[Changes in methicillin-resistant Staphylococcus aureus].
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Biomedical subjects
Publications and source records attributed to O Kunii.
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We evaluated the opsonic activities of human intravenous immunoglobulin (IVIG) preparations against pathogenic organisms by measuring the luminol-enhanced chemiluminescence (CL) from human polymorphonuclear leukocytes (PMN) during the phagocytosis of these organisms. Polyethylenglycol-treated IVIG significantly increased the CL of PMN by opsonization against various bacteria and Candida albicans (p less than 0.01). The high CL induced by IVIG with intact Fc-fragment showed no significant differences among lots or preparations made by different treatments. In both PMN-CL in the absence of human serum and whole blood CL at low concentration of serum complement, the CL response was not affected by pepsin-treated IVIG. In the severely burned patients' blood with a very low concentration of serum immunoglobulin, IVIG with intact Fc-fragment significantly increased CL (p less than 0.01). It is suggested that administration of IVIG is useful against infections in these patients. The measurement of whole blood CL in vitro may be useful for evaluating the opsonic activity of IVIG against target pathogens in vivo.
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A 62 year-old man had suffered from gout and mild renal insufficiency since he was 40 years old. He was admitted to our hospital complicated by a productive cough, high fever and a right swollen knee joint. The chest radiographs demonstrated a left upper lobe infiltration shadow. Streptococci pneumoniae were found in the sputum, arterial blood and synovial fluid of the right knee joint, suggesting a severe pneumonia followed by pneumococcal septicemia which led to purulent arthritis. He was treated with cefamandole (CMD) and penicillin G (PC-G) for one week, but the chest X-ray findings were not improved. After treatment with cefbuperazone (CBPZ) and latamoxef (LMOX), his fever and other symptoms gradually resolved. Streptococcus pneumoniae is an uncommon organism of septic arthritis. Pneumococcal arthritis in a patient without immunodeficiency such as this case is very rare, and has not been reported in Japan.
A 51-year-old male, who had a history of excessive drinking and chronic hepatitis, was admitted to our hospital because of high fever and shock. Physical examinations, chest X-ray films and hemodynamic data revealed that he had progressed to septic shock due to pneumonia. Combination chemotherapy of latamoxef plus piperacillin was immediately started. After Klebsiella pneumoniae was isolated from bronchoalveolar lavage fluid, the antibiotics were changed to ceftizoxime plus amikacin. Furthermore human gamma globulin preparations and frozen fractional plasma were administered because of granulocytopenia and a decrease in complement. Gabexate mesylate, methylprednisolone (MP) and branched chain amino acids were given to prevent disseminated intravascular coagulation and/or multiple organ failure. With this intensive care, he recovered from shock and pneumonia. The effects of MP on the whole blood chemiluminescence (CL) were examined. Incubation of whole blood with 25, 50 or 100 micrograms/ml of MP for 10 to 60 minutes had no effects on the CL response. This indicates that MP does not affect the production of reactive oxygen species from phagocytic cells at concentrations comparable to those used in drug therapy.
Binding of cefpiramide (CPM) and other beta-lactam antimicrobial agents to 2(3)-tert-butyl-4-hydroxyanisole (BHA)-induced liver glutathione (GSH) S-transferases (EC 2.5.1.18) from CD-1 mice was studied. A marked induction of hepatic GSH S-transferase from mice fed BHA was observed. Gel chromatography of liver cytosol from mice fed BHA showed an increased binding of CPM, cefotetan and cefazolin to BHA-induced GSH S-transferases. The extent of their binding to GSH S-transferase seemed to be correlated with the extent of their excretion into the bile. Binding of CPM to the GSH S-transferase fraction was inhibited by both indocyanine green, which is known to bind liver GSH S-transferases intensively, and by cefoperazon, which is mainly excreted into the bile. This study suggests that GSH S-transferases are the main binding proteins of CPM in the liver cytosol fraction and play an important role as carrier proteins of CPM and some antimicrobial agents in mouse liver.
Lomefloxacin (NY-198), a new antimicrobial quinolone, was examined for its antimicrobial activities against clinical isolates and clinical efficacies to biliary tract infections. The following results were obtained. 1. The MICs of NY-198 against Escherichia coli (20 strains) and Klebsiella pneumoniae (20 strains) were good and similar to those of ofloxacin (OFLX) or norfloxacin (NFLX). The MICs of NY-198 against Pseudomonas aeruginosa (20 strains) were inferior by 1 dilution factor to OFLX or NFLX, and against Enterococcus faecalis (10 strains), they were similar to NFLX and slightly inferior to OFLX. 2. NY-198 was administered to 8 patients with biliary tract infections (acute cholecystitis 7 cases, chronic cholangitis 1 case). The results were good in 7 and unevaluable in 1 case because the duration of the therapy was too short. 3. As for side effects, mild urticaria was observed in 1 case and epigastralgia with nausea in another. As for abnormal laboratory test values slight elevations of GOT and GPT were recognized in 1 case. 4. In conclusion, we consider NY-198 is a useful oral drug for the treatment of biliary tract infections.
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The mathematical formula with time function of transport phenomenon is obtained by the analysis of the concentrations of ampicillin in the serum, bile and urine. This formula indicates the speed of transport of the drug, or the ratio of the vascular permeability of it for the administrated dose from the site of intramuscular injection into the blood as the time function. About 80% of ampicillin was transported into the blood through capillaries for 120 min from the beginning of intramuscular injection.
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