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branhamella catarrhalis and other bacteria in the nasopharynx of children with longstanding cough.nasopharyngeal cultures from 180 children aged 1 to 9 were examined. all children were suffering from cough for at least 10 days. the findings were compared to those from 67 non-coughing children. bordetella pertussis was isolated from 12.2% of the children in the study group but from none of the control children. branhamella catarrhalis was isolated from 66.1% of the children in the study group and from 28.3% in the control group (p less than 0.01). br. catarrhalis was more common in pure cultu ...19817313564
preliminary serologic evidence for a pathogenic role of branhamella catarrhalis.branhamella catarrhalis has been suspected, on the basis of bacteriologic culture results, to have a pathogenic role in 6%-9% of cases of acute otitis media as well as in other upper respiratory tract infections. serologic evidence of this role was obtained with use of an enzyme immunoassay to detect antibodies to b. catarrhalis. the presence of both igg and iga antibodies to branhamella in the serum and/or middle ear fluid (mef) of children with acute otitis media correlated with the isolation ...19817328328
viability of six species of normal oropharyngeal bacteria after exposure to cigarette smoke in vitro.bacteria in culture medium at 37 degrees c were subjected to eight puffs of smoke from one cigarette, and viable cell counts were done at intervals ranging from 0 min to 3 h after exposure to smoke. the cigarette contained 23.0 mg of tar and 1.4 mg of nicotine. each 25.0 ml puff of smoke from a mechanical smoking apparatus was passed over a 1.0 ml suspension of bacteria dispersed over a 25 cm2 surface in a sterile flask. filtered air was in contact with the suspension between puffs, and during t ...19817339446
[immunologic characteristics of protein antigens of the neiseriaceae family. iii. study of delayed hypersensitivity cross reactions between different species of neisseria].the immunological interrelations between the protein complexes of 34 strains of 12 species belonging to the family neisseriaceae were studied with the use of delayed hypersensitivity reactions in specifically sensitized guinea pigs. no statistically significant differences between the nonpathogenic species of the family neisseriaceae and the strains of n. haemolysans, n. cuniculi, n. lactamicus, n. ovis, n. elongata, n. cinerea were revealed. the preparations of branhamella catarrhalis and n. ca ...19807415672
branhamella keratitis.three cases of suppurative keratitis caused by branhamella catarrhalis are described. each presented as a localised stromal infiltrate in a previously scarred cornea. the condition responded to penicillin g and to gentamicin treatment.19807448142
[susceptibilities of bacteria isolated from patients with respiratory infectious diseases to antibiotics (1991)].isolated bacteria from respiratory tract infections were collected since 1981 in cooperation with institutions located throughout japan, and have been investigated for their sensitivities to various antibacterial agents and antibiotics and reported by ikemoto, et al. relationships between these isolates and backgrounds of the patients were also studied each year. these results are discussed in detail in this report. in 20 institutions around the entire japan from october 1991 to september 1992, ...19957474326
resistant respiratory pathogens and extended-spectrum antibiotics.traditional antibiotics such as amoxicillin, tetracycline and erythromycin remain the drugs of first choice for most bacterial respiratory infections. however, the usefulness of these agents varies, depending on local bacterial resistance patterns and patient factors. in the united states, amoxicillin and penicillin resistance currently occurs in 20 to 30 percent of streptococcus pneumoniae strains, 30 to 40 percent of haemophilus influenzae strains and 70 to 90 percent of moraxella catarrhalis ...19957484684
[the microbiology of secretory otitis].the aa. realize a comparative study on the differences between the nasopharyngeal microbial flora of 50 children suffering a secretory otitis and other 40 children without middle ear disease. in nasopharyngeal cultures the pathogenic flora (haemophilus influenzae, streptococcus pneumoniae, moraxella catarrhalis, streptococcus beta hemoliticus group a, staphilococcus aureus) amounted for 96 percent in children with secretory otitis, which figure was reduced to 80 percent in healthy infants (p < 0 ...19957485853
effect of xylitol on growth of nasopharyngeal bacteria in vitro.xylitol is known to reduce caries by inhibiting the growth of streptococcus mutans. we hypothesized that xylitol could also affect the growth of other nasopharyngeal bacterial flora, which could be important when considering respiratory infections caused by these bacteria. we studied this in vitro by adding xylitol to the medium and observed that 1 and 5% xylitol reduced markedly the growth of alpha-hemolytic streptococci, including s. pneumoniae. it reduced slightly the growth of beta-hemolytic ...19957486925
comparative antimicrobial activities of the penem wy-49605 (sun5555) against recent clinical isolates from five u.s. medical centers.the in vitro activity of wy-49605 (sun5555) (wy) was compared with those of cefaclor, cefixime, and amoxicillin-clavulanic acid against 2,958 consecutive clinical isolates from five medical centers and 402 respiratory pathogens from 18 other facilities. most members of the family enterobacteriaceae were inhibited by wy (mic at which 50% of the isolates are inhibited [mic50], < or = 2.0 micrograms/ml). mic90s of > or = 8.0 micrograms/ml were observed for enterobacter cloacae, serratia spp., and p ...19957492110
evaluation of mupirocin e-test for determination of isolate susceptibility: comparison with standard agar dilution techniques.mupirocin e-test strips have been evaluated for their ease of use and accuracy in determining the susceptibilities of 171 strains of staphylococcus spp., streptococcus spp., haemophilus influenzae, and moraxella catarrhalis. the susceptibility of each strain was determined on two occasions, using parallel e-test and agar dilution methodologies each time. to ensure similar precisions for statistical analyses, e-test mics were rounded up to a standard twofold agar dilution scale. clear, elliptical ...19957494011
comparison of the local immune response to nontypable haemophilus influenzae (nhi) and moraxella catarrhalis (mc) during otitis media. 19957502887
structural studies of the o-polysaccharide from the lipopolysaccharide of moraxella (branhamella) catarrhalis serotype a (strain atcc 25238).the polysaccharide of the moraxella (branhamella) catarrhalis serotype a lipopolysaccharide was prepared by mild acid hydrolysis followed by gel permeation chromatography. the structure was established by methylation analysis, mass spectrometry, and nmr spectroscopy. it is concluded that the o-antigenic polysaccharide has the following structure. [formula see text] methylation analysis of the intact lipopolysaccharide showed that the lipid a portion consisted of 6-substituted glucosamine residue ...19947516823
