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PubMed1991

Antibacterial and antifungal properties of propylene glycol, hexylene glycol, and 1,3-butylene glycol in vitro.

The antimicrobial properties of three glycols, - propylene glycol, hexylene glycol, and 1,3-butylene glycol - against Candida albicans, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes A, Streptococcus mitis, and E. coli were studied in vitro. Within 20 h, 10% and 30% hexylene glycol in fresh tryptic soy broth were able to kill all the micro-organisms listed above. Five percent hexylene glycol showed some antimicrobial properties but the 1% agent had no effect. Thirty percent 1,3-butylene glycol and 30% propylene glycol were approximately as effective as 10% HG. The results speak in favour of using hexylene glycol in cosmetic and dermatological vehicles instead of propylene glycol and 1,3-butylene glycol.

Anti-Bacterial Agents↗

PubMed1994

[Antimicrobial activities of cefditoren against clinical isolates obtained from outpatients].

To examine the antimicrobial activity of cefditoren (CDTR) against strains clinically isolated from outpatients at this hospital from November, 1993 to February, 1994, the minimum inhibitory concentrations (MICs) were determined including those of the control drugs. The results were as follows: 1. CDTR showed strong antimicrobial activities against Staphylococcus aureus subsp. aureus, Streptococcus pyogenes and Streptococcus pneumoniae. The MICs of CDTR against benzylpenicillin-insensitive or -resistant S. pneumoniae distributed in the lowest concentration range even compared to those of the control drugs. 2. CDTR showed strong antimicrobial activities against Haemophilus influenzae, Moraxella subgenus Branhamella catarrhalis, Escherichia coli, and Klebsiella spp. The MIC of CDTR against CEPs-resistant E. coli was lower than those of most control drugs. 3. Since the microbes described above the major pathogens for the community-acquired infections, CDTR will be effective against infectious diseases transmitted at outpatient visits.

Bacteria↗

PubMed1993

[A clinical study on cefditoren pivoxil granules in the pediatric field].

The clinical efficacy of cefditoren pivoxil (CDTR-PI, ME 1207) was evaluated in 45 patients with various infections. CDTR-PI was administered after meals at a dose of 3 mg/kg t.i.d. to most patients. The clinical efficacy rate was 95.3%. As side effects, diarrhea occurred in 2 patients. Cefditoren showed excellent antibacterial activities against Haemophilus influenzae, Streptococcus pyogenes and Streptococcus pneumoniae, and was more effective against Staphylococcus aureus than other cephems.

Administration, Oral↗

PubMed1984

Evaluation of rapid identification of gram-positive cocci in positive blood cultures by use of the AutoMicrobic system Gram-Positive Identification Card.

Because rapid identification of gram-positive organisms from blood cultures may provide valuable information for patient care and because the AutoMicrobic system Gram-Positive Identification (AMS-GPI) Card (Vitek Systems, Inc., Hazelwood, Mo.) is designed for the identification of these organisms in 4 to 13 h, we designed this study to evaluate the performance of the AMS-GPI Card in the direct identification of gram-positive organisms upon detection of growth in blood culture bottles. We compared direct identification by the AMS-GPI Card with the final AMS-GPI Card identification and with our standard identification methods. We evaluated 51 gram-positive organisms from clinical blood cultures as well as 49 simulated blood cultures. The isolates included Streptococcus pneumoniae (17), Streptococcus pyogenes (13), group D enterococci (12), Streptococcus agalactiae (11), viridans streptococci (10), coagulase-negative staphylococci (21), Staphylococcus aureus (15), and Listeria monocytogenes (1). The AMS-GPI Card identified all of the group D enterococci, viridans streptococci, and coagulase-negative staphylococci and all but one each of the Streptococcus pyogenes and Streptococcus agalactiae isolates. L. monocytogenes was also correctly identified. However, the AMS-GPI Card identified only 12 of 17 Streptococcus pneumoniae and 9 of 15 Staphylococcus aureus isolates by direct inoculation. We therefore conclude that the results of direct identification of gram-positive organisms by the AMS-GPI Card may be used cautiously for rapid direct identification of gram-positive organisms from positive blood cultures.

