Staphylococcus

Am J Infect Control, 1989 Oct, 17(5), 311 - 5
Antimicrobial use in hospital-acquired infections; Ryan JL; The appropriate use of antibiotics in nosocomial infections has been a goal of infectious disease practitioners and hospital epidemiologists since the emergence of resistant staphylococci more than 30 years ago . This challenge has assumed new proportions in the 1980s for many reasons . First, resistant gram-positive and gram-negative bacteria are increasingly common . Thus many traditional drugs or combinations of drugs lack efficacy . Second, there are so many new antibiotics available that it is difficult for any but the most knowledgeable to use each of them appropriately . Third, economic reality has forced hospitals and physicians to alter their activities and focus more on cost considerations than was ever necessary before . Last, infectious disease as a subspecialty in internal medicine is profoundly different in the 1980s; many infections must be controlled for life rather than cured because of underlying infection with human immunodeficiency virus, which suppresses immunity . The use of antibiotics is now rapidly changing and the state of the art in 1989 is likely to be outdated very soon as new pathogens emerge and new drugs are developed . The appropriate use of the quinolones is a great challenge that we now face . Can we preserve this valuable class of drugs, or will resistance develop quickly because of widespread, indiscriminate, and inappropriate use? To what extent can we phase out aminoglycoside use without compromising efficacy and without promoting the development of resistance? Do the monobactams have a real role to play in combination therapy? How should formularies approach the diverse cephalosporins that now inundate the market? These are only a few of the fundamental questions that must be addressed as this decade ends.

Am J Infect Control, 1989 Oct, 17(5), 286 - 94
Epidemiology and mechanisms of antimicrobial resistance; Parry MF; Bacterial evolution and the emergence of antimicrobial drug resistance continue to interfere with the successful treatment of infections by both community- and hospital-based physicians . Resistance has emerged to even the newer, most potent antimicrobial agents . Although generalizations can be made about the appropriateness of antimicrobial agents on the basis of published susceptibility patterns, significant regional, demographic, and interinstitutional variables exist that require each hospital to establish its own antibiotic data base and antibiogram . In particular, multiresistant pathogens occur infrequently in acute care community hospitals compared with tertiary care centers . Important clinical factors that promote the emergence of drug-resistant flora include prolonged therapy, the persistence of foreign bodies, sequestra, or prostheses, and the inadequate surgical debridement of necrotic tissue or abscesses . Antibiotic resistance may occur through changes in the permeability of the cell wall or outer membrane, by alteration of the antimicrobial binding or target site, and by inactivation or modification of the drug by bacterial enzymes . These mechanisms are reviewed . In particular, gram-negative beta-lactamases, methicillin-resistant staphylococci, multiresistant enterococci, and the emergence of fluoroquinolone resistance are discussed in detail.

J Clin Microbiol, 1989 Oct, 27(10), 2381 - 3
Evaluation of four newer antimicrobial agents in the Avantage susceptibility test system; Wright DN et al.; Antimicrobial elution disks containing amoxicillin-clavulanic acid (Augmentin), cefotetan, ciprofloxacin, or norfloxacin were tested in the Avantage automated susceptibility test system . Performance was compared against an agar diffusion procedure in a three-site collaborative study . Results of 1,500 comparison with amoxicillin-clavulanic acid showed a full accord (agreement of both systems) of 93.6% and an essential accord (agreement excluding minor discrepancies) of 97.6% . Results for cefotetan showed a full accord of 95.1% and an essential accord of 98.3% by the two methods . Results for both ciprofloxacin and norfloxacin were in full accord for more than 98% of tests with gram-negative bacilli and staphylococci, but tests with enterococci gave 38 and 26.1% minor discrepancies (the result of one method was resistant or susceptible and the result of the other method was intermediate), respectively . The results indicated that the Avantage test system is accurate and reliable and provides appropriate determination of bacterial susceptibility with the four antibiotics tested.

J Clin Microbiol, 1989 Oct, 27(10), 2199 - 203
Characterization of coagulase-negative staphylococci by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot analyses; Thomson-Carter FM et al.; Coagulase-negative staphylococci are important nosocomial pathogens . At present, no wholly satisfactory typing scheme exists for these organisms . Therefore, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting were assessed as characterization methods . A total of 100 type strains and nontyped isolates representing nine species of coagulase-negative staphylococci were analyzed . Each species had a reproducible, characteristic whole-cell banding pattern when analyzed by either method . These species-specific profiles were obtained for all isolates despite disparate geographical origins and clinical isolation sites . Intraspecies similarities, calculated by using the Dice coefficient, were significantly higher than interspecies similarities . Although some species were more heterogeneous than others, the allocation of isolates to any particular species was reinforced by the high degree of interspecies dissimilarity . Application of SDS-PAGE also distinguished discrete subspecies groups . These groups possessed the characteristic profile of their species but were distinguished by a group of variable polypeptides . Species-specific banding patterns were also obtained by immunoblotting of whole-cell polypeptides . Differences between immunoblot and SDS-PAGE profiles could be attributed to variations of antigenicity of particular polypeptides . However, both SDS-PAGE and immunoblotting provided reproducible and sensitive methods for characterization of coagulase-negative staphylococci . Standardization of these techniques could provide the basis for a primary typing scheme.

J Appl Bacteriol, 1989 Oct, 67(4), 433 - 40
A procedure for urease and protein extraction from staphylococci; Sissons CH et al.; Staphylococcal cell protein and urease can be solubilized after growth in Todd-Hewitt broth supplemented with 0.5% yeast extract by extraction for 18-24 h in phosphate buffer, pH 7.0 . In general 20% (but up to 100%) of the urease present in the original cells could be solubilized . Less protein was solubilized . Species examined included coagulase-negative staphylococci, Staphylococcus intermedius and Staph . aureus . Extracts of Staph . epidermidis prepared by this procedure gave electrophoretic urease and protein patterns similar to those prepared by sonication . The procedure was simple and minimized handling of the cells.

J Appl Bacteriol, 1989 Oct, 67(4), 417 - 23
The preservation of micro-organisms in biological specimens stored at-70 degrees C; Ludlam HA et al.; The preservation of micro-organisms that may be found on the skin was studied by storage in liquid media at--70 degrees C . In the first part of the study the performance of 12 varieties of suspending media was evaluated with pure cultures of 17 species of micro-organisms maintained in the laboratory . After storage for 1 year the best medium (Oxoid Nutrient Broth with 15% glycerol) showed a mean survival for all organisms studied of 83.8%, with no significant differences between organisms . Even the worst medium (distilled water) permitted greater than 40% survival at 1 year . No changes in the characteristics of these micro-organisms were detected after 6 months storage in glycerol broth . In the second part of the study nose swabs were suspended in one representative medium (Bacto Nutrient Broth containing 7% glycerol) . The mean percentage survival of staphylococci in these suspensions after 1 year's storage at - 70 degrees C was 75.4% . These results indicate that coagulase-negative coagulase-negative staphylococci in samples of skin flora may be stored under these conditions for long periods, greatly reducing the work-load in epidemiological studies of infection.

