Empiema necessitatis por Campylobacter rectus. Identificación rápida por MALDI-TOF MS / Empyema necessitatis caused by Campylobacter rectus. Rapid identification by MALDI-TOF MS

Resumen El empiema necessitatis (EN) constituye una muy rara complicación de un empiema pleural en el cual la infección se extiende a los tejidos blandos adyacentes. La etiología por anaerobios es muy infrecuente y se da en el curso de infecciones crónicas. Se presenta el primer caso de empiema necessitatis por Campylobacter rectus. La identificación de este agente se efectuó por espectrometría de masas (MALDI-TOF MS) y su sensibilidad antimicrobiana se determinó por el método epsilométrico.

Abstract Empyema necessitatis (EN) is a very rare complication of a pleural empyema, in which the infection extends to adjacent soft tissues. Anaerobic bacteria are very rare etiologic agents of EN, which occurs in the course of chronic infections. We present the first case of empyema necessitatis caused by Campylobacter rectus. Bacterial identification was carried out by mass spectrometry (MALDI-TOF MS) and antimicrobial susceptibility was determined by the epsilometer method.

Anaerobes in cardiac infections: A decade experience from the tertiary care center

Purpose: Anaerobic infections are common yet life-threatening. They are being recovered from all sites of the body, including the cardiovascular system. This study was aimed to determine the retrospective analysis on the isolation of anaerobes in cardiovascular samples received for a decade-long duration. It helps in knowing the frequency of isolation of anaerobic causes of cardiovascular infection. Methods: All cardiovascular samples from the department of Cardio-thoracic vascular surgery from January 2010 to December 2020 were studied. Results: Of 601 samples received, predominant samples were vegetations and valvular tissues of 258, followed by 98 samples of pericardial tissues, 92 samples of embolus, 90 samples of blood and post-operative collections, and 63 excised aneurysms and vascular grafts. Of the total, 15 samples grew anaerobes where Clostridium species were the predominant isolates. Clostridioides difficile was isolated in 2 samples. Conclusions: Anaerobes in cardiovascular samples are uncommon yet form a significant cause of morbidity and mortality. Most infections are from the contiguous spread, penetrating trauma, and hematogenous causing endocarditis or valvular infections. These conditions and samples form the seat of infectious focus and clinical suspicion towards the anaerobic cause of these conditions, especially in conventional routine culture-negative samples. Timely diagnosis of anaerobic infections plays a vital role in the good prognostic outcome of patients undergoing cardiothoracic and vascular surgery.

Anaerobio osteomyelitis. A rare condition in children / Osteomielitis por anaerobios. Una entidad poco frecuente en pediatría

ABSTRACT Osteoarticular infections due to anaerobes are very rare in children, with the Fusobacterium genus being the most frequently isolated. The course is usually subacute and, although there are predisposing factors described, most patients do not present with them. Generally, joint fluid cultures are sterile since these microorganisms are very sensitive to contact with oxygen, so they require specific culture media. All of the above causes the diagnosis to be delayed, increasing the risk of long-term sequelae. However, the prognosis improves when treatment is started early. The case is presented of a 10-year-old patient who was admitted for 30 days due septic arthritis of the right hip caused by Fusobacterium nucleatum During the admission, he required three surgical interventions, and completed 6 weeks of effective antibiotic therapy, with a good outcome and remaining asymptomatic at the current time.

RESUMEN Las infecciones osteoarticulares por anaerobios son muy raras en los niños, siendo el género Fusobacterium el que se aisla con más frecuencia. El curso suele ser subagudo y, aunque hay factores predisponentes descritos, la mayoría de los pacientes no los presenta. Generalmente, los cultivos de liquido articular son estériles ya que estos microorganismos son muy sensibles al contacto con el oxigeno, por lo que precisan medios de cultivo específicos. Todo lo anterior hace que el diagnóstico se retrase y que el riesgo de secuelas a largo plazo aumente. Sin embargo, el pronóstico mejora cuando el tratamiento se inicia de modo precoz. Por todo ello, presentamos el caso de un paciente de 10 anos con una artritis séptica de cadera derecha por Fusobacterium nucleatum que permaneció ingresado 30 dias. Durante el ingreso precisó 3 intervenciones quirúrgicas y cumplió 6 semanas de antibioterapia efectiva, con buena evolución; permanece asintomático en el momento actual.

