J Periodontal Res, 1992 Nov, 27(6), 631 - 9 Tetracycline administration increases protein (presumably procollagen) synthesis and secretion in periodontal ligament fibroblasts of streptozotocin-induced diabetic rats; Sasaki T et al.; Streptozotocin-induced, insulin-deficient diabetic adult rats were daily administrated either minocycline or a chemically-modified non-antimicrobial tetracycline (CMT) by oral gavage for a 3-week time period; untreated diabetic and non-diabetic rats served as controls . On day 21, all rats received an intravenous injection of 3H-proline followed by perfusion fixation with an aldehyde mixture at 20 minutes and 4 hours after isotope injection . The upper and lower mandibles of these rats were dissected and processed for quantitative electron microscopic autoradiography to study 3H-proline utilization by fibroblasts in the periodontal ligament (PDL) of molars . In the non-diabetic controls, at 20 min after 3H-proline injection, radioprecursor was incorporated by the Golgi-RER system of PDL fibroblasts . At the 4-h time period, most of the label was present over the collagen fibers around these cells . In contrast, PDL fibroblasts in the untreated diabetic rats showed marked abnormalities ultrastructurally and minimal uptake (20 min) and secretion (4 h) of labeled proline . At both time periods, in both minocycline- and CMT-treated diabetic rats, fibroblasts were structurally more normal and the radioprecursor was localized in the fibroblasts and the PDL matrix in a pattern similar to that seen in the control rats . These results suggest that the diabetes-induced structural abnormalities and suppression of synthesis and secretion of protein (presumably collagen and its precursor) by PDL fibroblasts can be restored to near-normal by administration of a tetracycline and that this effect is mediated by a non-antimicrobial property of this family of antibiotics. Vet Surg, 1992 Nov-Dec, 21(6), 458 - 62 Comparison of an antimicrobial adhesive drape and povidone-iodine preoperative skin preparation in dogs; Osuna DJ et al.; The antimicrobial efficacy of an adhesive drape applied after a 1-minute alcohol scrub was compared to a povidone-iodine (PI) skin preparation technique in dogs . Each technique was applied to both sides of 15 adult anesthetized dogs on premeasured, clipped areas of skin . Skin bacteria were quantified before, immediately after, and 1 hour after skin preparation . Predominant skin bacteria were isolated by swabbing the skin . The percentages of bacterial reduction immediately after and 1 hour after skin preparation, percentages of negative culture results, cultures with more than five colony-forming units, and the frequency of skin reactions were calculated and analyzed statistically . Drape adhesion was assessed subjectively . The percentage reduction in skin bacteria was significant for both techniques and comparable to that reported in humans . The adhesive drape was significantly less effective in both the immediate and 1-hour periods . Lift occurred in 66% of drape applications but was not associated with high bacterial counts . Acute contact dermatitis was more frequent after skin preparation with PI . There was no difference between the techniques in recovery of potential skin pathogens . The authors conclude that application of this antimicrobial adhesive drape after a 1-minute alcohol scrub is not as effective in the reduction of skin bacteria in dogs as is PI preparation of the skin. Vet Clin North Am Small Anim Pract, 1992 Nov, 22(6), 1309 - 21 Feline experimental models for control of periodontal disease; Boyce EN; Feline periodontal disease has many elements in common with human and canine disease . Anatomic, physiologic, microbiologic, and immunologic differences between the three species make it impossible to predict with certainty whether successful approaches to controlling and treating canine oral disease will also prove successful in cats . We have developed methods for reproducible, quantitative evaluation of feline dental plaque and calculus . Our studies demonstrated that feline plaque accumulation peaks at 1 week after prophylaxis and that calculus peaks at 4 weeks after prophylaxis . These methods should be adequately sensitive to document control of plaque and calculus accumulation by efficacious chemical or antimicrobial agents. J Pharm Sci, 1992 Nov, 81(11), 1092 - 4 Pharmacological studies on quaternized 4(3H)-quinazolinones; Buyuktimkin S et al.; Locomotor activity-inhibiting, anticonvulsant, muscle relaxant, analgesic, and antimicrobial properties of 2-methyl-3-pyridinium-acetylamino-4(3H)-quinazolinone chloride (1), 2-methyl-3-(4-methylpyridinium)acetylamino-4(3H)-quinazolinone chloride (2), 2-methyl-3-(4-ethylpyridinium)acetylamino-4(3H)-quinazolinone chloride (3), 2-methyl-3-(3-carboxamidopyridinium)acetylamino-4(3H)-quinazolinon e chloride (4), and 2-methyl-3-(4-carboxamidopyridinium)-acetylamino-4(3H)- quinazolinone chloride (5) were investigated . The locomotor activity-inhibiting properties and anticonvulsant activity of 2 were almost equal to those of methaqualone . The analgesic activities of 2 and 3 in the hot-plate test were equal to that of aspirin, whereas in the Koster test, the analgesic activity of 2 was higher . The compounds did not exhibit antimicrobial or muscle relaxant properties . Most active compounds had higher lipophilicity values than those of inactive compounds. Am J Med, 1992 Nov, 93(5), 481 - 8 Response of latent syphilis or neurosyphilis to ceftriaxone therapy in persons infected with human immunodeficiency virus; Dowell ME et al.; OBJECTIVE: To evaluate the effect of ceftriaxone in treating latent syphilis or asymptomatic neurosyphilis in patients infected with the human immunodeficiency virus (HIV) . DESIGN: Follow-up study of patients treated at two HIV-based clinics during 16 months from 1989 to 1991 . PATIENTS: Patients were those in whom a clinical diagnosis of latent syphilis or asymptomatic neurosyphilis was made, who received all recommended doses of antimicrobial therapy, and who returned for follow-up visits for 6 or more months . RESULTS: Forty-three patients were treated with ceftriaxone, 1 to 2 g daily for 10 to 14 days . Thirteen underwent lumbar puncture before treatment; 7 (58%) had documented neurosyphilis (pleocytosis in 5, elevated protein levels in 6, VDRL reactive in cerebrospinal fluid {CSF} in 7), and 6 had documented latent syphilis (entirely normal CSF) . The remaining 30 were said to have presumed latent syphilis . There was no relation between the diagnosis and the selected dosage of ceftriaxone . Response rates were similar in those who had documented neurosyphilis and documented or presumed latent syphilis . Overall, 28 patients (65%) responded to therapy, 5 (12%) were serofast, 9 (21%) had a serologic relapse, and 1 (2%) who experienced progression to symptomatic neurosyphilis was a therapeutic failure . Thirteen patients received benzathine penicillin for presumed latent syphilis; results were similar to those observed after ceftriaxone therapy, with 8 (62%) responders, 1 (8%) serofast, 2 (15%) relapses, and 2 (15%) failures . CD4 cell counts in responders were not different from those who failed to respond . CONCLUSIONS: Even in the absence of neurologic symptoms, half of the HIV-infected persons who have serologic evidence of syphilis may have neurosyphilis . Although ceftriaxone achieves high serum and CSF levels, 10 to 14 days of treatment with this drug were associated with a 23% failure rate in HIV-infected patients who had latent syphilis or asymptomatic neurosyphilis . Three doses of benzathine penicillin did not have a significantly higher relapse rate and may provide appropriate therapy, at least for documented latent syphilis in persons co-infected with HIV . Studies comparing ceftriaxone with 10 to 14 doses of procaine penicillin are needed to determine the most cost-effective treatment for asymptomatic neurosyphilis or presumed latent syphilis in this group of patients. South Med J, 1992 Nov, 85(11), 1138 - 9 Disseminated infection due to Mycobacterium chelonei; Morris JT et al.; We have presented a case of M chelonei subsp abscessus in an immunocompromised patient . The patient was given antimicrobial therapy, to which the organism appeared sensitive for 4 weeks, but he died because of other medical problems . Repeated negative blood cultures for mycobacteria after the initiation of therapy and a careful postmortem examination suggested that the antimicrobial therapy was effective. J Bacteriol, 1992 Nov, 174(22), 7428 - 35 Microcin 25, a novel antimicrobial peptide produced by Escherichia coli; Salomon RA et al.; Microcin 25, a peptide antibiotic excreted by an Escherichia coli strain isolated from human feces, was purified to homogeneity and characterized . Composition analysis and data from gel filtration indicated that microcin 25 may contain 20 amino acid residues . It has a blocked amino-terminal end . Microcin synthesis and immunity are plasmid determined, and the antibiotic was produced in minimal medium when the cultures entered the stationary phase of growth . The peptide appears to interfere with cell division, since susceptible cells filamented when exposed to it . This response does not seem to be mediated by the SOS system. J Am Vet Med Assoc, 1992 Nov 1, 201(9), 1378 - 84 Milk antimicrobial drug residue assay results in cattle with experimental, endotoxin-induced mastitis; Tyler JW et al.; Antimicrobial drug residue testing was performed on milk samples obtained from 8 cows with experimental endotoxin-induced mastitis, using 4 commercially available assay kits . Although none of the cows in the study received antimicrobials, only 1 of the 4 assay procedures, assay C, had consistently negative results (specificity = 1.00) . The proportion of positive assay results varied from 0 to 1.00 among combinations of sampling time, sample status (endotoxin-infused quarter vs composite noninfused sample) . The proportion of positive results found when assay C was used (0) differed significantly from the proportion found when the 3 other assays were used . The proportion of positive results did not differ significantly between assay A (0.45) and assay B (0.48); however, both assays had a significantly lower proportion of positive assays than did assay D (0.86) . Logistic regression models were developed predicting positive milk antimicrobial drug residue assay results as a function of assay kit, sample status, and time interval following experimental challenge exposure . Using assay A as a baseline risk, assay B and assay D were more likely to have positive assay results, and assay C had a decreased risk of positive assay results . Milk samples from endotoxin-infused quarters were at increased risk for positive assay results, compared with noninfused composite samples . Samples collected from endotoxin-infused quarters or control quarters were at increased risk for positive assay results following the intramammary infusion of endotoxin . Our findings suggest that specificity of milk antimicrobial drug residue assays varies greatly among assay kits and that intramammary inflammation may increase the proportion of false-positive assay results. Exp Parasitol, 1992 Nov, 75(3), 353 - 60 Nitric oxide-mediated cytostatic activity on Trypanosoma brucei gambiense and Trypanosoma brucei brucei; Vincendeau P et al.; Macrophages collected from BCG-infected mice or exposed in vitro to interferon-gamma plus lipopolysaccharide developed a cytostatic activity on Trypanosoma brucei gambiense and Trypanosoma brucei brucei . This trypanostatic activity of activated macrophages was inhibited by addition of N-monomethyl-L-arginine, an inhibitor of the L-arginine-nitric oxide (NO) metabolic pathway, indicating a role for NO as the effector molecule . Contrary to trypanosomes treated with N2gas, trypanosomes treated with NO gas did not proliferate in vitro on normal macrophages . Compared to mice infected with control parasites, mice infected with NO-treated parasites had decreased parasitemias in the first days postinfection and had a prolonged survival . Addition of excess iron reversed the trypanostatic effect of both activated macrophages and NO gas . These data show that activated macrophages exert an antimicrobial effect on T.b . gambiense and T.b . brucei through the L-arginine-NO metabolic pathway . In trypanosomes, NO could trigger iron loss from critical targets involved in parasite division . The participation of this effector mechanism among the other immune elements involved in the control of African trypanosomes (antibodies, complement, phagocytic events) remains to be defined. Emerg Med Clin North Am, 1992 Nov, 10(4), 753 - 66 The rational use of antimicrobial agents in simple wounds; Rodgers KG; The wounds in most patients presenting to the Emergency Department will heal uneventfully and do not require the use of antimicrobial agents . Specific indications for antimicrobial use include simple wounds in patients with lymphedema, orthopedic prostheses, or in those patients prone to bacterial endocarditis . Relative indications include high-risk wounds in compromised hosts, wounds contaminated with feces, saliva, or vaginal secretions, or wounds clinically infected at the time of presentation . More important than antimicrobial administration is the commitment to aggressive, timely wound care . Pitfalls in therapy center around the injudicious use of antimicrobial agents . Such therapy does not give the physician permission to close wounds that should be left open or to give less than optimal wound care . Physicians should be keenly aware of the fact that antimicrobial use is not