In Vitro Susceptibility of Neisseria gonorrhoeae to Nine Antimicrobial Agents

The in vitro action of nine antibiotics was tested by the agar streak method against 45 gonococcal strains isolated from penicillin-therapy failures. The penicillin susceptibility range of these strains was 0.003 to 1.32 μg/ml, and the tetracycline susceptibility range was 0.125 to 2.0 μg/ml. Minimal inhibitory concentrations of minocycline and doxycycline paralleled the activity of tetracycline and ranged from 0.125 to 1.0 μg/ml and 0.125 to 2.0 μg/ml, respectively. Rifampicin, with a narrow range of 0.5 to 1.0 μg/ml, inhibited 75% of the strains at 0.5 μg/ml. The range for cephaloridine and cephaloglycine was 0.5 to 20.0 μg/ml, but another cephalosporium derivative, cephalexin, exhibited greater activity in its range of 0.25 to 20.0 μg/ml. A semisynthetic penicillin, carbenicillin, with a range of 0.025 to 0.75 μg/ml, displayed more activity against the lower susceptible penicillin G gonococcal strains.     

Susceptibility of Neisseria gonorrhoeae to seven antibiotics in vitro

One hundred consecutive isolates of N. gonorrhoeae were tested for susceptibility to penicillin, ampicillin, tetracycline, erythromycin, kanamycin, cephaloridine and cephalexin by an agar dilution method. Relative resistance to penicillin was frequent. For 39% of isolates the minimum inhibitory concentration (MIC) of penicillin was 0.05 U./ml. or less; in 55% the MIC was 0.5 to 2.0 U./ml. Ampicillin was slightly more active than penicillin G: all isolates were inhibited by 0.5μg./ml. or less. Resistance to tetracycline and erythromycin was frequent with MIC of 1 μg./ml. or greater observed in 32 and 24% of isolates respectively. The MIC of kanamycin for all gonococci was 8 μg./ml. or greater. Cephalexin was slightly more active than cephaloridine, though each drug exhibited a wide range of MIC values. Gonococcus isolates resistant to penicillin (MIC of 1.0 U./ml. or greater) tended to be resistant to the other antibiotics tested.     

In Vitro Studies of α-Carboxyl-3-Thienylmethyl Penicillin,a New Semisynthetic Penicillin

The activity of a new semisynthetic penicillin, α-carboxyl-3-thienylmethyl penicillin (BRL-2288) was determined against 535 clinical isolates of gram-negative bacilli, by using the tube dilution technique. Nearly 80% of isolates of Proteus spp. were inhibited by 3.12 μg or less of this antibiotic per ml. BRL-2288 was as active as ampicillin against Escherichia coli. It was slightly more active than carbenicillin or 6-(d-α-sulfoaminophenylacetamido)-penicillanic acid against Pseudomonas sp., with over half of the isolates being inhibited by 50 μg or less of BRL-2288 per ml. Isolates of Klebsiella sp. were routinely resistant to this antibiotic. The drug was bactericidal against most sensitive organisms. BRL-2288 was less active against large inocula. A strain of Pseudomonas sp. which developed resistance to carbenicillin also developed resistance to BRL-2288 simultaneously.     

Antibiotic sensitivities of Neisseria gonorrhoeae in the Toronto area

The antibiotic sensitivity pattern of 3872 isolates of N. gonorrhoeae tested in Toronto from 1969 to 1973 is reviewed. An increase in resistance to both penicillin and tetracycline was noted up to 1971, but no further increase has occurred since then. Ninety-seven percent of 135 patients with “sensitive” strains (inhibited by 0.3 U/ml of penicillin and/or 0.5 μg/ml of tetracycline) were cured by either 8 g of tetracycline or 5,000,000 U of penicillin, whereas only 59% of 58 patients with “resistant” strains (requiring 1.0 U/ml of penicillin and/or 2.0 μg/ml of tetracycline for inhibition) were cured by the same dosage. Spectinomycin appears to be an acceptable alternative therapy. Maximum doses of the chosen drug are recommended in the hope of retarding further spread of more resistant organisms.     

