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In vitro activity of azithromycin and erythromycin against organisms associated with bacterial vaginosis and chancroid.

The in vitro activity of the new macrolide azithromycin and erythromycin against Haemophilus ducreyi, Gardnerella vaginalis, Bacteroides spp. and Mobiluncus spp. was compared. Gardnerella vaginalis, Mobiluncus spp. and Haemophilus ducreyi were highly susceptible to both agents but azithromycin was more effective overall against all three groups of organisms. The activity of both antibiotics against Bacteroides spp. varied greatly, but azithromycin was again more active. Collectively, 62% of all Bacteroides strains were susceptible to erythromycin (MIC 1 mg/1) and 74% were susceptible to azithromycin.

Azides↗

The role of Haemophilus ducreyi bacteria, cytotoxin, endotoxin and antibodies in animal models for study of chancroid.

Haemophilus ducreyi cytotoxin-positive and -negative strains as well as bacterial sonicates and lipooligosaccharides (LOS) from such strains were evaluated for the capacity to produce dermonecrotic lesions, especially ulcers, after intradermal injections to rabbits and to different mouse strains, including nude mice. Dermonecrotic lesions of the ulcerous type were observed within 4 days and they were developed in both rabbits and mice with about 10(7) colony forming units (cfu) of H. ducreyi. Viable bacteria were isolated from the lesions up to 9 days after inoculation. All lesions healed spontaneously within 2-3 weeks. Bacterial sonicate (heated and unheated) and LOS preparations caused mainly abscess formation in rabbits, while in mice, a superficial, haemorrhagic ulceration was observed. To obtain ulceration at all injection sites, about 200 micrograms of LOS was required. Histological examination of acute, dermonecrotic lesions caused by viable bacteria showed deep necrosis, infiltrate of inflammatory cells, especially granulocytes and dilatation of blood vessels. The same type of inflammatory cells as seen in lesions caused by bacteria, were involved in the mouse lesions caused by bacterial sonicate and LOS preparations. The results indicate that LOS/endotoxin, probably in combination with other bacterial polysaccharides, can play a role in ulceration caused by H. ducreyi in animals; however, a relatively high amount of LOS preparation was necessary to cause dermal ulceration at all injection sites in the mouse model. The development of ulcers correlated with the endotoxin activity in bacterial sonicate and in LOS preparations. The model may therefore be useful to study the role of LOS components in development of ulceration. There was no significant difference in lesions caused by cytotoxin producing, respectively, non-producing H. ducreyi strains and cell-free preparations from such strains. The bacterial sonicates, cytotoxic for human cell lines, failed to kill animal cell lines, indicating that animal models do not adequately reflect the cytotoxin activity in experimental H. ducreyi infection. Antibodies to H. ducreyi sonicate and LOS, tested by means of ELISA, were found in pre-immune sera from both rabbits and mice. There was a significant antibody response to homologous cell sonicate and LOS, after primary and secondary infections with bacteria. Still, there was no clear difference between primary and secondary lesions in animals. Since animal lesions are mainly due to endotoxin activity, this may indicate that antibodies are of minor importance for protection in animal models.

Abscess↗

A mixed infection of syphilis and chancroid.

The clinical differentiation between a hard chancre and a soft chancre is well known to dermatologists. We present a patient with both a hard and a soft chancre developing on the penis. Thorough investigational studies should be made of all patients with venereal disease to determine whether more than one venereal disease is present.

Adult↗