Sensitivity of the causative agent of tularemia to antibiotics

Sensitivity of the tularemia causative agent of different geographical races to antibiotics such as streptomycin, tetracycline, gentamicin, rifampicin (20 strains), ampicillin, polymyxin M, erythromycin, oleandomycin (361 strains) and lincomycin (294 strains) was studied. High sensitivity of the tularemi a microbe to streptomycin, tetracycline, rifampicin (MIC of 10 gamma/ml), gentamicin (MIC of 1 gamma/ml) and resistance to 50 gamma of ampicillin and 1000 gamma/ml of polymyxin M were found. Combined use of 50 gamma of ampicillin and 100 gamma/ml of polymyxin M added to the nutrient medium for growth inhibition of the foreign flora on isolation of the tularemia causative agent from the infected material including stable laboratory animal carcases was recommended. Marked differences in sensitivity of the strains of different geographical races to the macrolides and lincomycin were observed. The strains of the non-Arctic and Central Asiatic races were of low resistance to the above drugs (the MIC of erythromycin, oleandomycin and lincomycin were 10--50, 50--400 and 25--100 gamma/ml respectively. Within the holarctic race 40 per cent were low resistant and 60 per cent were highly resistant to these drugs. The above drugs should not be used for treatment of tularemia cases.     

Dynamics of drug resistance of Vibrio cholerae isolated from surface water reservoirs in Siberia and the Soviet Far East in 1976-1990]

In the study on antibiotic resistance 1383 strains of El Tor Vibrio cholerae isolated from surface water reservoirs in 12 administrative territories of the Siberia and Far East within a period of 15 years were tested. The following antibiotics were used: ampicillin, streptomycin, monomycin, polymyxin, tetracycline, chloramphenicol, rifampicin and nalidixic acid. The resistance was unstable and its pattern was wave-like according to annual changes in the biological cycle. It was especially evident in regard to ampicillin, streptomycin, monomycin and polymyxin. The highest numbers of the strains were resistant to polymyxin, ampicillin and streptomycin (up to 100 per cent in some years). The lowest numbers of the strains were resistant to chloramphenicol (0.4 per cent) and tetracycline (1.9 per cent). No strains resistant to rifampicin and nalidixic acid were isolated. In some cases the antibiotic resistance level depended on the geographical zone where the strain was isolated. A direct quantitative dependence of the resistance level on the MIC was observed: the lower the MIC of the drug was, the lower the number of the strains resistant to it was. Within the 15-year period there was no general tendency to increase the resistance in V. cholerae to the antibiotics used.     

Drug resistance of the causative agent of Grigo'rev-Shiga dysentery (Shigella dysenteriae 1)isolated in the USSR

Forty strains of S. dysenteriae 1 isolated in the USSR within 1986-1988 were tested for their resistance to 11 antibacterial drugs. It was shown that 92.5-97.5 per cent of the isolates were resistant to chloramphenicol (Cm) and tetracycline (Tc), 22.5 per cent to streptomycin (Sm), 17.5 per cent to nalidixic acid (Nal) and 10 per cent to ampicillin (Ap) and polymyxin (Pm). Resistance to Cm Tc (51.4 per cent) and Cm Tc Nal (13.5 per cent) represented the predominating phenotype. 35 per cent of the strains carried conjugative R plasmids. In the majority of the cases, the determinants of resistance to Cm and Tc were transferred, which must define the high frequency of the strains resistant to Cm and Tc. All the tested strains were sensitive to gentamicin, neomycin, rifampicin, cefamezin and ciprofloxacin. Since the strains of S. dysenteriae 1 proved to be highly sensitive to the tested drugs it appeared possible to consider them as the drugs of choice in etiotropic therapy of patients with dysentery caused by the pathogens of the Grigoryev-Shiga group.     

