[In vitro antimicrobial susceptibility of anaerobic bacteria isolated from pleuropulmonary infections]. / Susceptibilidad in vitro de bacterias anaeróbicas en infecciones pleuropulmonares.

BACKGROUND: Aspirative pleuropulmonary infections are usually caused by anaerobic flora of the mouth, mainly Prevotella, Fusobacterium and Peptostreptococcus spp. Penicillin in high doses is the traditional treatment for this type of infections but the rising resistance developed in recent years has induced the empiric use of clindamycin, increasing treatment costs. AIM: To study antimicrobial susceptibility of anaerobic bacteria isolated from pleuropulmonary infections. MATERIAL AND METHODS: Thirty two strains obtained from bronchoalveolar lavage and 15 strains isolated from pleural effusions between 2000 and 2002, were studied. The phenotype of strains was identified using the semiautomated API 20 A method and their susceptibility to penicillin (PNC), clindamycin (CM) and chloramphenicol (CAF) was tested using the E test methods. RESULTS: All the strains were susceptible to CAF, 95% to CM and 74.4% to PNC. The predominant genus was Prevotella, which also exhibited the higher resistance. CONCLUSIONS: As CM and CAF are active "in vitro", high rates of clinical response should be expected. In contrast, PNC is less effective, especially against pigmented Prevotella.

Susceptibilidad in vitro de bacterias anaeróbicas en infecciones pleuropulmonares / In vitro antimicrobial susceptibility of anaerobic bacteria isolated from pleuropulmonary infections

Background: Aspirative pleuropulmonary infections are usually caused by anaerobic flora of the mouth, mainly Prevotella, Fusobacterium and Peptostreptococcus spp. Penicillin in high doses is the traditional treatment for this type of infections but the rising resistance developed in recent years has induced the empiric use of clindamycin, increasing treatment costs. Aim: To study antimicrobial susceptibility of anaerobic bacteria isolated from pleuropulmonary infections. Material and methods: Thirty two strains obtained from bronchoalveolar lavage and 15 strains isolated from pleural effusions between 2000 and 2002, were studied. The phenotype of strains was identified using the semiautomated API 20 A method and their susceptibility to penicillin (PNC), clindamycin (CM) and chloramphenicol (CAF) was tested using the E test methods. Results: All the strains were susceptible to CAF, 95% to CM and 74.4% to PNC. The predominant genus was Prevotella, which also exhibited the higher resistance. Conclusions: As CM and CAF are active "in vitro", high rates of clinical response should be expected. In contrast, PNC is less effective, especially against pigmented Prevotella.

Actualización sobre quinolonas / Up to date on quinolones

Las fluoroquinolonas son quimioterápicos de vida media prolongada, con actividad bactericida sobre bacilos aerobios gram negativos y positivos, estafilococos, cocos gram negativos y algunos microorganismos aerobios y anaerobios, por su acción sobre la DNA girasa microbiana. Se absorben muy bien por via oral logrando buenas concentraciones plasmáticas y tisulares , especialmente en pulmón, próstata, bilis y orina, por lo que sus principales indicaciones son las infecciones respiratorias y del tracto genitourinario. La resistencia a las quinolonas se debe principalmente a mutación cromosómica y es cruzada entre ellas. No deben administrarse a individuos alérgicos a la droga, con umbral convulsivante bajo, ni tampoco a niños en crecimiento y mujeres embarazadas