Levoflaxin and Streptococcus pneumoniae.
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Anti-Infective Agents↗
Biomedical subjects
L Hochstein
Publications and source records attributed to L Hochstein.
Rapid diagnosis of tuberculosis in various biopsy and body fluid specimens by the AMPLICOR Mycobacterium tuberculosis polymerase chain reaction test.
STUDY OBJECTIVES: This study was undertaken to determine the usefulness of the AMPLICOR Mycobacterium tuberculosis (MTB) polymerase chain reaction (PCR) test (Roche Diagnostic Systems, Inc; Branchburg, NJ) in diagnosing TB in tissue and body fluid specimens other than respiratory secretions. DESIGN AND SETTING: Prospective analysis of clinical and laboratory data in patients with suspected TB at the four divisional hospitals of Catholic Medical Center, located in New York. PATIENTS AND MEASUREMENTS: A total of 1,090 tissue and body fluid specimens from 1,032 patients with suspected TB were subjected to acid-fast bacillus (AFB) smear, culture, and the AMPLICOR MTB PCR test. RESULTS: Of the 1,090 specimens, 32 grew M tuberculosis complex and 8 specimens grew isolates belonging to the Mycobacterium avium complex (MAC). The AMPLICOR MTB PCR test was positive for 24 of the 32 specimens that grew M tuberculosis. It was also positive for four additional specimens that were culture-negative for M tuberculosis or MAC. Two of these specimens were from patients with a previously recorded positive sputum culture for M tuberculosis. The AMPLICOR test was negative for all eight specimens that yielded MAC only. When AMPLICOR MTB PCR test results were compared with the confirmed clinical diagnosis of TB, the sensitivity, specificity, positive predictive value, and negative predictive value for the AMPLICOR MTB PCR test were 76.4%, 99.8%, 92.8%, and 99.2%, respectively. PCR results were available within 6.5 hours, compared with an average of 3 weeks for culture of M tuberculosis. CONCLUSIONS: These data establish the utility of the AMPLICOR MTB PCR test for the rapid detection of M tuberculosis in tissue and body fluid specimens other than respiratory secretions.
Biopsy↗
Nitrate is a preferred electron acceptor for growth of freshwater selenate-respiring bacteria.
An anaerobic, freshwater enrichment grew with either nitrate or selenate as an electron acceptor. With both ions present, nitrate reduction preceded selenate reduction. An isolate from the enrichment grew on either ion, but the presence of nitrate precluded the reduction of selenate. Stock cultures of denitrifiers grew anaerobically on nitrate but not on selenate.
Journal Article↗
Evaluation of the Roche Septi-Chek AFB system for recovery of mycobacteria.
The Septi-Chek AFB system for the recovery of mycobacteria from clinical specimens was compared with a conventional approach using Lowenstein-Jensen and Middlebrook 7H11 agars. A total of 1,532 clinical specimens were analyzed; 132 yielded mycobacteria. Mycobacterium tuberculosis and Mycobacterium avium complexes were the predominant isolates. With the conventional combination of Lowenstein-Jensen and 7H11 agars, 75.8% of the isolates were recovered; the Septi-Chek AFB allowed recovery of 100% of the isolates. Septi-Chek AFB required less time for the detection of mycobacteria than did the conventional media.
Agar↗
False-positive latex agglutination test for Neisseria meningitidis groups A and Y caused by povidone-iodine antiseptic contamination of cerebrospinal fluid.
The cerebrospinal fluid of a patient yielded a positive latex agglutination test for Neisseria meningitidis groups A and Y. The latex agglutination results were not consistent with clinical and other laboratory findings. An investigation determined that the positive agglutination test was caused by contamination of the cerebrospinal fluid with povidone-iodine during the lumbar puncture.
Drug Contamination↗
Quantitative antimicrobial susceptibility test for Streptococcus pneumoniae using inoculum supplemented with whole defibrinated sheep blood.
The National Committee for Clinical Laboratory Standards recommends the use of lysed horse blood-supplemented Mueller-Hinton broth for determining the quantitative antimicrobial susceptibility of Streptococcus pneumoniae. This procedure may be difficult for laboratories using previously prepared or commercial MIC systems. Therefore, a study was undertaken to determine whether previously prepared microdilution trays containing Mueller-Hinton broth without blood could be used for determining the antimicrobial susceptibility of S. pneumoniae by adding whole defibrinated sheep blood to the bacterial suspension used to inoculate the trays. The presence of alpha-hemolysis was used as an indicator of bacterial growth. One hundred isolates of S. pneumoniae selected to represent a distribution of susceptibility patterns were tested by the National Committee for Clinical Laboratory Standards method and the sheep blood-supplemented-inoculum method. Greater than 94% agreement between the two methods was achieved. The sheep-blood-supplemented-inoculum procedure was highly reproducible and easy to perform and provides an acceptable alternative for determining the MICs for S. pneumoniae for laboratories using previously prepared or commercial microdilution systems.
Culture Media↗
Two fatal cases of type E adult food-borne botulism with early symptoms and terminal neurologic signs.