Bacteriological Techniques↗

PubMed1991

The role of day care givers in the identification and prevention of infections.

The prevalence of nasopharyngeal Streptococcus pyogenes in children attending day care centers in North Jordan was studied. Nasal and throat swabs, cultured for Streptococcus pyogenes were collected from 100 children enrolled in four day care centers serving middle to high socioeconomic status portions of the population in March 1989. The identity of the streptococcal isolates was confirmed by biochemical and serological methods. Throat infection manifestations of the past 3 days, as reported and observed by the care givers, were related to culture results. The study findings showed that the prevalence of nasopharyngeal Streptococcus pyogenes was high and ranged between 10 to 23.3%. It was also noted that the care givers were able to correctly identify children with suspected throat infection, in 11 to 25% of the children who grew Streptococcus pyogenes on cultures, by mere observation of the symptoms. Due to the high prevalence of nasopharyngeal Streptococcus pyogenes in these settings, measures to control and prevent the spread of Streptococcus pyogenes must be employed. This study suggests that care givers may play an important role in achieving such a goal if they are offered proper health education programs and instructions on child hygiene.

Caregivers↗

PubMed1991

Aggregation of group A streptococci by human saliva and effect of saliva on streptococcal adherence to host cells.

The aggregation of group A streptococci by whole, stimulated human saliva (WHS) and the effect of saliva on streptococcal adherence to host cells was investigated. WHS samples from 11 individuals were found to aggregate both M+ and M- group A streptococci to various degrees. The aggregating activity was sensitive to heat, EDTA, EGTA [ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid], sodium dodecyl sulfate, and lipoteichoic acid. None of the simple sugars tested, mercaptoethanol, albumin, or nonionic detergents had any effect on aggregation. The aggregating activity of EDTA-treated saliva was restored by 0.1 mM Ca2+ and 1.0 mM Mn2+ but not by up to 5 mM Mg2+. Only streptococci from the stationary phase were aggregated. Hyaluronidase treatment of streptococci from the exponential phase of growth restored their ability to be aggregated, suggesting that the hyaluronic acid capsule interferes with agglutination. Adsorption of WHS by one strain of Streptococcus pyogenes removed aggregating activity for other strains of S. pyogenes and Streptococcus sanguis but not agglutinins for Escherichia coli, suggesting that the agglutinin is specific for certain gram-positive bacteria. Molecular sieve chromatography of WHS and identification of streptococcus-binding components of saliva suggest that either a glycoprotein of approximately 360 kDa or a mucin of saliva of greater than 1,000 kDa mediates aggregation of streptococci. WHS also inhibited adherence of S. pyogenes to buccal epithelial cells.

Adsorption↗

PubMedDate not supplied

The effect of roxithromycin on the virulence of gram-positive cocci.

Antibiotics whose recognized mode of action comprises inhibition of bacterial protein biosynthesis are also recognized to modulate the expression of bacterial virulence factors when incorporated into culture media at sub-MIC levels. In this respect, one of the new macrolides, roxithromycin, has been examined for its effect on toxin/enzyme production by strains of Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae. Biosynthesis of staphylococcal coagulase and DNase could be potentiated, whereas that of staphylococcal alpha-hemolysin, streptolysins O and S, and pneumolysin were unaltered. Expression of one structural virulence factor, pneumococcal polysaccharide, was repressed in the drug's presence, resulting in potentiation of phagocytic ingestion of the drug-exposed bacteria. The drug failed to have any effect on ingestion of Staph. aureus or Strep. pyogenes. These studies provide evidence that roxithromycin may exhibit "added value" as an antibiotic in its ability to potentiate the susceptibility of Strep. pneumoniae to host defenses such as phagocytosis.

