[Ecology of pathogenic bacteria in the infected urine].

Ecological behaviors of uropathogenic bacteria in the infected urine were characterized, and they were compared to those in vitro cultivation. The organisms directly collected from the infected urine revealed no piliation, but when they were isolated and cultured in heart infusion broth (HIB), the pili appeared. The pili were identified as Type I pili as examined by immunogold electron microscopy. Although the organisms directly collected from the infected urine did not have pili and did not agglutinate against anti-Type I pili anti-serum, the whole cell lysate analysis by western blotting revealed that the organisms express Type I pili antigen intracellularly. The organisms in some cases revealed a capsule formation in the urine, but it disappeared when cultured in vitro. Hemolytic Escherichia coli were isolated from 9 cases out of 20 with acute cystitis, however, hemolysin was not detected from the infected urine and the organisms. When they were cultured in HIB, all strains produced the hemolysin. The composition of outer membrane proteins (OMPs) of the organisms in the infected urine was clearly different from those in vitro cultivation. As the most prominent finding, a 70 kDa OMP of the organisms in the infected urine disappeared in vitro. Antibacterial activities of several drugs examined in healthy human urine and in HIB were variable from drug to drug. The mean value of minimum inhibitory concentration (MIC) of ofloxasin was 25 times higher in the urine than in HIB, whereas the MIC of erythromycin was almost equal in both conditions.

[Clinical evaluation of cefpodoxime in respiratory tract infections].

Cefpodoxime (CPDX-PR) was evaluated clinically in respiratory tract infections. The results obtained are summarized as follows; 1. The total number of the patients who were treated with CPDX-PR was 61, out of whom 53 cases were evaluated for clinical efficacy and 55 cases were investigated for the safety of the drug. CPDX-PR was given orally twice a day at 100-200 mg for 5-21 days. 2. Clinical efficacies were excellent in 9 patients, good in 36, fair in 4 and poor in 4. The overall clinical efficacy was 84.9%. In particular, CPDX-PR showed satisfactory efficacy for acute respiratory infections and mild chronic respiratory infections, with efficacy rates of 88.6% (31/35) and 100% (8/8), respectively. 3. No adverse reactions was observed, but slight and transient elevation of BUN was noted. In conclusion, it has been confirmed that CPDX-PR is an excellent and safe drug for the treatment of the respiratory tract infections.

[A case report of meningitis and sepsis due to Enterococcus faecium complicated with strongyloidiasis].

A 80 year-old male was transferred to our department on 18th Aug. 1988, for high fever and clouding of the consciousness. He had been treated with steroid hormone (betamethasone 3.0 mg/day for 15 days) for his uveitis. Enterococcus faecium was isolated from both blood and spinal fluid, and then Strongyloides sterocoralis was revealed both in the sputum and stool. Anti-Human T-cell leukemia virus 1 (HTLV-1) antibody was also positive serologically. At first, beta-lactam antibiotics were used for the treatment of purulent meningitis and sepsis, but after performing sensitivity tests for E. faecium, the antibiotics were changed to rifampicin (RFP), fosfomycin (FOM) and ofloxacin (OFLX) for their excellent activity against the organism. After the clinical symptoms, subsided, thiabendazole was used for disseminated strongyloidiasis in daily doses of 2,500 mg for six days initially. The drug was used three times with two week intervals. Both bacterial and parasite infections subsided and no recurrence has been noticed until now. This is the first case of meningitis caused by E. facium complicated with strongyloidiasis.