. All the MRSA strains were resistant to all the beta-lactam antibiotics tested. 3. Most of the strains were also resistant to aminoglycosides. However, HBK inhibited the growth of 95% of the strains at 3.13 micrograms/ml or less, showing potent activities even against highly resistant MRSA strains. 4. The MIC distribution of HBK against MRSA strains showed no change since 1986 when year to year data were compared. Based on our studies on the drug resistance pattern of MRSA since 1986, a large proportion of MRSA strains isolated from blood and respiratory tract appeared to be coagulase type II. 5. Netilmicin-resistant MRSAs have increased since 1986, and MRSA resistant to fosfomycin, minocycline, ofloxacin and norfloxacin have also increased in 1989 compared to 1988. 6. The drug resistance pattern of MRSA has been changing every year and they are acquiring multi-drug resistance. Thus, in the treatment of MRSA infections, it is very important to identify the drug susceptibility of MRSA quickly and accurately.

Aminoglycosides↗
PubMed1990

[Activity of antibacterial preparations against the causative agent of pseudotuberculosis in vitro].

Antibacterial activity of 32 chemotherapeutics against 15 strains of Yersinia ++pseudotuberculosis was studied in vitro. The majority of the strains or 80% were sensitive to penicillins, cephalosporins, monobactams, aminoglycosides, tetracyclins , anzamycins, fluorine derivatives of quinolonecarboxylic acid, levomycetin and a combination of trimethoprim and ++sulfamethoxazole. It was shown that with respect to the Y. pseudotuberculosis strains with multiple antibiotic resistance, the fluorine derivatives of quinolonecarboxylic acid (ciprofloxacin, norfloxacin and enoxacin), tetracyclines, netilmicin, amikacin, cefotaxime and cefazolin were promising for in vivo studies.

Anti-Bacterial Agents↗
PubMed1989

[Antibiotic resistance of gram-negative bacteria isolated at a hospital intensive care unit].

The antibiotic sensitivity of Gram-negative facultatively pathogenic bacteria isolated between 1982-1986 in the respiratory intensive care unit of the 3rd department of pediatry of the "László" Hospital (Budapest) has been studied. Pseudomonas aeruginosa, Klebsiella, Acinetobacter calcoaceticus and Acinetobacter lwoffii were most frequently isolated both from the clinical samples (total 56.9%) and in samples obtained from hospital-hygienic check-examinations. 70-100% of the individual species was resistant to antibiotics used in Hungary. The gentamicin and tobramycin resistance of P. aeruginosa and A. lwoffii showed significant rate of increase. Favourable in vitro results were obtained only with ceftriaxon, ceftazidime, netilmicin and amikacin.

Acinetobacter↗