J Hosp Infect, 1989 Oct, 14(3), 183 - 91
Evaluation of three methods for culturing long intravascular catheters; Kristinsson KG et al.; During a one-year period, 236 intravascular catheter tips were investigated by culturing the outside by rolling the tips on the surface of blood agar plates, the inside by flushing with nutrient broth, and finally by culture after ultrasonication . Clinical information was collected prospectively by visiting the ward and symptoms and signs of catheter infection were correlated with the results of the catheter cultures . Coagulase-negative staphylococci were the organisms that were most frequently isolated from the catheters . The results of culture showed a clear bimodal distribution, and counts of 100 colony-forming units (cfus) and culture from the inside of the catheters were the best predictors of infection . Almost all infected catheters were colonized both on the inside and outside.

Med Lab Sci, 1989 Oct, 46(4), 291 - 4
Detection of phosphatase production by Staphylococcus species: a new method; Geary C et al.; The ability of staphylococci to produce phosphatase is an important character in the identification of species in the genus . Current methods are slow and difficult to interpret . A test is described which uses p-nitrophenyl phosphate as the substrate . It was evaluated by testing 1035 reference and clinical strains, and also compared with an alternative method . All strains of Staphylococcus aureus and 83% of Staphylococcus epidermidis were phosphatase positive: all strains of Staphylococcus saprophyticus were negative . The method proved to be an accurate, reliable, economic and relatively rapid technique to detect phosphatase production.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Oct, (10), 17 - 21
{The receptors ensuring Staphylococcus aureus fixation on fibronectin-containing surfaces}; Sokurenko EV et al.; The role of protein A and other components of S . aureus cell wall in binding fibronectin on the surface of formulated sheep red blood cells was studied . 41 out of 89 fibronectin-binding clinical isolates lost their capacity for agglutinating fibronectin-sensitized red blood cells after the treatment of such cells with the solution of commercial purified protein A . These strains were also shown to have pronounced direct relationship between the levels of binding of fibronectin and IgG . Other isolates in the collection possessed the protein A-independent receptor capable of binding fibronectin . The receptor was seemingly common for this group of strains, and its presence significantly increased the capacity of staphylococci for binding fibronectin.

Antimicrob Agents Chemother, 1989 Sep, 33(9), 1624 - 6
Restriction maps of the regions coding for methicillin and tobramycin resistances on chromosomal DNA in methicillin-resistant staphylococci; Ubukata K et al.; Chromosomal BamHI DNA fragments containing both the mecA gene encoding the penicillin-binding protein responsible for methicillin resistance and the aadD gene encoding 4',4"-adenylyltransferase responsible for tobramycin resistance were cloned from three methicillin- and tobramycin-resistant strains of Staphylococcus aureus and one strain of Staphylococcus epidermidis . Physical maps of the fragments were similar, suggesting their unique origin.

Zentralbl Veterinarmed B, 1989 Sep, 36(7), 527 - 31
Sampling of the bovine teat for studies of defence mechanisms and inflammatory reactions based on a surgical procedure separating the teat and udder cisterns; Persson K et al.; A surgical procedure to separate the teat and udder cisterns in the udder quarter was described . The sampling method used and its influence on the somatic cell count and bacteriological status of the teat samples were determined . The surgical procedure resulted in complete separation of the teat cistern from the udder cistern in nine out of fourteen teats in six cows . An increase in SCC was seen in one of nine teats during the sampling period of 4 to 8 days . Coagulase-negative staphylococci were isolated in samples from three of six teats at the end of the sampling period . The described methods could be of considerable importance in future studies of inflammatory reactions and defence mechanisms in the bovine teat.

J Antibiot (Tokyo), 1989 Sep, 42(9), 1379 - 92
Synthesis and in vitro activity of new semi-synthetic coumermycin analogs: chemical modification at the C-3 amide; Ueda Y et al.; Several new semi-synthetic coumermycin analogs, which carry a polar substituent at the C-3 amide moiety have been prepared . In vitro antibacterial activity of these new analogs against Gram-positive organisms, particularly methicillin-resistant strains of Staphylococci species has been described.

Eur J Cancer Clin Oncol, 1989 Sep, 25(9), 1379 - 82
Physiopathology of foreign body infections; Lew DP; Foreign body infections share several properties: a high susceptibility to microorganisms which are usually of low pathogenicity (such as S . epidermidis) and with only some exceptions failure to respond to antimicrobial therapy without surgery . The common denominator for the three elements that play a role in the physiopathology of such infections (bacteria, neutrophils and different materials) is host protein deposited over the surface of the foreign body . Staphylococci and neutrophils selectively adhere to fibronectin and to a variable degree to laminin and fibrinogen . These proteins potentially modulate phagocyte function . With the progress of biotechnology and the increasing numbers of implantable prostheses, it will become critical to increase our understanding on how to prevent and treat foreign body infections.

Indian J Exp Biol, 1989 Sep, 27(9), 816 - 9
Experimental model of staphylococcal osteomyelitis in dogs; Varshney AC et al.; Osteomyelitis was induced in 45 male dogs by inoculating hemolytic strain of Staphylococcus aureus alone into the tibial marrow cavity . Clinical, radiological and bacteriological studies were conducted to evaluate the progress of disease up to 15 weeks . Clinical signs consisted of localized soft tissue swelling, pain, pyrexia and lameness which later developed an open wound with purulent exudation . Predominant radiographic features were extensive periosteal reaction, cortical lysis, new bone formation, frequent development of sequestrum and formation of localized abscess pockets in advanced cases . Staphylococci were recovered from the tibial marrow cavity for as long as 15 weeks after onset of the infection.

Res Microbiol, 1989 Sep, 140(7), 467 - 75
Determination of G + C content of DNA using high-performance liquid chromatography for the identification of staphylococci and micrococci; Peyret M et al.; The guanine-plus-cytosine (G + C) content of different species of Staphylococcus and Micrococcus was determined by high-performance liquid chromatography . Purified bacterial DNA was hydrolysed by nuclease P1 . The nucleotides were separated by chromatography and quantified by measurement of the optical density at 260 nm . The G + C content of staphylococci ranged from 31.5 to 37.9 moles %, and that of micrococci from 68.7 to 75.2 . Most of our results were comparable to those obtained with the thermal method.

