Sensitization test against trimethoprim-sulfamethoxazole.
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When given in combination, both trimethoprim and sulfamethoxazole penetrated well into the cerebrospinal fluid of rabbits with experimental pneumococcal meningitis, reaching concentrations that should have been adequate for synergistic killing of Streptococcus pneumoniae. However, trimethoprim-sulfamethoxazole was less effective than ampicillin in the treatment of this experimental infection. The effect of the combination on pneumococci in vivo was bacteriostatic rather than bactericidal, possibly because the number of pneumococci in the cerebrospinal fluid of the rabbits at the start of treatment was larger than that in the inoculum used for in vitro sensitivity tests.
Many methods of disc susceptibility testing aim at an inoculum to yield a semi-confluent growth. We have improved the means of standardizing inoculum by measuring the turbidity with a spectrophotometer. Absorbance measurements were made for various bacterial suspensions and dilutions thereof, from 1 in 2 to 1 in 1000. Volumes of 0.1 ml of each dilution were spread on to Diagnostic Sensitivity Test agar. Viable counts of bacteria were made for each absorbance reading and for what constituted semi-confluent growth. Suspensions of bacteria having similar absorbance readings contained variable numbers of viable bacteria depending on the species. The number of bacterial cells that yielded semi-confluent growth also varied with different bacterial species. A chart was prepared to indicate the appropriate dilutions of bacterial suspensions with different absorbance readings to produce semi-confluent growth in sensitivity testing of each species.
It was shown that the residual amounts of tetracyclines adsorbed on membrane filters may be inactivated by addition of 2M magnesium sulphate solution to the agar for placing the filters after filtration. The antibiotic inactivation increases the possibilities of the test for antibiotic sensitivity of the microflora present in the drugs and may be used in determination of microbial dissmination of non-injection tetracyclines.
Gastric antral forceps biopsies taken at gastroscopy were cultured for Helicobacter pylori and tested for anti-microbial sensitivity. Using micro-aerophilic culture, and disc testing or E-testing, there was 98-100% sensitivity to amoxycillin, tetracycline, clarithromycin and erythromycin. However, there was apparent resistance to metronidazole in 19 of 102 samples (19%). When sensitivity by E-testing was performed with preliminary anaerobic culture for 24 h only two of 94 samples (2%) showed resistance. In 37 cultures both micro-aerophilic disc testing and anaerobic then micro-aerophilic E-testing were conducted. Eight cultures showed resistance upon disc testing (MIC > 5 mg/l) but all of these organisms were sensitive on E-testing (MIC 0.003-0.5 mg/l). Metronidazole may be used with confidence in eradication regimes.
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