Penetration of penicillins into cardiac valves and auricles of patients undergoing open-heart surgery.

Prophylactic use of antibiotics in open-heart surgery for insertion of prosthetic valves is common, because of the serious consequences of postoperative staphylococcal infections, most notably prosthetic valve endocarditis. To ensure effective antibiotic cover during surgery, the penetration of cloxacillin and benzylpenicillin into the heart muscle and valves was studied intraoperatively. Both antibiotics were given intravenously (respective initial doses 2 g and 6 g) at induction of anesthesia to ten patients undergoing replacement of aortic or mitral valve, and the same doses were repeated after 4 hours.

Anaerobic bacteria in urine before and after prostatic massage of infertile men.

In the present study 25 infertile men delivered urine before and after prostatic massage. Expressed prostatic secretion (EPS) was obtained from 11 men. Aerobic and anaerobic bacterial analyses showed that a total of 33 isolates was found in samples of urine voided before massage as compared to 59 isolates after massage of the prostate.

Ceftriaxone: pharmacokinetics and effect on the intestinal microflora in patients with acute bacterial infections.

12 patients with acute bacterial infections were treated with ceftriaxone, 1.5 g intravenously twice daily for 7-13 days. Pharmacokinetic variables were studied in 11 patients.

The composition of the faecal microflora in breastfed and bottle fed infants from birth to eight weeks.

Recent technical advances have improved the possibilities to classify anaerobic bacteria. The aim of the present study was to examine the validity of the time-honoured opinion that the faecal flora is dominated by bifidobacteria in breastfed infants but not in bottle fed ones. The composition of the faecal flora of 15 breastfed and of 7 bottle fed infants was followed from birth to 8 weeks.

Pathogenesis and diagnosis of clostridium difficile enterocolitis.

Antibiotic associated Clostridium difficile enterocolitis is an infectious disease with symptoms ranging from self-limiting diarrhoea to severe colitis with bloody stools and formation of pseudomembranes. The carrier rate of C. difficile in a general Swedish population was found to be low (2%; 11/594).

Beta-lactamases in anaerobic bacteria.

The known mechanisms of beta-lactam resistance in anaerobic bacteria involve production of beta-lactamases, alteration of penicillin-binding proteins and blocked penetration of beta-lactams through the outer membranes. The most important factor in beta-lactam resistance is production of beta-lactamase. Beta-lactamases in various Bacteroides, Fusobacterium and Clostridium species have been described.

Treatment of orofacial infections of odontogenic origin.

Acute purulent orofacial infections are often of odontogenic origin. The microorganisms and the anatomical site involved, largely determine the clinical manifestations. The infections are usually self-limiting but serious complications may ensue.

Changes in the oropharyngeal and colon microflora in relation to antimicrobial concentrations in saliva and faeces.

Phenoxymethylpenicillin, bacampicillin, clindamycin, erythromycin, doxycycline and tinidazole were given perorally for 7 days to a total of 56 subjects. Concentrations of antimicrobials in serum, saliva and faeces were determined daily, as were viable counts of different aerobic and anaerobic microorganisms in the oropharyngeal and colon microflora. Clindamycin, erythromycin, doxycycline and tinidazole were detected in saliva.

Diagnosis and epidemiology of Clostridium difficile enterocolitis in Sweden.

Experience of the diagnosis and epidemiology of Clostridium difficile in Sweden is reviewed. Samples from 5885 patients have been investigated at the National Bacteriological Laboratory in Stockholm from 1978-1983. Patients originate from all parts of the country and their number continues to increase.

Impact of imipenem/cilastatin therapy on faecal flora.

To evaluate the effects of parenteral imipenem/cilastatin therapy upon human faecal microflora, stool specimens obtained from ten patients before, during and after therapy were cultured quantitatively for aerobic and anaerobic microorganisms. The patients received 500 mg imipenem combined with 500 mg cilastatin every 6 h for 6-11 days. The antimicrobial therapy was associated with a small decrease in the numbers of enterobacteria, anaerobic cocci and bacteroides during treatment but afterward the microflora normalized in all patients.

Characterization of Staphylococcus aureus isolates from oral surgical outpatients compared to isolates from hospitalized and non-hospitalized individuals.

In 160 patients, 114 strains of Staphylococcus aureus were isolated from gingival mucosa, saliva, throat and nose. The patients were divided into 4 groups: one group from an oral surgery clinic for outpatients, one group from a dental clinic, one group from a general surgery clinic for inpatients and one group from a clinic for chronically ill and aged patients. The highest frequency of staphylococcal carriers was found in the outpatient groups (oral surgery and dental clinic), 55% and 45%, respectively.

Comparison between two non-absorbable antibiotic regimens for decontamination of the oropharynx.

Fourteen healthy individuals were studied regarding the oropharyngeal microflora. Seven subjects were given a non-absorbable multi-drug regimen, consisting of 1% polymyxin B, 3% neomycin and 3% amphotericin B, that was directed against aerobic gram-negative rods and fungi for local decontamination of the oropharynx. Seven others were given another multi-drug regimen consisting of 1% polymyxin B, 1% neomycin, 3% amphotericin B and 0.

