J Periodontol, 1993 May, 64(5), 379 - 86 A possible late onset variation of Papillon-Lefèvre syndrome: report of 3 cases; Brown RS et al.; Three unusual cases of Papillon-Lefevre syndrome with late onset of features and relatively mild periodontal disease are presented . These examples confirm some of the late onset of features and mild periodontal presentation of a previous case report . Bacteriologic associations, polymorphonuclear leukocyte chemotactic, phagocytic, and bactericidal activity, and therapeutics with regard to this syndrome are discussed. Infect Immun, 1993 May, 61(5), 2211 - 5 Biochemical and immunological properties of two forms of pertactin, the 69,000-molecular-weight outer membrane protein of Bordetella pertussis; Gotto JW et al.; Two apparent isoforms of the virulence-associated 69,000-molecular-weight protein pertactin were purified from Bordetella pertussis . Mass spectrometry showed a difference of 2,060 Da, which may result from differential C-terminal cleavage of a larger precursor . Both forms were protective in a mouse model, eliciting bactericidal antibodies and reducing respiratory tract colonization. J Antimicrob Chemother, 1993 May, 31 Suppl D, 71 - 85 Experimental endocarditis: a review of its relevance to human endocarditis; Carbon C; Bacterial endocarditis is a difficult-to-cure infection, owing to (i) poor penetration of antibiotics into infected vegetations; (ii) altered metabolic state of bacteria within the lesion; (iii) absence of adequate host-defence cellular response which could cooperate with antibiotic action . The contribution of infection models to definition and improvement of therapeutic regimens of endocarditis in man remains of great importance because of the difficulties encountered in clinical trials . The advantage of the experimental model is that besides the fact that it closely simulates the characteristics of the infection in humans, it provides clear endpoints which allow statistical comparisons among different therapeutic regimens: number of bacteria/g of tissue, frequency of emergence of resistance, positivity of blood cultures, death vs survival rates, and percentage of relapses after treatment has been stopped . All these parameters are more sensitive and more easy to use than in man . The infection model has definitively established that bactericidal therapy is warranted and that in-vitro susceptibility tests, especially those evaluating the killing rate, have a good predictive value for the therapeutic outcome . Three main aspects are discussed for their influence on human therapy (i) the kinetics of antibiotic diffusion into vegetations, with a special reference to the data obtained by autoradiography, (ii) the specificity of some pharmacodynamic aspects of antibiotics in endocarditis, including the clinical consequences of these two parameters on antibiotic dosing regimens and length of therapy, and (iii) in-vivo synergy . This phenomenon involves a variety of mechanisms which are difficult or even impossible to analyse on the sole basis of in-vitro data: enhanced bactericidal activity (beta-lactam-aminoglycoside), prevention of emergence of resistance (as demonstrated for rifampin, quinolones or fosfomycin) and, as shown with rifampin or quinolones, 'pharmacokinetic synergy' . Animal models have helped to define the importance of antibiotic dosing strategies to achieve in-vivo synergy which appears as essential to increase the rate of both bacteriological and clinical cure rate. Kansenshogaku Zasshi, 1993 May, 67(5), 473 - 81 {Influence of cisplatinum on activated oxygen generations by leukocytes}; Igarashi H; We investigated the activated oxygen generations by leukocytes in the presence of cisplatinum, an antitumor agent, in order to elucidate the influence of cisplatinum on leukocytes function in vitro and in vivo . In the in vitro study, polymorphonuclear leukocytes (PMNs) and monocytes were prepared from a normal volunteer . After stimulation with phorbol myristate acetate (PMA) or opsonized zymosan, activated oxygen generations by PMNs or monocytes were measured by means of chemiluminescence method in the presence or absence of cisplatinum . The concentrations of cisplatinum were adjusted at 0.5, 5.0 and 50 micrograms/ml, and the medium pH also varied at that time . Activated oxygen generations by PMNs and monocytes were reduced significantly in the platinum concentration dependent manner in the pH range from 6.0 to 6.5 . On the other hand, in the pH range from 8.3 to 8.8, the activated oxygen generations were not affected by cisplatinum at all . In the in vivo study, we administered 1.25 mg of cisplatinum to male wistar rats intravenously, and prepared whole blood at 4, 12 and 24 hours after administration of cisplatinum . And activated oxygen generations by whole blood were measured in the same manner . The numbers of leukocytes were also counted at the same time . As compared to the control group without administration of cisplatinum, no significant difference was observed in the leukocytes counts at 12 and 24 hours after the administration . However, the activated oxygen generations by whole blood were reduced in the cisplatinum-administration group . These results indicate that the bactericidal activities of leukocytes were immediately reduced before bone marrow suppression by cisplatinum, and the prevention of acidosis in the patients receiving cisplatinum might be important in order to keep the bactericidal activities of leukocytes. Lik Sprava, 1993 May-Jun, (5-6), 123 - 6 {A method for the differential diagnosis of chronic persistent hepatitis and liver cirrhosis}; Moshchych VP et al.; With a view to increase the accuracy of the differential diagnosis of chronic diseases of liver--chronic persistent hepatitis and initial manifestation of hepatic cirrhosis--the method based on the determination of general bactericidal activity of neutrophils is suggested . Cytochemical reaction on cationic proteins and nitroblue tetrazolium reduction with the blood of patients having the signs of liver lesion provide data for the calculation of the integral cytochemical activity of blood neutrophils . Values fluctuating from 4.0 to 6.0 indicate hepatic cirrhosis while their exceeding 7.0 may serve as an evidence of chronic persistent hepatitis. FEBS Lett, 1993 Apr 26, 321(2-3), 145 - 8 Microcin E492 forms ion channels in phospholipid bilayer membrane; Lagos R et al.; Microcin E492, a polypeptide antibiotic, has been shown to have an M(r) of 6,000 by urea-SDS-polyacrylamide gel electrophoresis of the fluorescently labelled compound . It is known that the bactericidal action of microcin involves a loss of the transmembrane potential . In this study we show that microcin forms cation-selective channels in planar phospholipid bilayers . The channels have two main conductance states the current-voltage curves of which rectify . The reversal potentials measured under biionic conditions indicate a permeability sequence of NH4+ > K+ = Rb+ = Cs+ > Na+ = Na+ = Li+ > Tris+ . The results suggest that membrane potential dissipation induced by microcin is a consequence of the formation of pores in the bacterial membrane. Immunol Lett, 1993 Apr, 36(1), 43 - 9 Regulation of macrophage function by human recombinant myeloperoxidase; Lefkowitz DL et al.; Myeloperoxidase is an enzyme which is found in the azurophilic granules of neutrophils and is associated with bactericidal, fungicidal, and tumoricidal activity . The present studies show that human recombinant myeloperoxidase (rec-MyPo) can regulate a number of macrophage (M phi) capacities and functions . Macrophages from mice exposed to rec-MyPo in vitro released reactive oxygen intermediates, tumor necrosis factor alpha (TNF alpha), and interferon alpha/beta (IFN alpha/beta) . Enhanced target cell killing was also demonstrated with TNF alpha sensitive but not TNF alpha insensitive cells . Intravenous injection of rec-MyPo induced high titers of systemic TNF alpha and IFN alpha/beta . These results indicate that MyPo can function as an immunomodulator both in vitro and in vivo . Because of these actions, it is apparent that MyPo represents a previously unrecognized endogenous immunomodulator. Avian Dis, 1993 Apr-Jun, 37(2), 366 - 74 Effects of chicken anemia virus on cell-mediated immune function in chickens exposed to the virus by a natural route; McConnell CD et al.; Three-week-old chicks were inoculated orally with CAV and killed at various times postinoculation (PI) . The spleens were removed, the cells were stimulated with concanavalin A, and lymphocyte transformation responses were determined . Supernatants from these cultures were also assayed for T-cell growth factor (TCGF) and interferon . Adherent macrophages from spleen or bone marrow were assayed for interleukin-1 production, Fc receptor expression, phagocytosis, and bactericidal activity . All CAV-inoculated chickens developed CAV antibodies, but no anemia was seen . Controls remained CAV-antibody-negative throughout the experiment . CAV-inoculated chickens showed significant differences from controls in their lymphocyte transformation responses and in production of TCGF and interferon . Differences were greatest at 14, 21, and 28 days PI . Significant differences were also observed in interleukin-1 production by spleen macrophages, as well as in Fc receptor expression, phagocytosis, and bactericidal activity of bone-marrow macrophages. Avian Dis, 1993 Apr-Jun, 37(2), 358 - 65 Effects of chicken anemia virus on macrophage function in chickens; McConnell CD et al.; One-day-old chicks were inoculated intramuscularly with chicken anemia virus (CAV) . Four birds were killed at 7, 14, 21, 28, and 42 days postinoculation (PI), and macrophages were recovered from spleen and bone-marrow suspensions . These were tested for interleukin-1 (IL-1) production, Fc receptor expression, phagocytosis, and bactericidal activity . Macrophages recovered from uninoculated chickens at the same sample times, and exposed to CAV in vitro, were also tested . IL-1 production, Fc receptor expression, phagocytosis, and bactericidal activity were significantly lower in all macrophage cultures from CAV-inoculated chickens, and in cultures exposed to the virus in vitro, than in uninfected controls. Ginekol Pol, 1993 Apr, 64(4), 197 - 203 {Effect of immunomodulators on selected functions of neonatal polymorphonuclear neutrophils in vitro}; Wysocki H et al.; Phagocytosis, bactericidal capacity, production of superoxide anions O2- and expression of receptor for the Fc portion of IgG of polymorphonuclear neutrophils (PMN) were estimated in umbilical venous blood of neonates and their mothers . We also evaluated the influence of immunomodulating agents on these parameters . The influence of the maternal serum on the function of neonatal PMN was examined . The obtained results indicate that functional defect of neonatal PMN may be corrected under the influence of the maternal serum and/or immunomodulating agents. Pathol Biol (Paris), 1993 Apr, 41(4), 349 - 57 {Evaluation of a micromethod for the bactericidal activity of five disinfectants on 108 hospital strains}; Dusseau JY et al.; The authors studied 5 disinfectants containing aldehyde and quaternary ammonium against 108 hospital strains . The minimal bactericidal activities (MBC) were determined with a microdilution method and the dilution-neutralization method (AFNOR T 72-150) . The microdilution method results were validated using the MBCs of four reference strains tested with the dilution-neutralization method (AFNOR T 72-150) . 3 disinfectants proved to be valuable . 1 disinfectant was valuable but with a MBC toward all bacteria only a dilution away from the dilution of use . 1 disinfectant was determined as unsatisfactory as 9.5 p . cent of all strains proved resistant toward it . All disinfectants matched AFNOR standards; but those specifications did not match toward hospital strains . Such an evaluation using a simple and reliable method should be of use. Pathol Biol (Paris), 1993 Apr, 41(4), 317 - 22 {Ciprofloxacin, clarithromycin, rifampin: in vitro bactericidal activity of double and triple drug combinations against strains of atypical mycobacteria}; Ximenes E et al.; Bactericidal activity of ciprofloxacin (CIP), clarithromycin (CLA), rifampin (RIF) alone and in combinations was studied against five atypical mycobacteria (4 isolates from patients with Acquired Immunodeficiency Syndrome and 1 collection strain) by time killing curves method . Drugs were used at their attainable serum levels: CIP (1 microgram/ml), CLA (2 micrograms/ml), RIF (16 micrograms/ml) . The decrease in CFU in comparison to inoculum (10(6)-10(7) CFU/ml) was evaluated by viable counts after 1, 2, 3, 4 and 5 days of incubation at 35-37 degrees C . Drug combinations enhanced slightly the killing of drugs alone . CIP+CLA was the most effective against MAC strains whereas CIP+RIF appeared as the best combination against rapidly growing species except M . phlei which was the most resistant strain. J Hosp Infect, 1993 Apr, 23(4), 255 - 62 The efficacy of a hospital dry cleaning cycle in disinfecting material contaminated with bacteria and viruses; Bates CJ et al.; It is not known how efficiently a standard dry cleaning cycle can kill bacteria or viruses . In-situ experiments were carried out to determine the cidal activity of such a cycle using perchloroethylene solvent against five clinical bacterial isolates and a DNA bacteriophage . Viable counts of bacteria recovered from material after dry cleaning were reduced by 3-8 logs, with up to 10(3) colony forming units (cfu) surviving per strip . Numbers of bacteriophage were only reduced by 10-100 fold . The resistance of the bacteriophage to solvent and heat (60 degrees C) was compared with that of polio and herpes simplex viruses in vitro . Polio virus and bacteriophage, but