Bacterial Proteins↗

PubMed2002

Patterns of isolation of common gram positive bacterial pathogens and their susceptibilities to antimicrobial agents in Jimma Hospital.

Gram positive bacteria are frequently emerging as antibiotic resistant pathogens, causing serious infections than ever before in the ill and debilitated patients. The pattern of isolation and the antimicrobial susceptibilities of common Gram positive cocci including Staphylococcus aureus, coagulase negative staphylococcus (CoNS), Streptococcus pyogenes, Enterococcus species and Streptococcus pneumoniae was investigated between January 1997 and June 2000 in Jimma Hospital. Of the 500 specimens collected from children and adults, 116 (23.2%) consisted of one or more of the above organisms. The following strains: Staphylococcus aureus, 47 (40.5%), CoNS, 36 (31.0%), Streptococcus pneumoniae, 26 (22.4%) Streptococcus pyogenes, 5 (4.3%) and Streptococcus faecalis, 2(1.7%) were isolated from different specimens including pus, sputum, urine, stool, blood and oro/nasopharyngeal swabs of patients. The in vitro activities of 14 different antibiotics including penicillin G, ampicillin, cloxacillin, cephalothin, gentamicin, kanamycin, tetracycline, chloramphenicol, erythromycin, trimethoprim-sulfamethoxazole, streptomycin, methicillin, vancomycin and clindamycin was determined against the clinical bacterial isolates. The antimicrobial activities were evaluated by agar diffusion technique using Mueller-Hinton agar according to NCCLS recommendations. The majority of the pathogens, 59(50.9%) were recovered from upper respiratory tract infections and 17 (14.6%) from the lower respiratory tract. The resistance patterns of S. aureus, CoNS, S. pneumoniae and enterococci to penicillin was 91.5%, 94.4%, 7.7% and 100% respectively. Penicillin, ampicillin and cloxacillin showed low effects (< 60%) on both S. aureus and CoNS. Multi-drug resistance was observed in all the gram-positive isolates, especially higher in staphylococcus species. All isolates of S. aureus (100%) were susceptible to vancomycin, clindamycin and gentamicin. In order to reduce morbidity and mortality due to antibiotic resistance susceptibility testing should be performed for the proper management of bacterial infections. This entails the need for national surveillance to monitor antibiotic resistance in bacteria by susceptibility testing using reliable methods.

Adult↗

PubMed1999

Antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy children.

In a study to determine the prevalence and antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy children, throat swabs obtained from 1765 children were cultured and the organisms recovered tested by the disk diffusion method and the E test. Six hundred ninety-one children (39.1%) harbored Haemophilus influenzae, 112 (6.3%) Streptococcus pyogenes, 73 (4.1%) Moraxella catarrhalis, 52 (2.9%) Streptococcus pneumoniae, and 50 (2.8%) Neisseria meningitidis in their oropharynx. The rate of penicillin resistance was 2%, 0%, and 12%, respectively, for Streptococcus pneumoniae, Streptococcus pyogenes, and Neisseria meningitidis. Ampicillin resistance was observed in 8.6% of Haemophilus influenzae strains and 78% of Moraxella catarrhalis strains and was associated with the presence of beta-lactamase, except in one strain of Haemophilus influenzae. Five (4.4%) isolates of Streptococcus pyogenes were resistant to macrolides. The low level of resistance observed in this area contrasts with the high rates reported in the literature.

Anti-Bacterial Agents↗

PubMed1997

Do simple laboratory tests help in etiologic diagnosis in acute maxillary sinusitis?

