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The therapeutic perspectives of flomoxef, SCE 2787, cefpirome, cefepime, latamoxef, cefotaxime and of piperacillin plus tazobactam were comparatively evaluated by their in vitro activity against 1119 clinical isolates of 83 bacterial species. Escherichia coli, Klebsiella spp. Enterobacter sakazakii, Proteus spp. and Shigella spp. were about equally susceptible to the cephalosporins (MIC90: 0.06 to 0.5 mg/l), while the MIC90 for piperacillin plus tazobactam was between 2 and 16 mg/l. Enterobacter cloacae, Enterobacter aerogenes and Serratia spp. were most susceptible to SCE 2787, cefpirome and cefepime (MIC90: 0.06 to 2 mg/l) followed by latamoxef, cefotaxime, flomoxef and piperacillin plus tazobactam. For Citrobacter spp., Providencia spp. and Yersinia enterocolitica MIC90 were between 0.06 and 0.5 mg/l. Flomoxef was between 2 to 4 log2 less active against these species but more active than piperacillin plus tazobactam (MIC90: 2 and 8 mg/l). Morganella morganii and Hafnia alvei were most susceptible to cefepime, cefpirome and latamoxef (MIC90: 0.13 to 0.5 mg/l) while cefotaxime (MIC90: 8 mg/l) and piperacillin plus tazobactam (MIC90: 8 and greater than 64 mg/l) were the least active compounds. SCE 2787, cefepime and cefpirome were the most potent beta-lactams against the majority of the 13 species of non-fermentative bacilli (NFB) investigated (MIC90: 0.5 to 16 mg/l). The oxacephems were the least active compounds against NFB. Cefepime was the most active of the compounds included against Pseudomonas aeruginosa (MIC90: 16 mg/l). Haemophilus spp., Neisseria gonorrhoeae and Bordetella pertussis were most susceptible to cefotaxime (MIC90: 0.03 to 0.06 mg/l). Latamoxef had the lowest activity of all compounds against gram-positive cocci. Flomoxef was the most active compound against penicillinase producing Staphylococcus aureus and about equally active as the other betalactams against methicillin susceptible staphylococci of other staphylococcal species.(ABSTRACT TRUNCATED AT 250 WORDS)
Infection 1991
PMID:In vitro activity and stability against novel beta-lactamases of investigational beta-lactams (cefepime, cefpirome, flomoxef, SCE2787 and piperacillin plus tazobactam) in comparison with established compounds (cefotaxime, latamoxef and piperacillin). 166 18

Infection with Yersinia enterocolitica had been associated with acute appendicitis in approximately six per cent of patients in northern European countries. However, the incidence of Y. enterocolitica in patients with appendicitis in this country is uncertain. Therefore, this study was undertaken to ascertain whether Y. enterocolitica is a possible infectious agent in appendicitis in the southwestern United States. Fifty prospective patients (35 men and 15 women) with an average age of 22.3 years (range 3 to 62 years) underwent appendectomy for presumed appendicitis. Portions of each specimen were cultured for Y. enterocolitica with highly selective media (Cefsulodin-Irgasan-Novobiocin [CIN] agar). Pathologically, 44 of the patients had appendicitis and 6 patients had normal appendices. Four of the 44 patients (9.1%) with appendicitis were found to be culture positive for Y. enterocolitica, while it was recovered from none of the normal appendices. This indicates that Y. enterocolitica may represent the major pathogen in acute appendicitis in a small, but distinct, portion of indigent patients within Los Angeles County as it does elsewhere in the world.
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PMID:The role of Yersinia enterocolitica in appendicitis in the southwestern United States. 174 91

The new oral cephalosporins cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten demonstrate enhanced activity against Enterobacteriaceae susceptible to the established compounds as well (e.g. cefuroxime, cefaclor, cefadroxil). In addition, cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten include in their spectrum species hitherto resistant to oral cephalosporins (Proteus vulgaris, Providencia spp., Yersinia enterocolitica). Besides, the majority of these compounds demonstrate relevant activity (MIC50 equal to or below 2 mg/l) against Enterobacter spp., Citrobacter freundii, Serratia spp. and Morganella morganii. Ceftibuten is the most potent oral cephalosporin against most of the Enterobacteriaceae. Non-fermentative bacilli (Acinetobacter spp., Pseudomonas spp.) remain completely resistant to oral cephalosporins (except some Acinetobacter species against cefdinir and Pseudomonas cepacia against ceftibuten). Antistaphylococcal activity for oral cephalosporins is highest for cefdinir followed by BAY 3522, cefprozil, cefuroxime and cefpodoxime. Loracarbef, cefaclor and cefadroxil are about equally active, while the other compounds are only weakly active (cefixime) or inactive (cefetamet, ceftibuten). Enterococci are insensitive to new generation oral cephalosporins as they have been to established compounds. The most active oral cephalosporins against hemolytic streptococci are cefdinir and cefprozil. Streptococcus pneumoniae, Streptococcus milleri and Streptococcus mitior are most susceptible to cefpodoxime, cefdinir, cefuroxime and BAY 3522. Penicillin resistant pneumococci have to be regarded as resistant to all oral cephalosporins. Fastidious pathogens like Haemophilus spp., Moraxella catarrhalis and Neisseria gonorrhoeae are more susceptible to cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten than to the other oral cephalosporins. The activity of oral cephalosporins is only weak against Listeria spp., Helicobacter pylori and anaerobic pathogens (except BAY 3522). Bordetella pertussis remains resistant to all absorbable cephalosporins. Progress in antibacterial activity of oral cephalosporins was mainly achieved by cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten against Enterobacteriaceae and the fastidious pathogens and against staphylococci and the nonenterococcal streptococci by cefdinir, BAY 3522, cefprozil and cefpodoxime.
Infection
PMID:Antibacterial activity of cefpodoxime in comparison with cefixime, cefdinir, cefetamet, ceftibuten, loracarbef, cefprozil, BAY 3522, cefuroxime, cefaclor and cefadroxil. 180 Mar 77

