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In vitro antibacterial activity of sucralfate.

The effect of sucralfate (12.5 mg/ml) on the growth of Escherichia coli (ATCC 25922), Enterococcus faecalis (ATCC 29212) and two isolates of Pseudomonas aeruginosa (ATCC 27853 and a multi-resistant clinical isolate) was studied in vitro at pH values of 3.0, 4.5, 6.0 and 7.4. A bacteriostatic effect of sucralfate was demonstrated for Pseudomonas aeruginosa at a pH of 6.0 and 7.4 and for Escherichia coli and Enterococcus faecalis at a pH of 6.0. The bacteriostatic effect was most pronounced at high pH values. Sucralfate had no bactericidal effect on the bacteria tested at the concentration used.

Bacteria↗

Urinary excretion and bactericidal activities of gemifloxacin and ofloxacin after a single oral dose in healthy volunteers.

In a randomized crossover study, 16 volunteers (8 men, 8 women) received single oral doses of 320 mg of gemifloxacin and 400 mg of ofloxacin on two separate occasions in the fasting state to assess the urinary excretion and urinary bactericidal titers (UBTs) at intervals for up to 144 h. Ofloxacin showed higher concentrations in urine compared with those of gemifloxacin. The median (range) cumulative excretion of gemifloxacin was 29.7% (8.4 to 48.7%) of the parent drug administered, and median (range) cumulative excretion of ofloxacin was 84.3% (46.5 to 95.2%) of the parent drug administered. The UBTs, i.e., the highest twofold dilutions (with antibiotic-free urine as the diluent) of urine that were still bactericidal, were determined for a reference strain and nine uropathogens for which the MICs of gemifloxacin and ofloxacin were as follows: Escherichia coli ATCC 25922, 0.016 and 0.06 microg/ml, respectively; Klebsiella pneumoniae, 0.03 and 0.06 microg/ml, respectively; Proteus mirabilis, 0.125 and 0.125 microg/ml, respectively; Escherichia coli, 0.06 and 0.5 microg/ml, respectively; Pseudomonas aeruginosa, 1 and 4 microg/ml, respectively; Staphylococcus aureus, 0.008 and 0.25 microg/ml, respectively; Enterococcus faecalis, 0.06 and 2 microg/ml, respectively; Staphylococcus aureus, 0.25 and 4 microg/ml, respectively; Enterococcus faecalis, 0.5 and 32 microg/ml, respectively; and Staphylococcus aureus, 2 and 32 microg/ml, respectively. Generally, the UBTs for gram-positive uropathogens were higher for gemifloxacin than for ofloxacin and the UBTs for gram-negative uropathogens were higher for ofloxacin than for gemifloxacin. According to the UBTs, ofloxacin-resistant uropathogens (MICs, >or=4 mg/liter) should also be considered gemifloxacin resistant. Although clinical trials have shown that gemifloxacin is effective for the treatment of uncomplicated urinary tract infections, whether an oral dosage of 320 mg of gemifloxacin once daily is also adequate for the treatment of complicated urinary tract infections has yet to be confirmed.

Adolescent↗

In vitro activities of linezolid combined with other antimicrobial agents against Staphylococci, Enterococci, Pneumococci, and selected gram-negative organisms.

The activities of linezolid, an oxazolidinone antibacterial agent active against gram-positive organisms, alone and in combination with 35 antimicrobial agents were tested in vitro against methicillin-sensitive (n = 1 to 2 strains) and methicillin-resistant (n = 8 to 10) Staphylococcus aureus strains; vancomycin-sensitive (n = 6) and vancomycin-resistant (n = 6 to 8) Enterococcus faecalis strains; vancomycin-sensitive (n = 5) and vancomycin-resistant (n = 6) Enterococcus faecium strains; penicillin-sensitive (n = 2 to 5), penicillin-intermediate (n = 5 to 6), and penicillin-resistant (n = 5 to 6) Streptococcus pneumoniae strains; Escherichia coli (n = 6); and Klebsiella pneumoniae (n = 6). The fractional inhibitory concentration indices of linezolid in combination with other antimicrobial agents for the organisms tested were generated on checkerboard broth microdilution plates prepared by a semiautomated method. Of 1,380 organism-drug combinations, 1,369 (99.2%) combinations of linezolid with 28 antimicrobial drugs were indifferent, 9 combinations (0.65%) of linezolid with 6 drugs (amoxicillin, erythromycin, imipenem, sparfloxacin, teicoplanin, and tetracycline) were synergistic, and 2 combinations (0.15%) of linezolid with 2 drugs (ofloxacin and sparfloxacin) were antagonistic. Overall, the in vitro data demonstrated that linezolid combined with other antimicrobial agents primarily produces an indifferent response, with infrequent occurrences of synergism and antagonism.

