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1.  Douching: A Risk to Women's Healthcare? 
PMCID: PMC1852284  PMID: 15022873
2.  Expanding Disease Spectrum Associated With Puerperal Mastitis 
Background: Staphylococcus aureus and the β-hemolytic streptococci are the commonest causes of puerperal mastitis which tends to be a localized disease process. This report describes 2 cases attributable to these bacteria that resulted in extramammary involvement and augmented morbidity.
Cases: Two cases of postpartum mastitis are described, one leading to necrotizing fasciitis caused by group A streptococci and the other leading to toxic shock syndrome (TSS) caused by S. aureus.
Conclusion: The spectrum of disease commonly attributed to mastitis occurring in this setting should be expanded.
PMCID: PMC2364592  PMID: 18476191
4.  Interrelationships Within the Bacterial Flora of the Female Genital Tract 
Analysis of 240 consecutive vaginal swabs using the compatibility profile technique revealed that only 2 bacteria have the ability to be a sole isolate and as such a candidate to be a major aerobic regulator of the bacterial flora of the female genital tract (BFFGT). Compatibility profiles of Lactobacillus and Gardnerella vaginalis have shown that these organisms shared compatibility profiling for the majority of the normal bacterial constituents of the female genital tract. Dominance disruption appears to come from the addition of compatible co-isolates and presumed loss of numerical superiority. These phenomena appear to be the keys to reregulation of BFFGT. Lactobacillus appears to be the major regulator of both G. vaginalis and anaerobic bacteria. When additional organisms are added to the bacterial flora, they may add to or partially negate the inhibitory influence of Lactobacillus on the BFFGT. Inhibitor interrelationships appear to exist between coagulase-negative staphylococci and Staphylococcus aureus and the group B streptococci (GBS) and other beta hemolytic streptococci. Facilitating interrelationships appear to exist between S. aureus and the GBS and selected Enterobacteriaceae.
PMCID: PMC2364555  PMID: 18476156
5.  When Antibiotics Appear to Fail 
PMCID: PMC2364526  PMID: 18476127
6.  Impact of Anaerobic Growth Conditions on Toxic Shock Syndrome Toxin-I Production by Staphylococcus aureus  
Objective: The impact of anaerobic growth conditions on the Staphylococcus aureus toxic shock syndrome toxin-1 (TSST-1) production was studied.
Methods: Ten strains of S. aureus derived from patients with toxic shock syndrome (TSS), 10 isolates of S. aureus, and documented TSST-1-producing strains recovered from patients with either staphylococcal septicemia or staphylococcal nongenital abscesses were grown under aerobic and anaerobic conditions. The bacterial growth was measured using optical density (OD) determinations at 520 nm. The toxin production was assayed using the TS-RPLA latex agglutination test.
Results: Both TSS and non-TSS strains of S. aureus grown under aerobic and anaerobic conditions exhibited comparable OD patterns of growth, and the levels of toxin production remained constant during the logarithmic phase. Toxin titers developed during the logarithmic growth phase and peaked after 24 h of incubation. When stationary-phase isolates grown initially under aerobic conditions were subjected to strict anaerobic conditions, subsequent toxin titers, compared with isolates grown in the continued presence of oxygen, were depressed 2-fold, peaking at a later time.
Conclusions: TSST-1 production is diminished under continued anaerobic conditions.
PMCID: PMC2364497  PMID: 18476098
7.  When Do Antibiotics Induce “Resistance”? 
PMCID: PMC2364477  PMID: 18476076
8.  Ampicillin Vs. Penicillin for In Utero Therapy 
The pharmacokinetics of penicillin G and ampicillin are reviewed as they pertain to their potential use in in vitro therapy.
PMCID: PMC2364461  PMID: 18476064
9.  In Vitro Ability of the Group B Streptococci to Inhibit Gram-Positive and Gram-Variable Constituents of the Bacterial Flora of the Female Genital Tract 
Objective: The purpose of this study was to analyze the ability of septicemic and nonsepticemic isolates of group B streptococci (GBS) to inhibit in vitro the principal bacterial groups found in the normal bacterial flora of the female genital tract.
Methods: The target groups were composed of 1) 10 strains each of the following: viridans streptococci, nonhemolytic streptococci (not group B or D), group A streptococci, GBS, peptostreptococci, coagulase-negative staphylococci, Staphylococcus aureus, and Gardnerella vaginalis; 2) 9 strains of enterococci; 3) 9 strains of group C or G streptococci; 4) 7 strains of lactobacilli; and 5) 7 strains of diphtheroids. All target groups were tested for inhibition by a test panel of either a group of 10 or 41 GBS isolates. If the GBS isolates failed to inhibit a target group, that group was tested for its ability to inhibit the GBS test panel.
Results: The GBS test panel did not inhibit the growth of coagulase-negative staphylococci or S. aureus but uniformly inhibited groups A, B, C, and G streptococci, lactobacilli, and G. vaginalis. One of the 7 strains of diphtheroids was inhibited by 37 of the 41 GBS isolates; the other 6 strains of diphtheroids were uniformly inhibited. Variable inhibition by GBS was observed with viridans streptococci, nonhemolytic (not group B or D) streptococci, peptostreptococci, and enterococci; however, inhibition or noninhibition was uniform for a given target strain against the entire GBS test panel. The 23 GBS isolates obtained from septicemic neonates or adults did not differ from the 18 nonsepticemic isolates in their ability to inhibit other species of streptococci or other gram-positive or gram-variable constituents of the bacterial flora of the female genital tract. When converse testing was done, all 10 GBS isolates were uniformly inhibited by coagulase-negative staphylococci and by the majority of enterococci, but were not inhibited by S. aureus.
Conclusions: These studies suggest that GBS may be significant regulators of other β-hemolytic streptococci, diphtheroids, lactobacilli, and G. vaginalis within the bacterial flora of the female genital tract. Moreover, the absence of GBS in the vaginal flora may be the result of mediation by coagulase-negative staphylococci and selected strains of enterococci.
PMCID: PMC2364431  PMID: 18476028
10.  Streptococcus pneumoniae as a Cause of Salpingitis 
Background: A case of pneumococcal septicemia associated with laparoscopically documented acute salpingitis is reported.
Case: Gram-stained cul-de-sac pus revealed gram-positive encapsulated diplococci.
Conclusion: This case coupled with reanalysis of prior genital tract involvement in nonpregnant individuals argues that Streptococcus pneumoniae can mimic gonococcal diseases.
PMCID: PMC2364347  PMID: 18475354

Results 1-10 (10)