Susceptibility patterns of anaerobes isolated from clinical specimens in tertiary Hospital, Malaysia

@# The susceptibility patterns of anaerobes are becoming less predictable due to the emergence of anaerobic resistance trends to antibiotics; hence increasing the importance of the isolation and antimicrobial susceptibility testing of anaerobes. Materials and Methods: This study investigated the isolation of anaerobes from the clinical specimens of Hospital Sungai Buloh, Malaysia, from January 2015 to December 2015. All isolates were identified using the API 20A system (bioMérieux, France). Antimicrobial susceptibility testing was performed using the E-test (bioMérieux, France). Results: The proportion of obligate anaerobes isolated from the clinical specimens was 0.83%. The Gram-positive anaerobes were most susceptible to vancomycin and imipenem, showing 100% sensitivity to these antimicrobials, followed by clindamycin (86.3%), penicillin (76.7%), and metronidazole (48.9%). Meanwhile, Gram-negative anaerobes were most susceptible to metronidazole (96%) followed by imipenem (89%), clindamycin (79%), and ampicillin (32%). The present study also showed that 3 out of 12 Bacteroides fragilis isolates were resistant to imipenem. Conclusion: This study demonstrated the differences in the susceptibility patterns of anaerobes towards commonly used antimicrobials for the treatment of anaerobic infections. In summary, continuous monitoring of antimicrobial resistance trends among anaerobes is needed to ensure the appropriateness of treatment. Keywords:

Identificación de microbiota bucal en caninos en estado de abandono / Identification of Bucal Microbiota in Canines in State of Abandonment

Resumen Objetivo. Describir la microbiota que se encuentra en la cavidad bucal de caninos en condición de abandono de la Fundación Razas Únicas en el municipio de Chía -Cundinamarca. Métodos. Para el estudio se tomaron 29 muestras orales con escobillón a 23 caninos de la Fundación Razas Únicas del municipio de Chía - Cundinamarca. 23 muestras se recolectaron para identificación de bacterias aerobias y anaerobias facultativas, las cuales se transportaron en medio líquido tripticasa soya y 6 muestras para recuperación de bacterias anaerobias estrictas transportadas en medio VMGA-III. El aislamiento de los microorganismos se realizó en medios selectivos y la identificación con el sistema BD BBL™ Crystal™. Resultados. De las 29 muestras analizadas se aislaron 59 bacterias, entre ellas 15 géneros y 15 especies diferentes como; Escherichia coli, Proteus mirabilis, Citrobacter freundii, Enterobacter sakazakii, Enterobacter cloacae, Enterococcus durans, Enterococcus faecalis, Eikenella corrodens, Porphyromonas endodontalis, Fusobacterium spp y Capnocytophaga spp. De acuerdo con la revisión de la literatura, las bacterias anaerobias encontradas están principalmente relacionadas con enfermedad periodontal y las enterobacterias con contaminación oro-fecal.

Abstract Objective. To describe the microbiota found in the oral cavity of canines in condition of abandonment of the Razas Únicas Foundation in the municipality of Chía - Cundinamarca. Methods. For the study, 29 oral samples were taken with a brush from 23 canines from the Razas Únicas Foundation of the municipality of Chía - Cundinamarca. 23 samples were collected for identification of facultative aerobic and anaerobic bacteria, which were transported in soybean tripticase liquid medium and 6 samples for recovery of strict anaerobic bacteria transported in VMGA-III medium. The isolation of the microorganisms was carried out in selective media and identification with the BD BBL™ Crystal™ system. Results. From the 29 samples analyzed, 59 bacteria were isolated, including 15 genera and 15 different species such as Escherichia coli, Proteus mirabilis, Citrobacter freundii, Enterobacter sakazakii, Enterobacter cloacae, Enterococcus durans, Enterococcus faecalis, Eikenella corrodens, Porphyromonas endodontalis, Fusobacterium spp and Capnocytophaga spp. According to the review of the literature, the anaerobic bacteria found are mainly related to periodontal disease and the enterobacteria with oral-fecal contamination.

