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P D Lister

Publications and source records attributed to P D Lister.

At least 19 recordsLinked to original sources

Pharmacodynamics of moxifloxacin and levofloxacin against Staphylococcus aureus and Staphylococcus epidermidis in an in vitro pharmacodynamic model.

An in vitro pharmacokinetic model was used to compare the pharmacodynamics of moxifloxacin and levofloxacin against 3 Staphylococcus aureus and 3 Staphylococcus epidermidis strains. Logarithmic-phase cultures were inoculated into the peripheral compartment of hollow-fiber cartridges and exposed to the peak serum concentrations achieved in humans with oral doses of moxifloxacin (400 mg) and levofloxacin (500 mg). Drugs were added at 0 and 24 h, elimination kinetics were simulated, and changes in viable bacterial counts were evaluated over the course of 36 h. Moxifloxacin was bactericidal against all 6 staphylococci (times to 99.9% kill, 1-3 h). Against most strains, bacterial killing continued through 36 h, with total kills exceeding 5.5 logs. Levofloxacin was bactericidal against 5 of the strains, with similar times to 99.9% kill. In contrast to moxifloxacin, however, resistant subpopulations emerged in 4 strains during therapy with levofloxacin, and this could have important implications for treatment of staphylococcal infections. These in vitro observations warrant the clinical evaluation of moxifloxacin in the treatment of staphylococcal infections.

Anti-Infective Agents↗

Pharmacodynamics of moxifloxacin, levofloxacin and sparfloxacin against Streptococcus pneumoniae.

An in vitro pharmacokinetic model (IVPM) was used to simulate the human serum pharmacokinetics of moxifloxacin, levofloxacin and sparfloxacin, and to compare their pharmacodynamics against Streptococcus pneumoniae exhibiting a wide range of susceptibilities to fluoroquinolones. Logarithmic-phase cultures were exposed to peak concentrations achieved in human serum of moxifloxacin, levofloxacin or sparfloxacin with oral doses of 400, 500 and 200 mg, respectively. Human elimination pharmacokinetics were simulated, and viable bacterial counts were measured at 0, 1, 2, 4, 6, 8, 24 and 36 h. Moxifloxacin was rapidly bactericidal (>3 logs of killing) against all 10 S. pneumoniae strains, with 99.9% kills of eight strains occurring within 1-3 h after dosing. Maximum kills ranged from 5 to >6 logs. Moxifloxacin eradicated seven strains from the IVPM within 8 h of the first dose, and eradicated two other strains within 24 h. Although levofloxacin and sparfloxacin were also bactericidal against all 10 S. pneumoniae strains, the rates of killing were somewhat slower, with sparfloxacin exhibiting the slowest rate of kill. In summary, moxifloxacin's increased anti-pneumococcal potency compared with levofloxacin and its more favourable pharmacokinetics compared with sparfloxacin provided enhanced pharmacodynamic activity against some S. pneumoniae strains when maximum doses were simulated in an IVPM.

Anti-Infective Agents↗

Beta-lactamase inhibitor combinations with extended-spectrum penicillins: factors influencing antibacterial activity against enterobacteriaceae and Pseudomonas aeruginosa.

Production of beta-lactamases is the most common mechanism by which gram-negative bacteria express resistance to beta-lactam antibiotics. One successful method of circumventing the threat of plasmid-encoded beta-lactamases is to combine inhibitors of these enzymes with a penicillin. Currently, four inhibitor-penicillin combinations are in clinical use: ampicillin-sulbactam, amoxicillin-clavulanate, ticarcillin-clavulanate, and piperacillin-tazobactam. Of these, ticarcillin-clavulanate and piperacillin-tazobactam have the broadest spectra of activity that includes Pseudomonas aeruginosa. Many factors influence the activity and pharmacodynamics of these combinations, including potency of both agents, pharmacokinetics of the inhibitor, type and quantity of beta-lactamase produced by the target bacterium, and potential for the inhibitor to induce expression of chromosomal cephalosporinases in the target bacterium. Although ticarcillin-clavulanate and piperacillin-tazobactam have similar spectra of activity, they have many differences. Most notable are increased potency of piperacillin against Enterobacteriaceae and P aeruginosa, increased activity of piperacillin-tazobactam against gram-negative pathogens producing penicillin-sensitive enzyme (PSE)-class beta-lactamase or hyperproducing other plasmid-encoded beta-lactamases, and the more favorable pharmacokinetics of tazobactam. In the treatment of P. aeruginosa infections, the potential for clavulanate to induce expression of chromosomal cephalosporinase and antagonize antibacterial activity of ticarcillin is a concern, especially in patients who lack protective host defenses. These are not concerns with piperacillin-tazobactam.