Acetamides↗

Bactericidal effect of the Nd:YAG laser in in vitro root canals.

The current study investigates the bactericidal effect of a pulsed Nd:YAG laser on 40, classically prepared, in vitro root canals under standardized conditions. The output of the device including quartz fiber was measured before and after every treatment to exclude any technical faults. A 300-micron fiber was used for the anterior teeth and a 200-micron fiber for the posterior teeth. The Enterococcus faecalis bacteria, as gram-positive cocci, display a heat tolerance in the upper range of the bacilli that can be found in the endodontology and the concentration also reflects the in vivo conditions. The results are quoted in "log kills" in accordance with the work of Rooney et al. On average, 99.91% of the Enterococcus faecalis bacteria injected into the root canals prepared in vitro could be eliminated (97.12% minimum, 99.9997% maximum). This setup suggests that the bactericidal effect of laser therapy in the framework presented here can also be achieved in vivo in clinical cases.

Colony Count, Microbial↗

[Status and drug resistance surveillance of enterococcus infection in patients with severe hepatitis].

OBJECTIVE: To analyze the infection status and the drug resistance of enterococci in patients with severe hepatitis to guide future treatment. METHODS: All bacteria from infected patients with severe hepatitis were cultured with BacT/Alert120 automation instrument (Aksu) and identified with Vitek-AMS60 (Biomerieux). Drug sensitivities of the isolated enterococci were tested with 11 antibacterial agents. RESULTS: Among the 112 isolated enterococci, Enterococcus faecalis was the most preponderant bacterium, and the second was E. faecium. Their isolation rates were 79.5% and 14.3%, respectively. 57.1% of all the enterococci were found in the ascetic fluid of patients with severe hepatitis. Fifty-eight (51.8%) isolated enterococci were found to be high level aminoglycoside resistant (HLAR), 19 (17.0%) enterococci were ampicillin-resistant enterococcus (ARE) and 7 (6.3%) were both HLAR and ARE. The susceptive rates of the enterococci to vancomycin and teicoplanin were very high, namely 96.4% and 100%, respectively. No vancomycin or teicoplanin resistant enterococci were found, but 4 enterococci were mildly sensitive to vancomycin. CONCLUSION: Enterococcus faecalis is the most prevalent species isolated in severe hepatitis patients infected with enterococcal infection. From our study, vancomycin and teicoplanin are the drugs of first choice to treat those infections.

Aminoglycosides↗

[Relationship between preoperative urine cultures and prostatic gland cultures in patients treated for benign prostatic hyperplasia].

