Bhavani Rao

In vitro susceptibility of anaerobic bacteria to ciprofloxacin (Bay o 9867).

About 80% of 70 clinical isolates of Bacteroides fragilis were inhibited by 4 micrograms of ciprofloxacin (Bay o 9867) per ml. The 90% MIC of ciprofloxacin was 8 micrograms/ml for other Bacteroides species, 2 micrograms/ml for Peptococcus species, 8 micrograms/ml for Peptostreptococcus species, and 16 micrograms/ml for Clostridium and Eubacterium species.

Cardiac tuberculosis: TB of the endocardium.

Tuberculosis involving the endocardium is extremely rare. The diagnosis is usually made during autopsy. Often there is involvement of other parts of the heart as well as other regions of the body. The infection is a result of direct extension from the myocardium or hematogenous spread. Two cases of disseminated tuberculosis with endocardial involvement are reported. In Case 1 miliary tuberculosis was diagnosed during life but the patient succumbed to extensive disease on the third hospital day. The patient in Case 2 presented with congestive cardiac failure and the possibility of tuberculosis was not suspected during life.

Ticarcillin plus clavulanic acid versus moxalactam in the treatment of skin and soft tissue infections

A formulation of 3.0 g of ticarcillin and 0.1 g of clavulanic acid was evaluated in the treatment of skin and soft tissue infections, and its efficacy was compared with that of moxalactam in a randomized open study. Thirty-three patients received 3.1 g of ticarcillin plus clavulanic acid every six hours via intravenous infusion, and 36 patients received 2.0 g of moxalactam every eight hours via intravenous infusion. Diagnostic categories included intramuscular abscesses, cellulitis, skin ulcers, gangrene, and perirectal abscesses. The average age of the patients and the duration of therapy were similar in both groups. Overall, 45 aerobic and 25 anaerobic bacteria were isolated from the ticarcillin plus clavulanic acid-treated patients; 58 aerobic and 24 anaerobic bacteria were isolated from the moxalactam-treated patients. Thirty of 33 patients in the ticarcillin plus clavulanic acid-treated group had a satisfactory response; a skin rash developed in one patient; therapy failed in one patient with Staphylococcus aureus infection; and one patient died as a result of a bleeding peptic ulcer. In the moxalactam-treated group, 32 of 36 patients had a satisfactory response; a skin rash developed in one patient; therapy failed in a patient with Pseudomonas aeruginosa infection; and two patients were unevaluable. Ticarcillin plus clavulanic acid as a single agent was found to be as effective as moxalactam in the treatment of skin and soft tissue infections.

Anaerobic bacteria associated with cervical neoplasia

Abstract The possible association between cervical neoplasia and anaerobic bacteria was examined by correlating the histopathology of cervical biopsies with anaerobic cultures obtained from the cervix in 90 patients. Fourteen patients had invasive carcinoma of the cervix (ICC). All but one of them had Stage I or II disease. Severe dysplasia was present in 11 patients, moderate dysplasia in 9, mild dysplasia in 11, and carcinoma in situ in 26. Cultures from patients with ICC were characterized by a relative sparsity of anaerobes. The cultures of 3 of 14 patients with ICC contained anaerobes, in contrast to 53 of 76 patients in the other categories. Further, none of the 14 patients with ICC had anaerobic gram-negative bacilli whereas they were present in 18 of 76 patients in the other categories. ICC was not associated with any specific anaerobic bacteria. These data suggest that anaerobic bacteria are sparse and anaerolic gram-negative bacilli are rare in early invasive carcinoma of the cervix.

In vitro activity of cefbuperazone, a new cephamycin, against anaerobic bacteria.

The 90% MIC of cefbuperazone (BMY 25182) was 32 micrograms/ml for Bacteroides fragilis and Bacteroides spp., 128 micrograms/ml for Fusobacterium and Clostridium spp., 64 micrograms/ml for Eubacterium and Peptococcus spp., 8 micrograms/ml for Actinomyces spp., and 32 micrograms/ml for Peptostreptococcus spp. The level of activity of cefbuperazone was higher against B. fragilis and lower against anaerobic cocci than those of related cephalosporins, i.e., cefoxitin, cefoperazone, cefotaxime, ceftizoxime, and cefmenoxime. However, the activity of cefbuperazone was comparable to that of moxalactam against all groups tested. Size of inoculum and type of media used did not alter the MICs of cefbuperazone for B. fragilis. Cefbuperazone showed synergistic activity when combined with cefoxitin against resistant strains of B. fragilis.