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PubMed1983

[Anaerobic infections in operative medicine].

Compared with other medical disciplines, anaerobic infections play an especially important role in operative medicine. In odontogenic soft tissue infections of the orofacial area, in intraabdominal suppurative processes and in post partum, post abortum or postoperative gynecological infections, anaerobic pathogens are almost inevitably encountered. Furthermore, even in times of peace exogenous or endogenous toxic clostridial infections do not occur so rarely that they should be excluded from considerations concerning differential diagnosis. Because of the substantial malignancy of some of these infections, because of considerable variation in the species composition of anaerobic infections at different body sites and because of the peculiar antibiotic sensitivity pattern of certain anaerobes, diseases caused by anaerobic pathogens deserve special diagnostic and therapeutic attention. The reliable recognition of the anaerobic etiology of inflammatory lesions is usually only possible when microscopic or cultural bacteriological examinations are performed. As complete bacteriological analyses may be comparatively time-consuming, the clinician's requirements for planning the appropriate treatment are met best when he is informed of the tentative diagnosis of an anaerobic infection as soon as possible. This may often be achieved by microscopic or gaschromatographic techniques within less than two hours. The treatment of "surgical anaerobic infections" usually consists of operative measures combined with antibacterial chemotherapy. Only in selected cases, incision and drainage will suffice to cure a localized anaerobic suppuration. As a rule, additional application of antibacterial drugs is necessary or at least advisable in order to reliably prevent relapses or systemic spread. Appropriate chemotherapeutics are selected according to the pathogens that are individually present or may be expected with some probability. Diseases due to Gram-positive, non-spore-forming anaerobes, fusobacteria and Bacteroides species of the melaninogenicus group are comparatively easy to treat as these organisms are usually susceptible to penicillins including benzylpenicillin in sufficiently high doses. Against beta-lactamase-producing intestinal Bacteroides species such as B. fragilis and B. thetaiotaomicron, lincomycins and nitroimidazoles have proved to be highly effective. Infections caused by these Bacteroidaceae may also respond to treatment with mezlocillin, cefoxitin, lamoxactam and possibly aminopenicillins combined with clavulanic acid.(ABSTRACT TRUNCATED AT 400 WORDS)

Anaerobiosis↗
PubMed1983

[Experience with preoperative preventive care in obstetrics and gynecology].

The clinical behaviour and post-operative course of 60 patients who had undergone obstetrics or gynaecological surgery is compared. In 30 cases (20 obstetric and 10 gynaecological), antibiotic prophylaxis took the form of a single i.m. injection of 600 mg of lincomycin and 80 mg of gentamycin, 30 minutes before the operation. In the remaining 30 cases (20 obstetric, 10 gynacological), the antibiotic cover was administered postoperatively by i.v. injection of doxicyclin (100 mg every 12 hours for 3 days and 100 mg every 12 hours per os for a further 2 days). From a comparison of the 2 groups, and keeping obstetric and gynaecological cases separate, it is concluded that preoperative antibiotic prophylaxis is comparable in its results to post-operative antibiotic cover. Postoperative haematochemical tests were also done and, as has been reported, showed no significant alterations from the tests administered preoperatively, thus confirming the high tolerance of the drugs in question in the above-stated doses. No cochleovestibular disturbances were encountered nor were drug-resistant bacteriological strains. The efficacy of this prophylactic treatment is confirmed and though comparable in results to the alternative postoperative types is indubitably advantageous both in the lower cost to the community and the short duration of the treatment itself.

Adult↗
PubMed1984

Preparation of amniotic membranes for surgical use with antibiotic solutions.

A comparative study was conducted to investigate the effectiveness of antibiotic solutions for disinfecting vaginally delivered amniotic membranes. The microbial flora of eight amniotic membranes was defined and six antibiotic solutions were tested for their effectiveness in eliminating aerobic and anaerobic organisms. A solution containing 600 micrograms lincomycin HCl/ml, 500 micrograms neomycin sulfate/ml, 25 micrograms polymyxin B sulfate/ml, and 25 micrograms amphotericin B sulfate/ml in 0.5N saline was found to be capable of disinfecting amniotic membranes stored at 4 degrees C for 24 hours. This solution is now being used to disinfect surgically used amniotic membranes at our institution.