not herpes simplex virus, survived exposure to perchloroethylene at room temperature for 40 min . Dry cleaning with perchloroethylene is not bactericidal and is particularly poorly virucidal for non-enveloped viruses. Stomatologiia (Mosk), 1993 Apr-Jun, 72(2), 10 - 3 {The use of taktivin in experimental apical periodontitis exacerbated by a secondary immunodeficiency state}; Zyrianov GV et al.; Apical periodontitis was simulated in 100 white rats with secondary immunodeficiency induced by a single total x-ray irradiation with the RUM {correction of PYM}-17 device . Nonspecific resistance of the rat body was assessed from the neutrophilic phagocytic activity, serum bactericidal activity, lysozyme and complement levels . These parameters were found reduced in the experimental animals; x-ray examinations revealed changes round the dental root apices . Daily injections of tactivin for 10 days in a dose 2-5 mg/kg b.m . resulted in elevation of the nonspecific resistance parameters, and the x-ray picture in this group of animals was the same as in intact controls; therefore, tactivin normalized the immunity system status and indirectly improved the clinical course of apical periodontitis. J Antimicrob Chemother, 1993 Mar, 31 Suppl C, 51 - 64 Modulation of human polymorphonuclear neutrophil function by macrolides: preliminary data concerning dirithromycin; Labro MT et al.; Polymorphonuclear neutrophils (PMN) play a prominent role in the host response to infectious diseases . One major bactericidal mechanism used by these cells is the production of reactive oxygen species during what is referred to as the oxidative burst . However, excessive oxidant generation can also be involved in cell and tissue damage associated with severe inflammatory reactions . Macrolide antibiotics are able to penetrate and concentrate within phagocytes and have been successfully used to treat infections due to facultative intracellular pathogens . However, intracellular accumulation of macrolides with possible alkalinization of cellular compartments may interfere with normal cell function . In-vitro and ex-vivo data suggest that macrolides affect various phagocytic functions . This paper presents an overview of the published data concerning the modulation of neutrophil function by macrolides . Preliminary data concerning the in-vitro modulation of the neutrophil oxidative burst by dirithromycin and its metabolite, erythromycylamine, are also discussed. Int J Lepr Other Mycobact Dis, 1993 Mar, 61(1), 66 - 9 Sparfloxacin is more bactericidal than ofloxacin against Mycobacterium leprae in mice; Franzblau SG et al.; The comparative bactericidal activities of sparfloxacin and ofloxacin against Mycobacterium leprae in mice were determined using the proportional bactericidal test at doses of 12.5 mg/kg-100 mg/kg . Significant bactericidal activity was found at 12.5 mg/kg sparfloxacin and 25 mg/kg ofloxacin . Sparfloxacin was significantly more bactericidal than ofloxacin at all doses, and the results with 25 mg/kg sparfloxacin were nearly identical to those obtained with 100 mg/kg ofloxacin . These results, together with pharmacokinetic and toxicological data in mice and man, suggest that sparfloxacin may have a higher therapeutic index than ofloxacin in leprosy, and that the tentative standard dosage of 200 mg sparfloxacin daily should be appropriate for a clinical trial. Int J Lepr Other Mycobact Dis, 1993 Mar, 61(1), 59 - 65 Clarithromycin is bactericidal against strains of Mycobacterium leprae resistant and susceptible to dapsone and rifampin; Walker LL et al.; The anti-Mycobacterium leprae activity of clarithromycin when administered alone and in combination with rifampin and dapsone in the diet was determined using the kinetic method of drug evaluation in mice . Clarithromycin when administered at a concentration of 0.1% (w/w) in the diet completely prevented growth of 2 pan-susceptible, 3 dapsone-resistant, 2 rifampin-resistant, and 2 rifampin and dapsone double resistant strains of M . leprae . A 0.03% (w/w) concentration also completely prevented growth of M . leprae in all mice infected with 2 of 7 strains tested, but in only some of the mice infected with the remaining 5 strains . No antagonistic drug interactions were observed between clarithromycin and dapsone or rifampin . The addition of clarithromycin to the currently recommended multidrug regimen should improve the rate of killing of M . leprae and help to prevent the growth of dapsone-resistant and rifampin-resistant strains. Ann Pharmacother, 1993 Mar, 27(3), 351 - 7 Aminoglycoside dosing considerations in intensive care unit patients; Watling SM et al.; OBJECTIVE: Factors affecting aminoglycoside dosing requirements in critically ill adult patients were reviewed . DATA SOURCES: A literature search was performed from 1979 to 1992 and articles pertaining to aminoglycoside dosing were obtained . STUDY SELECTION: Only studies appearing in peer-reviewed journals were selected . Topics selected included: bactericidal kill kinetics, once-daily dosing regimens, critical illness, toxicity, aminoglycosides, intensive care unit, and lung penetration . CONCLUSIONS: Studies suggest that larger initial aminoglycoside doses are necessary in critically ill patients (tobramycin/gentamicin 3 mg/kg or amikacin 9 mg/kg) to achieve adequate peak serum concentrations . Current studies have not shown an increase in the incidence of aminoglycoside toxicity when using these larger initial doses . Follow-up monitoring is dependent upon the patient's physiology and risk factors for aminoglycoside-induced toxicity. Anesteziol Reanimatol, 1993 Mar-Apr, (2), 50 - 2 {Ultraviolet irradiation of autologous blood in suppurative-inflammatory diseases in critically ill newborn infants}; Mezhirova NM et al.; The use of ultraviolet autoblood irradiation in pyoinflammatory diseases has been analysed in 52 critically ill newborns . The data obtained indicate that ultraviolet autoblood irradiation has a correcting impact on homeostasis due to bactericidal, oxygenating and detoxicating effect of the procedure. Diabetes, 1993 Mar, 42(3), 470 - 3 Granulocyte-colony stimulating factor improves an impaired bactericidal function in neutrophils from STZ-induced diabetic rats; Sato N et al.; To evaluate whether G-CSF improves an impaired production of oxygen-derived free radicals in diabetic neutrophils, we studied the effect of G-CSF on chemiluminescence amplified by a luciferin analog (CLA-DCL) and luminol (L-DCL) in response to fMLP in neutrophils from STZ-induced diabetic rats . Both CLA-DCL and L-DCL in diabetic neutrophils were significantly reduced, and L-DCL was more sensitive to this inhibition than CLA-DCL . G-CSF did not change the basal chemiluminescence in either control or diabetic neutrophils, but it apparently primed CLA-DCL and L-DCL . Although, in diabetic neutrophils, the priming effect of G-CSF to both CLA-DCL and L-DCL was less compared with that in control neutrophils, L-DCL was more sensitive than CLA-DCL to this priming effect . Because bacterial infection is still an important cause of morbidity and mortality in diabetic patients, these data suggest that G-CSF may be useful as a drug to prevent the aggravation of bacterial infection in diabetic patients. Biochem Biophys Res Commun, 1993 Feb 15, 190(3), 681 - 7 Presence of a serine protease in the complement-activating component of the complement-dependent bactericidal factor, RaRF, in mouse serum; Takahashi A et al.; A 100-kDa protein was isolated from the complement-activating component of mouse Ra-reactive factor . It generated a 29-kDa chain upon reduction . Partial amino acid sequences of the 29-kDa chain were determined after fragmentation with CNBr . A 386-bp-long probe was synthesized by the polymerase chain reaction with oligonucleotide primers designed by reference to the amino acid sequence . Using this probe, we cloned a 3.7-kb DNA from a mouse liver cDNA library . The amino acid sequence of the 29-kDa chain deduced from the nucleotide sequence of this cDNA was consistent with the amino acid sequences determined . The full sequence was found to have characteristics of a serine protease and exhibited 29% and 30% homologies with those of light chains of the C1r and C1s subcomponents of complement, respectively. J Antimicrob Chemother, 1993 Feb, 31 Suppl B, 23 - 33 Antibiotics and neutrophil function--potential immunomodulating activities; Gemmell CG; The advent of cytokines as possible therapeutic agents has stimulated investigation of old and new antibiotics for their potential activity as immunomodulators over and above their primary bactericidal or bacteristatic activity . Such investigations have focused largely on in-vitro functions of peripheral blood cells such as polymorphonuclear leucocytes and monocytes . Graded doses of various antibiotics have been tested for their ability to affect functions such as chemotaxis, phagocytic ingestion and killing, as well as particular biochemical mechanisms, such as a generation of superoxide . These drugs have been shown to have no effect on host defences (beta-lactams), or depress immune function (tetracyclines and teicoplanin), or display synergy with the immune system (macrolides and quinolones), or enhance immune function (certain cephalosporins) . In several instances, biological activity has been demonstrated at drug concentrations outside the therapeutic range . In addition, it has been recognized that a number of drugs can be concentrated within the phagocytic cells and, by so doing, are transported to the site of infection with consequent increased efficacy . It has also been demonstrated that subinhibitory concentrations of certain drugs can influence bacterial expression of structural and soluble virulence factors . Alterations of this kind have been shown to potentiate bacterial susceptibility to phagocytosis . Notwithstanding these in-vitro examples of immunomodulation, definite proof of clinical benefit is still lacking. Am J Respir Cell Mol Biol, 1993 Feb, 8(2), 193 - 200 Defensins reduce the barrier integrity of a cultured epithelial monolayer without cytotoxicity; Nygaard SD et al.; Polymorphonuclear leukocytes (PMN) contribute to epithelial injury at sites of inflammation, but their mechanisms of action are incompletely understood . PMN can injure target tissues by oxidative and nonoxidative mechanisms . Included in the nonoxidative mechanisms are defensins (DEF), small (3.5 to 4.0 kD), arginine- and cysteine-rich polypeptides . DEF are bactericidal, fungicidal, viricidal, and tumoricidal, but their ability to contribute to inflammatory injury has not been extensively evaluated . One marker of inflammatory injury is disrupted epithelial barrier integrity . Using Madin-Darby canine kidney (MDCK) epithelial monolayers, we measured the effect of both human and rabbit DEF on barrier integrity using mannitol permeability (Pmann) and transepithelial electrical resistance (Rt) . Human DEF (HNP1-3, 2:2:1 molar ratio) increased Pmann in a time- and concentration-dependent manner and Rt fell progressively over a 48-h period after exposure of monolayers to HNP1-3 . Rabbit DEF peptide 1 (NP-1) also increased Pmann, but rabbit peptide 5 (NP-5) had no effect on Pmann . To investigate the role of charge, HNP1-3 was added to the monolayers with the polyanions heparin or sulfated dextran . Heparin and sulfated dextran only partially inhibited the increase in Pmann . Fetal bovine serum (FBS), however, completely inhibited the effect of HNP1-3, but this protection was only partially explained by the anionic protein, albumin . The FBS protection was time dependent and was present when FBS was added up to 16 h after exposure to HNP1-3 . While both HNP1-3 and NP-1 increased epithelial permeability, neither were cytolytic to MDCK cells as measured by lactate dehydrogenase release.