OBJECTIVES: 1.--Investigate the bacteriuria preoperative in patients who will be operate on for Being Prostatic Hyperplasia (BPH). 2.--Define the prevalence of the prostatic colonization or infection. 3.--Try to correlate the bacteriological findings of urine and prostate, and find the degree of concordance between the microorganisms which can be commonly found in urine and prostatic tissue. METHOD AND MATERIALS: Prospective series of 175 patients undergoing prostatectomy for obstructive symptoms. The protocol revealed, among others variables: the preoperative urine culture; the presence or the absence of catheter; and the quantitative bacteriological culture of prostatic tissue. The information could be analised and its results could be obtained later on. The analysis stages consisted of both a descriptive and an analytic study. RESULTS AND CONCLUSIONS: 1.--Only 36 patients (20.6%) presented bacteriological increase of microorganisms (> or = 10(4) UFC/ml) in the preoperative urine culture. The Escherichia coli was the most common microorganism, followed by the Enterococcus faecalis, coagulase-negative Staphylococcus and the Pseudomona aeruginosa. A single microorganism grew in 31 out of the 36 positive cultures. 2.--The prevalence of the infection or colonization of the prostatic tissue was 25.1% (44 patients). The most common isolated microorganism was the coagulase-negative Staphylococcus followed by the Escherichia coli and the Enterococcus faecalis, in concentrations of at least 10(4) UFC/gr of tissue in the 79.6%. A single microorganism was isolated in 32 out of 44 patients. 3.--The proportion of positive prostatic cultures, in patients with positive urine culture (38.3%), was significantly higher than the one obtained in patients with negative urine cultures (16.5%) (p < 0.0001). Nevertheless, 52.3% of the 44 patients with positive prostatic cultures had negative urine culture, and only 21 (58.3%) out of the 36 patients with positive urine cultures presented a bacteriological growth in prostate. The degree of concordance (Kappa index) between the microorganisms which were found in preoperative urine and prostatic tissue is low or none for the majority of them.

Aged↗

[Active infective endocarditis remaining latent for six weeks after discontinuation of antibiotic therapy: a case report].

A 75-year-old man was treated for 4 weeks with penicillin administration for infective endocarditis in the mitral valve caused by Enterococcus faecalis. The infection recurred, so he received penicillin administration for a further 6 weeks. He remained afebrile and all laboratory examinations were within normal limits for 6 weeks after the antibiotic treatment was discontinued, but the vegetation remained large and highly mobile. Since the onset, possible embolic episodes had occurred three times. He underwent mitral valve repair with annuloplasty. Although the infection appeared to have healed by antibiotic therapy, resected tissue was strongly positive for Enterococcus faecalis. This case suggests that surgery should be aggressively considered if the vegetation does not shrink markedly.

Aged↗

Treatment of sanitary-important bacteria by bacteriocin substance V24 in cattle dung water.

Quantification of sanitary-important bacteria (e.g. Enterobacteriaceae), as well as indicators of environmental contamination, was assessed in samples of cattle dung from 25 cattle farms in 15 north-eastern Slovakia districts. The inhibitory effect of crude bacteriocin extract CBE V24 from Enterococcus faecalis V24 against Listeria monocytogenes Ohio and Yersinia enterocolitica YE85 was examined in cattle dung water with the aim of finding a new way of eliminating the health risk of the animal slurry. The following bacterial groups were quantified: Salmonella spp., Shigella-like spp. , Proteus spp., Enterobacter spp., Citrobacter spp., Pseudomonas spp. , Escherichia coli, Listeria spp., staphylococci, streptococci and enterococci (the average count ranged from 102 up to 104 cfu ml-1). Antagonistic effect of the crude bacteriocin from Enterococcus faecalis V24 in the range of 100-600 Arbitrary units per ml (AU ml-1) was shown against the following bacteria: Enterobacter cloacae, Ent. asburiae, Proteus spp., Salmonella spp., Acinetobacter lwoffi, L. monocytogenes as well as Y. enterocolitica YE85. During tests performed to study the inhibitory effect of the crude bacteriocin CBE V24 (concentration 800, 1600 AU ml-1) against L. monocytogenes Ohio and Y. enterocolitica YE85 in experimentally contaminated cattle dung, a reduction of 2.03 and 1.44 log cfu ml-1, respectively, was already noted after 1 h after crude bacteriocin CBE V24 addition.

Animals↗

Daptomycin in vitro susceptibility in European Gram-positive clinical isolates.

The objective of this study was to determine the activity of daptomycin, a novel lipopeptide, against European Gram-positive isolates (n = 1539). The MIC(90)-values of daptomycin against Staphylococcus aureus isolates was 0.25 mg/L, against Enterococcus faecalis 4 mg/L, against Enterococcus faecium 8 mg/L, 0.25 mg/L against Staphylococcus epidermidis, and 0.25mg/L against Streptococcus pneumoniae. Daptomycin was equally potent against antibiotic-susceptible and resistant strains within a particular species. Based on a breakpoint of 1 mg/L for S. aureus and group A streptococci, all isolates tested were susceptible to daptomycin. Based on a breakpoint of 4 mg/L for vancomcyin-susceptible E. faecalis 99.7% of these isolates were susceptible to daptomycin.