Amnion↗
PubMed1984

Porcine Haemophilus pleuropneumonia: microbiologic and pathologic findings.

Haemophilus pleuropneumoniae was isolated from 11% of porcine lung specimens submitted to the University of Illinois Diagnostic Laboratory during 1979-1982. Acute necrotizing fibrinous bronchopneumonia was the most common diagnosis; 65% of lungs had severe involvement of the caudal lobes; 10% of lungs had unilateral involvement only. In 46% of lungs, a second pathogen was isolated. Isolates of H pleuropneumoniae tested by the Kirby-Bauer disk method were most sensitive to nitrofurazone (100%), polymyxin B (97%), chloramphenicol (95%), gentamicin (94%), sulfachloropyridazine (87%), ampicillin (83%), and penicillin (77%). Isolates were less sensitive to 9 other antimicrobials tested. Over 4 years in 1 herd, succeeding isolates of H pleuropneumoniae developed resistance to ampicillin, streptomycin, bacitracin, lincomycin, penicillin, and tetracycline.

Animals↗
PubMed1984

Management of liver disease in dogs and cats.

Ampicillin or amoxicillin is a good initial choice for treatment of liver disease involving bacteria. Cephalosporins, among other antibiotics, can be used with aminoglycosides for a broad-spectrum effect. Metronidazole may benefit patients with hepatic encephalopathy. Tetracycline, penicillins and cephalosporins are good choices for biliary disease. Corticosteroids are indicated for chronic active hepatitis, cholangiohepatitis, immune-mediated hepatopathy, and hepatic lymphosarcoma and mast-cell tumors. D-penicillamine is used to treat hepatic Cu toxicosis. Colchicine has been used to combat hepatic fibrosis. Lactulose is used in long-term management of hepatic encephalopathy. Diuretics and a low-Na diet help control ascites. Cimetidine is used to control GI ulcers. Anabolic steroids help reverse protein catabolism. Acetylcysteine is an antidote for acetaminophen toxicity. Use of hetacillin, chloramphenicol, lincomycin, sulfonamides, erythromycin, acetaminophen and methyltestosterone should be avoided in patients with liver disease.

Acetylcysteine↗
PubMed1984

Antimicrobial susceptibility of Prototheca zopfii isolated from bovine intramammary infections.

In vitro antimicrobial susceptibility tests were carried out on 48 strains of Prototheca zopfii, an achlorophyllous algae causing refractory mastitis in dairy cows; 27 antimicrobials were evaluated. All strains were susceptible to both myxin and nystatin. In addition, 22 strains were susceptible to amphotericin B, 21 to polymyxin B, and 18 to gentamicin. Only 1 strain was susceptible to kanamycin. All strains were resistant to ampicillin, bacitracin, carbenicillin, cephalothin, chloramphenicol, clotrimazole, cloxacillin, erythromycin, flucytosine, ketoconazole, lincomycin, miconazole, neomycin, nitrofurazone, novobiocin, oleandomycin, penicillin, rifampin, streptomycin, tetracycline, and vancomycin.

Animals↗
PubMed1984

[Distribution of antibiotic-resistant microorganisms among newborn infants in an intensive care unit].

Bacteriological assay of the nasal, fauces and feces microflora of 40 newborns of the Department of Intensive Therapy revealed their primary colonization with various opportunistic microorganisms from the environment. Sensitivity of the isolates to 15 antibiotics was tested. It was shown that multiple resistance strains predominated. The staphylococcal strains were mainly resistant to benzylpenicillin, ampicillin, erythromycin and polymyxin. The enterococci were most frequently resistant to methicillin, lincomycin, kanamycin, monomycin and neomycin. Tetracycline and chloramphenicol resistant strains of E. coli were detected. Marked resistance to carbenicillin, ampicillin, cephuroxim and cephaloridin and high sensitivity to cephotaxim and gentamicin were determined in the Klebsiella strains with the method of serial dilutions on solid media. The presence of opportunistic microorganisms with multiple resistance to antibiotics, ate appearance of the own microflora and decreased immunological defence may be the cause of infection in newborns of departments of intensive therapy. Circulation of antibiotic-resistant strains in departments for newborns is fraught with a threat of hospital infections.

