The patterns and transmissibility of antibiotic resistance among clinical strains of Pseudomonas aeruginosa.

Four hundred and ninety-eight predominantly pyocin-type 10 clinical strains of Pseudomonas aeruginosa were analyzed for resistance to carbenicillin, cefoperazone, cefotaxime, ceftazidime, gentamicin, amikacin and netilmicin. Based on NCCLS-recommended MIC breakpoints, 245 strains were found to be resistant, of which 41.6% were resistant to carbenicillin, 38% to gentamicin, 37.8% to netilmicin, 26.3% to cefoperazone, 17.9% to cefotaxime, 0.6% to amikacin and none to ceftazidime. Quadruple resistance to carbenicillin, cefoperazone, gentamicin and netilmicin was the most frequent pattern observed. Resistance to older antibiotics (kanamycin, streptomycin and tetracycline) and to mercuric chloride were also common. Conjugation experiments suggested that self-transmissible and non-transmissible plasmids occurred in at least 66 strains.     

Synergistic activity of coriander oil and conventional antibiotics against Acinetobacter baumannii

In this study we investigated the existence of synergistic antibacterial effect between coriander (Coriandrum sativum L.) essential oil and six different antibacterial drugs (cefoperazone, chloramphenicol, ciprofloxacin, gentamicin, tetracycline and piperacillin). The antibacterial activity of coriander oil was assessed using microdilution susceptibility testing and synergistic interaction by checkerboard assays. The association of coriander essential oil with chloramphenicol, ciprofloxacin, gentamicin and tetracycline against Acinetobacter baumannii showed in vitro effectiveness, which is an indicator of a possible synergistic interaction against two reference strains of A. baumannii (LMG 1025 and LMG 1041) (FIC index from 0.047 to 0.375). However, when tested the involvement between coriander essential oil and piperacillin or cefoperazone, the isobolograms and FIC index showed an additive interaction. The in vitro interaction could improve the antimicrobial effectiveness of ciprofloxacin, gentamicin and tetracycline and may contribute to resensitize A. baumannii to the action of chloramphenicol.     

Effects of gentamicin sulfate on the contractility of myometrium isolated from non-pregnant cows

Gentamicin sulfate, an aminoglycoside antibiotic known to cause depression of neuromuscular function, is a drug of choice in intrauterine antibiotic treatment of bovine chronical or subclinical uterine infections but its effects on the contractility of the cow uterus have not been studied. The aim of this study was to characterize, in vitro, the effect of gentamicin sulfate on spontaneous as well as prostaglandin F2alpha (PGF2alpha) and oxytocin-induced contractility of the non-pregnant cow uterus. Myometrial strips were isolated from non-pregnant cows in follicular phase and suspended in a jacketed organ bath filled with Krebs solution at 37 degrees C (pH 7.4) continuously bubbled with 95% oxygen and 5% carbon dioxide and isometric contractions were recorded using isometric force displacement transducer. After manifestation of the spontaneous contractions during equilibration period the test substances PGF2alpha (1 microM), oxytocin (2.5 mIU/ml bath fluid) and gentamicin sulfate (150-600 microm) were added to the bath. The effects of gentamicin sulfate on amplitude (g) and frequency of spontaneous and the agonist-induced contractions were evaluated by 20 min intervals. Data were statistically analyzed using the Student's t-test and Wilcoxon signed-rank test where appropriate. P <0.05 was considered to be significant. Gentamicin sulfate inhibited spontaneous, as well as oxytocin or PGF2alpha-induced contractions in a dose-dependent manner. Although both the frequency and amplitude of contractions were significantly inhibited by gentamicin sulfate, the effect on the frequency of the spontaneous and agonist-induced contractions were more prominent than on the amplitude. The result from this in vitro study indicated that gentamicin sulfate inhibits spontaneous as well as oxytocin and PGF2alpha-induced contractions of myometrium isolated from non-pregnant cows. This may be of importance considering the potentially negative effect of gentamicin sulfate on uterine involution in cows with puerperal endometritis, resulting in impairment of fertility performance.     

