Azithromycin for the treatment of cat-scratch disease.
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Biomedical subjects
Publications and source records attributed to M M Nakata.
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The phenotypic characteristics of 89 Aeromonas strains, most of which had been isolated from feces, were examined. Eighty-two percent of the isolates could be placed into one of four groups on the basis of five tests. The relationship of these groups to the three motile species of Aeromonas (Aeromonas caviae, A. hydrophila, and A. sobria) that have been isolated from humans is unclear. Because the means for identification of Aeromonas strains to the species level appear to be imprecise and because the role of each of these species in human diarrhea is unclear at this time, we recommend that identification of enteric Aeromonas isolates to the species level not be done routinely.
We have reviewed the incidence of Aeromonas in patients with enteric disease at our hospital and found it to be the highest of any potential enteric pathogen. Eighty adult patients with diarrhea had Aeromonas isolated from feces, and in 73 Aeromonas was the only potential bacterial or parasitic pathogen detected. The spectrum of illness in patients with Aeromonas-related diarrhea ranged from acute, self-limited diarrhea to a chronic, indolent diarrheal illness. Sixteen percent (13/80) of the patients had evidence of colitis noted during sigmoidoscopy or colonoscopy. Our data (and those from other studies) indicate that Aeromonas is relatively common in the feces of adults with diarrhea; they also indicate the need for prospective, controlled clinical and bacteriological studies to determine whether or not Aeromonas is an important enteric pathogen in adults.
Five patients were seen in the UCLA hospital system with septic arthritis due to group G Streptococcus. All had prior joint disease or surgery on the affected joint. Findings from physical examination and laboratory evaluation were typical for pyogenic arthritis. Response to antimicrobial therapy was slow and marked by recurrent sterile joint effusions. Group G streptococcal arthritis may be diagnosed more frequently if routine serologic grouping of streptococcal isolates from joint fluid samples is performed. Such identification may also have prognostic significance.
Spirochete-like organisms were first detected in human feces in 1884. In the century since that observation an appreciable amount of epidemiologic and morphologic information has been published; nevertheless, it is not known how many species of cultivable human intestinal spirochetes exist, nor is the role of these organisms in health and disease known. Recent advances in microbiologic techniques, coupled with the recognition that the rate of carriage of such spirochetes in certain populations is approximately 30%-40%, should provide the impetus for careful scientific study of these organisms and of their importance-if any-to human health.
The etiologic importance of anaerobic microorganisms in bone and joint infections in certain settings has recently been emphasized. These settings include recovery of Actinomyces species, hematogenously acquired infection, the presence of anaerobes in pure culture, and prosthetic-joint infection. Frequently, mixed aerobic-anaerobic bone or joint infection develops as a consequence of infection in adjacent areas. The incidence with which anaerobes are present in these settings is undoubtedly underestimated and may often be unappreciated in regard to the selection of therapeutic agents. Therefore, a practical approach to the treatment of infections involving anaerobes that is based on our current knowledge is necessary. Animal models are now available for study of anaerobic osteomyelitis. In conjunction with prospective human studies utilizing careful microbiologic techniques, it should be possible to determine the significance of anaerobic bacteria when a polymicrobial flora is present in bone and joint infections.