Impact of single dose as compared to three dose prophylaxis with latamoxef (moxalactam) on the colonic microflora in patients undergoing colorectal surgery.

Twenty patients undergoing colorectal surgery were given an initial dose of 2 g latamoxef (moxalactam) parenterally at the induction of anaesthesia. Ten of the patients received two subsequent doses at 8 h intervals. A series of serum and faecal specimens were taken for analysis of latamoxef concentrations.

Immunochemical fingerprinting of Clostridium difficile strains isolated from an outbreak of antibiotic-associated colitis and diarrhoea.

Twenty eight strains of Clostridium difficile , isolated from an outbreak of antibiotic-associated colitis and diarrhoea in an orthopaedic ward and from sporadic cases throughout Sweden, were sent to Edinburgh for immunochemical fingerprinting without information about their origin. EDTA extracts of the organisms were examined by crossed immunoelectrophoresis (CIE), polyacrylamide gel electrophoresis (PAGE) and electroblot transfer. Two patterns were revealed by CIE: group A (18 strains) and group B (10 strains).

Influence on oropharyngeal and nasal carriage of Staphylococcus aureus by dicloxacillin therapy in patients undergoing oral surgery.

71 healthy oral, throat and nasal carriers of Staphylococcus aureus undergoing surgical removal of impacted mandibular third molars were assigned to the following regimens. 40 patients received dicloxacillin 500 mg orally 60 min before the operation and then 500 mg dicloxacillin 3 times daily for 7 days and 31 patients no antibiotic. Oropharyngeal and nasal cultures were obtained from each patient before, during and after the operation.

Prophylaxis with tinidazole in oral surgery. Tissue penetration and effect on the oral microflora.

10 patients with odontogenic cysts were given 500 mg tinidazole orally every 12 h for infection prophylaxis before cystectomy. The administration started 48 h before operation and lasted for 7 days. Samples for assay of tinidazole were collected from blood plasma and cystic fluid during surgery.

Impact of antimicrobial agents on the gastrointestinal microflora and the risk of infections.

The most common and significant cause of disturbances in the normal gastrointestinal microflora is the administration of antimicrobial agents. The microflora can be influenced by antimicrobial agents because of incomplete absorption of any orally administered antimicrobial agent, secretion of an antimicrobial agent by the salivary glands and in the bile, or secretion from the intestinal mucosa. In most cases the influence is not beneficial to the patient because suppression of the indigenous microorganisms often permits potential pathogens to overgrow and cause septic conditions, diarrhea, or colitis.

Impact of phenoxymethylpenicillin, erythromycin, clindamycin and doxycycline on Streptococcus salivarius in the oropharynx.

Streptococcus salivarius plays a role in the normal oropharyngeal resistance to colonization with group A streptococci. Suppression of Str. salivarius may increase the risk of colonization.

The impact of different antimicrobial agents on the normal gastrointestinal microflora of humans.

In the present study the impact on the gastrointestinal microflora of peroral administration of penicillin, bacampicillin, clindamycin, erythromycin, doxycycline, and tinidazole was investigated. The effects on the colonic flora of parenteral administration of ampicillin plus sulbactam, cefoxitin, clindamycin, and tinidazole also were studied. Pronounced changes were observed in the oropharyngeal and colonic microflora in patients receiving clindamycin, erythromycin, and tinidazole (intravenous), whereas moderate changes were seen in those patients receiving doxycycline, cefoxitin, and ampicillin plus sulbactam.

High mutagenic activity formed in pan-broiled pork.

Lean pork was pan-broiled at various temperatures between 100 and 290 degrees C. Cooking was performed in an open frying pan common for domestic use in Sweden. No fat was added.

Rectal bioavailability of bacampicillin hydrochloride in man as determined by reversed-phase liquid chromatography.

The relative bioavailability of bacampicillin hydrochloride, a pro-drug of ampicillin, was compared after rectal and oral administration. Bacampicillin was administered rectally as a microenema . The oral formulation was an aqueous microcapsule suspension.

Occurrence of penicillin-resistant and beta-lactamase-producing Bacteroides species in the oral cavity.

Bacteroides species are known to play an important role in orofacial infections. The present investigation shows that penicillin-resistant Bacteroides species are commonly found in the oral cavity and that their occurrence is related to previous penicillin therapy. Several of the penicillin-resistant isolates were also resistant to erythromycin and/or doxycycline while all strains were sensitive to clindamycin and tinidazole.

Gardnerella-associated vaginitis and anaerobic bacteria.

12 patients with mild or moderate symptoms of Gardnerella-associated vaginitis were examined clinically and microbiologically on 52 different occasions, 27 of which were asymptomatic. The symptomatic state was defined by fulfilling at least three of the following criteria: (1) subjective symptoms; (2) pH above 4.5; (3) positive amine test, and (4) clue cells in wet smear.

Clindamycin in the upper respiratory tract infections.

Bacterial infections of the upper respiratory airways are common. Some of these infections are caused by anaerobic bacteria and Staphylococcus aureus and may constitute considerable therapeutical problems. Chronic suppurative otitis media may sometimes give rise to serious osteitis of surrounding bone structures, sigmoid sinus thrombosis and intracranial abscesses.