innocuous . The economic burden and potential for adverse side effects must be weighed against the fact that the wounds in 90% to 95% of patients presenting to the Emergency Department will heal without the use of antimicrobial agents. Emerg Med Clin North Am, 1992 Nov, 10(4), 719 - 36 Emergency management of dog and cat bite wounds; Dire DJ; Most dog and cat bite injuries are minor wounds that require only local wound care as well a patient evaluation for tetanus and rabies postexposure immunoprophylaxis . For larger wounds, primary or delayed primary closure can be performed safely where indicated . When antimicrobial agents are necessary, inexpensive penicillins or cephalosporins are adequate for initial therapy . Large-scale, prospective, controlled clinical studies are needed to define further the role of prophylactic antimicrobial therapy for uninfected wounds. Emerg Med Clin North Am, 1992 Nov, 10(4), 655 - 63 Current and future trends in wound healing; Howell JM; New adjuncts to outpatient wound care focus on diminishing infection rates and improving the speed and effectiveness of laceration repair . This article provides an overview of growth factors, proteolytic enzymes, topical antimicrobial agents, and new materials that facilitate wound closure . Also, the pathophysiology of surface wound repair is summarized. Arch Otolaryngol Head Neck Surg, 1992 Nov, 118(11), 1159 - 63 Ampicillin-sulbactam vs clindamycin in head and neck oncologic surgery . The need for gram-negative coverage; Weber RS et al.; This study was undertaken to assess whether gram-negative antimicrobial coverage is required in patients undergoing head and neck oncologic surgery . Ampicillin sodium-sulbactam sodium and clindamycin phosphate were compared in a prospective, randomized, parallel, double-blind trial of 212 patients undergoing head and neck procedures involving clean-contaminated wounds . Both antibiotics were given up to 1 hour before surgery and continued at 6-hour intervals after surgery for an additional eight doses . Fourteen infections occurred in the ampicillin-sulbactam-treated group (13.3%) and 29 infections in the clindamycin-treated group (27.1%) . From patients receiving clindamycin, 29 gram-negative organisms were isolated, compared with six from those patients receiving ampicillin-sulbactam . This finding supports the need for gram-negative coverage in patients undergoing clean-contaminated head and neck oncologic surgery. Obstet Gynecol, 1992 Nov, 80(5), 759 - 62 Expectant management of preterm ruptured membranes: effects of antimicrobial therapy; Christmas JT et al.; OBJECTIVE: To determine whether the addition of broad-spectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term . METHODS: Patients with preterm PROM before 34 weeks' gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups: 1) expectant management alone and 2) expectant management plus antimicrobial therapy . Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days . Other than antibiotic use, management of the two groups was identical . RESULTS: Significantly more women (P < .01) treated with antibiotics (20 of 48, 42%) remained undelivered 7 days after admission compared with those managed expectantly without antibiotics (seven of 46, 15%) . In addition, more neonates in the group managed with antibiotics were admitted to the routine nursery (nine of 48 versus two of 45; P = .03) . However, there was no difference between the groups in the frequency of serious maternal or neonatal morbidity . CONCLUSIONS: The addition of broad-spectrum antimicrobial therapy to traditional expectant management of pregnancy complicated by preterm PROM may increase the number of gestations undelivered 7 days after admission . It may also decrease the proportion of infants admitted to special care nurseries . Whether these effects result in significant short- or long-term maternal or neonatal benefit remains to be determined. Med Clin North Am, 1992 Nov, 76(6), 1449 - 61 Sexually transmitted diseases and travelers; Parenti DM; Sexually active travelers are at risk for a variety of STDs, including traditional venereal infections such as gonorrhea, chlamydial urethritis, syphilis, chancroid, and herpes simplex infection . More recently, hepatitis B, hepatitis C, and HIV-1 have also been described . Risk varies depending on the geographic area of travel and the type of sexual contact . Physicians should be aware of the prevalence of antimicrobial resistance of N . gonorrhoeae and H . ducreyi because this will affect empiric antibiotic therapy . Prevention should focus on proper and consistent usage of barrier contraceptives. Med Clin North Am, 1992 Nov, 76(6), 1357 - 73 Travelers' diarrhea . Prevention and treatment; Okhuysen PC et al.; Travelers' diarrhea affects almost half of all travelers from developed to developing nations . Its occurrence frequently alters planned activities . Enterotoxigenic Escherichia coli and other bacterial pathogens endemic to the area visited account for the majority of pathogens isolated . Newer research technologies are assisting in defining virulence properties and epidemiologic characteristics . Prudence exercised during travel remains the preferred mode of prevention, reserving antimicrobial prophylaxis for specific situations . Oral rehydration and early pharmacologic intervention with antimicrobial and antimotility agents significantly decrease length of illness when diarrhea occurs. J Infect Dis, 1992 Nov, 166(5), 1097 - 102 Phagolysosomal alkalinization and the bactericidal effect of antibiotics: the Coxiella burnetii paradigm; Maurin M et al.; Most infections due to intracellular bacteria respond poorly to antibiotic treatment . The chemical conditions within the subcellular site of bacteria may change antibiotic activity . Coxiella burnetii multiplies within phagolysosomes . The antimicrobial activity of antibiotics combined with the lysosomotropic agents amantadine (1 microgram/mL), chloroquine (1 microgram/mL), and ammonium chloride (1 mg/mL), which alkalinized Coxiella burnetii-containing phagolysosomes from pH 4.8 to 5.3, 5.7, and 6.8, respectively, was evaluated . Percentages of residual viable bacteria (RVB) in cell cultures were significantly reduced after exposure to combinations of doxycycline (4 micrograms/mL) with amantadine (RVB = 18.2% +/- 8.7%, P < .05), chloroquine (RVB = 0.64% +/- 0.38%, P < .01), or ammonium chloride (RVB = 0.29% +/- 0.17%, P < .01); the same was seen with pefloxacin (1 microgram/mL) with chloroquine (RVB = 27.6% +/- 10.8%, P < .05) or ammonium chloride (RVB = 3.72% +/- 1.1%, P < .05) . Such bactericidal activity correlated with increased phagolysosomal pH, as determined by Pearson's correlation coefficient, suggesting that phagolysosomal alkalinization is critical for the bactericidal effect of antibiotics. Brain Inj, 1992 Nov-Dec, 6(6), 521 - 7 Antimicrobial prophylaxis for fractured base of skull in children; Ash GJ et al.; The details are reviewed of 50 children who were treated over a 10-year period with clinical signs of fractured base of skull . Two patients died early without signs of sepsis--due to the severity of their head injuries . Of the remainder, 23 received antibiotic prophylaxis and 25 did not . One patient from each of these groups developed pneumococcal meningitis, and they were successfully treated . Our results correlate well with those previously published, confirming the low incidence of infective complications with or without prophylaxis . The need to assemble a large enough series to make statistically significant conclusions regarding this infrequent condition is highlighted throughout the literature, which is reviewed here. Biotechnology (N Y), 1992 Nov, 10(11), 1436 - 45 Emerging strategies for enhancing crop resistance to microbial pathogens; Lamb CJ et al.; There are marked differences in the pattern of host gene expression in incompatible plant:microbial pathogen interactions compared with compatible interactions, associated with the elaboration of inducible defenses . Constitutive expression of genes encoding a chitinase or a ribosome-inactivating protein in transgenic plants confers partial protection against fungal attack, and a large repertoire of such antimicrobial genes has been identified for further manipulation . In addition, strategies are emerging for the manipulation of multigenic defenses such as lignin deposition and synthesis of phytoalexin antibiotics by overexpression of genes encoding rate determining steps, modification of transcription factors or other regulatory genes, and engineering production of novel phytoalexins by interspecies transfer of biosynthetic genes . The imminent cloning of disease resistance genes, further molecular dissection of stress signal perception and transduction mechanisms, and identification of genes that affect symptom development will provide attractive new opportunities for enhancing crop protection . Combinatorial integration of these novel strategies into ongoing breeding programs should make an important contribution to effective, durable field resistance. Antimicrob Agents Chemother, 1992 Nov, 36(11), 2468 - 72 Change of glutamic acid to lysine in a 13-residue antibacterial and hemolytic peptide results in enhanced antibacterial activity without increase in hemolytic activity; Sitaram N et al.; A 13-residue peptide corresponding to a hydrophobic segment of the antimicrobial 47-residue peptide seminalplasmin, PKLLETFLSKWIG (SPF), has been shown to have antibacterial and hemolytic activities (N . Sitaram and R . Nagaraj, J . Biol . Chem . 265:10438-10442, 1990) . In an effort to get an insight into the structural and charge requirements for these biological activities, an analog of SPF in which Glu has been replaced with Lys has been synthesized and its antibacterial and hemolytic properties have been examined . It has been demonstrated that the analog, SPFK, exhibits potent antibacterial activity at concentrations at which hemolysis does not occur. Antimicrob Agents Chemother, 1992 Nov, 36(11), 2408 - 12 Sparfloxacin, ethambutol, and cortisol receptor inhibitor RU-40 555 treatment for disseminated Mycobacterium avium complex infection of normal C57BL/6 mice; Perronne C et al.; Sparfloxacin (50 mg/kg of body weight given subcutaneously each day), alone or in combination with ethambutol (50 mg/kg given subcutaneously each day), was examined for its therapeutic efficacy against experimental infection induced with the Mycobacterium avium complex in normal C57BL/6 mice . In addition, the potential anti-infective role of RU-40 555 (100 mg/kg given intraperitoneally each day), a drug that inhibits the cortisol receptors, was examined in the same model . Treatments were started 24 h after intravenous bacterial challenge and were continued for 21 days . Compared with controls, sparfloxacin or ethambutol decreased the CFU counts in spleens and lungs (P < 0.001) . The sparfloxacin plus ethambutol combination was more effective than sparfloxacin alone in spleens (P < 0.001) but not in lungs . The sparfloxacin plus ethambutol plus RU-40 555 combination was more effective than the sparfloxacin plus ethambutol combination in spleens and lungs (P < 0.001) . Thus, in this model, RU-40 555 enhanced the antibacterial activities of the antibiotics tested . Results of the study showed that normal C57BL/6 mice infected with the M . avium complex can be used for the evaluation of antimicrobial agents. J Antibiot (Tokyo), 1992 Nov, 45(11), 1785 - 91 The in vitro profile of selected 14-membered azalides; Jones AB et al.; The in vitro antimicrobial potency of 10-aza-9-deoxo-11-deoxyerythromycin A, the first member of a new class of macrolide antibiotic, was determined . Several other members of this family of azalide were prepared and similarly screened in order to begin to define the antibiotic potential of the class . The results indicate that the SAR for this structural type parallels that of other macrolides and that it offers no apparent benefit over known 15-membered azalides. J Am Vet Med Assoc, 1992 Nov 1, 201(9), 1388 - 90 Treatment of opportunistic mycobacterial infections with enrofloxacin in cats; Studdert VP et al.; Marked improvement was observed in the condition of 6 cats with opportunistic mycobacterial infections during treatment with enrofloxacin, a fluoroquinolone antibiotic . Complete remission was achieved in 3 cats after 3 to 7 weeks of treatment . The other 3 cats were euthanatized after 1 to 2 weeks of treatment for reasons not related to the treatment . Lesions did not recur within the follow-up period, which ranged from 9 to 16 months . Treatment of opportunistic mycobacterial infection in cats is complicated because many mycobacteria are resistant to antituberculosis drugs, which also can be toxic to cats, and because results of susceptibility testing with other antimicrobials do not always correlate with clinical response . Often, neither satisfactory nor long-term response is observed in cats treated surgically or with the antibiotics currently recommended . These findings suggested that enrofloxacin is effective in the treatment of infections caused by Mycobacterium smegmatis and M fortuitum var fortuitum in cats. Nippon Rai Gakkai Zasshi, 1992 Nov, 61(3), 157 - 64 Evaluation of BACTEC 460 TB system for measurement of in vitro anti-Mycobacterium leprae activity of various antimicrobials; Tomioka H et al.; In vitro anti-leprosy activities of various antimicrobials were measured by using the BACTEC 460 TB System . The Growth Index reducing activities of test drugs were strong in clofazimine, KRM-1648, rifabutin, clarithromycin and rifampicin; intermediate in sparfloxacin, minocycline and ofloxacin; and