(ABSTRACT TRUNCATED AT 250 WORDS) Obstet Gynecol, 1993 Feb, 81(2), 255 - 60 Achievement of therapeutic concentrations of cefuroxime in early preterm gestations with premature rupture of the membranes; De Leeuw JW et al.; OBJECTIVE: To determine whether therapeutic cefuroxime concentrations can be achieved in maternal plasma, amniotic fluid (AF), neonatal plasma, placenta, and membranes in women with premature rupture of the membranes (PROM) at 27-33 weeks' gestation . METHODS: In an open nonrandomized, dose-response study, nine patients with PROM at 27-33 weeks' gestation received 1.5 g of cefuroxime intravenously three times daily . Maternal plasma and AF specimens were collected during pregnancy, and umbilical cord plasma, placenta, and membrane specimens were collected after delivery to assay cefuroxime concentrations using high-performance liquid chromatography . RESULTS: A high rate of placental transfer of cefuroxime was found . Bactericidal concentrations could be demonstrated in maternal plasma and in AF leaking from the vagina . A concentration-time curve in AF could be detected, with a peak concentration 3-4 hours after infusion . Therapeutically active levels were present in the newborns . The resorption of cefuroxime by the fetal membranes was high . CONCLUSIONS: Therapeutic concentrations of cefuroxime were found in all body fluids and tissues studied . Further study to establish the clinical utility of cefuroxime prophylaxis in PROM seems appropriate. Rev Med Interne, 1993 Feb, 14(2), 117 - 20 {Malacoplakia . Apropos of a case of retroperitoneal site}; Coutant G et al.; Malacoplakia is a granulomatous inflammatory disease caused by a disorder of macrophage bactericidal function . The disease, histologically characterized by the presence of Michaelis-Gutmann bodies, has a preference for the urogenital tract and less frequently affects the gastrointestinal tract and the retroperitoneal region . We report the unusual case of a male patient who presented with retroperitoneal pseudotumoral malacoplakia associated with vesical malacoplakia . The main pathophysiological, diagnostic and therapeutic aspects of this rare disease are described. Pol Tyg Lek, 1993 Feb 1-8, 48(5-6), 120 - 2 {Evaluation of phagocytic and bactericidal activities of neutrophils in peripheral blood of patients with anemia due to iron deficit}; Hrycek A et al.; Phagocytic and bactericidal properties of neutrophils have been evaluated in 20 women with anemia due to iron deficit . Twenty healthy women in corresponding age and domicile served as a control group . No statistically significant difference in both phagocytic and bactericidal properties of peripheral blood neutrophils have been noted in both groups . A decrease in plasma bactericidal activity has been sen in patients with anemia due to iron deficit . It may be one of the causes of increased susceptibility to infections noted in patients with plasma iron deficit. Biull Eksp Biol Med, 1993 Feb, 115(2), 168 - 9 {The effect of a natural complex of cytokines on oxygen-dependent function of rat vaginal phagocytes}; Rubleva KI et al.; Our investigation consisted in 10-days treatment of vaginal mucous membrane wounds in white not inbred rats by introduction of natural cytokines complex into the vagina . At the same time the dynamics of vaginal phagocytes oxygen-depended function change was studied . We have ascertained the activating influence of the cytokines complex on the phagocytes chemiluminescence (CL) that found expression in 2.5-7 times fold augmentation of the CL intensity in comparison with control level (an equal portion of Medium--199 was introduced in the vagina of control-group rats) . Having ended the application of the cytokines complex we have observed a rather fast normalization of the cells' activity (by the 15-17 days), consequently the cytokines did not have a distant effect on the oxygen-depended phagocytes function . We consider the activation of the phagocytes in wound as well as the bactericidal effect of the oxygen free radicals generated by the phagocytes as positive result. Clin Ther, 1993, 15 Suppl A, 44 - 9 Use of pharmacodynamic concepts in developing a cost-effective dosing method for piperacillin; Quintiliani R et al.; Because they were almost always used in combination with an aminoglycoside, piperacillin and mezlocillin were considered therapeutic alternatives at Hartford Hospital, a 900-bed teaching facility . To determine an appropriate comparative dose, the bactericidal activities of 5 gm of mezlocillin and 4 gm and 3 gm of piperacillin were compared . The results demonstrated that 4 gm of piperacillin possessed stronger bactericidal activity than either 3 gm of piperacillin or 5 gm of mezlocillin . Hartford Hospital has since approved an antibiotic management program using 4 gm of piperacillin every 8 hours, thereby reducing the daily cost of antibiotic therapy . The modified program offers the hospital measurable cost savings without jeopardizing the quality of care. Annu Rev Med, 1993, 44, 103 - 20 Pathogenesis and pathophysiology of bacterial meningitis; Tunkel AR et al.; Despite the availability of bactericidal antibiotics with potent in vitro activity against the major meningeal pathogens, the morbidity and mortality from bacterial meningitis remains unacceptably high . Animal models have proven to be extremely valuable in the study of the pathogenesis and pathophysiology of bacterial meningitis, with the hopes of providing new information that may lead to an improved outcome from this disorder . Bacterial meningitis usually begins with nasopharyngeal colonization by a new organism, followed by invasion and bacteremia . Subsequently there is central nervous system invasion, although the exact site and mechanism of meningeal invasion are unknown . The generation of an intense subarachnoid space inflammatory response, induced by release of bacterial virulence factors and/or inflammatory cytokines, contributes to many of the pathophysiologic consequences of bacterial meningitis, including cerebral edema, increased intracranial pressure, and alterations of cerebral blood flow . Attenuation of this inflammatory response (e.g . by co-administration of antiinflammatory agents) may diminish many of these pathophysiologic consequences of meningitis, and perhaps improve morbidity and mortality from this disorder. Rev Prat, 1993 Jan 1, 43(1), 54 - 8 {Antibiotic treatment of septic states}; Brun-Buisson C; The antibiotic therapy in septic syndrome is most often empiric . Decisions and antibiotic choices should result from a careful analysis of past history and setting (hospital-acquired infections vs community acquired infections), risk factors specific to the host, and characteristics of the suspected infections focus: direct examination of body fluid specimens should be obtained rapidly to guide the empiric choice . The choice of antibiotics should conform to usual guidelines, with the aim of a rapid bactericidal effect in blood, while attempting to avoid risks of toxicity . Changes in pharmacokinetics of drugs are usual in this context, and frequent dosing is necessary . While effective antibiotic therapy is a recognized prognostic parameter, antibiotics are only one part of therapy, besides supportive therapy of failing organs, and effective drainage or surgery of the infected focus, when feasible. Arch Oral Biol, 1993 Jan, 38(1), 75 - 8 Neutrophil dysfunction in rats with natural gingivitis; Isogai E et al.; The functions of polymorphonuclear neutrophils (PMN) from SUS rats with naturally occurring gingivitis were examined by the luminol-dependent chemiluminescence (CL), adherence and bactericidal tests . SUS rats with pre-gingivitis showed lower CL responses of isolated PMNs and whole blood than control rats (RES rats) . After plague formation and progression of gingivitis, the CL response gradually increased in SUS rats . RES rats had healthy gingiva and showed no increase in CL responses . Impaired PMN adherence was observed in SUS rats with pre-gingivitis but not in RES rats . PMNs from SUS rats with pre-gingivitis also showed lower bactericidal activity than those from RES rats . Dysfunction of PMNs might induce gingivitis as a result of decreased protection against periodontal pathogens and an elevated level of CL response can be recognized with progression of gingivitis. Anaesthesia, 1993 Jan, 48(1), 30 - 2 Growth of micro-organisms in solutions of intravenous anaesthetic agents; Berry CB et al.; This controlled bench study compared the growth of bacteria and yeast in solutions of commonly used intravenous anaesthetic agents at room and body temperatures . Drugs presented in aqueous emulsions support both bacterial and fungal growth . Five out of the six solutions supported the growth of yeast . The one exception was chlormethiazole, which is both fungicidal and bactericidal . Solutions of drugs which will support growth of micro-organisms should be used with great care and they should not be stored or infused over prolonged periods. Antimicrob Agents Chemother, 1993 Jan, 37(1), 111 - 4 MICs and MBCs of clarithromycin against Mycobacterium avium within human macrophages; Mor N et al.; The inhibitory and bactericidal activities of clarithromycin were determined quantitatively against the intracellular populations of five Mycobacterium avium strains growing in monocyte-derived human macrophages . The MICs were 1.0 microgram/ml, and the MBCs ranged from 16.0 to 64.0 micrograms/ml; these values were similar to the MICs and MBCs found in broth cultures at pH 7.4 and were substantially lower than those found in broth cultures at pHs 6.8 and 5.0 . Since the intracellular environment has a neutral or even an acidic pH, relatively low MICs and MBCs found in macrophage cultures can be associated with the fact that the drug concentrations in macrophages are substantially higher than those in the medium in which these cells are cultivated . Pretreatment of the macrophages 2 days prior to infection decreased the MICs twofold in comparison with results of experiments in which the drug was added to already infected macrophages. J Reprod Immunol, 1993 Jan, 23(1), 1 - 12 Fetal mononuclear cells show a comparable capacity with maternal mononuclear cells to produce IL-8 in response to lipopolysaccharide in chorioamnionitis; Taniguchi T et al.; IL-8 is a chemotactic and activating cytokine for neutrophils which eliminate invading bacteria by releasing bactericidal metabolites . Cord blood mononuclear cells (CBMCs) obtained from neonates born to mothers with chorioamnionitis actively produced a significantly higher amount of IL-8 than those of neonates without chorioamnionitis, suggesting that the mononuclear cells of fetuses with chorioamnionitis had been activated in utero . As lipopolysaccharide (LPS) can often be detected in the uteroplacental space in chorioamnionitis, the LPS-mediated activation mechanism of neonatal mononuclear cells was analyzed in vitro to produce IL-8 . Neonatal mononuclear cells stimulated with LPS increased IL-8 production in a time- and dose-dependent manner . The ability of term or preterm neonatal mononuclear cells to produce IL-8 was comparable with that of adult (maternal) mononuclear cells, suggesting functional maturity of the neonatal or fetal mononuclear cells to produce IL-8 . However, IL-8 production by neonatal CBMCs was down-regulated by dexamethasone, a glucocorticoid which is clinically administered to mothers to promote fetal lung maturity in preterm delivery . Our present study revealed a regulatory mechanism of fetal IL-8 production, suggesting that functionally mature fetal mononuclear cells produce IL-8 in response to LPS in chorioamnionitis and activate the fetal defense mechanism against infection. Dig Dis Sci, 1993 Jan, 38(1), 132 - 6 Helicobacter pylori in duodenal ulcer patients with idiopathic gastric acid hypersecretion; Collen MJ et al.; Thirty-three consecutive patients with idiopathic gastric acid hypersecretion (defined as a basal acid output > 10.0 meq/hr with a normal fasting serum gastrin level and negative secretin stimulation test) who were being treated for duodenal ulcer disease and other acid-peptic disorders were evaluated for the presence of Helicobacter pylori by means of a rapid urease test . Fourteen patients had duodenal ulcer and 19 had other acid-peptic disorders (gastroesophageal reflux in 14, including six with Barrett's esophagus; four with nonulcer dyspepsia; and one with erosive gastritis) . Helicobacter pylori was present in 12 of the 14 ulcer patients (86%) compared to only two of the 19 nonulcer patients (11%) (P < 0.0001) . The distribution of basal acid output for patients with duodenal ulcer was similar to that for nonulcer patients, and no significant difference in the mean basal acid output was found among Helicobacter pylori-positive compared to Helicobacter pylori-negative patients . Seven of the duodenal ulcer patients with a basal acid output greater than 15.0 meq/hr were Helicobacter pylori-positive, suggesting that the organism can withstand even extreme levels of gastric acidity . In conclusion, this study demonstrates that the prevalence of Helicobacter pylori infection in patients with duodenal ulcer disease associated with idiopathic gastric acid hypersecretion is not different from a majority of ulcer patients with normal acid secretory profiles and offers additional evidence that extreme levels of gastric acid are not bactericidal for the organism. J Immunol, 1993 Jan 1, 150(1), 236 - 45 Depression of macrophage respiratory burst capacity and arachidonic acid release after Fc receptor-mediated phagocytosis; Schwacha MG et al.; The phagocytosis of IgG-coated erythrocytes (ElgG) by macrophages results in a subsequent depression of macrophage phagocytic function, respiratory burst capacity, and bactericidal activity . Our study was carried out to determine the importance of impaired arachidonic acid release in the depression of the respiratory burst after ElgG phagocytosis . The depression of triggered H2O2 production after ElgG phagocytosis was not due to cyclooxygenase products because indomethacin or aspirin did not modify the depression . Further studies revealed that the depression of triggered H2O2 production after ElgG phagocytosis was associated with a depression in the ability of macrophages to release arachidonic acid in response to PMA, zymosan, or calcium ionophore . The addition of exogenous arachidonic acid partially prevented the depression of triggered H2O2 production after ElgG phagocytosis . Unlike phagocytosis mediated by FcR, complement receptor-mediated phagocytosis did not alter H2O2 production or arachidonic acid release . Ligation of FcR was not sufficient to depress triggered H2O2 production and arachidonic acid release because these functions were not depressed when phagocytosis was inhibited with cytochalasin D . Thus, it was found that the depression of triggered H2O2 production by macrophages after FcR-mediated phagocytosis was associated with impaired release of arachidonic acid and that H2O2 production could be partially restored by the addition of arachidonic acid . These results suggest that the impairment of arachidonic acid release after FcR-mediated phagocytosis contributes to the depression of macrophage respiratory burst capacity after FcR-mediated phagocytosis. Prostate, 1993, 23(2), 107 - 14 Bacterial localization in antibiotic-refractory chronic bacterial prostatitis; Nickel JC et al.; Chronic bacterial prostatitis, that has become resistant to antibiotic therapy, remains a frustrating clinical entity for both clinicians and patients . Twenty men with a history of documented bacterial prostatitis, that had become resistant to appropriate antibiotic therapy, were studied in an attempt to determine where the bacteria had become localized, and possibly