Anti-Bacterial Agents↗
PubMed1978

[Anaerobic bacteria in digestive surgery. Pathogenic role and prognostic incidence (author's transl)].

The authors isolated in common surgical practice 83 anaerobic bacteria mainly bacteroides and clostridia. They analyse their pathogenic role in relation to the site of sampling. Comparing the bacteriological results with a clinical study of 96 cases of generalised peritonitis, there appeared to be no significant differente between the prognosis in peritonitis and anaerobic bacteria and those without anaerobic bacteria. The mortality was identical in septicemia due to anaerobic and aerobic bacteria; jaundice was just as frequent in both series. However, the prognosis of peritonitis due to anaerobic bacteria seems better when antibiotic treatment is adapted to the bacteria, e.g. lincomycin, metronidazole. With regard to anaerobic bacteria, which represent only part of the fecal flora, it may be dangerous by selection of resistant strains to use prophylactic antibiotics as a routine; local treatment of the septic focus seems the most important. The pathogenic role of anaerobic bacteria in digestive pathology is far from clearly defined; one should not follow the fashion of using even specific antibiotics without justification.

Adolescent↗
PubMed1983

[Topical use of antibiotics for preventing wound infection in general surgery].

A group of 463 general surgery patients received topical applications of lincomycin and gentamycin, which significantly reduced the incidence of infected wounds compared to the untreated control group. This confirmed the prophylactic efficacy of topical antibiotic treatment which is also less dangerous than parenteral administration.

Administration, Topical↗
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

[Studies on Clostridium difficile and antimicrobial associated diarrhea or colitis].

Clostridium difficile has been implicated as the major cause of antimicrobial associated colitis or diarrhea. C. difficile was found in stools from 21 of 120 healthy subjects. C. difficile was found in stools from 8 of 9 patients with antimicrobial associated pseudomembranous colitis and in stools from 16 of 96 patients with antimicrobial associated diarrhea. The cytopathic toxin to HeLa cell neutralized by antitoxin to C. difficile was found in stools from all patients with antimicrobial associated colitis or diarrhea. Of 21 strains isolated in the stools from healthy subjects, 19 strains were toxigenic. Some of them were highly toxigenic strains. Such highly toxigenic strains, however, did not give rise to any clinical symptoms probably because of the limited number of this organisms in the normal flora of human intestines; the number of C. difficile ranged between less than 10 and 10(2) level per gram of stool when the organism was found. Of the 24 isolates from antimicrobial associated colitis or diarrheal patients, 4 were highly toxigenic. The susceptibilities of 65 isolates to various antimicrobial agents were determined by the agar dilution technique. All of the 65 strains were inhibited by low concentration of rifampicin, metronidazole, vancomycin, ampicillin and amoxicillin. The isolates were highly resistant to gentamicin, cefoxitin, cefotaxime and cefmenoxime. Wide variations in susceptibility of C. difficile strains to erythromycin, clindamycin and lincomycin were found. The studies have shown that subinhibitory concentrations of clindamycin, cephalothin and amoxicillin cause an increase in cytotoxin levels of C. difficile during broth culture. The increase in supernatant toxin levels occurs concomitant with a decrease in sonicated cell extract toxin levels. The data suggest that a number of factor can cause a release of toxin from C. difficile into the surrounding medium or the intestine.

Adult↗
PubMed1981

The role of nitroimidazole derivates in bacterial infections-metronidazole prophylaxis in appendectomy.