stability in the presence of widespread beta-lactamases. a prerequisite for the antibacterial activity of beta-lactam drugs.bacterial resistance to the beta-lactam drugs is extremely widespread, as a result of extensive drug use. loss of susceptibility is primarily attributable to hydrolysis by inactivating enzymes, namely the beta-lactamases. while the number of characterised beta-lactamases may exceed 100, only a few are a problem in the treatment of community-acquired infections (tem-1, tem-2, shv-1, bro-1). chromosomally mediated and extended-spectrum beta-lactamases are usually dominant in nosocomial pathogens w ...19947518761
phylogenetic relationships between some members of the genera neisseria, acinetobacter, moraxella, and kingella based on partial 16s ribosomal dna sequence analysis.we obtained 16s ribosomal dna (rdna) sequence data for strains belonging to 11 species of proteobacteria, including the type strains of kingella kingae, neisseria lactamica, neisseria meningitidis, moraxella lacunata subsp. lacunata, [neisseria] ovis, moraxella catarrhalis, moraxella osloensis, [moraxella] phenylpyruvica, and acinetobacter lwoffii, as well as strains of neisseria subflava and acinetobacter calcoaceticus. the data in a distance matrix constructed by comparing the sequences suppor ...19947520730
a large, antigenically conserved protein on the surface of moraxella catarrhalis is a target for protective antibodies.a monoclonal antibody (mab) to moraxella catarrhalis o35e bound to a surface-exposed epitope of a proteinaceous antigen of this organism. the antigen, designated uspa, was present in every strain of the pathogen tested in a colony blot ria. uspa had a molecular mass on sds-page that varied between 300 and 400 kda, depending on the individual m. catarrhalis strain. passive immunization of mice with the uspa-reactive mab enhanced pulmonary clearance of m. catarrhalis. use of this mab to screen a m ...19947523537
roxithromycin. an update of its antimicrobial activity, pharmacokinetic properties and therapeutic use.roxithromycin is a derivative of the macrolide antibacterial erythromycin with in vitro antibacterial activity resembling that of the parent compound. the drug has activity against some staphylococcus spp., many streptococcus spp., moraxella (branhamella) catarrhalis, mycoplasma pneumoniae, legionella pneumophila and chlamydia trachomatis as well as many less common organisms. measured using recently proposed guidelines, roxithromycin has in vitro activity against haemophilus influenzae. in comp ...19947527329
influence of gm allotype on the igg subclass response to streptococcal m protein and outer membrane proteins of moraxella catarrhalis.the igg antibody response to streptococcal m protein is distributed between the igg1 and igg3 subclasses, however individual sera vary with respect to the relative amounts of these two subclasses. the basis of this variation was investigated. sera were also analysed for igg subclass antibodies to the outer membrane proteins (omp) of moraxella catarrhalis, as these have also been reported to have a major igg3 component. the mean percentage of igg3 was higher in the antibody response to omp and th ...19947529743
structural studies of the o-antigen oligosaccharides from two strains of moraxella catarrhalis serotype c.the oligosaccharide parts from moraxella (branhamella) catarrhalis serotype c lipooligosaccharides were isolated by mild acid hydrolysis followed by gel permeation chromatography. four different oligosaccharides could be identified from strain rs26 and two from strain rs10. the structures of the o-oligosaccharides were established by methylation analyses, mass spectrometry, and nmr spectroscopy. it is concluded that the oligosaccharide o-antigens from rs26 are a mixture of octa-, deca-, and unde ...19957535189
the tetrasaccharide l-alpha-d-heptose1-->2-l-alpha-d-heptose1--> 3-l-alpha-d-heptose1-->(3-deoxy-d-manno-octulosonic acid) and phosphate in lipid a define the conserved epitope in haemophilus lipopolysaccharides recognized by a monoclonal antibody.a murine monoclonal antibody, mahi 3 (immunoglobulin g2b), that is broadly reactive with haemophilus influenzae lipopolysaccharides (lpss) but nonreactive with all enterobacterial lpss tested was generated by fusing mouse myeloma cells with spleen cells of balb/c mice immunized with azide-killed h. influenzae rm.7004. mahi 3 bound to all h. influenzae, all other human haemophilus spp., all bordetella pertussis and bordetella parapertussis, and all aeromonas spp. tested but not to any neisseria o ...19957543887
pulmonary penetration of dirithromycin in patients suffering from acute exacerbation of chronic bronchitis.the aim of this study was to evaluate the concentrations of dirithromycin, a new macrolide antibiotic, in bronchial secretions (bs), bronchial mucosa (bm), epithelial lining fluid (elf) and serum in 25 patients with acute exacerbation of chronic bronchitis after a 5-day, once-daily, dirithromycin regimen. all patients received dirithromycin, 500 mg (two 250 mg tablets) given orally once daily at 08.00 fasted, for 5 consecutive days. they were divided into five groups (n = 5 in each group) accord ...19947549225
bacterial infection in chronic obstructive pulmonary disease. a study of stable and exacerbated outpatients using the protected specimen brush.the lower airways of asymptomatic chronic obstructive pulmonary disease (copd) patients can be colonized by bacteria, mainly haemophilus influenza, streptococcus pneumoniae, and moraxella catarrhalis. however, the role of lower airway bacteria in stable and exacerbated copd has not been well defined. to determine the importance of lower airway bacterial infection in copd we studied 40 outpatients with stable copd (group a: age 61.1 +/- 9.9 yr; [mean +/- sd]; fev1/fvc 51.7 +/- 12.5) and 29 outpat ...19957551388
multicenter spanish study of ciprofloxacin susceptibility in gram-negative bacteria. the spanish study group on quinolone resistance.the susceptibility of 2,426 gram-negative bacteria obtained from 18 spanish hospitals to ciprofloxacin was evaluated. among different medical centers, susceptibility to ciprofloxacin ranged from 83 to 100% for enterobacteriaceae, from 35 to 100% for pseudomonas aeruginosa, from 0 to 100% for xanthomonas maltophilia, acinetobacter spp. and other gram-negative non-fermenting bacilli, and from 33 to 100% for campylobacter spp. all clinical isolates of haemophilus influenzae, moraxella catarrhalis a ...19957556239
adenovirus serotype 1 does not act synergistically with moraxella (branhamella) catarrhalis to induce otitis media in the chinchilla.a chinchilla model of otitis media in which adenovirus compromise of the tubotympanum facilitates the subsequent induction of middle ear disease was used to investigate moraxella (branhamella) catarrhalis pathogenesis. intranasally inoculated m. catarrhalis did readily colonize the nasopharynx of this host; however, despite evidence of viral infection and tubotympanal compromise, m. catarrhalis did not induce culture-positive otitis media in this model.19957558341