weak in ciprofloxacin, fleroxacin and DDS . Amikacin, pipemidic acid, enoxacin and norfloxacin had no such in vitro activities . There is a close correlation between in vitro and in vivo anti-M . leprae activities of a given agent, therefore indicating usefulness of the BACTEC 460 TB System in evaluation of in vitro anti-M . leprae activity of a given agent. Antibiot Khimioter, 1992 Nov, 37(11), 43 - 6 {Methods of local antimicrobial therapy and prevention of postpartum endometritis}; Solomatina LM et al.; To increase the effect of the treatment of puerperal endometritis, long-term washing of the uterus cavity with cool solutions of furacillin was used in 57 puerpera . The most favourable results were observed in 27 patients who at the final stage of the washings were treated with antibiotic solutions administered to the uterus cavity . The recovery terms, as well as the terms of the hospitalization lowered . For confirming the diagnosis of endometritis and control of the therapy efficacy cytograms of the metroaspirates were used . High efficacy of the prophylactic administration of antibiotics to the myometrium tissues during the cesarean section with high risk of infectious complications was also shown . Both the methods were recommended for their wide use in obstetric hospitals. Indian Pediatr, 1992 Nov, 29(11), 1413 - 7 Acquired immunodeficiency syndrome (AIDS) with lymphocytic interstitial pneumonitis (LIP) in a multi transfused child with thalassemia major; Sen S et al.; PIP: The case of a 10.5-year-old girl, who was diagnosed with a case of thalassemia major at the age of 8 months and had been on regular blood transfusions since then, is related . Donor screening for HIV was started in mid-1988, thus she had received unscreened blood for a number of years . In February 1991, she presented with a dry persistent cough, moderate grade continuous fever, and breathlessness on exertion for over 2 weeks . Chest X-ray showed bilateral infiltrations . She was put on penicillin and chloramphenicol with a provisional diagnosis of bronchopneumonia . In March 1991, she had to be hospitalized for impending respiratory failure . After treatment with intravenous fluids and parenteral antimicrobials, her condition stabilized and she was discharged . In April 1991, she was readmitted because of complaints of difficulty in swallowing and weight loss . Her chest signs had persisted and she had developed oropharyngeal candidiasis with ulcerations . She also had alopecia, a generalized lymphadenopathy, digital clubbing, and bilateral parotid enlargement . Candidiasis responded to vigorous therapy with clotrimazole . Fine needle aspiration of lymph node showed a reactive hyperplasia . HIV antibodies were detected in the serum with ELISA and confirmed by Western blot . Immunologic tests showed evidence of severe immunodeficiency . The Multitest CMI, which simultaneously tests delayed skin hypersensitivity to seven common recall antigens, was totally nonreactive . She was classified as having AIDS according to World Health Organization criteria for children under 13 years of age . The diagnosis of lymphocytic interstitial pneumonitis (LIP) was also made based on the symptoms . Oral prednisolone was given 2 mg/kg/day in 3 divided doses for a month . The cough and dyspnea showed great improvement and the parotid swellings disappeared; lymphadenopathy, clubbing, and alopecia, however, persisted . The child was kept on maintenance therapy of prednisolone and on alternate day co-trimoxazole for prophylaxis against Pneumocystis carinii infection . Izv Akad Nauk Ser Biol, 1992 Nov-Dec, (6), 854 - 9 {The antimicrobial proteins and peptides of neutrophilic leukocytes}; Rogovin VV et al.; Findings suggesting a vast variety of non-enzymic cationic proteins and peptides in human and animal leucocytes are reported . These cationic proteins and peptides demonstrate their antimicrobial and cytotoxic properties due to their detergent characteristics and their capacity to change the permeability of cellular wall and membrane by electrostatic interactions . Information on their homology with some serine proteases is presented. Izv Akad Nauk Ser Biol, 1992 Nov-Dec, (6), 835 - 43 {The peroxisomes of eosinophilic leukocytes}; Murav'ev RA et al.; Functional properties of peroxidase-containing granules (peroxidasosomes) of eosinophiles are discussed . Findings are reported on the activities of peroxidase systems and of non-enzymic cationic proteins which occur in the eosinophilic peroxidasosomes in normal state and in various pathological states as well as their antimicrobial and antiparasitic activities. Trans R Soc Trop Med Hyg, 1992 Nov-Dec, 86(6), 683 - 5 Septicaemic melioidosis: a review of 50 cases from Malaysia; Puthucheary SD et al.; Fifty cases of septicaemic melioidosis were reviewed . There was a preponderance of disease among males (male:female ratio 3.2:1) and those aged over 30 years . The presenting clinical features were very varied and not pathognomonic, ranging from fever, cough and septicaemia to fulminant septicaemia and shock . Pulmonary involvement was recorded in 58% of the patients . Skin and soft tissue sepsis was seen in 24%, but many had signs and symptoms of multiorgan involvement . Associated underlying illness was identified in 76% of patients, diabetes mellitus being the commonest (38%), while 34% had more than one predisposing factor . The mortality of 65% in our series is a reflection of the less than satisfactory status of the diagnosis and therapy of septicaemic melioidosis . Only 24% of our patients received appropriate empirical antibiotic therapy . A high index of suspicion of melioidosis in endemic areas and the use of appropriate empirical antimicrobial therapy would be a step towards reducing the high mortality rate. J Trauma, 1992 Nov, 33(5), 679 - 82 Treatment of intra-abdominal infection with granulocyte colony-stimulating factor; O'Reilly M et al.; Polymicrobial infection is a significant cause of mortality in critically ill patients . Antibiotics and surgical intervention are useful but limited in their effectiveness for combating mixed infections . New prophylactic and therapeutic approaches are required to improve survival in critically ill patients . Neutrophils are a known primary host defense mechanism against bacterial infection . We evaluated the use of a neutrophil growth factor, recombinant human granulocyte colony-stimulating factor (G-CSF), to improve survival in a well-established sepsis model, cecal ligation and puncture (CLP) . When administered beginning 4 days before CLP with injections continuing for 14 days after CLP, mice that received 10, 100, or 1000 ng of G-CSF had significantly improved survival compared with the control group . When treatment began at the time of CLP and continued for 7 days after CLP, G-CSF treatment resulted in a dose-dependent improvement in survival in groups that received 100, 500, or 1000 ng . The interaction of G-CSF and conventional antimicrobial therapy was evaluated by administration of G-CSF plus gentamicin . Mice received 100 ng of G-CSF beginning on day 1 before CLP with injections continuing for 3 days after CLP . Gentamicin-treated mice received a single 15 mg/kg injection of gentamicin at the time of CLP . Mice that received G-CSF alone or gentamicin alone had significantly improved survival compared with controls . Mice that received G-CSF plus gentamicin had improved survival compared with control mice and compared with mice that received G-CSF alone but not compared with mice that received gentamicin alone.(ABSTRACT TRUNCATED AT 250 WORDS) Biochem Biophys Res Commun, 1992 Oct 30, 188(2), 767 - 72 Tetracyclines inhibit intracellular muscle proteolysis in vitro; Schneider BS et al.; Tetracycline antibiotics (TETs) have a recently discovered novel action: inhibition of extracellular metalloproteinase activity, especially that of collagenase and gelatinase . This property, now confirmed in 8 different laboratories using > 40 tissue sources, includes natural and semi-synthetic TETs as well as a chemically modified TET (CMT) devoid of antimicrobial activity . We have used 14C-Tyr biosynthetically labelled intracellular proteins in L-6 myoblast culture as a test system to assess intracellular proteolysis . Starvation accelerates proteolysis, which can be suppressed by agents such as insulin or serum . Minocycline, doxycycline, and CMT all retarded the rate of intracellular protein degradation in a dose dependent manner . These agents also demonstrated marked synergism with insulin . A CMT derivative (pyrazole) stripped of one of its metal chelation sites and lacking anti-collagenase activity, also lost its antiproteolytic effect . CMT at physiologic concentrations (< or = 5 micrograms/ml) had no effect on protein synthesis, but at 15 micrograms/ml (pharmacologic), a suppressive effect was noted . These findings demonstrate that TETs can inhibit protein degradation as well as synthesis in a mammalian muscle-derived cell line. J Med Chem, 1992 Oct 30, 35(22), 4205 - 13 Fluoronaphthyridines and -quinolones as antibacterial agents . 5 . Synthesis and antimicrobial activity of chiral 1-tert-butyl-6-fluoro-7-substituted-naphthyridones; Di Cesare P et al.; A series of novel 7-substituted-1-tert-butyl-6-fluoronaphthyridone-3- carboxylic acids has been prepared . These derivatives are characterized by chiral aminopyrrolidine substituents at the 7 position . In this paper we report the full details of the asymmetric synthesis of this series of compounds . Structure-activity relationship studies indicate that the absolute stereochemistry at the asymmetric centers of the pyrrolidine ring is critical for maintaining good activity . Compounds 60 and 61 (3-amino-4-methylpyrrolidine enantiomers) were selected for preclinical evaluation. J Med Chem, 1992 Oct 30, 35(22), 4054 - 60 Synthesis and antibacterial activity of a series of basic amides of teicoplanin and deglucoteicoplanin with polyamines; Malabarba A et al.; Basic carboxamides of teicoplanin A2 (CTA) and its aglycon (TD) are prepared by condensation of the 63-carboxyl function of these antibiotics with linear or branched polyamines . The antimicrobial activities of some of the resulting compounds were better than those of the unmodified antibiotics . The presence of more than one basic group in the amidic chain enhanced the in vitro activity of some TD-amides against Gram-negative bacteria; two of these derivatives were also effective in vivo against Escherichia coli septicemia in the mouse . Among the CTA derivatives, the amide with spermine showed some unexpected in vitro activity against Gram-negatives . Both CTA- and TD-amides with polyamines are very soluble in water over a wide range of pH and are very hydrophilic. Dis Mon, 1992 Oct, 38(10), 691 - 764 AIDS: Part II; Kessler HA et al.; Great strides have been made in the therapy of human immunodeficiency virus (HIV) infection . Currently approved drugs include zidovudine and didanosine . A third drug, dideoxycytidine (zalcitibine), has recently been filed for approval with the Food and Drug Administration . All these drugs work through inhibition of the reverse transcriptase enzyme . Zidovudine is the only drug that has shown clinical efficacy against HIV . Treatment of patients with advanced HIV disease (i.e., acquired immune deficiency syndrome {AIDS} or symptomatic infection with < 200 CD4+ lymphocytes per mm3), results in a prolongation and improved quality of life . Zidovudine is the only antiretroviral agent approved for the treatment of asymptomatic patients . Early intervention with zidovudine has been shown to delay progression to AIDS when patients' CD4+ lymphocyte counts decline to less than 500/mm3, irrespective of clinical signs or symptoms of HIV infection . Didanosine is currently indicated for the treatment of patients with advanced HIV disease who are intolerant to or failing zidovudine therapy . The major toxicity of zidovudine is bone marrow suppression with anemia and granulocytopenia (which occurs in from 1% to 45% of patients, depending on the clinical stage of disease and the dose of the drug) . Didanosine and zalcitibine have both been associated with a severe peripheral neuropathy, which is generally reversible on cessation of the drug . In addition, didanosine has been implicated as a cause of pancreatitis that has been fatal in a small percentage of cases . The toxicities of didanosine and zalcitibine range from 1% to 10%, depending on dose, duration of therapy, and the presence of underlying HIV-related peripheral neuropathy or a previous history of pancreatitis . The clinical hallmark of HIV infection is the development of opportunistic infections and malignancies, which are a consequence of the profound immunodeficiency . The risk of an opportunistic infection increases significantly as the T-helper lymphocyte count declines to less than 20%, or 200 to 250/mm3 . The spectrum of opportunistic infections ranges from viruses to protozoa . Patients with advanced HIV disease are also at increased risk of infection with nonopportunistic, community-acquired pathogens . Primary and secondary prophylaxis against the most common AIDS-defining opportunistic infection, Pneumocystis carinii pneumonia, is now recommended . Studies are currently underway to determine the efficacy of prophylaxis against other opportunistic pathogens . Treatment of opportunistic infections associated with AIDS has improved significantly over the past 5 years as new drugs and combination regimens of antimicrobials have been developed.