R Factors in Hospital Infection

In order to assess the clinical importance of R factors 524 “coliform” infections were studied in a general hospital. Of these, 95 were caused by Pseudomonas aeruginosa. Among the remaining 429, 43% were caused by drug-resistant enterobacteria; resistance was frequently multiple and determined by transmissible R factors. Choice of therapy was thus limited but in every case at least one antibiotic, effective in vitro, was still available.     

Bacteroides Infection among Hospital Patients

In an 18-month period a total of 118 isolates of Bacteroides species, mainly Bacteroides fragilis, were grown from 112 hospital patients with various conditions. The infections were severe and were associated with serious operations such as intestinal surgery for carcinoma and postpartum hysterectomy. Blood cultures were often found to be positive too late in the course of infection for prompt and successful antibiotic therapy to be given. All the Bacteroides species tested were sensitive to clindamycin and co-trimoxazole. We suggest that clindamycin should be added to an empirical antibiotic regimen for the treatment of patients prone to the infection.