Daptomycin↗

The bactericidal effect of Ho:YAG laser irradiation within contaminated root dentinal samples.

OBJECTIVE: This in vitro study investigates the bactericidal effect of pulsed Ho:YAG laser irradiation in the depth of contaminated dentin specimens. BACKGROUND DATA: Previous studies have shown the effectiveness of laser irradiation in bacterial reduction of infected root canal. METHODS: Root dentin of bovine teeth were sliced longitudinally in 180 samples of 100 microm, 300 microm, and 500 microm thickness, sterilized, dried, and inoculated on one side, with 1 microL of Enterococcus faecalis suspension. The opposite side's were irradiated four times for 5 seconds each with Ho:YAG laser irradiation, a wavelength of 2.10 microm, using four different energy settings: 1 W/5 Hz; 1 W/10 Hz; 1.5 W/5 Hz, and 2.0 W/5 Hz through a 320-microm quartz fiber at an angle of approximately 5 degrees. In addition, two control groups were investigated, the first was inoculated and not submitted to any treatment, the second was inoculated and treated with NaOCl and H2O2. The remaining bacteria from each dentin sample in a transport media were removed by vibration, serially diluted, and plated out on culture dishes selective for Enterococcus faecalis. RESULTS: When compared with the untreated control group or even with the group treated with NaOCl plus H2O2, counting of colonies forming units (CFU) from the laser-treated samples revealed a high significant bacterial elimination with a maximum of 98.46% and a minimum of 83.65%. CONCLUSIONS: Our findings demonstrate a significant decrease of the bacterial population in depth, suggesting that the Ho:YAG laser irradiation could be effective to eliminate the microorganisms harbored within dentin or contaminated canals.

Animals↗

In vitro evaluation of antimicrobial activity of sealers and pastes used in endodontics.

The antimicrobial activity of four root canal sealers (AH Plus, Sealapex, Ketac Endo, and Fill Canal), two calcium hydroxide pastes (Calen and Calasept), and a zinc oxide paste was evaluated. Seven bacterial strains were used, six of them standard; Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 12228, Escherichia coli ATCC 25922, and Enterococcus faecalis ATCC 10541. There was a wild strain of Streptococcus mutans isolated from saliva obtained in an adult dental clinic. Activity was evaluated using the agar diffusion method with Brain Heart Infusion agar and Müller Hinton medium seeded by pour plate. Calcium hydroxide-based sealers and pastes were either placed directly into 4.0 x 4.0 mm wells or by using absorbent paper points. The plates were kept at room temperature for 2 hr for diffusion. After incubation at 37 degrees C for 24 hr, the medium was optimized with 0.05 g% TTC gel and inhibition haloes were measured. All bacterial strains were inhibited by all materials using the well method. However, when the materials were applied with absorbent paper points, Enterococcus faecalis was not inhibited by zinc oxide, and Pseudomonas aeruginosa was not inhibited by AH Plus, Fill Canal, and the zinc oxide-based paste. We conclude that sealers and pastes presented antimicrobial activity in vitro and culture medium optimization with 0.05 g% TTC gel facilitated observation of the inhibition haloes.

Adult↗

Surface disinfection tests with Salmonella and a putative indicator bacterium, mimicking worst-case scenarios in poultry houses.