Diagn Microbiol Infect Dis, 1989 Sep-Oct, 12(5), 395 - 9
Comparative evaluation of the MRS test . A 4 to 6 hour screening test for detecting oxacillin-resistant staphylococci; Wellstood S; A total of 131 strains of S . aureus and 25 strains of unspeciated coagulase-negative staphylococci (CNS) initially tested by automated methods for susceptibility to oxacillin were concurrently retested using standardized disk diffusion, reference 2% NaCl-supplemented broth microdilution, oxacillin salt agar, and the MRS test (a commercially prepared broth screening method) . Compared to the reference broth microdilution test results, the MRS test was 97% sensitive for S . aureus, 95% sensitive for CNS, and 100% specific for all staphylococci . Results were available in 4 hr for S . aureus and less than 6 hr for CNS . The oxacillin salt agar screen had sensitivities of 93 to 99% with a specificity of 100% . Although the disk diffusion method was the most sensitive method (100%), it was the least specific (83% for S . aureus and 80% for CNS) . Differences in manufacturers' agar affected results with most discrepancies resulting in a false-resistant interpretation . Although inoculum standardization was important for accurate susceptibility test results, overinoculation alone could not account for the 30 isolates falsely-resistant to oxacillin by the Vitek AMS or Abbott MS-2 . Contaminants or card-fill problems may have also have been responsible for some of the discrepancies . The MRS test was considered to be an acceptable alternative screen or a supplement to other methods for same-day testing for ORS.

Arch Inst Cardiol Mex, 1989 Sep-Oct, 59(5), 505 - 10
{Infectious endocarditis caused by Staphylococcus . Study at the Ignacio Chavez National Institute of Cardiology 1977-1987}; Barrera-Bustillos M et al.; This is a descriptive survey of infectious endocarditis (EI) due to Staphylococci, collected at the Instituto Nacional de Cardiologia "Ignacio Chavez", in a ten years period . All had anatomical and bacteriological diagnosis . There were 21 cases, this disease in not rare, and both coagulase-positive or negative Staphylococci were represented in similar proportion as etiologic agents . Coagulase positive organisms produce a clinical picture of septicemia and systemic boxicity, therefore early diagnosis and prompt therapy is forthcoming . Instead coagulase negative EI cause an insidious illness with late diagnosis, focal intramyocardial abscesses and low responsiveness to therapy explain the poor prognosis . It is impossible to differentiate with our present resources between Staphylococcal bacteremia and EI . We recommend, combined antimicrobial therapy and if necessary early surgical treatment.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Sep, (9), 22 - 6
{A comparative study of the fibronectin-binding capacity of staphylococci}; Sokurenko EV et al.; The comparative study of the fibronectin-binding capacity of S . aureus and S . epidermidis of clinical etiology was carried out . Fibronectin binding was evaluated by original methods: the indirect hemagglutination test and the passive coagglutination test . In this study the occurrence of S . epidermidis isolates, as well as their level (evaluated by the titer) of fibronectin binding, was shown to be lower than those of S . aureus isolates . Fibronectin-binding representatives of S . epidermidis lost this capacity after storage in semiliquid agar at 4 degrees C for 2 months.

Kansenshogaku Zasshi, 1989 Sep, 63(9), 991 - 6
{Studies on the biological activity of slime isolated from staphylococci}; Obana Y et al.; The biological characteristic and activity of slime isolated from Staphylococcus aureus No . 71 and Staphylococcus epidermidis No . 2 was studied . The slime isolated from both strains had high contents of protein, RNA (orcinol reaction-positive substances) and sugar . The slime showed low toxic effect when it was injected intravenously and intraperitoneally into mice . It, however, exhibited potent cytotoxic effect against mouse neutrophils in both ex vivo and in vivo experiments . The enhancement of virulence of Escherichia coli by slime isolated from staphylococci was due to neutrophil-impairing effect . It is suggested that the slime isolated from S . aureus and S . epidermidis may act as an virulence factor.

Res Vet Sci, 1989 Sep, 47(2), 152 - 7
Expression of a pseudocapsule by Staphylococcus aureus: influence of cultural conditions and relevance to mastitis; Watson DL et al.; Strains of Staphylococcus aureus from cases of mastitis in ruminants were cultured in various media and the cells examined electron microscopically for a pseudocapsule . Organisms grown inside the udder, or in nutrient broth supplemented with ovine, bovine or caprine milk whey produced a large, well-defined pseudocapsule outside the cell wall, but such cells had no true capsule when tested by the India ink technique . Modified staphylococcus 110 medium induced secretion by the organisms of copious extracellular slime but did not induce the pseudocapsule . Organisms grown in the presence of milk whey showed a strong propensity to autoagglutinate and produced pseudocapsular material which contained antigens in common with staphylococci grown in vivo . Supplementing media with lactose, dextrose or casein failed to modify the cell surface of S aureus in a manner analogous to that induced by ruminant whey.

Nippon Eiseigaku Zasshi, 1989 Aug, 44(3), 756 - 62
Dynamic aspects of airborne bacterial flora over an experimental area in a suburb and distribution of resistant strains to antibacterial agents among airborne staphylococci; Chihara S et al.; Airborne bacterial floras were investigated at stations A to E and P on the UOEH campus located in a suburb of the city of Kitakyushu . Bacterial collections were carried out by a filtration method using a soluble gelatin foam filter at an altitude of 1 m from the ground and viable bacterial cells were enumerated on nutrient agar plates supplemented with 50 micrograms/ml cycloheximide . At station P, where airborne bacterial composition was evaluated as a mean value of 20 repeated experiments, there were 42% Gram-positive cocci, 37% Gram-positive rods, 3.5% Bacillus strains and 5.5% Gram-negative rods . Fluctuating values of cell amounts for Gram-positive cocci and rods during these experiments suggested that in the atmospheric layer near the ground, the former was a more transient group of airborne bacteria than the latter . When airborne bacterial flora over the experimental area was surveyed by observations at six stations, the dispersion profile of bacterial flora closely corresponded to vegetating states on the surface of the ground . Over vegetating areas, airborne bacterial flora appeared in about equal amounts of Gram-positive rods and cocci, while over bare ground, Gram-positive rods appeared more abundantly than Gram-positive cocci . To investigate the distribution of drug-resistant strains among airborne bacteria, sensitivity tests to six antibiotics were carried out with S . xylosus strains isolated at stations P and E . As a result, considerable amounts of single-drug-resistant strains for TC (DOX) and EM were recognized, but the distribution of multiple-drug-resistant S . xylosus was restricted to a few strains.

J Bone Joint Surg Br, 1989 Aug, 71(4), 638 - 41
The diagnostic value of C-reactive protein in infected total hip arthroplasties; Sanzen L et al.; In 50 patients with non-infected total hip arthroplasties (THA), 233 C-reactive protein (CRP) values were obtained over a three-year period . Six of these 50 patients occasionally had CRP values of over 20 mg/l . The erythrocyte sedimentation rate (ESR) and CRP concentration were measured in 23 patients with deep infections of THA before revision . In 11 patients the infections were caused by coagulase-negative staphylococci . CRP exceeded 20 mg/l in 18 patients and the ESR was more than 30 mm/hr in 14 . In only one infected patient were both CRP and ESR below these levels . All of 33 patients with non-septic loosening had CRP less than 20 mg/l and ESR less than 30 mm/hr before revision . C-reactive protein seems to be a valuable supplement to the ESR in the monitoring of infection after THA.