In 40 submissions to the Regional Veterinary Laboratory (RVL) Wagga Wagga from sheep in southern New South Wales from 1981 to 1989, 53 isolates of Yersinia sp were recovered from 45 sheep in 37 flocks. Of 53 isolates, 26 were identified as Y. pseudotuberculosis, 20 as Y. enterocolitica, 5 as Y. intermedia and 2 as Y. frederiksenii. Twelve isolates of Y. pseudotuberculosis tested in the slide agglutination test all belonged to serotype III. The 20 Y. enterocolitica isolates were categorised biochemically as biotype 5 strains and, of 6 isolates serotyped, all belonged to serogroup 2,3. Outbreaks of yersiniosis were most common in late winter and early spring and affected flocks often had experienced a change in husbandry. Infection with Yersinia sp was associated with diarrhoea, illthrift and mortality. At necropsy, congestion and occasionally thickening of the intestinal mucosa were observed in affected sheep. Gastrointestinal nematodiasis and coccidiosis often were concurrent findings. The characteristic histological lesion in sheep infected with Y. pseudotuberculosis was acute segmental suppurative erosive enterocolitis. There were no lesions consistently associated with Y. enterocolitica, Y. intermedia or Y. frederiksenii.
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PMID:Yersinia species isolated from sheep with enterocolitis. 204 83

New knowledge in the understanding of infection immunology and the development of more effective antibiotics will influence the therapeutic options for extra- and intraocular bacterial diseases. The role of mucin with its high sIgA content, the glycoconjugate-mediated bacterial adherence phenomena of the cornea and conjunctiva, and the exact biomicroscopic classification can be constrated with the highly effective topically and systemically applicable antibiotics (e.g., Cephalosporins, Aminoglycosides, New Quinolones and Carbapenems). Recognition of the fact that the amplification mechanisms of the immune system are already fully activated when the clinical features of a serpent ulcer appear and that the destructive phase only represents an unwanted side-effect of the host defense mechanisms towards its own structures has resulted in the application of corticosteroids with simultaneous antibiotic medication and early tectonic perforating keratoplasty. Many intraocular inflammations of heretofore unknown etiology may be detected by modern diagnostic approaches as being localized manifestations of a systemic disease that can be properly treated (e.g., borreliosis, atypical syphilis). The incidence of "metastatic" endophthalmitis could be diminished in high-risk inpatients by preventive measures, including the elimination of potentially pathogenic agents with antibiotics (and antifungal drugs). Infection-associated intraocular inflammations ("Reiter's syndrome") have been linked to persisting pathogenic organisms at distant sites, thereby rendering themselves etiologically treatable (e.g., infections from Yersinia, Campylobaster, Urea-plasma, and Chlamydia). Except for a very few cases (use of monoclonal antibodies, serological methods and immunoblots), the diagnosis of bacterial infections is based on isolation of the organism concerned, which also represents a requirement for antibiotic susceptibility testing and, consequently a specific medication. Close cooperation with microbiologists and the direct culturing of isolates within ophthalmology clinics have seen a revival since the days of Theodor Axenfeld.
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PMID:[Diagnosis and therapy of acute bacterial infections of the eye]. 208 16

