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in-vitro activity of trovafloxacin against sensitive and resistant aerobic bacteria using the standard microdilution broth method and etest.a comparison of mics of trovafloxacin (cp-99,219) determined by the standard microdilution broth method versus the etest was performed for multiple strains of gram-positive and gram-negative bacteria. a comparison was also made of the in-vitro activity of trovafloxacin versus ciprofloxacin and ofloxacin. the mic50 and mic90 were determined by both methods for each species tested. the etest resulted in mics one to two dilutions higher than the microdilution broth method. trovafloxacin was the mos ...19979222068
infectious crystalline keratopathy caused by gram-negative bacteria.to identify the characteristics and outcomes of infectious crystalline keratopathy caused by gram-negative bacteria.19979222227
16s rrna gene sequence analyses and inter- and intrageneric relationships of xanthomonas species and stenotrophomonas maltophilia.the nearly complete, pcr-amplified, 16s rrna gene sequences have been determined from the representative type strains of eight xanthomonad phena, including six validly described species of the genus xanthomonas and stenotrophomonas maltophilia. pairwise sequence comparisons and phylogenetic analysis demonstrated that the xanthomonads comprise a monophyletic lineage-within the gamma-subclass of the proteobacteria. although the genus xanthomonas was observed to comprise a cluster of very closely r ...19979228747
in vitro antimicrobial activity of ru-59863, a c-7 catechol substituted cephalosporin.the in vitro activity of ru-59863, a so-called "fifth generation" catechol cephalosporin, was evaluated against 606 bacterial isolates and compared with the activities of cefotaxime, ceftazidime, cefepime, and cefpirome. ru-59863 demonstrated a broad spectrum of inhibition and superior overall activity than comparators when tested against enterobacteriaciae (mic90s, 0.015 to 2 micrograms/ml), pseudomonas aeruginosa (mic90, 0.5 microgram/ml), stenotrophomonas maltophilia (mic90, 0.25 microgram/ml ...19979239501
temperature-dependent resistance to gentamicin in graft keratitis by stenotrophomonas (xanthamonas) maltophilia. 19979246293
susceptibility testing of stenotrophomonas maltophilia to carbapenems.the susceptibility of 20 clinical isolates of stenotrophomonas maltophilia to the carbapenems imipenem and meropenem was investigated by various methods. s. maltophilia appeared sensitive to meropenem but resistant to imipenem by disc testing in iso-sensitest agar. agar dilution mics were performed using iso-sensitest agar and with incubation under three sets of atmospheric conditions. mics of meropenem were considerably lower than those of imipenem; this effect was maximal after incubation in 5 ...19979249199
analysis of 553 episodes of monomicrobial bacteraemia in cancer patients: any association between risk factors and outcome to particular pathogen?relationships between aetiology, various risk factors (such as neutropenia, catheter insertion, endoscopy, therapy with corticosteroids, therapeutic use of antimicrobials, antibiotic prophylaxis, source of infection), symptomatology and outcome were studied in 553 monomicrobial bacteraemic episodes in cancer patients observed within 7 years at the national cancer institute of the slovak republic. the ratio of gram-positive to gram-negative bacteraemia was 1:1 (43.5% vs 43.8%), and yeasts caused ...19979257432
epidemiological typing of stenotrophomonas maltophilia.stenotrophomonas maltophilia is increasingly recognized as a cause of hospital-acquired infection and respiratory tract colonization in cystic fibrosis patients. a number of methods have been described for the typing of strains in epidemiological studies. pulsed-field gel electrophoresis (pfge) of total chromosomal dna cleaved by low-frequency restriction site endonucleases (xbai, spei) is highly discriminatory and defines populations at the strain level. other molecular methods such as ribotypi ...19979261755
cleavage of influenza a virus h1 hemagglutinin by swine respiratory bacterial proteases.cleavage of influenza a virus hemagglutinin (ha) is required for expression of fusion activity and virus entry into cells. extracellular proteases are responsible for the proteolytic cleavage activation of avirulent avian and mammalian influenza viruses and contribute to pathogenicity and tissue tropism. the relative contributions of host and microbial proteases to cleavage activation in natural infection remain to be established. we examined 23 respiratory bacterial pathogens and 150 aerobic ba ...19979311838
[bacteremia caused by stenotrophomonas (xanthomonas) maltophila]. 19979312285
molecular epidemiology of acquisition of ceftazidime-resistant gram-negative bacilli in a nonoutbreak setting.we prospectively studied the acquisition of ceftazidime-resistant gram-negative bacilli (caz-rgn) in two surgical intensive care units (sicu) during a nonoutbreak period. surveillance cultures were obtained from patients at the time of admission and serially thereafter. caz-rgn isolates were typed by pulsed-field gel electrophoresis (pfge). three hundred and forty-three patients were enrolled from whom 1,621 baseline and follow-up cultures were obtained. the most common species isolated from pat ...19979316915
sequence analysis of a 1296-nucleotide plasmid from xylella fastidiosa.a cryptic plasmid from xylella fastidiosa strain atcc 35868 was cloned, sequenced, and the sequence entered into genbank (u71220). the plasmid is 1296 nucleotides in length with 55% gc content and three open reading frames. a plasmid with sequence homology was found in only one other strain of x. fastidiosa, atcc 35878. searches of the genbank reveal nucleotide sequence homology with plasmid pnkh43 from stenotrophomonas maltophilia, and amino acid sequence homology with phage pf3 from pseudomona ...19979351204
infections in patients with cystic fibrosis following lung transplantation.there is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation.19979377954
transferable antibiotic resistance in nosocomial stenotrophomonas maltophilia strain.stenotrophomonas maltophilia (298/85) was isolated from the extensively inflamed conjunctiva of a neonate in a regional hospital in ostrava, czech republic. it was resistant to all available antibiotics except cefepime and trimethoprim. the donor s. maltophilia strain 298/85 transferred carbenicillin and cephaloridine resistance determinants to recipient strains of escherichia coli k-12 3110 rif+ and proteus mirabilis p-38 rif+. all transconjugant colonies were co-resistant also to kanamycin, ce ...19979401804
