Lack of antibiotic compliance in patients treated for Campylobacter pylori-associated gastritis.
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Biomedical subjects
Publications and source records attributed to M Labbé.
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The cellular fatty acids of 31 strains belonging to the Streptococcus milleri group were analysed by capillary gas-liquid chromatography. Results were compared with findings from biochemical differentiation of the strains into Streptococcus constellatus (two strains), Streptococcus anginosus (16 strains) and Streptococcus intermedius (13 strains). Eight strains of various other streptococci were included as internal references, including three strains of streptococcus morbillorum, three strains of beta-hemolytic streptococci, and two strains of enterococci. The Streptococcus milleri strains formed a very homogeneous group according to fatty acid composition and were easily differentiated from other groups. However, within the group, it was not possible to differentiate Streptococcus constellatus, Streptococcus anginosus and Streptococcus intermedius by fatty acid composition alone.
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The in-vitro activity of Sch 34343 was evaluated against 137 strains of anaerobic bacteria by the agar dilution technique. Sch 34343 was compared with imipenem, cefoxitin, latamoxef (moxalactam), clindamycin and metronidazole. Organisms studied included the Bacteroides fragilis group, other Bacteroides spp., Clostridium perfringens, Cl. difficile, other Clostridium spp. and anaerobic cocci. Overall, Sch 34343 and imipenem were significantly more active than the other antibiotics against most organisms tested, especially the Bact. fragilis group, including clindamycin-resistant strains. Apart from Cl. difficile, which required up to 8 mg/l of Sch 34343 and imipenem for inhibition, all the strains were inhibited by 1 mg/l of Sch 34343 and by 2 mg/l of imipenem. Of the remaining agents tested, against the Bact. fragilis group metronidazole (2 mg/l to inhibit 90% of the strains) was the most active, followed by cefoxitin (16 mg/l), latamoxef (32 mg/l) and clindamycin (32 mg/l). On the basis of its activity in vitro, Sch 34343 appears to be one of the most promising new antimicrobial agents for the treatment of infections involving anaerobic bacteria.
In four adult women with various clinical conditions, curved anaerobic bacilli, similar to organisms recently assigned to the new genus Mobiluncus, were isolated from extragenital sources. None of the patients presented symptoms or clinical abnormalities related to the genital tract. The clinical data of these cases are reported and the microbiological findings are briefly described.
Gas-liquid chromatography has been used directly on clinical specimens as a method for presumptive diagnosis of anaerobic infections. This technique proved to be valuable and reliable. Combined with a Gram stain, it offers the possibility to differentiate in less than 1 hour aerobic from anaerobic infections by means of detection of volatile fatty acids (short chain monocarboxylic acids) others than acetic acid.
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Carbohydrate fermentation by anaerobic gram-negative bacilli was easily detected using Taxo-Disks placed on supplemented Columbia Agar. After incubation, two drops of a 0.2% solution of bromothymol blue were added to each disk: yellow coloring was indicative of a positive reaction. In the esculin hydrolysis test paper disks impregnated with 2 mg of esculin were placed on the same medium. The results were read after addition of two drops of a 10% solution of ferric chloride. When testing slow-growing and/or serophilic anaerobic gram-negative bacilli, such as Bacteroides melaninogenicus or Bacteroides oralis, the supplemented Columbia Agar was enriched with 10% sterile horse serum. Discrepancies between results with the conventional tube technique and the disk method were occasionally observed with salicin only.
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A new diagnostic kit, which contains a polyvalent antiserum for either Bacteroides fragilis or Bacteroides melaninogenicus, was tested for reliability and specificity on 146 clinical samples of different origin. A correlation between the culture and immunofluorescence was observed for B. fragilis in 87.39% of cases and for B. melaninogenicus in 81.48% of cases. When pure cultures were tested, aerobically as well as anaerobically, false-positive reactions were observed with staphylococci and Clostridium ramosum spores. The well-defined morphology of these bacteria and spores allows for the elimination of any diagnostic error. The method is rapid, and the margin for error is limited. The test gives a semiquantitative idea of the number of bacteroides organisms present in the clinical specimens even in the presence of a mixed flora.
In the course of a systematic search for Bacteroides corrodents and Eikenella corrodens in clinical specimens submitted for microbiological analysis, 61% of the specimens from anal abscesses, 6% of the vaginal specimens and none of the pharyngeal specimens yielded B. corrodens, whereas E. corrodens was recovered from only 9% of the pharyngeal specimens. Some characteristics were found to be useful in differentiating between the two species: B. corrodens strains were strictly anaerobic, cytochrome-oxidase-negative, urease-positive and gelatinase-positive; they were sensitive to lincomycin but resistant to vancomycin. E. corrodens strains on the other hand were facultatively anaerobic, oxidase-positive, urease-negative and gelatinase-negative; they were resistant to lincomycin but sensitive to vancomycin. The pathogenicity of the two species was difficult to assess as in most cases they were recovered from mixed cultures.
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This study is aimed at the evaluation of a 1% clindamycin hydrochloride containing gel on the microbial flora of periodontal pockets deeper than 5 mm. In order to achieve that purpose, 20 patients with pocketing in the premolar-molar regions were selected. Active and placebo gel were inserted once during the first 2 weeks of this experimental study. Microbial samplings were performed 1, 2, 4 and 12 weeks after the experiment started. The samples were submitted to microscopic examination and also to culture. Changes in the microbial content of the periodontal pockets treated by subgingival scaling and clindamycin 1% gel were significant, compared with those obtained with subgingival scaling and placebo gel, particularly with respect to anaerobic black-pigmented bacteria and the motile gram-negative flora. However, after 3 months, most of the treated cases were recolonized by the same initial species, though never at pre-clindamycin levels. In the light of this study, it will be concluded that the use of a small amount of clindamycin hydrochloride inserted into a periodontal pocket, once a week for 2 weeks as a complement to periodontal subgingival scaling, is beneficial in the treatment of adult periodontitis, by eliminating more effectively the microbial pocket colonization.
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