A dissertation submitted to the Faculty of
Medicine, University of the Witwatersrand,
Johannesburg, for the degree of Master of Science
in Medicine. / Analysis of organisms involved in hospital infections
has shown that Gram-positive bacteria have assumed an
increasingly important role. Examples that have been
recognised as important pathogens are staphylococci ,
enterococci, streptococci, Corynebacterium jeikeium and
Leuconostoc species. Methicillin resistance in
staphylococci has become a major problem in certain
hospitals. Viridans streptococci continue to be the most
frequent cause of native valve endocarditis. Leuconostoc
species are being increasingly isolated from blood
cuIture specimens. strains of Gram-positive bacteria
have become resistant to specific antibiotics; e.g.
staphylococci to methicillin, enterococci to ampicillin,
and viridans streptococci to penicillin. JK
corynebacteria are sensitive only to vancomycin and
resistant to other antimicrobials normally used for
treating infection caused by Gram-positive bacteria.
In this study various combinations of antimicrobials
against 35 clinical isolates of Gram-positive bacteria
obtained from three hospitals in the Johannesburg area
(Johannesburg, Hillbrow, and Baragwanath) from 1987-
1988 were investigated.
The MIC / MBC results conformed to others described in
worldwide studies.
Results when different methodologies for determining
synergy were used, varied. This emphasizes the need for
standardization, especially with regard to the time-kill
studies.
Most antimicrobial combinations
demonstrated
tested against
Leuconostoc species synergy using the
checkerboard method, but these results were not
confirmed by time-kill procedures, which showed mainly
indifference.
Synergy was also obtained when gentamicin plus
ciprofloxacin was combined
Corynebacterium jeikeium.
Because of increasing resistance and the fact that Gram-
positive bacteria cause serious infections, various and
new combinations of antimicrobials need to be tested
before treating these infections.
Parts of this dissertation have been presented at the
following congresses:
10th Annual Congress of the Society of Medical.
Laboratory Technologists of South Africal Sun city 1989
75th Anniversary Congress of Pathology Johannesburg
1990
11th Annual Congress of the Society of Medical
Laboratory Technologists of South Africa, Durban 1991 / Andrew Chakane 2019
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/26632 |
| Date | January 1993 |
| Creators | Van den Berg, Alan |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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