otitis media in a population of black american and white american infants, 0-2 years of age.to determine the incidence of otitis media (om) and the bacteriology of acute otitis media (aom) in a clinic population of young children in pittsburgh, 138 black infants and 60 white infants were followed from birth to 2 years of age, examined at monthly intervals and whenever an upper respiratory tract infection (uri) or om intervened. by 24 months of age the cumulative incidence of episodes of aom was 43% and 42%, and of episodes of middle-ear effusion (mee) was 86% and 85% in black and white ...19957558637
[clinical and bacteriological effects of cefetamet pivoxil against community-acquired respiratory tract infections].we investigated clinical and bacteriological effects of cefetamet pivoxil (cemt-pi) in community-acquired respiratory tract infections and obtained the following findings. 1. of the 420 respiratory tract infection cases that were treated with cemt-pi according to a same protocol at a total of 42 institutions in tokyo, kanagawa-ken, saitama-ken and chiba-ken from february to the beginning of april 1994, 359 cases in which clinical evaluations were considered possible were selected as the subjects ...19957563588
antibiotic resistance among respiratory pathogens in preschool children.to determine the prevalence of antibiotic resistance among common respiratory pathogens circulating in the community.19957565207
ceftibuten: a review of antimicrobial activity, spectrum and other microbiologic features.ceftibuten is a new, orally administered cephalosporin with exceptional beta-lactamase stability and potency against commonly isolated gram-negative pathogens. more than 90% of recent enterobacteriaceae clinical isolates were inhibited by < or = 8 micrograms/ml of ceftibuten. in only five enteric species (citrobacter freundii, enterobacter aerogenes, enterobacter cloacae, morganella morganii, serratia marcescens) were more than 15% of strains resistant (minimal inhibitory concentrations (mic, wi ...19957567314
postantibiotic effect of ceftibuten on respiratory pathogens.the postantibiotic effect (pae) of ceftibuten, a novel beta-lactamase-stable cephem, was determined for streptococcus pyogenes, streptococcus pneumoniae, haemophilus influenzae and moraxella catarrhalis. the ceftibuten pae after a 2-hour exposure to 2 micrograms/ml (4 x minimum inhibitory concentration) for s. pyogenes was 2.7 to > 10 hours. the pae for s. pneumoniae after a 2-hour exposure to 15 micrograms/ml, concentrations that are achieved in man after usual therapeutic doses, was 1.1 to 3.4 ...19957567315
ceftibuten: minimal inhibitory concentrations, postantibiotic effect and beta-lactamase stability--a rationale for dosing programs.ceftibuten, a new orally absorbed cephalosporin with a novel side chain, has broad in vitro activity against most of the important respiratory pathogens including streptococcus pneumoniae and both beta-lactamase-negative and beta-lactamase-positive haemophilus influenzae and moraxella (branhamella) catarrhalis. furthermore it has high activity against enterobacteriaceae, which contain classic tem-1 beta-lactamases and those containing the new extended spectrum beta-lactamases, which hydrolyze pa ...19957567316
antibiotic susceptibility of the sputum pathogens and throat swab pathogens isolated from the patients undergoing treatment in twenty-one private clinics in japan.bacteriology of the respiratory isolates from 2,539 patients with respiratory infections in 21 primary care clinics was documented. of a total of 1,887 strains of potential pathogens recovered from 1,507 patients, 996 were gram-positive and 891 were gram-negative. major pathogens were staphylococcus aureus, haemophilus influenzae, streptococcus pneumoniae and streptococcus pyogenes. the mic's against microbial isolates of six antimicrobial agents were determined. ciprofloxacin and ofloxacin were ...19957570582
changes in the core tonsillar bacteriology of recurrent tonsillitis: 1977-1993.microbiological studies of the core of tonsils removed from children with recurrent tonsillitis due to group a beta-hemolytic streptococci were conducted during three periods, with 50 patients in each period: 1977-1978 (period 1), 1984-1985 (period 2), and 1992-1993 (period 3). mixed flora were present in all tonsils, with 8.1 organisms per tonsil (3.8 aerobes and 4.3 anaerobes). the predominant isolates in each period were staphylococcus aureus, moraxella catarrhalis, peptostreptococcus species ...19957578726
complement resistance is a virulence factor of branhamella (moraxella) catarrhalis.the purpose of this study was to investigate complement resistance in branhamella (moraxella) catarrhalis isolated from healthy schoolchildren or sputum-producing adult patients. two techniques were used: a serum bactericidal assay as the gold standard and an easier 'culture and spot' test. children (age 4-13; n = 303) and patients (n = 1047) showed high colonization/infection rates with b. catarrhalis (31% and 19%, respectively). complement resistance or intermediate sensitivity occurred freque ...19957581272
the etiology of community-acquired pneumonia among hospitalized patients during a chlamydia pneumoniae epidemic in finland.the etiology of community-acquired pneumonia during a chlamydia pneumoniae epidemic was studied among 125 hospitalized patients. etiologic investigations included blood and sputum cultures, pneumococcal antigen detection, and serologic investigations for common respiratory viruses and for streptococcus pneumoniae, haemophilus influenzae, moraxella catarrhalis, mycoplasma pneumococcal antigen detection, and serologic investigations for common and for streptococcus pneumoniae, haemophilus influenz ...19957594672
influenza a virus--induced acute otitis media.to better understand the significance of viral upper respiratory tract infections in the pathogenesis of acute otitis media (om), 27 adults underwent intranasal inoculation with influenza a virus. monitoring consisted of antibody titer determination, tympanometry, and otoscopy. microbiologic analysis consisted of cultures and polymerase chain reaction (pcr)-based detection for influenza a virus, streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis. all subjects became infe ...19957594675
multi-centre collaborative study for the in vitro evaluation of new macrolides dirithromycin and erythromycylamine. australian group for antimicrobial resistance (agar).a national study was conducted to determine the in vitro activity of 2 newer macrolides, dirithromycin and erythromycylamine compared with that of erythromycin, tetracycline and penicillin. nineteen major teaching hospitals participated in the study. minimal inhibitory concentrations (mics) were determined by agar dilution, mostly using iso-sensitest agar and an inoculum of 10(4) cells per spot. 2284 clinically significant strains were isolated in late 1991 and early 1992, comprising 1736 gram-p ...19957603759