(ABSTRACT TRUNCATED AT 400 WORDS) Boll Chim Farm, 1992 Oct, 131(9), 335 - 8 A non-antibiotic antimicrobial mixture (C31G): evaluation of the antimicrobial efficiency of C31G on vaginal cultures; Calis S et al.; Minimum inhibitory concentrations and the effective period for cidal concentrations of an amphoteric surfactant mixture (C31G) were determined on 13 microorganisms (common bacteria, strains ATCC, and fungi) by microtiter dilution procedure . Also the antimicrobial efficiency of this composition (C31G) was evaluated on 105 culture samples which were obtained from (Turkish) patients having vaginal infections . E . coli was found to be the most frequently observed microorganism (45.45%) in these samples and C31G was determined to be active on microorganisms obtained from vagina at low concentrations in a short time. Boll Chim Farm, 1992 Oct, 131(9), 331 - 4 Novel pyrazolo {4,3-e} {1,4} diazepin-5,8-diones; Migliara O et al.; The synthesis of some pyrazolo {4,3-e} {1,4} diazepin-5,8-diones has been accomplished starting from the readily available 1-ethyl-3-methyl-4-nitro-5-pyrazolecarbonylchloride and the appropriate alpha-aminoesthers, 2a, b, c . The catalytic reduction of the obtained 3a, b, c gave the products 4a, b, c which were, in turn, cyclized into the title compounds 5a, b, c . The intermediates of type 3 and 4 and the pyrazolo-diazepin-diones 5 were tested in vitro for their antimicrobial activity. J Antimicrob Chemother, 1992 Oct, 30(4), 417 - 27 The quinine connection; Greenwood D; Quinine, an alkaloid derived from the bark of the cinchona tree was brought to Europe from Peru in the 17th century . Isolation of quinine and other cinchona alkaloids was achieved in France in the early part of the 19th century and uncertainties of supply of the bark stimulated efforts to synthesize quinine . While attempting synthesis, the young chemist, William H . Perkin, stumbled on mauve purple, the first aniline dye . Use of dyes in histopathology and the infant specialty of medical microbiology established the reputation of Paul Ehrlich, and partial success with the use of dyes in trypanosomiasis and malaria encouraged the German dye industry to pursue these substances as antimicrobial agents . By good fortune, this led to the discovery of the sulphonamides by Gerhard Domagk in the mid-1930s, an event that stimulated much other work and may have influenced the development of antibiotics. Eur J Clin Microbiol Infect Dis, 1992 Oct, 11(10), 908 - 11 A case of disseminated Mycobacterium marinum infection in an immunocompetent patient; Vazquez JA et al.; An unusual case of Mycobacterium marinum cutaneous infection is described . As a result of marked delay in the diagnosis, extensive local inflammation and destructive osteomyelitis occurred together with cutaneous dissemination in an immunocompetent host . Pathologic fractures in the infected bone necessitated amputation of the involved digit . The most striking feature of this case was the development of multiple widespread cutaneous lesions for several months following amputation of the infected digit and initiation of appropriate antimicrobial therapy . These new cutaneous lesions may reflect local immune and inflammatory reactions to previously disseminated microorganisms. Wei Sheng Wu Xue Bao, 1992 Oct, 32(5), 353 - 8 {Isolation and characterization of mutactimycin-producing mutant}; Li H et al.; Natural non-antibiotic producing Streptomyces sp . 1254 was mutagenized by UV irradiation and two active mutants were isolated . Mutant 113 produced novel anthracycline compounds designated mutactimycins . Mutactimycin A was active against the bacteriophage of Bac . subtilis and some viruses in tissue culture . The mutant 2-6 synthesized a basic water-soluble antimicrobial antibiotic . Chemical analysis of the whole cell hydrolysate and the morphological characterization showed that the strain 1254 and its mutant 2-6 were of chemotype I, belonging to the genus of Streptomyces, and the mutant 113 was of chemotype IV without mycolic acid . Co-synthesis test of strain 1254 and a blocked mutant of strain 113 gave the active compounds identical with mutactimycins . Using the actI gene as a probe, the Southern hybridization revealed homology between the actinorhodin polyketide biosynthase gene and the total DNA of the strain 1254 . Based on these data it was deduced that Streptomyces sp . 1254 should have a biosynthesis pathway for mutactimycin, but some of its genes might fail in expression and mutagenesis would make the silent gene(s) active. Pharmazie, 1992 Oct, 47(10), 773 - 6 Reactivity and microbiological activity of 2-methyl-3-carboethoxy-5-pyrrolinone derivatives; Lovren F et al.; This work describes the synthesis of 2-methyl-3-carboethoxy-5-pyrrolinone which was then allowed to react with aromatic aldehydes, nitromethines, benzendiazonium salts, hydrazine and amines . Several of the products have shown good results in preliminary antimicrobial and antifungal tests. Jpn J Antibiot, 1992 Oct, 45(10), 1282 - 94 {A clinical study of combined therapy of aspoxicillin and ceftazidime on intractable respiratory infections}; Yamaki K et al.; Both aspoxicillin (ASPC) and ceftazidime (CAZ) were administered together to 55 patients with intractable respiratory tract infections . ASPC and CAZ were administered at daily doses of 4 g and 2 to 4 g, respectively . Clinical effects were excellent in 11 cases, good in 33, fair in 7 and poor in 4, thus the efficacy rate was 80.0% . Bacteriologically, identified organisms were eradicated in 14 cases out of 21, decreased in 3, exchanged in 2 and unchanged in 2 . The eradication rate was 76.2% . As a side effect, diarrhea was found in only one case, and abnormal laboratory test values were observed in 4 cases . However, these adverse reactions were not severe, therefore it was possible to continue the chemotherapy . These results indicate that the combination antimicrobial chemotherapy of ASPC and CAZ is effective against intractable respiratory tract infections. Can J Microbiol, 1992 Oct, 38(10), 1084 - 8 Antimicrobial activity of 2-aminophenoxazin-3-one under anaerobic conditions; Atwal AS et al.; Potential toxicity of 2-aminophenoxazin-3-one to 20 bacterial species and two fungi and its inactivation under anaerobic conditions were investigated . Minimum inhibitory concentration for cellulolytic bacteria was in the range of 50-100 micrograms.mL-1, but at 100 micrograms.mL-1 of 2-aminophenoxazin-3-one, there was no effect on the growth of any of the noncellulolytic bacteria . Four noncellulolytic bacterial strains showed no inhibition of growth, even at 200 micrograms.mL-1 of this compound . Under anaerobic conditions and in the presence of cysteine, the long wavelength absorption band of this compound slowly shifted from about 434 to 320 nm, and its inhibitory effect on RNA synthesis was relieved after one-half of a generation time in cultures of cellulolytic ruminal bacteria . A similar shift of absorption band was observed in rumen fluid filtered through a 0.22-microns Millipore filter . It was concluded that protonation of 2-aminophenoxazin-3-one under anaerobic conditions present in the rumen would considerably reduce its potential toxicity to cellulolytic bacteria. J Antibiot (Tokyo), 1992 Oct, 45(10), 1633 - 44 Synthesis and biological activity of O56-substituted carboxyesters and carboxamides of teicoplanin aglycone; Seneci P et al.; A series of O56-substituted carboxyester or carboxyamide derivatives of deglucoteicoplanin (TD) was prepared by condensation of the 56-hydroxyl function with various alkylating agents of general formula RBr, where R represents functional groups with different physico-chemical properties . The modifications at position 56 influenced the antimicrobial activity of the new derivatives; activity depended on the structure of various R groups, their ionic properties, and their steric hindrance . The activity of the new compounds did not show any significant improvement when compared with TD . The physico-chemical and antibacterial properties of the synthesized compounds are reported. J Antibiot (Tokyo), 1992 Oct, 45(10), 1573 - 9 Eurystatins A and B, new prolyl endopeptidase inhibitors . I . Taxonomy, production, isolation and biological activities; Toda S et al.; Eurystatins A and B, were isolated from the cultured broth of Streptomyces eurythermus R353-21 . They showed specific and potent inhibitory activity against prolyl endopeptidase and did not show antimicrobial activity . No lethal toxicity was observed for the two compounds after ip administration in mice at 200 mg/kg. Yakugaku Zasshi, 1992 Oct, 112(10), 723 - 8 {Synthesis and antimicrobial properties of 3-O-alkyl and 3-O-haloalkyl-D-glucoses}; Yago K et al.; A series of 3-O-alkyl and 3-O-haloalkyl-D-glucoses were prepared from 1,2:5,6-di-O-isopropylidene-alpha-D-glucofuranose and their antibacterial activities were evaluated . The compounds with C12 and C14-alkyl chains were the most effective in vitro antibacterial screening, among 3-O-alkyl and 3-O-haloalkyl derivatives . The 3-O-alkyl derivatives were more effective than 3-O-haloalkyl derivatives. Chem Pharm Bull (Tokyo), 1992 Oct, 40(10), 2707 - 11 Synthesis and biological activity of 5'-aminobenzoxazinorifamycin derivatives; Yamane T et al.; Benzoxazinorifamycin reacted with various secondary amines to yield various 5'-substituted aminobenzoxazinorifamycin derivatives . The derivatives exhibited potent activities against gram-positive bacteria and mycobacteria . The antimicrobial activities of these compounds against Mycobacterium tuberculosis and Mycobacterium intracellulare were superior to those of rifampicin . Some of these compounds showed good plasma levels after oral administration in rats. Cesk Epidemiol Mikrobiol Imunol, 1992 Oct, 41(5), 281 - 4 {Isolation of Nocardia asteroides using hemoculture (clinical report)}; Nyc O et al.; The authors describe the finding of Nocardia asteroides from a haemoculture in a patient with right-sided pneumonia and several predisposing factors (TB, chronic bronchitis, anamnestic hepatitis, chronic hepatopathy, anaemia, ethylism and a neoplasm revealed in the final stage) . Early bacteriological diagnosis and aimed antimicrobial therapy led to radical improvement of the very dramatic clinical condition . The authors discuss the possible higher incidence of the infectious agent, which previously was detected only very rarely. Zentralbl Hyg Umweltmed, 1992 Oct, 193(3), 237 - 52 {The determination of the discrepancy between the mathematically ascertained and experimentally provable efficiency of UV facilities for water disinfection}; Leuker G et al.; Using three UV-plants of different technical designs for water disinfection, we studied the conformity between experimental germ reduction using standard test organisms and calculated UV-doses under various water flow conditions . Taking into consideration the style of construction of the UV-plants, the irradiation area and the layer thickness were used as constant parameters for dose calculations . This was also employed for the irradiation intensity, since the experiments were performed for a relatively short period compared of the life span of the UV-irradiators . Both exposure time and water transmission were employed as variable parameters in the dose calculations and experimental procedures respectively . The calculated UV-dose and experimentally obtained germ reduction values were comparatively the same for two of the three UV-plants studied . However, no correlation was observed between the reduction of E . coli and the corresponding calculated UV-dose values . Therefore, the calculated UV-dose values for any given UV-plant should be considered to be relative and by no means absolute values . We are of the opinion that within a certain range of water flow rate and transmission, antimicrobial effectiveness of different UV-plants should be demonstrated independent of dose values, technical and other construction characteristics . The applicability of the UV-plants studied is discussed. Immun Infekt, 1992 Oct, 20(5), 168 - 72 {The role of antibiotics in the management of verotoxin-associated hemolytic anemia syndromes}; Bitzan M et al.; Significant improvements of dialysis techniques and the supportive treatment of the hemolytic uremic syndrome (HUS) during the last three decades do not veil the fact that causal therapy is not yet feasible . This holds true for the classic HUS associated with infections by verotoxin-(VT-)producing E.coli (VTEC) as for the majority of the much less frequent "atypical" forms . The influence of antimicrobial agents on production of verotoxins produced by clinical VTEC isolates was examined . Co-trimoxazole significantly increased the total yield of toxin . In contrast, ciprofloxacin, lincomycin and gentamicin caused significant reduction in toxin yields . The pathogenetic and therapeutic relevance of this finding is not yet known . Analysis of the clinical literature for the postulated relation between antibiotic treatment and development of HUS or its impact on the severity of the disease reveals a controversial picture . Based on the dynamics of the disease, the in vitro findings, and reports on unfavourable outcomes after treatment, it is concluded that antibiotics are not indicated in most cases of the enteropathic HUS or other VTEC infections . Antibiotic prophylaxis has neither been proven to be efficacious nor safe for the prevention of secondary cases during VTEC outbreaks . Apart from the implementations of hygienic measures, prospective studies on the role of antibiotics seem clearly warranted . Possible future strategies may include the design of immunological therapeutic concepts. Clin Investig, 1992 Oct, 70(10), 932 - 7 Q fever endocarditis: diagnostic approaches and monitoring of therapeutic