ABSTRACT
The presence of antibodies was determined in the serum and cerebrospinal fluid in six patients with neurobrucellosis using the Rose Bengal test, the microdilution agglutination test, and the Coombs' test. Four of the patients were followed up for more than three months. The Rose Bengal test and the microagglutination test were positive in cerebrospinal fluid in five of the six cases at some stage. The Coombs' test was positive in cerebrospinal fluid in every patient and in one was the only positive serological test. Cerebrospinal fluid positivity is not excluded by low titres or negative results of antibodies in the serum for any of the three methods. A Coombs' test or some equivalent must always be made on the cerebrospinal fluid to diagnose neurobrucellosis.
Subject(s)
Antibodies, Bacterial/cerebrospinal fluid , Brucellosis/diagnosis , Central Nervous System Diseases/diagnosis , Adolescent , Adult , Agglutination Tests , Antibodies, Bacterial/analysis , Brucellosis/blood , Brucellosis/cerebrospinal fluid , Coombs Test , Female , Humans , Male , Middle Aged , Rose Bengal , Time FactorsABSTRACT
The first evidence is presented for the presence of inducible macrolides-lincosamides-streptogramin B resistance in Bacteroides species. Different macrolides induced clindamycin resistance in Bacteroides vulgatus RYC18F6, an erythromycin-resistant and clindamycin-susceptible strain. A study of 144 Bacteroides isolates indicated that erythromycin resistance was linked to diminished clindamycin susceptibility.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteroides/drug effects , Clindamycin/pharmacology , Erythromycin/pharmacology , Macrolides , Virginiamycin/pharmacology , Bacteroides/genetics , Drug Resistance, Microbial , Gene Expression Regulation/drug effects , Lincosamides , Microbial Sensitivity Tests , Species SpecificityABSTRACT
A study was made of trends in the susceptibility rates to clindamycin of 338 clinical strains of the Bacteroides fragilis group isolated in the period 1980-83. In 1980, the resistance rate of the species Bact. fragilis to 4 mg/l was only 3.3%, but this percentage increased regularly in 1981 (6.2%), 1982 (15.5%) and reached 19.6% in 1983. Resistance rates in other species of the group (Bact. distasonis, Bact. vulgatus, Bact. thetaiotaomicron) were already high in 1980 and no relevant increase has been documented since then. In order to asses the relationship between clindamycin resistance and hospitalization or macrolides-lincosamides consumption, 184 faecal strains of the Bact. fragilis group isolated from non-treated in-patients, out-patients and healthy volunteers were studied for clindamycin resistance. An unexpectedly high rate of resistance (around 25%) was found in all groups. Resistant strains appeared heterogeneous with regard to phagetype. For unknown reasons, clindamycin resistance seems to be widespread among intestinal Bacteroides strains of the human population, at least in our region.