in vitro and in vivo antibacterial activities of bo-2727, a new carbapenem.bo-2727, a new injectable carbapenem, was evaluated for its in vitro and in vivo antibacterial activities in comparison with those of biapenem, meropenem, imipenem, cefpirome, and ceftazidime. bo-2727 had activity comparable to that of imipenem against methicillin-susceptible staphylococci and streptococci, with mics at which 90% of strains tested (mic90s) are inhibited being equal to 0.5 microgram/ml or less. against methicillin-resistant staphylococci, bo-2727 was the most active among the ant ...19957625784
pulmonary penetration of ceftazidime.for an antibiotic to be effective in lower respiratory tract infections, it should be available in adequate concentrations in respiratory tissues and fluids. cephalosporins usually achieve modest concentrations in the respiratory tract. in this study we have determined the pulmonary penetration of intramuscularly administered ceftazidime (a single dose of 1 g). levels of ceftazidime in bronchial secretions (bs), bronchial mucosa (bm), epithelial lining fluid (elf), and serum (s) were measured by ...19957629560
[antibacterial activities of cefmenoxime against recent fresh clinical isolates from patients in sinusitis].in order to evaluate antimicrobial activity of cefmenoxime (cmx), minimum inhibitory concentrations (mics) of cmx and control drugs were determined against clinical isolates from patients of sinusitis that were obtained in our laboratory from october of 1993 to march of 1994. the results are summarized as follows; 1. cmx showed strong antimicrobial activities against streptococcus pneumoniae, haemophilus influenzae and moraxella subgenus branhamella catarrhalis that were 3 major aerobic bacteria ...19957637194
moraxella catarrhalis ventriculitis in a child with hydrocephalus and an external ventricular drain. 19957638020
antimicrobial therapy issues facing pediatricians.in the field of infectious diseases, the emergence of new pathogens or old diseases in newly recognized forms; changing virulence of pathogens; changing patterns of antimicrobial susceptibility; new diagnostic techniques, drugs or vaccines; changing concepts of chemoprophylaxis; controversies about medical vs. surgical techniques; and the challenge of care of children with infectious diseases within new guidelines of managed care are recently identified areas of change. the increased resistance ...19957638030
resistance among problem respiratory pathogens in pediatrics.during the past two decades, the prevalence of beta-lactamase production with nontypable strains of haemophilus influenzae has increased to about 35%. fortunately, rates of resistance to other oral antimicrobials have not developed at a comparable pace. amoxicillin/clavulanate, cefuroxime and cefpodoxime remain nearly uniformly active whereas rates of resistance to tetracycline, trimethoprim/sulfamethoxazole, chloramphenicol, cefaclor, loracarbef, cefprozil, azithromycin and clarithromycin remai ...19957638031
cefixime. a review of its therapeutic efficacy in lower respiratory tract infections.cefixime is an orally active third generation cephalosporin with in vitro antibacterial activity against most important lower respiratory pathogens. the drug is active against haemophilus influenzae, moraxella catarrhalis and penicillin-susceptible streptococcus pneumoniae but not staphylococcus aureus. cefixime has a long elimination half-life (3 hours compared with 0.5 hours for cefaclor and 1.5 hours for cefalexin), which allows once daily administration. several trials have established the c ...19957641600
comparative antimicrobial activity of piperacillin-tazobactam tested against more than 5000 recent clinical isolates from five medical centers. a reevaluation after five years.piperacillin combined with tazobactam at a fixed concentration (4 micrograms/ml) and a ratio (8:1) was tested against 5,029 aerobic isolates and 447 fastidious organisms, including anaerobes. among the enterobacteriaceae, > 95% inhibition was shared only by imipenem (99.1% at < or = 4 micrograms/ml), and some newer cephalosporins (95.1% - 99.8% at < or = 8 micrograms/ml), and piperacillin-tazobactam (95.8% at < or = 16/4 micrograms/ml). piperacillin-tazobactam was the most active agent tested ag ...19957648836
lack of serotype-specific antibody response to lipopolysaccharide antigens of moraxella catarrhalis during lower respiratory tract infection.an enzyme immunoassay (eia) was used to determine the antibody response to different serotypes of lipopolysaccharide (lps) antigens of moraxella catarrhalis in adult patients with lower respiratory tract infections (lrti). moraxella catarrhalis was isolated from sputum or nasopharyngeal samples from 20 patients with lrti. sixteen of the isolates were serotype a, four were type b and none were type c. the antibody response to the different lps serotypes was determined in paired sera from patients ...19957649192
multicenter clinical laboratory evaluation of a beta-lactamase disk assay employing a novel chromogenic cephalosporin, s1.s1, a new chromogenic cephalosporin (international bioclinical, inc., portland, oreg.), was used to detect beta-lactamase production among a variety of commonly encountered bacteria in a four-center collaborative study. results of an s1 disk assay were compared with those obtained by a nitrocefin-based disk procedure (cefinase; becton-dickinson microbiology systems, cockeysville, md.), with repetitive testing of five quality control organisms and with individual tests of recent clinical isolates ...19957650211
relation between beta-lactamase producing bacteria and patient characteristics in chronic obstructive pulmonary disease (copd).in addition to bronchodilator and anti-inflammatory therapy, exacerbations in patients with chronic obstructive pulmonary disease (copd) are often treated with antibiotics. haemophilus influenzae and moraxella (branhamella) catarrhalis, two important respiratory pathogens, may produce beta-lactamase which makes them resistant to ampicillin. surveillance studies conducted in various countries have shown an increasing incidence of these beta-lactamase producing bacteria. although this may simply b ...19957660337
[cephalosporin treatment of maxillary sinusitis].a new oral prodrug cephalosporin, cefcanel daloxate, was compared with cefaclor, another oral cephalosporin, in the treatment of acute purulent maxillary sinusitis. three hundred fifty-four patients with purulent sinus secretion were recruited and randomized at thirteen european ent clinics for the double blind study. the patients were treated with either cefcanel 300 mg tablets twice daily or cefaclor 250 mg capsules three times daily for ten days. apart from the sinus puncture and secretion as ...19957662079
dynamics of respiratory tract colonization by branhamella catarrhalis in bronchiectasis.branhamella catarrhalis is increasingly recognized as a lower respiratory tract pathogen, particularly in chronic lung diseases. this project defines a population of patients in whom the dynamics of colonization and infection caused by this organism could be studied. a method employing pulsed field gel electrophoresis (pfge) of genomic dna was developed. twenty-eight patients with bronchiectasis followed prospectively for 26.8 mo (mean) were seen monthly or bimonthly and at the time of a purulen ...19957663786