Antibiotic sensitivity and the characteristics of transmissive R plasmids in Shigella belonging to various species]

Sensitivity of 241 Shigella strains isolated from patients at various regions of the USSR in 1975--1978 was tested with respect to 14 antibiotics by the method of serial dilutions. 90.5 per cent of the isolates proved to be resistant to the antibacterial drugs and the greater part of 75.9 per cent of them had multiple resistance. The resistance of the Shigella was most pronounced and frequent with respect to tetracycline, streptomycin, levomycetin, as well as ampicillin and carbenicillin. Gentamicin, cephaloridin, polymyxin M, kanamycin, monomycin, neomycin and rifampicin were highly active against the Shigella. More than 50 per cent of the isolates were sensitive to levomycetin, ampicillin and carbenicillin. Differences in the frequency of the resistant strains and the spectrum of the antibiotic resistance of different Shigella subgroups (species) were observed. The study of 173 multiple resistant Shigella strains showed that about 67 per cent of the strains had a capacity for transduction of the resistance markers into the recipient cells of E. coli. The conjugative R-plasmids were most frequent in Sh. boydii and Sh. sonnei (95 and 95 per cent respectively), less frequent in Sh. flexneri and Sh. newcastle (68 and 53 per cent respectively) and least frequent in the mannitol negative Shigella (25 per cent). The capacity for transduction of R-plasmids in the strains carrying the determinants of resistance to 2 or 3 antibiotics was higher than in the strains carrying the determinant of resistance to one antibiotic. The clinical Shigella strains tested mainly had transmissive R-plasmids of fi--character (79 per cent).     

Antibiotics in the treatment of wounds in the victims of the earthquake in the Armenian SSR

Purulent wounds in 88 victims of the Armenian earthquake with the syndrome of long-term squeezing were examined microbiologically and the experience with using antimicrobial drugs for their treatment was analyzed. In all the cases microbial associations were detected, coliform and nonfermenting gram-negative bacilli, enterococci, anaerobes and yeast-like fungi being isolated from 80, 20, 15 and 25 per cent of the patients respectively. 130 bacterial strains were studied in detail. 80 to 100 per cent of the bacterial isolates were resistant to the antibiotics routinely used in surgical practice, i.e. benzylpenicillin, tetracycline, levomycetin, kanamycin, cephalothin and cefazolin and highly sensitive to new antimicrobial drugs belonging to ureidopenicillins (mezlocillin), quinolones (ciprofloxacin) and cephalosporins of the 3rd generation (cefoperazone and ceftazidime). Retrospective estimation of the antibiotic therapy revealed its inadequacy in 55.7 per cent of the patients for the most part because of the isolates resistance. The 19 variants of the antibiotic use prescribed by the physicians mainly included penicillins, aminoglycosides and their combinations (in 67.2 per cent of the cases). The use of the highly efficient drugs of the groups of ureidopenicillins and quinolones was extremely rare which was likely due to lacking of information on the drugs.     

Antibiotic resistance of Pseudomonas aeruginosa strains isolated from patients with infected burns

Sensitivity to 15 drugs of 248 P. aeruginosa strains isolated from patients with infected burns was studied by the method of agar dilution. All of the strains were resistant to polymyxin M, ceporin, erythromycin and oleandomycin. Most of the strains were resistant to streptomycin, monomycin, ampicillin and rifadin. Moderate resistance of the strains to carbenicillin, morphocycline, vibramycin, kanamycin, tetraolean and tetracycline was observed: the maximum concentrations of these antibiotics (128 microgram/ml) inhibited the growth of 85, 69, 63, 51.8, 43.6 and 41.2 per cent of the strains respectively. Gentamicin proved to be most active against the strains of P. aeruginosa and inhibited 87 per cent of the strains when used in the therapeutic doses. The study provided recomendation of the drugs for parenteral and local use in treatment of burns infected with P. aeruginosa.     

Drug resistance of opportunistic enterobacteria isolated from various sources]

Resistance of 159 strains of opportunistic enterobacteria to 9 antibacterial drugs was studied. The strains were isolated from man and cattle. It was shown that the overwhelming majority of the isolates (93 per cent) were polyresistant irrespective of the genus. There was a high frequency of the strains resistant to the widely used antibiotics such as chloramphenicol (73 per cent), ampicillin (73.6 per cent) and rifampicin (95.6 per cent) and sulfanilamides (99.3 per cent). Gentamicin and nalidixic acid proved to be the most active against the cultures: 11.9 and 10 per cent of the resistant strains, respectively. The strains of enterobacteria isolated from different sources had a sensitivity to the antibiotics. Multiple antibiotic resistance to at least 5 drugs, variability of the spectra and high resistance were more characteristic of the isolates from the animals. The necessity of a rational use of antibacterial drugs in veterinary is indicated.     