Action of Lincomycin on Staphylococci

On a solid medium, 0.1 to 1 μg/ml of lincomycin hydrochloride had a bacteriostatic effect upon 95 of 100 strains of staphylococci. Using cellophane transfers, we observed a bactericidal effect upon 54 of these strains after 3 to 14 hr of contact with 1 μg/ml. Five staphylococcal strains resistant to 100 μg/ml of lincomycin were also resistant to penicillin G, streptomycin, erythromycin, tetracycline, chloramphenicol (three strains), and rovamycin (three strains). Other staphylococcal strains resistant to methicillin, ampicillin, tetracycline, streptomycin, chloramphenicol, and erythromycin were sensitive to lincomycin.     

Comparative In Vitro Activities of Lysostaphin and Other Antistaphylococcal Antibiotics on Clinical Isolates of Staphylococcus aureus

The in vitro activity of lysostaphin against clinical isolates of Staphylococcus aureus was determined by conventional tube-dilution methods. For comparison, minimal inhibitory concentration (MIC) values were also determined for penicillin G, ampicillin, methicillin, ristocetin, vancomycin, and erythromycin. Phage type and penicillinase and coagulase production were determined for each isolate. The MIC values for lysostaphin ranged from <0.047 to 12.5 μg/ml; 96% of the penicillinase-positive strains were inhibited by 1.56 μg/ml of lysostaphin, whereas 3.12 μg/ml of vancomycin and methicillin were required to attain the same degree of inhibition.     

Ampicillin-Resistant Hemophilus influenzae: Emergence in California's Central Valley

Ampicillin-resistant Hemophilus influenzae had not been identified in Fresno, California, before June 1976. In the 12 months that followed, eight resistant type B strains and three resistant nontypable isolates were cultured from patients treated at two hospitals that provide nearly all of the acute pediatric inpatient care for the area. Two of the resistant strains were obtained from patients with invasive infections and represented 4.2 percent of Hemophilus influenzae isolated from blood, cerebrospinal fluid or joint aspirates during the 12 months. The remaining six resistant type B strains were obtained from 117 patients, and were the predominant organism in cultures of other sites, primarily respiratory secretions.In two of three patients infected with nontypable organisms, resistance appeared to emerge during therapy with ampicillin. Measurement of β lactamase was a practical and accurate method for differentiating between ampicillin-sensitive and resistant strains. All ten of the β lactamase-positive isolates tested had minimal inhibitory concentrations (MIC) for ampicillin of 15 μg per ml, or less. In contrast 30 β lactamase-negative strains had MIC''s of 1.5 μg per ml, or less, of ampicillin. Our results indicate that ampicillin resistance has become a significant problem in the Central Valley of California and probably the entire state.     

Resistance of Pseudomonas aeruginosa to gentamicin

The resistance to gentamicin 4 μg./ml. of 250 Pseudomonas aeruginosa isolates was measured by a proportion method. Twenty-eight (11.2%) of the cultures fell into the most resistant group, in whose populations between 10 and 100% of the organisms were resistant. A relatively high percentage of urinary isolates and a comparatively low percentage of isolates from respiratory sources occurred in this group. Three of the 28 were resistant to carbenicillin 150 μg./ml. and 6 of 18 tested were as resistant to gentamicin 8 μg./ml. as they were to 4 μg./ml. The distribution of Ps. aeruginosa isolates between the different grades of resistance did not change significantly during the 10 months in which the survey was performed.     

Long-term antibiotic susceptibility pattern of strains of Neisseria gonorrhoeae isolated in Czechoslovakia in the years 1957-1982