antimicrobial activity of 12 broad-spectrum agents tested against 270 nosocomial blood stream infection isolates caused by non-enteric gram-negative bacilli: occurrence of resistance, molecular epidemiology, and screening for metallo-enzymes.a total of 270 recent nosocomial blood stream isolates of non-enterobacteriaceae gram-negative bacilli representing nearly 50 u.s. medical centers were characterized. the numbers of isolates of individual organisms were: pseudomonas aeruginosa (n = 204), acinetobacter spp. (n = 48), and stenotrophomonas maltophilia (n = 18). mics were determined using the broth microdilution susceptibility method with 12 antimicrobial agents: piperacillin, piperacillin/tazobactam, ceftriaxone, ceftazidime, cefep ...19979401811
isolation and characterization of novel iron-oxidizing bacteria that grow at circumneutral ph.a gel-stabilized gradient method that employed opposing gradients of fe2+ and o2 was used to isolate and characterize two new fe-oxidizing bacteria from a neutral ph, fe(2+)-containing groundwater in michigan. two separate enrichment cultures were obtained, and in each the cells grew in a distinct, rust-colored band in the gel at the oxic-anoxic interface. the cells were tightly associated with the ferric hydroxides. repeated serial dilutions of both enrichments resulted in the isolation of two ...19979406396
resistance pattern of 2816 isolates isolated from 17631 blood cultures and etiology of bacteremia and fungemia in a single cancer institution.the resistance pattern of 2816 isolates from 17631 blood cultures and the etiology of isolates causing bacteremia and fungemia among 14591 admissions were investigated in an 80-bed single cancer institute during seven years (1990-1996) under the same empiric therapeutic antibiotic policy but with different prophylactic strategies. no change was found in the proportion of gram-positive versus gram-negative bacteria isolated from bacteremias (70% vs. 30%) during the past seven years. furthermore, ...19979408157
[meropenem: microbiologic perspective].meropenem is a beta-lactamic carbapenem derived from thienamycin and is structurally characterized by the presence of a beta-methyl group in position c1 which confers stability to the molecule versus renal dehydropeptidase 1 (dhp-1), thereby making the coadministration of an enzyme inhibitor unnecessary. its esterochemical configuration of the lateral chain in c2 (dimethyl carbomoilpyrrolidenethium) increases the activity versus gram negative bacteria (enterobacteria and pseudomonas) and moreove ...19979410064
[the role of carbapenems in the treatment of nosocomial infection].carbapenems are active beta-lactam antibiotics versus most of the gram positive and gram negative microorganisms and anaerobes although their activity is lacking in the case of staphylococcus sp. resistant to methicillin, enterococcus faecium and streptococcus pneumoniae with high resistance to penicillin and some gram negative bacilli which naturally produce an methaloenzyme able to hydrolyze them such as stenotrophomonas maltophilia. imipenem, the first synthetized carbapenem requires administ ...19979410075
inhibition of metallo-beta-lactamases by a series of thiol ester derivatives of mercaptophenylacetic acid.a series of mercaptophenylacetic acid thiol esters bearing a phenyl substituent adjacent to the carboxylic acid function has been shown to be inhibitors of metallo-beta-lactamases. the inhibition of the bacteroides fragilis cfia and bacillus cereus ii metallo-beta-lactamases was zn2- dependent, greater inhibition being observed at 1 microm znso4 than at 100 microm znso4. despite this zn2+ dependency, isothermal titration calorimetry studies illustrated that representative compounds had no detect ...19979418252
in vitro activities of beta-lactam-beta-lactamase inhibitor combinations against stenotrophomonas maltophilia: correlation between methods for testing inhibitory activity, time-kill curves, and bactericidal activity.the activities of ampicillin, ampicillin-sulbactam, amoxicillin, amoxicillin-clavulanic acid, ticarcillin, ticarcillin-clavulanic acid, piperacillin, piperacillin-tazobactam, aztreonam, and aztreonam-clavulanic against stenotrophomonas maltophilia strains for which the mics of penicillins and commercially available beta-lactam-beta-lactamase inhibitor combinations were higher than the breakpoints usually recommended for pseudomonas aeruginosa in commercially available broth microdilution methods ...19979420028
in vitro and in vivo antibacterial activities of cs-834, a novel oral carbapenem.cs-834 is a novel oral carbapenem antibiotic. this compound is an ester-type prodrug of the active metabolite r-95867. the antibacterial activity of r-95867 was tested against 1,323 clinical isolates of 35 species and was compared with those of oral cephems, i.e., cefteram, cefpodoxime, cefdinir, and cefditoren, and that of a parenteral carbapenem, imipenem. r-95867 exhibited a broad spectrum of activity covering both gram-positive and -negative aerobes and anaerobes. its activity was superior t ...19979420035
susceptibility of 100 strains of stenotrophomonas maltophilia to three beta-lactams and five beta-lactam-beta-lactamase inhibitor combinations.one hundred clinical strains of stenotrophomonas maltophilia were investigated for their susceptibility to ticarcillin, piperacillin, ceftazidime and five combinations with beta-lactamase inhibitors (clavulanic acid, tazocillin or sulbactam) at three concentrations; 26% of the strains were susceptible to ticarcillin, 23% to ceftazidime and 12% to piperacillin. eighty-two percent of the strains were susceptible to ticarcillin/clavulanic acid. in most cases, no synergy was observed with tazobactam ...19979421322
microbiological and clinical aspects of infection associated with stenotrophomonas maltophilia.the gram-negative bacterium stenotrophomonas maltophilia is increasingly recognized as an important cause of nosocomial infection. infection occurs principally, but not exclusively, in debilitated and immunosuppressed individuals. management of s. maltophilia-associated infection is problematic because many strains of the bacterium manifest resistance to multiple antibiotics. these difficulties are compounded by methodological problems in in vitro susceptibility testing for which there are, as y ...19989457429
the significance of aerobic gram-negative bacilli in clinical specimens following orthotopic liver transplantation.in a prospective study of 284 liver transplant patients, we sought associations between aerobic gram-negative bacillus acquisition or infection and 35 preoperative, perioperative, and postoperative variables. although the 128 (45%) who acquired aerobic gram-negative bacilli had longer admissions (p = 0.0001), no associations were found with pretransplant variables. fifty-three (41%) of the 128 acquired coliforms (e.g., escherichia coli, klebsiella spp., or enterobacter spp.), 50 (39%) acquired n ...19989457967
ventilator-associated pneumonia caused by potentially drug-resistant bacteria.to determine risk factors for ventilator-associated pneumonia (vap) caused by potentially drug-resistant bacteria such as methicillin-resistant staphylococcus aureus, pseudomonas aeruginosa, acinetobacter baumannii, and/or stenotrophomonas maltophilia, 135 consecutive episodes of vap observed in a single icu over a 25-mo period were prospectively studied. for all patients, vap was diagnosed based on results of bronchoscopic protected specimen brush (> or = 10(3) cfu/ml) and bronchoalveolar lavag ...19989476869