Clavulanic Acid↗

Emerging resistance problems among respiratory tract pathogens.

The number-1 indication for antibiotic prescriptions in the United States is a respiratory tract infection. The changing spectrum of pathogens and emerging bacterial resistance are changing the way these infections are managed. The epidemiology of community-acquired pneumonia has changed significantly in the past 20 years, with increased diversity of pathogens and mortality. Emerging resistance in respiratory tract pathogens, particularly to beta-lactams, is an increasing concern. Of the important gram-negative pathogens, more than a third of Haemophilus influenzae isolates are now resistant to beta-lactam antibiotics, as well as virtually all isolates of Moraxella catarrhalis. Of the gram-positive organisms, more than 40% of Streptococcus pneumoniae isolates are no longer susceptible to penicillin, and methicillin resistance has been reported in up to half of Staphylococcus aureus isolates in some institutions. Among staphylococci, resistance to the beta-lactam methicillin is often accompanied by resistance to multiple classes of antibiotics, particularly the macrolides. Little resistance to fluoroquinolones has been reported among gram-negative respiratory tract pathogens and S pneumoniae, although increasing resistance may be seen as these drugs are used with increasing frequency. In contrast, fluoroquinolone resistance can develop rapidly in S aureus and appears to be associated with methicillin resistance. Fortunately, many of the newer fluoroquinolones appear to offer significant activity against methicillin-resistant S aureus isolates and are active against ciprofloxacin-resistant strains of S pneumoniae. Today, to combat respiratory tract infections, a broad-based empiric therapy needs to be used and bacterial resistance must be taken into account. New antimicrobial options must be considered, with an emphasis on effective drug use and optimal dosing. Even if a direct relationship between antibiotic resistance and clinical outcomes in the treatment of pneumonia in adults has not been extensively demonstrated, the increasing problem of resistance has changed treatment approaches for respiratory tract infections as a whole.

Anti-Infective Agents↗

Pharmacodynamics of levofloxacin and ciprofloxacin against Streptococcus pneumoniae.

An in-vitro pharmacokinetic model was used to compare the pharmacodynamics of levofloxacin and ciprofloxacin against four penicillin-susceptible and four penicillin-resistant Streptococcus pneumoniae. Logarithmic-phase cultures were exposed to the peak concentrations of levofloxacin or ciprofloxacin observed in human serum after 500 mg and 750 mg oral doses, human elimination pharmacokinetics were simulated, and viable bacterial counts were measured at 0, 1, 2, 4, 6, 8, 12, 24 and 36 h. Levofloxacin was rapidly and significantly bactericidal against all eight strains evaluated, with eradication of six strains occurring despite area under the inhibitory curve over 24 h (AUIC24) values of only 32-64 SIT(-1) x h (serum inhibitory titre over time). The pharmacodynamics of ciprofloxacin were more variable and the rate of bacterial killing was consistently slower than observed with levofloxacin. Ciprofloxacin eradicated five strains despite having an AUIC24 of only 44 SIT(-1) x h. These data suggest that the increased potency of levofloxacin and more favourable pharmacokinetics compared with ciprofloxacin provide enhanced pharmacodynamic activity against S. pneumoniae. Furthermore, these data suggest that the minimum AUIC required for clinical efficacy against and eradication of S. pneumoniae with levofloxacin and ciprofloxacin may be well below the 125 SIT(-1) x h identified by other studies.

Anti-Infective Agents↗

Clavulanate induces expression of the Pseudomonas aeruginosa AmpC cephalosporinase at physiologically relevant concentrations and antagonizes the antibacterial activity of ticarcillin.

