Shelf life of case-ready beef steaks (Semitendinosus muscle) stored in oxygen-depleted master bag system with oxygen scavengers and CO2/N2 modified atmosphere packaging.

This study aims to evaluate the stability of beef from Semitendinosus muscle packaged in oxygen permeable wrapped-tray units and stored in a master bag system, with and without oxygen scavengers. Changes in the atmosphere composition, microbiological indexes, myoglobin forms and color parameters were monitored during the storage in master bag, blooming and display life. The presence of scavengers reduced rapidly the oxygen concentration and maintained it at values not detectable instrumentally. Within few days of storage in master bags, the resolution of the transient discoloration was completed and the meat quality was maintained over the anoxic storage. After the removal from master bags meat bloomed completely reaching OxyMb level and Chroma values higher than those on fresh meat at t(0). During 48 h of display life at 4 °C, quality attributes had a decay slower than samples stored traditionally in air. Without scavengers the oxygen caused the irreversible discoloration within 7 days, due to the formation of metmyoglobin on the surface.

[Correlation between radiologic and ultrasonographic patterns and clinical manifestations in symptomatic hip osteoarthritis]. / Correlazione tra quadro clinico e patterns radiologici ed ecografici in pazienti affetti da artrosi sintomatica dell'anca.

Increasing amounts of data have recently been published regarding ultrasonographic (US) findings of osteoarthritic joints, but very few data concern hip joints. In the current study we described US patterns concerning 490 patients affected by symptomatic hip osteoarthritis (OA) who underwent to intra-articular injections of hyaluronic products under US guidance. All patients were studied by US and X-ray of hip, clinical evaluation was assessed by the followings indexes: Lequesne, pain VAS, ICED, Global Physician Assessment and Global Patient Assessment. US findings were summarized in four main patterns, effusion and synovial proliferation were also detected. The aim of this study was to correlate US findings with clinical assessment and radiographic findings (according to Kellgren-Lawrence classification). Pearson's r correlation coefficient were computed and come out significant and positive between X ray and US patterns and between clinical indexes and US patterns. Also the correlation between K-L score and US patterns showed a significant positive correlation indicating that higher K-L scores are associated with increasing abnormal US findings. Our data suggest that ultrasonography of the hip may give useful information about the state of synovial membrane, synovial fluid, joint margins and bone profile in hip OA. Further studies are needed to evaluate their prevalence in hip OA symptomatic and not-symptomatic patients and their correlation to treatment outcome.

Ticarcillin/clavulanic acid: determination of minimal inhibitory concentrations against bacterial strains isolated from patients in intensive care units. Comparison with other agents.

A total of 303 bacterial strains isolated from bronchoaspirates of Intensive Care Unit (ICU) patients, collected through June and December 1993, were tested for susceptibility to ticarcillin/clavulanic acid, imipenem, amikacin, ceftazidime, ciprofloxacin and piperacillin. The minimal inhibitory concentration (MIC) for each antibiotic was determined according to the NCCLS, by means of serial dilution on microplates. The isolates, 80.8% of which were beta-lactamase producing strains, belonged to Pseudomonas aeruginosa (79 strains), Pseudomonas fluorescens (8 strains), Xanthomonas maltophila (25 strains), Escherichia coli (16 strains), Klebsiella-Enterobacter-Serratia (KES) (62 strains), Proteus spp. (15 strains), Acinetobacter spp. (22 strains), Moraxella spp. (15 strains), Bacteroides catarrhalis (8 strains), Haemophilus spp. (11 strains), Staphylococcus aureus (32 strains), Enterococcus faecalis (10 strains). The highest rate of susceptibility to ticarcillin/clavulanic acid (100%) was detected among E. faecalis (MIC 2-16 micrograms/ml), B. catarrhalis (MIC 1-4 micrograms/ml) and Haemophilus spp. (MIC 1-4 micrograms/ml). Among the non-fermenting microorganisms ticarcillin/-clavulanic acid showed good activity toward P. aeruginosa and P. fluorescens (86% and 75% respectively). It was also very active against X. maltophilia with a susceptibility of 96%. Susceptibility to the other antibiotics tested was within the range of 16% and 28%.