explain their survival in a relative bactericidal environment . The antibiotics were discontinued for 4 weeks, and cultures of the expressed prostatic secretions, tissue biopsies, histology, and ultrastructure were correlated . Twelve (60%) of the tissue biopsies cultured presumed pathogens . In six of the tissue-positive cases, the expressed prostatic secretion was negative . Specific electron micrographs demonstrate exopolysaccharide coated microcolonies of bacteria firmly attached to the ductal and acinar walls . This mode of growth helps explain some of our difficulties in the diagnosis and treatment of chronic bacterial prostatitis. Probl Tuberk, 1993, (1), 45 - 7 {An assessment of the bactericidal capacity of the blood monocytes in tuberculosis patients}; Mel'nikov VP; The nitro-blue tetrasolum (NBT) test was used for the study of the bactericidal capacity of blood monocytes in 30 healthy subjects and 86 pulmonary tuberculosis patients . The monocyte capacity of tuberculosis patients to restore NBT in the process of phagocytosis was found to be reduced . The NPT test parameters in the absence of cell stimulation were the same in both groups of the examined subjects . Administration of 50 TU of tuberculin subcutaneously is accompanied by the lowered capacity of monocytes to restore NPT during phagocytosis in patients with minimal activity of the tuberculous process, while this capacity was increased in subjects with post-tuberculous changes in the lungs. Biotechnol Ther, 1993, 4(3-4), 239 - 52 Leukocyte inhibitory factor (LIF) potentiates human macrophage aggregation and activation responses to calcium ionophore A23187 and directly induces leukotriene B4 and thromboxane A2 release; Conti P et al.; Aggregation studies have become a useful criterion for analyzing leukocyte motility and activation in vitro . The T-cell-derived lymphokine human leukocyte inhibitory factor (LIF) is a modulator of many important polymorphonuclear (PMN) functions in addition to aggregation such as chemotaxis, lysosomal degranulation, phagocytosis, bactericidal killing, augmented antibody-dependent cellular cytotoxicity (ADCC), induction of neutrophil Fc-gamma, complement type-1 and FMLP receptors, and production of superoxide and H2O2 . Our investigations focused on the ability of LIF to modulate the aggregation of macrophages (MO) induced by calcium ionophore A23187 . The ionophore A23187 directly induced potent aggregation of macrophages, which was markedly enhanced when the cells were pretreated with LIF . However, the addition of LIF in the absence of other costimuli did not directly induce MO aggregation . LIF was shown to enhance PMN aggregation induced by N-formyl-Met-Leu-Phe (FMLP), but did not augment the aggregation of FMLP-stimulated macrophages, indicating a cellular specificity of aggregation-inducing costimuli following LIF priming . Additional cytokines examined for possibly inducing MO aggregation were interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF), and interleukin-6 (IL-6); all proved to be incapable of inducing aggregation directly, nor did they enhance the effect of A23187 ionophore on macrophage aggregation . Additionally, we found that LIF can directly stimulate MO to activate specific pathways of the arachidonic acid cascade, inducing the synthesis and release of thromboxanes and leukotriene B4 . LIF did not augment the potent ability of A23187 to induce increased production of LTB4 or TxA2 by human MO . These new results coupled with our previously published data indicate that LIF can enhance the activation of both MO and PMN leukocytes when exposed to either A23187 or FMLP, respectively . Moreover, these data suggest that LIF can contribute directly to monocyte-macrophage leukocyte activation, in addition to PMN activation, during inflammatory responses, resulting in greater cell aggregation, activation, and specific proinflammatory arachidonic acid product release. J Endod, 1993 Jan, 19(1), 40 - 3 Effective shelf-life of prepared sodium hypochlorite solution; Johnson BR et al.; Although the tissue solvent and bactericidal properties of sodium hypochlorite are well known, the effective shelf-life of prepared sodium hypochlorite solutions is not known . The stability of sodium hypochlorite is adversely affected by exposure to high temperature, light, air, and the presence of organic and inorganic contaminants . The purpose of this study was to investigate the variables of storage conditions and time on the tissue-dissolving capacity of three different concentrations of sodium hypochlorite . Fresh frozen human umbilical cord was used as the tissue sample for this experiment . Tissue samples were dissolved at time intervals ranging from 1 day to 10 wk in 5.25%, 2.62%, and 1.0% solutions of sodium hypochlorite . The tissue-dissolving ability of 5.25% sodium hypochlorite remains stable for at least 10 wk . The tissue-dissolving ability of 2.62% and 1.0% sodium hypochlorite remains relatively stable for 1 wk after mixing, then exhibits a significant decrease in tissue-dissolving ability at 2 wk and beyond. Rev Latinoam Microbiol, 1993 Jan-Mar, 35(1), 71 - 5 Lambda prophage decreases Escherichia coli sensitivity to human serum bactericidal effect; Vaca-Pacheco S et al.; Escherichia coli C600 and C600(lambda) strains were tested for their susceptibility to the bactericidal action of 4% normal human serum . C600 survival was reduced to 30%, 23% and 16% after 60, 150 and 180 min of exposure to serum, respectively, whereas the percentage of survival of C600(lambda) was 199, 109 and 65% at the same times . The estimated exposition times for 50% killing showed an eight-fold difference, they were 23 and 202 min for C600 and C600(lambda), respectively . None of the two strains tested was killed when incubated with serum whose alternative complement pathway was inactivated by heating at 50 degrees C for 20 min, showing that this pathway, and not the classical one, was responsible of the bactericidal action, a conclusion further supported by the finding that both strains were differentially killed by the alternative complement pathway, C600 showing a 14X, 10X and 4X greater susceptibility than C600(lambda) at 60, 120 and 180 min of exposure to serum whose classical pathway was selectively inhibited by chelation with 10 mM EGTA plus 2 mM MgCl2 . We feel that lambda phage may lower the serum sensitivity of its lysogen by altering the bacterial external surface, perhaps by the inclusion of some protein encoded by an accessory gene of the lambda genome, and thus interfering with either the formation, deposition or activity of the membrane attack complex. Probl Tuberk, 1993, (4), 45 - 8 {Cephalosporins as possible methods of etiotropic therapy of tuberculosis}; Vinogradova TI et al.; Cephalosporin antibiotics cefamezin (I generation drug sensitive to beta-lactamase) and cefotaxime (III generation drug resistant to beta-lactamase) have been tested for antituberculous activity . The latter was found dependent on resistance to mycobacterial beta-lactamase . A minimal inhibiting concentration of cefotaxime was similar to that of etambutol and tisamid . Cefotaxime also enhanced tuberculostatic and bactericidal effect of isoniazid and rifampicin . Combination cefotaxime+isoniazid+rifampicin proved more effective than cefotaxime+etambutol+tisamid . The effectiveness against tuberculosis of the beta-lactamase resistant cephalosporin points to the validity of further research for active phthisiatric drugs among III generation cephalosporins. Ter Arkh, 1993, 65(11), 36 - 9 {The strategy for curing open pulmonary tuberculosis in a short period}; Ursov IG; The new approaches to short-term cure of open pulmonary tuberculosis imply intensification of etiotropic therapy with the emphasis on its bactericidal potential, introduction of pneumothorax as early as the treatment week 3, initiation of early surgery . Intravenous drug administration needs breaks in its course to make mycobacteria surviving after the previous dose sensitive to the antibiotics . Such intermittent regimens are beneficial for the patients as they contribute to better tolerance, to reducing total drug dosage, to earlier discharge from hospital for outpatient after treatment . Out of 1190 patients treated for 6.5 months according to the above principles cavern healing was achieved in 1106 (93%). Acta Pol Pharm, 1993, 50(4-5), 393 - 5 Influence of Tołpa Peat Preparation on the phagocytic activity and bactericidal properties of granulocytes in healthy volunteers; Kowalska M et al.; It was found, that Tolpa Peat Preparation (TPP) administered to healthy volunteers in doses of 100-300 mg/day during 14 days evoked the stimulation of the phagocytic and bactericidal activity of the granulocytes . The dose of 600 mg/day causes only a transient and insignificant increase of phagocytic and bactericidal properties of the granulocytes. Acta Microbiol Pol, 1993, 42(3-4), 315 - 9 Ozone as sensitizer of bacteria to the bactericidal action of complement; Doroszkiewicz W et al.; The purpose of this study was to answer the question whether the exposure of bacterial cells to ozone results in changes of their sensitivity to the bactericidal action of normal bovine serum (NBS) . Our initial studies have demonstrated that contact of bacteria with O3 enhances serum-mediated killing. FEMS Microbiol Lett, 1992 Dec 15, 79(1-3), 211 - 5 The mechanism of action of chlorhexidine; Kuyyakanond T et al.; Chlorhexidine did not inhibit ATPase in intact cells of Escherichia coli K12 W1317i-, even at bactericidal concentrations, and ATP hydrolysis was greatest at the highest concentration (40 mg/l), even though no net uptake of substrate occurred . Like dinitrophenol and tribrominated salicylanilide, polymyxin and chlorhexidine collapsed the membrane potential at inhibitory concentrations . Membrane disruption, and not ATPase inactivation, is considered the lethal event in chlorhexidine action. J Gen Microbiol, 1992 Dec, 138 ( Pt 12), 2721 - 4 A new colicin that adsorbs to outer-membrane protein Tsx but is dependent on the tonB instead of the tolQ membrane transport system; Bradley DE et al.; A new colicin, Col5, was synthesized by an Escherichia coli isolate of human origin from the ECOR Collection . It was unique because it adsorbed to the outer-membrane protein Tsx, but used the tonB rather than the tolQ membrane transport system, which is employed by the only other Tsx-specific colicin, ColK . Col5 was encoded by a 5.2 kb plasmid, p5 . It was inducible by mitomycin C, and strains harbouring p5 exhibited quasi-lysis . The bactericidal protein had an M(r) of 56,000. Antimicrob Agents Chemother, 1992 Dec, 36(12), 2799 - 803 In vitro antibiotic susceptibility of the newly recognized agent of ehrlichiosis in humans, Ehrlichia chaffeensis; Brouqui P et al.; Ehrlichiosis in humans, a rickettsial disease recently discovered in the United States, is generally treated successfully with tetracyclines; however treatment with these agents is usually avoided with children and pregnant women . The in vitro susceptibility of Ehrlichia chaffeensis, the agent of human ehrlichiosis in the United States, was assessed by a quantitative evaluation of infected DH82 cells cultivated in 96-well microtiter plates in the presence of different concentrations of selected antibiotics . Extracellular MICs and MBCs were evaluated after 72 h of exposure to the antibiotics . Doxycycline and rifampin were found to exert rapidly bactericidal effects, with MBCs in the extracellular culture medium of less than 0.5 and 0.125 microgram/ml, respectively . E . chaffeensis was resistant to chloramphenicol, ciprofloxacin, erythromycin, co-trimoxazole, penicillin, and gentamicin, which had MICs greater than 16, 4, 8, 4, 40, and 32 micrograms/ml, respectively . These observations are consistent with the finding that human ehrlichiosis appears to respond to tetracycline therapy, which has been the therapy of first choice . Further clinical investigations are necessary to evaluate the role of rifampin in the treatment of human ehrlichiosis, especially in children. J Leukoc Biol, 1992 Dec, 52(6), 625 - 9 Killing of Legionella pneumophila by nitric oxide in gamma-interferon-activated macrophages; Summersgill JT et al.; The role of nitric oxide (NO) radicals in killing the intracellular bacterial pathogen Legionella pneumophila (Lp) was examined in infected macrophages . Murine (RAW 264.7) and human (HL-60) cell monolayers were treated with 100 U/ml gamma-interferon (IFN) and cocultured with Lp in the presence and absence of NGMMA, a specific inhibitor of NO production . Viable Lp in IFN-treated RAW 264.7 cells decreased from 3.8 to 0.7 +/- 0.12 log CFU/ml after 24 h incubation, whereas in IFN+NGMMA-treated RAW 264.7 cells, viable Lp persisted at 2.2 +/- 0.2 log CFU/ml after 24 h . This increased survival corresponded with an inhibition of NO production (5.65 +/- 2.99 microM with NGMMA vs . 