assessment of complement-mediated killing of moraxella (branhamella) catarrhalis isolates by a simple method.recently, we showed that complement resistance is an important virulence factor of moraxella (branhamella) catarrhalis. our study used a serum bactericidal assay to determine complement resistance in m. catarrhalis. although the serum bactericidal assay is considered the "gold standard" for determining complement resistance, it is laborious and time-consuming and therefore not well suited for large-scale studies. using a large number (n = 324) of m. catarrhalis isolates obtained from the sputa o ...19957664184
immunological aspects of otitis media: present views on possibilities of immunoprophylaxis of acute otitis media in infants and children.the article reviews, based on current knowledge of immunological events affecting the middle ear, the possibilities and prospects for the prevention of otitis media (om) by immunologic measures. while pneumococcal capsular polysaccharide vaccines proved not to be effective against infant acute otitis media (aom), pneumococcal conjugate vaccines provide good immunogenicity even in infants, and call for trials with better prospects of clinical efficacy. the other future approaches currently under ...19957665281
comparative activities of pefloxacin and ciprofloxacin in the treatment of chronic respiratory tract infections.to determine the efficacy in vivo of pefloxacin and ciprofloxacin in the treatment of acute infectious bronchopneumopathies, 90 patients, suffering from acute exacerbation of chronic bronchitis and with no known allergies to quinolones, were admitted to the study. patients were randomly divided into three groups of 30; the first group was dosed with pefloxacin 800 mg i.v. every 24 hours; the second group with pefloxacin 800 mg per os every 24 hours and the third with 500 mg per os of ciprofloxac ...19957666121
bacterial antibody assays in the diagnosis of acute lower respiratory tract infection in children.bacterial antibodies were studied in acute, intermediate and convalescent phase sera (mean duration from first to last sample 36 days) of 121 children hospitalized for acute lower respiratory tract infection. antibody responses were observed in 45% of all cases and in 29% of the 21 children < 1 year old. a total of 15 responses to streptococcus pneumoniae (pneumolysin), 20 to haemophilus influenzae, 9 to moraxella catarrhalis, 3 to chlamydiae and 8 to mycoplasma pneumoniae were found. in 79 pati ...19957667051
cefprozil. a review of its antibacterial activity, pharmacokinetic properties, and therapeutic potential.cefprozil is an orally active cephalosporin which has demonstrated activity against a wide range of organisms in vitro. it is particularly active against the gram-positive organisms streptococcus pyogenes, pneumoniae and agalactiae and against methicillin-susceptible staphylococcus aureus. strains of methicillin-resistant s. aureus are not susceptible to cefprozil. cefprozil is also moderately active against haemophilus influenzae, moraxella catarrhalis, neisseria gonorrhoeae, many enterobacteri ...19937681376
a major outer membrane protein of moraxella catarrhalis is a target for antibodies that enhance pulmonary clearance of the pathogen in an animal model.a murine immunoglobulin g monoclonal antibody (mab) raised against outer membrane vesicles of moraxella catarrhalis 035e was shown to bind to a surface-exposed epitope of a major outer membrane protein of this organism. this outer membrane protein, which had an apparent molecular weight of approximately 80,000 in sodium dodecyl sulfate-polyacrylamide gels, was designated copb. mab 10f3, reactive with copb, bound to a majority (70%) of m. catarrhalis strains tested. more importantly, mice passive ...19937683000
cefetamet pivoxil. a review of its antibacterial activity, pharmacokinetic properties and therapeutic use.cefetamet pivoxil is an oral third-generation cephalosporin which is hydrolysed to form the active agent, cefetamet. cefetamet has excellent in vitro activity against the major respiratory pathogens streptococcus pneumoniae, haemophilus influenzae, moraxella (branhamella) catarrhalis and group a beta-haemolytic streptococci; it is active against beta-lactamase-producing strains of h. influenzae and m. catarrhalis, but has poor activity against penicillin-resistant s. pneumoniae. cefetamet has ma ...19937684677
comparison of monoclonal antibody methods and a ribosomal ribonucleic acid probe test for neisseria gonorrhoeae culture confirmation.recently, a chemiluminescent nucleic acid probe test that specifically detects the ribosomal ribonucleic acid of neisseria gonorrhoeae has been released for clinical laboratory use (accuprobe neisseria gonorrhoeae). in this study, three coagglutination tests (gonogen i, meritec gc, and gc omni), the gonogen ii immunofiltration method and the micro trak neisseria gonorrhoeae fluorescent monoclonal antibody test were compared with accuprobe for identification of gonococci. strains tested (n = 376) ...19937685283
loracarbef. a review of its antimicrobial activity, pharmacokinetic properties and therapeutic efficacy.loracarbef is an orally administered member of a new synthetic class of beta-lactam antibiotics, the carbacephems, which is characterised by enhanced chemical stability. at low concentrations (< 2 mg/l) in vitro, it inhibits streptococcus pneumoniae, s. pyogenes, beta-haemolytic streptococci groups b, c and g. proteus mirabilis and moraxella catarrhalis, including beta-lactamase-producing strains. at therapeutic plasma concentrations it is also active in vitro against most strains of staphylococ ...19937686466
in vitro activities of a streptogramin (rp59500), three macrolides, and an azalide against four respiratory tract pathogens.broth microdilution tests were carried out with 2,671 respiratory tract isolates from 19 medical centers throughout the continental united states. the tests compared a streptogramin (rp59500) to erythromycin, dirithromycin, clarithromycin, and azithromycin against streptococcus pneumoniae, s. pyogenes, haemophilus influenzae, and moraxella catarrhalis. against macrolide-susceptible strains, the potency of rp59500 was similar to that of the macrolides: the azalide, azithromycin, was two to four t ...19957695313
increased beta-lactamase activity in branhamella catarrhalis after exposure to amoxicillin and clavulanic acid.branhamella catarrhalis, previously regarded as a harmless member of the normal nasopharyngeal flora, has periodically been implicated as the major pathogen in representative cases of a variety of infections such as sinusitis, pneumonia, septicemia and meningitis. in addition, beta-lactamase production of these microorganisms, first described in 1977, has been reported with increasing frequency, up to 80%. the first-choice drug for the therapy of the infections caused by beta-lactamase producing ...19947699424
