PubMed HealthSearch

Biomedical subjects

A L Barry

Publications and source records attributed to A L Barry.

At least 19 recordsLinked to original sources

Spontaneously occurring staphylococcal mutants resistant to clinically achievable concentrations of ciprofloxacin and temafloxacin.

The frequency of spontaneously occurring mutants resistant to 0.5, 1, 2, 4 and 8 micrograms of temafloxacin or ciprofloxacin per milliliter was documented with four Staphylococcus aureus and four Staphylococcus epidermidis strains. Resistant mutants were recovered at two- to four-fold the MIC of either drug, and they displayed cross-resistance to other fluoroquinolones. Resistance to temafloxacin occurred at frequencies lower than those observed with equal concentrations of ciprofloxacin. Resistance to greater than four-fold the MIC of either drug was not detected (frequencies less than 10(-10).

Anti-Infective Agents

In-vitro methods for determining minimal lethal concentrations of antimicrobial agents.

To determine the minimal lethal concentration of an antimicrobial agent, broth dilution tests may be performed and then a sample from each tube showing no visible growth may be subcultured onto a drug-free agar medium. By counting the number of viable cells recovered from each tube, the minimal concentration of drug required to kill 99.9% of the cells in the initial inoculum can be determined. Studies were undertaken to determine the circumstances under which false-negative tests could occur as a result of continued inhibition of growth by the antimicrobic carried over in the sample. Drug carryover did significantly reduce the number of viable cells recovered from broth containing relatively high concentrations of antimicrobic: the larger the sample, the greater the effect of drug carryover. The effect was minimal with samples of 10 microliter or less. Furthermore, the effect of drug carryover was reduced by spreading the sample over the surface of an agar medium. The relative precisions of four methods for performing subcultures with such small-volume samples were determined; coefficients of variation were 16-25%. Sampling errors inherent in the procedure for subculturing broth tubes should be taken into consideration when interpreting results of individual tests, and replicate subcultures will improve the reliability of the colony counts.

Enterococcus faecalis

In-vitro activities of cefamandole and cephalothin against 1,881 clinical isolates. A multi-center study.

By use of an agardilution technic, 1,881 clinical isolates were tested against cefamandole and cephalothin. The isolates represented 18 genera, recovered in five geographically separate centers within the United States. The majority of strains were susceptible (MICs less than or equal to 8 micrograms/ml) to both drugs. Cefamandole showed greater activity against most of the bacterial pathogens. Enterococci, Serratia spp., and Acinetobacter spp. were resistant to both drugs. Cephalothin was more active against Staphylococcus aureus, and both cephalosporins were relatively inactive against methicillin-resistant strains of S. aureus. Enterobacter spp. and indole-positive Proteus spp. were susceptible to cefamandole but resistant to cephalothin.

Bacteria

A system for reporting quantitative antimicrobic susceptibility test results.

A reporting system for the laboratory to communicate quantitative antimicrobic susceptibility test results to the physician in a manner that will optimize proper utilization of such test results is described. Minimal inhibitory concentrations are reported on a scale of clinically achievable concentrations, thus indicating the degree of susceptibility.

Anti-Bacterial Agents

Piperacillin susceptibility tests by the single-disk agar diffusion technique.

Piperacillin is a new semisynthetic penicillin with a spectrum of activity broader than that of carbenicillin or ticarcillin. Studies were performed to establish standards for agar diffusion susceptibility tests with piperacillin disks. Tests with 100-, 150-, and 200-micrograms piperacillin disks and with 100-micrograms carbenicillin disks were evaluated. With both penicillins, 100-micrograms disks were satisfactory, in spite of the fact that piperacillin is a larger molecule and diffuses at a slower rate. With both carbenicillin and piperacillin disks, resistant strains of Staphylococcus aureus produced zones less than or equal to 28 mm and susceptible strains gave zones greater than or equal to 29 mm in diameter. When testing other microorganisms, zone standards of less than or equal to 13 mm for resistant (minimal inhibitory concentration, greater than or equal to 256 micrograms/ml) and greater than or equal to 17 mm for susceptible (minimal inhibitory concentration, less than or equal to 64 micrograms/ml) are recommended for tests with 100-micrograms piperacillin disks. Similar zone standards are currently recommended for carbenicillin and ticarcillin disk tests.

Bacteria

Collaborative evaluation of a proposed reference dilution method of susceptibility testing of anaerobic bacteria.

