Odontogenic bacteria in periodontal disease and resistance patterns to common antibiotics used as treatment and prophylaxis in odontology in Spain.

Resistance in streptococci or Gram-negative bacteria is associated with antibiotic consumption. Scarce information exists on the antibiotic susceptibility of bacterial isolates from patients with periodontitis in countries with high antibiotic consumption, as this is an area in which microbiological testing is not performed in daily practice. The present study was undertaken to explore the susceptibility of bacterial isolates in periodontitis to antibiotics prescribed in odontology in Spain as treatment for local infections or prophylaxis for distant focal infections. Periodontal samples were prospectively collected in 48 patients classified by pocket depth of <4 mm and >or=4 mm. Species were identified by culture, selecting the five most frequent morphotypes per sample, and polymerase chain reaction (PCR). Susceptibility was determined by E-test. A total of 261 isolates were identified: 72.9% patients had Streptococcus oralis; 70.8% Streptococcus mitis; 60.4% Prevotella buccae; 39.6% Prevotella denticola; 37.5% Fusobacterium nucleatum; 35.4% Prevotella intermedia; 25% Capnocytophaga spp.; 23% Veillonella spp.; 22.9% Prevotella melaninogenica and Streptococcus sanguis; and <20% other species. Streptococcus viridans resistance rates were 0% for amoxicillin, approximately 10% for clindamycin, 9-22% for tetracycline, and for azithromycin ranged from 18.2% for S. sanguis to 47.7% for S. mitis. Prevotella isolates were susceptible to amoxicillin-clavulanic acid, with amoxicillin resistance ranging from 17.1% in P. buccae to 26.3% in P. denticola. Metronidazole resistance was <6% in all Prevotella species, while clindamycin resistance ranged from 0 to 21.1%. beta-Lactamase production was positive in 54.1% Prevotella spp., 38.9% F. nucleatum, 30% Capnocytophaga spp., and 10% Veillonella spp. In this study, amoxicillin-clavulanic acid was the most active antibiotic against all species tested, followed by metronidazole in the case of anaerobes.

Odontogenic bacteria in periodontal disease and resistance patterns to common antibiotics used as treatment and prophylaxis in odontology in Spain

La resistencia de los estreptococos o de las bacterias gramnegativas se asocia al consumo antibiótico, pero existe escasa información sobre la sensibilidad de los aislamientos de pacientes con periodontitis en los países con alto consumo de antibióticos, como es España; datos que pueden ser importantes cuando en la práctica diaria no se realizan determinaciones microbiológicas. En este estudio se analiza la sensibilidad de aislamientos de periodontitis a los antibióticos prescritos habitualmente en España en odontología para el tratamiento de infecciones locales o la profilaxis de infecciones a distancia. Se tomaron de forma prospectiva muestras periodontales de 48 pacientes clasificados, según la profundidad de la bolsa, en dos grupos: <4 mm y ≥ 4 mm. La identificación de las especies se realizó por PCR y por cultivo, seleccionando los cinco morfotipos más frecuentes en cada muestra. La sensibilidad antibiótica se determinó por E-test®. Se identificaron 261 cepas. El 72,9% de los pacientes presentaron Streptococcus oralis, el 70,8% Streptococcus mitis, el 60,4% Prevotella buccae, el 39,6% Prevotella denticola, el 37,5% Fusobacterium nucleatum, el 35,4% Prevotella intermedia, el 25% Capnocytophaga spp., el 23% Veillonella spp., el 22,9% Prevotella melaninogenica y Streptococcus sanguis, y <20% otras especies. Las tasas de resistencia de S. viridans fueron 0% a la amoxicilina, ≈10% a la clindamicina y 9% a 22% a la tetraciclina; se halló resistencia a la azitromicina entre el 18,2% de S. sanguis y el 47,7% de S. mitis. Los aislamientos de Prevotella fueron sensibles a la amoxicilina-ácido clavulánico. La resistencia a la amoxicilina osciló entre el 17,1% de P. buccae y el 26,3% de P. denticola. La resistencia al metronidazol fue <6% en las especies de Prevotella, mientras que a la clindamicina osciló entre un 0% y un 21,1%. El 54,1% de Prevotella spp., el 38,9% de F. nucleatum, el 30% de Capnocytophaga spp. y el 10% de Veillonella spp. eran productores de betalactamasas. Amoxicilina-ácido clavulánico fue el antibiótico más activo frente a todas las especies aisladas, seguido del metronidazol en el caso de los anaerobios