[bacteriological, pharmacokinetic and clinical studies of sy5555 dry syrup in the pediatric field].bacteriological, pharmacokinetic and clinical studies on sy5555 dry syrup (powder which is dissolved before use), a new penem antibiotic for oral use, were performed. the following results were obtained. 1. antibacterial activities. mics of sy5555, clavulanic acid/amoxicillin (cva/ampc), cefotiam (ctm), cefpodoxime (cpdx), cefaclor (ccl) and cefdinir (cfdn) were determined against clinically isolated staphylococcus aureus, coagulase negative staphylococci, streptococcus pneumoniae, streptococcus ...19957699846
the in-vitro activity of fk-037, a new broad spectrum injectable cephalosporin.the in-vitro activity of the parenteral cephem fk-037 was compared to those of cefpirome, ceftazidime, cefuroxime, cefixime, amoxycillin and co-amoxiclav. against the enterobacteriaceae fk-037 was generally > or = 16-fold more active than cefuroxime and two- to four-fold more active than ceftazidime and similar in activity to cefpirome. pseudomonas aeruginosa displayed similar susceptibilities to ceftazidime and fk-037 (mic90 4 and 8 mg/l respectively). methicillin-resistant staphylococcus aureu ...19947706158
children with persistent cough--outcome with treatment and role of moraxella catarrhalis?52 children with severe cough persisting for more than 10 days were randomized to treatment with amoxycillin/clavulanic acid or placebo in a prospective double-blinded study. clinically suspected cases of pertussis were excluded, yet 12 (23%) of the children had laboratory verified pertussis infection. the nasopharyngeal colonization showed a predominance of moraxella catarrhalis which was isolated in 37 (71%) children. streptococcus pneumoniae and haemophilus influenzae were isolated in 11 (20% ...19947710536
serum antibody response to proteins of moraxella (branhamella) catarrhalis in patients with lower respiratory tract infection.we searched for antibodies against moraxella (branhamella) catarrhalis proteins in the sera of patients with lower respiratory tract infection. sera from 48 patients with m. catarrhalis and 39 patients without m. catarrhalis in their lower respiratory tract specimens were studied by a gel electrophoresis-immunoperoxidase technique; sera from 23 healthy adult blood donors were also included. immunoglobulin g (igg) antibodies against a 28-kda protein were found significantly more frequently in pat ...19957719906
human immune response against outer membrane proteins of moraxella (branhamella) catarrhalis determined by immunoblotting and enzyme immunoassay.the role of moraxella (branhamella) catarrhalis as a respiratory tract pathogen is increasingly recognized. we looked at the human immune response against individual outer membrane proteins of m. catarrhalis and against the 81-kda copb protein, which has previously been shown to be a target for protective antibodies. paired serum samples from six elderly patients with pneumonia were tested by western blot (immunoblot) analysis by using outer membrane vesicles of m. catarrhalis 035e as antigen. a ...19957719910
cloning, sequencing, and characterization of the gene encoding frpb, a major iron-regulated, outer membrane protein of neisseria gonorrhoeae.frpb (for fe-regulated protein b) is a 76-kda outer membrane protein that is part of the iron regulon of neisseria gonorrhoeae and neisseria meningitidis. the frpb gene from gonococcal strain fa19 was cloned and sequenced. frpb was homologous to several tonb-dependent outer membrane receptors of escherichia coli as well as hemr of yersinia enterocolitica and copb of moraxella catarrhalis. an omga insertion into the frpb coding sequence caused a 60% reduction in 55fe uptake from heme, but careful ...19957721696
[microbiological study of the nasopharynx].a microbiological study of the posterior wall of the nasopharynx have been carried out in 90 children subjected to adenoidectomy by chronically hypertrophied and infected adenoids. streptococcus pneumoniae, haemophilus influenzae, moraxella catarrhalis, streptococcus pyogenes and staphylococcus aureus are the most important pathogens responsible for upper respiratory tract infection. adenoidectomy produces a physiological effect on the nasopharyngeal microflora by converting an abnormal flora in ...19957734162
evidence of lectin-mediated adherence of moraxella catarrhalis.clinical isolates of moraxella catarrhalis (n = 86) were evaluated for their haemagglutinating activity with different types of erythrocytes. of all the isolates tested, 12 did not agglutinate with any of the erythrocytes, whereas 65 reacted with human erythrocytes of type a, b, and 0, and 26 with erythrocytes from rabbit, guinea pig, dog, or rat. none of the isolates agglutinated with sheep and goat erythrocytes. the agglutination titres ranged from 0 to 64. among these isolates, 13 different a ...19957744489
molecular analysis of bacterial pathogens in otitis media with effusion.to determine if the polymerase chain reaction (pcr) can detect bacterial dna in pediatric middle ear effusions that are sterile by standard cultural methods.19957745773
bacteriologic failure of amoxicillin-clavulanate in treatment of acute otitis media caused by nontypeable haemophilus influenzae.to evaluate the rate of bacteriologic failure of amoxicillin-clavulanate in the treatment of acute otitis media (aom) and to identify the risk factors associated with failure.19957752010
[beta-lactamase production of clinically isolated bacteria].we examined beta-lactamase productions by clinically isolated strains of bacteria. the results were as follows; 1. it appears that beta-lactamases produced by strains of five species of staphylococcus spp. are mostly penicillinase (90%). source of beta-lactamase producing strains of haemophilus influenzae (23%) and all of moraxella subgenus branhamella catarrhalis: strains (100%) are "high & low producer" strains. 2. a large proportion of beta-lactamase producing strains of enterobacteriaceae an ...19957752455
persistent acute otitis media: i. causative pathogens.in this prospective study tympanocentesis was performed to determine the pathogens isolated from middle ear fluid of 200 ears in 137 children with acute otitis media (aom) which had not responded after one or two empiric antimicrobial treatment courses (termed persistent aom). for comparison tympanocentesis from 154 ears in 111 children with aom not previously treated are described. patients were enrolled from october, 1989, until september, 1992. in the persistent aom group amoxicillin and trim ...19957761181
rapid identification of pathogenic neisserias using the identicult-neisseria test.a rapid enzymatic method using chromogenic substrates for the rapid identification of pathogenic neisseria (identicult-neisseria, scott laboratories inc., ca, usa) was tested in parallel with the rapid carbohydrate utilization test (rcut) and the phadebact monoclonal gc test against 198 consecutive clinical isolates of oxidase-positive gram-negative diplococci (118 neisseria gonorrhoeae, 76 n. meningitidis and four n. lactamica). on initial testing the identicult-neisseria gave a 95% overall con ...19947765397