Antibiotic sensitivity of nonfermenting gram-negative bacteria

Antibiotic resistance of 132 strains of nonfermenting gram-negative bacteria (NGNB) was studied. 43, 20, 17, 14 and 12 of them belonged to Acinetobacter calcoaceticus (anitratus and lwoffi), Pseudomonas cepacia, Alcaligenes faecalis, P. stutzeri and P. maltophilia, respectively. With rare exceptions all the strains were resistant to benzylpenicillin, oxacillin, lincomycin, ampicillin and cephaloridine. Sensitivity to the other antibiotics varied within wide ranges. Amikacin (94.3 per cent) and tobramycin (90.8 per cent), as well as polymyxin, rifampicin and gentamicin (71.7-66.9 per cent) had the highest effect. The majority of the antibiotics had higher activity (p less than 0.01) against the tested NGNB as compared to their activity against P. aeruginosa. Antibioticograms of every of the tested species of NGNB revealed that P. cepacia and P. stutzeri were the most resistant species. The biovars of Acinetobacter varied in their antibiotic resistance: A. subsp. lwoffi was more sensitive to the majority of the antibiotics though some of them, i.e. doxycycline, carbenicillin, and polymyxin were more active against A. subsp. anitratus.     

Detoxifying effect of antibiotics and their effectiveness in experimental plague at the stage of explicit intoxication]

The effect of antibiotics such as amikacin, rifampicin, doxycycline, polymyxin B and cefotaxime on the toxins of the plague microbe (lipopolysaccharide + fraction II according to Beiker) was studied in vitro and in vivo. The study on the antibiotic neutralization of plague toxins revealed that only polymyxin had toxin neutralizing capacity which depended on the dose. Investigation of the polymyxin effect at various stages of plague infection showed that when polymyxin in a dose of 1250 units and a mixture of plague toxins in lethal doses were administered simultaneously to albino mice, the positive effect amounted to 100 per cent. When the antibiotic was administered 30 or 60 minutes later, the antibiotic efficacy proved to be lower by 90 or 76.6 per cent, respectively. The intoxication in later periods (in 90-120 minutes) resulted in a decrease in animal survival up to 40-15 per cent. It was demonstrated on the model of the plague infection in albino mice that the use of amikacin, cefotaxime, rifampicin or doxycycline during polymyxin therapy at the stage of marked generalization of the infection provided a significant increase in the animal survival (60 to 80 per cent) as compared to that after the use of the same drugs alone (0 to 20 per cent).     

Sensitivity of Corynebacterium diphtheriae isolated in Saint-Petersburg to antibacterial drugs]

One hundred and thirty strains of Corynebacterium diphtheriae isolated in St. Petersburg (42 toxigenic and 88 nontoxigenic) were tested with the method of serial dilutions in solid media for their susceptibility to 20 antibacterial drugs. The MICs of the drugs for the isolates ranged from < or = 0.015 to > or = 32.0 micrograms/ml. 13 per cent of the isolates was resistant at least to one antibacterial drug. The isolates resistant to erythromycin (11.5 per cent), lincomycin (11.5 per cent) and trimethoprim (8.5 per cent) were most frequent. 3 isolates (2.3 per cent) had multiple resistance to 8 drugs: benzylpenicillin, ampicillin, oxacillin, chloramphenicol, erythromycin, lincomycin, trimethoprim, and nitroxolin. No significant differences in the susceptibility of the toxigenic and nontoxigenic strains of C. diphtheriae were detected. Gentamicin, rifampicin, tetracycline, doxycycline and pefloxacin were the most active antibiotics.     

Antibiotic sensitivity of Vibrio cholerae 01 isolated from environmental objects]

The sensitivity of 252 Vibrio cholerae-O1 strains isolated from environmental objects to antibiotics of various groups was assayed by the method of serial dilutions on solid media. The biological characteristics of the isolates are presented. The Vibrio cholerae isolates with serological variation were the most frequent (36.6 per cent), so are the cultures detected by their sensitivity to the specific phages (87.5 per cent). It was found that changes in some biological properties of the strains did not coincide with the changes in the antibiotic sensitivity. The isolates were highly sensitive to tetracycline, chloramphenicol, gentamicin, erythromycin and rifampicin and less sensitive to novobiocin and the other aminoglycosides. The sensitivity to the beta-lactams was the lowest. The resistance determinants were detected in single strains (6.3 per cent), the kanamycin and novobiocin resistance determinants being detected in 15 out of the 16 strains tested. The study showed that the cultures of Vibrio cholerae-O1 isolated from the environmental objects generally preserved their sensitivity to the diverse group antibiotics.     