synergistic activity of trovafloxacin with other agents against gram-positive and -negative organisms.the synergistic activity of trovafloxacin with other agents against 55 gram-positive and -negative bacteria was determined by checkerboard titration. synergistic fractional inhibitory concentration (fic) indices (< or = 0.5) were seen in two methicillin-susceptible and one methicillin-resistant staphyloccocus aureus with teicoplanin, one of each of the latter two with vancomycin; one methicillin-resistant coagulase-negative staphylococcus with rifampin and one with fusidic acid; five stenotropho ...19989488833
treatment with beta-lactams and superinfection with stenotrophomonas maltophilia: a historical cohort study could show us more. 19989502503
in-vitro bactericidal efficacy of sub-mic concentrations of liposome-encapsulated antibiotic against gram-negative and gram-positive bacteria.it has been shown previously that tobramycin encapsulated in fluid liposomes (composed of dipalmitoylphosphatidylcholine (dppc) and dimyristoylphosphatidylglycerol (dmpg)) eradicated mucoid pseudomonas aeruginosa in an animal model of chronic pulmonary infection. exponential cultures of p. aeruginosa, stenotrophomonas maltophila, burkholderia cepacia, escherichia coli and staphylococcus aureus were treated with (i) free tobramycin, (ii) sub-mic tobramycin encapsulated in dppc/dmpg liposomes, (ii ...19989511035
[clinical significance of the determination of esbl (extended- spectrum beta-lactamase) production by gram-negative nosocomial bacteria].data on the incidence of multiresistant nosocomial bacterial strains of xanthomonas (stenotrophomonas) maltophilia, producing in addition to metallo-beta-lactamases also new types of broad spectrum beta-lactamases (esbl) called for analyses of the production of different types of enzymes.19989511267
in vitro and in vivo antibacterial activities of cs-834, a new oral carbapenem.cs-834 is a prodrug of the carbapenem r-95867, developed by sankyo co., ltd., tokyo, japan. to investigate the possibility that cs-834 may be the first carbapenem usable in an oral dosage form, its in vitro antibacterial activity (as r-95867) and in vivo antibacterial activity were compared with those of cefpodoxime proxetil, cefditoren pivoxil, cefdinir, ofloxacin, imipenem, and amoxicillin. r-95867 had high levels of activity against methicillin-susceptible staphylococci and streptococci, incl ...19989517932
two nosocomial strains of stenotrophomonas maltophilia transferring antibiotic resistance to proteus mirabilis p-38 recipient strain.in this report we describe a specific transfer of carbenicillin and cephaloridine resistance determinants from two different strains of stenotrophomonas maltophilia: no. 215 and 221 isolated from two critically ill patients treated in different intensive care units of a large university hospital in ostrava, czech republic. these strains were resistant to flouroquinolones and the following beta-lactam drugs: carbenicillin, cephaloridine, cefotaxime, ceftazidime, cefepime, imipenem, meropenem and ...19989531071
overexpression, purification, and characterization of the cloned metallo-beta-lactamase l1 from stenotrophomonas maltophilia.the metallo-beta-lactamase l1 from stenotrophomonas maltophilia was cloned, overexpressed, and characterized by spectrometric and biochemical techniques. results of metal analyses were consistent with the cloned enzyme having 2 mol of tightly bound zn(ii) per monomer. gel filtration chromatography demonstrated that the cloned enzyme exists as a tightly held tetramer with a molecular mass of ca. 115 kda, and matrix-assisted laser desorption ionization and time-of-flight mass spectrometry indicate ...19989559809
in vitro activity of cefpirome against microorganisms isolated in haematology, oncology and intensive care units in switzerland.the in vitro activity of cefpirome, a new parenteral fourth-generation cephalosporin, was investigated in the 5 university hospitals of switzerland, and compared to 9 other antibiotics mainly used in hospitals, such as ceftazidime, ceftriaxone, cefotaxime, piperacillin, imipenem, gentamicin, vancomycin, ciprofloxacin and ofloxacin. a total number of 992 strains collected only from intensive care units and haematology-oncology units were tested by microdilution according to nccls. cefpirome showe ...19979571744
identification of acinetobacters on blood agar in presence of d-glucose by unique browning effect.a positive phenotypic characteristic of glucose-oxidizing acinetobacters was demonstrated with blood agar containing d-glucose. glucose-oxidizing acinetobacter baumannii, acinetobacter genospecies 3, acinetobacter lwoffii, and acinetobacter genospecies 13 sensu tjernberg and ursing caused a unique brown discoloration of media supplemented with 5% blood (of horse, sheep, or human origin) and an aldose sugar (0.22 m d-glucose, d-galactose, d-mannose, d-xylose, or lactose). the browning effect was ...19989574714
characterization and sequence of the chryseobacterium (flavobacterium) meningosepticum carbapenemase: a new molecular class b beta-lactamase showing a broad substrate profile.the metallo-beta-lactamase produced by chryseobacterium (formerly flavobacterium) meningosepticum, which is the flavobacterial species of greatest clinical relevance, was purified and characterized. the enzyme, named blab, contains a polypeptide with an apparent mr of 26000, and has a pi of 8.5. it hydrolyses penicillins, cephalosporins (including cefoxitin), carbapenems and 6-beta-iodopenicillanate, a mechanism-based inactivator of active-site serine beta-lactamases. the enzyme was inhibited by ...19989576862
bottled water as a source of multi-resistant stenotrophomonas and pseudomonas species for neutropenic patients.stenotrophomonas maltophilia is an emerging nosocomial pathogen in patients rendered neutropenic following cytoreductive therapy for malignancy. the identification of sources and routes of transmission of this bacterium is of importance in the development of strategies to prevent nosocomial acquisition of s. maltophilia. a previous study had shown high rates of faecal carriage of s. maltophilia amongst patients with haematological malignancy and, as bottled water was consumed by many patients, w ...19989582746
interactions of beta-lactamases with sanfetrinem (gv 104326) compared to those with imipenem and with oral beta-lactams.sanfetrinem is a trinem beta-lactam which can be administered orally as a hexatil ester. we examined whether its beta-lactamase interactions resembled those of the available carbapenems, i.e., stable to ampc and extended-spectrum beta-lactamases but labile to class b and functional group 2f enzymes. the comparator drugs were imipenem, oral cephalosporins, and amoxicillin. mics were determined for beta-lactamase expression variants, and hydrolysis was examined directly with representative enzymes ...19989593145