Discovery of early urinary biomarkers in preclinical study of gentamicin-induced kidney injury and recovery in rats

LC/MS- and NMR-based global metabolomics analyses were utilized to study the changes in rat urine in response to gentamicin treatment. Sprague?CDawley rats were dosed with gentamicin sulfate at 0, 75, 150 or 300?mg/kg/day for one, two or three consecutive days. Four animals from each group were sacrificed to harvest kidney tissue and to collect urine on days 1, 2, 3, 7, 10, 15, 18, 22, 29, 36 and 44 for a total of 11 different time points. Both uni- and multivariate statistical analyses were employed to identify the significantly changed metabolites in urine at the different dose levels and time points. Increases and decreases in amino acids including tyrosine, valine and hydroxyproline reflected histopathology changes of kidney injury development and/or kidney injury recovery. Glucosuria was noted much earlier than changes in the classic kidney function biomarkers, blood urea nitrogen and serum creatinine. Dopamine-related compounds, homovanillic acid sulfate (HVA-SO₄) and homoveratric acid sulfate (HVrA-SO₄) were significantly increased at early time points and could be early indicators of a renal adaptive response to gentamicin-induced renal injury. Furthermore, the drug efficacy of gentamicin was evaluated through the detection of changes in gut microflora-related compounds (e.g. indole-containing metabolites). Metabolomics was successful in identifying valine, hydroxyproline, HVA-SO₄ and HVrA-SO₄ that might serve as potential early injury biomarkers or adaptive markers of gentamicin-induced renal injury, and in assessing gentamicin efficacy through changes in compounds reported to be related to gut microflora. However, caution should be taken in direct translation of the biomarkers reported in clinical settings because a much higher dose of gentamicin than the normal therapeutic dose (~1?C2?mg/kg) was used to cause kidney damaged.     

替加环素与5种抗生素对多重耐药鲍曼不动杆菌体外联合药敏实验的研究

分析亚胺培南、头孢哌酮-舒巴坦、头孢曲松、左氧氟沙星、庆大霉素5种临床常用鲍曼不动杆菌治疗的抗生素单用和分别与替加环素联用的体外敏感性实验的研究,以期发现较好的联合用药方案,为临床合理使用抗生素提供用药参考。采用微量肉汤稀释法测定5种抗生素对鲍曼不动杆菌的MIC值,再采用棋盘法测定5种抗生素分别与替加环素联用MIC值,并计算FIC指数。结果显示,替加环素与亚胺培南、头孢哌酮舒巴坦、左氧氟沙星、头孢曲松具有协同和相加作用,替加环素与庆大霉素具有拮抗作用。临床在选择抗生素治疗鲍曼不动杆菌所引起的重症感染时,可根据该药敏实验结果与亚胺培南或头孢哌酮舒巴坦或左氧氟沙星或头孢曲松与替加环素联合使用,但应避免与庆大霉素联合使用。     

Gentamicin palmitate as a new antibiotic formulation for mixing with bone tissue and local release

During surgery with bone grafting, the impaction of bone tissue creates an avascular area where local circulation is disrupted. If infections arise, they may prevent systemically administered antibiotics from reaching the infected bone. In this study we evaluated gentamicin palmitate (GP) mixed with gentamicin sulfate (GS) as a coating for bone chips (BCh). The efficacy of the coated BCh was measured by gentamicin base release tests using B. subtilis, S. epidermidis and S. aureus. Gentamicin base release was evaluated in phosphate-buffered saline for up to 7 days using B. subtilis bioassay. Antimicrobial efficacy was tested with S. aureus and S. epidermidis. A significant difference on the release of gentamicin base between GS and GS + GP was observed. S. epidermidis are significantly more susceptible to GS + GP and GS than S. aureus. BCh can act as gentamicin carriers and showed efficacy against S. aureus and S. epidermidis.     

Effect of different forms of nitrogen in the biosynthesis of gentamicin by a Micromonospora purpurea var. violacea 1935 culture]

The effect of different inorganic sources of reduced and oxidized nitrogen on biosynthesis of gentamicin was studied. It was shown that both the ammonium and the nitrate nitrogen were consumed by the antibiotic-producing organism. Out of all the salts tested only ammonium sulfate stimulated the biosynthesis of gentamicin. The positive role of this salt was due to both the ammonium and the sulfogroup, since the presence of the sulfogroup alone in sodium sulfat, magnesium or sulfuric acid resulted only in partial stimulation of gentamicin biosynthesis. Simultaneous addition of sulfuric acid ammonium nitrate which suppressed the antibiotic biosynthesis when used alone was equal to introduction of ammonium sulfate.     