Over the past 25 years a total of 7492 strains of Neisseria gonorrhoeae have been isolated in Czechoslovakia, mainly in Prague (64%). All these strains have been tested for susceptibility to the following antibiotics: penicillin G, ampicillin, tetracycline, spectinomycin, erythromycin, doxycycline, kanamycin, rifampin, chloramphenicol, gentamicin, cephalothin, cephaloridine, lincomycin and clindamycin. In addition, seven derivatives of newer antibiotics of penicillin and cephalosporin series were tested in 1981. The study showed that in 1957 the MIC of 0.03 units of penicillin per ml was effective against 95% of strains, but in 1981 only 37% of isolates were sensitive to this concentration. The first gonococcal strains with the MIC value of 4.0 units/ml to penicillin were detected in 1981. This tendency towards decreased gonococcal susceptibility to benzylpenicillin is alarming. Over the last eight years there have been described sporadic isolations of strains relatively resistant to tetracycline (MIC = 8.0 mg/l). The susceptibility to spectinomycin has been tested in over 4000 gonococcal strains, since 1967. The test showed that this antibiotic remained highly effective against the gonococcal infection with over 95% of gonococci with the MIC value of 16.0 mg/l. No fully spectinomycin resistant strains have been found. Penicillin G as well as spectinomycin and cefotaxim are still considered the antibiotics of the first choice in the treatment of gonorrhoea. The alternative antibiotics may include cefuroxim, chloramphenicol and, in cases of sensitive strains, tetracyclines.     

Comparison of amoxicillin and ampicillin in single-dose oral treatment of males with gonococcal urethritis

Amoxicillin in single oral doses of 2.0 g, 2.0 g plus 1.0 g probenecid, or 3.0 g was compared with ampicillin 3.5 g plus 1.0 g probenecid in the treatment of 203 males with uncomplicated acute gonococcal urethritis. Cure rates above 95% were produced by all treatments except the 2.0-g amoxicillin dose, which cured 89% of patients. Of 198 pretreatment gonococcus isolates tested by an agar dilution technique for susceptibility to penicillin G, ampicillin and amoxicillin, over 50% showed relative resistance (MIC > 0.06 μg/ml) to the antibiotics. However, amoxicillin was somewhat more active against isolates showing considerable resistance (MIC ≥ 1.0 μg/ml) to penicillin G or ampicillin. Adverse effects of amoxicillin were few: two patients reported transient nausea and six noted short-lived diarrhea. No hypersensitivity reactions were observed.     

Method for Establishing a Bacterial Inoculum on Corn Roots

Few bacteria from the corn rhizosphere grew in media with 50 μg of mancozeb per ml. A mancozeb-resistant Pseudomonas strain from the rhizosphere was serially subcultured in media containing mancozeb and spectinomycin until it was resistant to 175 μg of mancozeb and 850 μg of spectinomycin per ml. The population of the pseudomonad added to soil fell to low numbers in 6 days in unamended or glucose-amended soil, but its numbers exceeded 10⁵/g for at least 12 days if the soil was supplemented with mancozeb. The numbers of this organism remained small on corn roots derived from untreated, inoculated seeds, but the population was two or more orders of magnitude greater on roots derived from mancozeb-coated seeds. The abundance of the inoculum strain on the 3-cm portion of roots nearest the stem declined markedly after about 1 week, but applying urea to the foliage reduced or prevented the decline. The numbers of the pseudomonad on segments of roots 3- to 6- and 6- to 9-cm from the stem were higher on plants derived from the mancozeb-coated seeds. Applying spectinomycin to the foliage did not promote growth of the bacterium. This method is proposed as a means to establish an introduced bacterium on plant roots.     

II. In vitro studies of antibacterial activity

One hundred and forty isolates of beta-hemolytic streptococcus cultured from patients with clinical pharyngitis were studied by disc diffusion for antibiotic sensitivity to lincomycin, erythromycin, cephalexin and penicillin and by agar dilution to cephalexin and penicillin. All isolates were sensitive to ≤ 0.1 μg./ml. penicillin and ≤ 1.56 μg./ml. cephalexin. The disc-diffusion test was reliable in predicting the sensitivities in vitro. One strain of group A betahemolytic streptococcus was resistant to erythromycin by disc diffusion. When compared to Lancefield grouping 18% of strains were incorrectly identified as group A by the bacitracin-disc test. Cephalexin was uniformly effective in vitro in inhibiting beta-hemolytic streptococci and the 30 μg. cephalexin disc was reliable in predicting these sensitivities.     