molecular heterogeneity of the l-1 metallo-beta-lactamase family from stenotrophomonas maltophilia.we have determined the nucleotide sequence of the blas gene encoding the carbapenem-hydrolyzing l-1 beta-lactamase from stenotrophomonas maltophilia gn12873. analysis of the dna and deduced amino acid sequences identified a product of 290 amino acids. comparisons of the l-1 amino acid sequence with those of other zinc beta-lactamases showed 88.6% identity with the l-1 enzyme from s. maltophilia iid1275 and less than 20% identity with other class b metalloenzymes.19989593158
a standardized protocol for the rapid preparation of bacterial dna for pulsed-field gel electrophoresis.a rapid method for the preparation of bacterial dna for pulsed-field gel electrophoresis was developed for gram-positive and gram-negative bacteria. this method was accomplished by reducing the time for the cell lysis reaction, restriction endonuclease digestion, and electrophoresis to 1, 1.5, and 18 h, respectively. the whole procedure from the initial bacterial culture plate to the final analysis of restriction fragments can be completed within 24 h. this rapid method was successfully achieved ...19989597387
comparison of in vitro activity of trovafloxacin against gram-positive and gram-negative organisms with quinolones and beta-lactam antimicrobial agents.the in vitro activity of trovafloxacin against 721 gram-negative and 498 gram-positive organisms was determined by the standard microdilution broth method using commercially prepared frozen microtiter plates. the activity of trovafloxacin was compared to ofloxacin, ciprofloxacin, amoxicillin/clavulanate, ampicillin/sulbactam (1:1), piperacillin/tazobactam, ceftriaxone, and imipenem. trovafloxacin had equal or greater activity compared with the other agents tested against citrobacter diversus, en ...19989597391
aztreonam-clavulanic acid synergy does not mean extended-spectrum beta-lactamase in stenotrophomonas maltophilia. 19989598782
bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (copd) requiring mechanical ventilation.we carried out a comprehensive microbiological study of the upper and lower airways in patients with severe exacerbations of chronic obstructive pulmonary disease (copd) requiring mechanical ventilation in order to describe microbial patterns and analyze their clinical significance. quantitative cultures of tracheobronchial aspirates (tbas), bronchoscopically retrieved protected specimen brush (psb) and bronchoalveolar lavage fluid (balf) at admission to the icu and after 72 h, as well as serolo ...19989603129
imipenem resistance in aerobic gram-negative bacteria.a prospective study was undertaken to observe the emergence of resistance to imipenem, if any, among aerobic gram-negative bacteria. a total of 736 isolates were tested during 1994-95 and less than 1% of them were resistant to imipenem, whereas the next year ('95-'96) the rate increased to 11 of the 903 isolates tested. the resistant isolates during '94-'95 were all stenotrophomonas maltophilia whereas the spectrum of resistant bacterial species increased in '95-'96 to include pseudomonas aerugi ...19989603633
antibiotic susceptibility of stenotrophomonas (xanthomonas) maltophilia: comparative (nccls criteria) evaluation of antimicrobial drugs with the agar dilution and the agar disk diffusion (bauer-kirby) tests.ninety-six clinical isolates of stenotrophomonas maltophilia were examined with the agar dilution method for susceptibility to 19 antimicrobial drugs. doxycycline, cotrimoxazole, timentin, ofloxacin, fosfomycin, and piperacillin + tazobactam, in that order, inhibited the majority of strains. all isolates were resistant to nitrofurantoin. concurrent disk susceptibility (bauer-kirby method) testing, using currently valid nccls interpretative criteria for pseudomonas aeruginosa, uncovered a signifi ...19989612606
predictors of mortality in bacteremic cancer patients: retrospective analysis of 64 deaths occurring among 262 bacteremic episodes.a total of 262 bacteremic episodes were observed in cancer patients in a single cancer institution during the last 7 years, and the recorded outcome was death in 65. the 65 patients who died (24.8% overall mortality) were divided retrospectively into two subgroups: (a) those who died of underlying disease with bacteremia (45 cases, 16.9% crude mortality) and (b) those who died of bacteremia (20 patients, 7.7% attributable mortality). comparison of several risk factors in subgroups of patients wh ...19989629885
men 10700, a new penem antibiotic: in-vitro activity and its correlation with beta-lactamase stability, pbp affinity and diffusion through the bacterial cell wall.the in-vitro activity of men 10700, a novel penem, was compared with that of imipenem, ritipenem, ampicillin/sulbactam, cefotaxime, ciprofloxacin and amikacin against 1088 strains taken from 21 genera, including gram-negative, gram-positive and anaerobic bacteria. mic data showed that men 10700 was very active against staphylococci and streptococci (mic90 < or = 0.5 mg/l) and against most members of the enterobacteriaceae (mic90 < or = 2 mg/l), with reduced activity only against providencia stua ...19989630405
stenotrophomonas maltophilia in cystic fibrosis: incidence and prevalence.stenotrophomonas maltophilia (sm) was recovered from 211 of 773 cystic fibrosis (cf) patients followed for at least one year, and seen between 1982 and 1994. yearly prevalence (5.6% to 8.7%) and incidence rates (1.6% to 5.7%) showed no trends. sm persistence varied greatly and was unlike that of pseudomonas aeruginosa. fifty percent of sm-positive patients had only one positive culture and only 24 (11%) remained chronically infected. although sm-positive patients were more likely to be hospitali ...19989635931
occurrence of gram-negative bacteria in drinking water undergoing softening treatment.a study was carried out on the presence of gram-negative bacteria in the municipal waters of bologna (italy) undergoing softening using domestic ion exchangers with an automatic disinfection mechanism. the softening process was seen to cause a 15 fold increase in 22 degrees c and 36 degrees c heterotrophic plate counts. there was a 30 fold increase in gram-negative bacteria and their number correlated directly with temperature and inversely with active residual chlorine. organic matter had no ef ...19979636986
gram-negative bacteremia in non-neutropenic patients: a 3-year review.the causative organisms, clinical manifestations, factors influencing prognosis, and other epidemiological characteristics of 81 episodes of bacteremia due to gram-negative organisms, in non-neutropenic patients, were studied retrospectively during a 3-year period (1992-1994) at the department of internal medicine of the university hospital of heraklion, crete, greece. the gram-negative bacteremia incidence was 2% and the overall mortality 12%. all 81 patients had fever; escherichia coli was the ...19989646106