Surface disinfection studies mimicking worst-case scenarios in badly cleaned poultry houses were made with 3 bacterial isolates (Salmonella enteritidis, Salmonella senftenberg, and Enterococcus faecalis), and 3 1% disinfectant solutions, formaldehyde (F; 24.5% vol/vol), glutaraldehyde/benzalkonium chloride (G; Bio Komplet Plus), and a peroxygen compound (P; Virkon S), with World Health Organization (WHO) standard hard water as a control. Materials (concrete paving stones, steel feed chain links, wooden dowels, and jute egg belts) and organic matter found commonly in poultry houses (feed, fats, egg yolk) were used in the tests. Organic matter inoculated with high numbers of stationary phase cultures was added to materials and dried for 24 h at different temperatures (6, 11, 20, or 30 degrees C), immersed in solutions for set time periods (5, 15, or 30 min), and dried again for 25 h (6, 11, or 30 degrees C). Then, traditional recovery procedures (using 10-fold dilutions until 10(-4), i.e., a most probable number method) were applied. For the 2 Salmonella isolates, the efficacy of the solutions was (in decreasing order): formaldehyde > glutaraldehyde/benzalkonium chloride > peroxygen compound > WHO hard water, except when feed chain links with fats were disinfected using 30 degrees C before and after disinfection, for which the peroxygen compound seemed more effective. Enterococcus faecalis was equally or less susceptible than S. enteritidis and S. senftenberg, indicating its suitability as an indicator bacterium. For the peroxygen compound, S. senftenberg was more susceptible than S. enteritidis in spite of higher minimum inhibitory concentrations to this disinfectant for the former.

Animals↗

Enterococcus faecium in hospitals.

Most of the characteristics that have ensured the success of enterococci as nosocomial pathogens were described early in this century. Enterococcus faecium and Enterococcus faecalis, the enterococci most frequently isolated from clinical material, differ fundamentally. The intrinsic antimicrobial resistance of Enterococcus faecium, supplemented by acquired resistance mechanisms, can generate a glycopeptide-multiply-resistant nosocomial pathogen that survives on hands and in the environment, and has the potential for intra-hospital and inter-hospital spread. The use of terms such as 'an enterococcus', 'faecal streptococci' and 'group D streptococci' have hindered, and still hinder, our understanding of a species rapidly emerging as the most problematic of nosocomial pathogens.

Anti-Bacterial Agents↗

Outcome of a screening program for vancomycin-resistant enterococci in a hospital in Victoria.

OBJECTIVE: To screen for faecal colonisation with vancomycin-resistant enterococci (VRE) among potentially at-risk patients. DESIGN: Infection control screening program. SETTING: Monash Medical Centre (a tertiary care hospital), Melbourne, Victoria, in the seven months from June 1997. PATIENTS: Patients in the Renal, Oncology and Intensive Care (ICU) Units. MAIN OUTCOME MEASURES: Presence of VRE in a rectal swab or faecal specimen taken at admission and at regular intervals during inpatient stay; presence of vancomycin-resistance genes (vanA, vanB and vanC) assessed by polymerase chain reaction (PCR); genetic clonality of isolates assessed by pulsed-field gel electrophoresis (PFGE). RESULTS: 574 patients (356 renal, 134 ICU and 84 oncology) were screened; 12 were colonised with VRE--nine renal inpatients, two having peritoneal dialysis or incentre haemodialysis, and one ICU patient. Nine isolates were Enterococcus faecalis (seven positive for vanB and two negative for all three resistance genes) and three were Enterococcus faecium (all positive for vanB). Eight were high-level gentamicin resistant. PFGE suggested genetic clonality between the index isolate and five other isolates from renal patients. No specific clinical practice was associated with VRE colonisation. Attempts to clear rectal carriage with oral ampicillin/amoxycillin or bacitracin were of limited success. Although antibiotic prescribing in the Renal Unit was generally consistent with defined protocols, use of vancomycin and third-generation cephalosporins has been further restricted. CONCLUSIONS: Renal inpatients in our institution appear most at risk of VRE colonisation (4.6% overall) and therefore of VRE infection. Routine screening, especially of potentially high-risk patients, should be considered in major Australian hospitals.