Although previous studies have indicated that clavulanate may induce AmpC expression in isolates of Pseudomonas aeruginosa, the impact of this inducer activity on the antibacterial activity of ticarcillin at clinically relevant concentrations has not been investigated. Therefore, a study was designed to determine if the inducer activity of clavulanate was associated with in vitro antagonism of ticarcillin at pharmacokinetically relevant concentrations. By the disk approximation methodology, clavulanate induction of AmpC expression was observed with 8 of 10 clinical isolates of P. aeruginosa. Quantitative studies demonstrated a significant induction of AmpC when clavulanate-inducible strains were exposed to the peak concentrations of clavulanate achieved in human serum with the 3.2- and 3.1-g doses of ticarcillin-clavulanate. In studies with three clavulanate-inducible strains in an in vitro pharmacodynamic model, antagonism of the bactericidal effect of ticarcillin was observed in some tests with regimens simulating a 3.1-g dose of ticarcillin-clavulanate and in all tests with regimens simulating a 3.2-g dose of ticarcillin-clavulanate. No antagonism was observed in studies with two clavulanate-noninducible strains. In contrast to clavulanate. No antagonism was observed in studies with two clavulanate-noninducible strains. In contrast to clavulanate, tazobactam failed to induce AmpC expression in any strains, and the pharmacodynamics of piperacillin-tazobactam were somewhat enhanced over those of piperacillin alone against all strains studied. Overall, the data collected from the pharmacodynamic model suggested that induction per se was not always associated with reduced killing but that a certain minimal level of induction by clavulanate was required before antagonism of the antibacterial activity of its companion drug occurred. Nevertheless, since clinically relevant concentrations of clavulanate can antagonize the bactericidal activity of ticarcillin, the combination of ticarcillin-clavulanate should be avoided when selecting an antipseudomonal beta-lactam for the treatment of P. aeruginosa infections, particularly in immunocompromised patients. For piperacillin-tazobactam, induction is not an issue in the context of treating this pathogen.

Anti-Bacterial Agents↗

Pharmacodynamics of trovafloxacin, ofloxacin, and ciprofloxacin against Streptococcus pneumoniae in an in vitro pharmacokinetic model.

An in vitro pharmacokinetic model was used to simulate the pharmacokinetics of trovafloxacin, ofloxacin, and ciprofloxacin in human serum and to compare their pharmacodynamics against eight Streptococcus pneumoniae strains. The MICs of ofloxacin and ciprofloxacin ranged from 1 to 2 micrograms/ml. Trovafloxacin was 8- to 32-fold more potent, with MICs of 0.06 to 0.12 microgram/ml. Logarithmic-phase cultures were exposed to peak concentrations of trovafloxacin, ofloxacin, or ciprofloxacin achieved in human serum after 200-, 400-, and 750-mg oral doses, respectively. Trovafloxacin was dosed at 0 and 24 h, and ofloxacin and ciprofloxacin were dosed at 0, 12, and 24 h. Human elimination pharmacokinetics were simulated, and viable bacterial counts were measured at 0, 2, 4, 6, 8, 12, 24, and 36 h. Trovafloxacin was rapidly and significantly bactericidal against all eight strains evaluated, with viable bacterial counts decreasing at least 5 logs to undetectable levels. Times to 99.9% killing were only 1 to 3 h. Although the rate of killing with ofloxacin was substantially slower than that with trovafloxacin, ofloxacin was also able to eradicate all eight strains from the model, despite a simulated area under the inhibitory curve/MIC ratio (AUC/MIC) of only 49. In contrast, ciprofloxacin eradicated only five strains (AUC/MIC = 44) from the model. Against the other three strains (AUC/MIC = 22), the antibacterial activity of ciprofloxacin was substantially diminished. These data corroborate clinical data and suggest that trovafloxacin has a pharmacodynamic advantage over ciprofloxacin and ofloxacin against S. pneumoniae in relation to its enhanced antipneumococcal activity.

Administration, Oral↗

Cefepime-aztreonam: a unique double beta-lactam combination for Pseudomonas aeruginosa.