Pharmacology of gentamicin sulfate]

Pharmacology of gentamicin sulfate prepared at the All-Union Research Institute of Antibiotics was studied. By the paramaters of acute toxicity the drug did not differ from a Bulgarian sample of gentamicin sulfate. Under the conditions of the acute experiment on animals it was found that only high doses of gentamicin significantly exceeding the therapeutic ones induced some decrease in the arterial pressure, respiration suppression, blocking of the neuromuscle transmission in the synapses of the skeletal muscles. The latter may be eliminated by the use of calcium chloride. Under conditions of the chronic experiment with intramuscular administration of gentamicin sulfate to the animals for 4 weeks in doses equivalent to the theraputic ones for humans, impairement of the vestibular function and albuminuria often accompanied by pronounced distrophic changes in the kidney canaliculi were observed in some animals. An increase in the drug dose resulted in more pronounced distrophic changes in the kidney tissue.     

Sensitivity of bacteria of the genus Acinetobacter to antibiotics and ofloxacin

Between 1989-1989 276 strains of Acinetobacter genus were isolated which contained: Acinetobacter calcoaceticus subsp. anitratus (n = 167), Acinetobacter calcoaceticus subsp. Iwoffi (n- = 83), Acinetobacter haemolyticus (n = 26). Their sensitivity to aminoglycoside antibiotics, beta-lactams, tetracyclines, chloramphenicol, colistin, and ofloxacin was tested. More than 90% of strains were sensitive to colistin and ofloxacin. The sensitivity to remaining antibiotics differentiated depending on species. Acinetobacter anitratus were highly resistant to Ist and IInd generation of cephalosporins, and moreover to penicillins, tetracyclines, and chloramphenicol. Cephalosporins of IIIrd generation were active against 70% of strains with exception of cefoperazone what was also the case for representatives of aminoglycosides as netilmicin and amikacin. Strains of Acinetobacter Iwoffi were in majority sensitive to all antibiotics with exception of cephalothin, cephradine and cefoperazone. More than 90% of Acinetobacter haemolyticus strains were sensitive to gentamicin, carbenicillin, azlocillin, ceftriaxone, cefotaxime and tetracyclines.     

Measurement of urinary clusterin as an index of nephrotoxicity.

Measurements of tissue immunoassayable clusterin, a protein associated with programmed cell death and tissue reorganization, were performed in rats treated with nephrotoxic doses of gentamicin sulfate. Adult Lewis rats were treated with 100 mg/kg/day of gentamicin sulfate for 12 days. Urine, serum, and tissue levels of clusterin protein were measured, as were urinary N-acetyl beta-glucosaminidase (NAG) and serum creatinine levels. Induction of renal injury by gentamicin was detectable within 4 days by increased levels of urinary N-acetyl beta-glucosaminidase (from 280 +/- 66 (mean +/- SD) to 910 +/- 210 nmol/mg creatinine), and within 9 days of initiating gentamicin treatment by increased serum creatinine (from 0.5 +/- 0.1 to 1.2 +/- 0.4 mg/dl). Paralleling these changes, renal, urinary, and serum levels of clusterin increased 10-, 116-, and 3-fold (P less than 0.05). Treatment with gentamicin sulfate did not increase clusterin levels in the seminal vesicle, ventral prostate, testis, or epididymis. The measurement of urinary or serum clusterin may play a role in the early detection of renal injury.     