effects; Peter O et al.; The scope of current diagnostic methods for Q fever endocarditis includes serology, direct demonstration of Coxiella burnetii in the resected heart valve tissue, and animal inoculation studies . Illustrated by a clinical case report, the different methods are presented and discussed . Serology represents the primary method, using the techniques of complement fixation, indirect immunofluorescence, and enzyme-linked immunosorbent assay (ELISA) . The latter two techniques allow the detection of immunoglobulins G, M, and A to the phase I and II antigens of C . burnetii . After cardiac surgery, we visualized C . burnetii on smears and specifically stained it on histologic sections of the resected heart valve by light and electron microscopic immunohistochemistry . In addition, seroconversion in animals after inoculation with valve specimens confirmed the presence of C . burnetii in the heart valve . The antibody titers determined by ELISA correlated well with the patient's clinical course during the treatment period . Therefore it is suggested that its usefulness for monitoring the efficacy of antimicrobial agents in patients with Q fever endocarditis should be further evaluated. Bol Med Hosp Infant Mex, 1992 Oct, 49(10), 659 - 65 {Treatment of children with acute diarrheal disease . Knowledge and attitudes of the health personnel}; Mota-Hernandez F et al.; Diarrheal diseases are still one of the most frequent causes of death due to dehydration in children; lack of information regarding the adequate treatment of diarrhea is the main cause . The results of an inquire sent to 620 physicians and nurses were analyzed to determine the knowledge and attitudes of the health care workers that reside in different diarrheal mortality areas in Mexico . The less professional experience time was correlated with more knowledge in etiology of diarrhea . More physicians than nurses had correct answers regarding the place of diarrheal diseases in child mortality and the correct use of antimicrobial, and other drugs and liquids to prevent and treat dehydration . Most workers did not know the inconvenience of hypertonic solutions to prevent dehydration and the importance of the oral solution flavor . This results suggest that nurses will, be included in clinical training by means of seminars in oral hydration therapy . Furthermore it seems convenient to increase the access to oral hydration solutions as well as the diffusion of its advantages. Nippon Yakurigaku Zasshi, 1992 Oct, 100(4), 301 - 5 {Effects of drugs on the convulsions induced by the combination of a new quinolone antimicrobial, enoxacin, and a nonsteroidal anti-inflammatory drug, fenbufen, in mice}; Hara Y et al.; The effects of drugs on the convulsions induced by the combination of a new quinolone antimicrobial, enoxacin, and a nonsteroidal anti-inflammatory drug, fenbufen, were studied in mice . The combination of enoxacin at 30 or 100 mg/kg, p.o . and fenbufen at 100 mg/kg, p.o . induced convulsions; and the mice died as a result of the convulsions . Pretreatment with either phenobarbital, phenytoin, valproic acid intraperitoneally, or morphine intravenously did not influence the convulsions . A high dose of diazepam or clonazepam prolonged the survival time, but could not prevent the mice from dying . After the occurrence of convulsions induced by enoxacin with fenbufen, administration of the excitatory amino acid antagonist MK-801 at 1 mg/kg, i.v . extended the survival time, even though all the mice died as a result of the convulsions . Simultaneous intravenous injections of MK-801 and diazepam suppressed the convulsions . This suppression was stronger than that produced by MK-801 or diazepam, injected separately . However, no mouse survived at the end . From these results, participation of both GABA-ergic and excitatory amino acidergic systems in the convulsions induced by enoxacin and fenbufen was discussed. Aust Dent J, 1992 Oct, 37(5), 368 - 73 Effect of gels containing stannous fluoride on oral bacteria--an in vitro study; Tseng CC et al.; The purposes of this investigation were to evaluate and compare the antimicrobial effect of (1) twelve 0.4 per cent stannous fluoride (SnF2) commercial products and (2) different concentrations of SnF2 (range = 0.02 to 3.28 per cent) . The antibacterial inhibitory effect of various SnF2 gels was evaluated as to their effectiveness against oral plaque bacteria including strains of S . mutans, S . sanguis, S . sobrinus, A . viscosus, A . actinomycetemcomitans, and B . intermedius . When twelve different commercial preparations of 0.4 per cent SnF2 were compared for inhibitory effect on plaque bacteria, several of the SnF2 preparations were significantly more effective in inhibiting oral bacteria (p < 0.05) . With increasing concentration of SnF2, there was a comparable increase in the inhibitory effect on the oral bacteria tested (r2 ranged from 0.867 to 0.996) . SnF2 at a concentration of 0.4 per cent had a similar antibacterial effect to 0.12 per cent chlorhexidine . This in vitro study demonstrated that certain SnF2 products are highly effective in inhibiting the growth of bacteria often found in plaque, and this inhibitory effect is directly related to the concentration of the SnF2. Antimicrob Agents Chemother, 1992 Oct, 36(10), 2197 - 200 Antimicrobial susceptibilities and beta-lactamase characterization of Capnocytophaga species; Roscoe DL et al.; Capnocytophaga species have been associated with a wide variety of infections in both immunocompetent and immunocompromised patients . On the basis of data from antimicrobial susceptibility studies, beta-lactam antibiotics have been considered efficacious therapy . Six of 19 isolates from primarily clinical sources across Canada demonstrated beta-lactamase production, and agar dilution susceptibility testing showed broad resistance to beta-lactam antibiotics . For the beta-lactamase producing isolates, clavulanate reduced the MIC of amoxicillin for 90% of the strains tested by 64-fold . Isolates were highly susceptible to clindamycin, imipenem, and ciprofloxacin . Characterization of the beta-lactamases produced by two of these isolates (Van1 and Van2) was performed . Isoelectric focusing revealed an identical isoelectric point of 5.6 for both enzymes, but they had markedly different relative hydrolysis efficiencies, and different conditions were required to extract the enzymes . This study demonstrates the production of different types of beta-lactamases by Capnocytophaga spp . and suggests the need to screen all clinical isolates of Capnocytophaga spp . for the presence of beta-lactamases. Antimicrob Agents Chemother, 1992 Oct, 36(10), 2080 - 4 CP-72,588, a semisynthetic analog of the polyether ionophore UK-58,582 with increased anticoccidial potency; Ricketts AP et al.; We have employed semisynthesis to enhance the anticoccidial potency of a polyether ionophore . CP-72,588 is the alpha-methyl analog of the fermentation-derived polyether ionophore UK-58,852 . The parent ionophore required a dose of 15 ppm to achieve anticoccidial efficacy in chickens equivalent to that of salinomycin at 60 ppm . CP-72,588 demonstrated substantially improved potency, with efficacy at 5 to 7.5 ppm . The intrinsic antimicrobial potencies of the two ionophores are similar; however, CP-72,588 was found in chicken tissues at higher levels than those of the parent ionophore when each was administered at the same dose (8 ppm) . The enhanced potency of CP-72,588 may be partially due to enhanced uptake into tissues. Am J Surg, 1992 Oct, 164(4A Suppl), 28S - 38S Cefotaxime is extensively used for surgical prophylaxis; Sader HS et al.; Cefotaxime, a broad-spectrum third-generation cephalosporin, has been extensively used worldwide for chemotherapy of serious infections . Based on the characteristics of its antimicrobial spectrum, low incidence of allergy, and lack of adverse effects, cefotaxime has been used successfully for prophylaxis of a number of different surgical procedures . Extensive data have been accumulated for single-dose or short-course cefotaxime prophylaxis regimens . These cefotaxime regimens have been demonstrated to be very effective and inexpensive . For this article, over 11,500 published cefotaxime prophylaxis cases are reviewed (10,500 control cases) and 98 references are cited . Single-dose cefotaxime was clearly indicated for hysterectomies, cesarean sections, upper gastrointestinal cases, bone and joint operations, biliary tract procedures, transurethral resections, open urologic surgeries, and some vascular procedures . Short-course (3-4 doses) may be required for colorectal resections, cardiac surgeries, head and neck surgeries, organ transplants, specific pediatric surgical cases, and for some patients with compromised immune function, regardless of origin . Cefotaxime has reduced wound morbidity of contaminated abdominal operations to < 10% . This change from multiple-dose regimens to the single-dose or short-course regimens, enabled by cefotaxime use, decreases the risk of inducing or selecting bacterial resistance; the change would generate a significant reduction in hospital costs . Surgeons should not hesitate to employ cefotaxime and other third-generation cephalosporins with proven limited-dose indications to greatly benefit their patients and the hospital environment. Ther Umsch, 1992 Oct, 49(10), 692 - 6 {Chronic bronchitis: when are antibiotics indicated?}; Gerber AU; The role of bacterial infections in chronic obstructive pulmonary diseases is still poorly understood, and so is the importance of antimicrobial chemotherapy . Based on the present knowledge from clinical studies, it is suggested that antibiotic treatment should be initiated for seven to ten days in patients suffering from an 'Anthonisen type-1 exacerbation', i.e . clinical deterioration with a significant increase in sputum production and sputum purulence, but not in others . The best tolerated, least toxic and least expensive oral antibiotic with adequate activity against pneumococci and H . influenzae is probably most appropriate . These prerequisites are still best fit by aminopenicillins and cotrimoxazol. Nippon Geka Gakkai Zasshi, 1992 Oct, 93(10), 1265 - 71 {Innovative elastomeric bio-adhesive (pup-201) synthesized by urethane-prepolymer}; Tani T et al.; Properties of PUP-201 for the application to vital organs were estimated . Basic properties of PUP-201 were compared with two kinds of commercial fibrin and synthetic adhesives . Its initial and wet adhesive strength was 40 and 150 times stronger than those of fibrin adhesives respectively . Its curing time was 50 seconds, and elongating rate was 150% nearly as same as that of the intestine . This adhesive had not antimicrobial activities . The strength of adhesive bonded pig skin in shear by tension loading by way of JIS K6850 recorded 2.0-2.7kg/cm2 five minutes after, and 2.0-2.8kg/cm2 after 24 hours . The results of the same test in small intestine defined 0.4-1.0kg/cm2 in sero-sero attachment . There was no toxicity on the pig skin . Practical examinations for application to hemostasis on the section of dog liver and sealing of the lung section were performed successfully . PUP-201 was demonstrated excellently useful material for the adhesive, hemostasis and sealant of vital tissue. Mikrobiyol Bul, 1992 Oct, 26(4), 349 - 54 {Appropriate concentrations of antimicrobial agents in used cadaver pools}; Sarsilmaz M et al.; Samples for microbiologic culture were taken from 17 cadaver and 4 cadaver pools in the Department of Anatomy of Gulhane Military Medical Academy (GMMA), Military Faculty of Medicine . Samples were inoculated on bacteriologic and mycologic media and were incubated in aerobic and 10% CO2 atmosphere conditions . From 3 of 4 pools containing different concentration of phenol and formalin, pathogenic bacteria that might be present in normal flora and saprophytic fungi were isolated . In the guidance of these results, in order to keep the cadavers for a long time and laboratory safety, use of formalin and phenol not less than 5% and 4% concentrations of the cadavers respectively and the pools should be taken into consideration. Comp Immunol Microbiol Infect Dis, 1992 Oct, 15(4), 229 - 34 Observations on production of hemolysin, heat-labile enterotoxin and antimicrobial drug resistance among enterotoxigenic Escherichia coli from pigs; Hariharan H et al.; A total of 52 isolates of Escherichia coli belonging to enterotoxigenic serotypes from piglets with diarrhea were examined for hemolysis, production of cholera-like enterotoxin (LT) and susceptibility to 10 antimicrobial drugs . A strong association between production of LT and hemolysis was seen . Ninety percent of 29 hemolylic isolates were LT+ whereas 100% of 23 nonhemolytic isolates were LT- in a commercial latex agglutination assay . Antimicrobial susceptibility tests employing disc diffusion showed that resistance to trimethoprim-sulfamethoxazole (TMS), neomycin and tetracycline was significantly less among LT+ isolates compared to LT- ones . Enrofloxacin was the only antimicrobial drug to which all the 52 isolates were susceptible. Clin Microbiol Rev, 1992 Oct, 5(4), 420 - 32 Tests for bactericidal effects of antimicrobial agents: technical performance and clinical relevance; Peterson LR et al.; Bactericidal testing has been used for several decades as a guide for antimicrobial therapy of serious infections . Such testing is most frequently performed when bactericidal antimicrobial agent therapy is considered necessary (such as when treating infectious endocarditis or infection in an immunocompromised host) . It has also been used to ensure that the