extended spectrum beta-lactamase reactions in stenotrophomonas maltophilia. 19989646115
molecular epidemiology of stenotrophomonas maltophilia isolated from clinical specimens from patients with cystic fibrosis and associated environmental samples.stenotrophomonas maltophilia was isolated from the respiratory tracts of 41 (25%) of 163 children attending our pediatric cystic fibrosis unit between september 1993 and december 1995. the extents of s. maltophilia contamination of environmental sites frequented by these patients were investigated with a selective medium incorporating vancomycin, imipenem, and amphotericin b. eighty-two isolates of s. maltophilia were cultured from 67 different environmental sites sampled between january and jul ...19989650943
reconstituted recombinant factor viii can be safely infused continuously for at least three days: it is a poor microbial growth medium.reconstituted recombinant factor viii (fviiirec) loses little biologic activity at room temperature for up to seven days and continuous infusion is convenient, effective hemostatically and requires less fviiirec concentrate than treatment by conventional bolus injections. however, the potential for bacterial contamination, with proliferation to high levels that can cause bacteremia, is a concern with continuous infusion. we studied the growth properties at 4, 25 and 35 degrees c in reconstituted ...19989663704
further studies of transferable antibiotic resistance in strains of pseudomonas aeruginosa from four clinical settings in three countries.this paper describes transferability of antibiotic resistance determinants in clinical isolates of pseudomonas aeruginosa resistant to imipenem, cefotaxime and ceftazidime obtained from different clinical settings in three different countries. two strains of enterobacteriaceae (escherichia coli k-12 and proteus mirabilis p-38) and two strains of p. aeruginosa (pao and ml) were used as recipient strains. the conjugative transfer of resistance was very specific, i.e. donor strains of p. aeruginosa ...19989669646
bacteremia and fungemia in pediatric versus adult cancer patients after chemotherapy: comparison of etiology, risk factors and outcome.one hundred and eighteen (118) episodes of bacteremia and fungemia in children with cancer were compared to 401 episodes of bacteremia and fungemia in adults with cancer to assess differences in etiology, risk factors and outcome. a retrospective univariate analysis was performed of all episodes of bacteremia in national pediatric and adult cancer institutions appearing in 1990-1996. a total of 519 episodes of bacteremia were assessed and compared. both cancer centers differed in prophylactic an ...19989669650
microbiology of sputum from patients at cystic fibrosis centers in the united states.during a phase iii national collaborative study of aerosolized tobramycin (1 july 1995 through 30 september 1996), the microbiology of specimens from 595 patients at 69 cystic fibrosis (cf) centers was examined. samples from three screening visits were processed in a single laboratory by means of standardized techniques for identification and susceptibility testing. from 1,753 pretreatment specimens, 5,128 pathogens were isolated (average, 2.9/specimen). of the 3,936 pseudomonas aeruginosa isola ...19989675470
activities of three quinolones, alone and in combination with extended-spectrum cephalosporins or gentamicin, against stenotrophomonas maltophilia.the present study examined the activities of trovafloxacin, levofloxacin, and ciprofloxacin, alone and in combination with cefoperazone, ceftazidime, cefpirome, and gentamicin, against 100 strains of stenotrophomonas maltophilia by the mic determination method and by synergy testing of the combinations by the time-kill and checkerboard titration methods for 20 strains. the respective mics at which 50% and 90% of isolates were inhibited for the drugs used alone were as follows: trovafloxacin, 0.5 ...19989687397
specific ribosomal dna sequences from diverse environmental settings correlate with experimental contaminants.phylogenetic analysis of 16s ribosomal dna (rdna) clones obtained by pcr from uncultured bacteria inhabiting a wide range of environments has increased our knowledge of bacterial diversity. one possible problem in the assessment of bacterial diversity based on sequence information is that pcr is exquisitely sensitive to contaminating 16s rdna. this raises the possibility that some putative environmental rrna sequences in fact correspond to contaminant sequences. to document potential contaminant ...19989687486
nosocomial outbreak of colonization and infection with stenotrophomonas maltophilia in preterm infants associated with contaminated tap water.between march and may 1996 stenotrophomonas maltophilia was cultured from endotracheal aspirate samples from five preterm infants in a neonatal intensive care unit (nicu). four infants were superficially colonized, but a fifth died due to s. maltophilia septicaemia. s. maltophilia was cultured from tap water from three outlets in the nicu including one with a previously unnoticed defective sink drain. water from these outlets was used to wash the preterm infants. environmental and clinical s. ma ...19989692603
detection of bacteraemia in patients with fever and neutropenia using 16s rrna gene amplification by polymerase chain reaction.episodes of fever and neutropenia are common complications of treatment for cancer. the use of prophylactic and early empirical antibiotics has reduced mortality but decreases the sensitivity of diagnostic tests based on culture. the aim of this study was to determine the potential of a broad diagnostic approach (eubacterial) based on 16s rrna gene amplification and sequencing to augment cultural methods of diagnosis of bacteraemia in patients with fever and neutropenia in a regional paediatric ...19989707307
resistance mechanisms in pseudomonas aeruginosa and other nonfermentative gram-negative bacteria.nonfermentative gram-negative bacilli are still a major concern in compromised individuals. by far the most important of these organisms is pseudomonas aeruginosa, although acinetobacter baumannii (previously acinetobacter calcoaceticus), stenotrophomonas maltophilia (previously pseudomonas and xanthomonas maltophilia), and burkholderia cepacia (previously pseudomonas cepacia) are also of substantative concern because of their similar high intrinsic resistances to antibiotics. the basis for the ...19989710677
clinical problems posed by multiresistant nonfermenting gram-negative pathogens.in this review i will briefly survey the role of pseudomonas aeruginosa, acinetobacter baumanii, stenotrophomonas maltophilia, and burkholderia cepacia as opportunistic pathogens. a common feature of these organisms is intrinsic resistance to multiple antibiotics. all of these organisms can be recovered from the environment, commonly cause device-related infections, are often resistant to disinfectants, and have the potential to spread from patient to patient via fomites or the hands of medical ...19989710680