Adult↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1990). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 848 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1990 to May 1991. Of the above total bacterial isolates, Gram-positive bacteria accounted for 23.9% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 76.1% and most of them were Escherichia coli. 1. Enterococcus faecalis: Ampicillin (ABPC), imipenem (IPM) and vancomycin (VCM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 2 micrograms/ml. Piperacillin (PIPC) was also active with the MIC90 of 4 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 2. Staphylococcus aureus: VCM and arbekacin (ABK) showed the highest activities against S. aureus isolated from patients with urinary tract infections. The MIC90s of them were 1 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 3. Escherichia coli: Cefozopran (CZOP), carumonam (CRMN) and ofloxacin (OFLX) showed the highest activities against E. coli isolated from patients with urinary tract infections. The MIC90s of them were of 0.125 microgram/ml or below. IPM, cefotiam (CTM) and cefmenoxime (CMX) were also active with the MIC90s of 0.25 micrograms/ml. Penicillins were not so active with the MIC90s of 32 micrograms/ml or above. 4. Klebsiella pneumoniae: Flomoxef (FMOX), cefixime (CFIX), CZOP and CRMN showed the highest activities against K. pneumoniae isolated from patients with urinary tract infections. The MIC90s of them were of 0.125 microgram/ml or below. IPM and gentamicin (GM) were also active with the MIC90s of 0.25 microgram/ml and 0.5 microgram/ml, respectively. All other cephems were also active with the MIC90s of 4 micrograms/ml or below. 5. Citrobacter freundii: GM and IPM showed the highest activities against C. freundii isolated from patients with urinary tract infections. The MIC90s of them were 1 microgram/ml. Amikacin (AMK) was also active with the MIC90 of 4 micrograms/ml. The others were not so active. 6. Enterobacter cloacae: IPM and GM showed the highest activities against E. cloacae isolated from patients with urinary tract infections. The MIC90s of them MIC90s of 0.5 microgram/ml. AMK and OFLX were also active with the MIC90s of 4 micrograms/ml. Penicillins and cephems generally showed lower activities. 7. Proteus mirabilis: Most of the agents were active against P. mirabilis. Cephems were generally active with the MIC90s in a range of < or = 0.125 microgram/ml-4 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1991). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 751 bacterial strains isolated from patients with urinary tract infections in 11 hospitals during the period of June 1991 to May 1992. Of the above total bacterial isolates, Gram-positive bacteria accounted for 28.6% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 71.4% and most of them were Escherichia coli. 1. Enterococcus faecalis Ampicillin (ABPC), imipenem (IPM) and vancomycin (VCM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 2 micrograms/ml. Piperacillin (PIPC) and chloramphenicol (CP) were also active with the MIC90s of 8 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 2. Staphylococcus aureus including MRSA Arbekacin (ABK) showed the highest activities against S. aureus isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. VCM was also active with its MIC90 of 1 microgram/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 3. Citrobacter freundii Ciprofloxacin (CPFX) showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. IPM, gentamicin (GM), ABK and norfloxacin (NFLX) were also active with the MIC90s of 1 microgram/ml. Penicillins and cephems were not so active. 4. Enterobacter cloacae IPM showed the highest activities against E. cloacae isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. CPFX was also active with the MIC90 of 2 micrograms/ml. Aminoglycosides were active comparatively. The MIC90s of them were 4 micrograms/ml. Penicillins and cephems generally showed lower activities. 5. Escherichia coli IPM and ciprofloxacin (CPFX) showed the highest activities against E. coli isolated from patients with urinary tract infections. The MIC90s of them were 0.125 micrograms/ml or below. Flomoxef (FMOX), cefmenoxime (CMX), cefuzonam (CZON), latamoxef (LMOX), norfloxacin (NFLX) and ofloxacin (OFLX) were also active with the MIC90s of 0.25 microgram/ml. Penicillins except mecillinam (MPC) were not so active showing the MIC90s of 32 micrograms/ml or above. 6. Klebsiella pneumoniae IPM showed the highest activities against K. pneumoniae isolated from patients with urinary tract infections. Its MIC90 was 0.25 microgram/ml. Gentamicin (GM) and arbekacin (ABK) were also active with the MIC90s of 0.5 microgram/ml, respectively. But minocycline (MINO) and penicillins were not so active showing the MIC90s of 32 micrograms/ml or above. 7. Proteus mirabilis Most of the agents were active against P. mirabilis.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗

A one-year survey of respiratory and urinary pathogens and their antimicrobial susceptibility.