Sensitivity of Shigella to antibiotics]

Three hundred and twenty two Shigella cultures isolated from dysentery patients within 1986-1989 were tested with the use of standard paper disks for their sensitivity to levomycetin, streptomycin, tetracycline, monomycin, neomycin, kanamycin, erythromycin, gentamicin, carbenicillin, ampicillin, oxacillin, methicillin and doxycycline. The number of the cultures belonging to Shigella sonnei amounted to 85.1 per cent of the total number of the strains studied. 91.9, 89.5, 87.3, 87.3, 80.1 and 80.1 per cent of the cultures were sensitive to gentamicin, kanamycin, carbenicillin, neomycin, levomycetin and ampicillin, respectively. 99.4 per cent of the isolates were resistant to streptomycin and 97.2 per cent were resistant to tetracycline. The sensitivity to erythromycin remained rather high (70.2 per cent). The overwhelming majority of the Shigella sonnei isolates had multiple resistance.     

Psychiatric care and politics.

The minimum inhibitory concentrations (MIC''s) of penicillin, ampicillin, tetracycline, erythromycin, spectinomycin and sulfadiazine were determined for 732 isolates of Neisseria gonorrhoeae collected in 1973-74. Comparison of the results of this survey with data from other Canadian studies showed that the percentage of isolates resistant to tetracycline had not changed since 1966, but that the percentage of erythromycin-resistant isolates had decreased. After an initial increase in 1966 the percentage of penicillin-resistant isolates stabilized. Spectinomycin-resistant isolates were not found. Positive correlations were observed between the MICs of the antibiotics tested; the highest positive correlations were between penicillin and ampicillin and between penicillin and tetracycline. A positive correlation was also noted between penicillin resistance and increasing spectinomycin MICs. Finally, a significant seasonal variation in MICs was found, the trend being towards increasing MICs during the summer.     

Effect of Carbenicillin on Pseudomonas aeruginosa

The activity of carbenicillin against 200 strains of Pseudomonas aeruginosa was measured by a quantitative agar dilution method. Minimal inhibitory concentrations (M.I.C.''s) for five graded inocula were measured in terms of complete inhibition (CI) and reduced growth (RG). The M.I.C. decreased progressively as inocula were reduced, median values for the 200 strains ranging from 100 to 37.5 μg. per ml. by the CI criterion, and from 75 to 25 μg. per ml. by the RG definition. Ratios of M.I.C. obtained for large and small inocula were usually small. Identical M.I.C.''s by both CI and RG criteria were most often obtained when the inoculum for the RG criterion was 1 or 2 logs higher than that for complete inhibition.Population analysis of 15 strains of Ps. aeruginosa showed that one specific drug concentration usually caused a sharp drop in proportion of viable cells, ranging from 3 to 5 logs. None of the populations were completely non-viable even at 150 μg. per ml. There was evidence that the viability of different-sized populations was reduced disproportionately by carbenicillin.Carbenicillin 300 μg. per ml. exerted appreciable bactericidal effect against nine of 15 strains of Ps. aeruginosa after a 24-hour contact period; after only six hours the bactericidal effect was very small.Quantitative sensitivity measurements for carbenicillin should include M.I.C. values for both CI and RG criteria, using a range of inocula for testing. Such M.I.C. values may well be useful in monitoring carbenicillin therapy of tissue infections.     

In Vitro Studies of a New Semisynthetic Penicillin, 6-(D-α-Sulfoaminophenylacetamido)-Penicillanic Acid

The activity of 6-(D-α-sulfoaminophenylacetamido)-penicillanic acid was determined against 357 clinical isolates of gram-negative bacilli by use of the tube-dilution technique. The majority of the isolates of Pseudomonas species were inhibited by 200 μg/ml or less of this antibiotic. Most of the isolates of Escherichia coli had a minimal inhibitory concentration of 50 μg/ml or less. Seventy-three per cent of the isolates of P. mirabilis, 40% of the isolates of P. morganii, and 45% of the isolates of Enterobacter species were inhibited by 12.5 μg/ml or less, whereas most of the isolates of Klebsiella species and Serratia species were resistant. The activity of this semisynthetic penicillin was affected by the size of the inoculum. The drug was bactericidal against all isolates of E. coli and Proteus species that were sensitive to it, but it was bactericidal against only 32% of the sensitive isolates of Pseudomonas species.     