A study was undertaken on the presence and frequency of Listeria sp. in feces from 1,000 patients suffering from diarrheal diseases and from 2,000 healthy persons. Furthermore, the feces of patients were examined for other well-documented enteropathogens such as Campylobacter, Salmonella, Shigella, Staphylococcus aureus, Yersinia enterocolitica, protozoa and rotavirus as well as for organisms of questionable enteropathogenic potency such as fungi, i.e. Candida. Finally, in continuation of previously described investigations of the enteropathogenic role of Proteus mirabilis but not of Proteus vulgaris, both these species were studied too. Only Listeria innocua and Listeria monocytogenes could be detected in the investigated fecal specimens. There were no differences of the frequencies of L. innocua, and L. monocytogenes between patients and healthy persons. 17 strains (= 1.7%) of L. innocua and six strains (= 0.6%) of L. monocytogenes were isolated from 1,000 samples of patients. As a comparison 2,000 fecal samples from healthy people contained 40 strains (= 2.0%) of L. innocua and 16 strains (= 0.8%) of L. monocytogenes. A coincidence study showed that there were no statistically significant correlations between well-known enteropathogens and Listeria sp., Proteus sp. or any of the other isolates. Significant correlations were found only between harmless species such as L. innocua and P. vulgaris.
Infection
PMID:Listeria isolations from feces of patients with diarrhea and from healthy food handlers. 211 Jan 18

We report a case of hematogenous Yersinia enterocolitica coxitis 10 years after hip replacement. Despite extraction of the prosthesis and antibiotic treatment, the infection relapsed. Infections in replaced joints with Yersinia enterocolitica call for long-standing treatment with specific antibiotics.
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PMID:Yersinia enterocolitica coxitis after hip replacement. A case report. 240 93

To determine if Yersinia enterocolitica (YE) enteritis is associated with an alteration of intestinal myoelectric and motor activity, and with an increased rate of aboral transit, New Zealand white rabbits (500-900 g) were surgically prepared with ileal bipolar electrodes and a manometry catheter adjacent to the distal electrode. One week later animals were inoculated with 10(10) organisms of YE in 10 mL NaHCO3 (infected group) or 10 mL NaHCO3 (sham-infected pair-fed and control groups). Daily food intake, weight gain, YE excretion, and stool pattern were noted. Intestinal myoelectric and motor activity over a 6- to 8-h period before and 3, 6, and 14 days after inoculation was compared in infected (I), pair-fed (PF), and control (C) groups. Intestinal transit was evaluated in I and C animals on days 3 and 6 after inoculation by measuring the distribution in the intestinal lumen of 51Cr 20 min after it was instilled directly into the jejunum. Infected animals exhibited diarrhea, fecal excretion of YE, and significantly decreased food intake, weight gain, and survival (11.4 +/- 0.6 days). Infection was associated with a significant (p less than 0.05) decrease in both the cycle period of the migrating myoelectric complex (MMC) and the total number of single, paired, and (or) clustered contractions per MMC, and a significant (p less than 0.001) increase in duration of phase III of the MMC. There was no change in intestinal slow wave frequency (19 cycles/min), motility index per MMC, or the percentage of contractions that propagated in an orad (7%) or aboral (69%) direction or that appeared stationary (25%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intestinal motility during acute Yersinia enterocolitica enteritis in rabbits. 277 74

Infections of the gastrointestinal tract still are numerous, ranging on the second place after infections of the respiratory tract. Some of them show quite severe or prolonged course. In contrast to other infections, especially those of the urinary tract, laboratory diagnostic of enteritis is only scarcely ordered. During the last ten years new methods and knowledge of etiologic germs like Campylobacter, Yersinia, various types of E. coli, Clostridium difficile, Rotavirus, Adenovirus, Giardia, Blastomyces and Cryptosporidia have been accumulated. A better etiologic diagnosis of these infections should enable the clinician to start a more precise and therefore more effective therapy.
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PMID:[Bacteriologic and serologic diagnosis of enteral infections]. 305 77

The role of preceding infection as a risk factor for ischaemic stroke was investigated in a case-control study of 54 consecutive patients under 50 years of age with brain infarction and 54 randomly selected controls from the community matched for sex and age. Information about previous illnesses, smoking, consumption of alcohol, and use of drugs was taken. A blood sample was analysed for standard biochemical variables and serum cholesterol, high density lipoprotein cholesterol, triglyceride, and fasting blood glucose concentrations determined. Titres of antimicrobial antibodies against various bacteria, including Staphylococcus, Streptococcus, Yersinia, and Salmonella and several viruses were determined. Febrile infection was found in patients during the month before the brain infarction significantly more often than in controls one month before their examination (19 patients v three controls; estimated relative risk 9.0 (95% confidence interval 2.2 to 80.0)). The most common preceding febrile infection was respiratory infection (80%). Infections preceding brain infarction were mostly of bacterial origin based on cultural, serological, and clinical data. In conditional logistic regression analysis for matched pairs the effect of preceding febrile infection remained significant (estimated relative risk 14.5 (95% confidence interval 1.9 to 112.3)) when tested with triglyceride concentration, hypertension, smoking, and preceding intoxication with alcohol. Although causality cannot be inferred from these data and plausible underlying mechanisms remain undetermined, preceding febrile infection may play an important part in the development of brain infarction in young and middle aged patients.
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PMID:Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients. 313 45


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