Study of Anaerobic Bacteria in Dental Abscess in a Tertiary Care Hospital

Majority of anaerobes involved in dental infections are thought to be endogenous in origin. Due to breech of continuity of pulp chamber bacterial colonization occurs. Responsible pathogens are polymicrobial. If left untreated in early stages, it can act as foci of disseminated infections and spread rapidly to adjacent structures leading to life threatening conditions. Aims: The present study was undertaken to identify different anaerobic organisms and their association with risk factors. Methods: 40 pus samples were collected after mouth wash from patients presented with dental abscess. Samples were processed immediately for aerobic and anaerobic culture. After comparing with the aerobic culture, obligate anaerobes were checked for aero tolerance. Subculture done for identification of species by Gram stain, colony morphology and conventional biochemical tests. Final identification was done by Vitek 2 system. Results: 40 (100%) samples were culture positive. Total 60 bacterial isolates recovered from this 40 samples. Out of which aerobes 36 (60%) and anaerobes 24 (40%) isolated. Aerobes present in 18 (45%), anaerobes present in 12 (30%) cases and mixed aerobic and anaerobic flora in 10 (25 %) cases. Predominant isolates were anaerobic cocci, Peptostreptococcus micros (41.6%) followed by Peptostreptococcus anaerobios (25%).Diabetes mellitus, bad chewing habits, poor oral hygiene found as significant risk factors. Conclusion: This study highlights polymicrobial nature of infections and role of anaerobes play as pathogens. Early diagnosis and interventions are extremely important to prevent systemic complications. One should have a high index of suspicion of anaerobes while dealing with dental infections.

Microbiota Evaluation and Extracellular Cytokine Profile in Patients Affected with Intraabdominal Infection.

Failures in the control of infectious focus may be associated with Intra-abdominal infections (IAI)-driven sepsis. We evaluated the bacterial antimicrobial profile and the cytokine production in patients with IAI in Belo Horizonte, Brazil. To the analyses, Vitek 2 bioMérieux and BD-CBA Human Inflammatory Cytokines were used. Escherichia coli, Enterococcus faecalis and Bacteroides fragilis were predominant in this cohort. Enterobacteriaceae was resistant to at least 4 different antimicrobial classes and 80.0% of Acintobacter baumannii strains to imipenem. 81.8% of Staphylococcus spp. were methicillin-resistant. Penicillin and clindamycin resistance were found in 80.0% and 26.7% of anaerobes, respectively. IL-8 was found in all IAI secretions and in 93.5% of analyzed sera; while IL-6 was identified in 93.5% of patient’s serum and in 51.6% analyzed secretions. IL-10 was detected in 53.3% of patient’s serum. Our data indicates the relevance of further cytokine profile studies to better understanding the evolution of these processes.

Evaluation of Pathogenic Potentialities and Transmissibility of Aerobic and Anaerobic Bacteria in Sexually Transmitted Diseases.