Treatment of gonorrheal urethritis with spectinomycin hydrochloride

One hundred and eighty-seven males with uncomplicated gonorrheal urethritis were treated with spectinomycin hydrochloride in a dosage of 2 g. given intramuscularly. A failure rate of 3.2% was observed and no complications of therapy were encountered. In addition, 310 strains of N. gonorrhoeae were tested for susceptibility to penicillin G and spectinomycin. All strains were sensitive to 20 μg./ml. of spectinomycin and this susceptibility appeared to decrease as penicillin resistance increased. A greater incidence of relative resistance to penicillin G was observed than in similar studies from other Canadian areas.     

Isolation and Characterization of Coumaphos-Metabolizing Bacteria from Cattle Dip

Coumaphos, an organophosphate insecticide, is used for tick control in cattle dipping vats along the U.S.-Mexican border. Recently, several vats (problem vats) have experienced a loss of efficacy because of microbial degradation. Three morphologically distinct bacteria (designated B-1, B-2, and B-3) that metabolized coumaphos were isolated from enrichment cultures that were initiated from problem vat dip material. In general, amino acids, pyrimidines, and acetate supported growth; carbohydrates were not utilized. Only B-2 required growth factors. In resting cell experiments, coumaphos was hydrolyzed to diethylthiophosphoric acid and chlorferon by all three isolates. Chlorferon was subsequently metabolized by B-1 and B-2 to α-chloro-β-methyl-2,3,4-trihydroxy-trans-cinnamic acid. Only B-1 produced additional metabolites. Experiments with [benzo ring-labeled U-¹⁴C]coumaphos or chlorferon demonstrated that B-1 was capable of both mineralizing and incorporating into biomass the aromatic portion of the molecule. The majority of label, however, was recovered in the form of soluble products, including α-chloro-β-methyl-2,3,4-trihydroxy-trans-cinnamic acid. Although B-1 had the capacity to use chlorferon as a carbon source at low concentrations (100 μg/ml), visible growth at higher concentrations (1,000 μg/ml) was not observed. The addition of 400 μg of chlorferon per ml to B-1 cells in the mid-log phase of growth resulted in complete inhibition of growth, while the addition of 100 to 200 μg of chlorferon per ml resulted in partial inhibition. The growth of B-2 and B-3 was inhibited by 100 μg of chlorferon per ml. These data suggest that, although B-1 and, to a lesser extent, B-2 and B-3 are responsible for the primary degradation of coumaphos, other organisms in the enrichment culture may play a secondary role in coumaphos degradation by removing inhibitory products of coumaphos metabolism.     

Susceptibility In Vitro and In Vivo of Pseudomonas pseudomallei to Rifampin and Tetracyclines

Tests were performed on 64 strains of Pseudomonas pseudomallei to compare rifampin, various tetracyclines, and other antibiotics for inhibitory activity in vitro. Rifampin minimum inhibitory concentration (MIC) values generally fell between 25 to 50 μg/ml. For deoxycycline, methacycline, tetracycline, and minocycline, MIC means ranged from 1.3 to 2.7 μg/ml. Delayed treatment tests in subacute mouse infections revealed a better rifampin activity than was expected from its weak activity in vitro, whereas of the others, minocycline appeared superior. None of these five antibiotics demonstrated fully curative effectiveness in terms of mouse survival or eradication of residual infection in organs.     

Serotypes and biotypes and antibiotic susceptibility of Haemophilus influenzae encountered in a clinical laboratory in Taiwan.

Forty-four serologically and biochemically typable Haemophilus influenzae isolates from clinical specimens in Taiwan were subjected to analysis in their relationship with source of isolation and age distribution. It was found that all isolates from blood and cerebrospinal fluid were serotype b, biotype I, and all were in children less than 4 years of age. Serotypes b and e, biotypes I and III were encountered to have the highest incidence of infection caused by H. influenzae in this area. All H. influenzae isolates were further tested for susceptibility to several selected antibiotics. All strains of this organism were susceptible to erythromycin and chloramphenicol. All but two strains were susceptible to tetracycline, whereas more strains were resistant to carbenicillin, gentamycin, keflin, and penicillin. Thirty-four percent strains were found to be resistant to ampicillin and all were beta-lactamase producer. No direct correlation between ampicillin resistance and serotypes or biotypes was recognized.