Antibiotic sensitivity and pathogenetic factors of hospital strains of Pseudomonas aeruginosa isolated from patients treated in a resuscitation unit]

Strains of Pseudomonas aeruginosa were isolated from patients treated in the Centre of Thermal Affections in 1985-1989. It was shown that 72.9, 59.3, 33.8 and 54.2 per cent of the isolates were sensitive to cefotaxime, tobramycin, gentamicin and polymyxin, respectively. The study of pathogenicity factors of the isolates revealed that 83 per cent of the strains produced thermolabile enterotoxin, 79.6 per cent of the strains had adhesive activity and 71.1 per cent of the strains produced hemolysin. The study detected combinations of various pathogenicity factors. 42.3 per cent of the isolates had both adhesive and enterotoxigenic properties. Adhesiveness and hemolytic activity were shown by 13.5 per cent of the strains. 16.9 per cent of the strains produced both enterotoxin and hemolysin. Adhesive activity, enterotoxigenicity and hemolysin production were observed in 6.7 per cent of the strains. It was noted that the strains of P. aeruginosa resistant to polymyxin mainly produced enterotoxin (18.6 per cent) and those resistant to cefotaxime had adhesive activity (34.0 per cent).     

Level and nature of the drug resistance of Shigella flexneri]

Characteristics of antibiotic resistance of 300 strains of Shigella flexner 2a isolated from patients within 1976--1977 in the regions where these bacteria were very rare for a long period of time were studied. It was shown that most of the isolates were resistant to chloramphenicol (88.1 per cent), tetracycline (94.8 per cent), streptomycin (89.1 per cent), polymyxin M (82.4 per cent) and others. 46.5--61.6 per cent of the isolates were resistant to neomycin antibiotics. A high level of the resistance was also noted: the bactericidal effect was registered in 52.0-74.0 per cent of the cultures at a dose of 500--1000 microgram/ml. 91.4 per cent of the strains possessed multiple dug resistance, 78.8 per cent of them being simultaneously resistant to 4--7 drugs. Transmissive R-plasmids were found in 68.8 per cent of the isolates. After exposure to acridine dyes the plasmid nature of the resistance was confirmed in 72.3 per cent of the cultures. Variability of the r-determinant sets in r-plasmids was noted. Strains (64.9 per cent) carrying r-determinants Tc, Cm, Sm and Tc, Cm were more frequent. Strains with one transmissive r-determinant were usually solitary.     

血培养中病原菌的分布及其耐药状况分析

目的:了解血培养中病原菌的菌群分布及其耐药状况.方法:血培养标本用Bact/Alert-120自动血液分析系统和Vitek60鉴定仪进行血培养及鉴定,药敏用K-B法,用Whonet 5软件进行分析.结果:在3 680份血培养标本中分离出细菌348株,阳性检出率为9.4%,病原菌中以革兰阴性杆菌为主共分离出189株,占54.3%,其中主要为大肠埃希菌占15.5%,肺炎克雷伯菌占12.4%;革兰阳性菌138株,占39.7%,主要为凝固酶阴性葡萄球菌占14.9%,金黄色葡萄球菌占12.1%;链球菌占6.6%.血培养中的革兰阴性杆菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦治疗较为敏感:革兰阳性球菌对万古霉素和替考拉宁较为敏感.结论:肠杆菌科细菌和葡萄球菌是血培养中的主要病原菌,而产ESBLs菌株、MRSA、MRCNS耐药严重,提示应高度重视合理使用抗生素,减少细菌耐药性产生,以提高临床治疗效果.     

Isolation of Peptostreptococcus heliotrinreducens from human polymicrobial abscesses

Five strains of Peptostreptococcus heliotrinreducens were identified out of 256 strains of Gram-positive anaerobic cocci from human sources. They could be distinguished from similar organisms, notably P. micros , by their preformed enzyme profile, colonial morphology and sensitivity to novobiocin and neomycin. They were isolated from polymicrobial abscesses in which other anaerobes, particularly Bacteroides spp., were present.     