A one-year (1993) survey of the distribution of pathogens causing respiratory and urinary infections and their antimicrobial susceptibility was performed. The most common bacteria isolated from the lower respiratory tract of patients in a district general hospital were Pseudomonas aeruginosa (35.9%) and Staphylococcus aureus (21.4%). About half of the Pseudomonas strains revealed a resistance to imipenem and gentamicin, whereas almost all Staphylococcus strains were resistant to penicillin G. The most common isolates from urine of in and out-patients were Escherichia coli (32.3% and 39.8%) and Enterococcus faecalis (16.6% and 14.2%). Escherichia coli strains were largely susceptible to almost all chemoantibiotics tested, whereas Enterococcus faecalis demonstrated a high resistance pattern. Pseudomonas aeruginosa isolated from urine were more sensitive to chemoantibiotics than respiratory strains and the susceptibility of Staphylococcus aureus isolated from hospitalized or out-patients was different. A periodic monitoring system devised to give information about the circulation of bacteria and the chemoantibiotic resistance in a local context would be useful to assess the local trends and select drugs for therapy.

Drug Resistance, Microbial↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 567 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1994 to May 1995. Of the above total bacterial isolates, Gram-positive bacteria accounted for 26.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 73.2% and most of them were Escherichia coli. 1. Enterococcus faecalis. Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 1 microgram/ml. Vancomycin (VCM) was also active with the MIC90 of 2 micrograms/ml. Piperacillin (PIPC) and biapenem (BIPM) were also active with the MIC90s of 4 micrograms/ml and 8 micrograms/ml, respectively. The others were not so active with the MIC90s of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA. VCM showed the highest activities against S. aureus isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml against both S. aureus and MRSA. Arbekacin (ABK) was also active with the MIC90 of 2 micrograms/ml. The others except minocycline (MINO) were not so active with the MIC90s of 64 micrograms/ml or above. 3. Staphylococcus epidermidis. MINO showed the strongest activity against S. epidermidis isolated from patients with urinary tract infections. Its MIC90 was 0.25 microgram/ml. ABK was also active with the MIC90 of 1 microgram/ml. Cephems were active with the MIC90s of 2 approximately 16 micrograms/ml, but penicillins and quinolones were not so active with the MIC90s and 64 approximately 128 micrograms/ml. 4. Citrobacter freundii. Gentamicin (GM) showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. IPM was also active with the MIC90 of 2 micrograms/ml. Cefpirome (CPR) and cefozopran (CZOP) were also active with the MIC90s of 4 micrograms/ml and 8 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 5. Enterobacter cloacae. IPM showed the highest activities against E. cloacae. Its MIC90 was 0.5 microgram/ml. GM and amikacin (AMK), ciprofloxacin (CPFX) and tosulfloxacin (TFLX) were also active with the MIC90s of 4 micrograms/ml. Penicillins and cephems except latamoxef (LMOX), cefmenoxime (CMX), CPR and CZOP showed lower activities with the MIC90s of 256 micrograms/ml or above. 6. Escherichia coli. Most of antimicrobial agents were active against E. coli. CPR, CZOP, IPM, carumonam (CRMN), CPFX and TFLX showed the highest activities against E. coli. The MIC90s of them were 0.125 microgram/ml or below. Cefotiam (CTM), flomoxef (FMOX) CMX, ceftazidime (CAZ), and LMOX were also active with the MIC90s of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 7. Klebsiella pneumoniae. CRMN showed the highest activities against K. pneumoniae. Its MIC90 was < or = 0.125 microgram/ml. CZOP was also active with the MIC90 of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 8. Proteus mirabilis. P. mirabilis was susceptible to a majority of drugs. CMX, CAZ, LMOX, CRP, cefpodoxime (CPDX), CRMN, CPFX and TFLX showed the highest activities against P. mirabilis isolated from patients with urinary tract infections. The MIC90s of them were 0.125 microgram/ml or below. MINO was not so active with the MIC90 of 128 micrograms/ml. 9. Pseudomonas aeruginosa. Most of the agents were not so active against P. aeruginosa. IPM showed MIC90 of 8 micrograms/ml. The others were not so active with the MIC90s of 16 micrograms/ml or above. CPFX showed MIC50 of 0.5 microgram/ml.

Anti-Bacterial Agents↗