The commonest complication of appendicetomy is surgical sepsis, the incidence of which may vary from 4% for normal appendices to 77% for gangrenous or perforated appendices. Although some of these infections are relatively trivial others are serious or even life-threatening. In an effort to reduce the incidence of serious sepsis surgeons have used a variety of topical and systemic prophylactic antibacterial agents such as penicillin, ampicillin, tetracycline, lincomycin, tobramycin, cephalosporins, neomycin, bacitracin, polymyxin and povidone iodine. Although none of these prophylactic procedures has been consistently effective, appropriate systemic antibiotics generally reduce the incidence of intra-abdominal sepsis, while appropriate local treatment reduces the incidence of wound infection. Most reports on the chemoprophylaxis of sepsis after appendicectomy have been concerned solely with clinical aspects of infection and have not considered the nature of the infecting agents. During the last few years there has been an increasing awareness of the importance of non-sporing anaerobes as the major cause of sepsis after surgery of the gastrointestinal tract. Studies carried out at the Luton and Dunstable Hospital and subsequently at other centres have shown that systemic metronidazole, which is a specifically anaerobicidal agent, is highly effective in preventing the development of sepsis due to anaerobes in postappendicetomy patients.

Appendectomy↗
PubMed1978

A comparative study of Staphylococcus epidermidis isolates from clinical material and healthy carriers.

A total of 190 Staphylococcus epidermidis isolates from healthy carriers and clinical material were biotyped according to the Baird-Parker scheme, phage typed by a provisional set of 18 typing phages and tested for antimicrobial susceptibility. The majority of the strains from both groups were found to belong to biotype 1. A considerable number of strains were lysed at 100 x RTD by at least one phage. The strains from healthy carriers were distributed in 24 phage types and about half of them were clustered among three major phage types. Nine of the 30 clinical isolates were of the phage type 130/456 and another nine strains were of eight different phage types. The strain 130/456 represented only three per cent of the phage types from healthy carriers. The clinical strains exhibitbd a multiple resistance pattern to 13 antibiotics. Statistically significant was the difference in the resistance to Penicillin, Streptomycin, Carbenicillin, Erythromycin, Lincomycin, Ampicillin and Kanamycin between the groups of strains from clinical material and healthy carriers. No correlation was observed between biotypes, phage types and antimicrobial susceptibility in both groups of the isolates.

Anti-Bacterial Agents↗
PubMed1981

[Indicator method of determining the beta-lactamase-inhibiting activity of various compounds].

An indicator for determination of beta-lactamase inhibitory activity of various compounds was developed. The method is based on the direct contact of beta-lactamase with the compounds tested. It excludes the use of test-bacteria and provides recording in the data on the day of the experiment. The indicator method enables the detection of the beta-lactamase inhibitory properties of both beta-lactamase inhibitors and beta-lactam antibiotics, not subjected to destruction by beta-lactamases. The method is likely to be fit for detection of atypical beta-lactams having beta-lactam groups in their molecules (bleomycin group). Antibiotics not belonging to the group of beta-lactams, such as gentamicin, sisomicin, lincomycin and fusidin showed no beta-lactamase inhibitory activity under the conditions of the indicator method. The use of the indicator method provided determination of the inhibitory activity with respect to penicillinase of Bac. licheniformis 749/C in 30 (8.5 per cent) out of 350 fermentation broths of actinomycetes.

Actinomycetales↗
PubMed1980

[Fundamental and clinical evaluations of 9, 3"-diacetylmidecamycin in the field of surgery (author's transl)].