An agar dilution method for susceptibility testing of anaerobic bacteria was evaluated to determine whether results obtained would be consistent enough to recommend it as a reference method. The study was conducted in 10 laboratories where the minimum inhibitory concentrations of six antibiotics (carbenicillin, cefoxitin, chloramphenicol, clindamycin, penicillin G, and tetracycline) were determined against 10 bacterial strains on Wilkins-Chalgren agar prepared by three manufacturers. Minimum inhibitory concentrations falling on the modes varied from 57 to 80% of all determinations and on the mode or within +/-1 log(2) dilution of the mode from 87 to 100% within each laboratory. When data from all laboratories were pooled, minimum inhibitory concentrations from each laboratory agreed with the overall mode 48 to 71% of the time, with an overall agreement at +/-1 log(2) dilution of 96%. This degree of reproducibility allows for recommendation of the procedure as a reference method. Results with three of the test strains were very consistent, and these strains are recommended as control strains: Clostridium perfringens ATCC 13124, Bacteroides fragilis ATCC 25285 and Bacteroides thetaiotaomicron ATCC 29741. The minimum inhibitory concentrations for these strains were on the mode or within +/-1 log(2) dilution of the mode 98, 99, and 99% of the time, respectively. The remaining anaerobic bacteria are recommended as reference strains.

Anaerobiosis

Fortimicin A: collaborative in vitro susceptibility. Comparison with amikacin and gentamicin against 11,840 clinical bacterial isolates.

The susceptibility of 11,840 clinical bacterial isolates to fortimicin A was determined by agar dilution or broth microdilution methods and compared with their susceptibility to amikacin and gentamicin. In general, the in vitro activity of fortimicin A was essentially the same as that of amikacin. Significant exceptions were the increased effectiveness of fortimicin A against Serratia marcescens and the greater activity of amikacin against Pseudomonas and other nonfermentative gram-negative bacilli. On a weight-for-weight basis, gentamicin showed greater activity than the other two antimicrobial drugs against most species; S. Marcescens was the major exception. However, at concentrations equivalent to achievable nontoxic serum levels, the proportion of isolates inhibited by the three drugs was quite comparable. There were several strains with unusually high resistance to one or more of the tested antibiotics. These usually occurred in one of the six participating institutions and could be traced to specific enzyme-producing or permeability mutants endemic to that particular institution.

Amikacin

Rapid identification of Enterobacteriaceae with the micro-ID system versus API 20E and conventional media.

The Micro-ID system for rapid (4 h) identification of Enterobacteriaceae was evaluated by testing 433 enteric bacilli and 9 other gram-negative bacilli. Each isolate was identified with conventional tubed media and was also tested in the Micro-ID and API 20E systems. The overall accuracy of both systems was 97%. Micro-ID tests for the Voges-Proskauer reaction, indole and H2S production, and ornithine and lysine decarboxylase all demonstrated a 97 to 99% correlation with conventional methods. Only 86% of the Micro-ID urease tests agreed with Christenson urea agar. Two inoculum densities were tested in Micro-ID panels, with 157 stock cultures. Over 90% of the tests were unaffected by changes in inoculum density. Tests with four control strains suggested that the Micro-ID system was more reproducible when a light inoculum was used. The Micro-ID system was found to be a very convenient method for rapid, accurate, and precise identification of the Enterobacteriaceae.

Bacteriological Techniques

Identification of Enterobacteriaceae in frozen microdilution trays prepared by Micro-Media Systems.

Frozen microdilution trays, with 20 different biochemical test media for identification of Enterobactericeae, were evaluated. The test panels were those provided by Micro-Media Systems (MMS), who also provided a code book for interpretation of the test results. The interpretations of the MMS test system and of the Analytab API 20E test system were compared with those obtained from tests with conventional media. Tests with 468 Enterobacteriaceae demonstrated nearly comparable results with the two commercial systems. About 6% (API) and 7% (MMS) of the isolates could not be identified without additional tests, and another 3% (MMS) to 4% (API) of the isolates gave test patterns that were not found in the code books. One to three percent of the isolates were misidentified. It was concluded that the MMS Enteric Quad Panels provide an efficient, relatively inexpensive, and reasonably accurate method for identification of the Enterobacteriaceae.

Bacteriological Techniques

Methods of measuring zones of inhibition with the Bauer-Kirby disk susceptibility test.

Standard Bauer-Kirby disk tests were performed with 85 selected isolates, each tested in triplicate by four different investigators. Each disk test was observed, and zone diameters were measured, under two lighting conditions (transmitted light and reflected light). The two lighting systems produced similar zone measurements (+/-2 mm) with 96% of the tests. When there were greater differences, zones appeared to be larger when observed with reflected light. Interlaboratory reproducibility was much greater when using reflected light rather than transmitted light. We concluded that zone diameters should be measured from the back of the plate while it is resting on, or held 2 to 3 inches [ca. 5.1 to 7.6 cm] above, a black, nonreflecting, flat surface, illuminated by a reflected light source.

Anti-Bacterial Agents

Simple inoculum standardizing system for antimicrobial disk susceptibility tests.

A collaborative study was undertaken to evaluate a simple, convenient device which expedites inoculum standardization for antimicrobial disk susceptibility tests. The Inocupac system (Minnesota Mining & Manufacturing [3M] Co., St. Paul, Minn.) was used to perform disk tests in parallel with the standard Bauer-Kirby method. Five investigators tested 100 selected isolates, each in triplicate. Inter- and intralaboratory precision of both disk procedures was essentially comparable. The Inocupac system failed to consistently provide satisfactory growth with some streptococci, but when testing common gram-negative bacilli, staphylococci, and most enterococci, the Inocupac system gave zones about the same size (+/-2 mm) as the Bauer-Kirby procedure. Interpretive agreement between the two test systems varied from 90 to 99% with different antimicrobial agents, and repeated tests with the Bauer-Kirby method demonstrated the same degree of interpretive agreement. The Inocupac system is a valid alternative method for inoculating disk susceptibility tests.