58.6 +/- 5.36 microM without NGMMA) . Viable Lp were susceptible to killing, in a dose-dependent fashion, by 0, 2.5, and 5.0 mM sodium nitroprusside, a source of NO radicals . IFN-treated RAW 264.7 cells also had significantly decreased levels of intracellular iron (below assay limit) when compared to IFN+NGMMA-treated cells (72.0 +/- 0.78% of control) . Normally permissive HL-60 cells treated with IFN were bacteriostatic rather than bactericidal, and NO production was not detected above background . Thus, NO radicals play a critical role in the bactericidal activity against Lp by IFN-treated RAW 264.7 cells, but the absence of NO production limits IFN-treated HL-60 cells to bacteriostasis. Infect Immun, 1992 Dec, 60(12), 5316 - 8 A bactericidal monoclonal antibody specific for the lipooligosaccharide of Bordetella pertussis reduces colonization of the respiratory tract of mice after aerosol infection with B . pertussis; Mountzouros KT et al.; A mouse immunoglobulin G3 monoclonal antibody specific for the core oligosaccharide moiety of the lipooligosaccharide (LOS) of Bordetella pertussis has been shown to have complement-dependent bactericidal activity . This monoclonal antibody exhibits bactericidal activity against strains of B . pertussis that express the LOS A phenotype . In addition this monoclonal antibody was effective in reducing colonization by B . pertussis in both the lungs and tracheas of mice after aerosol infection. Gastroenterology, 1992 Dec, 103(6), 1902 - 8 Human pancreatic tissue concentration of bactericidal antibiotics; Buchler M et al.; Pancreatic infection represents the most important cause of fatal outcome in human acute pancreatitis . In a comparative analysis, human pancreatic tissue concentrations of 10 different bactericidal antibiotics were determined in 89 patients undergoing pancreatic surgery . Concentrations of the antibiotics were determined in the blood and pancreatic tissue using high-pressure liquid chromatography . Pancreatic tissue concentrations 120 minutes after intravenous administration were as follows: mezlocillin, 19.0 mg/kg; piperacillin, 20.3 mg/kg; cefotaxime, 9.1 mg/kg; ceftizoxime, 7.9 mg/kg; netilmicin, 0.4 mg/kg; tobramycin, 0.4 mg/kg; ofloxacin, 1.7 mg/kg; ciprofloxacin, 0.9 mg/kg; imipenem, 6.0 mg/kg; metronidazole, 3.5 mg/kg . Three groups of antibiotics were established: group A, substances with low tissue concentrations (netilmicin, tobramycin), which were below the minimal inhibitory concentrations of most bacteria found in pancreatic infection; group B, antibiotics with pancreatic tissue concentrations which were sufficient to inhibit some but not all bacteria in pancreatic infection (mezlocillin, piperacillin, ceftizoxime, cefotaxime); group C, substances with high pancreatic tissue levels as well as high bactericidal activity against most of the germs present in pancreatic infection (ciprofloxacin, ofloxacin, imipenem) . These data could serve as the basis for adequate antibiotic prophylaxis or treatment of pancreatic infection. J Infect Dis, 1992 Dec, 166(6), 1354 - 61 Recombinant murine interferon-gamma reversibly activates rat alveolar macrophages to kill Legionella pneumophila; Skerrett SJ et al.; The interaction of interferon (IFN)-gamma, rat alveolar macrophages, and Legionella pneumophila was studied in vitro to define the effector cell potential of alveolar macrophages against an intracellular pathogen in a model in which the efficacy of IFN-gamma could be tested in vivo . Alveolar macrophages preincubated with IFN-gamma up-regulated Ia antigen and killed 0.5-4 logs of L . pneumophila over 4 days compared with 1-2 logs of bacterial growth in untreated cells . The bactericidal effect was dose dependent, evident over a wide range of bacterial inocula, and not suppressed by hydrocortisone . Preincubation with IFN-gamma was unnecessary and insufficient, as intracellular replication was reversed by exposure to IFN-gamma up to 48 h after infection, and neutralization of IFN-gamma after infection permitted bacterial growth . IFN-gamma thus converts alveolar macrophages from target cells to effector cells in host defense against L . pneumophila and may be of therapeutic benefit in legionellosis. Int J Lepr Other Mycobact Dis, 1992 Dec, 60(4), 556 - 61 Bactericidal activities of single or multiple doses of various combinations of new antileprosy drugs and/or rifampin against M . leprae in mice; Ji B et al.; The bactericidal activities against Mycobacterium leprae of single or multiple doses of various combinations of new antileprosy drugs {minocycline (MINO), clarithromycin (CLARI), ofloxacin (OFLO), and sparfloxacin (SPFX)} and/or rifampin (RMP) were titrated in immunocompetent mice by the proportional bactericidal method . Drugs were administered by gavage at the following dosages (mg/kg) per dose: RMP 10, MINO 25, CLARI 100, OFLO 150, and SPFX 50 . All 15 regimens exerted significant bactericidal activities, at least 96% of viables were killed . The activity of a single dose MINO + CLARI was only slightly inferior to that of RMP, and the activities of a single dose OFLO/SPFX + MINO + CLARI were similar to that of RMP . This suggests that either MINO + CLARI or OFLO/SPFX + MINO + CLARI may be administered once monthly together with RMP 600 mg for the treatment of multibacillary (MB) leprosy, and monthly administration of MINO + CLARI or OFLO/SPFX + MINO + CLARI may also be employed for the treatment of RMP-resistant MB leprosy . Because the killing effects of multiple doses of the combinations were so powerful, comparison of the bactericidal activities of these regimens was beyond the sensitivity of the immunocompetent mouse model, and are being tested in the nude mouse model . Although SPFX is more active against M . leprae than OFLO on a weight-to-weight basis, when both drugs were administered in mice at dosages equivalent to clinically tolerated dosages in humans, SPFX did not show more superiority than OFLO, and its real advantage over OFLO in the treatment of leprosy remains unclear. Chest, 1992 Dec, 102(6), 1780 - 6 Host defense activity in various hosts . Human neutrophil NADPH oxidase activity; Umeki S et al.; The superoxide generation of neutrophil NADPH oxidase from healthy subjects, patients with respiratory infections, and patients receiving effective therapy with antibiotics or steroids was investigated . In young healthy nonsmokers the mean oxidase activity of neutrophils in women was significantly lower than that in men . In healthy women the mean oxidase activity was significantly lower in young nonsmokers than in young smokers or the elderly . In young nonsmokers, oxidase activity significantly increased during respiratory infections; however, in elderly nonsmokers, no significant increase in oxidase activity was observed during respiratory infections . The mean oxidase activity in patients receiving steroids was very low . In in vitro experiments using cell-free activation systems of NADPH oxidase, steroids were found to injure the membrane-bound components of the oxidase enzyme . These results suggest that decreased superoxide generation in patients receiving steroids may result from steroid-induced damage in the membrane-bound components of the NADPH oxidase system . The inhibitory effect of steroids on superoxide production may reduce bactericidal action of neutrophils, ie, one defense mechanism of the body against many kinds of pathogens . Therefore, long-term therapy with steroids in the elderly should be avoided at all costs. Biull Eksp Biol Med, 1992 Dec, 114(12), 641 - 3 {The stimulation of the bactericidal activity of human neutrophils by lymphoid cells activated by interleukin-2; the effect of inflammatory cytokines}; Potapnev MP et al.; Regulation of bactericidal activity of neutrophils (BAN) of healthy volunteer blood donors was studied . Interleukin-2 (IL-2)-activated lymphocytes potentiated BAN more effectively then resting lymphocytes . IL-2-activated mononuclear cells (containing lymphocytes and monocytes/macrophages) decreased neutrophil-potentiating activity when compared with nonactivated mononuclear cells . It was concluded that IL-2-activated monocytes exerted potent suppressive influence upon lymphocytes . Recombinant interleukin-1 beta, tumour necrosis factor-alpha, interferon-gamma acted synergistically with IL-2-activated lymphocytes on BAN when the level of neutrophil bactericidal activity was low. Nihon Kyobu Shikkan Gakkai Zasshi, 1992 Dec, 30(12), 2069 - 74 {Effects of respiratory tract infections and antibiotic therapy on NADPH oxidase activity}; Umeki S; The superoxide generation of neutrophil NADPH oxidase was investigated in healthy subjects, patients with respiratory tract infections, and patients receiving effective antibiotic therapy . In adults, oxidase activity significantly increased during respiratory tract infections and decreased after treatment with effective antibiotics . In the elderly, no significant increase in oxidase activity was observed during respiratory tract infections, while the activity significantly decreased after therapy . Increases in white blood cell counts, neutrophil counts and C-reactive protein values in the elderly during respiratory tract infections were less marked than those in adults . These abnormalities in both adults and the elderly were restored to within normal limits after antibiotic therapy . In in vitro experiments, antibiotics, such as imipenem, ceftazidime and cefoperazone, at each therapeutic dose did not inhibit the superoxide generation of NADPH oxidase . These results suggest that in the elderly, defense activity against infections may be suppressed, and that these antibiotics may normalize neutrophil NADPH oxidase activity as a result of their bactericidal action and a possible biological action to normalize the peri-neutrophil environment of the body. Nippon Eiseigaku Zasshi, 1992 Dec, 47(5), 939 - 51 {Conditions for low-intensity voluntary wheel running in rats and its chronic effects on health indexes}; Suzuki K et al.; Studies were undertaken to evaluate the fundamental conditions for a low-intensity voluntary wheel running model in rats and its chronic effects on health indexes . Male Fischer rats (SPF) 5 weeks of age were housed in individual sedentary conditions or in individual wheel-cage units which allowed free access to voluntary wheel running for 8 months . Voluntary running averaged 640 +/- 198 m/day, reached a peak (965m) at the 2nd month and waned over time, reaching a plateau after the 6th month (about 400-500m) . Exercising rats consumed more food (+23%), but exhibited decreased body weight gains (-9%), suggesting a remarkable lowering of fat . A lowering effect on resting blood pressure (-5%) was also recognized . In addition, preventive effects on oxygen toxicity and effective bactericidal activity of neutrophils and pulmonary alveolar macrophages (PAM) were suggested . Although the amount of exercise in this study was the smallest of the other preceding ones conducted with a voluntary wheel running model, many potential health benefits were recognized . Such health promoting and protective effects by low-intensity voluntary exercise and the harmfulness of forced exercise in rats have been reported in researches on cancer, lowering fat and hypertension . Therefore it is important to set up conditions for low-intensity voluntary running . It was also demonstrated by this study that strictly controlled environmental conditions, such as room temperature and humidity, a 12-hr light-dark cycle and prevention of infection and psychological stress to rats, as well as using male rats, which are more inactive, were important factors to establish this model. Biochem Biophys Res Commun, 1992 Nov 16, 188(3), 1169 - 75 In vitro induction of cecropin genes--an immune response in a Drosophila blood cell line; Samakovlis C et al.; The Drosophila melanogaster cell line mbn-2 was explored as a model system to study insect immune responses in vitro . This cell line is of blood cell origin, derived from larval hemocytes of the mutant lethal (2) malignant blood neoplasm (1(2)mbn) . The mbn-2 cells respond to microbial substances by the activation of cecropin genes, coding for bactericidal peptides . The response is stronger than that previously described for SL2 cells, and four other tested Drosophila cell lines were totally unresponsive . Bacterial lipopolysaccharide, algal laminarin (a beta-1,3-glucan), and bacterial flagellin were strong inducers, bacterial peptidoglycan fragments gave a weaker response, whereas a formyl-methionine-containing peptide had no effect . Experiments with different drugs indicate that the response may be mediated by a G protein, but not by protein kinase C or eicosanoids, and that it requires a protein factor with a high rate of turnover. Arch Biochem Biophys, 1992 Nov 15, 299(1), 129 - 36 Multivalent ligand binding by serum mannose-binding protein; Lee RT et al.; The serum-type mannose-binding protein (MBP) is a defense molecule that has carbohydrate-dependent bactericidal effects . It shares with mammalian and chicken hepatic lectins similarity in the primary structure of the carbohydrate-recognition domain, as well as the ligand-binding mode: a high affinity (KD approximately nM) is generated by clustering of approximately 30 terminal target sugar residues on a macromolecule, such as bovine serum albumin, although the individual monosaccharides have low affinity (KD 0.1-1 mM) . On the other hand, MBP does not manifest any significant affinity enhancement toward small, di- and trivalent ligands, in contrast to the hepatic lectins whose affinity toward divalent ligands of comparable structures increased from 100- to 1000-fold . Such differences may be explained on the basis of different subunit organization between the hepatic lectins and MBP. Arch Biochem Biophys, 1992 Nov 1, 298(2), 452 - 7 Bactericidal activity of peroxynitrite; Zhu L et al.; Peroxynitrite is a strong oxidant formed by macrophages and potentially by other cells that produce nitric oxide and superoxide . Peroxynitrite was highly bactericidal, killing Escherichia coli in direct proportion to its concentration with an LD50 of 250 microM at 37 degrees C in potassium phosphate, pH 7.4 . The apparent bactericidal activity of a given concentration peroxynitrite at acidic pH was less than that at neutral and alkaline pH . However, after taking the rapid pH-dependent decomposition of peroxynitrite into account, the rate of the killing was not significantly different at pH 5 compared to pH 7.4 . Metal chelators did not decrease peroxynitrite-mediated killing, indicating that exogenous transition metals were not required for toxicity . The hydroxyl radical scavengers mannitol, ethanol, and benzoate did not significantly affect