Clinical experience with the treatment of severe nosocomial infections by inhibitor-protected 3rd generation cephalosporin cefoperazone/sulbactam]

A retrospective analysis of the clinical and microbiological efficacy and safety of cefoperazone/sulbactam in the treatment of 39 cardiosurgical patients operated under the conditions of artificial circulation is presented. The age of the adult patients (n = 28) varied from 44 to 58 years and that of the pediatric patients varied from 4 months to 6 years. Antibacterial therapy of 26 patients was needed because of postoperative infectious complications, such as nosocomial pneumonia in 22 patients and sepsis in 4 patients. The antibacterial therapy with cefoperazone/sulbactam in 9 patients was performed during the operation because of active infectious endocarditis. In 4 patients there were observed clinical and laboratory signs of infection without the infection foci. The initial empirical therapy with cefoperazone/sulbactam was applied to 14 patients (group 1) and the target-aimed therapy based on the data of the pathogen susceptibility to cefoperazone/sulbactam was used in 6 patients (group 2). 19 patients (group 3) were treated with cefoperazone/sulbactam because of the fail of the previous antibacterial therapy, including the 4th generation cephalosporins and carbapenems as well. Cefoperazone/sulbactam was used in the monotherapy of 15 cases (38%). Cefoperazone/sulbactam showed high efficacy in the treatment of severe nosocomial infections and infectious endocarditis (in combination with vancomycin or linezolid). It amounted to 93, 100 and 79% in groups 1, 2 and 3 respectively, the total of 94%. The results of the microbiological assay were evident of the cefoperazone/sulbactam high activity against the problem gram nagative isolates of Klebsiella pneumoniae (n = 12), Acinetobacter baumanii (n = 4), Pseudomonas aeruginosa (n = 4) and Stenotrophomonas maltophilia (n = 5). Adverse reactions were stated in 2 patients (5%), 1 case of urticaria requiring discontinuation of the drug use. Many of the patients proved to be colonized by MRS before the therapy with cefoperazone/sulbactam. The high probability of staphylococcal superinfection required combination of cefoperazone/sulbactam with antistaphylococcal agents, such as rifampicin, fusidin, vancomycin, linezolid. The best results were provided by the target-aimed therapy based on the microbiological monitoring.     

Effect of antibiotics on motion characteristics of cooled stallion spermatozoa

The control of bacteria in semen of stallions has been most effective with the use of seminal extenders containing suitable concentrations of antibiotics. However, the detrimental effect of antibiotics on sperm motility may be greater in stored, cooled semen due to the prolonged exposure to the antibiotic. Therefore, a study was conducted to determine the effect of various antibiotics on sperm motion characteristics following short term exposure and during cooled storage of semen. Reagent grade amikacin sulfate, ticarcillin disodium, gentamicin sulfate and polymixin B sulfate were added to a nonfat, dried, skim milk - glucose seminal extender at concentrations of 1000 or 2000 mug or IU/ml. Aliquots of raw semen were diluted with extender-antibiotic combinations to a concentration of 25 x 10(6) spermatozoa/ml. An aliquot was also diluted with extender without antibiotic. Aliquots were incubated at 23 degrees C for 1 h. In addition, portions of the aliquots were cooled from 23 to 5 degrees C and stored for 48 h. During 1 h of incubation of extended semen at 23 degrees C, there was a significant (P<0.05) reduction in the percentage of progressively motile spermatozoa for samples containing gentamicin sulfate. After 24 h of storage at 5 degrees C, 2000 mug/ml of gentamicin and levels equal to and greater than 1000 IU/ml of polymixin B in seminal extender resulted in significant (P<0.05) reductions in the percentages of motile and progressively motile spermatozoa. After 48 h of cooled storage, a level of 1000 mug/ml of gentamicin sulfate. resulted in significant (P<0.05) reductions in the percentages of motile and progressively motile spermatozoa. Levels equal to or greater than 1000 IU/ml of polymixin B sulfate also resulted in a significant (P<0.05) reduction in mean curvilinear velocity. Levels up to 2000 mug/ml of amikacin sulfate and ticarcillin disodium had no significant effect on sperm motion characteristics during short-term incubation at 23 degrees C or storage for 24 h at 5 degrees C. Overall, the addition of antibiotics to extender did not significantly (P>0.05) improve motion characteristics of spermatozoa over control samples. However, levels of gentamicin sulfate greater than 1000 mug/ml and of polymixin B sulfate equal to or greater than 1000 IU/ml should be avoided in seminal extenders used for cooled semen.     