infecting organism is killed by (not tolerant to) usually bactericidal compounds . However, few data are available to support the role of such tests in direct patient care . Several important variables affect the reproducibility of the test results; however, proposed reference methods are now available for performing the MBC test . With minor modifications, these can provide a standardized approach for laboratories that need to perform them . Currently, little evidence is available to support the routine use of such testing for the care of individual patients . However, testing of new (investigational) antimicrobial agents can be beneficial in determining their potential to provide bactericidal antimicrobial activity during clinical use . New methods to assess bactericidal activity are being developed, but as yet none have been rigorously tested in patient care settings; further, for most of these methods, little information is available as to which technical parameters affect their results . In clinical laboratories, all bactericidal tests must be performed with rigorously standardized techniques and adequate controls, bearing in mind the limitations of the currently available test procedures. Clin Infect Dis, 1992 Oct, 15(4), 654 - 67 Concepts on the use of liposomal antimicrobial agents: applications for aminoglycosides; Karlowsky JA et al.; Liposomes are microscopic lipid vesicles consisting of one or more concentric phospholipid bilayers enclosing discrete aqueous spaces . Liposomes provide an apparently nontoxic biological delivery system for hydrophobic and hydrophilic drugs . With few exceptions liposomal antimicrobial drugs are administered intravenously, although other routes have been investigated . Intravenously administered, conventionally prepared vesicles are rapidly cleared from the blood principally by phagocytic cells of the mononuclear phagocyte system (MPS), in particular by macrophages located in the liver (Kupffer's cells) and spleen . The expectation that liposomes would provide a new form of drug carrier capable of diverse physiological selectivity has not been realized . The low endocytotic capacity of many cell types and the inability of liposomes to transverse continuous vascular endothelia have prevented the active targeting of non-MPS tissues with liposomes . Despite their well-documented toxicity and the development of new antimicrobial classes, aminoglycosides continue to have an important antimicrobial role . The encapsulation of aminoglycosides into liposomes may reduce the toxicity associated with the multiple daily administration often required for patients with normal renal function . In addition, the encapsulation of aminoglycosides alters their pharmacokinetics, increases t1/2 and area under the curve, decreases Vd and Cpmax, and causes a shift in drug accumulation from the kidney to other organs, thus potentially reducing nephrotoxicity . Studies demonstrate improved outcome for intracellular infections treated with liposomal aminoglycosides vs . free aminoglycosides . Unresolved questions include what role liposomal aminoglycosides have in the treatment of extracellular infection and whether their sustained release action will promote resistance. Clin Infect Dis, 1992 Oct, 15(4), 582 - 90 Neurobrucellosis: clinical and therapeutic features; McLean DR et al.; Eighteen patients with neurobrucellosis are described . Eleven patients had meningitis alone or with papilledema, optic neuropathy, or radiculopathy . Four patients had meningovascular complications manifested by stroke or intracerebral hemorrhage from a presumed mycotic aneurysm . Two patients had parenchymatous dysfunction, including a child who had a cerebellar syndrome without evidence of direct infection of the central nervous system . One patient presented with polyradiculopathy . Twelve of 16 patients had pleocytosis; none had cell counts greater than 419 x 10(6)/L . Most patients had hypoglycorrhachia and elevated levels of protein in the cerebrospinal fluid (CSF) . Results of an agglutination test for Brucella in serum were positive for all patients . Six of 16 patients had positive blood cultures, and four of 14 had positive CSF cultures . Antimicrobial treatment included concurrent administration of two or more of the following drugs: streptomycin, tetracycline (or doxycycline), rifampin, and trimethoprim-sulfamethoxazole . Eleven patients fully recovered . Five patients were left with residual neurological deficits . Four of these patients suffered permanent hearing loss, one of whom also had significant loss of vision in one eye . One elderly senile patient with meningovascular brucellosis remained in a vegetative state despite receiving antimicrobial therapy for 6 months . One patient died due to rupture of a mycotic aneurysm within 7 days of initiation of therapy . One other patient was treated after sustaining an intracerebral hemorrhage, but this patient's condition was diagnosed only after discharge. Arch Surg, 1992 Oct, 127(10), 1219 - 24 Complement activation and polymorphonuclear neutrophil leukocyte elastase in sepsis . Correlation with severity of disease; Gardinali M et al.; Complement activation is necessary for an adequate immune and inflammatory response to infections . Activation releases anaphylatoxins that cause vasodilation, increase vascular permeability, and trigger release of polymorphonuclear neutrophil leukocyte (PMN) lysosomal enzyme and oxygen radicals . Under normal circumstances, an orderly progression of such events has a beneficial antimicrobial effect . The same mechanism, however, when uncontrolled, may damage host tissues . To provide information about the clinical importance of such events in sepsis, different complement parameters (C3, C4, and the desarginated forms of C3a {C3a(des)-Arg} and C5a {C5a(des)-Arg}), PMN elastase, and malondialdehyde (a by-product of membrane peroxidation by oxygen radicals) were measured daily in 26 septic patients and correlated with two objectively assessed and previously validated severity scores (acute physiology and chronic health evaluation {APACHE II} and Sepsis Severity Score {SSS}) . Nonsurvivors (n = 12) had significantly greater and longer lasting complement activation than that in survivors, as reflected by higher levels of catabolic peptides (C3a(des)-Arg) and lower levels of native proteins (C3 and C4) . C3a(des)-Arg, C3, C4, and the C3a(des)-Arg-C3 ratio were correlated with Sepsis Severity Scores . Polymorphonuclear neutrophil leukocyte elastase levels were higher in nonsurvivors and were correlated with C3a(des)-Arg and the C3a(des)-Arg-C3 ratio . Malondialdehyde levels were significantly higher in all patients than in controls, without, however, any relationship to severity of disease or clinical outcome . Since the higher and more persistent the complement activation and polymorphonuclear neutrophil leukocyte stimulation, the worse the patient's prognosis, we conclude that these mechanisms may be important in the clinical development of sepsis. Todays OR Nurse, 1992 Oct, 14(10), 11 - 4 Recognition and treatment of surgical wound infections; Barrett T; 1 . Tissue traumatized by surgery heals in a three-phase sequential process: a defensive response to the injury, reconstruction of the site, and maturation (closing) of the wound . 2 . Not all patients undergoing surgery are at equal risk for infection . The anatomic location of the surgery, the seeding of the surgical site with the patient's own normal flora, the OR environment and personnel, and the presence of a foreign body left in place after closure all contribute to the risk of infection . 3 . The treatment of postoperative infection can be divided into the physical aspects of wound care and the appropriate use of antimicrobial agents. Oral Surg Oral Med Oral Pathol, 1992 Oct, 74(4), 426 - 30 Healing after dental extractions in men with HIV infection; Robinson PG et al.; To determine the incidence of delayed healing after dental extractions in men with HIV infection, a retrospective audit was conducted of all extractions performed in a dedicated dental clinic over a 26-month period . The incidence of delayed healing in patients with HIV was compared with the incidence in those patients without HIV . Eighty men with HIV had 163 teeth extracted, which resulted in five dry sockets (3.01%) . Thirty-six men thought not to have HIV had 70 extractions and three dry sockets (4.28%) . All three dry sockets in the control group occurred in men who had tested negative for HIV antibodies in the year before their extraction . There were no other incidents of delayed healing . These findings contrast with other reports since they reveal no increase in delayed healing after extractions in men with HIV and do not support recommendations that prophylactic antimicrobials are required for extractions in this group of patients. J Trop Med Hyg, 1992 Oct, 95(5), 339 - 42 Enteropathogenic Escherichia coli as a cause of diarrhoea among children in Singapore; Lim YS et al.; Enteropathogenic Escherichia coli (EPEC) was isolated from 2.7% of 2983 children under 3 years of age with diarrhoea in Singapore . Of the nine serotypes identified, the most common were 0126:K71(B16), 086:K61(B7) and 0127:K63(B8) . Infants were at the greatest risk of contracting gastroenteritis due to EPEC, and female children were slightly more susceptible than males . Antimicrobial susceptibility tests showed that the EPEC strains were generally resistant to ampicillin, streptomycin, tetracycline and triple sulpha, but highly sensitive to ceftriaxone and gentamicin. J Clin Microbiol, 1992 Oct, 30(10), 2692 - 7 In vitro antimicrobial susceptibility testing of Borrelia burgdorferi: a microdilution MIC method and time-kill studies; Dever LL et al.; The susceptibility of Borrelia burgdorferi, the causative agent of Lyme borreliosis, to various antimicrobial agents varies widely among published studies . These differences are probably due in part to variations in susceptibility testing techniques and growth endpoint determinations . We developed a microdilution method for determining the MICs of antibiotics against B . burgdorferi . The method incorporated BSK II medium, a final inoculum of 10(6) cells per ml, and a 72-h incubation period and was found to be simple and highly reproducible . A variety of antibiotics and strains of B . burgdorferi and one strain of Borrelia hermsii were examined by this method . MICs of penicillin, ceftriaxone, and erythromycin for the B31 strain of B . burgdorferi were 0.06, 0.03, and 0.03 microgram/ml, respectively . We compared the MICs obtained by the microdilution method with those obtained by a macrodilution method using similar criteria for endpoint determinations and found the values obtained by both methods to be in close agreement . To further investigate the bactericidal activities of penicillin, ceftriaxone, and erythromycin against strain B31, we used subsurface plating to determine MBCs and we also performed time-kill studies . The MBCs of penicillin, ceftriaxone, and erythromycin were 0.125, 0.03, and 0.06 micrograms/ml, respectively . Time-kill curves demonstrated a greater than or equal to 3-log10-unit killing after 72 h with penicillin, ceftriaxone, and erythromycin; ceftriaxone provided the greatest reduction in CFU . The described methods offer a more standardized and objective approach to susceptibility testing of B . burgdorferi. Epilepsy Res, 1992 Oct, 13(1), 59 - 71 Effects of fluoroquinolone antimicrobials alone and in conjunction with theophylline on seizures in amygdaloid kindled rats . Mechanistic and pharmacokinetic study; Vancutsem PM et al.; The influence of three fluoroquinolone (FQ) antimicrobial drugs (ciprofloxacin (CP), norfloxacin (NF), enrofloxacin (EF)) on seizure parameters in amygdaloid kindled rats was investigated . CP and NF (100 mg/kg i.p.) did not modify seizure parameters while EF induced a decrease in seizure activity . Since clinical data indicate a seizure enhancing interaction between FQ and theophylline (THEO) we studied the influence of concurrent FQ-THEO administration in kindled rats . CP and NF, but not EF given concurrently with a non-seizure modulating dose of THEO (10 mg/kg i.p.) caused increases in seizure activity and aggressiveness in the animals . The CP-THEO induced seizure enhancement was antagonized by 2-chloroadenosine and diazepam . Pharmacokinetic studies demonstrated that THEO serum levels and elimination were not altered by concurrent CP administration . We conclude that coadministration of FQ-THEO can aggravate amygdala kindled seizures and that this aggravation may involve centrally mediated mechanisms. Tokai J Exp Clin Med, 1992 Oct, 17(3-4), 109 - 13 Incidence of transient bacteremia following dental surgery--prophylactic use of cefuroxime, ceftriaxone or clindamycin; Katoh H; The incidence of transient bacteremia after dental surgery as examined in 15 ml of venous blood has been previously found to amount to 69% . In this study, cefuroxime (1.5g), ceftriaxone (1.0g) or clindamycin (0.6g) was used for chemoprophylaxis to investigate the rate of transient bacteremia after dental surgery . The concentrations of these antimicrobial agents in peripheral blood and an effusion from the tooth extraction wound were measured . The incidence of transient bacteremia was limited to 4.2% by cefuroxime, 0% by ceftriaxone and 5.9% by clindamycin. Zhonghua Liu Xing Bing Xue Za Zhi, 1992 Oct, 13(5), 288 - 90 {Surveillance on ViII phage typing and antimicrobial susceptibilities of S . typhi strains in Guangdong Province}; Li Q; 72 S . typhi strains collected in Guangdong were tested for their Vi II phage types and their antimicrobial susceptibilities . The result of Vi II phage typing showed that 62 strains could be divided into definite types . The result of antimicrobial susceptibilities showed that, as national standard reference strains, all the 72 local strains were susceptible to choloramphenical, gentamycin, neomycin and polymycin B and were of different resistance to other 14 antimicrobial agents . The resistant profiles of strains isolated in different ages shared no significant difference . Choloramphenical remains Commonally selectable to treat Typhoid. Biull Eksp Biol Med, 1992 Oct, 114(10), 391 - 2 {The antimicrobial cationic proteins of the neutrophilic granulocytes in experimental Q rickettsiosis}; Kuzina VA et al.; Blood of 56 guinea pigs with experimental Q rickettsiosis was studied cytochemically (lysosomal cationic test) to measure the level of cationic proteins in neutrophil granulocytes . Development of Q rickettsiosis resulted in a decrease in the killing ability of neutrophils, depending on infection dose introduced . However, by day 7 of the disease, the level of cationic proteins in blood neutrophil granulocytes returned to the initial range . Similar situation was noted after subcutaneous injection of Coxiella burnetti corpuscular antigen . Subcutaneous infection with the living culture stimulus induced the wave-like decrease of the cationic proteins content . Infection of pre-immunized animals led to smaller decrease in the cationic proteins levels and to their more rapid recovery . Aspects of antimicrobial activity of neutrophil granulocyte cationic proteins in experimental Q rickettsiosis is discussed. Minerva Chir, 1992 Sep 30, 47(18), 1455 - 9 {Endoscopic and intraoperative ultrasonography in staging of stomach neoplasms}; Balbo G et al.; In Japan a better prognosis of gastric cancer has been achieved by early diagnosis and wide, careful lymphectomy . This is not true in western countries . Thus the Authors believe that rational surgical strategy and the careful use of advanced diagnostic tools would produce a better outcome . The Authors report the new diagnostic methods that they adopt in every case of gastric neoplasm: endoscopic ultrasonography, which also proved useful in submucosal tumors, like lymphomas; parenteral nutrition, immune status assessment for a possible use of immune response modulators, single-dose antimicrobial prophylaxis, antithrombotic prophylaxis, autologous blood storage, in order to reduce transfusion-linked risks . Surgical strategy is also reported, which includes wide resection with adequate margins, R2 lymphectomy and intraoperative assessment of disease extension by ultrasonography. J Biol Chem, 1992 Sep 15, 267(26), 18814 - 20 Purification and characterization of a novel antimicrobial peptide from maize (Zea mays L.) kernels; Duvick JP et al.; Several small, acid-soluble, basic peptides with anti-microbial properties have been isolated from maize (inbred B73) kernels . One of these peptides (MBP-1) has been purified to homogeneity and characterized . The peptide has a molecular weight of 4127.08 as determined by plasma desorption mass spectroscopy, has no free cysteines, and is predominantly alpha-helical as determined by circular dichroism . The primary sequence of the peptide (33 residues) has been determined by Edman degradation and shows no homology to the thionins, a group of cysteine-rich peptides found in some cereals including wheat, barley, and sorghum, as well as several dicot species . Like the thionins, however, MBP-1 has been found to have antimicrobial properties in vitro . MBP-1 inhibits spore germination or hyphal elongation of several plant pathogenic fungi, including two seed pathogens of maize (Fusarium moniliforme Sheld . and Fusarium graminearum (Gibberella zeae (Schw.) Petsch)), and several bacteria, including a bacterial pathogen of maize (Clavibacter michiganense ssp . nebraskense) . A synthetic MBP-1 peptide, air-oxidized and purified by reverse phase chromatography, was equally antifungal as compared with the naturally occurring peptide. Am J Ophthalmol, 1992 Sep 15, 114(3), 336 - 8 Ciprofloxacin-resistant bacterial keratitis; Snyder ME et al.; Ciprofloxacin, a new broad-spectrum antibiotic effective against a variety of gram-positive and gram-negative bacteria, has recently become available in topical ophthalmic solution (3 mg/ml) for the treatment of bacterial keratitis . It has rapidly become the drug of choice in treating bacterial keratitis . We treated three patients with bacterial corneal ulcers that were resistant to ciprofloxacin, yet were effectively treated with other topical antimicrobial agents . The initial culture results are important in the therapy of corneal ulcers. J Am Vet Med Assoc, 1992 Sep 15, 201(6), 899 - 901 Antemortem diagnosis of cholangiocellular carcinoma in a horse; Mueller PO et al.; A 10-year-old Tennessee Walking Horse gelding was admitted to the veterinary teaching hospital for evaluation of intermittent fever, lethargy, and anorexia . Initial laboratory analyses revealed anemia and hyperfibrinogenemia . Abdominocentesis and thoracentesis yielded fluid samples with high nucleated cell counts and total protein concentrations . The tentative diagnosis was nonseptic peritonitis . The horse did not improve after 4 days of antimicrobial treatment, and pitting edema of the ventral midline developed . Thoracic radiography and ultrasonography revealed consolidation of the ventral aspect of the lung fields and pleural effusion . Pleuroscopy of the right hemithorax revealed pleural effusion and a soft-tissue mass in the caudal portion of the mediastinum . Findings on biopsy of the liver and mediastinal mass led to a presumptive diagnosis of metastatic cholangiocellular carcinoma . The horse was euthanatized, and the diagnosis was confirmed at necropsy. Experientia, 1992 Sep 15, 48(9), 891 - 2 Isometachromin, a new cytotoxic sesquiterpenoid from a deep water sponge of the family Spongiidae; McConnell OJ et al.; Isometachromin (1), a new sesquiterpene-quinone that is related structurally to metachromin C (2), and the known compounds ilimaquinone (3) and 5-epi-ilimaquinone (4), were isolated from a deep water sponge in the family Spongiidae; the structure of isometachromin was elucidated by spectral methods . Isometachromin exhibits in vitro cytotoxicity against the human lung cancer cell line A549 (IC50 = 2.6 micrograms/ml), but not against P388 murine leukemia (IC 50 > or equal to 10 micrograms/ml) and also exhibits antimicrobial activity. Am Rev Respir Dis, 1992 Sep, 146(3), 626 - 32 Sulfuric acid aerosol exposure in humans assessed by bronchoalveolar lavage; Frampton MW et al.; Epidemiologic and experimental evidence suggests that exposure to acidic aerosols may affect human health . Brief exposures to acidic aerosols alter mucociliary clearance and increase airway responsiveness, but effects on host defense mechanisms at the alveolar level have not been studied in humans . Twelve healthy, nonsmoking volunteers between 20 and 39 yr of age were exposed for 2 h to aerosols of approximately 1,000 micrograms/m3 sulfuric acid (H2SO4) or sodium chloride (NaCl {control}), with intermittent exercise, in a randomized, double-blind fashion . Each subject received both exposures, separated by at least 2 wk . Bronchoalveolar lavage (BAL) was performed 18 h after exposure in order to detect evidence of an inflammatory response, changes in alveolar cell subpopulations, or changes in alveolar macrophage (AM) function, which is important in host defense . When compared with NaCl, exposure to H2SO4 did not increase polymorphonuclear leukocytes in BAL fluid . The percentage of T lymphocytes decreased in association with H2SO4 exposure, but the difference was not statistically significant (14.9% after NaCl, 11.5% after H2SO4; p = 0.14) . Antibody-mediated cytotoxicity of AM increased in association with H2SO4 exposure (percent lysis 19.1 after NaCl, 23.6 after H2SO4; p = 0.16) . No significant change was seen in release of superoxide anion or inactivation of influenza virus in vitro . Brief exposures to H2SO4 aerosol at 1,000 micrograms/m3 do not cause an influx of inflammatory cells into the alveolar space, and no evidence was found for alteration in antimicrobial defense 18 h after exposure. JAMA, 1992 Sep 9, 268(10), 1311 - 3 Use of a novel technique of cutaneous lavage for diagnosis of Lyme disease associated with erythema migrans; Wormser GP et al.; OBJECTIVE--Determining the microbial cause of cellulitis is often difficult . In this study, a novel two-needle lavage technique was used to culture Borrelia burgdorferi from the skin of suspected erythema migrans lesions . DESIGN--The yield of lavage cultures for B burgdorferi was compared with that of a 2-mm skin biopsy sample . SETTING--A Lyme disease diagnostic center located in an area in which Lyme disease is epidemic . PATIENTS--Forty-five patients with suspected erythema migrans who had not been treated with antimicrobial agents . INTERVENTION--Cutaneous lavage of the advancing edge of a suspected primary erythema migrans lesion was done for all 45 participants, 33 of whom also had a skin biopsy of the same lesion at an identical (14) or an adjacent (19) site . MAIN OUTCOME MEASURES--Growth of B burgdorferi in in vitro culture . RESULTS--Lavage fluid cultures grew B burgdorferi in 13 (29%) of the 45 cases (95% confidence interval {CI}, 16% to 44%) . Among the 33 cases in which both lavage and skin biopsy cultures were done, the yield of lavage culture was less than that of biopsy culture (P less than .09, 12/33 vs 20/33) . If contaminated cultures are excluded, this difference is significant (P less than .05, 12/30 vs 20/27) . CONCLUSION--Cutaneous lavage is a new diagnostic technique for recovery of B burgdorferi from erythema migrans lesions that has potential applicability to other types of cutaneous infections. Biochim Biophys Acta, 1992 Sep 4, 1159(1), 22 - 8 Molecular weight determination and compositional analysis of dextran-protein conjugates using low-angle laser light scattering technique combined with high-performance gel chromatography; Kato A et al.; The low-angle laser light scattering technique combined with high-performance gel chromatography was applied for characterization of the dextran-ovalbumin and dextran-lysozyme conjugates obtained from the mild heating in dry state, which is attracting interest as a way leading to stabilization of proteins and to production of proteins with excellent emulsifying or antimicrobial ability (Nakamura, S., Kato, A . and Kobayashi, K . (1991) J . Agric . Food Chem . 39, 647-650) . According to the above technique, providing the information about the molecular weight distribution and the composition of the conjugates, one or two dextran molecules were found to be linked to one molecule of the proteins . In addition, each of the conjugates was shown to exist as an oligomeric assembly of which formation is promoted by an increase in the salt concentration of buffer . The observations suggest that the increase in the hydrophobicity of the protein moiety as a result of partial denaturation and the introduction of the hydrophilic dextran chain affords the conjugate an amphiphilic property. J Allergy Clin Immunol, 1992 Sep, 90(3 Pt 2), 424 - 30 Human nasal host defense and sinusitis; Kaliner MA; Sinusitis is an exceptionally common disorder that affects an estimated 35 million Americans per year . The development of sinusitis requires both the presence of a virulent pathogen and the failure of the local immune system to prevent or effectively combat the infection . Identification of the components of the immune defense system of the upper respiratory tract and the possible areas of dysfunction that predispose to sinusitis may be important steps in the eventual prevention of this common disease . The nasal and sinus passages are lined by respiratory mucous membranes . Recent studies have identified some of the constituents found in mucus and their roles in human health and disease . However, the local immune system of the respiratory mucosa is largely unknown, and its role in sinusitis is conjectural . Nasal secretions include many proteins that serve important functions in local mucosal host defense . Most of these host-defense molecules are synthesized and secreted by serous cells in the submucous glands, and it appears that the serous cell is the resident antimicrobial cell in mucous membranes . Currently data suggest that serous cell secretion is abnormal in patients with recurrent sinusitis and that effective treatment leads to correction of the secretory abnormality along with improvement in sinusitis. Vet Clin North Am Small Anim Pract, 1992 Sep, 22(5), 1173 - 86 Bordetella and Mycoplasma respiratory infections in dogs and cats; Bemis DA; The consequences of B . bronchiseptica and mycoplasma infections in dogs and cats vary greatly . Only careful clinical judgment can dictate when to institute antimicrobial and other supportive treatments . Approaches to controlling diseases caused by these organisms should be tailored to meet individual needs . Management strategies that reduce natural exposure levels in the animal's environment and maintain active immunity to contagious components of disease have the highest likelihood of success. Clin Lab Med, 1992 Sep, 12(3), 523 - 52 Laboratory diagnosis of fetal infections; McGowan KL et al.; In utero infections of the fetus can lead to significant morbidity and mortality in the newborn child . The signs and symptoms of clinical disease, however, do not always suggest a given pathogen . The laboratory must be able to provide an early and accurate diagnosis of the causative agent so that prompt and appropriate