toxicity while dimethyl sulfoxide enhanced peroxynitrite-mediated killing . Dimethyl sulfoxide is a more efficient hydroxyl radical scavenger than the other three scavengers and increased the formation of nitrogen dioxide from peroxynitrite . In the presence of 100 mM dimethyl sulfoxide, 60.0 +/- 0.3 microM nitrogen dioxide was formed from 250 microM peroxynitrite as compared to 2.0 +/- 0.1 microM in buffer alone . Thus, formation of nitrogen dioxide may have enhanced the toxicity of peroxynitrite decomposing in the presence of dimethyl sulfoxide. Infect Immun, 1992 Nov, 60(11), 4973 - 5 Human neutrophil azurocidin synergizes with leukocyte elastase and cathepsin G in the killing of Capnocytophaga sputigena; Miyasaki KT et al.; Azurocidin was purified in the presence of phenylmethylsulfonyl fluoride . Electrophoresis revealed at least seven species which exhibited N-terminal sequences consistent with azurocidin . Azurocidin exhibited no bactericidal activity against Capnocytophaga sputigena or other oral bacteria but synergized the bactericidal activity of enzymatically active elastase . Azurocidin also interacted synergistically with cathepsin G. Infect Immun, 1992 Nov, 60(11), 4720 - 5 Activity of defensins from human neutrophilic granulocytes against Mycobacterium avium-Mycobacterium intracellulare; Ogata K et al.; We have examined the activity of defensins from human neutrophilic granulocytes against Mycobacterium avium-Mycobacterium intracellulare . M . avium-M . intracellulare at 2.5 x 10(6)/ml or 2.5 x 10(8)/ml was cultured in the presence of defensins at 37 degrees C from 4 to 48 h . After incubation, CFU were enumerated . Human neutrophil peptide 1 (HNP-1) at 5 micrograms/ml had the ability to kill M . avium-M . intracellulare . Treatment with HNP-1 resulted in significant (96.3 to 97.7%) killing of M . avium-M . intracellulare, even after taking clumping into consideration . This activity was not affected by the presence of calcium (0.5 and 1.0 mM), magnesium (0.5 and 1.0 mM), or sodium chloride (25, 50, and 100 mM) . The optimal pH for bactericidal activity was higher than 5 . We tested numerous M . avium-M . intracellulare strains, and HNP-1 was successful in killing every strain, although the degree of killing varied among them (34.2 to 87.2%) . Additionally, this activity was independent of colonial morphology . We also examined the activity of HNP-2 and HNP-3 against M . avium-M . intracellulare and found that they were as effective in killing M . avium-M . intracellulare as HNP-1 was . These observations suggest that defensins may play an important role in the host defense against M . avium-M . intracellulare. J Hosp Infect, 1992 Nov, 22 Suppl A, 61 - 7 Activity of amoxycillin-clavulanic acid against Legionella pneumophila in vitro and in an experimental respiratory infection model; Smith GM et al.; Amoxycillin and clavulanic acid show good activity against Legionella pneumophila in vitro, and synergy has been observed between the two agents . However, in tissue culture studies, amoxycillin was inactive against intracellular legionellae, whereas clavulanic acid and amoxycillin plus clavulanic acid were as effective as erythromycin in preventing bacterial growth . These latter findings were reflected in the results of therapy of a L . pneumophila pneumonia in the neutropenic rat . Amoxycillin was ineffective in reducing bacterial counts in the lungs of infected animals, but clavulanic acid and amoxycillin-clavulanic acid produced bactericidal effects similar to those of erythromycin . The data illustrate the bactericidal activity of amoxycillin-clavulanic acid and clavulanic acid against intracellular L . pneumophila in contrast to the lack of activity of amoxycillin. Antimicrob Agents Chemother, 1992 Nov, 36(11), 2544 - 7 Activities of various quinolone antibiotics against Mycobacterium leprae in infected mice; Gelber RH et al.; Previously, pefloxacin and ofloxacin were found to be active against Mycobacterium leprae in vitro, in experimental animals, and in clinical trials of lepromatous leprosy patients . In this study, we compared certain more recently developed fluoroquinolones (lomefloxacin, PD 124816, WIN 57273, temafloxacin, and sparfloxacin) with pefloxacin and ofloxacin in M . leprae-infected mice at doses of 50, 150, and 300 mg/kg given five times weekly . All seven of the fluoroquinolones studies were active against M . leprae; temafloxacin and sparfloxacin were the most active, being fully bactericidal at all three dosage schedules . Additionally, sparfloxacin was found to be fully bactericidal at 15 and 30 mg/kg given five times weekly. Int J Immunopharmacol, 1992 Nov, 14(8), 1391 - 8 Augmentative effects of tumor necrosis factor-alpha (human, natural type) on polymorphonuclear leukocyte-derived superoxide generation induced by various stimulants; Yoshikawa T et al.; We investigated the effects of tumor necrosis factor-alpha (human, natural type: n-TNF) on polymorphonuclear leukocyte (PMN)-derived superoxide generation by the new method of Cypridina luciferin analog-dependent chemiluminescence, which had high sensitivity and specificity to superoxide . Preincubation of PMNs with n-TNF for 3 min increased PMN-derived superoxide generation induced by phorbol myristate acetate, A23187, opsonized zymosan and N-formyl-methionyl-leucyl-phenylalanine in a concentration dependent manner (0.5-50 Japan reference units/ml of n-TNF) . In addition, the enhanced PMN-derived superoxide generation by n-TNF showed a positive correlation to the preincubation time of PMNs with n-TNF (3-15 min) . However, a direct incubation of PMNs with n-TNF for 1 h did not induce superoxide from PMNs without the above stimulants . The augmentative effects of n-TNF on PMN-derived superoxide generation should be useful in the PMN-mediated host defense mechanism, such as bactericidal and antitumor activity . The local concentration of n-TNF and the n-TNF-PMN contact time are considered very important in obtaining these effects more efficiently in addition to the presence of PMN-stimulants including complements, chemotactic peptides and phorbol esters. J Surg Oncol, 1992 Nov, 51(3), 159 - 63 Impaired neutrophil bactericidal activity correlates with the infection occurring after surgery for esophageal cancer; Saito T et al.; We examined whether or not preoperative impaired bactericidal activities of polymorphonuclear neutrophils (PMN) are associated with infections following surgery for esophageal cancer . Intracellular killing (KI), superoxide anion-producing capacity (SOP), and myeloperoxidase (MPO) activity were measured in 22 patients with esophageal cancer, 27 with gastric cancer, and 13 age-matched controls . The average level of KI was significantly depressed in patients with esophageal cancer or with gastric cancer, to a similar extent, compared to findings in controls, but SOP was not . In esophageal cancer patients, the SOP level was significantly higher in those with postoperative septic complications than in those without such problems, whereas the KI level was depressed to a similar extent in both . Therefore, a depression of KI with elevation of SOP of PMN may serve to predict complications of infection following surgery in patients with esophageal cancer. J Immunol, 1992 Nov 1, 149(9), 3059 - 65 Alpha-1-antichymotrypsin inhibits the NADPH oxidase-enzyme complex in phorbol ester-stimulated neutrophil membranes; Kilpatrick L et al.; The generation of superoxide anion and release of granule contents are essential to the bactericidal function of neutrophils, but may also contribute to host tissue damage during inflammation . In previous studies (J . Immunol . 146:2388), we have demonstrated that the acute phase reactant alpha-1-antichymotrypsin (ACT), a potent inhibitor of the serine protease cathepsin G, also suppresses superoxide anion generation . The inhibitory effect of ACT was not directly linked to its antiproteolytic activity and may reflect interaction at a site other than its reactive loop . To further characterize the mechanism of inhibition, we investigated the direct effects of ACT on the NADPH oxidase enzyme complex and the signaling pathways that regulate motivation of the respiratory burst . We present evidence that ACT does not intefer with agonist-stimulated calcium mobilization or translocation and activity of protein kinase C . ACT was an effective inhibitor of superoxide anion generation in membrane preparations isolated from PMA-activated cells . These results support the notion that ACT is acting on a component of the active assembled NADPH oxidase complex . Thus, ACT may have an important role in regulation of specific aspects of the inflammatory processes and the modulation of toxic oxygen-based host tissue damage. Antibiot Khimioter, 1992 Nov, 37(11), 14 - 7 {Effect of antibiotics on Francisella tularensis}; Sidorenko SV et al.; The minimum inhibitory concentrations of rifampicin, doxycycline, sisomicin, ciprofloxacin and phosmidomycin for various strains of Francisella tularensis were 0.5 to 2.0, 0.5 to 2.0, 0.125 to 0.4, 0.625 to 0.125 and 2.0 to 12.5 micrograms/ml, respectively . Ciprofloxacin and sisomicin had a marked bactericidal effect . The bactericidal effect of rifampicin was insignificant . Doxycycline and phomidomycin had practically no such effect . All the antibiotics had a post effect . The level of the post-antibiotic effect was different and depended on the antibiotic concentration. Biochem J, 1992 Oct 15, 287 ( Pt 2), 573 - 8 Purification and characterization of a diptericin homologue from Sarcophaga peregrina (flesh fly); Ishikawa M et al.; A protein with a molecular mass of 8 kDa was found to be synthesized specifically when the fat-body from injured Sarcophaga peregrina larvae was cultured in vitro . This protein was purified from the haemolymph of the injured larvae to near-homogeneity . Partial amino acid sequencing revealed that this protein is a diptericin homologue . It showed bactericidal activity on growing, but not resting Escherichia coli cells . E . coli cells become elongated on treatment with this protein. Infect Immun, 1992 Oct, 60(10), 4407 - 9 Effects of gamma interferon and indomethacin in preventing Brucella abortus infections in mice; Stevens MG et al.; Increased resistance to infection with Brucella abortus 2308 resulted when recombinant murine gamma interferon (rMuIFN-gamma) was given to mice both before and during infection but not when given only before infection . Mice given rMuIFN-gamma had enhanced peritoneal and splenic macrophage bactericidal activity against B . abortus . Treatment of mice with rMuIFN-gamma plus indomethacin did not further enhance resistance to infection or macrophage bactericidal activity compared with that after treatment of mice with rMuIFN-gamma alone. J Antimicrob Chemother, 1992 Oct, 30(4), 525 - 34 Bactericidal effects of co-amoxiclav (amoxycillin clavulanic acid) against a Legionella pneumophila pneumonia in the immunocompromised weanling rat; Smith GM et al.; To evaluate the activity of co-amoxiclav (amoxycillin/clavulanic acid) against Legionella pneumophila in vivo, a model of L . pneumophila pneumonia was developed in weanling rats rendered leukopenic by pre-administration of cyclophosphamide . Assessment of therapy was by lung bacterial counts and histological examination . Amoxycillin was ineffective in reducing bacterial counts in the lungs of infected rats, whereas erythromycin, the standard agent, was significantly more effective (P < 0.01) . Co-amoxiclav and erythromycin, administered parenterally, produced significant bactericidal effects (P < 0.01), reducing the counts of L . pneumophila strain 1624 at 96 h to 1.2 log10 cfu/lungs compared with counts of 6 log10 cfu/lungs in the untreated animals . Clavulanic acid was also highly effective in preventing development of the infection, and was as efficacious as co-amoxiclav . Because of the significant reduction in bacterial numbers, a marked reduction in inflammation and consolidation of lung tissue was seen in rats treated with erythromycin, clavulanic acid or co-amoxiclav . The activity of co-amoxiclav was no greater than clavulanic acid alone, and no synergy was noted between the two components . When therapy was delayed until 48 h after infection, co-amoxiclav was as effective as erythromycin, with both treatments reducing bacterial numbers to 3.3 and 3.6 log10 cfu/lungs by 96 h, after only two days of therapy, in comparison with non-treated rats (5.6 log10 cfu/lungs) . In a prolonged infection, produced by extending the period of leucopenia, co-amoxiclav and erythromycin were equally effective in preventing growth of the organism, with 1.5 and 1.6 log10 cfu/lungs, respectively, present at 96 h, in contrast to the non-treated rats with 5.7 log10 cfu/lungs (P < 0.01) . After cessation of therapy, regrowth of L . pneumophila occurred in the erythromycin-treated group to such a degree that by 168 h, lung viable counts from these rats were significantly higher (4.8 log10 cfu/lungs) than in co-amoxiclav-treated rats (2.1 log10 cfu/lungs) (P < 0.05) . Oral therapy of this infection with erythromycin or clavulanic acid, either alone or in combination with amoxycillin, resulted in counts of 3.3, 3.6 and 3.5 log10 cfu/lungs at 96 h, respectively . Although oral therapy was significantly less effective than parenteral therapy (P < 0.05), the bacterial counts in the treated groups were significantly lower than in the non-treated animals . The data show that co-amoxiclav displayed bactericidal activity consistently against intracellular L . pneumophila in vivo. Eur J Clin Microbiol Infect Dis, 1992 Oct, 11(10), 923 - 6 Killing kinetics of five orally administered antibiotics at clinically achievable concentrations against Moraxella catarrhalis; Bingen E et al.; Time-kill kinetic studies were used to measure the