Antibiotic susceptibility of clinical isolates of Listeria monocytogenes.

A broth microdilution method was used to measure the minimal inhibitory concentrations (MICs) of the antibiotics most often recommended for treatment of listeriosis. The MICs of ampicillin, penicillin, erythromycin, and tetracycline for 175 strains of Listeria monocytogenes were below the approximate MIC breakpoint for susceptible strains as recommended by the National Committee on Clinical Laboratory Standards. Inhibition diameters for 125 strains were measured by the standardized disk method (National Committee on Clinical Laboratory Standards) and compared with the appropriate MIC values. By both methods, strains were susceptible to the above four antibiotics, except for three strains, which were intermediate in susceptibility to penicillin by the disk method. Since the minimal bactericidal concentrations for ampicillin and penicillin significantly exceeded the MICs for these antibiotics, 45 strains were evaluated with ampicillin (5 mug/ml) and gentamicin (1 mug/ml) to compare the synergistic bactericidal effect of the two used in combination and singly. An increased kill of 100-fold was observed with the antibiotics combined in 19 strains after 4 to 6 h and in 40 strains after 24 h. A comparison of results with microdilution in Trypticase soy broth and agar dilution in Mueller-Hinton agar revealed that MICs for gentamicin, kanamycin, and streptomycin were strongly influenced by the media used. The MICs were consistently lower in Mueller-Hinton agar.

An unclassified gram-negative rod isolated from the pharynx on Thayer-Martin medium (selective agar).

An oxidase-positive, small gram-negative rod was isolated on Thayer-Martin medium (TM) inoculated with pharyngeal swabs obtained during surveys to detect Neisseria carriers. In one survey, this organism was isolated from 48% of the subjects, and 50 or more colonies were present on the majority of the primary isolation plates. Other characteristics of the organism, which has been given the provisional designation "TM-1," include: delayed production (2 to 10 days) of acid from glucose, formation of gas during nitrate reduction, and the frequent formation of "pits" in the agar surface. On TM, nonpitting colonies of TM-1 are morphologically similar to colonies of Neisseria gonorrhoeae and N. lactamica. Comparison of the characteristics of TM-1 strains with other similar fastidious gram-negative organisms encountered in clinical laboratories indicates that TM-1 is a distinct species. Further studies are required before proper taxonomic placement can be made.

Antibiotic susceptibility patterns of recent isolates of Corynebacterium diphtheriae.

A variety of factors which might affect zone sizes were studied with strains of Corynebacterium diphtheriae; a standard disc method for antimicrobial sensitivity testing was used. Moderate variations in inoculum size, inoculum preparation, and pH of Mueller Hinton agar (MHA) did not appreciably affect zone sizes. The addition of blood to MHA was necessary to insure the growth of all C. diphtheriae strains on all lots of MHA. Zone diameters on MHA with blood were consistently 4 to 9 mm smaller than on plain MHA; however, zone diameters were within the sensitive range for seven antibiotic discs used on both media. Minimal inhibitory concentration (MIC) values for penicillin, erythromycin, and rifampin were determined by a plate dilution method. The geographical source, toxigenicity, and type of the strains showed no significant correlation with MIC values or zone diameters for eight antibiotic discs. When MIC values were compared to obtainable blood levels, all of the strains appeared to be sensitive with MIC values of

Susceptibility of Neisseria meningitidis strains from the civilian population to sulfadiazine, penicillin, and rifampin.

The minimal inhibitory concentration (MIC) values of sulfadiazine, penicillin, and rifampin for meningococcal strains isolated from civilians during 1970 were compared. The strains were isolated from various sources and geographical areas and represented several serogroups. The ranges of MIC values were as follows: 0.05 to 20 mg/100 ml for sulfadiazine, 0.01 to 0.4 mug/ml for penicillin, and 0.01 to 0.8 mug/ml for rifampin. There was no significant relationship between MIC values of sensitive or resistant sulfadiazine strains and the MIC values to the other two antimicrobial agents. Comparisons of sulfadiazine MIC values with inhibition zones around sulfathiazole discs showed excellent correlation, provided the strains were separated into sensitive and resistant groups on the basis of growth at 1 mg/100 ml. Regression curves for penicillin and rifampin sensitivity showed homologous sensitive populations with the strains studied.