Infect Immun, 1989 Aug, 57(8), 2358 - 63
Fibrinogen-binding protein/clumping factor from Staphylococcus aureus; Boden MK et al.; The binding of staphylococcal components to fibrinogen was studied . Fibrinogen-binding material from lysed staphylococcal cells or culture supernatants was affinity purified on fibrinogen-Sepharose and analyzed on Western (immuno-) blots by the use of fibrinogen and antifibrinogen antibodies . Two main bands of 87 and 19 kilodaltons (kDa) and a weaker band of 35 kDa bound specifically to fibrinogen . A monoclonal antibody bound to all three bands, indicating that these were of the same origin . The yield of these components was much higher in the culture supernatant than on washed cells, suggesting that these molecules are essentially extracellular products . In a plasma coagulase test, the 87-kDa band, but not the 19-kDa band, clotted rabbit plasma, demonstrating that the 87-kDa molecule is coagulase . This was further confirmed by the fact that the 87-kDa band binds specifically to prothrombin . It was shown that the 87- and the 19-kDa molecules were present on the cell surface by surface labeling the cells with 125I . In addition, the fact that killed and washed cells could induce plasma clotting demonstrates that staphylococci have coagulase exposed on the surface . It was concluded that cell-bound coagulase has affinity for fibrinogen also in the absence of prothrombin and thus is responsible for the clumping of staphylococci in fibrinogen.

Antibiot Khimioter, 1989 Aug, 34(8), 610 - 4
{Phagocytosis of chloramine B sensitive and resistant staphylococci isolated from healthy persons and patients}; Balakliets NI et al.; Phagocytic reaction with respect to antibiotic and chloramine B sensitive and resistant staphylococci isolated from healthy persons and patients, air and stock of medical institutions was studied on albino mice . It was shown that the staphylococcal isolates included strains simultaneously sensitive to antibiotics and chloramine, sensitive to antibiotics and resistant to chloramine, resistant to antibiotics and sensitive to chloramine and simultaneously resistant to antibiotics and chloramine . Activity, intensity and completeness of phagocytosis by leucocytes from mouse abdominal cavity exudates with respect to the staphylococcal strains sensitive to antibiotics and resistant to chloramine, resistant to antibiotics and sensitive to chloramine and simultaneously resistant to antibiotics and chloramine were lower than the values of the phagocytic reaction with respect to the isolates simultaneously sensitive to antibiotics and chloramine . This suggested that not only antibiotic resistance of microbes but also their resistance to disinfectants could be referred to complicating factors of hospital infections.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Aug, (8), 73 - 6
{Changes in the immunotropic activity of neutrophilokins in the course of experimental staphylococcal infection}; Vlasov AV et al.; The influence of the products secreted by activated neutrophils (neutrophilokins) of mice, both intact and infected with staphylococci, on the activity of mouse spleen cells in the graft-versus-host reaction, immune response to sheep red blood cells and the antigen-presenting function of peritoneal macrophages was studied . Neutrophilokins of intact mice stimulated the activity of immunocompetent cells . Neutrophilokins obtained from infected mice on day 3 after infection produced an immunosuppressing effect . On day 7 after infection the immunostimulating activity of neutrophils was restored and showed practically no difference from the normal level.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Aug, (8), 3 - 5
{The frequency of the production of toxic-shock exotoxin by Staphylococcus aureus strains isolated in the USSR}; Pozhar PF et al.; 515 S . aureus strains, isolated from carriers and patients with staphylococcal infection in different regions of the USSR, were studied . Of these, 52.2% were found capable of producing exotoxin of toxic shock (ETS) . The occurrence of the capacity for ETS production was the same among the strains isolated from the upper respiratory ways of carriers and from the purulent inflammatory foci of patients and little varied in staphylococci isolated in different regions . The study revealed that in strains sensitive to the typing phages of the International Set the capacity for ETS production occurred considerably more frequently than in nontyped cultures . No essential differences with respect to this sign between strains belonging to different phage groups were established.

J Hosp Infect, 1989 Aug, 14(2), 135 - 40
Direct isolation of coagulase-negative staphylococci from neonatal blood samples; Kite P et al.; Coagulase-negative staphylococci (CNS) were isolated by direct inoculation of anticoagulated whole blood onto agar from 14 (41.2%) of 34 episodes (30 neonates) of suspected bacterial infection, associated with isolation of CNS from the same blood sample by broth-dilution blood cultures . The equivalent of more than 1,000 cfu ml-1 were isolated from four samples (four neonates); the range of counts was 1-103 cfu 25 microliters-1 . There was a statistically significant association between isolation of CNS by direct agar inoculation and a raised C-reactive protein level and/or a positive nitroblue tetrazolium test and with the use of an intravascular catheter when compared to those episodes where CNS were isolated from broth blood cultures only . This simple procedure provides an estimate of the number of CNS in the blood of a neonate with suspected bacteraemia and may help to corroborate a diagnosis of CNS bacteraemia.

Antimicrob Agents Chemother, 1989 Aug, 33(8), 1335 - 41
Mobility of gentamicin resistance genes from staphylococci isolated in the United States: identification of Tn4031, a gentamicin resistance transposon from Staphylococcus epidermidis; Thomas WD Jr et al.; Homologous genes encoding resistance to gentamicin, tobramycin, and kanamycin through the bifunctional acetylating {AAC(6')} and phosphorylating {APH(2")} aminoglycoside-modifying enzyme were identified in staphylococci isolated from patients in the United States . The mobility of gentamicin resistance (Gmr) genes found on a prototype conjugative plasmid (pGO1) was compared with that of genes cloned from chromosomal sites . Plasmid-encoded Gmr genes and flanking sequences were introduced onto a temperature-sensitive plasmid (pRN3208) from pGO1 by homologous recombination between insertion sequence-like elements present on both replicons . Growth of Staphylococcus aureus strains containing the temperature-sensitive recombinant (pGO161) at the nonpermissive temperature for plasmid replication (42 degrees C) revealed no translocation of Gmr from its plasmid location . A transposon (Tn551) resident on the same replicon did translocate . Chromosomal Gmr determinants were cloned, together with the gene for trimethoprim resistance (dfrA), from three geographically distinct S . epidermidis isolates; two were subcloned onto temperature-sensitive Escherichia coli-S . aureus shuttle plasmids as 7.2-kilobase BglII fragments . Growth of both recombination-deficient and-proficient S . aureus strains containing the cloned genes at 42 degrees C allowed detection of transposition of Gmr sequences and identification of insertion into random chromosomal sites . We have designated this 5-kilobase transposon from S . epidermidis as Tn4031.