Aims: Sexually transmitted diseases (STDs) caused by various aerobic and anaerobic bacteria have been reported from many developed and developing countries of the world. However, there is limited data available on the association of these pathogens with STDs on the Indian sub-continent. Therefore, the aim of this is to the presence of anaerobic and aerobic bacteria in sexually transmitted infections. Study Design: Patients attending the Department of Dermatology, Venereology & Leprology, Calcutta Medical College & Hospital, suspected to be suffering from STDs, were thoroughly examined and those having typical lesions of chancroid were excluded Original Research Article British Journal of Medicine & Medical Research, 4(27): 4533-4541, 2014 4534 from further work. The prevalence of different aerobic and anaerobic bacteria was determined from among the remaining patients after ruling out cases of chancres. Place and Duration of Study: This work was carried out in the Department of Oral Medicine, R. Ahmed Dental College; Department of Dermatalogy, Venereology & Leprology, Calcutta Medical College and Hospital; Division of Microbiology, Department of Pharmaceutical Technology, Jadavpur University and Department of Microbiology, Herbicure Healthcare Bio-Herbal Research Foundation, Kolkata, for a period of seven months from April 1 to October 31, 2012. Methodology: At least two smears were prepared from the infected ulcers of each of the patients who were not diagnosed as of chancroid. One smear was for dark ground microscopy and the other for Gram’s staining. Confirmation of chancre was by serological testing, while aerobes/anaerobes were identified following standard procedures. Results: The organisms isolated were Staphylococcus aureus, Shigella flexneri, Shigella sonnei, Gardenerella vaginalis, Actinomyces spp, Veillonella purvula, Peptococcus heliotrinreducens, Peptostreptococcus magnus and Peptostreptococcus hydrogenalis. These were subjected to tests for their antibiotic sensitivity pattern which was followed by successful specific therapy. Conclusion: Various Gram positive and Gram negative aerobes and anaerobes were found to be associated with STDs and these were transmissible among homosexual and heterosexual partners.

Vertebral osteomyelitis and epidural abscesses caused by Prevotella oralis: a case report

An interesting case of pyogenic vertebral osteomyelitis with multiple epidural abscesses caused by non-pigmented Prevotella oralis is reported. The patient was a 68-year-old female who presented to the emergency room (ER) with severe pain and tenderness in her lower back with fever. She had recently undergone esophagogastroduodensoscopy (EGD) for complaints of esophageal reflux, which showed submucosal cyst in the esophagus. Magnetic resonance imaging (MRI) of the thoracic spine revealed multiple spinal epidural abscesses with signal enhancement at the level of T6 and T7, suggestive of vertebral osteomyelitis. Two blood cultures drawn one hour apart grew Prevotella oralis. The body fluid aspirated from the abscesses was also positive for the anaerobic commensal P. oralis. Necrosis associated with the submucosal cyst was implicated as the cause of sepsis and osteomyelitis due to this organism.

Microbiota associated with chronic osteomyelitis of the jaws

Chronic osteomyelitis of maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of mandible or maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37ºC for 14 and 3 days, respectively. Bacteria were cultivated from twelve patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from sixteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.

Neomycin robertson’s cooked meat medium (N.RCM) for the selective isolation of anaerobes.

As Robertson’s cooked meat medium (RCM) promotes the simultaneous multiplication of facultative anaerobes along with anaerobes, it may be interfered with the isolation rate of anaerobes. In the present study RCM was made selective to overcome this difficulty by the incorporation of Neomycin. The efficacy of modified RCM was evaluated by growing stock cultures of various anaerobes and aerobes well as by inoculating clinical specimen directly and comparing the results with routine RCM. Among the 160 stock cultures of aerobes 8 of the 28 neomycin resistant aerobes grew in N.RCM but none of the 132 neomycin sensitive aerobes. Out of the 150 clinical samples tested in the study,77 anaerobes and 97 aerobes were isolated from routine RCM whereas 89 anaerobes and 8 Neomycin resistant aerobes from NRCM (i.e. NRCM inhibited 91.7% of aerobes and gave an increased yield of 13.5% anaerobes).These findings suggest that NRCM can be employed to suppress the aerobes and at the same time to enhance the isolation of anaerobes.

