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R R Facklam

Publications and source records attributed to R R Facklam.

158 records · Page 9Linked to original sources
PubMed1973

Streptococcal pharyngitis therapy: comparison of clindamycin palmitate and potassium phenoxymethyl penicillin.

Clindamycin palmitate and potassium phenoxymethyl penicillin were evaluated in 103 children with upper respiratory illnesses and pharyngeal group A streptococci, from November 1970 to July 1971. The children were assigned randomly by weight to one of the antibiotic regimens given orally for 10 days. Clindamycin palmitate and potassium phenoxymethyl penicillin dosages were 75 and 125 mg, respectively, in 5 ml tid for children weighing less than 25 kg, and 150 and 250 mg, respectively, in 10 ml bid for children weighing 25 kg or more. Recurrences of the original streptococcal group A, M, and T types within 3 weeks after the end of treatment were classified as failures. The failure rates were: clindamycin palmitate, 10% (5 of 52), and potassium phenoxymethyl penicillin, 18% (9 of 51). Possible drug-related rashes were observed in 8 of 52 clindamycin palmitate-treated patients. The geometric mean minimal inhibitory concentrations of clindamycin and penicillin against 103 isolates of group A streptococci were 0.033 and 0.007 mug/ml, respectively. The serum concentrations about 70 min after ingesting 150 mg of clindamycin palmitate averaged 3.8 mug/ml and after 250 mg of potassium phenoxymethyl penicillin averaged 0.9 mug/ml. Clindamycin palmitate was as effective as potassium phenoxymethyl penicillin in eradicating group A streptococci from the pharynx in tid and bid regimens. Nevertheless, because of its rash-producing tendency in some patients and higher cost, clindamycin palmitate should not be preferred to penicillin for treatment of streptococcal sore throat in the non-penicillin-allergic patient.

Child↗
PubMed1973

Comparison of several laboratory media for presumptive identification of enterococci and group D streptococci.

Bile-esculin (Difco), modified bile-esculin (Difco), selective enterococcus (Pfizer Co.), and eosin-methylene blue agar media were evaluated for accuracy in identifying group D streptococci. The regular and modified bile-esculin media performed equally well, but the selective enterococcus and eosin-methylene blue agars did not accurately differentiate the group D from non-group D streptococci. A modified 6.5% NaCl broth was compared with unmodified 6.5% NaCl broth and Streptococcus faecalis (SF; Difco) broth for accuracy in differentiating enterococci from non-enterococci. The modified and unmodified broths worked equally well in the salt tolerance test, but the lot-to-lot variability of SF broth made this medium unusable as an indicator for enterococci. With all seven media, the number of strains giving positive tests decreased when the tests were incubated at 45 C as compared with 35 C, and the number of strains giving negative tests increased. Thus, the number of false-positive identifications decreased, but the number of false-negative identifications increased. Variability in the susceptibility of group D non-enterococcal streptococci to oxacillin and methicillin sensitivity disks limited the usefulness of these tests for presumptive identification of either enterococci or group D streptococci.

Bile↗
PubMed1973

Distribution by serological type of group B streptococci isolated from a variety of clinical material over a five-year period (with special reference to neonatal sepsis and meningitis).

A total of 898 group B streptococci isolated from a wide variety of human clinical sources from July 1967 through June 1972 were typed by the Lancefield precipitin test. Only 11% of the strains were nontypable. Twenty-six percent of the group B strains were from respiratory sources, 22% were from cerebrospinal fluid (CSF) and blood, 13% were from the female genital tract, 12% were urine specimens, and the remaining 27% were from other varied sources. The clinical conditions reported for patients from whom these organisms were isolated included neonatal meningitis and sepsis, pharyngitis, urinary tract and female genital tract infections, and various skin and wound infections. Seventy percent of the CSF and blood cultures from patients with meningitis or sepsis, or both, were type III, whereas the overall percentage of this type was 32%. All but three CSF isolates were from patients under 2 years of age; the distribution of CSF isolates appeared to be the same for both sexes. In contrast, group B streptococci were isolated more frequently from the blood of males than from the blood of females. There were twice as many blood cultures from patients under 2 years of age than from those that were older.

Adolescent↗
PubMed1972

Recognition of group D streptococcal species of human origin by biochemical and physiological tests.

The speciation of 262 strains of group D streptococci isolated from human sources is described. One hundred forty-two isolates from blood cultures were included; 96 of these were submitted as isolates from clinical cases of subacute bacterial endocarditis. The results show that 98 Streptococcus faecalis, 29 S. faecalis var. zymogenes, 44 S. faecalis var. liquefaciens, 27 S. faecium, 13 S. durans, 44 S. bovis, and 7 unspeciated S. bovis-like group D isolates were identified. No S. faecium var. casseliflavus, S. equinus, or S. avium (group Q streptococci) were identified among the human isolates. The speciation procedures and techniques are detailed. The procedures and limitations of the tests used are discussed. Ninety-eight percent of the 262 strains were speciated by a spectrum of tests that allowed us to recognize atypical as well as typical strains within species.

