ISSN:0009-3157    

DOI:10.1159/000238144

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The clinical picture of candidal vaginitis was described for the first time in 1792. The connection with yeasts was already discovered in the 19th century. Not until the last 35 years, however, have the epidemiologic aspects of genital mycoses and the diagnostic and therapeutic principles been systematically developed. The rise in the incidence of the disease is due to several factors: the administration of corticosteroids, cystostatic agents, and oral contraceptives as well as socioeconomic circumstances. Two serious complications of vaginal yeast infection in pregnant women should be noted: the amniotic infection syndrome and neonatal contamination at the time of delivery. Vulvovaginitis is one of the most common genital diseases in childhood and adolescence. Mycoses can be diagnosed in daily gynecological practice by simple, reliable methods, but only culture on prepared media or by incubation of standardized plates can be depended upon to establish or rule out a mycosis. Effective antimycotics with a broad spectrum of activity have been developed in the last 15 years. We have been primarily concerned with clotrimazole because of our own investigations and impartial comparisons with other fungicidal drugs. Studies of patient compliance have shown that the diseased women accept short-term therapy most readily. However, appropriate control examinations are needed to document the results of treatment.

ISSN:0009-3157    

DOI:10.1159/000238145

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Hospital isolates of Serratia marcescens able to transfer resistance to up to 11 antibiotics were found to contain conjugative R plasmids. One set of strains harbors only a single R plasmid with a mass of 89 megadaltons (Mdal). This plasmid codes for resistance to nine antibiotics including ampicillin, carbenicillin, cephalothin, streptomycin, kanamycin, gentamicin, tobramycin, sisomycin, and sulfonamides. The 2nd set of strains harbors 2 R plasmids, 1 with a mass of 89 Mdal, the other 57 Mdal. Analysis of progeny from genetic crosses indicates that the larger R plasmid codes for resistance to the same antibiotics as does the 89-Mdal plasmid described above. The 57-Mdal species codes for resistance to ampicillin, carbenicillin, cephalothin, kanamycin, neomycin, and tetracycline. The 89- and 57-Mdal R plasmids appear unrelated by a number of genetic and physical criteria. The 89-Mdal plasmid, but not the 57-Mdal species, is transferable by conjugation to Pseudomonas aeruginosa, and renders this species stably resistant to carbenicillin, streptomycin, kanamycin, gentamicin, tobramycin, and sisomycin.

ISSN:0009-3157    

DOI:10.1159/000238054

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Clear microscopic evidence of yeasts together with a detailed case history and results of the clinical examination are adequate for a definite diagnosis of vaginal mycoses. In principle, vaginal mycoses can only be ruled out by culture studies. This must be taken into account particularly when assessing the efficacy of antimycotics. Yeasts, in particular Candida albicans, are often detected on the mucosa and morphologically similar areas in man and animals without any symptoms being present. They are also occasionally found elsewhere, for example on fruit, foodstuffs, etc. This has led to the organisms being termed ‘facultative pathogenic saprophytes’ and to them being evaluated as relatively harmless. The term ‘facultative pathogenic opportunists’ is certainly more relevant. The problems in determining the pathogenicity of yeasts are similar to those encountered in the past with various bacteria. The pathogenic significance of yeast contamination is also linked to the interaction between organism- and host-related factors. In the case of organism-related factors, viable count and rate of proliferation are important as well as the different biochemical properties of the individual yeast strains, such as endo- and exotoxin formation and proteolytic activity. Endocrine disturbances, such as diabetes mellitus, hypothyroidism and hypoparathyroid-ism are accompanied by an increase in yeast infestation and a corresponding increase in the incidence of infection. The transition from yeast contamination to yeast infection largely depends upon the tolerance of the host or host tissue. This is lowered by a general reduction in resistance, antibody deficiency syndrome, avitaminosis, serum iron deficiency, etc. The well-known enhancing effect of various chemotherapeutic agents on the virulence of yeasts or responsiveness of the host organism is assessed in different ways; the threshold for the transition from contamination to infection is difficult to define, and the pathophysiological mechanism of yeast-related diseases is also unclear. Yeasts produce endo- and exotoxins only on a small scale, a purely toxic genesis is therefore improbable. Their interpretation as an allergic reaction, which is possible in gynaecological observations of acute mycotic vulvitis, is questionable since inflammatory reactions have also been observed in neonates with immature immunological systems during the first days of life and very occasionally even during intrauterine life. More information about the infectious process is expected from additional immunological and histochemical investigations. The following report deals with experimental investigations which provide an answer to some current p

