[Microbiological study of patients with enterocutaneous fistulae treated with long-term total parenteral nutrition]. / Mikrobiologické sledování nemocných s enterokutánními pístelemi lécených dlouhodobou úplnou parenterální výzivou.

The authors followed up 12 patients with dehiscences of surgical wounds and postoperative enterocutaneous fistulas treated by on a long-term basis by complete parenteral nutrition. Previous operations were performed on account of different non-tumorous (11/12) and tumourous (1/12) diseases of the gastrointestinal tract. Microbiological examinations were made in every patient on admission and during total parenteral nutrition, always once a week for a total period of 2-8 weeks (mean 4.4; median 4.5). The authors examined aerobic and facultatively anaerobic bacteria in smears from the fistulas, stomies, dehiscent surgical wounds and from the rectum. The findings did not confirm the suspicion of local nosocomial infection. Strikingly often bacteria producing indole were found (in 8/12 examined subjects) and/or bacteria with positive urease (12/12) and lecithinase activity (9/12 patients). In the detected strains of Pseudomonas aeruginosa (in 8/12 examined patients) lecithinase activity was confirmed in all. It cannot be ruled out that the above described enzymatic bacterial activities may have contributed to the failure of conservative therapy in the majority of patients (10/12).

Lecithinase activity of Proteus vulgaris.

Lecithinase production is described as a new biochemical property of P. vulgaris strains grown in a selective agar medium containing brilliant green, crystal violet and lecithin (BCL agar), the authors' own modification of egg-yolk culture medium. By using this BCL agar as a medium inhibiting the swarming growth of P. vulgaris cultures the authors succeeded in identifying 12 lecithinase-positive strains among the P. vulgaris isolates obtained from patients with Crohn's disease. Of 50 P. mirabilis strains tested in parallel none gave the positive test for lecithinase production in this medium.

Enterobacter sakazakii: a tween 80 esterase-positive representative of the genus Enterobacter isolated from powdered milk specimens.

Enterobacter sakazakii is the new species name introduced in 1977 for yellow-pigmented strains originally designated as yellow Enterobacter cloacae. All of the six E.sakazakii strains isolated from powdered milk specimens were found to produce Tween 80 esterase after 7 days of incubation at 25 degrees C and 37 degrees C. From E.cloacae it is distinguishable by reactions in four, or even three, biochemical tests, i.e. by production of yellow pigment, positive production of Tween 80 esterase and by non-fermentation of sorbite and mucate; from the Serratia species it can be differentiated by the negative test for lecithinase production.

Tween-esterase activity in Enterobacter sakazakii.

Seventy-one of 73 E. sakazakii strains isolated in Czechoslovakia produced Tween 80 esterase; its production was slower and less intensive than in Serratia, vibrios and aeromonads. The E. sakazakii strains did not produce lecithinase (yolk reaction was negative for 8 days). The following set of tests was recommended for verification of E. sakazakii identification: pigment (was produced by 100% of strains), Tween 80 esterase (was positive in 97.3%), mucate (negative in 100%) and sorbitol (negative in 100%).