virulence factors in the colonization and persistence of bacteria in the airways.haemophilus influenzae, streptococcus pneumoniae, moraxella catarrhalis, staphylococcus aureus, klebsiella pneumoniae, and pseudomonas aeruginosa are commonly isolated from sputum specimens of patients with lower respiratory tract infections. haemophilus influenzae, s. pneumoniae, and m. catarrhalis have several pathogenic properties in common. these bacteria are able to interact with mucus, to exert ciliotoxic activity, to adhere to bronchial epithelial cells, and to invade airway epithelium. h ...19957767563
serum bactericidal activity against moraxella catarrhalis and streptococcus pneumoniae after administration of four oral cephalosporins in healthy volunteers. 19957768778
moraxella (branhamella) catarrhalis bacteremia in children. a report of two patients and review of the literature.we report two cases of moraxella catarrhalis (m. catarrhalis) bacteremia in apparently healthy children. one patient had bilateral otitis media and the other had pharyngitis and sinusitis; both patients had uncomplicated clinical courses. a literature review revealed 22 reported cases of m. catarrhalis bacteremia in children, 14 (63%) of which occurred in patients who had no identified underlying condition. eight (36%) cases were seen in children who were immunocompromised. nine (40%) patients p ...19957774141
[the effect of cefaclor and cefixime on nasopharyngeal pathogens in children].changes in nasopharyngeal flora were investigated in children with acute otitis media and with acute exacerbations of chronic sinusitis in whom antibiotic therapy of relatively long duration was required until substantial improvement in clinical findings was achieved. 1. the antibiotics used were two cephalosporins, i.e., cefaclor (ccl) and cefixime (cfix), administered to 18 patients each for 1 week and to 26 and 20 patients, respectively, for 2 weeks. bacteriologic examination of the nasophary ...19957782974
[antimicrobial activities of sulbactam/ampicillin against clinically isolated microbial strains].antimicrobial activities were examined for sulbactam/ampicillin (sbt/abpc) against clinically isolated microbial strains in 1987, 1990, 1994. besides, the beta-lactamase productivity and mics of these strains were measured, and the following conclusions were obtained. 1. the ratio of beta-lactamase producing strains were 90% of methicillin (dmppc)-susceptible staphylococcus aureus subsp. aureus (mssa), about 80% of dmppc-resistant s. aureus (mrsa), 100% of escherichia coli, klebsiella pneumoniae ...19957783316
[bacteremic pneumonia due to moraxella catarrhalis in an immunosuppressed patient]. 19957784666
moraxella catarrhalis bacteraemia in an immunocompetent adult. 19957784828
development, characterization, and initial evaluations of s1. a new chromogenic cephalosporin for beta-lactamase detection.a novel, chromogenic cephalosporin reagent (s1) for beta-lactamase testing was produced that shares physicochemical characteristics with nitrocefin (formerly 87/312). s1 and nitrocefin in a disk-testing format for beta-lactamase performed at 100% agreement for detecting enzyme-producing isolates of bacteroides fragilis group, haemophilus influenzae, moraxella catarrhalis, neisseria gonorrhoeae, staphylococcus aureus, and selected enterobacteriaceae. the time required to achieve an initial color ...19957789091
multicenter trial of cefpodoxime proxetil vs. amoxicillin-clavulanate in acute lower respiratory tract infections in childhood. international study group.acute lower respiratory tract infections in children are a worldwide public health problem, with an estimated 4 million potentially preventable deaths every year. until recently, penicillin and related drugs were the treatment of choice for empiric therapy of paediatric lower respiratory tract infections. however, concerns over the emergence of penicillin-resistant strains of streptococcus pneumoniae and beta-lactamase-producing strains of haemophilus influenzae and moraxella catarrhalis have le ...19957792126
otitis media complications and treatment failures: implications of pneumococcal resistance.classic complications of untreated otitis media include meningitis, lateral sinus thrombosis and chronic suppurative otitis media. in the past, in countries where otitis media is usually treated, complications have been rare, because of the good activity of almost all orally administered antibiotics against the most common cause of complications, streptococcus pneumoniae. treatment failures were usually caused by beta-lactamase-producing nontypable haemophilus influenzae or by moraxella (branham ...19957792127
[antimicrobial activities of cefditoren against clinical isolates obtained from outpatients].to examine the antimicrobial activity of cefditoren (cdtr) against strains clinically isolated from outpatients at this hospital from november, 1993 to february, 1994, the minimum inhibitory concentrations (mics) were determined including those of the control drugs. the results were as follows: 1. cdtr showed strong antimicrobial activities against staphylococcus aureus subsp. aureus, streptococcus pyogenes and streptococcus pneumoniae. the mics of cdtr against benzylpenicillin-insensitive or -r ...19947807697
an in vitro characterization of cefditoren, a new oral cephalosporin.cefditoren (me 1206) is a new cephalosporin available for oral administration as the pivaloyloxymethyl ester (me 1207). the effect of medium formulation. ph, cation concentration and inoculum on the in vitro activity of cefditoren was investigated prior to determining its comparative antibacterial potency against a wide range of clinical bacterial isolates, its bactericidal activity against susceptible strains and the duration of its post-antibiotic effect (pae). cefditoren was shown to possess ...19947813385
use of api nh system for identification of moraxella catarrhalis. 19947814516
[oropharyngeal flora. epidemiologic survey of prevalence].epidemiological surveys which are not frequently carried out in medical practice should provide useful information for the choice of antibiotics to be prescribed in community-acquired infections particularly with the recent development of therapeutic difficulties due to resistant strains. we therefore analyzed the prevalent pharyngeal flora in a general patient population.19947831228
evaluation of opc-17116 against important pathogens that cause respiratory tract infections.the antibacterial activity of opc-17116, a new fluoroquinolone antibacterial agent, against important pathogens that cause respiratory tract infections was evaluated in vitro and in vivo and compared with those of ciprofloxacin, ofloxacin, and norfloxacin. the pharmacokinetic profiles of opc-17116 were studied in both mice and rats given the drug orally at doses of 50 and 40 mg/kg of body weight, respectively. opc-17116 showed a high degree of distribution in the lung tissues of both species, wi ...19947840567