a relatively small change in sodium chloride concentration has a strong effect on adhesion of ocular bacteria to contact lenses.adhesion of bacteria to hydrogel lenses is thought to be an initial step of ocular colonization allowing evasion of normal host defences. the salt concentration of media is an important parameter controlling microbial adhesion. salinity varies from 0.97% nacl equivalents in the open eye to 0.89% in the closed eye state. in this study, the effect of sodium chloride in the concentration range of 0.8-1.0% (w/v) nacl on adhesion of ocular bacteria to soft contact lenses was investigated using a stat ...19989717279
bacteremia due to multiresistant gram-negative bacilli in neutropenic cancer patients: a case controlled study.the aim of this study was to see if multiresistant gram-negative bacteremias (mrgnb) are associated with specific risk factors and/or higher mortality in comparison to sensitive gnb (sgnb). both groups, 51 patients and 102 controls, were matched for sex, age, underlying disease and neutropenia. in addition there were no significant differences in the incidence of cytotoxic chemotherapy administered, vascular catheter insertion and catheter as source of bacteremia and etiology of bacteremia. the ...19989720472
infective endocarditis due to stenotrophomonas (xanthomonas) maltophilia.stenotrophomonas maltophilia (formerly xanthomonas maltophilia) is a gram-negative bacillus increasingly associated with serious nosocomial infections. here, the case of a 69-year-old female patient who developed prosthetic valve endocarditis associated with this organism is described. a review of the literature revealed only 18 previous reports; eight involved native valves, the remainder prosthetic valves. most cases were associated with risk factors, including intravenous drug abuse (6 patien ...19989721966
molecular identification of a stenotrophomonas species used in the bioassay for erythromycin in aquaculture samples.a bacterial strain isolated from aquaculture pond slurry, which was extremely sensitive to erythromycin, was used to detect erythromycin at levels as low as 0.05 micrograms ml-1 in aquaculture water, sediments and soil samples. identification of the indicator organism was attempted by 16s rrna sequencing, biochemical profile, fatty-acid analysis and polymerase chain reaction (pcr). genbank comparison showed that the 16s rrna sequence of the strain was similar to those of more than 20 copies of x ...19989727203
stenotrophomonas (xanthomonas) maltophilia: in vitro susceptibility to selected antimicrobial drugs, single and combined, with and without defibrinated human blood.sixteen selected isolates of stenotrophomonas maltophilia varied in susceptibility to the combined phagocytic/serum bactericidal activity of fresh defibrinated human blood (65 vol%). four representative isolates (x1, x11, x25, and x50), which differed in susceptibility to cefepime, ceftazidime, rifampin, and timentin, were subjected to checkerboard microtiter broth dilution tests involving combinations of cefepime plus timentin, ceftazidime plus ofloxacin, cotrimoxazole plus timentin, rifampin p ...19989732143
total nutrient admixtures appear safer than lipid emulsion alone as regards microbial contamination: growth properties of microbial pathogens at room temperature.the extraordinary growth properties of most microorganisms in 10% and 20% lipid emulsions has led to the centers for disease control and prevention recommendation that if lipids are given through an i.v. line, the administration set should be replaced every 24 hours rather than the usual 72-hour interval used for crystalloid solutions, including those used for conventional total parenteral nutrition. for nearly 15 years, parenteral alimentation has been given as a total nutrient admixture (tna), ...19989739032
the o7 antigen of stenotrophomonas maltophilia is a linear d-rhamnan with a trisaccharide repeating unit that is also present in polymers for some pseudomonas and burkholderia species.the o antigen polymer recovered from the reference strain for stenotrophomonas (xanthomonas or pseudomonas) maltophilia serogroup o7, after mild acid hydrolysis of the lipopolysaccharide, was constructed from d-rhamnose. by means of chemical degradations and nmr studies, the repeating unit of the polymer was shown to be a linear trisaccharide with the structure -->2)-alpha-d-rhap-(1-->3)-alpha-d-rhap-(1-->3)-alpha-d-r hap-(1-->. the same repeating unit is present in the common antigen of pseudom ...19989741084
[evaluation of antibacterial activities of various antibiotics against glucose non-fermentative gram-negative rods other than pseudomonas aeruginosa].mics of piperacillin, sulbactam/cefoperazone, minocycline (mino), gentamicin, amikacin, flomoxef, ceftazidime, cefozopran, cefsulodin and imipenem were determined, against 189 clinical isolated strains of glucose non-fermentative gram-negative rods (nfgnr; acinetobacter baumannii (44), alcaligenes faecalis (5), alcaligenes xylosoxidans (25), burkholderia cepacia (12), chryseobacterium indologenes (23), chryseobacterium meningosepticum (9), pseudomonas fluorescens (8), pseudomonas putida (12), st ...19989755431
[bacteremia caused by stenotrophomonas maltophilia: a clinical-epidemiological study and resistance profile].over a 7-year period (1990-1996), the causal disease, predisposing factors, focus infection, clinical manifestations, complications and evolution of patients presenting bacteremia from stenotrophomonas maltophilia were analyzed retrospectively in a university hospital. a microbiological study was carried out to determine the percentage of positive blood cultures per episode and the characteristics of bacteremia and to evaluate the antibiotic susceptibility of the isolated strains. twenty-seven e ...19989795306
the crystal structure of the l1 metallo-beta-lactamase from stenotrophomonas maltophilia at 1.7 a resolution.the structure of the l1 metallo-beta-lactamase from the opportunistic pathogen stenotrophomonas maltophilia has been determined at 1.7 a resolution by the multiwavelength anomalous dispersion (mad) approach exploiting both the intrinsic binuclear zinc centre and incorporated selenomethionine residues. l1 is unique amongst all known beta-lactamases in that it exists as a tetramer. the protein exhibits the alphabeta/betaalpha fold found only in the metallo-beta-lactamases and displays several uniq ...19989811546
polymerase chain reaction amplification of bacterial 16s rrna genes from cold-cup biopsy forceps.in looking for a possible infectious cause for interstitial cystitis (ic), we previously determined that bladder tissue specimens from both ic patients and controls were uniformly positive by polymerase chain reaction assay (pcr) for bacterial 16s ribosomal rna genes from various genera including escherichia, propionobacterium, acinetobacter, and salmonella. we therefore determined whether the biopsy forceps might be contaminated with bacterial dna.19989817375
