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Identification of Enterobacteriaceae by the automicrobic system: Enterobacteriaceae biochemical cards versus Enterobacteriaceae-plus biochemical cards.

Enterobacteriaceae Biochemical Cards (EBC) may be used in the AutoMicrobic system for identification of enteric bacilli. Recently, the card has been modified to permit identification of enteric and certain nonenteric bacilli. Also, minor modifications have been in the computer program used for interpretation of tests with the new cards (EBC+). The two types of cards (EBC and EBC+) were tested in parallel and found to be in agreement with 97% of 650 Enterobacteriaceae. Most of the discrepancies were resolved when selected strains were retested on 3 separate days. A lack of absolute reproducibility with either system was demonstrated and explained most of the initial discrepancies. Approximately 97% of the AutoMicrobic system identifications agreed with those obtained from standard reference methods, after equivocal AutoMicrobic system results (P less than 0.80) were excluded. Equivocal responses occurred with 4% of our EBC tests and 7% of our EBC+ tests; additional tests are needed before such strains can be identified with confidence.

Bacteriological Techniques

Problems in the laboratory isolation of simian hemorrhagic fever viruses and isolatse metaboli enterobacteriaceae classificat enterobacteriaceae enzymology hydrogen peroxide metaboli enterobacteriaceae metaboliion of the agent responsible for the Sussex-69 epizootic.

At least six epizootics of simian hemorrhagic fever have occurred at four different primate centers. Although these diseases could easily be transmitted to other monkeys of the Macaca species, difficulty has been encountered in isolating the causative virus in cell culture. The results of this study have shown that the isolation of simian hemorrhagic fever virus strains in cell culture is dependent upon the use of a susceptible MA-104 cell strain and that the ability of such strains to support the replication of these viral agents may vary. By using this information we have been able to isolate a viral agent in cell culture from materials derived from the Sussex/69 epizootic.

Animals

Tigemonam activity against clinical isolates of Enterobacteriaceae and Enterobacteriaceae with known mechanisms of resistance to beta-lactam antibiotics.

Tigemonam, a new oral monobactam, was at least as active as aztreonam or carumonam against clinical isolates of Enterobacteriaceae (MIC90:0.06-16 mg/l). Tigemonam was very stable in the presence of classical plasmid mediated beta-lactamases but its MICs were increased (4-256 mg/l) in the presence of new broad-spectrum plasmid mediated beta-lactamases (either TEM of SHV derivatives). Increased MICs (0.25-8 mg/l) were also observed for different isogenic mutants of Enterobacteriaceae, which either produced high levels of chromosome-encoded cephalosporinases, or had a permeability defect.

Anti-Bacterial Agents

[Evaluation of a new semi-automatic method of identifying enterobacteriaceae, M.I.S.-Enterobacteriaceae].

M.I.S.-Enterobacteriaceae is a new kit for identifying Enterobacteriaceae using a microplate consisting of 21 biochemical characters with automated reading and interpretation. The validity of this method was studied by the identification of 350 strains of enterobacteria belonging to 44 species and comparison with the classical method of identification in test-tubes. Results showed a diagnosis accuracy of 96 p. cent at the species level and 97.7 p. cent at the genus level. Diagnosis accuracy reached 100 p. cent for those bacterial species isolated routinely: Proteus, Providencia, Morganella, Klebsiella, Enterobacter. Accuracy was 97 p. cent for E. coli, 95 p. cent for Serratia marcescens and 94 p. cent for C. freundii. For several less frequently isolated species such as Salmonella, Hafnia, Shigella and Yersinia, diagnosis accuracy was 100 p. cent. This identification system for enterobacteria can however also be used for identification of Aeromonas genus and for Pseudomonas maltophilia and Acinetobacter baumannii non fermenting Gram-negative bacilli with oxidase negative reaction.

Bacteriological Techniques

Enterobacteriaceae in the jejunal microflora prevalence and relationship to biochemical and histological evaluations in healthy Colombian men.