Chronic osteomyelitis of the maxilla and mandible: microbiological and clinical aspects / Osteomielitis crónica del maxilar y mandíbula: aspectos microbiológicos y clínicos

Osteomyelitis of the mandible and maxilla are common in developing countries and their treatment may belong-standing and difficult. Thus, the aim of this study was to discuss the main biological aspects of the chronic osteomyelitis of the jaws of especial interest for dental team. These infections are associated with a complex microbiota composed mainly by anaerobic bacteria, sometimes associated with microorganisms originated from the skin and digestive tract. These data suggest that chronic osteomyelitis of the mandible and maxilla should be treated as anaerobic infections in most cases. In addition, local surgical treatments are relevant in the therapy outcome, associated to the use of antimicrobial agents, and the failure to accomplish them is a major cause of treatment failure.

La osteomielitis maxilar y mandibular son comunes en países en desarrollo y su tratamiento puede ser difícil y de larga duración. Así, el objetivo del presente estudio fue discutir los principales aspectos biológicos de especial interés odontológico de la osteomielitis crónica del maxilar. Estas infecciones están asociadas a una microbiota compleja compuesta principalmente de bacterias anaerobias, algunas veces asociadas a microorganismos oriundos de la piel y del tracto digestivo. Estos datos sugieren que la osteomielitis crónica maxilar y mandibular deben ser tratadas como infecciones anaerobias en la mayoría de los casos. Además, tratamientos quirúrgicos locales son relevantes en el éxito de la terapia, asociados al uso de agentes anti-microbianos, e cuyos resultados no satisfactorios representan una de las principales causas de un tratamiento fallo o no adecuado.

Effects of hyperbaric oxygen on subgingival obligately,facultatively anaerobes and black pigmented bacteroides in periodontics pocket / 实用口腔医学杂志

Objective: To investigate the effects of hyperbaric oxygen(HB0_2) on black pigmented bacteroides groups(BPB), obligately and facultatively anaerobes of periodontitis. Methods: 60 periodontitis cases were divided into 2 groups. The HB0_2 group(gingival scaling was done at the first visit)was exposed in 0.25 MPa pure oxygen 90 minutes each day, and treated 10 days continuously. The control group received gingival scaling at the first visit. The clinical indices of each group were measured. The microorganisms in periodontal pocket were incubated and analyzed. The number of subgingival anaerobes as well as the number of BPB,obligately and facultatively anaerobes were measured and counted by routine anaerobic culture. Results: Highly significant differences in Gingival Indices (GI), Probing Depth (PD), Attachment Loss (AL), and also significant differences in Plaque Index (PLI),and teeth mobility were seen between the HB0_2 group and the control group. There were significant difference of PLI, GI,PD,AL, teeth mobility in HB0_2 group pre-therapy and post-therapy. There were significant difference of subgingival anaerobes amounts, obligately and facultatively anaerobes sorts between pre-therapy and post-therapy. The positive rate of BPB of group HB0_2 post-therapy were reduced more than that of pre-therapy(P<0.01). Conclusion: HB0_2 has beneficial therapeutic effects on chronic and aggressive periodontitis. The mechanism of the HB0_2 therapy might inhibit the growth of subgingival obligately and facultatively anaerobes and BPB of human periodontitis, especially the obligately anaerobes and BPB in periodontal pockets.

Avaliação da microbiota associada a osteomielite crônica dos maxilares através de meio de cultura e PCR / Evaluation of the microbiota associated with chronic osteomyelitis of the jaws by means of culture and PCR

A osteomielite crônica de maxila e mandíbula é rara em países industrializados e sua ocorrência, nos países em desenvolvimento, está associada a trauma e procedimentos cirúrgicos, sendo que sua etiologia não foi estudada profundamente. O objetivo desse estudo foi avaliar a microbiota associada com a osteomielite de mandíbula e maxila em pacientes brasileiros. Após exames clínicos e radiográficos, amostras de seqüestros ósseos, secreção purulenta e biopsias de tecido granulomatoso de vinte e dois pacientes com osteomielite crônica da mandíbula e maxila foram cultivadas e submetidas à detecção de um conjunto de patógenos através do método do PCR. O isolamento bacteriano foi realizado em ágar “fastidious anaerobe” suplementado com hemina, menadiona e sangue de cavalo, para os microrganismos anaeróbios, e em ágar de tripticaseína de soja suplementado com extrato de levedura e sangue de cavalo, para os aeróbios e anaeróbios facultativos. Cada paciente apresentava uma única lesão. As placas foram incubadas em anaerobiose e aerobiose, a 37oC, por 14 e 3 dias, respectivamente. Bactérias foram cultivadas de 10 amostras de pacientes e os gêneros Actinomyces, Fusobacterium, Parvimonas e Staphylococcus foram os mais freqüentes. Através do PCR, DNA bacteriano foi detectado em amostras de 20 pacientes. Os resultados sugerem que as osteomielites crônicas dos maxilares geralmente são infecções anaeróbias mistas, reforçando o conceito de que estão relacionadas principalmente aos microrganismos do ecossistema bucal e que as infecções periapicais e periodontais podem atuar como fatores predisponentes

