Evaluation of the Binax NOW, BD Directigen, and BD Directigen EZ assays for detection of respiratory syncytial virus.

The Binax NOW assay (Binax, Inc., Portland, Maine) and the BD Directigen EZ assay (Becton Dickinson and Company, Sparks, Md.), two new rapid immunoassays for detection of respiratory syncytial virus (RSV), as well as the BD Directigen RSV assay (DRSV) (Becton Dickinson and Company) and direct immunofluorescence staining (DFA) were compared with culture for detection of RSV in fresh specimens from both children and adults during the 2002-2003 respiratory virus season.

Plasma cell endometritis in women with symptomatic bacterial vaginosis.

Objective: To evaluate the endometrial microbiology and histopathology in women with symptomatic bacterial vaginosis but no signs or symptoms of upper genital tract disease or other vaginal or cervical infections.

Methods: Endometrial biopsies were performed on 41 women complaining of vaginal discharge or pelvic pain at a sexually transmitted disease clinic. These women had neither culture nor serologic evidence of Neisseria gonorrhoeae or Chlamydia trachomatis infection.

Comparison of rapid tests for detection of group B streptococcal colonization.

Accurate rapid detection of maternal lower genital tract colonization with group B streptococci (GBS) in high-risk patients is essential for selective institution of intrapartum antibiotic treatment to reduce neonatal GBS infection. In this study, pure GBS isolates were used to evaluate five commercially available rapid tests in terms of speed, ease of use, and sensitivity. The products tested were Directigen, Equate, Bactigen, PathoDx, and Phadebact.

Comparison of cefotetan plus doxycycline with cefoxitin plus doxycycline in the inpatient treatment of acute salpingitis.

Pelvic inflammatory disease (PID), one of the major sequelae of the current epidemic of sexually transmitted diseases, has been shown to be a polymicrobial infection. This study compares the efficacy and safety of two broad-spectrum combination drug regimens, cefotetan with doxycycline and cefoxitin with doxycycline, in the treatment of PID. A total of 108 patients with acute salpingitis were hospitalized and randomized into two treatment groups: cefotetan/doxycycline (N = 54) and cefoxitin/doxycycline (N = 54).

Combination antimicrobial therapy in the treatment of acute pelvic inflammatory disease.

We compared the clinical and microbiologic efficacy of two broad-spectrum combination antimicrobial regimens in the treatment of 148 patients with acute pelvic inflammatory disease. Patients were randomized to inpatient treatment with either cefoxitin and doxycycline (n = 75) or clindamycin and tobramycin (n = 73). These antibiotics were administered intravenously for at least 4 days, and up to 48 hours beyond defervescence.

Efficacy of single-agent therapy for the treatment of acute pelvic inflammatory disease with ciprofloxacin.

A prospective, randomized, controlled, non-blind clinical trial was conducted to compare the efficacy of monotherapy with ciprofloxacin with that of a combination of clindamycin plus gentamicin in the treatment of patients with acute pelvic inflammatory disease. Pretreatment and post-treatment cervical culture specimens were obtained for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum. Pretreatment and post-treatment endometrial culture specimens were obtained for those organisms plus facultative and anaerobic bacteria.

Prophylaxis in caesarean section with cefmetazole and cefoxitin.

A prospective, randomized, open comparison of three 1 g doses of cefmetazole with three 2 g doses of cefoxitin for non-elective Caesarean section was performed. Sixty-nine patients were evaluated. The two groups were comparable with respect to labour characteristics that might influence risk of postoperative infectious morbidity.

Treatment of hospitalized patients with acute pelvic inflammatory disease: comparison of cefotetan plus doxycycline and cefoxitin plus doxycycline.

Acute pelvic inflammatory disease remains the major medical and economic consequence of sexually transmitted diseases among young women. The polymicrobial origins of pelvic inflammatory disease have been well documented and the major organisms recovered from the upper genital tract in patients with pelvic inflammatory disease include Chlamydia trachomatis, Neisseria gonorrhoeae, and mixed anaerobic and aerobic bacteria. This study was undertaken to compare the efficacy and safety of cefotetan plus doxycycline with that of cefoxitin plus doxycycline in the treatment of hospitalized patients with acute pelvic inflammatory disease.

In vitro activity of cefmetazole, cefotetan, amoxicillin-clavulanic acid, and other antimicrobial agents against anaerobic bacteria from endometrial cultures of women with pelvic infections.

The MICs of the new antimicrobial agents cefmetazole, cefotetan, and amoxicillin-clauvulanic acid were compared with the MICs of other antimicrobial agents against anaerobic bacteria from endometrial cultures from women with pelvic inflammatory disease or endometritis. The activity of cefmetazole was similar to that of cefoxitin and generally greater than that of cefotetan. Amoxicillin-clavulanic acid was generally more active than all cephamycins tested.

Cesarean section prophylaxis: comparison of two doses with three doses of mezlocillin.

A prospective randomized double-blind comparison of two doses, with three doses of mezlocillin for nonelective cesarean section prophylaxis was performed. One hundred seven (107) patients were evaluated. Mezlocillin (4 g) was given post-cord clamping and then at 4-h intervals for a total of two doses or three doses.

Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis.

