Martin, William J.

The mechanisms by which bacteria colonize and damage ciliated epithelium are important in understanding the pathophysiology of rhinitis, sinusitis, and otitis. Bacteria that have the ability to impair mucociliary clearance would be at an advantage in establishing infection of ciliated surfaces. This study investigates the effect of Hemophilus Influenzae, Streptococcus pneumoniae, Brahmanella catarralis, and Staphylococcus epidermidis on the ciliary activity of normal ciliated nasal epithelium in human beings. Ciliary activity of the nasal epithelium in the presence of each pathogen was assessed for more than 240 minutes with a photometric method of ciliary beat frequency (CBF) measurement. H. influenzae exerted significant effects on ciliary activity, with a 46% decrease in the CBF by 4 hours (with bacteria‐containing broth) and a 32% decrease with bacteria‐free filtrate. S. epidermidis decreased CBF by 44% with the bacterial broth. A sterile cell‐free filtrate had no significant effect. S. pneumoniae and B. catarralis had no significant effect on CBF within a 240‐minute period. H. influenzae and S. epidermidis disrupted normal synchronous ciliary motion, causing adjacent cilia to beat at different rates.

Thirty-three cases of enterococcal endocarditis encountered during the decade from January 1944 through December 1953 are reviewed. In vitro studies indicate that penicillin and streptomycin are the best antibiotic pair for bactericidal effect. Twelve of the last 14 patients were cured (86 per cent), 10 with combined therapy. The cure rate in enterococcal endocarditis now approximates that of endocarditis caused by penicillin-sensitive streptococci. A maximal number of cures is achieved by individualization of therapy. The daily dosage of penicillin and the duration of combined penicillin-streptomycin therapy should be guided by in vitro bactericidal tests employing the patient's strain of enterococcus.