Singular case of tardive anastomotic disjunction in a Dacron R vascular graft.

We investigated a case of anastomotic disjunction of the termino-lateral insertion of a bifurcate aortic graft in the right external iliac artery. The graft in woven Dacron R n. 19, was implanted in 1977 and the left femoral insertion became infected shortly after surgery. The infection was treated according to standard procedures with removal of the infected branch, reconstruction with the transobturatory by-pass and antibiotics. For antibiotic treatment of local and general sepsis the approach was completely new as regards dose regimen and duration. In 1993 a pseudoaneurysm developed through weakening of the right iliac anastomosis. In view of the anamnesis we were surprised to find that the origin was of a mechanical nature.

[Importance of Staphylococcus epidermidis in the bacterial colonization of abdominal drains in surgical patients]. / Rilevanza dello Staphylococcus epidermidis nella colonizzazione batterica dei drenaggi addominali in pazienti chirurgici.

Bacterial adherence to biomaterials as an element of clinical relevance is a well-known factor in the pathogenesis of sepsis. Drainages, intravascular catheters, surgical prostheses and other devices are susceptible to bacterial colonization with clinical consequences. In the last few years attention has been paid to coagulase-negative Staphylococcus (S. epidermidis), mainly to some strains able to produce a highly adhesive polysaccharide substance, called glycocalix or slime. This promotes adherence either interbacterial either between bacteria and biologic tissues or synthetic materials acting as a pathogenetic factor in sepsis being able to increase bacterial resistance to phagocytes and antibiotics. Bacterial contamination of 40 abdominal drainage tubes in patients operated in elective and in emergency surgery for various pathology has been evaluated. Sonication of the tip of the drainage was utilized in order to promote the detachment of adherent colonies and its effectiveness was compared to that of microcentrifugation. Culture of 25 drainages (62.5%) showed no bacterial contamination; 7 drainages (17.5%) have proved to be colonized by S. epidermidis, in 4 cases the isolated strains were also methicillin-resistant, 2 of which slime-producing. Out of the 7 drainages colonized by S. epidermidis, 4 were removed from patients operated in emergency: none of the isolated strains was slime-producing. Six drainages (15%) were colonized by Gram+ bacteria (S. fecalis, P-sensible cocci, rods), 1 (2.5%) by E. coli and 1 (2.5%) by P. aeruginosa, S. epidermidis appears to be the chief contaminant of abdominal drainages, especially in emergency surgery; slime production has always been observed in methicillin-resistant strains: this confirms the hypothesis that slime production is typical of specialized, virulent strains.(ABSTRACT TRUNCATED AT 250 WORDS)

Ciprofloxacin for infection prophylaxis in granulocytopenic patients with acute leukemia.

Forty consecutive neutropenic patients with acute leukemia receiving oral ciprofloxacin (500 mg twice daily) and ketoconazole (200 mg daily) for selective intestinal decontamination were compared retrospectively with 33 comparable patients treated with polymyxin E (1,500,000 U x 3/day) and nystatin (1,000,000 U x 3/day). The incidence of febrile episodes was slightly lower in ciprofloxacin treated patients (87.5% vs 100%). No gram-negative sepsis was observed in this group compared with seven cases in patients receiving polymyxin E (p less than 0.01). Furthermore, eight patients in ciprofloxacin group (20%) had gram-positive sepsis, compared with five (15.5%) in the polymyxin E group. The incidence of documented fungal infections was similar in the two groups. Ciprofloxacin appears to be an effective agent for the prevention of gram-negative infections in granulocytopenic patients with acute leukemia, but may contribute to a shift in the type of infections in these patients towards those caused by gram-positive microorganisms, intrinsically fairly sensitive or with acquired drug resistance.

[Enoxacin in the treatment of bacterial prostato-cystitis]. / L'enoxacina nel trattamento delle prostatovescicoliti batteriche.