J Clin Pathol, 1989 Aug, 42(8), 872 - 4
New method for detecting slime production by coagulase negative staphylococci; Freeman DJ et al.; An alternative method for detecting the production of slime by coagulase negative staphylococci was compared with the routinely used Christensen method on 124 isolates of coagulase negative staphylococci from carriage sites, blood cultures, and infected peritoneal dialysis fluids . The alternative method requires the use of a specially prepared solid medium--brain heart infusion broth, supplemented with 5% sucrose, and Congo red stain . Of the 124 tests, there was complete agreement between methods in 107 and only one strain was clearly negative by Christensen's method while positive on Congo red agar . The Congo red method is rapid, sensitive, and reproducible and has the advantage that colonies remain viable on the medium . It is also not subject ot interbatch variation of media which sometimes affects the reproducibility of the Christensen method.

BMJ, 1989 Jul 29, 299(6694), 294 - 7
Outbreak of coagulase negative staphylococcus highly resistant to ciprofloxacin in a leukaemia unit; Oppenheim BA et al.; OBJECTIVE--To define an outbreak of bacteraemia due to coagulase negative staphylococci highly resistant to ciprofloxacin in a leukaemia unit, investigate the source and mode of spread of the outbreak strain, and assess control measures . DESIGN--The outbreak strain was characterised by five different typing methods . Surveillance of patients, staff, and environment was carried out during the outbreak and five months after control measures were introduced . SETTING--A unit with 10 beds for adults with leukaemia and patients receiving bone marrow transplants . The outbreak occurred during a trial of ciprofloxacin for empirical treatment of neutropenic fevers . INTERVENTIONS--Ciprofloxacin was withdrawn from use in the unit and daily bathing with chlorhexidine gluconate solution started . Main outcome measure--The absence of bacteraemia due to the outbreak strain for five months after control measures . RESULTS--During the study 49 patients developed 21 episodes of bacteraemia due to the outbreak strain, which was ciprofloxacin resistant (minimum inhibitory concentration greater than or equal to 128 mg/l), susceptible to phage 155 A9C, and SII biotype and had characteristic immunoblot and DNA fingerprint features . There was a high amount of colonisation of patients but not staff with this strain, which was also wide spread in the environment . The control measures led to rapid resolution of the outbreak and disappearance of the strain from the unit . CONCLUSIONS--In areas where coagulase negative staphylococcal infections are common doctors must be aware of the possibility of cross infection with single strain, and the availability of more discriminatory methods of typing will facilitate the identification and control of such episodes.

Vojnosanit Pregl, 1989 Jul-Aug, 46(4), 264 - 7
{Methicillin-resistant staphylococci . Identification and distribution in the hospital environment}; Tomanovic B et al.; Occurrence of methicillin resistant staphylococcal strains in hospital environment is more frequently found . These strains are multiresistant so that diseases caused by them require a special therapeutical approach . They are significant causative agents of intrahospital infections which may have epidemic character . Using two methods for detection of methicillin resistant staphylococcus 335 strains were tested . Methicillin resistance was found in 36 (20.6%) of 175 strains of St . aureus and 49 (30.5%) strains of coagulase negative staphylococci . The largest number of methicillin resistant strains is isolated from materials of patients hospitalized at surgical and hematological clinics.

J Burn Care Rehabil, 1989 Jul-Aug, 10(4), 321 - 6
Use of Pseudomonas hyperimmunoglobulin to treat septic shock in burn cases; Kistler D et al.; The progress of 18 episodes of septic shock in nine patients with burn injuries after administration of a Pseudomonas immunoglobulin is presented . In nine instances the septic shock was treated successfully . The mean burn index of these nine patients was 96 . In six of the nine patients the septic shock was accompanied by simultaneous inhalation trauma and in six by acute kidney failure . In four cases the sepsis was caused by P . aeruginosa and in five by staphylococci . Despite the different causative agents, successful treatment was possible in these cases . The mean burn index for the four patients who eventually died was 119; all patients in this group were suffering from an inhalation trauma and acute kidney failure requiring dialysis . In these cases even the use of Pseudomonas immunoglobulin had no decisive effect.

Fiziol Zh, 1989 Jul-Aug, 35(4), 27 - 32
{Patterns of the forming of an immunologic memory to staphylococcal corpuscular antigen}; Liashchenko KP et al.; The experiments carried out on inbred mice have revealed that the level of the immunological memory to staphylococci depends on the intensity of the antigenic stimulation; high priming dose of antigen proving to be the most effective one . The opposite character of immune responsiveness observed during primary antibody response to particulate staphylococcal antigen in C3H and A/Sn mice increased after the second immunization . It is established that immunological memory to staphylococci may be induced in genetically athymic mice . Many antibody-forming cells are found in the bone marrow of the secondary immunized mice . This phenomenon may be due to the repopulation of the bone marrow tissue by recirculating memory cells.

Z Lebensm Unters Forsch, 1989 Jul, 189(1), 16 - 20
Growth of Staphylococcus aureus and synthesis of enterotoxins in home-made yoghurt; Orden JA et al.; Staphylococcus aureus strains FRI-100, S6, FRI-137 and FRI 472 were inoculated into milk to study growth and enterotoxin production in home-made yogurts . The yogurt used as starter was progressively weakened by successive inoculations (up to four) in milk to prepare other yogurts in order to study the ability of yogurt microflora to inhibit staphylococci . After elaboration, yogurts were stored at 4 degrees C, 22 degrees C, and 37 degrees C for a maximum of 21 days . Periodically, staphylococcal counts, pH and the production of enterotoxins A, B, C, and D were determined . Enterotoxins were only detected in the last batch . It was concluded that the inhibitory effect of the starter culture is not only due to the decrease of pH, but also to other factors.

J Med Entomol, 1989 Jul, 26(4), 354 - 9
Survey of medically important true bacteria found associated with carrion beetles (Coleoptera: Silphidae); Solter LF et al.; Thirty-six carrion beetles (Silphidae: Nicrophorus tomentosus Weber, Oiceoptoma noveboracense (Forster), Necrophila americana (L.} collected in the Great Swamp National Wildlife Refuge, Basking Ridge, N.J., were dissected and the midgut, hindgut, and associated hemolymph were cultured for bacteria . Analytical profile index rapid biochemical systems were used for bacterial identifications . Nineteen bacteria were identified to species and four to the genus level . Although frank pathogens were not found, several of the identified coliform and staphylococci bacteria were known opportunistic pathogens . More than 20 additional morphologically distinct bacteria were cultured, but these could not be identified using the rapid biochemical test strips because of data base limitations.