Treatment of staphylococcal pneumonias

Sensitivity of 129 strains of pathogenic staphylococci isolated from patients with pneumonia was studied with respect to a large number of drugs in the Bacteriological Laboratory of Konstantiny in the Algerian People's Democratic Republic. The method of paper discs and the Müller-Hinton solid nutrient medium were used. The staphylococcal strains were highly sensitive to cephalosporins, some of aminoglycosides (neomycin, gentamicin, tobramycin), nitrofurans, rifampicin, some antibiotics of other groups. Minocycline proved to be the most active among the tetracycline antibiotics. The number of the strains sensitive to it amounted to 82 per cent. 74--76 per cent of the isolates were resistant to tetracycline and oxytetracycline. 40--77 per cent of the isolates were resistant to sulfanilamides.     

Resistance of Shigella to antibiotics

Antibiotic sensitivity of 104 Shigella clinical strains and 104 Escherichia coli strains isolated from patients with acute dysentery not treated with antibiotics in 1986-1987 was studied. It was shown that 100 per cent of the dysentery pathogens and colon bacilli were antibiotic resistant. Strains resistant simultaneously to chloramphenicol, ampicillin, streptomycin, tetracycline, monomycin and kanamycin were the most frequent among the dysentery pathogens. Colon bacilli and dysentery pathogens isolated from the same patient had specific sets of antibiotic resistance markers. Pathogenetic therapy of dysentery and exclusion of antibiotic use for several years did not result in lower numbers of Shigella antibiotic resistant strains.     

Response to antibiotics of Proteus strains isolated from different types of clinical material

The data on the study of the antibiotic response to 42 Proteus strains isolated from different sources in the hospitals of Kharkov are presented. The isolates belonged to P. mirabilis and P. vulgaris. Many strains were resistant to gentamicin, ampicillin and carbenicillin irrespective of the isolation source. 58.0 and 90.3 per cent of the strains isolated from patients with intestinal infections, 66.6 and 100 per cent of the strains isolated from patients with otitis, 33.3 and 66.6 per cent of the strains isolated from patients with bronchopulmonary affections and 100 and 100 per cent of the strains isolated from patients with urological diseases were resistant to gentamicin and carbenicillin, respectively. As for ampicillin, the respective figures were 74.2, 66.6, 66.6 and 100 per cent. All the strains of P. vulgaris isolated from patients with otitis, urological diseases and bronchopulmonary affections were resistant to ampicillin. The MIC of carbenicillin for all the strains except 4 indole-positive strains of P. vulgaris isolated from the faeces and bronchial excreta was much higher than the borderline values.     

Empirical antibiotic therapy of wounds complicated by anaerobic non-clostridial infection

Antibacterial activity of 14 drugs against clinical strains of asporogenic anaerobes causing wound infections in the soft tissues i. e. Bacteroides fragilis and Bacteroides melaninogenicus as well as anaerobic gram-positive++ cocci was assayed with the method of serial dilutions in agar. It was shown that among the investigated species B. fragilis had the most marked resistance since out of the 14 drugs only 8 were sufficiently active against it i.e. carbenicillin, levomycetin, lincomycin, dioxidine, metronidazole, thinidazole, nitrazole and erythromycin. The choice of drugs for treating infections caused by B. melaninogenicus and anaerobic grampositive cocci unlike those caused by B. fragilis offered no difficulty since practically++ all the investigated drugs were highly active against the causative agents. There was observed relationship between the frequency of asporogenic anaerobes and the wound genesis. The characteristic features of the species composition connected with localization of the suppurative foci were indicated. The detected specific antimicrobial profiles of the asporogenic anaerobes causing wound infections and the peculiarity of their participation in development of purulent infections of the soft tissues provided a differential approach to empirical antibacterial therapy prior to the pathogen bacteriological investigation and availability of the antibioticograms.     

Antibiotic resistance and its transmissibility in strains of opportunistic enterobacteria

Sensitivity of 39 opportunistic Enterobacteria strains was studied with respect to tetracycline, kanamycin, ampicillin, levomycetin, streptomycin and nevigramon. The strains were isolated from children with acute intestinal infections of obscure etiology. 38 isolates were resistant to one or more drugs. The highest number of the strains was resistant to kanamycin, ampicillin and levomycetin, i.e. 81.5, 84.2 and 84.2 per cent of the cultures respectively. Nevigramon proved to be the most effective in vitro (76.4 per cent of the sensitive strains). The ability of the strains to transfer the antibiotic resistance markers on conjugation was tested. Transmission of R plasmids was shown in 75 per cent of the isolates.