In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses.

One hundred and forty-eight isolates of bacteria from 20 intraoral odontogenic abscesses were tested for their susceptibility to spiramycin and metronidazole alone or in combination. All isolates, except Rothia spp. (one), Enterococcus avium (three), Haemophilus parainfluenzae (one) and Staphylococcus aureus (one) were sensitive to spiramycin and/or metronidazole.

Efficacy of topical povidone-iodine during the first week after ophthalmic surgery.

Purpose: In the first postoperative day, povidone-iodine ophthalmic solution prevents an increase in conjunctival bacterial colony-forming units and decreases the species compared with antibiotic. We sought to determine whether these beneficial effects of povidone-iodine could be sustained during the first postoperative week.

Methods: In 42 eyes of 35 consecutive patients, one or two drops of either a broad-spectrum antibiotic (polymyxin B sulfate-neomycin sulfate-gramicidin) or povidone-iodine 1.

Single-tube, nested, reverse transcriptase PCR for detection of viable Mycobacterium tuberculosis.

Several problems remain before molecular biology-based techniques, such as PCR, are widely accepted for the detection of infectious agents. Among the most formidable of these problems are the inability of the tests to distinguish between viable and nonviable organisms. We approached this problem by using the fact that bacterial mRNA has an extremely short half-life, averaging only a few minutes.

The effect of povidone-iodine solution applied at the conclusion of ophthalmic surgery.

Purpose: Povidone-iodine 5% solution decreases the incidence of postoperative endophthalmitis when used on the eye for preoperative preparation. We sought to determine whether it also minimized conjunctival bacterial flora immediately after surgery by preventing bacteria present on the surface of the eye from entering surgical wounds.

Methods: In 42 eyes of 40 patients, at the conclusion of surgery, on an alternating basis, each patient received either a drop of a broad-spectrum antibiotic solution (polymyxin B sulfate-neomycin sulfate-gramicidin) or a 5% povidone-iodine solution in the operated-on eye.

Povidone-iodine for ophthalmia neonatorum prophylaxis.

Purpose: The agents currently used to prevent ophthalmia neonatorum are less than optimal, with reports indicating evidence of bacterial resistance, ineffectiveness, and toxicity. Povidone-iodine ophthalmic solution, which has been shown to be effective in the preoperative preparation of the eye, generates no resistance, is an effective antimicrobial agent, and has low toxicity. We evaluated the effectiveness and safety of povidone-iodine for ophthalmia neonatorum prophylaxis.

Nonfluorescent erythrasma of the vulva.

Background: Erythrasma is an uncommon vulvar infection, best diagnosed by its fluorescence under the Wood lamp. This report shows that despite a negative Wood lamp examination, the diagnosis can be made histologically.

Case: A 42-year-old woman was referred to our clinic with a persistent candidal infection.

Outpatient topical use of povidone-iodine in preparing the eye for surgery.

Povidone-iodine 5% solution placed on the eye immediately before ophthalmic surgery within the preoperative preparation significantly reduces the conjunctival bacterial flora. In 40 patients undergoing ophthalmic surgery, the authors compared the outpatient use of povidone-iodine for 3 days before surgery with a 3-day course of a combination antibiotic ophthalmic solution (Neosporin) placed on the other eye. All patients also received topical povidone-iodine on the operating table directly preceding surgery.

Source of the conjunctival bacterial flora at birth and implications for ophthalmia neonatorum prophylaxis.

To understand better the source of conjunctival bacteria in neonates, we studied 106 infants immediately after birth before any eyedrops were applied. The 50 infants delivered by cesarean section had significantly fewer species (0.50 +/- 0.

Bacterial flora of the conjunctiva at birth.

In the largest study to date of bacterial flora in newborns, we cultured the conjunctivae of 100 infants within 15 minutes after vaginal delivery and before any antimicrobial agents had been applied to the eye. All cultures were intensively analyzed for anaerobic and aerobic bacteria. By far the largest group of bacteria isolated were microaerophilic, such as Lactobacillus species and diphtheroids, accounting for 46.

pH changes caused by bacterial growth in contaminated platelet concentrates.

While platelet concentrates are stored at room temperature, lactic and other acids are produced and the pH decreases as the buffering capacity of the plasma is exhausted. Platelet viability will be compromised if the pH decreases to pH 6.0 and below.

