During a 6-month period, 892 positive blood cultures were detected in the Copenhagen County hospitals. 302 (34%) were regarded as contaminations, and of the remaining cases 419 (71%) were community-acquired and 171 (29%) hospital-acquired, giving incidence rates of 6.8/1,000 admissions and 2.8/1,000 admissions, respectively. Both frequency and rate of hospital-acquired bacteremia were lower compared to most other studies. E. coli was more commonly found in community-acquired infections, while coagulase-negative staphylococci were the organisms most often considered as a contaminant. The main causative organisms in hospital-acquired infections were S. aureus (n = 37) and E. coli (n = 34). The proportion of polymicrobial bacteremias in this study was lower compared to most other studies (8%). E. coli from hospital-acquired infections were resistant to ampicillin in 42% of cases, but other Enterobacteriaceae showed higher percentage of resistance to beta-lactam antibiotics. S. aureus was penicillin-resistant in 92% of cases, but no methicillin-resistant strains were isolated. The frequency of antibiotic resistance was low compared to reports from other countries. A total of 136 hospital-acquired cases were followed prospectively. 61% of the patients were male and 46% were > or = 60 years of age. Most patients had predisposing diseases, 90% had foreign body and/or recent surgery performed, and 74 (54%) had an intraveneous catheter. The portal of entry was known in 132 (97%) of the cases, the most common being the urinary tract (42%), followed by an intravenous catheter (30%). The prevalence of urinary tract catheters gave an increased number of cases with E. coli bacteremia. The mortality was 16%.
The comparative analysis of 133 S. typhi clinical strains isolated from patients and carriers in Dnepropetrovsk Province in 1978-1987 was carried out. As shown by this analysis, 10 Vi phage types were represented in the set of strains under study, phage types A and F1 being the most numerous ones. Phage type F1 occurred less frequently among the strains isolated from carriers. 31.1% of the strains were found to contain plasmids with different molecular weight ranging from 96 to 0.5 MD. The occurrence of plasmid-containing strains remained at the same level during the whole period under study. Low-molecular plasmids occurred more frequently in the strains isolated from carriers. The minimal suppressive concentrations of a number of antibiotics, such as penicillin, ampicillin, monomycin, chloramphenicol, tetracycline, rifampicin and streptomycin, were determined. 7% of the strains were resistant to penicillin, 9% to monomycin, 15%--to tetracycline and 2.6% to chloramphenicol. The correlation between penicillin and monomycin resistance of the strains and the presence of the plasmid with a molecular weight of 60 MD in these strains was established. All strains were shown to be highly variable in the degree of their virulence: from 10(2) to 10(8). The strains isolated from patients possessed greater virulence.
A new probiotic Biosporin and other commercial biopreparations based on aerobic sporulating bacteria of the Bacillus genus have been comparatively studied for their specific activity and safety. It has been established that only Biosporin is characterized by expressed antagonistic activity in respect to a wide range of pathogenic and conditionally pathogenic microorganisms including those with multiple resistance to antibiotics. Biosporin is also characterized by the absence of any negative action on the organism of animals even in the doses considerably exceeding those recommended for use.
Activity of macrolides, lincosamines, streptogramins and fluoroquinolones against streptococcus pneumoniae and enterococci isolates from the western hemisphere: example of international surveillance (SENTRY antimicrobial surveillance program )in the development of new drugs.
Resistance among commonly isolated Gram-positive cocci have compromised the available therapeutic regimens and require structured monitoring at the local, regional, national, and international levels. Two popular treatment classes of antimicrobials (macrolides-lincosamines-streptogramins [MLS], fluoroquinolones) have been tested against 3, 049 isolates of Streptococcus pneumoniae and enterococci from the SENTRY Antimicrobial Surveillance program. The strains were obtained from clinical cases in hospitals in the United States, Canada, and six nations (10 medical centers )in Latin America. MLS and fluoroquinolone compounds had moderate activity against vancomycin-susceptible Enterococcus faecalis only (gatifloxacin, and trovafloxacin MIC(50), 0.5 microg/ml), and quinupristin/dalfopristin was potent only against E.faecium isolates (MIC(90), 1 microg/ml(-2) microg/ml). When tested against pneumococci, gatifloxacin, trovafloxacin, sparfloxacin, and quinupristin/dalfopristin (MIC(90), or =99.8% and 84.7% to 99.1% of strains, respectively. These results from a global resistance monitoring program should encourage rapid drug development. Based on in vitro sensitivity testing, they indicate a promising role for the treatment of emerging resistant Gram-positive cocci. The clinical role for each new agent will depend on safety profiles, rates of administration, and other issues identified during development in the clinical trials process.
Cases of sepsis with bacteriemia detected in the S. P. Botkin State Clinical Hospital within 2000-2007 were analysed. The sources of the bacteriemia, the etiological pattern of the pathogens and their susceptibility to antibacterials were estimated. The study enrolled 256 patients with sepsis. The antibiotic susceptibility of 227 isolates from the blood samples was tested. More than a half of the infection sources was detected in the organs of the respiratory tract and abdominal cavity. All the grampositive pathogens were susceptible to vancomycin and linesolid. The overwhelming majority of the enterococcal isolates proved to be susceptible to carbapenem and cefepim.
The occurrence of Branhamella catarrhalis in the nasopharynx and middle ear exudate was investigated in 3 studies. Bacteria were isolated from the nasopharynx in 63% of 180 healthy children and B. catarrhalis, the most common bacterium present, was isolated in 36%. In 75 children with primary acute otitis media, bacteria were isolated from the nasopharynx in 98% and from the middle ear exudate in 80%. B. catarrhalis was found in the nasopharynx in 43% and in the middle ear exudate in pure culture in 9%. In those children in whom B. catarrhalis was isolated from the middle ear exudate it was also present in the nasopharynx. In 420 children, 338 with primary acute otitis media and 82 who relapsed or did not respond to previous antibiotic therapy, B. catarrhalis was isolated from the nasopharynx in approximately 50%. About half of the B. catarrhalis strains were beta-lactamase-producing and the majority of these strains were isolated in children under 3 years of age. Of children with primary acute otitis media who had beta-lactamase-producing B. catarrhalis about 50% had not previously received antibiotic treatment. B. catarrhalis is commonly found in the nasopharynx of healthy children as well as in children with acute otitis media. Many of the strains are beta-lactamase-producing though many of the children have not been previously treated with antibiotics. In middle ear exudate, B. catarrhalis is found in about 10% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Enterococci are common causative agents in a broad range of human infections. Although formerly considered to be of low virulence, in recent years they have emerged as important pathogens, particularly in the hospital environment. Enterococci are not only intrinsically resistant to several antibiotics, but are also characterised by a potent and unique ability to exchange genetic material. With the increasing prevalence of strains resistant to ampicillin, aminoglycosides and glycopeptides, serious therapeutic difficulties have become more common. Epidemiological aspects, the mechanisms of action, the detection of antibiotic resistance, and the situation of enterococci in Sweden are discussed in the article.