ISSN:0009-3157    

DOI:10.1159/000238147

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The bactericidal activity of cefazolin, cefoxitin, and cefmetazole against clinical isolates of Escherichia coli and Klebsiella pneumoniae was investigated. The mean geometric minimum inhibition concentrations against 200 strains each of the test organisms were lowest for cefmetazole, followed by cefazolin and cefoxitin. The killing activity at 5 and 50 μg/ml of cefazolin and cefmetazole was almost the same and was superior to that of cefoxitin. In the kinetic model under conditions simulating the serum levels of the two drugs in humans after intravenous injection (1 g), cefazolin was the strongest of the three drugs in bactericidal activity. The results indicate that the highest and most prolonged serum concentrations of cefazolin reflected the strong bactericidal activity and the longest inhibition period of bacterial regrowth

ISSN:0009-3157    

DOI:10.1159/000238056

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The introduction of clotrimazole into the therapy of vaginal Candida and Torulopsis infections has significantly shortened the previously customary duration of treatment and reduced the frequency of dosage of the active ingredient. This simplification of therapy was based on the highly favorable antimycotic properties of clotrimazole. Since compliance problems arose among patients neverheless, it was desired to shorten the length of treatment even further. This led us to carry out extensive studies on the basis, mechanisms and kinetics of the antimycotic action of azoles so that possibilities and limits to further reductions of the duration of treatment might be ascertained. The data presented below on the structure/activity relationships, mechanism of action, MIC values under special test conditions, fungicidal action, and active ingredient release in vitro and in vivo made it possible to propose a 1-day treatment for vaginal mycoses.

ISSN:0009-3157    

DOI:10.1159/000238148

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A simple test procedure is described for the rapid evaluation of β-lactamase substrate profiles against all the clinically important β-lactam antibiotics. By use of this method 100 clinical isolates of Escherichia coli were classified into four β-lactamase types: TEM-like, 35; chromosomal-like, 56; others, 3; β-lactamase-less, 6 strains. They were tested for their susceptibilities to cefuroxime, cefoxitin, cefamandole, cephalexin, cefazolin, cephaloridine, cephalothin, ampicillin, carbenicillin and kanamycin. The isolates of each of TEM-like and chromosomal-like β-lactamase types showed a good correlation between the β-lactamase activity and the minimum inhibitory concentration (MIC) determined by the agar dilution method and the least square line analysis; MIC = ax + b, where x is enzyme activity, and a and b are constants. TEM-like β-lactamase increased the resistance to ampicillin and carbenicillin markedly and that to cephalothin, cephaloridine and cefamandole moderately. In contrast, chromosomal-like β-lactamase increased the resistance to ampicillin, cephalexin and cephalothin only s

ISSN:0009-3157    

DOI:10.1159/000238057

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The antibacterial activity of two different clotrimazole formulations was tested in vitro. A neutral vaginal tablet with 100 mg active ingredient has a partial bactericidal effect on gram-positive bacteria. A new formula containing 500 mg clotrimazole and lactic acid, designed for a one-dose therapy of vulvovaginal mycoses, shows an improved bactericidal activity against gram-positive bacteria and, owing to the lactic acid content, a broad bactericidal effect on gram-negative species.

ISSN:0009-3157    

DOI:10.1159/000238149

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Absorption of clotrimazole after vaginal application was estimated to be between 3 and 10%. In order to investigate the fate of clotrimazole reaching systemic circulation, pharmacokinetic studies following oral and intravenous administration were carried out. The concentrations of clotrimazole in vaginal fluid and in blood plasma after vaginal application of 200 and 500 mg were determined using a specific assay by quantitative thin-layer chromatography. Fungicidal concentrations of clotrimazole in vaginal fluid up to 3 days after application of one vaginal tablet containing 500 mg were found. In contrast, clotrimazole plasma levels were lower than 0.01 μg/ml, demonstrating that clotrimazole is rapidly metabolized

ISSN:0009-3157    

DOI:10.1159/000238150

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

We have compared the antibacterial activities of cephalexin and cephradine against Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus (Micrococcus spp. type III), and group B streptococci (35 strains in total), using the Biophotometer. Analysis of growth curves obtained in the presence of various concentrations of the antibiotics revealed little difference between the activities of the two cephalosporins. However, both antibiotics showed maximal activity at 8–16 ug/ml, and increasing the concentration past this point resulted in a reduced antibacterial effect. Unlike the other species tested, streptococci were not lysed by cephalexin or cephradin

ISSN:0009-3157    

DOI:10.1159/000238058

出版商:S. Karger AG    

年代:1982

数据来源: Karger