Anti-Bacterial Agents

Piperacillin (T-1220), a new semisynthetic penicillin. II. In vitro antimicrobial activity and synergy comparison with carbenicillin and gentamicin.

Piperacillin, a new semisynthetic penicillin, was found to have potent antimicrobial activity against nearly all (405) tested bacterial species. Piperacillin was consistently 4 approximately 16-fold more active than carbenicillin against the Enterobacteriaceae, 16 approximately 32-fold against Pseudomonas aeruginosa and Pseudomonas species, and 16-fold against Streptococcus faecalis. Carbenicillin and piperacillin were equally effective against Staphylococcus aureus, but inactivated by beta-lactamase. A 38% overall synergy rate for the piperacillin-gentamicin combination was identified, a finding similar to that for carbenicillin-gentamicin. Highest incidences of synergy were found for both antibiotic pairs tested on gentamicin-resistant isolates (Ps. aeruginosa and Providencia). In vitro findings suggest that piperacillin alone or in combination with aminoglycosides may be highly efficacious in the treatment of most serious bacterial infections.

Bacteria

Aerobic and anaerobic susceptibility tests with three tetracyclines. Reassessment of the "class concept" of disk testing.

Both aerobic and anaerobic susceptibility tests were performed with tetracycline, doxycycline, and minocycline, using disk diffusion and agar dilution technics. The data were examined in order to reassess the concept of testing a single disk, representative of the tetracycline class of antimicrobics. All strains that were susceptible to a tetracycline disk were predictably susceptible to the tetracycline analogs. Some strains that gave zones in the resistant or intermediate range were susceptible or moderately susceptible to doxycycline and minocycline by agar dilution methods. However, disk tests with the more active analogs were often unproductive, since most tetracycline-resistant strains gave indeterminate results with doxycycline or minocycline disks. It was concluded that the "class concept" of disk testing is still appropriate and that tests with tetracycline disks predict susceptibility to the other tetracycline analogs reasonably well.

Agar

Reassessment of the "class" concept of disk susceptibility testing. Cephalothin disks versus minimal inhibitory concentrations with eleven cephalosporins.

Reassessment of the "class" concept of disk susceptibility testing. Cephalothin disks versus minimal inhibitory concentrations with eleven cephalosporins. Am J Clin Pathol 70: 909--913, 1978. Studies were carried out to determine whether susceptibility or resistance to 11 cephalosporins could be predicted reliably from the results of tests with a single cephalothin disk. The cephalosporins were tested with a microdilution technic and with a standardized disk test. Strains susceptible to a cephalothin disk were predictably susceptible to all other cephalosporins. However, 2--12% of the strains were resistant to cephalothin disks but were susceptible to the more active parenteral drugs cefoxitin, cephamandole, cefuroxime, and BL-S786. Because of differences in antimicrobial activities, the cephalosporins could be divided into three subgroups for purposes of susceptibility testing: one subgroup includes the majority of cephalosporins and may be represented by tests with cephalothin, the second subgroup inclues three active parenteral drugs (cephamandole, cefuroxime, and BL-S786) and may be represented by tests with cefuroxime, and the third subgroup consists of cefoxitin, a cephamycin with a unique broad spectrum of activity. Until the drugs in the second and third subgroups are released for general therapeutic use, the practice of testing only one cephalosporin disk appears to be a reasonably reliable procedure.

Bacteria

Evaluation of the micro-media system for quantitative antimicrobial drug susceptibility testing: a collaborative study.

Micro-Media Systems (MMS) has developed a procedure by which microdilution trays can be filled with dilutions of antimicrobial agents, frozen, and distributed to clinical laboratories. The trays are prepared in various distribution centers throughout the United States to supply clinical laboratories in the vicinity of each center. For use, trays are removed from the freezer, allowed to thaw, and then inoculated with inocula prepared as for any other susceptibility test, using a convenient disposable inoculator (ca. 5 mul per well). A collaborative study was planned to evaluate microdilution trays prepared in three Micro-Media Systems distribution centers. Microdilution minimal inhibitory concentrations (MICs) were compared to standard tube dilution tests (the international collaborative study group method). With gram-positive cocci, the two techniques gave essentially equivalent results. With gram-negative bacilli, the microdilution MICs were generally one doubling dilution lower than the standard tube dilution MICs. Similar results were seen with microdilution trays prepared with a Cooke Dynatech MIC 2000. Inter- and intralaboratory reproducibility with the macro- and microdilution techniques were quite satisfactory, i.e., at least 96% of the end points were within a range of +/-1 log(2) dilution intervals.

Evaluation Studies as Topic