bactericidal activity of amoxicillin/clavulanic acid (in a new form for pediatric use), cefaclor, cefuroxime, cefixime and erythromycin against 30 beta-lactamase producing Moraxella catarrhalis strains . Antibiotics were tested at the mean maximum serum concentration observed after administration of a standard dose and at 0.5 x Cmax, 0.33 x Cmax and 0.25 x Cmax . A 2 log10 reduction in colony counts was obtained with the Cmax of amoxicillin/clavulanic acid and cefixime after 5 h of incubation . After 24 h of incubation a decrease of 3 and 4 log was observed with cefixime and amoxicillin/clavulanic acid respectively . At 0.5 x Cmax and 0.33 x Cmax, bactericidal activity was obtained only with amoxicillin/clavulanic acid. Yakugaku Zasshi, 1992 Oct, 112(10), 712 - 22 {Synthesis of new antirusty disinfectants . I}; Makino M et al.; New quaternary ammonium salts {N-alkyl-N-2-hydroxyethyl-N,N-dimethylammonium ethyl phosphate (21, 22), isopropyl phosphate (23), n-butyl phosphate (24) and N-alkyl-N-2-hydroxy-3-phenoxypropyl-N,N-dimethylammonium ethyl phosphate (25, 26), isopropyl phosphate (27), n-butyl phosphate (28) and bis(N-alkyl-N-2-hydroxy-3-phenoxypropyl-N,N-dimethylammonium) malate (29), fumarate (30), succinate (31), adipate (32) and N-alkyl-N-2-hydroxy-3-phenoxypropyl-N,N-dimethylammonium tartrate (33)} were synthesized by alkylation of the corresponding trialkylammonium salts with various epoxy compounds . The new quaternary ammonium salts showed much greater bactericidal activities and antirusting effects than those of benzalkonium chloride . They had also good compatibilities since no precipitate was observed if the solution of any anionic surface active agents were added to the solution of these new quaternary ammonium salts . This property is the same as that of amphoteric surface active agents. Genitourin Med, 1992 Oct, 68(5), 328 - 30 A clinical evaluation of trichomoniasis in San Jose, Costa Rica using the InPouch TV test; Borchardt KA et al.; OBJECTIVE--to determine the prevalence of trichomoniasis in San Jose, Costa Rica, comparing two methods, the InPouch TV test and the saline wet mount . METHODS--One hundred symptomatic and asymptomatic female patients at two hospitals and at a sexually transmitted disease (STD) clinic were evaluated . Vaginal discharge was the most prevalent genitourinary abnormality among symptomatic patients . The patients were between 18 and 70 years old . Fifty-seven were from the STD clinic, 43 from the two hospitals . A saline wet mount and a culture were taken from each patient . The culture employed a new procedure for diagnosis of trichomonads, the InPouch TV test (BioMed Diagnostics, San Jose, CA) . RESULTS--Thirteen of the 100 patients were culture positive, two of whom were wet mount positive . No wet mount positives were culture negative . Eleven of the positive tests were from the STD clinic and two were from the hospitals . CONCLUSIONS--The results of this initial epidemiologic study indicate a prevalence of 19% for trichomoniasis in the STD clinic population and 4.6% in the hospitals group . Trichomonas vaginalis was not diagnosed by laboratory methods prior to this study . The InPouch TV test has a selective fungicidal and bactericidal, enriched proteose-peptone medium which provides a sensitivity of 4 organisms per ml and a 1 year shelf life at room temperature . This in vitro culture test demonstrated unique capabilities as a transport and culture medium . Its procedure offers simplicity in application and an excellent visualisation of trichomonads. J Leukoc Biol, 1992 Oct, 52(4), 407 - 14 Circulating factors contribute to elevation of intracellular cyclic-3',5'-adenosine monophosphate and depression of superoxide anion production in polymorphonuclear leukocytes following thermal injury; Bjornson AB et al.; We have previously demonstrated that bactericidal activity and superoxide anion (O2-) production are depressed concomitantly in polymorphonuclear leukocytes (PMNs) following thermal injury in a guinea pig model, and the bactericidal defect is related to elevation of intracellular cyclic-3',5'-adenosine monophosphate (cAMP) . The purpose of the present investigation was to determine the relationship between elevation of intracellular cAMP and depression of O2- production in PMNs following thermal injury and determine the involvement of circulating factors in the development of these alterations . The kinetics of O2- production and dose responses to formylmethionyl-leucyl-phenylalanine (fMLP) and phorbol myristate acetate (PMA) were depressed in peripheral PMNs following thermal injury in this experimental model . Sera obtained during the period of PMN dysfunction induced depression of O2- production in response to fMLP and elevation of intracellular cAMP in normal PMNs . Pretreatment of normal PMNs with nonsteroidal anti-inflammatory drugs (NSAID; indomethacin or piroxicam) inhibited the elevation of intracellular cAMP mediated by sera from the injured animals but had no effect on the depression of O2- production observed under similar conditions . Treatment of PMNs from injured animals with NSAID under conditions known to reduce the cAMP content of the cells and correct the bactericidal defect did not normalize O2- production . Studies utilizing sera from two thermally injured patients confirmed findings in the guinea pig model of serum-mediated elevation of intracellular cAMP and depression of O2- production in normal PMNs and effects observed with NSAID . These results suggest that circulating factors contribute to the elevation of intracellular cAMP and depression of O2- production in PMNs following thermal injury . Whereas the increase in intracellular cAMP may be involved in the depression of O2- production, our results suggest that there is not a direct link between these alterations. Acta Cytol, 1992 Sep-Oct, 36(5), 668 - 73 Increased surfactant protein A content in human alveolar macrophages in hypersensitivity pneumonitis; Guzman J et al.; Surfactant protein A (SP-A) appears to have an important function in the assembly and maintenance of the alveolar surfactant monolayer . SP-A has also been implicated in modulating the activity of immunoactive cells, such as increasing the bactericidal capacity of alveolar macrophages . In this immunocytochemical study the SP-A content of alveolar macrophages from seven patients with hypersensitivity pneumonitis was compared with the results obtained from six healthy controls . A polyclonal rabbit antibody against human SP-A was used for detection of SP-A in the cytoplasm of alveolar macrophages, applying the immunoperoxidase adhesive slide assay . In hypersensitivity pneumonitis a significant increase in the percentage of SP-A+ alveolar macrophages was observed as compared with the percentage in healthy controls . The intensity of the staining reaction was also increased in the alveolar macrophages of hypersensitivity pneumonitis . We conclude that the observed abnormalities in SP-A content in alveolar macrophages may play a role in the pathogenesis of hypersensitivity pneumonitis. Int J Lepr Other Mycobact Dis, 1992 Sep, 60(3), 410 - 5 An experimental study to evaluate the bactericidal activity of ofloxacin against an established Mycobacterium leprae infection; Banerjee DK et al.; The bactericidal effect of a new quinolone, ofloxacin (OFLO), was determined on an established Mycobacterium leprae infection in nude mice . Various drug regimens, including combinations of drugs, were examined for different treatment periods . OFLO and rifampin (RMP) individually failed to produce significant killing after treatment with a single large dose . However, when single large doses of OFLO and RMP were given in combination, a 100-fold reduction in viability was achieved . For a longer period of treatment both of these drugs, at lower doses, produced a moderate reduction in viability . The addition of dapsone to the lower dose of OFLO resulted in a significant reduction in viability, while lower doses of RMP and OFLO together produced a moderate reduction in viability. Eur J Clin Invest, 1992 Sep, 22(9), 630 - 4 Colchicine analogues: effect on amyloidogenesis in a murine model and, in vitro, on polymorphonuclear leukocytes; Wolach B et al.; Colchicine has been used in diverse clinical settings such as gout, familial Mediterranean fever, liver cirrhosis, Behcet's disease and pericarditis . It also has an antimitotic potential hitherto unexplored due to its narrow therapeutic toxic ratio . The aim of the present study was to compare the effectiveness and the toxicity of colchicine and three analogues: thiocolchicine, 2,3 dimethyl-colchicine and 3-dimethylthiocolchicine in the blockage of amyloid synthesis in a murine model . 3-demethylthiocolchicine was equipotent to colchicine in the blockage of casein induced amyloidogenesis . However, it was markedly less toxic (LD50 11.3 mg kg-1 vs . 1.6 mg kg-1) . Thiocolchicine was toxic (LD50 1.0 mg kg-1) and 2,3 didemethyl-colchicine was far less effective . The effect of 3-dimethylthiocolchicine on polymorphonuclear leukocytes was then compared to colchicine . The effect of this analogue on inhibition of chemotaxis was equivalent to that of colchicine whereas the latter was superior to the analogue in the suppression of phagocytosis (by a ratio of 2:1) and in the inhibition of bactericidal activity (by a ratio of 10:1) . Since in therapeutic concentrations the only detectable effect of colchicine on PMNs is inhibition of chemotaxis, our data may point to 3-demethylthiocolchicine as an optional, perhaps superior alternative to colchicine for some of its therapeutic indications. Kidney Int, 1992 Sep, 42(3), 602 - 9 Decreased O2 consumption by PMNL from humans and rats with CRF: role of secondary hyperparathyroidism; Kiersztejn M et al.; Bactericidal ability of polymorphonuclear leukocytes (PMNL) is impaired in chronic renal failure (CRF) . This function of PMNL is mediated by the generation of oxidizing radicals and the latter event requires O2 consumption by these cells . The present study examined both basal and FMLP-stimulated rise in cytosolic calcium ({Ca2+}i) and O2 consumption of PMNL from normal subjects and hemodialysis patients and from CRF rats, and evaluated the potential role of secondary hyperparathyroidism of CRF on these properties of PMNL . Basal levels of {Ca2+}i were significantly higher, and FMLP-induced increments in {Ca2+}i were significantly lower in PMNL of both humans and rats with CRF than in normals . Basal and FMLP-stimulated O2 consumption were significantly lower in CRF subjects and rats than in normals . These derangements were prevented by prior parathyroidectomy of CRF rats or by their treatment with verapamil from day one of CRF . Also, therapy of rats with pre-existing CRF with this drug reversed the abnormalities in {Ca2+}i and in O2 consumption of PMNL . The data indicate that: (1) CRF is associated with derangements in the homeostasis of {Ca2+}i of PMNL and their oxygen consumption, (2) these abnormalities are, most likely, mediated by the state of secondary hyperparathyroidism of CRF, and (3) verapamil, which blocks the PTH-induced entry of calcium into cells, and prevents as well as reverses these PMNL dysfunctions . These results implicate the excess PTH of CRF in the genesis of the defective bactericidal function of PMNL, and assign a new dimension to PTH toxicity in CRF. Infect Immun, 1992 Sep, 60(9), 3852 - 60 Inhibition of bactericidal activity of anticapsular antibody by nonspecific antibodies reactive with surface-exposed antigenic determinants on Actinobacillus pleuropneumoniae; Udeze FA et al.; In an attempt to understand the mechanism of serum resistance in Actinobacillus pleuropneumoniae, in the present study we examined various interactions among the bacterial surface constituents, serum antibodies, and complement . Analysis of swine sera revealed the presence of anticapsular antibodies in convalescent-phase sera but not in preimmune sera . Both types of sera contained antibodies which reacted with each of 14 polypeptides present in saline extracts of the bacteria . Absorption of the preimmune sera with intact bacteria depleted antibodies to two of the polypeptides (27 and 32 kDa) and high-molecular-weight (greater than 97.4,000) components which did not stain with Coomassie blue . Data derived from complement consumption and C3-binding experiments indicated that the organism was capable of initiating complement activation and binding C3 during incubation in preimmune and immune sera . Experiments designed to evaluate the bactericidal effectiveness of anticapsular antibody revealed that the purified antibody was bactericidal only when preimmune sera absorbed with intact bacteria were used as a source of complement . The bactericidal effects of anticapsular antibody and absorbed preimmune sera were inhibited in a dose-dependent manner by heat-inactivated preimmune sera and immunoglobulin G derived from the sera . The inhibitory activity of the preimmune sera was neutralized by preincubating the sera with column fractions of the saline extract which contained either the 27- or the 32-kDa polypeptide . These results indicate that serum resistance in A . pleuropneumoniae 4074 could be related to inhibition of the bactericidal action of anticapsular antibody by nonspecific antibodies which recognize surface-exposed epitopes on the polypeptides. Rev Hosp Clin Fac Med Sao Paulo, 1992 Sep-Oct, 47(5), 215 - 22 {The effect of lipid emulsions on the mechanisms of organic defense in infectious injury}; Waitzberg DL et al.; For treatment of metabolic derangements in infective states intravenous lipidic emulsions have been used . Their use is however not harmless existing reports on fat inhibiting the function of blood polymorphonuclear leukocytes and macrophages . The purpose of the research reported herewith