antimicrobial interactions of trovafloxacin and extended-spectrum cephalosporins or azithromycin tested against clinical isolates of pseudomonas aeruginosa and stenotrophomonas maltophilia. 19989818765
antimicrobial activity of merocyanine 540: a photosensitizing dye.the antimicrobial activity of merocyanine 540 (mc 540), a photosensitizing dye previously used to purge malignant cells from autologous bone marrow grafts, was evaluated against a panel of gram-positive and gram-negative bacteria and candida albicans in the presence and absence of light. in the absence of light, mc 540 demonstrated no antibacterial activity against any of the organisms tested. when combined with increasing intervals of photoillumination, growth inhibition was observed with all g ...19989823532
comparison of various in vitro susceptibility methods for testing stenotrophomonas maltophilia.a total of 57 clinical isolates were screened by disk diffusion for a related pharmacodynamic study. testing was performed using national committee for clinical laboratory standards guidelines, except that results were interpreted at 16 to 18 h and 48 h. of the 57 isolates, 19 were randomly chosen for additional comparative susceptibility testing of five methods (disk diffusion, etest, alamar colorimetric broth microdilution, vitek, and microscan) and an in-house broth microdilution method. the ...19989884841
[community-acquired bacteremia and pneumonia caused by stenotrophomonas maltophilia in a patient with aids]. 19989887635
[bacteremia with granulocytopenia--microbiology and empiric antibiotic treatment].this article sums up a retrospective analysis of 84 episodes of bacteraemia in acute leukaemia patients with severe neutropenia in a norwegian teaching hospital during the period 1990-95. gram negative bacteria represented 54% of the blood culture isolates, all of which were susceptible to aminoglycosides, and nearly all to ceftazidime and imipenem. penicillin/aminoglycoside was used as initial therapy in 43% of the episodes. initial empiric therapy was modified in 52% of the events. only 15% of ...19989889610
antibiotic susceptibility among aerobic gram-negative bacilli in intensive care units in 5 european countries. french and portuguese icu study groups.surveillance of antibiotic resistance is especially important in intensive care units (icus) because the infection rates are much higher there than in other hospital wards and most epidemics with multiresistant bacteria originate in icus.19999892453
stenotrophomonas maltophilia endocarditis following dental treatment in a previously healthy patient. 19989892541
a melanin pigment purified from an epidemic strain of burkholderia cepacia attenuates monocyte respiratory burst activity by scavenging superoxide anion.the acquisition of burkholderia cepacia in some cystic fibrosis patients is associated with symptoms of acute pulmonary inflammation that may be life threatening. the ability of lipopolysaccharide (lps) from b. cepacia to prime a monocyte cell line for enhanced superoxide anion generation was investigated and compared with the priming activities of lpss from pseudomonas aeruginosa, stenotrophomonas maltophilia, and escherichia coli. the human monocyte cell line monomac-6 (mm6) was primed overnig ...19999916107
aetiology, cost of antimicrobial therapy and outcome in neutropenic patients who developed bacteraemia during antimicrobial prophylaxis: a case-control study.sixty four episodes of bacteraemia that appeared during antimicrobial prophylaxis with an oral quinolone plus an azole in neutropenic cancer patients were compared with 128 cases of bacteraemia in a cohort of controls matched for age, sex, underlying disease, neutropenia and vascular catheter in situ to assess differences in aetiology, cost of therapy and outcome. patients who received prophylaxis had breakthrough bacteraemias of a different aetiology compared with the control group: they had si ...19989916907
[occurrence of gram-negative non-fermenting rods in hemocultures and their sensitivity to antimicrobial agents].in the period from january 1993 to june 1996 were at the department of microbiology of the university hospital in olomouc 122 strains of gram-negative nonfermentative rod-shaped bacteria isolated from haemocultures. the majority represented the group of 51 strains of the genus acinetobacter (41.8%), complex a. calcoaceticus-baumannii (acb complex). the second largest group were 21 strains (17.2%) of pseudomonas aeruginosa. these were followed by 17 strains (13.9%) of stenotrophomonas maltophilia ...19989919762
kinetic mechanism of metallo-beta-lactamase l1 from stenotrophomonas maltophilia.the reaction of nitrocefin with metallo-beta-lactamase l1 from stenotrophomonas maltophilia was studied using rapid-scan and stopped-flow ultraviolet-visible (uv-vis) studies in an effort to discern the kinetic mechanism used by l1 to hydrolyze penicillins and cephalosporins. rapid-scan and stopped-flow uv-vis studies of nitrocefin hydrolysis by l1 identified three species: (1) the substrate (nitrocefin) displayed an absorbance peak at 390 nm (epsilon = 11 500 m(-1) cm(-1)) that decreased during ...19999931021
in vitro activity of meropenem against common pathogenic bacteria isolated in taiwan.the in vitro antimicrobial activity of meropenem, in comparison with nine other antimicrobial agents, against 12 different common pathogenic bacteria were evaluated to know the susceptibility of common bacteria to meropenem in taiwan. meropenem was active against most gram-positive, gram-negative, and anaerobic bacteria, including methicillin-sensitive staphylococcus aureus, streptococcus pyogenes, enterococcus faecalis, escherichia coli, klebsiella pneumoniae, enterobacter cloacae, pseudomonas ...19989934544
faucet aerators: a source of patient colonization with stenotrophomonas maltophilia.multiple nosocomial outbreaks have been linked to contaminated water sources within the hospital. we report in this article a cluster of patients in a surgical intensive care unit who were colonized or infected with stenotrophomonas maltophilia.19999949380
comparative in-vitro activities of trovafloxacin, ciproflaxacin, ofloxacin, and broad-spectrum beta-lactams against aerobe blood culture isolates.the in vitro activity of trovafloxacin, a new fluoroquinolone, was compared with that of ciprofloxacin, ofloxacin, fleroxacin, ceftazidime, piperacillin/tazobactam, and meropenem against 613 consecutively recovered blood isolates from recently hospitalized patients. susceptibility testing was performed by agar dilution according to nccls guidelines. test strains included acinetobacter species (n = 26), escherichia coli (n = 137), enterobacter species (n = 27), klebsiella species (n = 42), proteu ...19989987189