When 23 healthy native Southwestern Colombian men were studied to determine the prevalence of Enterobacteriaceae in the jejunal microflora in a sample of thoroughly evaluated tropical inhabitants who were normal by physical examination, chest x-ray, and medical history, 14 of the 23 proved to be Enterobacteriaceae-positive, with counts of 10(3) to 10(9) per milliliter of jejunal aspirate. Thirteen had Escherichia coli, and the fourteenth had Klebsiella pneumoniae. Four had a second species of Enterobacteriaceae associated with E. coli: three were K. pneumoniae, and one was Proteus morganii. Laboratory studies routinely done on all subjects disclosed a total of 18 low biochemical values, 17 of which were associated with 12 of the 14 Enterobacteriaceae-positive subjects: six were low in serum cholesterol, four low in serum vitamin B12, four low in D-xylose excretion, and three low in creatinine coefficient; whereas, the Enterobacteriaceae-negative subjects had normal values for all biochemical tests except for serum vitamin B12 in one case. Nitrogen balance means were significantly different for the two groups: 3.39 g for the Enterobacteriaceae-positive subjects and 1.94 g for the Enterobacteriaceae-negative. No relationship was evident when the histology of the jejunal biopsies was compared with the microbiological or laboratory findings. When the 23 subjects were grouped into those (N = 19) with significant microbial recoveries of any type and those (N = 4) without, the data yielded no meaningful relationships.

Adolescent

[Current aspects of the fecal flora of the newborn without antibiotherapy during the first 7 days of life: Enterobacteriaceae, enterococci, staphylococci].

Last years, il became obvious that the colonization pattern described in 1976-1978 was no more valid: early colonization by Enterobacteriaceae at the 2-3 rd day of life in all newborns, with constant presence of antibioresistant strainseven in non treated newborns. To establish the new pattern of colonization, the same quantitative method of dilution and culture on selective media was used daily from day 1 to day 7 (5 days only for M). The number of Enterobacteriaceae, enterococci and staphylococci was determined in the stools of 10 newborns in the Maternity unit (= M) (term 40 weeks +/- 1, birth weight 3,356 g +/- 383), 10 in the Premature nursery (= P) (term 34.9 weeks +/- 1, birth weight 2,457 g +/- 676), and 14 in the Neonatal intensive care unit (= R) (term 35.2 weeks +/- 3.8, birth weight 2,457 g +/- 763). The results establish that colonization by Enterobacteriaceae is no more constant at D3. It could be demonstrated only in 8/10 M, 1/10 P, and 6/14 R (statistically different - p < 0.01 - between M and P). At D5, 9/10 M, 5/10 P, 10/14 R, and at D7, 6/10 P and 10/14 R were colonized. Resistant Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae) could be found in only 3/10 M, 4/10 P and 6/14 R. Enterococci could be found in 1 newborn M, 2 P and 7 newborns R. Staphylococci appeared earlier: all newborns M, P and R were colonized at D2, 4 and 5 respectively. These bacteria were coagulase negative, associated with Staphylococcus aureus in 3 P. Our hypothesis is that late colonization with Enterobacteriaceae and enterococci is due to the improvement of hygiene procedures and due to the decontaminating effect of antibiotics in other treated newborns (Enterobacteriaceae by 3 rd generation cephalosporin and enterococci by pharyngeal vancomycin).

Anti-Bacterial Agents

Inhibition of Salmonella typhimurium attachment to chicken cecal mucus by intestinal isolates of Enterobacteriaceae and lactobacilli.