Bacteriological Techniques↗
PubMed1970

Antigenic variation in group A streptococci: types 11 and 9.

A strain of group A Streptococcus which was virulent but M-nontypable was isolated from patients in a hospital nursery during an epidemic. This strain, Boston 11, reacted in T-agglutination tests with antisera for types 9 and 11, an unusual combination. A comparison of this strain with Lancefield's M-11 strain (NCDC SS-721) and Alabama 11 (Provisional 61) revealed three serologically related but distinct strains. Antiserum produced with the Boston 11 strain exhibited similar reactivity with all three "11" strains as well as with M-9 (SS-501) as demonstrated in precipitin tests. Immunodiffusion studies indicated that the Boston 11 antigen was partially identical with the M-11 and M-9 strains and shared at least one antigen with the Alabama 11 strain. The Boston 11 antiserum could be made specific for precipitin tests, but bactericidal activity for the Alabama 11, M-11, and Boston 11 strains was essentially negative.

Agglutination Tests↗
PubMed1970

Presumptive identification of group D streptococci: the bile-esculin test.

Six tests commonly used for the presumptive identification of group D streptococci were evaluated. Strains tested included 282 group D streptococci and 366 non-group D. Ratios of percentages of group D to non-group D strains which gave positive reactions for each test are as follows: bile-esculin, 100:2; salt tolerance, 88:24; heat tolerance, 100:80; SF broth, 86:1; KF broth, 99:40; and methylene blue milk reduction, 90:17. These data indicate that the bile-esculin test provided a reliable means of identifying group D streptococci and differentiating them from non-group D streptococci. Methodology for reading and interpreting positive reactions and time of incubation of the bile-esculin medium was defined. Evidence of the need for standardization of salt and heat-tolerance tests was obtained.

Agar↗
PubMed1969

Effect of incubation temperature on T-agglutination typing of Streptococcus pyogenes.

The temperature of incubation affected the typability of beta-hemolytic group A streptococci by T-agglutination tests. When strains could not be typed after routine incubation at 30 C, they were incubated at 22 to 25 C, and nearly a 10% increase in typability was achieved. The clinical source of the strains was related to their typability. Incubation at the lower temperature was required for successful typing of higher percentages of strains from the skin and other clinical sources than from the throat. Sixty per cent of the skin strains were represented by six serotypes. Of these, 53% of the strains required incubation at 22 to 25 C before they could be typed.

Agglutination Tests↗
PubMed1968

Production of streptococcal M-typing antisera. I. Antigenic response in different breeds of rabbits.

M-antigens of seven M-types of group A streptococci were used to compare antigenic response in six breeds of rabbits: New Zealand White, New Zealand Red, Dutch, Googy, California, and Palomino. No appreciable differences among breeds were demonstrated. M-types used for immunization varied considerably in their ability to evoke a response of an antibody which met rigid criteria for streptococcal M-typing antisera. The importance of the injection and bleeding schedule and absorption conditions for preparing type-specific absorbed antisera were demonstrated. Evaluating and processing sera from individual animals at an optimal time rather than using pooled sera enhanced the possibilities for preparing satisfactory type-specific antisera.

Animals↗
PubMedDate not supplied

Streptococcal abscesses following diphtheria-tetanus toxoid-pertussis vaccination.

Abscesses developed in seven children who received diphtheria-tetanus toxoid-pertussis vaccine at a clinic in Indiana. Epidemiologic investigation revealed that all seven children had received vaccine from the same multidose vial and had been vaccinated by the same nurse at the office of one physician. Group A beta-hemolytic Streptococcus was isolated from abscesses in six of the seven children. No source was identified as the cause of this cluster of abscesses. Vaccine of the same lot number used elsewhere was not associated with the development of abscesses. It appears that the vaccine became contaminated during use.

Abscess↗
PubMedDate not supplied

Effectiveness of pneumococcal polysaccharide vaccine for preschool-age children with chronic disease.

To estimate the effectiveness of pneumococcal polysaccharide vaccine, we serotyped isolates submitted to the Pneumococcal Sentinel Surveillance System from 1984 to 1996 from 48 vaccinated and 125 unvaccinated children 2 to 5 years of age. Effectiveness against invasive disease caused by serotypes included in the vaccine was 63%. Effectiveness against serotypes in the polysaccharide vaccine but not in a proposed seven-valent protein conjugate vaccine was 94%.

Bacterial Vaccines↗