An in vitro pharmacokinetic model was used to determine if aztreonam could enhance the pharmacodynamics of cefepime or ceftazidime against an isogenic panel of Pseudomonas aeruginosa 164, including wild-type (WT), partially derepressed (PD), and fully derepressed (FD) phenotypes. Logarithmic-phase cultures were exposed to peak concentrations achieved in serum with 1- or 2-g intravenous doses, elimination pharmacokinetics were simulated, and viable bacterial counts were measured over three 8-h dosing intervals. In studies with cefepime and cefepime-aztreonam against the PD strain, samples were also filter sterilized, assayed for active cefepime, and assayed for nitrocefin hydrolysis activity before and after overnight dialysis. Against WT strains, the cefepime-aztreonam combination was the most active regimen, but viable counts at 24 h were only 1 log below those in cefepime-treated cultures. Against PD and FD strains, the antibacterial activity of cefepime-aztreonam was significantly enhanced over that of each drug alone, with 3.5 logs of killing by 24 h. Hydrolysis and bioassay studies demonstrated that aztreonam was inhibiting the extracellular cephalosporinase that had accumulated and was thus protecting cefepime in the extracellular environment. In contrast to cefepime-aztreonam, the pharmacodynamics of ceftazidime-aztreonam were not enhanced over those of aztreonam alone. Further pharmacodynamic studies with five other P. aeruginosa strains producing increased levels of cephalosporinase demonstrated that the enhanced pharmacodynamics of cefepime-aztreonam were not unique to the isogenic panel. The results of these studies demonstrate that aztreonam can enhance the antibacterial activity of cefepime against derepressed mutants of P. aeruginosa producing increased levels of cephalosporinase. This positive interaction appears to be due in part to the ability of aztreonam to protect cefepime from extracellular cephalosporinase inactivation. Clinical evaluation of this combination is warranted.

Aztreonam↗

Importance of beta-lactamase inhibitor pharmacokinetics in the pharmacodynamics of inhibitor-drug combinations: studies with piperacillin-tazobactam and piperacillin-sulbactam.

An in vitro pharmacokinetic model was used to study the pharmacodynamics of piperacillin-tazobactam and piperacillin-sulbactam against gram-negative bacilli producing plasmid-encoded beta-lactamases. Logarithmic-phase cultures were exposed to peak antibiotic concentrations observed in human serum after the administration of intravenous doses of 3 g of piperacillin and 0.375 g of tazobactam or 0.5 g of sulbactam. Piperacillin and inhibitor were either dosed simultaneously or piperacillin was dosed sequentially 0.5 h after dosing with the inhibitor. In studies with all four test strains, the pharmacodynamics observed after simultaneous dosing were similar to those observed with the sequential regimen. Since the ratio between piperacillin and tazobactam was in constant fluctuation after sequential dosing, these data suggest that the pharmacodynamics of the piperacillin-inhibitor combinations were not dependent upon maintenance of a critical ratio between the components. Furthermore, when regrowth was observed, the time at which bacterial counts began to increase was similar between the simultaneous and sequential dosing regimens. Since the pharmacokinetics of the inhibitors were the same for all regimens, these data suggest that the length of time that the antibacterial activity was maintained over the dosing interval with these combinations was dictated by the pharmacokinetics of the beta-lactamase inhibitor in the combination. The antibacterial activity of the combination appeared to be lost when the amount of inhibitor available fell below some critical concentration. This critical concentration varied depending upon the type and amount of enzyme produced, as well as the specific inhibitor used. These results indicate that the antibacterial activity of drug-inhibitor combinations, when dosed at their currently recommended ratios, is more dependent on the pharmacokinetics of the inhibitor than on those of the beta-lactam drug.

Bacteria↗

Rationale behind high-dose amoxicillin therapy for acute otitis media due to penicillin-nonsusceptible pneumococci: support from in vitro pharmacodynamic studies.