Type E botulism, one of the least common forms of botulinal intoxication on the East Coast of the United States, is described for two elderly patients with chronic underlying disease. Both patients consumed tainted kapchunka, a salted, ungutted whitefish. Gastrointestinal symptoms and signs were prominent, but neurologic complaints, although noted soon after the consumption of the fish in one patient, did not progress until late in the course of the patient's illness. One patient exhibited both urinary retention, which was reported mainly in one outbreak of type E botulism (M.G. Koenig, A. Spickard, M.A. Cardella, and D.E. Rogers, Medicine [Baltimore] 43:517-545, 1964), and muscular fasciculations, which have been rarely reported.
Animals↗
Collaborative evaluation of the UniScept qualitative antimicrobial susceptibility test.
The UniScept system (Analytab Products, Plainview, N.Y.) is a commercially prepared microdilution antimicrobial susceptibility test for the determination of qualitative susceptibility results for gram-negative and gram-positive bacteria. The system showed excellent correlation with the reference agar diffusion approach for organisms from clinical specimens and with stock and reference cultures. Intra- and interlaboratory reproducibility was high.
Anti-Bacterial Agents↗
Evaluation of the BIOGRAM antimicrobial susceptibility test system.
BIOGRAM is an antimicrobial susceptibility test system for the determination of MICs from the standard disk diffusion test zone diameters. The system was challenged with 511 recent clinical isolates of members of the family Enterobacteriaceae, nonfermentative gram-negative bacteria, staphylococci, and enterococci. Results were compared with those obtained with the broth microdilution method. Appropriate control organisms were included with each test series. A total of 10,085 organism-drug combinations were evaluated. BIOGRAM demonstrated an overall correlation of 95.9% with the reference broth microdilution method.
Anti-Bacterial Agents↗
An archaebacterial ATPase from Halobacterium saccharovorum.
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Ammonium Sulfate↗
Collaborative evaluation of the UniScept quantitative antimicrobial susceptibility test.
UniScept (Analytab Products, Plainview, N.Y.) is a commercially prepared microdilution antimicrobial susceptibility system for the determination, in a single tray, of antimicrobial MICs for gram-negative and gram-positive bacteria and those isolated from urinary tract infections. The system showed excellent correlation with the reference microdilution approach for organisms from clinical specimens and with stock and reference cultures. Intra- and interlaboratory reproducibility was high.
Anti-Bacterial Agents↗
Evaluation of a rapid inoculum preparation method for agar disk diffusion susceptibility testing.
A rapid inoculum preparation method for agar disk diffusion susceptibility testing which does not require incubation before inoculation of Mueller-Hinton plates was compared with the National Committee for Clinical Laboratory Standards (NCCLS) method. A total of 326 fresh clinical isolates were tested, and the NCCLS-recommended quality control organisms were included with each test series. Randomly distributed interpretative changes occurred with 27 (0.8%) of the 3,215 test results for the clinical isolates. The quality control organisms were tested on 29 separate days, and results were consistently within tolerance limits. The rapid method was found to be equivalent to the standard NCCLS method and required less time and expense.
Agar↗
In-vitro comparison of four antipseudomonal antibiotics in a general hospital.
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Adolescent↗
Amikacin pharmacokinetics in the therapy of childhood urinary tract infection.
Amikacin, a new aminoglycoside antibiotic with a spectrum similar to that of gentamicin, has been used mainly in adults. This report summarizes the first use of this drug in children with urinary tract infection. Organisms were eradicated in all cases and recurrent infection occurred in one half after one week. No evidence of ototoxicity or nephrotoxicity was found. Four children developed transient elevation of serum glutamic oxaloacetic transaminase. Serum level (17 mug/ml) of the drug at one hour and its urinary excretion in six hours (60% of the dose) was comparable to those of adults. This antibiotic is potentially valuable and has thus far not shown major toxicity when given for up to 11 days in patients with normal renal and liver functions.
Amikacin↗
In vitro activity of ampicillin/sulbactam against enterococci determined by the time-kill method.
Time-kill studies demonstrated that at clinically achievable serum concentrations, ampicillin/sulbactam was equivalent in activity to ampicillin alone against non-beta-lactamase producing isolates of Enterococcus faecalis and Enterococcus faecium. Sulbactam possessed no antibacterial activity against these organisms. It is not yet known if the activity of ampicillin will be increased with the addition of sulbactam when tested against beta-lactamase-producing enterococci.
Ampicillin↗
In vitro activity of cefoperazone/sulbactam and other antimicrobials against anaerobic bacteria.
Sulbactam inhibits the hydrolytic activity of several, clinically important beta-lactamases including those produced by anaerobic bacteria. This study was undertaken to determine the effect of sulbactam on the activity of cefoperazone against 250 anaerobic bacteria including 174 isolates belonging to the Bacteroides fragilis group and to compare the activity of cefoperazone/sulbactam with other antimicrobial agents. beta-lactamase activity was detected in 98% of the isolates of the Bacteroides fragilis group but not in the other species evaluated. Antagonistic activity between cefoperazone and sulbactam was not observed with any of the species. Forty-two percent of the isolates belonging to the B. fragilis group were resistant to cefoperazone. Ninety-four percent of these were converted to either the susceptible or moderately susceptible range upon the addition of sulbactam. Sixty-seven percent were susceptible to the combination cefoperazone/sulbactam and 27% were moderately susceptible. Overall, metronidazole and chloramphenicol were the most active antimicrobials. Significant differences in the antimicrobial susceptibility patterns of members of the B. fragilis group were observed. Sulbactam demonstrated some intrinsic activity against all of the species tested.
Anti-Bacterial Agents↗