[Streptococcal pharyngitis].
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Biomedical subjects
Publications and source records attributed to C Betriu.
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The aim of this study was to determine the susceptibility patterns of 100 group B streptococcal strains isolated in our hospital and to ascertain tolerance to penicillin by determining quantitative killing curves. We found two strains with intermediate susceptibility to penicillin and eight strains to ampicillin. Seventeen isolates were tolerant to penicillin, with bacterial counts decreasing 2 to 3 log during the first 8 h but still above 10(2) CFU/ml after 24 h. The kinetic study shows that penicillin tolerance is not rare among group B streptococci isolated in our hospital.
We developed a biliary and pulmonary microbiologic study in 22 Large-White pigs that underwent bile-duct ligation in order to demonstrate that sepsis has a biliary and pulmonary origin which may be involved in the gatroesophageal pathology. All the pigs died at 18.2 +/- 8.9 days of the post-operative period. The cause of death was hemorrhagic ulceration of the gastroesophageal region in 36.3% (n = 8) of the animals that also presented multiple bilateral miliary lung abscesses. High infestation rates with intestinal germs were found in the bile and lung. In conclusion, the experimental model of extrahepatic cholestasis in the Large-White pig could be useful for the study of etiopathogenic mechanisms by which the pulmonary infection produces a hemorrhagic gastroesophageal ulceration considered as stress ulcer.
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The susceptibility patterns of group A streptococci over the last 6 years in our hospital were determined. Since our last study, carried out in 1987, all isolates have remained very susceptible in vitro to penicillin and all of the other beta-lactam agents tested. We observed resistance to erythromycin, clindamycin, tetracycline, and ofloxacin. The prevalence of erythromycin-resistant group A streptococci did not change appreciably throughout the study period.
The in vitro activity of metronidazole, chloramphenicol, clindamycin and 11 beta-lactam antibiotics against 135 clinical isolates of the Bacteroides fragilis group was compared. In addition, changes in the resistance patterns of members of the Bacteroides fragilis group isolated at the Hospital Universitario San Carlos in Madrid, Spain, between 1979 and 1989 were documented. The most active beta-lactam drugs were imipenem and beta-lactamase inhibitor combinations. In 1989, however, two strains were found to be resistant to imipenem and to all other beta-lactam agents tested. There was no emergence of resistance to metronidazole. Chloramphenicol was very effective: only one resistant strain was detected in 1979 and no chloramphenicol-resistant isolates were found during the rest of the study period. An outbreak of clindamycin resistance was noted in 1982, and the first cefoxitin resistant strains were recovered in 1985. The changing patterns of susceptibility of anaerobic bacteria to antimicrobial agents and the emergence of Bacteroides fragilis strains resistant to new beta-lactam agents suggest that periodic antimicrobial susceptibility tests should be performed in order to guide the selection of antimicrobial agents for therapy.
A total of 94 clinical isolates of the Bacteroides fragilis group was tested for susceptibility to metronidazole, chloramphenicol, clindamycin, cefoxitin, cefotetan, cefmetazole, moxalactam, mezlocillin, amoxicillin-clavulanic acid, and imipenem. All the strains tested were susceptible to imipenem, metronidazole, amoxicillin-clavulanic acid, and chloramphenicol. The rate of resistance to clindamycin was 21%. The results of this study demonstrate a difference in resistance rates from one species of the B. fragilis group to another.
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We have compared the sensitivity, specificity and reproducibility of four rapid tests for the detection of group A beta-hemolytic streptococci antigen directly from a throat swab. The four methods were very specific, all of them offered reproductibility and surpassed conventional culture in speed and simplicity.
BACKGROUND: The recent emergence of glycopeptide-resistant enterococci limits the treatment of enterococcal infections. The aim of this study was to evaluate the in vitro activity of a new streptogramin, quinupristin/dalfopristin, against 30 clinical isolates of vancomycin-resistant enterococci and compared with those of other 15 antimicrobials. MATERIAL AND METHODS: Enterococci were identified by using Rapid ID 32 Strep system. Genotyping of the isolates was performed by PCR. The MICs of quinupristin/dalfopristin were determined by the agar dilution technique recommended by the NCCLS. Susceptibilities to the rest of antibiotics tested (teicoplanin, ampicillin, penicillin, imipenem, doxycicline, chloramphenicol, gentamicin, streptomycin, rifampin, levofloxacin, fleroxacin, trovafloxacin, sparfloxacin, pefloxacin and clinafloxacin) were determined by using the E test. beta-lactamase production was examined with nitrocefin disks. RESULTS: Quinupristin/dalfopristin has demonstrated excellent activity against Enterococcus faecium (MIC90' 2 micrograms/ml). Enterococcus faecalis was considerably less susceptible than E. faecium, at concentration of 4 micrograms/ml inhibited only 31% of tested strains. For doxycicline 77% of strains were susceptible. Only five isolates were susceptible to clinafloxacin; the other quinolones tested displayed poor activity. Resistance to chloramphenicol was detected in 47% of isolates. None of the isolates produced beta-lactamase. CONCLUSIONS: This study indicates that vancomycin-resistant enterococci are often concomitantly resistant to multiple antibiotics. Quinupristin/dalfopristin was the most active agent tested against E. faecium strains. On the basis of these results quinupristin/dalfopristin could be a therapeutic option for the treatment of vancomycin-resistant E. faecium infections.
During the 32 months between October 1984 and May 1987 there were 72,800 admissions in our center; 31,523 blood cultures were undertaken and in 3,831 of them (11.5%) at least one significant organism was recovered; 6.7% of blood cultures yielded anaerobic bacteria, and 3.1% Bacteroides spp. In the 1,478 instances of bacteremia recorded during that period, the relative frequencies of bacteremia by anaerobic bacteria and by Bacteroides were 8.6% and 3.9%, respectively. In overall 50 Bacteroides bacteremias (47 due to Bacteroides fragilis and 3 to Bacteroides spp), 32 (64%) were hospital acquired and 14 (28%) postsurgical. Their most common source was the abdominal cavity (25, 50%), followed by the skin and soft tissues (7, 14%), feminine pelvis (4, 8%), miscellaneous (8, 16%), and unknown (7, 14%). Fifteen bacteremias (30%) were polymicrobial, 20 (40%) were associated with septic shock, and 15 (30%) with renal failure. Overall mortality rate was 52%, and that directly attributable to bacteremia was 32%. Poor prognostic predictors included the source from a perforated viscus, septic shock, renal failure or gastrointestinal hemorrhage, and the absence of adequate antimicrobial therapy.
BACKGROUND: Streptococci group A is the most frequently isolated pathogen in the cases of acute pharyngotonsilitis in school-aged children. Hemolytic streptococci B, which are not of group A, have recently been described as a cause of pharyngotonsilitis. A study was carried out in school children in primary school with the aim of knowing the frequency of the state of pharyngeal carriers of streptococci in groups A, B, C and G. METHODS: A total of 347 children with ages ranging from 4 to 14 years of age were included in the study in which a pharyngeal exudate was obtained to investigate the presence of hemolytic streptococci B. RESULTS: The prevalence of streptococci group A in all the age groups studied was of 11.52% being significantly greater (40.47%) among children of preschool age (4-6 years). The prevalence of streptococci group C was 2.3% with no carriers of groups B or G being observed. CONCLUSIONS: The results of this study are in agreement with the literature reviewed in which asymptomatic carriers of streptococci group A were found to be principally school aged children who are those who most frequently have acute pharyngotonsilitis. Neither the pathogenicity of hemolytic streptococci B, which are not of group A, nor their epidemiologic implications are totally clear.