Fluorometric determination in biological fluids of the release kinetics of liposome-entrapped doxorubicin

Abstract

A fluorometric method is presented that allows a continuous monitoring in 50% (v/v) human serum of the release of liposome-entrapped doxorubicin (DXR).This method exploits the intrinsic fluorescence of DXR and uses DNA as a fluorescence quencher of the released drug. It is much more simple and rapid than the commonly used methods. It is shown that this method can be applied to the study of the stability of liposomal-DXR encapsulated using either an ammonium sulfate gradient or a pH gradient. Small unilamellar vesicles (SUVs) made from egg yolk phosphatidylcholines (EPC) were much less stable, either in phosphate buffer saline or in human serum, than SUVs made from a 1/1 mixture of EPC and cholesterol (Choi). SUVs made from EPC/Chol loaded with DXR using an ammonium sulfate gradient were found to be more stable than those loaded using a pH gradient.     

A method of quantitative analysis of gentamicin sulfate

A procedure for quantitative assay of gentamicin sulfate was developed. It is based on formation of an ionic associate with bromothymol blue followed by chloroform extraction and the photometric determination at 420-422 nm. The relative error does not exceed 0.94 and 0.98 per cent in regard to the substance and its dosage form (gynecological suppositories), respectively. Optimal conditions for the assay were elaborated i.e. the ratio of the reagent and extraction agent, the time and the number of the extractions and pH of the medium. The process obeys to the main law of light absorption within the concentration of gentamicin sulfate in aqueous solution equal to 8-128 micrograms/ml.     

幼年大鼠脾虚腹泻合并肠道菌群失调模型的建立

目的 建立一种脾虚腹泻合并肠道菌群失调的模型,为研究中医药治疗小儿脾虚腹泻证的疗效机制提供可行性模型。方法 按照随机的原则将20只清洁级3周龄SD幼年大鼠分为正常和模型两组,采用番泻叶、生大黄联合头孢拉定、硫酸庆大霉素灌胃,观察其对幼年SD大鼠外观、体质量、肠道微生物和小肠黏膜的影响。结果 与正常组相比,模型组幼年大鼠被毛枯槁、精神萎靡,体质量增长缓慢;4种琼脂培养基培养的肠球菌、大肠埃希菌、细菌、乳酸菌数量差异均有统计学意义（Ps＜0.01）;小肠黏膜层次模糊,结构混乱,小肠绒毛形态破坏。结论 番泻叶、生大黄联合头孢拉定、硫酸庆大霉素灌胃能够建立一种合适的幼年大鼠脾虚腹泻合并肠道菌群失调的模型。     

Molecular mechanisms of cephalosporin resistance in Gram-negative bacteria of the Enterobacteriaceae family]

Extended spectrum beta lactamase genes were detected by the PCR in 87.6% of 231 Enterobacteriaceae strains isolated in medical institutions of Moscow, St. Petersburg, Tomsk and Nazran that showed a decrease in their susceptibility to 3rd generation cephalosporins. Alone or in various combinations TEM type beta lactamases were detected in 43.3% of the isolates, 46.8 and 51.2% of the isolates produced SHV type and CTX type beta lactamases respectively. Combinations of 2 and 3 different determinants were detected in 40 and 14% of the isolates respectively. Production of class C beta lactamases was suspected in 28% of the isolates by their resistance to cefoxitin. The gene of ACT type beta lactamase was detected in 1 strain of Klebsiella pneumoniae and the gene of CMY type beta lactamase was detected in 1 strain of Proteus mirabilis. By the NCCLS 100% of the isolates was susceptible to meropenem, 14% was susceptible to cefotaxime, 64% was susceptible to cefepime, 81% was susceptible to cefoperazone/sulbactam, 47% was susceptible to gentamicin, 57% was susceptible to amikacin and 36% was susceptible to ciprofloxacin.     