To evaluate whether increased doses of amoxicillin should be used to treat acute pneumococcal otitis media, an in vitro pharmacokinetic model was used to evaluate the killing of pneumococci by amoxicillin when middle ear pharmacokinetics were simulated. Logarithmic-phase cultures were exposed to peak concentrations of 3, 6, and 9 microg of amoxicillin per ml every 12 h, and an elimination half-life of 1.6 h was simulated. Changes in viable bacterial counts were measured over 36 h. All three doses rapidly decreased the viable bacterial counts of penicillin-susceptible strains below the 10-CFU/ml limit of detection by 6 to 10 h and maintained counts below this limit through 36 h. The 3-microg/ml peak dose was much less effective against two of three strains with intermediate penicillin resistance and all three penicillin-resistant strains, with bacterial counts approaching those in drug-free control cultures by 12 h. The 6-microg/ml peak dose completely eliminated two of three strains with intermediate penicillin resistance and maintained viable counts of the other nonsusceptible strains at 1.5 to 2 logs below the initial inoculum through 36 h. The 9-microg/ml peak dose was most effective, completely eliminating all three strains with intermediate penicillin resistance and maintaining the viable counts of the resistant strains at 3 to 4 logs below the original inoculum. The pharmacodynamics observed in this study suggest that peak concentrations of amoxicillin of 6 to 9 microg/ml may be sufficient for the elimination of penicillin-nonsusceptible pneumococcal strains causing otitis media, especially those with intermediate resistance to amoxicillin. In vivo pharmacokinetic studies are needed to determine if these levels can be achieved in middle ear fluid with amoxicillin at 70 to 90 mg/kg/day divided into two daily doses. If these levels are reliably achieved, then clinical studies are warranted.

Acute Disease↗

Efficacy of ampicillin-sulbactam is not dependent upon maintenance of a critical ratio between components: sulbactam pharmacokinetics in pharmacodynamic interactions.

An in vitro pharmacokinetic model (IVPM) and a mouse model of lethal bacteremia were used to compare the pharmacodynamics of ampicillin-sulbactam when the two components were dosed simultaneously and in sequence against TEM-1-producing Escherichia coli. The challenge isolates included three strains of E. coli producing various levels of beta-lactamase. Human pharmacokinetics of ampicillin-sulbactam (1.5- and 3.0-g intravenous doses) were simulated in each model, and pharmacodynamic interactions were evaluated over one 6-h dosing interval. Against all three strains, the sequential dosing of sulbactam prior to ampicillin did not alter the pharmacodynamics of these combinations from comparison with results obtained with the simultaneous administration of the two components. Similar pharmacodynamics were observed for the two dosing regimens regardless of the ampicillin-sulbactam dose used or whether the bacteria were treated in an immunocompetent mouse or in the absence of immune defenses in the IVPM. When antibacterial activity was lost and regrowth of the inoculum was observed, viable bacterial counts increased in both the simultaneous and sequential regimens at a point when sulbactam levels fell below a critical concentration. These data suggest that the efficacy of ampicillin-sulbactam is not dependent upon the maintenance of a constant 2:1 ratio for the two components. Rather, the efficacy of ampicillin-sulbactam appears to be dependent upon the maintenance of one or both components above a critical concentration. Furthermore, the pharmacokinetics of sulbactam, specifically, how long sulbactam levels remain above a minimum critical concentration, appears to dictate how long antibacterial activity is maintained with the combination.

Ampicillin↗

Comparison of ampicillin-sulbactam regimens simulating 1.5- and 3.0-gram doses to humans in treatment of Escherichia coli bacteremia in mice.

A mouse model of bacteremia was used to compare the efficacies of 1.5- and 3.0-g intravenous doses of ampicillin-sulbactam. Seven strains of Escherichia coli producing various levels of TEM-1 beta-lactamase were used as the challenge isolates. These strains included six clinical isolates (MICs from 2/1 micrograms/ml [with 2 and 1 microgram/ml being the respective concentrations of ampicillin and sulbactam] to 32/16 micrograms/ml) with similar degrees of virulence in mice and a laboratory genetic transformant (E. coli AFE) which hyperproduces TEM-1 (MIC = 128/64 micrograms/ml). Human pharmacokinetics were simulated by injecting mice subcutaneously twice (1 h apart) with ampicillin-sulbactam at concentrations of 40 mg/kg of body weight (1.5 g) and 80 mg/kg (3.0 g). Against two clinical isolates for which ampicillin-sulbactam MICs were < or = 8/4 micrograms/ml, no difference was observed in either the rate or level of killing between the two doses, and both doses were 100% protective against lethal infection. Against the four clinical isolates for which ampicillin-sulbactam MICs were between 16/8 and 32/16 micrograms/ml, a slight delay in killing was noted with three of the strains. This delay was followed by a rapid 2- to 3-log drop in the level of bacteremia, and both doses of ampicillin-sulbactam were 100% protective against lethal septicemia. With strain AFE, no killing was observed with the 40-mg/kg dose compared with a 2-log killing with the 80-mg/kg dose. This difference in killing correlated with a decreased protective efficacy of the 40-mg/kg dose. These data suggest that the 1.5-g preparation of ampicillin-sulbactam is as effective as the 3.0-g dose in the treatment of experimentally induced E. coli bacteremia, as long as ampicillin-sulbactam MICs are 32/16 micrograms/ml or less.