Urethral cultures were obtained from 90 adolescent youth, 16 of whom denied previous sexual activity. Among the sexually active boys was a group of 32 with clinically significant pyuria, consistent with the diagnosis of urethritis, on a first-part urinalysis (FPU) specimen. To relate differences in urethral microflora to sexual activity, 42 sexually active patients with a negative FPU were compared with the never sexually active group.

Ampicillin/sulbactam versus metronidazole-gentamicin in the treatment of soft tissue pelvic infections.

The clinical efficacy and safety of ampicillin/sulbactam versus metronidazole-gentamicin were evaluated in a comparative, randomized, prospective study. Forty-four patients were enrolled: 22 received the ampicillin/sulbactam regimen, and 22 received the metronidazole-gentamicin combination. There were 33 cases of severe acute pelvic inflammatory disease, two tuboovarian abscesses, five cases of endomyometritis, and two cases of posthysterectomy pelvic cellulitis.

Occurrence of clindamycin-resistant anaerobic bacteria isolated from cultures taken following clindamycin therapy.

MICs of clindamycin were determined by the agar dilution method against anaerobic organisms isolated from endometrial cultures in women with pelvic soft tissue infections. Cultures were obtained from 100 women both before and after clindamycin therapy, from 107 women before therapy with clindamycin or another antimicrobial agent or after treatment with an antimicrobial agent other than clindamycin, and from 9 women 1 to 9 weeks after they were discharged from the hospital following clindamycin therapy. Only 5 (0.

Sulbactam/ampicillin versus metronidazole/gentamicin in the treatment of severe pelvic infections.

The clinical efficacy and safety of sulbactam/ampicillin versus metronidazole/gentamicin were compared in 39 patients with severe pelvic infections. 30 patients had severe acute pelvic inflammatory disease with peritonitis, 3 tubo-ovarian abscesses, 4 endomyometritis, and 2 posthysterectomy pelvic cellulitis. Aerobic and anaerobic cultures from the sites of infection yielded 259 micro-organisms from 38 patients; an average of 6.

Microbiology of the lower genital tract in postmenarchal adolescent girls: differences by sexual activity, contraception, and presence of nonspecific vaginitis.

The prevalence of selected microorganisms in the lower genital tract in postmenarchal adolescent girls was assessed, including vaginal Gardnerella vaginalis, group B streptococcus, lactobacillus, Mycoplasma species, Ureaplasma urealyticum, Staphylococcus aureus, and yeast, and endocervical Mycoplasma species, U. urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Specific attention was focused on important sexually transmitted disease organisms, and differences in isolations by age, sexual activity, ethnicity, contraception, and the diagnosis of nonspecific vaginitis were measured.

Moxalactam versus clindamycin plus tobramycin in the treatment of obstetric and gynecologic infections.

The clinical efficacy of moxalactam versus clindamycin/tobramycin was evaluated in a comparative, randomized, prospective study. Sixty patients were treated: 30 with moxalactam and 30 with clindamycin/tobramycin. There were 15 cases of tuboovarian abscess, 36 cases of severe pelvic inflammatory disease with peritonitis, eight cases of endomyometritis, and one wound abscess.

In vitro activity of cefbuperazone and other antimicrobial agents against isolates from the female genital tract.

Cefbuperazone (BMY 25182), a new cephamycin, showed activity similar to those of moxalactam and other cephalosporin-cephamycins against aerobic and anaerobic bacteria from female genital tract infections. MICs of the antimicrobial agents were less than or equal to 16 micrograms/ml for greater than 97% of organisms tested. All of the anaerobic bacteria tested were susceptible to clindamycin, metronidazole, and chloramphenicol.

Comparative study of piperacillin versus cefoxitin in the treatment of obstetric and gynecologic infections.

Piperacillin sodium (Pipracil, Lederle Laboratories, Wayne, New Jersey), a new semisynthetic penicillin, demonstrated in vitro activity against a broad spectrum of clinical pathogens. It is active against most strains of the clinically important gram-negative aerobic or facultative bacteria and against virtually all the clinically important anaerobic organisms, including Bacteroides fragilis and Bacteroides bivius. This broad antibacterial spectrum suggested that piperacillin might be an effective single antimicrobial agent for the treatment of mixed aerobic/anaerobic infections in obstetric and gynecologic patients.

In vitro activity of new beta-lactam antibiotics and other antimicrobial drugs against anaerobic isolates from obstetric and gynecological infections.

The in vitro activities of N-formimidoyl thienamycin, clindamycin, chloramphenicol, metronidazole, cefoperazone, cefotaxime, cefoxitin, moxalactam, penicillin G, and piperacillin were determined against 158 anaerobic bacteria isolated from endometrial wash cultures of women with pelvic infections. In general, N-formimidoyl thienamycin was the most active, with all organisms inhibited by less than or equal to 0.5 microgram/ml.

Effect of estrogen treatment on the genital tract flora of postmenopausal women.

The anaerobic and aerobic flora of the vagina was identified in 79 postmenopausal women, 33 of whom received estrogen replacement. Four anaerobic species were more prevalent among estrogen-treated women than among untreated women, whereas 2 anaerobic species were less prevalent in the treated group. The types of organisms isolated from both groups are similar and all organisms isolated were considered usual inhabitants of the genital tract.