Resistance of urinary tract infection pathogens and choice of antibacterial therapy in pediatric urologic practice]

The data on antibiotic resistance of the main uropathogens isolated from patients with urinary tract infection in an urologic department (319 isolates) and outpatient and diagnostic units (360 isolates) are presented. It was shown that by the antibiotic resistance the Escherichia coli isolates from the urologic department patients and outpatients did not practically differ: 44.1 and 47.8% of the isolates were resistant to ampicillin, 26.7 and 23.4% were resistant to amoxycillin/clavulanate, 28.9 and 24.9% were resistant to co-trimoxazole and 26.5% was resistance to cefuroxime (outpatients). The basic differences referred to Pseudomonas aeruginosa: resistance to ceftazidime in 38.5% of the isolates and resistance to gentamicin in 36.2% of the isolates. The activity against P. aeruginosa could be arranged as follows in the decreasing order: amikacin = meropenem > imipenem > cefepime = cefoperazone/sulbactam > gentamicin = ceftazidime. Resistance of P. aeruginosa to fluoroquinolones (ciprofloxacin and levofloxacin) remained low (7.4 and 8.0% respectively). No ampicillin resistance was revealed in the isolates of Enterococcus faecalis.     

Comparative effect and fate of non-entrapped and liposome-entrapped neuraminidase injected into rats

Non-entrapped and liposome-entrapped Clostridium perfringens neuraminidase (0.5-0.6 unit) was injected into rats and its fate as well as its effect on plasma and erythrocyte N-acetylneuraminic acid was investigated. The following observations were made. (1) Although removal of both non-entrapped and liposome-entrapped neuraminidase from the circulation was completed within 5h after injection, their recovery in tissues was distinctly different; 7-10% of the injected non-entrapped enzyme was found in the liver and none in the liver lysosomal fraction or the spleen. In contrast, 20-26% of the liposome-entrapped enzyme was found in the liver of which 60-69% was in the lysosomal fraction. Spleen contained 3.6-5.0% of the enzyme. (2) The presence of the non-entrapped neuraminidase in blood led to the extensive desialylation of plasma and to a decrease in the concentration or total removal from the circulation of some of the plasma glycoproteins. (3) Injection of non-entrapped neuraminidase also led to the partial desialylation of erythrocytes the life span of which was diminished and their uptake by the liver and spleen augmented. (4) Entrapment of neuraminidase in liposomes before its injection prevented the enzyme from acting on its substrate in plasma or on the erythrocyte surface, and values obtained for plasma glycoproteins and erythrocyte survival were similar to those observed in control rats. (5) Entrapment in liposomes of therapeutic hydrolases intended for the degradation of substances stored within the tissue lysosomes of patients with storage diseases could prevent the potentially hazardous enzymic action of hydrolases in blood and at the same time direct the enzymes to the intracellular sites where they are needed.     

Some inhibitory effects of gentamicin on plant tissue cultures

Summary Tracheary element differentiation in cultured explants of pith parenchyma isolated from heads of romaine lettuce (Lactuca sativa L. var. Romana) was strongly inhibited by concentrations of gentamicin sulfate recommended for tissue culture media (50 to 100 μg/ml). Similar results were obtained with cultured explants of Jerusalem artichoke tuber (Helianthus tuberosus L.). Callus formation was suppressed in the presence of increasing levels of gentamicin sulfate in both tissue systems. Plant tissue culture media employed in studies on cell division and xylem differentiation should be supplemented with this antibiotic in concentrations of 10 μg/ml or less according to these results.     

Evaluation of the In Vitro Activity of Tobramycin as Compared with That of Gentamicin Sulfate

The in vitro activity of tobramycin was quantitatively compared with that of gentamicin sulfate against 195 bacterial isolates from clinical material. Tobramycin was found to be twice as active as gentamicin against isolates of Pseudomonas aeruginosa. Conversely, gentamicin proved fourfold more active than tobramycin against isolates of Serratia marcescens. Both drugs were of comparable activity against isolates of Staphylococcus aureus and the majority of the enterobacterial isolates other than S. marcescens. On the basis of the obtained data, the following criteria are proposed for the interpretation of diffusion susceptibility tests with 10-μg discs of gentamicin and tobramycin. Enterobacteriaceae and isolates of S. aureus are designated as susceptible to gentamicin and tobramycin if the zones of inhibition measure 15 mm or more in diameter; zones of 14 mm or less are indicative of resistance. Pseudomonadaceae are interpreted as sensitive to tobramycin and gentamicin if the inhibition zones measure at least 15 and 12 mm in diameter, respectively.