in vitro activities of 12 orally administered antimicrobial agents against four species of bacterial respiratory pathogens from u.s. medical centers in 1992 and 1993.clinical isolates of haemophilus influenzae, streptococcus pneumoniae, streptococcus pyogenes, and moraxella catarrhalis were gathered from 19 different clinical laboratories throughout the continental united states. the in vitro activities of 12 orally administered antimicrobial agents were compared by broth microdilution tests with 3,151 bacterial isolates. among 890 h. influenzae isolates, 30% were capable of producing beta-lactamase enzymes (12 to 41% in different medical centers). most of t ...19947840581
[respiratory tract infections: how frequent is antibiotic resistance? in vitro activity of older and recent antibiotics against the significant pathogens].presumably influenced by the new cost-saving health care regulations, more of the long-established antibiotics are now being prescribed. this fact prompted the present study on the current resistance profiles of such antibiotics used to treat major pathogens responsible for airway infections. a total of 202 strains of streptococcus pneumoniae, streptococcus pyogenes, moraxella catarrhalis and haemophilus influenzae were investigated. sensitivity was determined using the agar dilution test for do ...19947843673
in vitro activity of cefpodoxime in comparison with other oral beta-lactam antibiotics.the aim of our study was to re-evaluate the in vitro activity of cefpodoxime in comparison with other oral beta-lactam antibiotics against bacteria causing respiratory tract infections. the study drugs were cefpodoxime, cefaclor, cefixime, cefuroxime, cefetamet, cefprozil, and the combination of amoxicillin and clavulanic acid (= augmentin). in addition, cefotaxime as the standard agent of parenteral third generation cephalosporins was examined. the organisms tested were staphylococcus aureus, s ...19947843823
bacterial colonization of the nasopharynx predicts very early onset and persistence of otitis media in australian aboriginal infants.otitis media (om) develops in the first months of life and persists throughout childhood in many rural aboriginal children. we have followed aboriginal and non-aboriginal infants from birth to determine the relationship of the early onset of om to nasopharyngeal colonization with respiratory pathogens. aboriginal infants were colonized with multiple species of respiratory bacteria (moraxella catarrhalis, haemophilus influenzae, streptococcus pneumoniae) at a rate of 5% per day and the timing of ...19947845752
disk diffusion versus broth microdilution susceptibility testing of haemophilus species and moraxella catarrhalis using seven oral antimicrobial agents: application of updated susceptibility guidelines of the national committee for clinical laboratory standards.susceptibility testing of haemophilus species and moraxella catarrhalis is medium and inoculum dependent. seven oral agents, ampicillin, amoxicillin-clavulanic acid, cefaclor, loracarbef, cefuroxime-axetil, cefixime, and erythromycin, were tested against 400 beta-lactamase-positive and -negative clinically significant respiratory strains of haemophilus species and 100 strains of m. catarrhalis. sources of the strains included teaching and regional hospitals and a private laboratory. all strains ...19947852573
pneumonia in a nursing home.the authors studied nursing home residents serologically to determine whether atypical organisms were causes of radiologic pneumonia. the study was conducted at the wisconsin veterans home, a facility with on-site microbiology and x-ray. over one year, serologic examinations for legionella, mycoplasma, and chlamydia were conducted for the residents who had pneumonia. cultures and mortality were reviewed. fifty-six episodes were studied (mean resident age 78 years). there was no fourfold titer ch ...19947853075
[pharmacokinetic, bacteriological and clinical studies on cefozopran in children].pharmacokinetic, bacteriological and clinical studies on cefozopran (czop) were performed in children. the results were as followed: 1. a total of 13 patients were treated with czop. the tested dose was 20 mg/kg (50 mg/kg in maxillary sinusitis), and the drug administered via intravenous bolus injection or 30-minute intravenous drip infusion 3 times daily, for 3-11 days. clinical efficacies of czop in 13 patients with bacterial infections (11 with pneumonia, 1 with otitis media and 1 with maxill ...19947853676
[pharmacokinetic and clinical studies on cefozopran in the field of pediatrics].blood and urine levels of cefozopran (czop) were determined, and its efficacy and safety profile was evaluated in the field of pediatrics. the results of this study are summarized as follows. 1. blood levels of czop peaked in 30 minutes to 1 hour (initial blood collection) after intravenous administration at a dose of 20 or 40 mg/kg. its blood levels at 6 hours after intravenous administration were 1.6 micrograms/ml (hplc) or 1.9 micrograms/ml (bioassay) at a dose of 20 mg/kg and 2.9 to 9.1 micr ...19947853687
influenza complicated by moraxella catarrhalis bacteremia. 19947854902
significance of isolation of moraxella catarrhalis in routine cultures from the respiratory tract in adults: antibody response studied in a whole cell eia.the significance of the isolation of moraxella catarrhalis from sputum or nasopharynx was studied in patients treated at an infectious disease clinic. a whole-cell enzyme immunoassay was used to detect a specific antibody response to m. catarrhalis during infection. in all, 27 patients with respiratory tract infections and 4 with other infections were studied. titre rises were recorded in 11/23 patients with lower respiratory tract infections, whereas patients with common cold or infections else ...19947855552
[microbiological aspects of antibiotics with immunomodulating action].through the introduction of a 7-mercapto-1,3-thiazole chain at position 3' of the dihydrothiazine ring, cefodizime, which is structurally similar to cefotaxime, has acquired a number of remarkable immunomodulatory properties while retaining a potent antimicrobial spectrum of activity. cefodizime penetrates in fact readily through the bacterial cell wall and interacts with its molecular targets in such a way that at high concentrations cell death and lysis are rapidly induced. its spectrum of act ...19947861204
group a streptococcal tonsillopharyngitis: cost-effective diagnosis and treatment.most patients who seek medical attention for sore throat are concerned about streptococcal tonsillopharyngitis, but fewer than 10% of adults and 30% of children actually have a streptococcal infection. group a beta-hemolytic streptococci (gas) are most often responsible for bacterial tonsillopharyngitis, although neisseria gonorrhea, arcanobacterium haemolyticum (formerly corynebacterium haemolyticum), chlamydia pneumoniae (twar agent), and mycoplasma pneumoniae have also been suggested as possi ...19957864482
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