Neisseria lactamicus sp. n., a lactose-fermenting species resembling Neisseria meningitidis.

The biochemical and serological characteristics of lactose-utilizing strains of Neisseria were determined. These organisms were found in the nasopharynx of man and grew well on Thayer-Martin Selective Medium. They were compared with N. meningitidis to ascertain whether they were variants of this species. Differences between the lactose-using strains and the recognized species of Neisseria were considered significant enough to warrant designation of a new species, Neisseria lactamicus. This group has not been widely recognized as being separate from N. meningitidis; therefore, the normal incidence and clinical significance of these organisms has not been fully established. These organisms are oxidase-positive and positive for beta-D-galactosidase activity; they demonstrate fermentation in King Oxidation-Fermentation Medium; and they produce acid from only glucose, lactose, and maltose, of the 27 substrates incorporated in Cystine Trypticase Agar. Individual strains vary in their ability to grow on Nutrient Agar at both 25 and 37 C and in their pigmentation on Loeffler Medium. Results indicated that these organisms are serologically distinct from the N. meningitidis serogroups. Only 34 of 116 strains of N. lactamicus were smooth and could be tested by slide agglutination. None of the 34 could be grouped as N. meningitidis group A, B, C, D, X, Y, or Z. Thirty-one of these strains could, however, be specifically grouped with antisera prepared with N. lactamicus strains. Cross absorptions confirmed that N. lactamicus is serologically distinguishable from N. meningitidis.

Tissue culture method for toxigenicity testing of Corynebacterium diphtheriae.

A method for toxigenicity testing of Corynebacterium diphtheriae in tissue cultures was developed. Results were obtained by comparing destruction of the monkey kidney or, preferably, rabbit kidney monolayer by 0.1 ml of the C. diphtheriae culture in Elek's broth containing 20% rabbit serum with the appearance after the addition of 0.2 ml of a mixture of the C. diphtheriae culture and diphtheria antitoxin. The mixture of C. diphtheriae broth culture and 10 antitoxin units per ml was incubated for 1 hr at room temperature before it was added to the tissue cultures which were then incubated as long as 5 days; most results, however, were read in 72 hr. Elek's broth medium was superior to heart infusion broth for toxin production by C. diphtheriae. Addition of 20% rabbit serum improved toxin production in either broth. Numerous toxigenic and atoxigenic C. diphtheriae cultures were tested for toxigenicity in primary rabbit and monkey kidney tissue cultures. If properly controlled, this in vitro method appeared to have an advantage over the in vitro agar gel method; its results were comparable with the rabbit intradermal test. With the wider use of tissue cultures in most laboratories, we believe that the tissue culture method for toxigenicity would be more economical and easier to perform than the animal intradermal method.

Serological studies of ungroupable Neisseria meningitidis.

Verification that Slaterus' Neisseria meningitidis serotypes X, Y, and Z are groups distinct from each other and from groups A, B, C, and D was made by use of the tube agglutination test on absorbed and unabsorbed antisera. A significant number of meningococcal strains in this country, which could not be classified serologically with standard antisera prepared to Branham's neotype A, B, C, and D strains, were grouped specifically with antisera prepared to the Slaterus types. The strains grouped as X, Y, and Z were from various geographical areas of the United States and were isolated from both carriers and cases. Over a 2-year period, the cultures tested ranged in predominance in descending order as follows: group B, C, Y, X, Z, A, and D. It is recommended that Slaterus' types should be considered as standard groups and follow in alphabetical order with the standard A, B, C, and D groups; i.e., X would be designated as group E, Y as group F, and Z as group G. It was observed that false-grouping cross-reactions could be greatly reduced by reconstituting the lyophilized grouping antisera in 50% glycerol-water. Of 99 cultures which could not be specifically grouped with antisera reconstituted in distilled water, 19 were specifically grouped with antisera reconstituted in 50% glycerol-water.