Laboratory diagnosis of S. pneumoniae infection relies on culture of the bacterium from relevant clinical samples. Typically, S. pneumoniae colonies have an umbilicated appearance surrounded by a zone of a-hemolysis when grown on blood agar. Identification of S. pneumoniae isolates is usually based on the demonstration of capsule formation, bile solubility, and/or susceptibility to opto-chin. Blood and other samples from normally sterile sites are the samples of choice for culture. Sputum culture is complicated by contamination with nasopharyngeal colonizing bacteria. Recent developments in pneumococcal infection diagnostics include a new immunochromato-graphic urinary antigen test that is sensitive for diagnosing pneumococcal pneumonia in adults.
p-Lactams are the antibiotics of choice for treating S. pneumoniae infections. However, the global emergence of penicillin-resistant strains over the past 20 years has restricted therapeutic options. Extended spectrum cephalosporins (e.g., ceftriaxone) have been successfully used to treat serious infections with penicillin-resistant pneu-mococci, but resistance to this class of antibiotic is also increasing. Resistance to other classes of antibiotics (mac-rolides, tetracycline, cotrimoxazole, fluoroquinolones, and chloramphenicol) has also emerged to significant levels, and many S. pneumoniae strains are now exhibiting resistance to multiple antibiotic classes.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.