Resistance in streptococci or Gram-negative bacteria is associated with antibiotic consumption. Scarce information exists on the antibiotic susceptibility of bacterial isolates from patients with periodontitis in countries with high antibiotic consumption, as this is an area in which microbiological testing is not performed in daily practice. The present study was undertaken to explore the susceptibility of bacterial isolates in periodontitis to antibiotics prescribed in odontology in Spain as treatment for local infections or prophylaxis for distant focal infections. Periodontal samples were prospectively collected in 48 patients classified by pocket depth of <4 mm and ≥ 4 mm. Species were identified by culture, selecting the five most frequent morphotypes per sample, and polymerase chain reaction (PCR). Susceptibility was determined by E-test®. A total of 261 isolates were identified: 72.9% patients had Streptococcus oralis; 70.8% Streptococcus mitis; 60.4% Prevotella buccae; 39.6% Prevotella denticola; 37.5% Fusobacterium nucleatum; 35.4% Prevotella intermedia; 25% Capnocytophaga spp.; 23% Veillonella spp.; 22.9% Prevotella melaninogenica and Streptococcus sanguis; and <20% other species. Streptococcus viridans resistance rates were 0% for amoxicillin, ≈10% for clindamycin, 9-22% for tetracycline, and for azithromycin ranged from 18.2% for S. sanguis to 47.7% for S. mitis. Prevotella isolates were susceptible to amoxicillin-clavulanic acid, with amoxicillin resistance ranging from 17.1% in P. buccae to 26.3% in P. denticola. Metronidazole resistance was <6% in all Prevotella species, while clindamycin resistance ranged from 0 to 21.1%. β-Lactamase production was positive in 54.1% Prevotella spp., 38.9% F. nucleatum, 30% Capnocytophaga spp., and 10% Veillonella spp. In this study, amoxicillin-clavulanic acid was the most active antibiotic against all species tested, followed by metronidazole in the case of anaerobes

Staphylococcus aureus meticilin-resistente en el Hospital Central de la Defensa / Staphylococcus aureus meticillin resistant in the Defence Central Military Hospital

Antecedentes: desde la década de los 60 en que fue descrito el SAMR (Staphylococcus aureus meticilín resistente) ha ocasionado un elevado porcentaje de infecciones nosocomiales, convirtiéndose en un problema sanitario en muchos países europeos, aunque el incruento de la prevalencia en éstos ha sido desigual. Objetivos: conocer la situación epidemiológica respecto al SAMR en nuestro hospital y plantear posibles medidas de control. Material y métodos: se recogen datos del total de aislamientos de S. aureus durante un año en el Hospital Central de la Defensa, y se realiza biotipificación y estudio de sensibilidad. Resultados: se obtienen 209 aislamientos que corresponden a 194 casos, con un 32,5 por ciento de meticilin-resistentes. Además, se expone la distribución por servicios (destacan los servicios de Medicina Interna y de Cirugía Vascular como los de mayor número de SAMR aislados), así como el tipo de muestras y los patrones de resistencia más frecuentes: el patrón de resistencia DEN (oxacilina-eritromicina-norfloxacino) se perfila como el más frecuente y corresponde a un 36,51 por ciento de los SAMR. Conclusión: el potencial riesgo de nuestros pacientes para adquirir una infección nosocomial por SAMR hace recomendable la aplicación y el seguimiento de ciertas medidas preventivas (AU)

Cefminox versus metronidazole plus gentamicin intra-abdominal infections: a prospective randomized controlled clinical trial.

BACKGROUND: The aim of this prospective study was to compare the safety and efficacy of a new cephamycin, cefminox 2 g/12 h, to those of the usual regimen combining metronidazole 500 mg/8 h and gentamicin 80 mg/8 h (M+G). PATIENTS AND METHODS: 160 patients with clinically proven intra-abdominal infection were prospectively included in an open parallel randomized comparative multicenter trial. Antibiotics were started preoperatively and discontinued after clinical and laboratory evidence of resolution of the infection. Serum and peritoneal fluid levels and serum bactericidal activities were also studied. RESULTS: 150 patients were clinically evaluable. There was one failure in the cefminox group and three in the M+G group (not significant, RR: 1.07, 95% CI: 1-1.15). No differences were found in the number of wound infections, length of stay or duration of antibiotic therapy. Adverse effects were reported in 11 cases, all of them mild to moderate. Escherichia coli and Bacteroides fragilis were the most frequently found microorganisms. CONCLUSION: Cefminox is as effective and as safe as M+G in the treatment of intra-abdominal infections.

[Cefminox versus cefotaxime in the treatment of complicated urinary tract infection]. / Cefminox versus cefotaxima en el tratamiento de la infección urinaria complicada.

A comparative study of Cefminox, a new cefamicin, and Cefotaxime was conducted to evaluate the efficacy and safety of the former in the treatment of complicated urinary infection, and to correlate in both cases the bacteriological response with isolates MICs. To this end a phase III, randomized, blind and controlled clinical trial was conducted in 22 patients who met the study's preestablished criteria, 19 of which were evaluable. Both treatments achieved 100% clinical efficacy, while microbiological eradication was accomplished in 90.9% patients treated with Cefminox and 75% patients who received the comparator. Cefminox shows greater in vivo activity than that expected for the MICs, excellent efficacy and safety.

Cefminox: correlation between in-vitro susceptibility and pharmacokinetics and serum bactericidal activity in healthy volunteers.

Plasma concentration of cefminox and serum bactericidal activity against four ATCC strains (Escherichia coli 25992, Klebsiella pneumoniae 13833, Serratia marcescens 8100 and Bacteroides fragilis 25285), were determined over a 24 h period after administration of cefminox 1 and 2 g to six healthy volunteers in a randomized, cross-over, single blind study. The increase observed in the area under the bactericidal curve (AUBC) with the 2 g dose was at least 3.5 times that seen with the 1 g dose for all four test strains and was larger than predicted by the corresponding increase (1.84 times) in the area under the serum concentration versus time curve (AUC); a correlation (r = 0.88, P = 0.0001) between the cefminox concentration and the serum bactericidal titres was, however, observed with all four strains tested. The MBC6h showed a better association with the serum bactericidal titre (P < 0.01) than did the MIC or MBC.