Ampicillin↗

The effect of ethanol ingestion on killing of Streptococcus pneumoniae, Staphylococcus aureus and Staphylococcus epidermidis by rat neutrophils.

The precise effects of chronic ethanol ingestion on the role of neutrophil function in pneumococcal pneumonia have not been fully delineated. In this study, the bactericidal capacity of polymorphonuclear leucocytes (PMNL) from rats pair-fed an ethanol-containing liquid diet or a liquid control diet was compared both in vitro and in vivo. The PMNL were allowed to phagocytose several bacterial species in vitro, and intracellular killing after 1h was determined by plate counts. There was no significant difference in killing of Streptococcus pneumoniae types 6B or 37, Staphylococcus aureus or Staphylococcus epidermidis by PMNL from ethanol-fed and pair-fed rats (E-PMNL and P-PMNL, respectively). However, E-PMNL killed significantly less of Streptococcus pneumoniae types 10A, 14 and 19F. To corroborate these results in vivo, rats were infected transtracheally, and quantitative lung counts were performed 1 week post infection. Streptococcus pneumoniae types 6B and 37, as well as Staphylococcus aureus, were effectively cleared from the lungs of both groups of rats. Streptococcus pneumoniae types 10A, 14 and 19F, however, were cleared well from the lungs of pair-fed but not ethanol-fed animals. These data suggest that chronic ethanol ingestion induces a strain-specific deficit in neutrophil bactericidal activity against certain S. pneumoniae which does not extend to commonly encountered staphylococci.

Alcoholism↗

Multiply-resistant pneumococcus: therapeutic problems in the management of serious infections.

The control of penicillin-resistant pneumococci has become one of the more serious therapeutic challenges facing clinicians today. The occurrence and geographical coverage of these microorganisms have increased rapidly since they were first recognized in the late 1960s. They have now been reported from every continent, and in some regions can account for over 60% of the pneumococci isolated. An even greater concern is the propensity of penicillin-resistant pneumococci towards resistance to multiple antibiotics, including the cephalosporins and non-beta-lactam drugs. In areas where multiply-resistant strains are common, the therapeutic choices for the treatment of life-threatening infections may be limited to drugs which are either toxic for the patient or for which we are only beginning to gain clinical experience. As the importance of Streptococcus pneumoniae in meningitis continues to increase and multiply-resistant strains become more widespread and entrenched, it is essential that the search for more well-tolerated and effective treatment regimens continues. However, unless the effect of antibiotics on the selection of these resistant pathogens is addressed and a more judicious approach towards drug use is taken; this resistance problem will continue well into the future.

Bacterial Vaccines↗

Ethanol impairs neutrophil chemotaxis in vitro but not adherence or recruitment to lungs of rats with experimental pneumococcal pneumonia.