J Clin Microbiol, 1989 Jul, 27(7), 1560 - 6
Is ingestion of milk-associated bacteria by premature infants fed raw human milk controlled by routine bacteriologic screening?
Law BJ, Urias BA, Lertzman J, Robson D, Romance L.
Expressed human milk is often used to feed premature infants . Raw milk contains bacteria which may be a source of infection . Milk banks have developed screening programs which combine periodic quantitative milk cultures with arbitrary rules specifying limits of bacterial concentration . It is unknown whether such programs succeed in preventing infants from being fed milk containing bacteria . At the Health Sciences Centre (Winnipeg, Manitoba, Canada), milk is screened once weekly . When a woman's milk is found to have excess bacteria, it is discarded only if she is an unrelated donor (as opposed to an infant's mother) . To assess the effectiveness of this screening program, we determined the frequency at which infants fed raw human milk were exposed to milk-associated bacteria and compared the bacterial contents of donor and maternal milk . From February 1986 to April 1987, all human milk fed to 98 premature infants during the first 2 weeks of feeding (n = 10,128 feeds) was cultured quantitatively . Among study infants, 100% were exposed at least once to coagulase-negative staphylococci, 41% were exposed to Staphylococcus aureus, and 64% were exposed to gram-negative bacilli . The proportions of feeds containing bacteria and the quantities (log10 CFU {mean +/- standard deviation}) ingested per positive feed were: 39% and 5.9 +/- 0.5 for coagulase-negative staphylococci; 2.4% and 5.1 +/- 1.0 for S . aureus; and 5.2% and 4.8 +/- 1.1 for gram-negative bacilli . There were no adverse events attributable to ingestion of milk-associated bacteria . Milk coagulase-negative staphylococcal isolates were multiply antibiotic susceptible, whereas infant isolates were antibiotic resistant . Donor milk was significantly less likely than maternal milk to contain coagulase-negative staphylococcal species in any quantity (40 versus 93% of samples, respectively {P < 0.001}) or in concentrations exceeding 10(8) CFU/liter (3 versus 27% of samples, respectively {P < 0.0001}) . There was no difference between milk from either source in terms of S . aureus or gram-negative bacterial content (4 to 6%) . These results suggest that the Health Sciences Centre screening program is effective in limiting the number of harmless coagulase-negative staphylococcal species but has no impact on the quantity of potentially pathogenic bacteria ingested by premature infants . Implications for screening donor milk are discussed.

J Postgrad Med, 1989 Jul, 35(3), 123 - 34
Bombay experience in intensive respiratory care over 6 years; Kamat SR et al.; The experience of the intensive respiratory care in 930 cases treated from 1983 for 4 years and in 404 cases over the next 2 years is reported . The background operational problems are stressed . Those between age 10 and 50 years did significantly better (p less than 0.05) . The survival over the first 4 years in IPPR cases was 16.3% and in non IPPR group 71.8%; over the next 2 years, the former group, survival was 32.4 and 36.3% . The survival in asthmatic patients was high (76%) . In cases with organophosphorus poisoning (without IPPR), survival was 81% while in IPPR group it was 29% . In 1988, the results in this group were better due to more aggressive management . In autopsy data on 85 cases, infection was not a major feature in those dying within 24 hours . The survival in COPD cases showed significant relation to age (p less than 0.05), initial arterial pO2 below 60 mm (p less than 0.01) and arterial pH below 7.3 (p less than 0.01) . In cases with pneumonia (also asthma) younger cases did better (p less than 0.05) as also those with pneumonia and initial pO2 above 60 mm (p less than 0.01) and pH above 7.3 (p less than 0.001) . When pneumonia was community acquired, survival (64.8%) was better than when it was hospital acquired (24%; p less than 0.01) . Only the need for IPPR affected survival in trauma group . The major cause of death was infection with Klebsiella, Pseudomonas, Staphylococci and other gram--ve organisms . It is concluded that with proper planning and training, the IRCU does provide a useful mode of treatment in selected patients with respiratory problems.

Diagn Microbiol Infect Dis, 1989 Jul-Aug, 12(4 Suppl), 109S - 116S
Overview of mechanisms of bacterial resistance; Neu HC; Many antimicrobial agents have been either found in nature or synthesized in the past 45 years . Antibacterial agents inhibit cell-wall formation, disrupt cytoplasmic membrane function, prevent DNA synthesis, interfere with protein synthesis, and halt folate synthesis . Resistance to antibiotics is a result of three major mechanisms: prevention of the antibacterial agent from reaching its receptor site, production of altered targets, and destruction or modification of the agents . Bacterial resistance has occurred due to chromosomal changes or the presence of plasmids and transposons . Resistance to beta-lactams is the result of beta-lactamases and the production of altered penicillin-binding proteins as well as altered cell-wall permeability . Important examples of these resistance forms occur in staphylococci and pneumococci which have altered penicillin-binding proteins . A new form of target change has been the production of proteins in enterococci that inhibit the activity of glycopeptides . Beta-lactamases are present in both Gram-positive and Gram-negative species; recently, new plasmid beta-lactamases have been isolated that destroy iminomethoxy and iminocarboxy cephalosporins . Resistance to aminoglycosides is due to enzymes that acetylate, adenylate, or phosphorylate aminoglycosides that inhibit binding to ribosomes and thus cause the poor uptake of drug . Tetracycline resistance is due to plasmids which cause efflux of the agent from the cytoplasm . Macrolide and lincinoid resistance is the result of an altered 23S ribosomal component of the 50S ribosomes . Sulfonamide and trimethoprim resistance is due to production of altered synthetase and reductase enzymes essential in the synthesis of folate.(ABSTRACT TRUNCATED AT 250 WORDS)

Z Orthop Ihre Grenzgeb, 1989 Jul-Aug, 127(4), 484 - 7
{The German Society of Orthopedics and Traumatology study: pathogen spectrum and resistance status}; Nowak ME et al.; In the scope of a DGOT Study various aspects and evaluations of the bacterial spectrum of wound infections are reviewed and the frequency of resistance is presented . The study is based on 3700 wound healing protocols . Our results suggest that the bacterias involved in the field of orthopaedic surgery and traumatology are for the most part known germs . This should be decisive for the type of antibiotic therapy being possibly required . The main organisms are Staphylococci, Enterococci and Pseudomonades; available agents of choice are penicillinase-resistant and -susceptible Penicillins, Ampicillins and Cephalosporins of the first and second generation.

Tijdschr Diergeneeskd, 1989 Jul 1, 114(13), 719 - 20
{A case of swollen head syndrome in a flock of guinea fowl}; Litjens JB et al.; A case of swollen head syndrome in guinea-fowl is reported . In addition to the isolation of E . coli and staphylococci during the course of the disease, antibodies to rhinotracheitis were shown to be present in the blood . Treatment with Baytril produced satisfactory results.