The aim of the present study was to evaluate whether the results of such simple hematologic tests as erythrocyte sedimentation rate (ESR), white blood cell count (WBC) and C-reactive protein (CRP) could give any useful information about the causative agents in 176 patients with acute maxillary sinusitis (AMS). The great majority of tests (82%) showed values which were within normal limits. This may be due to the fact that 22% of AMS cases were culture negative for bacteria and about 60% of culture positive cases had Haemophilus influenzae as the etiologic agent. Significantly raised test values were seen in connection with Streptococcus pyogenes in the majority of cases, less frequently with Streptococcus pneumoniae and rarely with Haemophilus influenzae. We conclude that none of the evaluated routine blood tests are particularly sensitive indicators of the specific etiology of AMS in general. However, elevated CRP values (> 40 mg/l) associated with AMS should alert the physician to the suspicion of Streptococcus pyogenes or Streptococcus pneumoniae in etiology, since both, if left untreated, may lead to sinus empyema. With CRP or other evaluated tests Haemophilus influenzae- or Branhamella catarrhalis-positive AMS cannot be distinguished from a purely viral disease.

Acute Disease↗

PubMed1984

Exogenous thymidine and reversal of the inhibitory effect of sulfamethoxazole-trimethoprim on streptococci.

The practice of using sulfamethoxazole-trimethoprim (SXT) for the selective isolation of Streptococcus pyogenes and as a taxonomic character in the presumptive identification of streptococci was applied to 17 strains of different groups of streptococci to determine their characteristic behaviour in the presence of exogenous thymidine. Streptococcus pyogenes, Streptococcus agalactiae and group D enterococci utilized thymidine, the first two species obtaining a maximum reversal of the inhibitory effect of SXT at thymidine concentrations of 1.2 micrograms/ml and 0.6 micrograms/ml or higher, respectively. For group D enterococci, the degree of reversal of the inhibitory effect was proportional to the thymidine concentration. In contrast, the four viridans species studied (Streptococcus sanguis I, Streptococcus salivarius, Streptococcus mitis and Streptococcus sanguis II) and Streptococcus pneumoniae were unable to utilize thymidine from an exogenous source and thus growth remained inhibited even at the highest concentrations of thymidine tested. For selective isolation and identification of streptococci only stable media with batch-to-batch consistency are recommended together with a known quantity of thymidine.

Agar↗

PubMed1954

The binding of penicillin in relation to its cytotoxic action. II. The reactivity with penicillin of resistant variants of streptococci, pneumococci, and staphylococci.

1. In a previous study, the differing sensitivity of bacterial strains as they occur in nature appeared to be correlated with their correspondingly differing reactivity with penicillin. Presumably, the over-all reactivity of the cell with penicillin paralleled that of the vulnerable cell component(s). However, when penicillin-resistant variants of these strains (Streptococcus pyogenes, Micrococcus pyogenes, Diplococcus pneumoniae, and Streptococcus faecalis) were produced by serial passage through increasing concentrations of antibiotic, this correlation between resistance and the ability of the cell to bind penicillin was no longer apparent. Some resistant variants bound more penicillin than the parent, sensitive cell (Streptococcus faecalis, Micrococcus pyogenes), some were unchanged in their reactivity (Diplococcus pneumoniae, Micrococcus pyogenes), and some bound less (Streptococcus pyogenes, Micrococcus pyogenes). One resistant variant of Micrococcus pyogenes at first showed enhanced reactivity with penicillin; on continued passage through antibiotic, there was a further increase in resistance, but now associated with a significantly decreased reactivity. In the case of Diplococcus pneumoniae, a resistant variant at first reacted normally with penicillin; on continued passage in antibiotic, its binding affinity for penicillin gradually decreased, but with no associated further increase in resistance. 2. The reactivity with penicillin of cell-free sonic extracts of the resistant variants paralleled that of the intact organisms. Permeability considerations therefore did not seem involved in the increased resistance produced by serial passage in antibiotic. 3. The penicillin-resistant variants did not have an enhanced capacity to degrade the free intracellular antibiotic. 4. Possible alternative explanations are discussed in the text.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Significance of normal oropharyngeal flora in the development of streptococcal pharyngitis and outcome of penicillin therapy].