Chronic osteomyelitis of the maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of the mandible and maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of the mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37oC during 14 and 3 days, respectively. Bacteria were cultivated from ten patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from thirteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors

Osteomielite crônica dos maxilares: aspectos clínicos, terapêuticos e microbiológicos / Chronic osteomyelitis of the jaws: clinical, therapeutic and microbiological aspects

As osteomielites de maxila e mandíbula são bastante comuns nos países em desenvolvimento, sendo que em alguns casos a microbiota associada a essas condições clínicas se mostra resistente a antimicrobianos, tornando refratário o tratamento dessas infecções, de forma que o resultado desse tratamento é, por vezes, comprometido. Assim, foi objetivo dos autores discutir os principais aspectos microbiológicos das osteomielites crônicas dos maxilares, os quais interferem nos aspectos clínicos e terapêuticos dessas infecções. A análise da literatura bem como a experiência no cultivo e caracterização de microrganismos bucais sugere que as osteomielites crônicas dos maxilares devem ser tratadas como infecções anaeróbias mistas na grande maioria dos casos. Entretanto, quando existir histórico prévio de uso de antimicrobianos, procedimento cirúrgico ou trauma extenso, a possibilidade da participação de microrganismos da pele e da microbiota intestinal e do ambiente deve ser considerada...

The chronic osteomyelitis of maxilla and mandible are quite common in developing countries and, in some patients, the microbiota associated with osteomyelitis is refractory to antimicrobial drugs and the treatment outcome is frequently compromised. Then, the aim of the authors was to discuss the major microbiological aspects of the chronic osteomyelitis of the jaws, which interfere with clinical and therapeutic aspects of these infections. The analysis of the literature as well as the experience in the cultivation and characterization of oral microorganisms suggest that chronic osteomyelitis of the jaws are mixed anaerobic infections in most cases. However, whenever there is a history of previous antimicrobial usage, surgery, extensive trauma, the possibility of participation of microorganisms of skin, intestine and external environment in the pathogenesis must be considered...

Detection of Commonly Encountered Anaerobes:Comparison of Two Types of Anaerobic Blood Culture Bottles / 中华医院感染学杂志

OBJECTIVE To compare the BacT/Alert FN with Botai SN anaerobic blood culture bottles for detection of commonly encountered anaerobes.METHODS Using these two types of anaerobic bottles to culture 5 commonly encountered anaerobes in automatic blood culturing system and BacT/Alert system,and then to analyze the results.RESULTS There were all 32 anaerobic bottles reported positive results by BacT/Alert FN bottles,and only 8 positive bottles were reported by Botai SN bottles.CONCLUSIONS The performance of the BacT/Alert FN is much better than Botai SN anaerobic blood culturing bottle when it is used to detect commonly encountered anaerobes.