The ability of selected strains of Enterobacteriaceae or lactobacilli isolated from the intestines of adult chickens to inhibit in vitro attachment of Salmonella typhimurium 3333/O to cecal mucus in the presence or absence of D-mannose was determined. Attachment in the absence of mannose was reduced by prior exposure of mucus to cultures of two isolates of Enterobacteriaceae, an Escherichia coli and a Hafnia alvei strain, but not to a third isolate, an Enterobacter agglomerans strain. Attachment of S. typhimurium was not inhibited when mannose was present in the blocking or attachment step. Formation of fimbriae by the two inhibitory Enterobacteriaceae strains and the S. typhimurium strain, as indicated by titers of mannose-sensitive hemagglutination of guinea pig erythrocytes was optimal in Z biphasic medium (consisting of tryptone, yeast extract, dextrose, and NaCl) incubated anaerobically at 42 C. Fimbriae of each of three strains prepared from these cultures also inhibited attachment. These are characteristics consistent with attachment and inhibition of attachment mediated by a mannose-sensitive adhesin associated with type 1 fimbriae on bacterial cells of Enterobacteriaceae strains. Attachment in the presence of mannose was significantly reduced by prior exposure of mucus to cultures of a Lactobacillus salivarius strain and a Lactobacillus delbrueckii delbrueckii strain but not to a strain of Lactobacillus for which the species had not been determined. Washed cells or spent culture supernatant fluid from brain-heart infusion broth, Z broth, or Z biphasic cultures of the inhibitory strains of lactobacilli incubated at 37 or 42 C inhibited this form of attachment. Of 27 intestinal isolates of Enterobacteriaceae and 21 of lactobacilli, the lactobacilli strains were generally more hydrophobic than the Enterobacteriaceae as determined by adherence to hexadecane. The lactobacilli isolates did not agglutinate guinea pig erythrocytes. The data suggest more than one mechanism for mediating attachment of inhibitory bacterial strains and for subsequent attachment of S. typhimurium.

Adhesins, Bacterial

Activity of ciprofloxacin (BAYo 9867) against Pseudomonas aeruginosa and ampicillin-resistant Enterobacteriaceae.

We studied the in vitro activity of ciprofloxacin against 570 strains of ampicillin-resistant Enterobacteriaceae and 286 Pseudomonas aeruginosa strains. 95.26% of the Enterobacteriaceae and 53.45% of the P. aeruginosa were inhibited by 0.1 mg/l of ciprofloxacin. 2 mg/l of ciprofloxacin inhibited all of the Enterobacteriaceae strains and 4 mg/l all of the P. aeruginosa. We compared the activity of ciprofloxacin with that of temocillin in the Enterobacteriaceae strains. In the P. aeruginosa strains, classified according to their susceptibility to carbenicillin and gentamicin, we compared the activity of ciprofloxacin with that of ceftazidime. In the strains studied, the in vitro activity of ciprofloxacin is superior to that of temocillin against the Enterobacteriaceae and to that of ceftazidime against the P. aeruginosa strains.

Ampicillin

The enumeration of thermotrophic types amongst the Enterobacteriaceae colonizing perishable foods.

A total of 41 pure cultures of Enterobacteriaceae, comprising 32 thermotrophic and nine psychrotrophic strains, pathogens or marker organisms, were examined for numbers of colony forming units obtained at 37 degrees and 42.5 degrees C (thermotrophs) and 30 degrees C (psychrotrophs), when surface-plated on a rich infusion agar and violet red bile agar. In addition 42 food and water samples, collected in a rural area of the Philippines, were examined by surface inoculating violet red bile AIPC (agar immersion plating and contact; 'dip') slides and incubating at 37 degrees and 42.5 degrees C. At 42.5 degrees C there was almost total recovery of the thermotrophic Enterobacteriaceae, whereas the psychrotrophic strains were completely suppressed. At 37 degrees C the psychrotrophs were only slightly inhibited. The Philippine foods, predominantly cooked meals, milk and drinking water, appeared to be significantly colonized by thermotrophic Enterobacteriaceae. It is concluded that incubation at 42.5 degrees C satisfactorily selects enteropathogenic and other enteric Enterobacteriaceae while suppressing the psychrotrophic types which are mainly of vegetable origin. It is emphasized that, regardless of the temperature used, a resuscitation procedure for Enterobacteriaceae populations that have incurred sublethal injury in food has to precede counts on or in the usual selective media.

Animals

Oral Enterobacteriaceae in patients with HIV infection.

160 oral swabs of 149 HIV-infected patients and 168 swabs of 166 controls were cultured to detect a possible colonization of the oral cavity with yeasts and Enterobacteriaceae. In 5.0% of the HIV-infected patients and in 4.8% of the controls different species of Enterobacteriaceae were found. Yeasts were always associated with Enterobacteriaceae in the group of HIV-infected patients. Clinically, different oral lesions were seen in the study group. A correlation between the nature of these lesions and the presence of Enterobacteriaceae could not be found. A possible pathogenic role of the Enterobacteriaceae associated with these oral lesions is yet uncertain and remains to be established by further studies.

