Antibiotic susceptibility of anaerobic bacteria in Europe.

Twenty-two laboratories in 15 European countries determined the MICs of 12 antibiotics for 1,289 isolates of the B. fragilis group by a microdilution method. There was no resistance to metronidazole (breakpoint, 8 mg/L), and only one isolate was found to be resistant to chloramphenicol (breakpoint, 8 mg/L).

Cellular fatty acids in Fusobacterium species as a tool for identification.

Identification of fusobacteria from clinical specimens currently requires analysis of metabolic end products by gas-liquid chromatography in addition to certain biochemical and enzymatic tests because of the relative biochemical inactivity of these bacteria. Even the finding of pointed, thin gram-negative cells on Gram-stained slides can no longer be relied on for identification of Fusobacterium nucleatum, since at least four other species of fusobacteria have been seen to exhibit similar morphology. We examined 46 clinical isolates and six American Type Culture Collection type strains of fusobacteria by conventional methods and by the Microbial ID Systems MIDI software package for analyzing cellular fatty acid patterns measured by capillary column gas-liquid chromatography.

Effect of beta-lactamase inhibitors on beta-lactamases from anaerobic bacteria.

Three beta-lactamase inhibitors in clinical use--clavulanic acid, sulbactam and tazobactam--were investigated for their activity on beta-lactamases from Bacteroides uniformis, Clostridium butyricum and Fusobacterium nucleatum. Purification of the beta-lactamases was carried out by anion-exchange chromatography, gel filtration and FPLC. The inactivation of beta-lactamase activity was determined spectrophotometrically with nitrocefin as substrate.

Bilophila wadsworthia isolates from clinical specimens.

Bilophila wadsworthia is an anaerobic, gram-negative, asaccharolytic, bile-resistant, catalase-positive bacillus that is usually urease positive and was originally recognized in specimens of peritoneal fluid and tissue from patients with appendicitis. Additional isolations from clinical specimens, including a scrotal abscess, mandibular osteomyelitis, axillary hidradenitis suppurativa, pleural fluid, joint fluid, and blood, are described here.

Effect of clavulanic acid, sulbactam and tazobactam on three different beta-lactamases from Bacteroides uniformis, Clostridium butyricum and Fusobacterium nucleatum.

The effect of three beta-lactamase inhibitors, clavulanic acid, sulbactam and tazobactam used in clinical practice were compared for their activity against purified beta-lactamases from Bacteroides uniformis, Clostridium butyricum and Fusobacterium nucleatum. The enzymes from B. uniformis and C.

Detection and quantitation by lysis-filtration of bacteremia after different oral surgical procedures.

Patients with bacteremia after dental extraction, third-molar surgery, dental scaling, endodontic treatment, and bilateral tonsillectomy were studied by means of lysis-filtration of blood samples with subsequent aerobic and anaerobic incubation. Samples were obtained before, during, and 10 min after treatment. Bacteremia was observed in 100% of patients after dental extraction, 55% of patients after third-molar surgery, 70% of patients after dental scaling, 20% of patients after endodontic treatment, and 55% of patients after bilateral tonsillectomy.

Purification and characterization of a new beta-lactamase from Clostridium butyricum.

A highly penicillin-resistant beta-lactamase-producing strain of Clostridium butyricum, strain NBL 3, was isolated. The specific activity of the unpurified beta-lactamase was 0.29 U/mg of protein.

Beta-lactamase producing anaerobic bacteria in the oropharynx and their clinical relevance.

The mechanisms of resistance to beta-lactam antibiotics in anaerobic bacteria are production of beta-lactamases, alteration of penicillin-binding proteins and blocked penetration of beta-lactam agents through the outer membranes. The most important factor in beta-lactam resistance is production of beta-lactamase. Beta-lactamases have been found in oropharyngeal strains of bacteroides and fusobacteria isolated from orofacial infections, peritonsillitis and recurrent tonsillitis.

Emergence of beta-lactamase producing anaerobic bacteria in the tonsils during penicillin treatment.

The emergence of beta-lactamase producing bacteria in the microflora in the oropharyngeal cavity was studied in ten healthy volunteers treated with 1 g phenoxymethylpenicillin b.i.d.

Impact on peritonsillar infections and microflora of phenoxymethylpenicillin alone versus phenoxymethylpenicillin in combination with metronidazole.

In a double-blind study, 20 patients with peritonsillar abscesses were treated with 2 g phenoxymethylpenicillin b.i.d.

Characterization of a new beta-lactamase from Fusobacterium nucleatum by substrate profiles and chromatofocusing patterns.

Seven beta-lactamase-producing Fusobacterium nucleatum strains were isolated from patients with recurrent tonsillitis. The isolates were highly resistant to phenoxymethylpenicillin, benzylpenicillin, ampicillin, piperacillin and cloxacillin. They were all sensitive to cefaclor, cephaloridine, cefotaxime, cefoxitin, latamoxef (moxalactam) and imipenem.

Purification and properties of a novel beta-lactamase from Fusobacterium nucleatum.

A strain of Fusobacterium nucleatum which produced high levels of beta-lactamase was isolated. The specific activity of the unpurified beta-lactamase was 7.8 U/mg of protein.

Impact of phenoxymethylpenicillin and clindamycin on microflora in recurrent tonsillitis.

A total of 75 patients with recurrent tonsillitis, between 15 and 44 years of age, were divided into three groups, two of which were treated with antibiotics before surgery. Bacteriological specimens were collected before treatment started and the microflora of the excised tonsils were analyzed. Bacteroides species were found in the tonsils of 83% of the patients, and 50% of these microorganisms were beta-lactamase producers.

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.

Betalactamase-producing microorganisms in recurrent tonsillitis.

In 73% of 167 patients with recurrent tonsillitis, colonization with betalactamase-producing microorganisms was found. Betastreptococci group A were recovered in 6% of the patients and group C and G streptococci in 23%. Other microorganisms found were Staphylococcus aureus in 42%, Haemophilus species in 52%, bacteroides species in 80% and fusobacteria in 40%.

Battered women. A surgical problem.

In a retrospective study on 456 women hospitalized at the Departments of Surgery and Oto-rhinolaryngology of Huddinge Hospital for emergency injuries during the years 1978 and 1979, the injuries were found to have been caused by battering in 29%. The majority of the women had been physically abused by their husbands, fiancés or cohabitees. As women seldom seek social or psychiatric assistance for this problem spontaneously, it is an important task of the responsible accident surgeon both to detect battering as the cause of the injuries and to act as mediator in contacting a women's refuge or other social assistance agency.