Diagnosis of Bacterial Vaginosis in Women in Labour

A prospective study on 120 women in labour was conducted to determine the reliability of of different methods like clinical criteria, gram staining and vaginal culture for diagnosing bacterial vaginosis(BV). To determine the laboratory methods that best predicted the BV we calculated sensitivity, specificity, predictive value of a positive and negative test for clinical criteria, gram stain criteria of Nugent and vaginal cultures compared with gram stain criteria of Spiegel. BV was diagnosed in 23.3% of women in labour by Spiegel criteria. Sensitivity and specificity of Amsel criteria was 60.7% and 97.8% respectively. Culture of vaginal specimens yielded 58.8% predictive value of a positive test except for Mobiluncus species. Gram stain evaluation of vaginal smears is a sensitive method for diagnosing BV. Amsel clinical criteria, which are more commonly used to diagnose BV, may lead to under diagnosis of BV.

In Vitro Activities of Panipenem against Clinical Isolates of Aerobic and Anaerobic Bacteria

BACKGROUND: Panipenem is a carbapenem antimicrobial agent which has been shown to have broad-spectrum activities against various aerobic and anaerobic bacteria. In this study, in vitro activities of panipenem against recent clinical isolates of aerobic and anaerobic bacteria were determined. METHODS: Aerobic and anaerobic bacteria were isolated in 2001 and in 2000-2001, respectively, from a tertiary-care hospital patients. Antimicrobial susceptibility was tested by the NCCLS agar dilution method. RESULTS: MIC90s of panipenem were:similar to those of imipenem for aerobic gram-positive cocci and Enterobacteriaceae; slightly lower than those of meropenem for gram-positive cocci, but slightly higher for Enterobacteriaceae; slightly higher than imipenem for A. baumannii, but similar for anaerobic bacteria. CONCLUSION: MIC90s of panipenem were similar to those of imipenem for aerobic and anaerobic bacterial isolates, which frequently involve respiratory, urinary, intraabdominal and wound infections. When imipenem breakpoints are applied to interpret panipenem susceptibilities, panipenem can be considered useful for the treatment of various infections, including nosocomially acquired ones.

In Vitro Activities of Panipenem against Clinical Isolates of Aerobic and Anaerobic Bacteria

BACKGROUND: Panipenem is a carbapenem antimicrobial agent which has been shown to have broad-spectrum activities against various aerobic and anaerobic bacteria. In this study, in vitro activities of panipenem against recent clinical isolates of aerobic and anaerobic bacteria were determined. METHODS: Aerobic and anaerobic bacteria were isolated in 2001 and in 2000-2001, respectively, from a tertiary-care hospital patients. Antimicrobial susceptibility was tested by the NCCLS agar dilution method. RESULTS: MIC90s of panipenem were:similar to those of imipenem for aerobic gram-positive cocci and Enterobacteriaceae; slightly lower than those of meropenem for gram-positive cocci, but slightly higher for Enterobacteriaceae; slightly higher than imipenem for A. baumannii, but similar for anaerobic bacteria. CONCLUSION: MIC90s of panipenem were similar to those of imipenem for aerobic and anaerobic bacterial isolates, which frequently involve respiratory, urinary, intraabdominal and wound infections. When imipenem breakpoints are applied to interpret panipenem susceptibilities, panipenem can be considered useful for the treatment of various infections, including nosocomially acquired ones.

A comparison of intravenous and rectal metronidazole in acute nonperforated appendicitis

A prosective randomized study was conducted between January 1990 and December 1991 to compare the effectiveness of intravenous metronidazole and rectal metronidazole in acute nonperforated appendicitis. There were 92 patients entered in the study, and 70 were considered evaluable. Each patient was administered either metronidazole 1 gm IV (Group I) or metronidazole 1 gm suppository (Group II). No postoperative metronidazole was given. A standard operative protocol was followed. Follow up was done up to one month after the operation. There was only one postoperative infection that occurred, a wound infection, for an overall incidence of 1.43%. The wound infection occurred in Group II (1/36), with an incidence of 2.78% there were no infection in Group I (0/34). There was no significant difference in infection rate between the two groups. The duration of operation and the pathologic classification of the appendix did not influence the development of postoperative infection. A single dose of metronidazole is effective in reducing the infection rate in acute nonperforated appendicitis. The rectal administration of metronidazole in the form of suppository is as effective as the intravenous route.