Acquired Immunodeficiency Syndrome

Accurate automated identification of selected Enterobacteriaceae at four hours.

The Enterobacteriaceae Biochemical Card of the AutoMicrobic system Vitek Systems, Inc., Hazelwood, Mo.) provides completely automated identification of members of this family within an 8-h test period. Identification of 776 clinical and stock isolates to species level by the Enterobacteriaceae Biochemical Card under routine operating conditions correlated at 96% with our present 18- to 24-h methods of identification. Further, utilizing a special program, we investigated presumptive identification of certain organisms within 4-h--an interval that provides greater practical clinical usefulness on a real-time rapid basis. In a single year, 1978, 97% of 23,464 Enterobacteriaceae isolated in our diagnostic laboratory belonged to 11 species of six genera. Our results suggest that, by limiting the number of the identified Enterobacteriaceae that could be actually presumptively reported to those 11 species of six genera. Our results suggest that, by limiting the number of the identified Enterobacteriaceae that could be actually presumptively reported to those 11 species with the highest frequency of occurrence, we could have correctly identified and presumptively reported 83% of these to genus or species after only 4 h. Approximately 2% of the isolates would have been presumptively identified and reported incorrectly, whereas the identification of the remaining 15% would not have been reported before the completed 8-h incubation period.

Autoanalysis

Clinical laboratory evaluation of the Auto-Microbic system for rapid identification of Enterobacteriaceae.

The capability of the Auto-Microbic system (Vitek Systems, Inc., Hazelwood, Mo.) has been expanded to identify members of the family Enterobacteriaceae with the use of a sealed, disposable accessory card (the Enterobacteriaceae Biochemical Card) containing 26 biochemical tests. To judge the accuracy of the AutoMicrobic system's identification in a hospital laboratory, 933 Enterobacteriaceae isolates were studied. The AutoMicrobic system provided the correct identification for 905 of the isolates (97%). For Enterobacteriaceae excluding Escherichia coli (533 isolates not E. coli), 506 isolates were correctly identified (94.9%). The AutoMicrobic system integrates well into the clinical microbiology laboratory, providing a simple, accurate, and efficient automated system for the rapid identification of Enterobacteriaceae.

Bacteriological Techniques

Salmonella and other Enterobacteriaceae found in commercial poultry feed.

Poultry feed (mash and pelleted) and meat and bone meal samples were collected from commercial mills. All samples were analyzed for Enterobacteriaceae count (ENT) and Salmonella. The genus and species of the various Enterobacteriaceae present were also determined. The average ENT for mash, pelleted, and meal samples was log 4.1, .8, and 1.8/g, respectively. Enterobacteriaceae were present in 100, 60, and 92% and Salmonella in 58, 0, and 92% of the mash, pelleted, and meal samples, respectively. Overall, the Enterobacteriaceae most frequently isolated from all samples were Enterobacter agglomerans, Enterobacter cloacae, and Klebsiella pneumoniae. Although no Salmonella were found in the pelleted samples, the presence of other Enterobacteriaceae suggests that commercial pelleting may not totally destroy Salmonella since their heat resistance is similar to the other organisms found.

Animal Feed

[Enterobacteriaceae as indicators of the presence of Salmonella and the hygienic conditions of meat and bone meals].

The purpose of this study was to establish the relationship between Enterobacteriaceae counts and the presence of Salmonella in meat-and-bone meals. Ninety meat-and-bone meal sample units (9 lots) from five producing plants from the Greater Buenos Aires, Argentina, were analyzed. The presence of Salmonella was detected through pre-enrichment of the samples followed by selective enrichment in two broth cultures and isolations after 24 and 48 hours. For Enterobacteriaceae counts the recovery of sublethally injured cells was carried out for two hours on trypticase soy agar, followed by the addition of selective agar. The overall Enterobacteriaceae count for the 90 sample units was 3.0. Seven (77.7%) of the 9 lots were positive for Salmonella. The correlation coefficient between Enterobacteriaceae counts and Salmonella was 0.81 with a confidence limit (95%) of 0.35-0.95. The results of this study indicate that Enterobacteriaceae counts are not good indicators of the presence of Salmonella in meat-and-bone meals. However, they could be used to assess their hygienic quality.

Colony Count, Microbial