Chemical preparation of the eye in ophthalmic surgery. IV. Comparison of povidone-iodine on the conjunctiva with a prophylactic antibiotic.

We previously found that half-strength (5%) povidone-iodine solution significantly reduced the bacterial flora of the conjunctiva. To compare the antibacterial effect of a topical combination antibiotic (Neosporin ophthalmic solution) given three times daily for three days preoperatively with that of half-strength povidone-iodine solution given as part of the preoperative preparation, conjunctival cultures were studied from 35 patients undergoing ocular surgery. When used individually, the antibiotic and povidone-iodine solutions caused a similar and substantial decrease in the number of colonies and species of bacteria cultured.

Antimicrobial preparation of the eye for surgery.

An important source of postoperative eye infection is the indigenous flora in and around the eye. Therefore, proper preparation of the operative field is crucial. Through an international survey we determined that ophthalmic surgeons used widely varying techniques in the pre-operative antimicrobial preparation of the eye.

Chemical preparation of the eye in ophthalmic surgery. III. Effect of povidone-iodine on the conjunctiva.

A half-strength povidone-iodine (Betadine) solution was used topically as part of the preoperative chemical preparation of the eye. Aerobic and anaerobic bacterial cultures of the conjunctiva were taken before and after the chemical preparation in 30 consecutive patients; the second eye served as a control. In the control eyes, no significant change in the number of colonies or species of bacteria was found.

Postoperative neurosurgical infections due to bacillus species.

The cases of 2 patients with postoperative ventriculitis due to Bacillus species bacteria are presented. Bacillus licheniformis was isolated from one patient following removal of an intraventricular meningioma, and Bacillus cereus from another patient following placement of a ventriculoperitoneal shunt. Both isolates were resistant to a variety of antibiotics, but both were sensitive to gentamicin and chloramphenicol.

Wound botulism in pediatrics.

A 6-year-old boy with congenital deafness sustained compound fractures to his left ulna and radius. Six days after the injury, he appeared lethargic, and his illness progressed to respiratory failure within three days. Although the wound at the fracture site appeared benign, cultures obtained when the wound was opened grew Clostridium botulinum, type B.

Phaeohyphomycosis of brain: granulomatous encephalitis caused by Drechslera spicifera.

Drechslera spicifera is a dematiaceous fungus which occurs widely in nature but only rarely has been implicated in animal and human infections. Previous infections have occurred in superficial and subcutaneous sites or were encountered in immunologically compromised hosts. This report documents a case of granulomatous encephalitis due to Drechslera spicifera in an immunologically competent woman with no known underlying disease, from whom the fungus was isolated.

Cerebritis due to group B streptococcus.

A premature infant who died of early-onset group B streptococcal meningitis was found to have cerebritis with direct bacterial infection of the basal ganglia. Although the organism was sensitive to penicillin by in vitro testing, it was not eradicated from the cerebrospinal fluid after 48 h of antibiotic treatment. These findings illustrate that suppurative extension with cerebritis of the basal ganglia as a complication of group B streptococcal meningitis may be one of the factors responsible for treatment failure.

Antimicrobial therapy of postpartum endomyometritis. II. Prospective, randomized trial of mezlocillin versus ampicillin.

Seventy patients with postpartum endomyometritis were treated with either intravenous mezlocillin (16 gm/day) or ampicillin (8 gm/day) in a prospective, randomized, double-blind comparison. Endocervical dilatation was routinely performed. Clindamycin (2 gm/day) was added if patients failed to improve within 48 hours of beginning therapy.

Relative importance of bacteremia and viremia in the course of acute fevers of unknown origin in outpatient children.

During a 12-month period 80 children greater than 3 months of age seen at an emergency room with acute fevers greater than or equal to 39.7 C (103.5 F) and no localizing signs of infection were studied using blood and buffy coat cultures to isolate bacteria and viruses.

Importance of medium in demonstrating penicillin tolerance by group B streptococci.

A total of 30 clinical isolates of group B streptococci were studied for penicillin tolerance in vitro. Minimal inhibitory and bactericidal concentrations of penicillin were determined simultaneously in three test media which have been used for group B streptococci, tryptose phosphate, Mueller-Hinton, and Todd-Hewitt broths, using a logarithmic-phase inoculum of 10(5) colony-forming units per ml. Minimal inhibitory concentrations in the three media did not differ significantly.

Susceptibility of Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) to minocycline.

The in vitro activity of minocycline against Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) was examined. All strains of A.