Thirty-three patients suffering from acute, subacute or chronic prostatovesiculitis were admitted to an open, non comparative trial. Enoxacin was administered at the daily dosage of 400 mg every 12 hours for 10 days starting from the enrollment. A second cycle of treatment was performed if cure was not obtained with the first cycle. Treatment efficacy was established by assessing patient symptoms related to the infection, such as pollakiuria and dysuria, consistency and volume of prostate and spermatic vesicles (evaluated by rectal examination and transrectal ultra-sonography); bacterioscopical and bacteriological evaluations of prostate/vesicles secretion with sensitivity testing were also carried out. All observations were collected at baseline, 5 and 30 days after the end of the first cycle and 5 days after the end of the 2nd cycle of treatment. After the first cycle of treatment, cure was obtained in 22 subjects (67%) and clinical improvement in 24 (73%). All but one patients still infected at the end of the first treatment period, showed improvement (5; 45.5%) or cure (6; 54.5%). The end of the second cycle None of the 22 patients cured with one cycle of treatment relapsed within 30 days after the end of treatment, confirming they really achieved cure. Side effects were observed only in 1 case (mild vertigo); no drop outs were observed. These results suggest that enoxacin may be successfully used in the treatment of prostato-vesiculitis.

Acetohydroxamate in struvite stones: in vivo study.

This report describes the results obtained with a combination of acetohydroxamic acid (AHA) and antibacterial agents in 13 patients with recurrent struvite stones complicated by refractory infections with urease-producing bacteria. Intravenous antibiotic pulses plus oral AHA achieved urine sterilisation in all. Then oral chemotherapy plus AHA was given for a mean period of 10.8 +/- 5.4 months. In four patients, the urine remained sterile, but in all the patients urinary pH remained below 6.4 and urinary NH4+ below 40 mg/dl. Despite the persistence of urea-splitting bacteria, the radiographic data showed an arrest of stone growth during the first year of treatment.

[Evaluation of a screening method for the rapid detection of bacteriuria]. / Valutazione di un apparato per lo screening rapido delle batteriurie.

A screening method for the rapid detection of bacteriuria through a combination of filtration and staining has been evaluated. 307 urine samples have been tested with both the regular colony enumeration on culture media and the rapid method. Taking 10(5) CFU/ml as a cut-off, the agreement was reached for 279 (90.9%) samples, 65 (21.2%) of which positive and 214 (69.7%) negative. Only 4 (1.3%) false negative and 24 (7.8%) false positive were obtained; false positive (whose real significance is further discussed) anyhow can be corrected after cultural confirmation. If the cut-off is lowered to 10(4) CFU/ml the frequency of agreements is slightly less (88.6%). From the operational side, the method is unsensitive to the antimicrobial content of the urines, and appears easy to apply and quite rapid: a sample needs not longer than 2 minutes to be processed.

[Isolation and serotyping of Streptococcus pneumoniae]. / Isolamento e sierotipizzazione di Str. pneumoniae.

87 strains of Str. pneumoniae were typed by serology and a chemoantibiotic resistance assay was made. Among them, the most frequent serological types are 4, 6, 7, 19, 33. None of these has shown a marked chemoantibiotic resistance and no prevalent resistance has been related to a particular specimen.

[Comparison of manual agar-diffusion (Bauer) technique and "Abac" semiautomatic device for the determination of "in vitro" bacterial sensitivity to antibiotics (author's transl)]. / Confronto tra metodo di diffusione in agar e apparecchio semiautomatico "ABAC" per la determinazione della sinsibilita' batterica al chemioantibiotici.

A comparison of antibiotic in vitro sensitivity tests performed on 115 freshly isolated Gram-negative bacterial strains with the manual standardized agar-diffusion technique according to Bauer and with the semiautomatic Abac (Intertechnique) device showed univocal results 85.5% of times, being Abac sensitivity 85.6% and specificity 86.2%. The frequency of univocal results is higher that in most of the previous trials, especially for ampicillin and cephalotin. No particular responses have been shown by the dirrerent microorganisms tested. After a discussion of the variables which can influence the results and the suggestion of some steps to be taken, the AA. analyze the role of Abac and its possible achievements in small and medium-size bacteriological laboratories.