Gas liquid chromatography in the rapid diagnosis of meningitis.

Gas liquid chromatography was employed to detect lactic acid in the cerebrospinal fluid of patients suspected of having bacterial meningitis. The technique was found to be both rapid and reliable. Differentiation between aseptic, purulent, and partially treated bacterial meningitis was readily achieved. The effectiveness of therapy in bacterial meningitis was indicated by a rapid fall in the concentration of lactic acid.

Metronidazole in prevention and treatment of bacteroides infections in elective colonic surgery.

A double-blind randomised trial was carried out among 46 patients undergoing elective colonic surgery; 27 patients received prophylactic metronidazole and 19 received placebo. Anaerobic infections did not develop in any of the metronidazole-treated patients, but did develop in 11 (58%) of 19 controls who were subsequently successfully treated with metronidazole.

Bifidobacteria in the intestinal tract of infants: an in-vivo study.

Weekly faecal specimens from 18 babies were examined during the first 8 weeks of life. Eight infants were breast fed, ten were bottle-fed. All suckling infants received supplementary feeds for the first 8 days. A buffer consisting of acetic acid and acetate was demonstrated in the faeces of all the breast-fed infants at some time during the period of examination. This buffer was rarely detected during the 1st week of life when supplementary feeds were given, and buffer already present gradually disappeared with the introduction of mixed feeding. In contrast, at no time was an acetate buffer demonstrated in the faeces of bottle-fed infants. Babies receiving breast milk produced faeces with low pH, high counts of saccharolytic organisms including bifidobacteria and Streptococcus faecium, and low counts of Escherichia coli, bacteroides and clostridia. Bottle-fed infants on the other hand produced faeces with a high pH and high counts of E. coli and putrefactive bacteria, but with low counts of bifidobacteria.

Bifidobacteria in the intestinal tract of infants: an in-vitro study.

In-vitro studies showed that a number of factors are likely to influence the production and maintenance of a bifidobacillary flora and low pH in the faeces of newborn infants. Considerable importance is attached to the nature of the end products of bacterial metabolism in the large intestine. Thus, there is evidence to suggest that acetic acid and other metabolites of intraluminal bacterial growth suppress the growth of gram-negative organisms, but are without effect upon that of bifidobacteria. This mechanism in turn is controlled by the nature of the feed; important factors in breast milk include high lactose, low protein and low phosphate content.

Rapid diagnosis of anaerobic infections by gas-liquid chromatography of clinical material.

Gas-liquid chromatographic analysis of samples of pus provides a rapid and reliable means for the presumptive differentiation of anaerobic from aerobic infections.

Metronidazole in prevention and treatment of bacteroides infections after appendicectomy.

The frequency of non-clostridial anaerobic infection was studied in 95 patients who had undergone acute appendicectomy: 49 received prophylactic metronidazole and 46 received placebo. Anaerobic infection did not develop in any of the metronidazole-treated patients, but infections did develop in nine (19%) of the 46 controls. Metronidazole is conveniently administered by suppository to patients who cannot take oral drugs. Five patients with intra-abdominal infections caused by non-clostridial anaerobes were successfully treated with metronidazole.