Sensitivity to penicillin of S. pneumoniae strains isolated from various pathological conditions.

297 S. pneumoniae strains isolated from patients with different pneumococcal infections during 1990-1991 were tested for the sensitivity to antibiotics--by the diffusimetric method to 9 antibiotics (Penicillin (6 micrograms), Ampicillin (10 micrograms), Erythromycin (15 micrograms), Oxacyllin (5 micrograms), Streptomycin (50 micrograms), Tetracycline (50 micrograms), Chloramphenicol (50 micrograms), Rifampicin (6 micrograms), and Kanamycin (30 micrograms) and by MIC determination to Penicillin and Erythromycin. 30% of S. pneumoniae strains were resistant to Penicillin and Erythromycin corresponding to a MIC > or = 1 UP/ml or > or = 1 microgram E/ml. The most active antibiotics were Chloramphenicol and Rifampicin and the less active: Tetracycline, Kanamycin and Streptomycin. A relation between the origin and serotype of the strains and the sensitivity to antibiotics was revealed. The strains from the throat, conjunctive and otic secretions and belonging to serotypes 19, 6 and 14 showed the highest levels of resistance to all antibiotics. A good correlation between MIC and diffusion method results was observed to Erythromycin and no correlation to Penicillin. In this last case the results of MIC determination to Penicillin were better correlated with the results of inhibitions diameters to Oxacyllin, method which have to be recommended.

Diagnosis methods for pneumococcal etiology determination in lower respiratory tract infections.

A comparative study of etiological diagnosis in lower respiratory tract infections (LRTI), by conventional bacteriological methods and by pneumococcal antigen direct detection in sputum was performed. This work followed the establishing of rapid methods place, respectively of coagglutination (CoA), counterimmunoelectrophoresis (CIE), within the methodology of bacteriological diagnosis in lower respiratory tract infections presenting pneumococcal etiology. The results of investigations performed on 84 sputa from LRTI patients proved the utility of CoA method in determining a rapid etiological diagnosis, important for applying an emergence targetted antibiotherapy. CoA method, with the reagents in use, covering only 10 out of 83 serological types of S. pneumoniae in not capable of replacing conventional methods of bacteriological diagnosis; they complete each other, increasing the efficiency of etiological diagnosis in LRTI. CIE method is less sensitive and more difficult to perform, being less useful in rapid etiological diagnosis of LRTI.

Diagnosis of pneumococcal meningitis by coagglutination method.

It was tested the possibility to evidence the pneumococcal capsular antigen, by coagglutination, directly in CSF, using a specific coagglutinating reagent for all the 10 serological types of S. pneumoniae more frequently encountered in our country. Were investigated 134 CSF from purulent meningitis, out of which 37 were of probable pneumococcal etiology, on the basis of bacterioscopic examination, 26 of other etiology and 71 of unknown etiology. The results obtained showed 28 (75.7%) positive reactions in the fluids from probably pneumococcal meningitides on the basis of the positive bacterioscopic examination. The specificity of the reactions is demonstrated by the negative reactions with the fluids from meningitides of other etiology, as well as by the concordance between the antigen serotype from the liquid and that of the isolated S. pneumoniae strain. For a good test sensitivity could argue the positive reactions obtained with 6 CSF from meningitides of unknown etiology.

[Results of the use, for a period of 3 years (1974-1977), in pilot districts, of the complex program of measures for prevention of streptococcal infections and their complications]. / Rezultatele aplicarii timp de 3 ani (1974--1977) în statiile pilot a programului complex de masuri pentru prevenirea infectiilor streptococice si a complicatiilor lor.

Starting with the year 1974 a total 11 pilot units have been organized, in as many counties in which a complex program of surveillance of streptococcal infections was applied, that had the following objectives: 1. Prevention and fight against acute streptococcal infection ; 2. Prevention of severe complications of acute rheumatic fever of rheumatic carditis and acute glomerulonephritis ; 3. Prevention of relapses of acute rheumatic fever. The establishment and verification of methods for clinical and laboratory diagnosis was followed, as well as of therapeutic techniques and dispensarization. The analysis of results obtained after the application for a period of 3 years of the program in high-risk collectivities, and in the conditions of an intensive circulation of some epidemic strains of streptococcus has shown the decrease each year of the incidence of scarlet fever, the increased efficiency of detection of acute non-eruptive (non-rash) streptococcal infections, as well as a significant decrease in the number of cases that developed a first attack of acute rheumatic fever and acute glomerulonephritis. A significant decrease was also obtained in the number of relapses and of severe evolution of rheumatic carditis, due to active detection, continuous evidence, prophylaxis and periodic control of cases with acute rheumatic fever.