Bent Korner

Urosepticemia and Fatal Endocarditis Caused by Aerococcus-like Organisms

Two cases of invasive infections with aerococcus-like organisms (ALO) are presented: an 81-year-old man with fatal endocarditis and a 63-year-old man with urosepticemia. No antigenic relationship was found between ALO and Aerococcus viridans (NCTC 8251) in crossed immunoelectrophoretic assay.

Susceptibility testing of Danish isolates of Capnocytophaga and CDC group DF-2 bacteria

Twelve Capnocytophaga and seven DF‐2 strains were tested for their susceptibility to 14 antimicrobial agents using an agar dilution and an agar diffusion method. Twenty‐three other antibiotics were evaluated using the diffusion test only. All strains were fully susceptible to penicillin, ampicillin, cefuroxime, cefotaxime, erythromycin, clindamycin, chloramphenicol, doxycycline, rifamycin and ofloxacin using both methods. Clindamycin, rifamycin and cefotaxime were most active. Using agar dilution some strains were susceptible to gentamicin, but agar diffusion showed total resistance. One Capnocytophaga strain was susceptible and another moderately susceptible to metronidazole, other strains were resistant. The agar diffusion test showed that both Capnocytophaga and DF‐2 were resistant to most other aminoglycosides, to fosfomycin, polymyxin and trimethoprim. All strains of both taxa were fully susceptible to piperacillin, cefoxitin, imipenem and fusidic acid and showed different susceptibilities to the other agents. Susceptibility testing by means of agar diffusion using an enriched chocolate agar and 5% CO2 atmosphere could be used to test Capnocytophaga and DF‐2 strains and gives sufficient accuracy for routine use, when revised inhibition zone breakpoints are employed.

Aerococcus urinae: Intraspecies Genetic and Phenotypic Relatedness

A number of Aerococcus-like organisms were recently recognized as human pathogens. Five Aerococcus-like strains were proposed as members of the new species Aerococcus urinae (with type strain E2 [= NCTC 12142]) on the basis of the results of a 16S rRNA sequence analysis. The intraspecies phenotypic and genetic relatedness of 22 selected A. urinae strains was investigated, and a hitherto unrecognized esculin hydrolysis-positive biotype was identified. A total of 14 of the 15 more common esculin-negative strains exhibited very high DNA relatedness as determined by the hydroxyapatite method (the levels of relatedness were greater than 90% in 55 and 70 degrees C reactions, with 1.5% or less divergence in related sequences). The DNA relatedness among the six esculin-positive strains was more heterogeneous, and two DNA hybridization subgroups were formed. Our results are compatible with the hypothesis that both biotypes are members of the single species A. urinae, which contains two or more genetic subspecies. The putative subspecies have not been formally proposed since they cannot be definitively differentiated. The inclusion of A. urinae in the genus Aerococcus is supported by the results of 16S rRNA sequencing. The rRNA sequence data also is compatible with placing both biotypes in a single species.

Fl 1039 In Bacteriuria Following Prostatectomy: A Double-Mind Comparison with Pivampicillin and Placebo

FL 1039 is a novel β-lactam antibiotic, being a 6 β-amidinopenicillanic acid derivative. This compound was compared with pivampicillin and placebo in patients with E. coli, Klebsiella-Enterobacter, and Proteus-Providencia bacteriuria following prostatectomy. In a double-blind trial 59 patients received either FL 1039 or pivampicillin or placebo orally for a period of 12 days. After the course. 16 of 20 patients from the FL 1039 group and II of 20 from the pivampicillin group had a bacterial count less than I05 organisms per milliliter of urine. Placebo had no effect. Four weeks later no difference in cure rates between the three groups could be demonstrated. No development of resistance was observed. No toxic effects were noted. FL 1039 is a promising drug in bacteriuria caused by Enterobacteriaceae.

Haemophilus Isolated from Unusual Anatomical Sites

During a 15-year period Haemophilus species were isolated from unusual anatomical sites in 80 patients, mostly adults. The origin of specimens was pus and swabs from suppurative lesions, fluids from serosal cavities and gall bladder, gut content, and blood in cases with a supposed tissue focus. In 17 patients Haemophilus species were isolated in pure culture, in 63 patients in conjunction with other bacteria. 17 patients had gynaecological complaints: bartholinitis, salpingitis, and vaginal discharge. 22 patients had gastrointestinal complaints, comprising 17 with appendicitis, peritonitis following perforation of gastric ulcer, gall-duct infections, and an abscess in the stomach wall, and 5 patients with colonization of the gut. 41 patients had soft tissue and bone infections.

An Endemic Caused by Multiresistant Klebsiella in An Urological Unit

A long-term endemic caused by Klebsiella pneu-moniae occurred in the period 1966 to 1970 among patients in an urological unit. The multiresistant bacteria which were uniformly resistant to sulfonamides, ampicillin, and tetracyclines, were responsible for asymptomatic significant bacteriuria or overt urinary tract infection in 93 patients during an observation period covering one year (1967). Septicemia developed in 12 patients and 6 of the patients eventually succumbed. The endemic was provoked by two different types of Klebsiella: a chloramphenicol-sensitive and kanamycin-resistant one of capsular type 35, and a chloramphenicol-resistant and kanamycin-sensitive one of capsular type 7. Each of the two serotypes possessed their distinct phage pattern. Aseptic as well as antiseptic procedures were reviewed, but no flaws of any importance were disclosed either in the operating theatres or in the wards. A search for the Klebsiella throughout the environment was futile except in one locality, namely in a soile...