antimicrobial therapy and medical care can be initiated . The scope of this article includes the methods employed by the laboratory to assist in the diagnosis of bacterial, fungal, parasitic, and viral infections of the fetus . Where appropriate, detection methods were addressed for the diagnosis of the major pathogens responsible for infection during the birth process. Clin Infect Dis, 1992 Sep, 15(3), 453 - 63 Infections due to Nocardia transvalensis: clinical spectrum and antimicrobial therapy; McNeil MM et al.; Nocardia transvalensis, a rare Nocardia species, has previously been recognized as a cause of actinomycotic mycetoma . In a retrospective review of N . transvalensis isolates referred to the Centers for Disease Control (Atlanta) during the period January 1981 through January 1990, we identified 15 patient isolates . Four N . transvalensis isolates originated from one Australian reference laboratory; one patient's isolate that was identified by the Australian laboratory but that was not received at the Centers for Disease Control was also included in our study . A review of the cases of these 16 patients found that N . transvalensis caused infection in 10 patients and colonization in two patients . Six (75%) of eight patients with primary pulmonary or disseminated N . transvalensis infections had an underlying immunologic disorder or were receiving immunosuppressive therapy; three patients with disseminated infection died . All nine infected patients for whom specific antimicrobial therapy was prescribed received trimethoprim-sulfamethoxazole . Results of in vitro antimicrobial susceptibility tests of 11 N . transvalensis isolates revealed increased antimicrobial resistance to amikacin and other drugs when compared with that of other Nocardia species . Severely immunocompromised patients are predisposed to N . transvalensis pneumonia or disseminated infection, and the lung may be the portal of entry. Clin Infect Dis, 1992 Sep, 15(3), 402 - 7 Septic arthritis and bacteremia due to Mycoplasma resistant to antimicrobial therapy in a patient with systemic lupus erythematosus; Clough W et al.; We report a case of septic arthritis caused by Mycoplasma hominis in a patient with systemic lupus erythematosus . The infection started as monarthritis but spread to at least four joints despite apparently suitable therapy with various antimicrobial agents, including doxycycline, clindamycin, and ciprofloxacin; subsequent bacteremia was documented . Control was ultimately achieved with use of the experimental fluoroquinolone temafloxacin in combination with doxycycline administration, arthroscopic drainage of a persistently infected joint, several intravenous infusions of immunoglobulins (which led to increases in levels of antibodies specific to M . hominis), and discontinuation of corticosteroid therapy . Antimicrobial susceptibility testing of various mycoplasmal isolates showed the presence of the tetM gene, disparity between susceptibility to tetracycline and doxycycline, and increasing resistance to most antimicrobial agents used (including to fluoroquinolones before clinical use), although the patient ultimately had a favorable clinical response to treatment with combined modalities. Chest, 1992 Sep, 102(3), 972 - 4 Polypoid endobronchial lesions . A manifestation of bacillary angiomatosis; Slater LN et al.; Polypoid endobronchial lesions occurred in a patient with acquired immunodeficiency syndrome (AIDS) with recent fever, skin lesions, lymphadenopathy, lung infiltrates, and pleural effusions . His condition improved with antimicrobials and vincristine . After therapy ceased, skin lesions recurred and gastroesophageal mucosal lesions developed . Bacillary angiomatosis was identified during retrospective analysis of skin and endobronchial biopsy specimens. Obstet Gynecol, 1992 Sep, 80(3 Pt 2), 553 - 5 Enterobius vermicularis salpingitis: a distant episode from precipitating appendicitis; Schnell VL et al.; Chronic pelvic inflammatory disease is a common gynecologic diagnosis in women with chronic pelvic pain . When standard antimicrobial therapy does not improve the clinical status, uncommon diagnoses such as Enterobius vermicularis should be considered . In this case, E vermicularis presented as acute and chronic salpingitis in a patient who had had E vermicularis-related appendicitis 5 years earlier. Vopr Med Khim, 1992 Sep-Oct, 38(5), 57 - 9 {Increase in the level of luminol-dependent chemoluminescence in mouse blood under the effect of certain synthetic peptides}; Frolova VM et al.; Synthetically produced peptides increased the luminol-dependent chemoluminescence of mice whole blood during phagocytosis . Using some peptides it is possible to cause an increase in the antimicrobial peroxidase system activity of neutrophils very rapidly (within seconds). Biull Eksp Biol Med, 1992 Sep, 114(9), 272 - 4 {Free-radical mechanism of antimicrobial action of xanthine oxidase and lactoperoxidase}; Al'perovich DV et al.; The interaction between milk xanthine oxidase (XO) and lactoperoxidase (LP) in model system and antimicrobial action of these enzymes on Escherichia coli 0-111 were studied . It was shown, that bacterial superoxide dismutase (SOD), which transforms O2- . (XO-reaction product) into H2O2 (substrate of LP), is necessary for binding of the reaction sequence: XO-->LP-->antimicrobial products . It is suggested, that these enzymes unite in the protective system in intestinal infections of newborns . Bacterial SOD in this case acts as the key factor, creating the system. Clin Ther, 1992 Sep-Oct, 14(5), 688 - 95 In vitro activity of several antimicrobial agents against genital mycoplasmas; Echaniz Aviles G et al.; The increasing resistance of genital mycoplasmas to tetracyclines is a serious problem, since this group of antibiotics is one of the few that is effective against virtually all species of mycoplasmas . Tetracyclines are also used to treat many sexually transmitted diseases . In this study, we assessed the susceptibility of Mycoplasma hominis and Ureaplasma urealyticum to macrolides, tetracyclines, spectinomycin, and trospectomycin by the agar dilution method . For M hominis, trospectomycin was the most active agent . Spectinomycin, tetracycline, and doxycycline had comparable mycoplasmatic activity, and the macrolides were ineffective . Against U urealyticum, spectinomycin and trospectomycin were the most active drugs, and were at least twofold more active than the macrolides and tetracyclines. Clin Ther, 1992 Sep-Oct, 14(5), 616 - 52; discussion 615 Third-generation cephalosporins: a review; Cunha BA; Third-generation cephalosporins play a pivotal role in the management of infections because of their potent and broad-spectrum antimicrobial activity, proven clinical efficacy in a wide variety of infections, safety, and potential for cost savings . Selection of third-generation cephalosporins poses a dilemma, however, particularly for clinicians who view the six antibiotics within this class as interchangeable . Choice of drug should be based on antimicrobial spectrum and other factors such as lack of resistance development and cost considerations . This review focuses on the distinguishing features of the parenteral third-generation cephalosporins . Such differences suggest the need for retiring the convenient "generation" classification system for cephalosporins in favor of a system that encourages recognition of clinically important features of each agent in this diverse group of cephalosporin antibiotics. J Antimicrob Chemother, 1992 Sep, 30(3), 279 - 88 Decreased susceptibility of penicillin-resistant pneumococci to twenty-four beta-lactam antibiotics; Linares J et al.; The in-vitro activity of 24 beta-lactam antibiotics was compared using three groups of pneumococci and an agar dilution method comprising 100 penicillin-susceptible, 100 intermediately penicillin-resistant, and 100 highly penicillin-resistant pneumococcal strains . Our results show that intermediately penicillin-resistant and highly penicillin-resistant pneumococci had decreased sensitivity to other beta-lactam agents . According to their relative in-vitro activity, the antimicrobials were classified into three groups . The first group included drugs more active than penicillin (imipenem, meropenem, cefotaxime, ceftriaxone, and cefpirome), which could be useful for the treatment of infections due to penicillin-resistant strains . The second group showed slightly lesser activity than did penicillin, and included: ampicillin, cefdinir, cefuroxime, cefoperazone, azlocillin, mezlocillin, piperacillin, cephalothin, and cefamandole . The remaining antibiotics (oxacillin, cefixime, ceftizoxime, cefetamet, cefaclor, ceftazidime, cefoxitin, cefonicid, and latamoxef) showed poor activity against penicillin-resistant strains, precluding their use for empirical treatment in areas with a high prevalence of penicillin-resistant strains. Pediatr Infect Dis J, 1992 Sep, 11(9), 694 - 8; discussion 698-701 Duration of symptoms and outcome in bacterial meningitis: an analysis of causation and the implications of a delay in diagnosis; Radetsky M; The prompt diagnosis and therapy of bacterial meningitis remain enduring clinical challenges, for no physician would knowingly delay appropriate therapy . However, whether a delay in the initiation of antimicrobials in fact causes a worse outcome is a separate and tangential question . In clinical medicine a treatment decision involves a bedside estimate of the risk and potential severity of illness balanced against the benefits and adverse effects of therapy . For severe infections, the inexorable damage of untreated disease is presumed, and antimicrobials properly are given without hesitation . In contrast the methodical weighing of evidence regarding the issue of causation is for the purpose of characterizing biologic phenomena . Although legal and medical implications may be contained in such an analysis, its relevance to any particular clinical case is only retrospective . To judge responsibly the strength of a causative link, all available scientific evidence must be analyzed by established criteria . Such as analysis suggests that any connection between a delay in the treatment of bacterial meningitis and outcome depends on the presenting clinical pattern . If the presentation is that of a nonspecific illness with general symptoms, then a short delay of < 3 to 5 days does not appear to alter the risk of sequelae or death . In the case of fulminant meningitis a delay in initiating therapy seems unconnected to outcome . Finally for patients with a history of clinically overt meningitis, an inappropriate delay in commencing therapy incrementally increases the risk of permanent injury. Arzneimittelforschung, 1992 Sep, 42(9), 1157 - 9 In vitro activity of taurolidine, chlorophenol-camphor-menthol and chlorhexidine against oral pathogenic microorganisms; Zimmermann M et al.; The antimicrobial activity of taurolidine (Taurolin, CAS 19388-87-5), a synthetic broad-spectrum antimicrobial agent and anti-toxin, and two conventional antiseptics, chlorophenol-camphor-menthol (CCM) and chlorhexidine digluconate (CHX) were compared using the serial dilution test on 10 potential oral pathogenic bacterial species . The minimum inhibitory and minimum bactericidal concentrations were lowest for CHX (MIC 0.03-0.12 mg/ml), followed by taurolidine (MIC 0.12-0.5 mg/ml) and CCM (MIC 0.5-2.0 mg/ml) . However, if both bacterial efficacy and cytotoxicity are considered, only taurolidine achieves extensive bactericidal activity with tissue tolerability. Arch Pharm (Weinheim), 1992 Sep, 325(9), 569 - 77 Studies on annelated {1,4}benzothiazines and {1,5}benzothiazepines, V . Synthesis and biological activity of N-2 alkylamino derivatives of 4,5-dihydro-s-triazolo{3,4-d}-1,5-benzothiazepine; Ambrogi V et al.; The synthesis of a new series of N-2 alkylamino derivatives of 4,5-dihydro-s-triazolo{3,4-d}-1,5-benzothiazepine has been accomplished starting from 2,3-dihydro-1,5-benzothiazepin-4(5H)ones and their 2-methyl and 2-aryl derivatives . All the compounds were tested in vitro for their antimicrobial activity, but none of them showed remarkable activity . The tricyclic compounds 7a-j, 8a-j, 9a-j, 10a-j, and 11a-j were also screened for their CNS activity in mice and several of them showed interesting activity. Antibiot Khimioter, 1992 Sep, 37(9), 34 - 6 {The antimicrobial activity of Augmentin (amoxicillin/clavulanic acid) compared to other antibacterial agents}; Zubkov MN et al.; Sensitivity of clinical strains of gram-positive and gram-negative bacteria to Augmentin was studied in comparison to other antibiotics . Augmentin was shown to be advantageous in the level and spectrum of its antibacterial activity over ampicillin and other broad-spectrum antibiotics. Z Gesamte Inn Med, 1992 Sep, 47(9), 417 - 21 {Therapy of bacterial infections in neutropenic and immunocompromised patients}; Helbig W et al.; Neutropenias, especially extended an long-lasting stages, lead to life-threatening endogenous infection . Therefore, after taking off materials for bacteriological investigations an empirical schedule of a combined high dose, treatment with broad-band antibiotics and/or antimycotics has immediately to be introduced and to continue until the body temperature and the peripheral blood granulocytes are normalized . In case of treatment failure one should complete the therapy by other additional antibiotics or correct the combination of its in respect to the results of the microbiological investigations . Supplements of this antimicrobial treatments are immunoglobulins and growth factors (G-CSF, GM-CSF) . In case of an expected neutropenica