Yoshiteru Shigeno

Clinical and Bacteriological Evaluation of Branhamella catarrhalis in Respiratory Infections

SummaryThe clinical significance of Branhamella catarrhalis in respiratory infections is evaluated. 175 strains were isolated, mainly from the sputum, in 71 patients with respiratory infections. B. catarrhalis was most frequently isolated in mixed infections with Haemophilus influenzae (38.3%), H. influenzae plus Streptococcus pneumoniae (10.3%) or S. pneumoniae (9.7%). The rate of isolation of B. catarrhalis alone was as low as 5.1% and from mixed infections with Pseudomonas aeruginosa, Escherichia coli, and Enterobacter and/or Klebsiella species it was 36.6%. More than 107 cfu/ml of B. catarrhalis were isolated from 71.4% of cases.In 29 cases the organism was determined to be causative according to our criteria, most often in secondary infections in patients with complicated pneumoconiosis, chronic bronchitis and bronchiectasis.29 of 47 strains (61.7%) produced β-lactamase of the penicillinase type. Against these strains, penicillin antibiotics and first and second generation cephalosporin antibiotics (except cefroxadine) showed weak activity compared with their activity against non-β-lactamase- producing strains. The third generation cephalosporins showed a uniform spectrum of activity against both groups of organisms.

Respiratory superinfections after the use of third-generation cephem antibiotics

SummaryThis paper is a report on our studies on superinfections in respiratory tract infections treated during the years 1981–1984. The isolated strains ofStaphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis, Streptococcus faecium and glucose non-fermentative gram-negative rods such asPseudomonas aeruginosa were resistant to third-generation cephem antibiotics. These organisms proved to be widely distributed in hospitals and were frequently isolated from the sputum, excised lung and cardiac blood. The colonization of the sputum by bacteria in respiratory tract infections before, during and after treatment with third-generation cephem antibiotics revealed a tendency for these organisms to appear after treatment. Among the gram-positive cocci,S. faecium was most resistant to these antibiotics, followed byS. faecalis, S. epidermidis andS. aureus in that order. The incidence of resistant isolates in 1984 exceeded that in 1983, suggesting an annual increase in resistant bacteria.ZusammenfassungWir berichten über unsere Studien zu Superinfektionen bei Infektionen der Atemwege, die von 1981–1984 behandelt wurden. Die isolierten Stämme vonStaphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis undStreptococcus faecium sowie von Glukose nicht fermentierenden gramnegativen Stäbchen wiePseudomonas aeruginosa waren resistent gegen Cephem-Antibiotika der dritten Generation. Es zeigte sich, daß diese Erreger in den Krankenhäusern weit verbreitet waren; sie wurden häufig aus Sputum, Lungenexzisaten und Herzblut isoliert. Untersuchungen zur Kolonisation des Sputums vor, während und nach der Therapie mit Cephem-Antibiotika der dritten Generation ließen eine Tendenz für das Auftreten dieser Bakterien im Anschluß an die Behandlung erkennen. Unter den grampositiven Kokken warS. faecium am resistentesten gegen diese Antibiotika,S. faecalis, S. epidermidis undS. aureus zeigten eine in der genannten Reihenfolge geringgradigere Resistenz. Die Inzidenz resistenter Isolate war 1984 höher als 1983, was auf eine jährliche Zunahme resistenter Bakterien schließen läßt.