Plucne Bolesti, 1989 Jul-Dec, 41(3-4), 187 - 92
{Comparison of amoxicillin and amoxiclav in the therapy of respiratory infections}; Music E et al.; Randomly hospitalized patients with respiratory tract infections admitted to three pulmonary departments of the Golnik Institute for Pulmonary Diseases and Tuberculosis were enrolled in an open, comparative clinical study of Amoksiklav and Amoxicillin . A group of 26 patients with a mean age of 64.5 years presenting with pneumonia (13), exacerbation of chronic bronchitis (12) and bronchiectasis (1) were given Amoskilav, while another 20 patients with a mean age of 61.4 years presenting with pneumonia (9), exacerbation of chronic bronchitis (5), bronchiectasis (5) and sinusitis (1) received Amoxicillin . The efficacy of treatment was assessed by bacteriological findings of respiratory tract specimens, sputum and blood leucocytosis, macroscopic purulence of sputum and the presence of fever . The bacteriological findings are shown in detail . Leucocytosis and macroscopic purulence of sputum significantly improved on Amoksiklav therapy (p less than 0.05) while with Amoxicillin there was no significant improvement . With respect to the presence of fever, there was no significant difference between Amoksiklav and Amoxicillin . The overall clinical and bacteriological response was very good and good in 88.5% of patients treated with Amoksiklav compared to 75% of those receiving Amoxicillin . Additionally, 1000 pathogenic strains were tested for their response to Amoksiklav and Amoxicillin . Amoksiklav proved superior against strains of Branhamella catarrhalis, E . coli, coagulase-negative staphylococci and K . pneumoniae (p less than 0.01).

J Postgrad Med, 1989 Jul, 35(3), 147 - 51
Correlation between beta-lactamase production and MIC values against penicillin with coagulase negative staphylococci; Narayani TV et al.; Two hundred strains of coagulase negative staphylococci (CNS) isolated from various clinical specimens (116) and healthy hospital personnel (84) were investigated for the production of beta-lactamases by means of three iodometric techniques and correlated with the minimum inhibitory concentration (MIC) values of penicillin-G by agar dilution technique and disc diffusion technique . One hundred and fifty (75.0%) of the 200 strains tested produced beta-lactamases . Seventy two per cent of the CNS were found to be beta-lactamase positive by the starch paper technique which was the most sensitive one in our study . The MIC values of penicillin against CNS ranged from less than or equal to 1.25 to greater than or equal to 2000 units . The present study indicated the higher prevalence of beta-lactamase producers with increased penicillin resistance among CNS strains isolated from healthy carriers and hospitalised patients.

Scand J Immunol, 1989 Jul, 30(1), 91 - 8
Increased expression of leucocyte adherence-related glycoproteins by polymorphonuclear leucocytes during phagocytosis of staphylococci on an endothelial surface; Vandenbroucke-Grauls CM et al.; Phagocytosis of Staphylococcus aureus by human polymorphonuclear leucocytes (PMN) on the surface of endothelial cells is accompanied by adherence of the PMN to the endothelial surface and detachment of the endothelial cells from the culture monolayer . We studied the role of the leucocyte adherence-related glycoproteins (Leu-CAM: Mo1/LFA-1/150,95 or CD11a-c-CD18 complex) in these processes . Phagocytosis of S . aureus induced increased expression of the common beta chain (CD18) of Leu-CAM as demonstrated by flow cytometric analysis of PMN treated with a monoclonal antibody (MoAb) (CLB-LFA-1/1) directed against CD18 and fluorescein isothiocyanate (FITC)-conjugated anti-MoAb . This same MoAb also inhibited the increased adherence of the PMN to the endothelial cells which occurs during phagocytosis . Blocking of adherence during phagocytosis with MoAb CLT-LFA-1/1 had no effect on the detaching activity of the PMN on the endothelial cells . We conclude that adherence of PMN to endothelial cells during phagocytosis of S . aureus is mediated by the Leu-CAM complex . Adherence through the Leu-CAM, however, is not necessary for endothelial damage by the phagocytosing PMN.

Antibiot Khimioter, 1989 Jul, 34(7), 523 - 6
{Glycopeptide antibiotics: eremomycin, vancomycin, and teicoplanin . Comparison of several parameters of pharmacokinetics and antimicrobial activity}; Filippos'iants ST et al.; Pharmacokinetic parameters of eremomycin (Institute of New Antibiotics, the USSR Academy of Medical Sciences), teichoplanin (Lepetit) and vancomycin (Eli Lilly) were compared after their intravenous administration to rats in the same dose of 50 mg/kg . It was shown that the area under the concentration time curve of eremomycin was 2 times smaller than that of teichoplanin and 6 times larger than that of vancomycin . The mean retention time of eremomycin was close to that of teichoplanin and 1.6 times higher than that of vancomycin . Bioavailability of eremomycin and teichoplanin after their extravascular administration was the same and amounted to 94 per cent . Antibacterial activity of eremomycin against methicillin resistant strains of staphylococci was 4 times higher than that of teichoplanin and vancomycin.

Acta Otolaryngol, 1989 Jul-Aug, 108(1-2), 122 - 5
The bacterial flora of the nasopharynx, with special reference to middle ear pathogens . A quantitative study in twenty children; Stenfors LE et al.; Quantification of middle ear pathogens (S . pneumoniae, H . influenzae and B . catarrhalis) and potential pathogens (S . aureus and coagulase-negative staphylococci) adhering to the posterior wall of the nasopharynx was performed in 20 patients of whom 5 were suffering from secretory otitis media (SOM), 5 from recurrent attacks of acute otitis media (rAOM), 5 from attacks of upper respiratory infection (URI) and 5 from blocked nose (BN) . While the patients were under general anesthesia a glass cylinder (diameter 1.3 cm) was pressed against the posterior wall of the nasopharynx and swabs were taken from the mucosa delineated by the glass tube . Quantification of the bacteria was performed using blood and chocolate agar plates . Total bacterial counts ranged between 2.6 x 10(4)CFU/cm2 and 4.0 x 10(8)CFU/cm2 . In the rAOM group, 4 out of 5 children had bacterial counts in the nasopharynx which constituted of 95% pathogens . Coagulase-negative staphylococci never exceeded 1.9 x 10(5)CFU/cm2.

J Gen Microbiol, 1989 Jul, 135 ( Pt 7), 2093 - 7
Differentiation of staphylococcal species and strains by ribosomal RNA gene restriction patterns; Thomson-Carter FM et al.; Staphylococcal DNA was digested with endonucleases and probed with labelled ribosomal RNA (rRNA) from Escherichia coli . Reproducible restriction patterns containing between seven and 22 bands were obtained for seven different species of staphylococci . These profiles were species-specific with different strains of a particular species sharing an identical or similar restriction pattern . The results reported here indicate that rRNA gene restriction pattern analyses have an application in the taxonomy of staphylococci.

Med Clin (Barc), 1989 Jun 17, 93(3), 93 - 6
{Endocarditis of a natural valve caused by coagulase-negative staphylococci}; Aguado Garcia JM et al.; Eleven patients with endocarditis of a natural valve due to coagulase-negative staphylococci are reported . Nine had some underlying heart disease . The course was subacute in seven and acute (two weeks or less) in the remaining four . All patients developed complications: heart failure in nine, arterial emboli in eight, atrioventricular conduction disorders in four, development of paravalvular and/or myocardial abscesses in four, and perforation or rupture of valve leaflets in four . Eight patients were cured, seven of them requiring surgical treatment . Three of the isolated coagulase-negative staphylococci strains were methicillin-resistant; two of them caused community-acquired endocarditis . Natural valve endocarditis due to coagulase-negative staphylococci usually has a subacute course with a tendency to develop severe complications . This makes surgical therapy necessary in a sizeable number of patients.