Pharyngitis is one of the most frequent diseases in children. The most important of the bacterial infections is due to Streptococcus pyogenes. For many years, penicillin is considered to be the drug of choice for streptococcal pharyngitis, although failure rates of up to 20% have been reported. One of possible explanations for penicillin treatment failure is presence of other species of bacteria in the normal oropharyngeal flora that can interfere with colonization and growth of Streptococcus pyogenes and influence the development of pharyngitis. A wide variety of microorganisms, including alpha-haemolytic streptococci and anaerobic bacteria, are present within the oropharynx (table 1). The strain of alpha-haemolytic streptococci is in interference with Streptococcus pyogenes. By producing bacteriocins, they inhibit colonization and growth of Streptococcus pyogenes and assist in its eradication. Anaerobic bacteria may play a direct or indirect role in development of pharyngitis. They may be directly responsible for specific forms of pharyngitis or contribute indirectly with possibility of synergy between them and Streptococcus pyogenes. Beta-lactamase-producing aerobic and anaerobic organisms may contribute to penicillin treatment failure. By producing beta-lactamase within the tonsillar tissue, they destroy penicillin and protect streptococci from the antibacterial effect of penicillin. Pharyngeal bacterial flora may vary according to the state of the patient (Figure 1). During an acute infection and in the cases of treatment failure and recurrent pharyngitis the number of alpha-haemolytic streptococci declines, while there is an increase in the number of anaerobic and beta-lactamase-producing organisms. After successful treatment the number and type of bacteria is similar to those found within normal tissue. Knowing the distribution and changes in pharyngeal bacterial flora is important for choosing the optimal drug for treatment of streptococcal pharyngitis. Although penicillin reduces the number of interfering beta-haemolytic streptococci, because of its advantages, if remains the drug of choice for the treatment of streptococcal pharyngitis. In cases of treatment failure and recurrent infections cephalosporins and macrolides may be a useful alternative to penicillin because they possess relatively poor activity against alpha-haemolytic streptococci, resistance to beta-lactamase and because of better penetration into tonsilar tissue.

Humans↗

PubMed1983

In vitro and in vivo evaluation of MDL 19,592, an oral cephalosporin.

MDL 19,592 is a new semisynthetic cephalosporin with a good therapeutic potential against Gram-positive bacterial infections when administered orally or parenterally. In the oral treatment of benzylpenicillin-resistant Staphylococcus aureus infections in mice, MDL 19,592 was superior to cephalexin, cephradine, cefaclor, cefadroxil and cefroxadine. These in vivo results reflect the in vitro superiority expressed by MDL 19,592 over the other oral cephalosporins against staphylococci. Additionally, MDL 19,592 orally was superior to cefazolin and cephalothin administered subcutaneously and to a number of penicillinase-resistant penicillins given orally or subcutaneously in the treatment of S. aureus mouse infections. MDL 19,592 killed S. aureus cells at the same or faster rate than did cephalexin or cephradine. As compared to cephalexin, MDL 19,592 was marginally superior in vitro against Streptococcus pyogenes and Streptococcus pneumoniae. In vivo, MDL 19,592 was significantly the more effective of the two against S. pyogenes and marginally more effective against S. pneumoniae. Against Gram-negative organisms, with the exception of Haemophilus influenzae, cephalexin was the more potent of the two antibiotics both in vitro and in vivo. Administered orally to mice, MDL 19,592 was absorbed as rapidly as cephalexin with both drugs attaining similar concentrations in the blood. MDL 19,592, like cephalexin, was minimally bound by mouse serum.

Administration, Oral↗

PubMed1985

Antimicrobial activity of bupivacaine and morphine.

Antimicrobial activity of bupivacaine and morphine against 10 microbial strains was studied with an agar dilution method. The strains tested were Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 25923), and one of each of the clinical isolates of Staphylococcus epidermidis (a multiresistant strain), Staphylococcus epidermidis (a sensitive strain), Streptococcus pneumoniae, Streptococcus pyogenes (A), Streptococcus faecalis, Bacillus cereus, and Candida albicans. The antimicrobial effect of bupivacaine was tested at concentrations of 0.5, 1.25, 2.5, and 5 mg/ml (0.05% 0.125%, 0.25%, and 0.5%). Bupivacaine at a concentration of 2.5 mg/ml inhibited the growth of the sensitive S. epidermidis strain, S. pyogenes, and S. pneumoniae, and all of the others except P. aeruginosa at a concentration of 5 mg/ml. Morphine 0.2 and 2 mg/ml (0.02 and 0.2%) did not inhibit any of the strains.