The distribution of sensitivity to 9,3"-diacetylmidecamycin (MOM) was examined of 10 strains of Staphylococcus aureus isolated from foci in our hospital. A level of less than 3.13 mcg/ml was seen distributed in the majority of 7 cases, and it could be assumed that MOM would be sufficiently effective against infections by Staphylococci in clinical practice. In the comparison with other antibiotics popularly used, the sensitivity of the 10 strains to them was comparable to those against MDM, but were slightly inferior to cephalexin (CEX) and lincomycin (LCM), and slightly better than ampicillin (ABPC). The evaluation of clinical results revealed that, of the 20 cases with surgical and superficial infections, 6 and 10 were markedly and moderately effective, respectively, while 3 and 1 were fairly and poorly effective, respectively. It was therefore concluded to be an effective remedy for treatment of surgical and superficial infections in which Gram-positive cocci share the majority of the etiological factors. Of the side effects, there was none showing symptoms in digestive tracts or abnormalities such as rash, nor was there any patient for whom further administration of the agent had to be suspended due to side effects. No abnormality was seen in the test results between the premedication and postmedication findings on the hemogram, or hepatic and renal functions. It was therefore conjectured that this agent has a large margin of safety in its application.

Adolescent↗
PubMed1982

Localization of genes coding for macrolide resistance on the penicillinase plasmid of isolates of an epidemic Staphylococcus aureus.

Genetic localization of gene(s) coding for erythromycin and oleandomycin resistance in five isolates of phage complex 52, 52A, 80, 81, multiple antibiotic resistant epidemic Staphylococcus aureus was studied. The 100% coelimination rate of erythromycin, oleandomycin, penicillin (penicillinase production) and certain heavy metal ion resistances from each of the clinical isolates and the 100% cotransduction rate of these resistance markers from two clinical isolates as well as changes in the partially purified extrachromosomal DNA patterns of the clinical wild types after elimination and the recipients after transduction indicated that erythromycin and oleandomycin resistance determining gene(s) resided on the penicillinase-heavy metal ion resistance plasmid in each of the isolates. The electrophoretic mobility of these macrolide-penicillinase-heavy metal ion resistance plasmids (MacPc plasmids) was the same in four strains and higher in one strain. These MacPc plasmids did not confer any resistance to spiramycin and lincomycin (even after induction) or to kanamycin, which features differentiate them from MacPc plasmids pI 258 and pTU 512 formerly identified in Staphylococcus aureus in Japan.

Erythromycin↗
PubMedDate not supplied

[Saprophytic and opportunistic non spore-forming anaerobic microflora of the vagina (author's transl)].

A microbiological survey has been carried out on 179 healthy, child-bearing aged, non-pregnant women, with the aim to evaluate the incidence of anaerobic non-spore forming bacteria in the normal vaginal flora. This group of bacteria has been isolated in 50.3% of women, with a clear prevalence of "anaerobic Streptococci " and Bacteroides, followed by Fusobacterium and Veillonella. No Propionibacterium, Eubacterium or Bifidobacterium have been isolated. According to many Authors the non-spore forming anaerobes must be considered opportunistic bacteria, responsible of many infections of the female genital tract, especially when associated with other aerobic or facultative bacteria. Antibiograms have demonstrated a wide spectrum of activity of chloramphenicol and clindamycin; although not widely distributed, antibacterial activity have also shown metronidazole, penicillins, cephalosporins and lincomycin.

Adolescent↗
PubMed1982

Cellular antibiotic pharmacology.

Many perinatal pathogens are able to survive and in some cases replicate intracellularly. With the exception of viruses and toxoplasma, these pathogens principally infect phagocytic cells of the reticuloendothelial system. Such intracellular organisms, by evading the effects of antibiotics that act only extracellularly, may respond poorly to conventional therapy. Of currently available antibiotics, rifampin, chloramphenicol and trimethoprim are the most active intracellularly. Other antibiotics are either taken up by cells but appear to be inactive intracellularly (lincomycin) or are excluded from cells (penicillins, cephalosporins, aminoglycosides). The clinical role of antibiotics that are active intracellularly is not clear; anecdotal human experience and limited controlled animal experience suggests that they may be useful in the treatment of some infections. Because of the decreased microbicidal activity of newborn phagocytes, intracellular activity of antibiotics may be of greater importance than in older patients. Further study is needed to answer these questions. Methods of enhancing intracellular activity of antibiotics are available should this property prove to be desirable.

Anti-Bacterial Agents↗