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Biomedical subjects

L J Harrell

Publications and source records attributed to L J Harrell.

22 records · Page 2Linked to original sources

Effect of anaerobiosis on antimicrobial susceptibility of staphylococci.

The minimum inhibitory concentration (MIC) of 12 antibiotics was determined for four strains of staphylococci (representing the three major species) under aerobic and anaerobic conditions by using the broth dilution method. Nine of the antibiotics showed no significant difference between aerobic and anaerobic MIC for any of the four cultures. Gentamicin and kanamycin showed a small, but significant, increase in MIC for at least two strains under anaerobic conditions. Trimethoprim was less effective against all strains under anaerobic conditions.

Anaerobiosis↗

The North American component (the United States and Canada) of an International Comparative MIC trial monitoring ofloxacin resistance.

Common lots of reference MIC (minimum inhibitory concentration) method reagents were used to monitor ofloxacin, a newer fluoroquinolone, and 13 other drugs against 3200 recent clinical isolates in February-April 1992. Five medical centers in the United States and Canada contributed 640 strains per facility as follows: Escherichia coli, Staphylococcus aureus, coagulase-negative staphylococci, Klebsiella spp., and Pseudomonas aeruginosa (100 strains each); Streptococcus pneumoniae (40 strains); and Enterobacter cloacae, Serratia marcescens, Salmonella spp., Haemophilus influenzae, and Moraxella catarrhalis (20 strains each). Quality-control strains were processed concurrently, MICs recorded, and data processed at a common location. Selected ofloxacin-resistant isolates were retested at a reference laboratory to confirm resistances and determine cross-resistant patterns. Results indicate the following (a) fluoroquinolones were superior in usable spectrum of activity to other orally administered drugs (for example, cefaclor, cefixime, ampicillin, amoxicillin-clavulanate, minocycline, oxacillin, and trimethoprim-sulfamethoxazole); (b) ofloxacin and ciprofloxacin were generally equal to gentamicin and cefotaxime against commonly isolated Gram-negative pathogens; (c) fluoroquinolone resistance was rare among enteric bacilli, pneumococci (ciprofloxacin > ofloxacin), H. influenzae, and M. catarrhalis, but more common among oxacillin-resistant staphylococci and P. aeruginosa; (d) cross resistance was generally observed between ofloxacin and ciprofloxacin but was species or genus dependent; and (e) a new fluoroquinolone, levofloxacin, demonstrated promising activity against contemporary pathogens.

Anti-Bacterial Agents↗

Pseudomonas putrefaciens bacteremia.

Pseudomonas putrefaciens is an unusual cause of human disease. Since 1978 only five cases of bacteremia due to this organism have been reported. Within 12 recent months four cases of bacteremia due to P. putrefaciens were seen - two occurred in patients with chronic infections of a lower extremity, one in a patient with neutropenia, and one in a patient with fulminant septicemia and disseminated intravascular coagulation. Two of the patients had prostheses; in neither case did prosthetic infection or prosthetic failure occur. Two syndromes of bacteremic infection with P. putrefaciens are suggested. One syndrome is associated with chronic infection of a lower extremity, is fairly well tolerated, and responds to appropriate antimicrobial agents. The other syndrome is more fulminant and may be associated with severe underlying debility, liver disease, and malignancy. It is not yet known whether this is a meaningful distinction. The significance of the recent increase is the isolation of this organism is not clear at present.

Adult↗