Bacillus cereus↗

PubMed1983

The value of bacteriology and serology in the diagnosis of necrotizing fasciitis.

Fourteen patients with necrotizing fasciitis are described. In thirteen the cause was Streptococcus pyogenes [Group A beta haemolytic streptococcus (BHS)]; in the fourteenth, Staphylococcus aureus was responsible. In the acute fulminating form of the disease, BHS can be cultured from the affected tissues. In the less acute form, particularly when the patient has been previously treated with antibiotics, other bacteria colonize the tissues and the BHS cannot be isolated. Serological evidence of infection with Streptococcus pyogenes can be ascertained in all such patients by finding high levels of anti-desoxyribonuclease B and anti-hyaluronidase. Measurement of the anti-streptolysin O titre is not helpful. Once the diagnosis is made, surgical removal of all necrotic tissue is still the treatment of choice.

Adult↗

PubMed1999

Ribosomal Resistance: Emerging Problems and Potential Solutions.

Many systemic antibiotics use ribosomal inhibition to suppress the replication of bacteria. Current research suggests that resistance to macrolide, lincosamide, and streptogramin B (MLS(B)) antibiotics is emerging among clinical isolates of Streptococcus pyogenes and Streptococcus pneumoniae. Erythromycin methylases, encoded by erm genes, modify an essential adenine residue in 23S rRNA and confer cross-resistance to MLS(B) antibiotics. More recently, macrolide efflux (mef) genes were identified in isolates of S. pyogenes and S. pneumoniae that show resistance to 14- and 15-membered macrolides (M phenotype). Resistance to MLSB has been associated with the increased use of erythromycin, and the recent emergence of the M phenotype has coincided with the marketing of newer macrolides. However, despite increasing macrolide resistance among clinical isolates of S. pneumoniae, convincing data on treatment failures directly attributable to MLS(B) or M phenotypes are limited. Possible solutions to emerging MLS(B) and M phenotype resistance include the introduction of alternative antibiotics, the more prudent use of antibiotics, combination therapy, molecular diagnostics, enhanced understanding of pharmacodynamic variables, and redefined resistance breakpoints.

Journal Article↗

PubMed1999

[Phenotypes of macrolide, lincosamide, and streptogramin resistant Streptococcus viridans isolated from blood].

Macrolide resistance has been widely studied in Streptococcus pyogenes and Streptococcus pneumoniae although not in viridans group streptococci (VGS). We studied 30 blood culture isolates of viridans group streptococci (25 resistant to erythromycin: 10 S. mitis, 8 S. milleri, 6 S. sanguis and 1 S. salivarius; and 5 susceptible: 2 S. mitis, 2 S. milleri and 1 S. sanguis). We carried out a double-disk test and determined MICs. The susceptibility testing was carried out by agar dilution for 14-, 15- and 16-member lactone ring macrolides, as well as for clindamycin and quinupristin-dalfopristin. Fifty-six percent of the erithromycin-resistant strains (6 S. mitis, 6 S. milleri and 2 S. sanguis) showed an MLS(B) phenotype, with a high level of intrinsic resistance to all the macrolides studied and clindomycin; 28% were of the M phenotype (4 S. sanguis, 2 S. mitis and 1 S. salivarius). We found a third resistance phenotype, which was present in 4 strains with MICs of 2-8 microg/ml, with resistance to macrolides and different degrees of resistance to clindamycin. All isolates were fully susceptible to quinupristin-dalfopristin. The MLS(B) and M phenotypes initially described in S. pyogenes and S. pneumoniae are also observed in VGS.

Anti-Bacterial Agents↗