The effect of 7 days of ethanol ingestion on circulating neutrophil (PMNL) counts and PMNL adherence, chemotaxis, and recruitment was investigated. Pair-feeding of rats resulted in a significant decrease in PMNL counts in both ethanol-fed and control rats. The mean number of PMNL exhibiting chemotaxis in a modified Boyden chamber in response to lipopolysaccharide-activated normal rat serum was significantly decreased in ethanol-fed rats compared with controls. The percentage of adherence to nylon wool columns, however, was similar in both groups. To measure pulmonary PMNL recruitment, rats were infected transtracheally with 10(5) Streptococcus pneumoniae and sacrificed. Bronchoalveolar lavage fluid from both groups contained similar numbers of PMNL 8 h after infection. By 24 h, PMNL numbers in lavage fluid from ethanol-fed rats exceeded those in controls. PMNL recruitment continued in the ethanol-fed rats at 48 and 72 h, whereas values in controls had returned to baseline. Thus, the impaired pulmonary defense against S. pneumoniae in ethanol-fed rats is not due to defective PMNL recruitment.

Animals↗

Granulocyte colony-stimulating factor protects control rats but not ethanol-fed rats from fatal pneumococcal pneumonia.

A model of chronic ethanol ingestion was used to study the effects of granulocyte colony-stimulating factor (G-CSF) on the pathogenesis of pneumococcal pneumonia in intoxicated rats. G-CSF or 5% dextrose in water (D5W) was administered subcutaneously to ethanol-fed and pair-fed control rats on days 6 and 7 of pair feeding. Rats were infected transtracheally with type 3 Streptococcus pneumoniae on day 8. In pair-fed control rats, G-CSF significantly increased the total number and percentage of polymorphonuclear leukocytes (PMNL) in the peripheral blood (P < .001), augmented PMNL recruitment to infected lungs (P < .01), and significantly increased survival from pneumococcal pneumonia (P = .01). In contrast, treatment of ethanol-fed rats with G-CSF did not enhance pulmonary PMNL delivery and did not increase survival following experimental pneumococcal pneumonia, despite a significant increase in the total number and percentage of circulating PMNL (P < .001). These data suggest that despite increasing the numbers of circulating PMNL, G-CSF is unable to provide protection against fatal pneumococcal pneumonia in ethanol-fed rats.

Animals↗

Cirrhosis impairs serum bacteriostasis for Escherichia coli.

To study the effects of cirrhosis on serum inhibition of Escherichia coli, cirrhosis with ascites was induced in male Sprague-Dawley rats by intragastric administration of carbon tetrachloride. Heat-inactivated (56 degrees C for 30 minutes) serum from cirrhotic rats (CRS) or that from control rats (NRS) was inoculated with 1 x 10(5) colony-forming units per milliliter (CFU/ml) of E. coli, and growth was measured after 24 hours. The mean growth of E. coli in CRS was significantly higher than growth in NRS: 3.5 +/- 5.4 x 10(8) CFU/ml versus 1.2 +/- 2.0 x 10(6) CFU/ml, respectively (p < 0.01). Fifty-four percent of CRS samples (22/41) completely lacked bacteriostatic activity. These CRS samples were categorized as growth-supporting (G+CRS) because their growth exceeded the mean + 2 SD of NRS (5.2 x 10(6) CFU/ml). Serum bacteriostasis could be restored to G+CRS by adding purified rat apotransferrin (1 mg/ml), suggesting the presence of excess iron in G+CRS. However, serum iron concentration (SI) and total iron binding capacity (TIBC) were virtually the same in G+CRS (SI = 120 +/- 22 micrograms/dl; TIBC = 351 +/- 45 micrograms/dl) as in growth-inhibitory CRS (SI = 131 +/- 16 micrograms/dl; TIBC = 347 +/- 46 micrograms/dl) but were significantly less than NRS (SI = 208 +/- 29 micrograms/dl; TIBC = 533 +/- 57 micrograms/dl), p < 0.01. The percent transferrin saturation was similar in all groups: 34% +/- 6%; 38% +/- 5% and 39% +/- 9%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

In vitro susceptibilities of Plesiomonas shigelloides to 24 antibiotics and antibiotic-beta-lactamase-inhibitor combinations.

The antibiotic susceptibilities of 29 isolates of Plesiomonas shigelloides were studied with 24 antibiotics and antibiotic-inhibitor combinations. Results indicated that all isolates were susceptible to the cephalosporins, penicillins combined with a beta-lactamase inhibitor, aztreonam, and ciprofloxacin. Most isolates were resistant to the penicillins, possibly via production of a penicillinase.

Anti-Bacterial Agents↗