Biochemical and serological characteristics of Serratia marcescens isolated from various clinical and environmental sources.
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Biomedical subjects
Publications and source records attributed to M Neguţ.
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A restricted biochemical scheme for the identification of enterobacteria, consisting of 12 enzymatic tests, of which 7 performed on the multitest TSI and MIU media (H2S, the production of acid and gas from glucose, fermentation of lactose/saccharose, mobility, urease and indol production) and 5 additional tests performed separately : lysindecarboxylase, phenylalanindeaminase, beta galactosidase, increase on citrate media and splitting of sodium malonate is proposed. Of 7782 coprocultures, 275 were selected on TSI and MIU media as belonging to one of the groups of known pathogenic enterobacteria ; 94.87% of these cultures were correctly identified by using the 5 additional tests alone. Of the 14 cultures that could not be listed taxonomically, 10 gave atypical reactions with at least one of these tests. The current use of this restricted scheme and the use of the more extensive sets only in doubtful cases presents a real advantage by reducing the volume of work and materials under satisfactorily accurate conditions for identification.
After testing 18 experimental variants against 40 reference strains belonging to different Enterovacteriaceae groups, the authors chose a multitest medium that permits concomitant testing of mobility, indol, lysinedecarboxylase and phenylalanine deaminase (MILP). In this medium, the reactions of 3734 strains belonging to the genera Escherichia, Shigella. Salmonella, Citrobacter, Klebsiella, Enterobacter, Serratia. Proteus and Providencia were concordant with the reactions in individual test media, taking as reference, in a proportion of 99.7 and 100%. The authors, associating the MILP medium to TSI agar, propose a simple scheme consisting of eight test which permits, within only 24 hours, the correct identification of the genus and sometimes of the species of cultures or isolated colonies from selective media.
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Of 12,930 Salmonella serotype typhimurium strains, phage typed during 1985-1988, 45.68% were "nontypable" by Anderson's set; the percent of typable strains decreased from 54.17 in 1986 to 30.54 in 1988. Of 90 phage patterns of sensitivity, 22 were currently encountered. Phage types 1, 18 and 104 were most frequent to strain of both human and non-human origin. In food generating S. typhimurium outbreaks, phage types 1 and 36 were prevalent. Except lysotypes 198 and 95, isolated from "single cases" in man only, all other phage types were common in man and animals, too. Introducing other typing methods to serotype typhimurium "nontypable" strains (by Anderson's set) was considered necessary for epidemiological purposes.
Enterotoxin-producing Klebsiella pneumoniae was implicated in the induction of intrahospital infections in new-born babies. A total of 46 children and 4 adults (hospital personnel) were involved. Most of the subjects (82.6%) had median and light forms of gastroenterocolitis, and recovered following biological re-equilibration. In 17.39% of the cases the evolution was more severe due to advanced dehydration and secondary dissemination of the infection. Two children (approximately 4%) died. Factors that favored the dissemination of the infection were hygiene deficiencies and ignorance of functioning rules of materno-infantile units, and these included: admission to the hospital of working personnel with acute phenomena of enterocolitis; administration of sweetened solutions that were prepared without control and stored at room temperature; the "critical" point represented by the special room for "the accommodation" of the newborns, a "key-point" where infection was disseminated to other wards following dispersion of "adapted babies".
The authors describe the evidencing of the O157H7 E. coli serotype--an enterohaemorrhagic strain of E. coli--for the first time in our country. This germ is incriminated in haemorrhagic enteritis of children and adults, accompanied or not by an uremic haemolytic syndrome. A total of 717 strains were investigated, obtained from cases of haemorrhagic enteritis (283), nonhemorrhagic enteritis (174), food poisoning (27), and a control lot of subjects without signs of enteritis (233). Identification of the strains was done with a screening method (McConkey) with D-sorbitol in place of lactose, and with anti-O157, and anti-H7 sera. The results obtained have indicated a total of 37 positive strains in haemorrhagic enteritis (69.8%), 12 strains in nonhemorrhagic enteritis (22.65%), and 4 strains in food poisoning (7.55%). No strain was isolated from the control group. The percentage of isolated O157H7 E. coli strains in our county is of 7.55% and this contributes to additional knowledge in the definition of the still unknown etiology of diarrhoeic disease in our country.
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The sensitivity of 112 S. marcescens strains, isolated under various clinico-epidemiologic conditions, was tested by the dilution in agar method against 10 different antibiotics and sulfonamides active against Gram-negative bacteria. With the maximum concentrations used only Gentamycin and nalidixic acid were active against a high proportion of the strains tested, i.e. 96.4% and 91.1%. Kanamycin, Neomycin, Chloramphenicol, Streptomycin and Tetracyclin had an inhibitory effect against less than 25% of tested strains. One strain was resistant to all the antibiotics, 49.1% were only sensitive to 2 antibiotics and 33.9% to 3 antibiotics. Among tested strains 22 different antibiotypes were established. Evidence of 2 or more types of resistance within the same epidemic outbreaux, reduces the value of the "antibiotype" as epidemiologic indicator within this species. The readily acquired transfer factors of resistance might be responsible for the marked "mobility" of the antibiotypes, as well as for the spread of S. marcescens in hospital pathology.
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In the out patients investigated between 1974 and 1977 a number of 14046 quantitative urocultures were performed; 2206 (15.5%) gave relevant results for a diagnosis of urinary infection. In 98.5% of the cases, infection was caused by Gram negative bacilli, particularly Enterobacteriaceae (98.14%). A set of 11 biochemical tests, performed in a single stage, was used, correctly establishing the genus and in most cases also the species, thus realizing marked economy of material and work. It is considered that the taxonomic listing by this set is sufficient for a diagnosis of urinary infection. In such cases the clinical interest and testing the sensitivity of the strains to antibiotics is of greater importance than determination of the serotype, lysotype or biotype, of prevalent interest in other types of infection produced by enterobacteria, particularly those known to be pathogens.