in vitro activity of trovafloxacin against ciprofloxacin-susceptible and -resistant clinical bacterial isolates and assessment of the trovafloxacin disk test.a total of 4241 consecutive clinical bacterial isolates from 10 north american medical centers were tested for susceptibility to trovafloxacin. trovafloxacin was significantly more active than ciprofloxacin against gram-positive bacteria, acinetobacter spp., and stenotrophomonas maltophilia, and resistance to trovafloxacin occurred in these groups only among isolates with high-level resistance (mic > or = 16 micrograms/ml) to ciprofloxacin. with other species, the two drugs had comparable activi ...19999990473
lipopolysaccharide (lps) from burkholderia cepacia is more active than lps from pseudomonas aeruginosa and stenotrophomonas maltophilia in stimulating tumor necrosis factor alpha from human monocytes.whole cells and lipopolysaccharides (lpss) extracted from burkholderia cepacia, pseudomonas aeruginosa, stenotrophomonas maltophilia, and escherichia coli were compared in their ability to stimulate tumor necrosis factor alpha (tnf-alpha) from the human monocyte cell line monomac-6. b. cepacia lps, on a weight-for-weight basis, was found to have tnf-alpha-inducing activity similar to that of lps from e. coli, which was approximately four- and eightfold greater than the activity of lpss from p. a ...199910024601
[evaluation of mycobacterium kansasii isolates from a clinical laboratory in a city hospital].fifteen isolates of mycobacterium kansasii in showa university fujigaoka hospital between 1982 and 1995 were investigated. comparing by gender, 13 were isolated from male patients and only two were isolated from female patients. the average of cases was 48 years old and 14 out of 15 cases (93%) were isolated from respiratory tract specimens. the rate of the smear- and culture-positives was 64%, which was significantly higher than that (26%) of m. avium complex (p < 0.01 by chi 2 test). all 4 iso ...199910067052
stenotrophomonas maltophilia infection and colonization in the intensive care units of two community hospitals: a study of 143 patients.study objective: to study the epidemiology of stenotrophomonas maltophilia infections in the intensive care units (icus) of community general hospitals.199910076113
the increase in carbapenem use and emergence of stenotrophomonas maltophilia as an important nosocomial pathogen.carbapenems, being the broadest spectrum antibiotics, may allow those organisms intrinsically resistant to these drugs to be involved more frequently in nosocomial infections. imipenem was introduced to the specialized hospital units in kuwait in october, 1992 and meropenem in late 1996. the main objective of this study was to observe prospectively whether, under similar laboratory conditions for microbial isolation/identification while these drugs are in use in the hospital, there is any propor ...199910078777
[clinical manifestations of stenotrophomas (xanthomonas) maltophilia infection].stenotrophomonas maltophilia (sm) is a gram-negative bacillus whose incidence like nosocomial pathogen has been incremented in the last years, especially in immunocompromised patients, subjected to invasive procedures and those receiving broad-spectrum antimicrobial therapy.199810079538
in vitro activity of ciprofloxacin, levofloxacin, and trovafloxacin, alone and in combination with beta-lactams, against clinical isolates of pseudomonas aeruginosa, stenotrophomonas maltophilia, and burkholderia cepacia.we tested three fluoroquinolones (ciprofloxacin, levofloxacin, and trovafloxacin), each combined with each of four beta-lactams (cefoperazone, ceftriaxone, imipenem, and meropenem) for synergy against clinical isolates of nosocomial strains of pseudomonas aeruginosa, stenotrophomonas maltophilia, and burkholderia cepacia. the ciprofloxacin-beta-lactam combinations showed synergy against none or only a small fraction (7 to 10%) of the p. aeruginosa and b. cepacia isolates. ciprofloxacin-cefoperaz ...199910091030
surfactant-enhanced biodegradation of high molecular weight polycyclic aromatic hydrocarbons by stenotrophomonas maltophiliathe objectives of this study were to isolate and evaluate microorganisms with the ability to degrade high molecular weight polycyclic aromatic hydrocarbons (pahs) in the presence of synthetic surfactants. stenotrophomonas maltophilia vun 10,010, isolated from pah-contaminated soil, utilized pyrene as a sole carbon and energy source and also degraded other high molecular weight pahs containing up to seven benzene rings. various synthetic surfactants were tested for their ability to improve the pa ...199810099362
in vitro antibacterial properties of pexiganan, an analog of magainin.pexiganan, a 22-amino-acid antimicrobial peptide, is an analog of the magainin peptides isolated from the skin of the african clawed frog. pexiganan exhibited in vitro broad-spectrum antibacterial activity when it was tested against 3,109 clinical isolates of gram-positive and gram-negative, anaerobic and aerobic bacteria. the pexiganan mic at which 90% of isolates are inhibited (mic90) was 32 micrograms/ml or less for staphylococcus spp., streptococcus spp., enterococcus faecium, corynebacteriu ...199910103181
location and survival of leaf-associated bacteria in relation to pathogenicity and potential for growth within the leafthe growth and survival of pathogenic and nonpathogenic pseudomonas syringae strains and of the nonpathogenic species pantoea agglomerans, stenotrophomonas maltophilia, and methylobacterium organophilum were compared in the phyllosphere of bean. in general, the plant pathogens survived better than the nonpathogens on leaves under environmental stress. the sizes of the total leaf-associated populations of the pathogenic p. syringae strains were greater than the sizes of the total leaf-associated ...199910103233
decrease in expenditures and selected nosocomial infections following implementation of an antimicrobial-prescribing improvement program.to evaluate changes in antimicrobial use and expenditures and the rates of selected nosocomial infections due to resistant organisms associated with implementation of an antimicrobial-prescribing improvement program.199710176026
effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis.pseudomonas aeruginosa endobronchial infection causes significant morbidity and mortality among cystic fibrosis patients. microbiology results from two multicenter, double-blind, placebo-controlled trials of inhaled tobramycin in cystic fibrosis were monitored for longitudinal changes in sputum microbial flora, antibiotic susceptibility, and selection of p. aeruginosa isolates with decreased tobramycin susceptibility. clinical response was examined to determine whether current susceptibility sta ...199910191222
stenotrophomonas (xanthomonas) maltophilia infection in necrotizing pancreatitis.although the therapy of infected pancreatic collections or organized pancreatic necrosis remains surgical, we have demonstrated that infected organized pancreatic necrosis can be treated endoscopically.199910211423
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