was to study in rats the effect of new intravenous lipidic emulsions containing medium chain triglycerides and long chain triglycerides and compare it with the effect of long chain triglycerides emulsion on function of polymorphonuclear leukocytes (chemotaxis, phagocytosis and bactericidal activity) . The intraperitoneal implant of an E . coli capsule was used for the study . The transfusions of both lipidic emulsions in septic rats have not altered functions of polymorphonuclear leukocytes when compared with saline infusion . However there was found hepatic steatosis, hypertrophy and presence of fat globules in the Kupffer cells in rats infused with medium chain and long chain triglyceride emulsions . Sequential blood cultures obtained from rats infused with the emulsions showed increased bacterial growth with medium chain triglyceride emulsion . There was no significant difference between the rats that received both lipid infusions and those that received saline infusions as to the mortality . Our experimental study suggests that the use of fat emulsions in infective states be done with care and monitoring of seric triglycerides and steroids. Mol Microbiol, 1992 Sep, 6(18), 2617 - 28 Antibodies to N-terminal peptides of gonococcal porin are bactericidal when gonococcal lipopolysaccharide is not sialylated; Elkins C et al.; Six synthetic 25-mer peptides corresponding to certain presumed surface-exposed regions of gonococcal porin protein I (PI) were made from strains FA19 (PIA) and MS11 (PIB) . Four peptides were immunogenic in rabbits . Affinity-purified antisera against both PIA and PIB N-terminal peptides were bactericidal for homologous gonococci and many heterologous PI serovars . However, sialylation of gonococcal lipopolysaccharide (LPS) by growth of gonococci in the presence of cytidine monophosphate-neuraminic acid (CMP-NANA) abrogated the bactericidal activity of these antisera . Binding of anti-PI monoclonal antibodies to whole gonococci was reduced two- to fourfold by sialylation of LPS, suggesting that sialylation may inhibit bactericidal activity by masking porin epitopes . However, binding of anti-PII (Opa) monoclonal antibodies was not inhibited, yet complement-mediated killing was inhibited by sialylated LPS . Binding of complement components C3 and C9 was inhibited in the presence of either anti-PI or anti-PII monoclonals when gonococci were grown in the presence of CMP-NANA . Thus sialylation inhibited both anti-PI antibody binding and complement deposition, with a resultant decrease in bactericidal activity. Ugeskr Laeger, 1992 Aug 17, 154(34), 2318 - 9 {Conservative treatment of brain abscess complicating neonatal Escherichia coli meningitis}; Bottzauw JL et al.; The case of a newborn infant who developed meningitis caused by E . coli is presented . During i.v . treatment with ampicillin and gentamycin in recommended doses and according to susceptibility patterns, the patient developed cerebral abscesses detected on CT . After changing to third generation cephalosporin, the patient improved clinically and the CT-changes regressed and disappeared . Because of their superior bactericidal effect, we recommend a third generation cephalosporin as a first choice in the treatment of neonatal E . coli meningitis. Infect Immun, 1992 Aug, 60(8), 3098 - 104 Selection of an escape variant of Borrelia burgdorferi by use of bactericidal monoclonal antibodies to OspB; Coleman JL et al.; Two immunoglobulin G (IgG) monoclonal antibodies (MAbs) to outer surface protein B (CB2 and CB6), affinity purified from mouse ascitic fluid, exhibited concentration-dependent inhibitory and bactericidal properties against Borrelia burgdorferi after a 24-h incubation period in spirochete medium . Fab fragments derived from these MAbs showed the same effects, indicating that they were not caused by agglutination of the organisms by the intact MAbs . The inhibition of spirochete growth in cultures containing MAbs was also detected by spectrophotometric analysis of the media . CB2 did not inhibit the growth of Borrelia hermsii or the BEP4 strain of B . burgdorferi, neither of which is recognized by the MAb . Affinity-purified IgG from hybridoma supernatants had similar effects on B . burgdorferi as the ascitic-fluid-derived IgG did, indicating that the inhibitory and bactericidal properties were not due to nonspecific toxic contaminants . The bactericidal properties of the MAbs were not complement dependent as there was none in the serum-free system . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of B . burgdorferi organisms surviving after exposure to CB2 revealed an escape variant which failed to express OspB . The continued presence of OspA in these escape variants indicates that the lack of OspB was not due to the loss of the plasmid which contains the genes for both of these proteins. Nihon Kyobu Shikkan Gakkai Zasshi, 1992 Aug, 30(8), 1520 - 5 {Production of reactive oxygen species by rat alveolar macrophages . Dissociation between the intracellular and extracellular release of hydrogen peroxide}; Uwabe Y et al.; In order to clarify the features of reactive oxygen species produced by rat alveolar macrophages (AMs), the concentrations of intracellular and extracellular hydrogen peroxide were measured under various experimental conditions . Intracellular hydrogen peroxide was measured by DCFH method using a flow cytometer, while the extracellularly released fraction was measured by scopoletin method using a spectrophotometer . The concentration of intracellular hydrogen peroxide after stimulation with opsonized zymosan (10 micrograms/ml) was significantly higher than that after stimulation with phorbol myristate acetate (PMA; 100 ng/ml) . On the other hand, hydrogen peroxide released extracellularly after stimulation with PMA was significantly greater that that after stimulation with opsonized zymosan . These results indicate that the soluble membrane stimulant and the phagocytic particles have different mechanisms in activating the production of hydrogen peroxide in AMs . That is, hydrogen peroxide induced by PMA was mainly released extracellularly, while that induced by zymosan was mainly released into the intracellular environment . At rest, the concentration of intracellular hydrogen peroxide in rat AMs was high . Potassium cyanate, a known mitochondrial inhibitor, suppressed the intracellular hydrogen peroxide in AMs not only at rest but also after stimulations, indicating that most of the reactive oxygen species released into the intracellular environment in AM are produced by mitochondria . From these results, in order to gain a closer insight into the function of AMs, it is very important to distinguish the oxidative metabolites produced intracellularly which are related to bactericidal function from those of the extracellularly released fraction which give rise to lung damage. Antimicrob Agents Chemother, 1992 Aug, 36(8), 1695 - 8 Bacteriostatic and bactericidal activities of gentamicin alone and in combination with clarithromycin against Mycobacterium avium; Heifets LB et al.; The inhibitory activity of gentamicin against Mycobacterium avium depended on the pH of the medium, and the broth-determined MICs for 90% of strains were 5.0 micrograms/ml at pH 7.4, 9.5 micrograms/ml at pH 6.8, and greater than 16.0 micrograms/ml at pH 5.0 . The MBCs were two- to eightfold higher than the MICs . The combined effect of gentamicin and clarithromycin was additive, and the MICs and MBCs of each drug were either the same as those in the single-drug tests or reduced twofold. Acta Derm Venereol, 1992 Aug, 72(4), 297 - 300 Roxithromycin in Lyme borreliosis: discrepant results of an in vitro and in vivo animal susceptibility study and a clinical trial in patients with erythema migrans; Hansen K et al.; A new semisynthetic macrolide roxithromycin was evaluated for its potential use in the treatment of Lyme borreliosis . Using a macro-dilution broth technique, Borrelia burgdorferi was shown to be susceptible to roxithromycin with a minimal bactericidal concentration (MBC) of 0.06-0.25 microgram/ml . A systemic B . burgdorferi infection was established in gerbils; a dosage of greater than or equal to 25 mg/kg/day roxithromycin for 10 days eliminated the infection . A single blind, randomized multicenter study was performed to evaluate the efficacy of roxithromycin 150 mg b.i.d . versus phenoxymethyl-penicillin 1 g b.i.d . for 10 days in patients with uncomplicated erythema migrans . The study was interrupted when 19 patients had enrolled because of five treatment failures . All 5 patients had received roxithromycin; three patients had persisting or recurrent erythema migrans, one developed a secondary erythema migrans-like lesion and severe arthralgia and one developed neuroborreliosis . B . burgdorferi was isolated from skin biopsies after roxithromycin therapy from two patients with persistent erythema migrans and both isolates were still highly susceptible to roxithromycin (MBC = 0.03 microgram/ml) . No treatment failures were seen in 10 patients treated with phenoxymethyl-penicillin . Roxithromycin is thus not recommended for treatment of Lyme borreliosis. Dtsch Tierarztl Wochenschr, 1992 Aug, 99(8), 347 - 9 Characterization of serum lysosomal enzymatic activities . II . Effect of lumpy skin disease in Egyptian cows; Abdalla MA et al.; Clinical findings and lysosomal enzymes (LYE) in eight lumpy skin diseases (LSD) cows and same number of healthy ones were reported in Tal-El Baker village and Tal Alkabir centre, Ismailia province, Egypt . LSD began with fever, anorexia, skin lesions in form of nodules all over the body, which disappeared spontaneously or gathered to form large lumps . It was complicated with respiratory manifestation, corneal opacity, mastitis, dehydration and later on recumbency . It is noteworthy that the level of 3 LYE showed the same trend of significant reduction in acute stage of the disease (5 days after occurrence of LSD) probably due to injection of animals with a therapeutics dose of terramycin . Acid-phosphatase (ACP) enzyme is the sole that behaved very high significant increase in the serum in acute stage of LSD due to the damaged tissues caused by the virus . It underwent insignificant decrease in late stage of the disease (20 days after its occurrence) to restore the normal LYE level in control cows indicating recovery . Alpha-galactosidase (alpha-GAL) decreased perpetually by the progression of LSD because of the decreased bactericidal index which ist in concomitance with the secondary bacterial invader . N-acetyl-beta-glucosaminidase (beta-NAG) and beta-galactosidase (beta-GAL) in LYE had the same fluctuating manner . The activities showed very highly significant decrease in acute stage, followed by highly significant and significant increases (late LSD stage) respectively . The appreciable significant increase of beta-GAL may declare the effect of anorexia on LSD . In view of these findings, it can be postulated that LSD may be diagnosed and prognosed through LYE changes in the serum. J Med Microbiol, 1992 Jul, 37(1), 3 - 7 Killing of alpha-haemolytic and non-haemolytic Escherichia coli strains in human serum and polymorphonuclear leucocytes; Siegfried L et al.; The role of alpha-haemolysin (AH) in the resistance of Escherichia coli strains, isolated from patients with extra-intestinal diseases or diarrhoea, to the bactericidal activity of human serum and intracellular killing in polymorphonuclear leucocytes (PMNL) was investigated in vitro . Sets of alpha-haemolytic and non-haemolytic E . coli strains and sets of isogenic E . coli strains, which included wild-type alpha-haemolytic strains and derived strains with a reduced production of AH, were used . Compared with non-haemolytic strains, alpha-haemolytic strains were significantly more resistant to the bactericidal activity of 10% and 100% human serum and to intracellular killing in PMNL . Higher resistance to serum killing and to intracellular killing in PMNL was also found in wild-type alpha-haemolytic E . coli than in isogenic bacteria with reduced production of AH . These results provide evidence that production of AH in E . coli strains counteracts both the bactericidal activity of serum and intracellular killing in PMNL. Surg Gynecol Obstet, 1992 Jul, 175(1), 33 - 40 The influence of an attachable subcutaneous cuff for preventing triple lumen catheter infections in critically ill surgical and trauma patients; Norwood S et al.; One hundred and ninety-one triple lumen central venous catheters were placed into 107 sites in 81 surgical and trauma patients who were prospectively studied to determine the rate of catheter related infection using a subcutaneous cuff of biodegradable collagen containing bactericidal silver and a guide wire exchange protocol . Thirty-seven sites in 36 nonseptic patients (group 1) were compared with 70 sites in 45 septic patients (group 2) . The data were also compared with data consecutively collected one year earlier, using the same exchange protocol without the cuff . Fourteen of 70 sites in group 2 had catheter related infections, with seven causing bloodstream infection . Five of 14 were the result of fungus, with three causing fungemia . Two of 37 sites in group 1 had catheter related infections (p = 0.044), with no associated bacteremia . The number of triple lumen catheter related infections and associated bacteremia or fungemia are higher in septic patients compared with nonseptic critically ill surgical and trauma patients . The cuff significantly prolongs time of catheter site use in patients who are nonseptic, but may be of no benefit in reducing infection rates or prolonging site use time in patients who are septic and may predispose to fungal colonization. J Infect Dis, 1992 Jul, 166(1), 53 - 7 Complement factor 9 deficiency in serum of human neonate