Evaluation of the ATB 32 A system for identification of anaerobic bacteria isolated from clinical specimens.

A new miniaturized 4-h method for the identification of anaerobic bacteria, ATB 32 A (API System SA, Montalieu Vercieu, France), was evaluated against conventional methods of identification. The evaluation was done by using 260 recent clinical isolates and 21 reference strains of anaerobic bacteria. All reference strains were correctly identified and did not figure in the detailed analysis. Of the 140 gram-negative bacilli, 90.6% of Bacteroides spp. and 95.5% of Fusobacterium spp. were correctly identified to the species level, with an additional 8.4% of the Bacteroides spp. being identified to the genus level. Clostridia were correctly identified in 85.9% of cases, with an additional 9.9% being identified to the genus level. Peptostreptococci were correctly identified in 91.6% of cases. The 4 strains of Actinomyces spp. were all identified correctly, as were 10 of the 11 strains of Propionibacterium spp. A total of 3.1% of strains were not identified by ATB 32 A, while for 1.9% of strains, completely false identifications were obtained. Estimation of the individual preformed enzyme results may pose problems, although these decrease with familiarity with the system. With certain enzyme profiles, additional testing was necessary to arrive at an identification; however, there was no requirement for gas-liquid chromatography. If certain additions are made to the data base and the difficulties of determination of organisms to the species level among the non-Bacteroides fragilis (sensu stricto) members of the B. fragilis group can be reduced, this system holds promise as a reliable standardized alternative for the identification of anaerobic bacteria in clinical laboratories.

[Septicemia caused by Branhamella (Neisseria) catarrhalis in an immunosuppressed patient]. / Septicémie à Branhamella (Neisseria) catarrhalis chez une patiente immuno-déprimée.

A case is reported of Branhamella catarrhalis septicemia occurring during the aplastic phase of treatment for acute myeloblastic leukemia. Skin lesions were observed which are ordinarily seen in chronic gonococcal or meningococcal septicemia. The pathogenic role of this agent, which is normally considered nonaggressive, is discussed.

Erosive group G streptococcal arthritis. Case report and review of the literature.

A case of Group G streptococcal arthritis in a previously healthy man is reported. The 2nd and 3rd metatarso-phalangeal joints of the left foot were simultaneously affected. Unusual erosive joint destruction occurred in spite of early therapy and clinical improvement. Circulating immune complexes were raised and were not completely normal at 1 year.

[Campylobacter fetus bacteremia]. / Bactériémies à Campylobacter fetus.

Five cases of Campylobacter fetus bacteremia are reported. This germ, found in blood cultures, induces high fever and is accompanied by either gastroenteritis with colitis or thrombophlebitis. Other, but much rarer septic sites are the meninges and endocardium. Patients already debilitated by chronic disease are more susceptible to bacteremia with Campylobacter fetus, which worsens the prognosis of the infection. Although non-debilitated patients can contract this infection, the prognosis here is more favourable. Antibiotic treatment is indicated in all cases. Campylobacter fetus bacteremias are rare and their pathogenesis still little understood. This "microaerophil" germ does not survive in air which makes culturing difficult under ordinary conditions. On the other hand, Campylobacter jejuni induces gastrocolitis with spontaneous recovery. It is found in feces and thrives in contaminated water and milk.

[In vitro activity of a new cephalosporin--cefoperazone--against Enterobacteriaceae and Pseudomonas aeruginosa]. / In vitro-Aktivität eines neuen Cephalosporins--Cefoperazon--gegen Enterobacteriaceae und Pseudomonas aeruginosa.

431 recent clinical isolates from the families Enterobacteriaceae and Pseudomonadaceae drawn from the western part of Switzerland have been tested for Cefoperazone sensitivity. With 6 exceptions, all strains were susceptible or highly sensitive to the antibiotic. Striking was the excellent activity of cefoperazone against Pseudomonas aeruginosa, Serratia marcescens and indol-positive Proteus species, in contrast that of most of the already established cephalosporins.

[A dosage regimen for epicillin in renal impairment (author's transl)]. / Ein Dosierugsschema für Epicillin bei eingeschränkter Nierenfunktion.

After oral administration of 1 g 6-[D-2-amino-2-(cyclohexa 1,4-dien-1-yl)-acetamido]-penicillanic acid (epicillin Spectacillin capsules, 500 mg) in patients with renal impairment the elimination rate constant was calculated by means of the declining serum levels. There is good correlation (r = 0.83) between the elimination rate constant and the creatinine clearance. With this data it was possible to calculate the reduced loading and maintenance dose for a certain creatinine clearance and a certain dosage interval to avoid accumulation. The values could also be read from nomograms without calculation. For comparison the possibility to extend the dosage interval corresponding to the elimination rate constant in renal impairment is confronted.

[Smallpox vaccination--Waterhouse-Friderichsen syndrome (author's transl)]. / Waterhouse-Friderichsen-Syndrom nach Pockenschutzimpfung.

A fatal acute meningococcal sepsis (Waterhouse-Friderchsen syndrome) appearing 25 days after smallpox vaccination (re-vaccination) on military service is reported. In order to assume a causal connection between the vaccination reaction and the acute infectious complication on atypically long "unspecific negative phase" after the vaccination is postulated. The morphological findings at the vaccination pustule, which shows the same changes as a first vaccination, also support a pathological post-vaccinal course. In consideration of these observations, revaccination after 20 years is apparently a risk.

Streptococcus pneumoniae isolates relatively insensitive to penicillin G recovered from patients in Switzerland.

The sensitivity to penicillin G of pneumococci isolated in Switzerland has been determined by the quantitative tube dilution method. 3 out of 100 strains were relatively insensitive to this antibiotic (minimum inhibitory concentration greater than 0.1 microgram/ml), thus confirming observations already made in other countries. These results underline the necessity of routinely testing the sensitivity of pneumococci to penicillin G.

[The isolation of enteritis causing Salmonellae from the sputum]. / Uber den Nachweis von Enteritis-Salmonellen in Sputum

In the light of the author's diagnostic experience, attention is drawn to the fact that enteritis Salmonellae appear to be more frequently present in sputum than in generally supposed. The diagnostic and epidemiologic implications of this observation are discussed.