Antimicrob Agents Chemother, 1989 Jun, 33(6), 813 - 6
Comparative in vitro antibiotic resistance of surface-colonizing coagulase-negative staphylococci; Gristina AG et al.; The MBCs of nafcillin, vancomycin, gentamicin and daptomycin (LY146032) were determined for three clinical isolates of coagulase-negative staphylococci grown in suspension and adherent to biomaterials . Strains studied were the slime-producing strain Staphylococcus epidermidis RP-12 (ATCC 35983), S . hyicus SE-360, and the non-slime-producing strain S . hominis SP-2 (ATCC 35982) . All three strains were allowed to colonize surgical-grade disks of stainless steel, polymethylmethacrylate, and ultrahigh-molecular-weight polyethylene for 24 h, and the disks were then exposed to various concentrations of antibiotics for 24 h . Surviving adherent bacteria were mechanically dislodged from the disks and quantitated by standard broth dilution plating techniques . Biomaterial-adherent RP-12 and SE-360 yielded approximately 10 times more CFU per disk than non-slime-producing SP-2 did . For all organisms, 10 times more bacteria bound to polymethylmethacrylate disks than to the other biomaterials . In general, bacteria adherent to biomaterials exhibited greater resistance to antibiotics than the same strains in suspension did . Resistance was independent of bacterial slime-producing characteristics and was related to the biomaterial colonized.

Am J Infect Control, 1989 Jun, 17(3), 130 - 5
Use of cellular hydrophobicity, slime production, and species identification markers for the clinical significance of coagulase-negative staphylococcal isolates; Martin MA et al.; Determining the clinical relevance of coagulase-negative staphylococci isolated from cultures of clinical specimens remains a common dilemma . One hundred eighteen strains of coagulase-negative staphylococci isolated from patients with and without indwelling foreign bodies were characterized with regard to cell-surface hydrophobicity, slime production, and species to determine the predictive value of these phenotypic markers in distinguishing clinically significant from insignificant isolates . The single test with the highest positive predictive value was hydrophobicity (79%) . Hydrophobicity and speciation had the greatest combined predictive value of any two tests (89%), and this increased to only 90% when determination of slime production was added . These tests provide additional clinical information when coagulase-negative staphylococci are isolated in culture.

Epidemiol Infect, 1989 Jun, 102(3), 365 - 78
Prevalence of peritonitis-associated coagulase-negative staphylococci on the skin of continuous ambulatory peritoneal dialysis patients; Beard-Pegler MA et al.; The predominance of coagulase-negative staphylococci as normal skin flora is thought to be a factor in their association with episodes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis . We investigated the prevalence of peritonitis-associated strains on the skin of 28 patients undergoing peritoneal dialysis . Coagulase-negative staphylococci were the most frequently isolated organisms, comprising 47% of peritoneal dialysis fluid isolates and 59% of body site isolates . A total of 142 coagulase-negative staphylococci were speciated, tested for their antimicrobial sensitivity and slime production, and identified by phage typing and plasmid-profile analysis . Staphylococcus epidermidis was the most commonly identified species from both peritoneal dialysis fluid (73%) and body sites (53%) . Multiple antibiotic resistance was common, and the greater proportion of isolates were resistant to methicillin; 63.6% of peritoneal dialysis fluid isolates and 61.7% of body-site isolates . S . haemolyticus isolates were significantly more resistant to methicillin than other species . By phage typing and plasmid-profile analysis it was shown that peritonitis was rarely caused by skin-colonizing strains . In only 3 of 14 patients were peritonitis-associated strains isolated as skin colonizers, and no patients developed peritonitis due to organisms previously isolated as skin colonizers.

J Pediatr, 1989 Jun, 114(6), 1029 - 34
Surface colonization with coagulase-negative staphylococci in premature neonates; D'Angio CT et al.; To follow the emergence of surface colonization with coagulase-negative staphylococci in neonates, we sampled four surface sites (axilla, ear, nasopharynx, and rectum) in 18 premature infants during the first 4 weeks of life . Swabs were obtained on the first day of life, twice weekly for 2 weeks, and weekly thereafter . Isolates were characterized by species, biotype, antibiotic susceptibility patterns, and slime production . Over 4 weeks the percentage of infants with Staphylococcus epidermidis as the only surface coagulase-negative staphylococci rose from 11% to 100% . Predominance of a single S . epidermidis biotype increased from none to 89% . Multiple antibiotic resistance rose from 32% to 82% of isolates, and the prevalence of slime production increased from 68% to 95% . This microbiologic pattern was established by the end of the first week of life and persisted throughout the month of study . In three infants, S . epidermidis sepsis developed with organisms identical to their predominant surface isolate . We conclude that species, multiple antibiotic resistance, and slime production appear to confer a selective advantage for the surface colonization of premature newborn infants in the intensive care nursery environment . Infants so colonized may be at greater risk for subsequent infection with these strains of coagulase-negative staphylococci.

Zentralbl Veterinarmed B, 1989 Jun, 36(4), 297 - 302
Synergistic hemolytic reactions between staphylococci and Micrococcus lylae; Lammler C et al.; The primary culture of a clinical specimen obtained from a dog with an acute squamous eczema revealed three different bacterial species which demonstrated synergistic hemolytic activities on sheep blood agar plates . The three cultures were identified as beta-hemolytic Staphylococcus intermedius, as a coagulase-negative staphylococcal species, producing a delta-like hemolysin and as non-hemolytic Micrococcus lylae . The coagulase-negative staphylococcal species as well as M . lylae produced synergistically with beta-hemolytic S . intermedius zones of complete hemolysis . The occurrence of three different synergistically active bacterial species from one clinical specimen might be of clinical significance.

Infect Dis Clin North Am, 1989 Jun, 3(2), 329 - 38
Infections of hip prostheses and artificial joints; Fitzgerald RH Jr; Infections following total joint arthroplasty have been dramatically lowered with the administration of prophylactic antibiotics . Anecdotal experience as well as prospective data suggests that ultra-clean operating rooms can further reduce the incidence of postoperative wound sepsis following total joint arthroplasty . Once a deep infection complicates a total joint arthroplasty, resection arthroplasty will usually be necessary . Staphylococci are the most common causal organisms . Four weeks of specific, parenteral therapy should be administered at the time of the resection arthroplasty . Reconstruction with another total joint can be performed in a "one-staged" or a delayed fashion . The decision as to which procedure should be performed is made based on the degree of virulence of the infection (microbiology) and the anatomic location . Successful reconstruction can be achieved in 95 per cent of carefully selected patients.

Clin Lab Med, 1989 Jun, 9(2), 255 - 67
Methicillin-resistant staphylococci; Thornsberry C; Staphylococcus aureus and coagulase-negative staphylococci are among the most frequent causes of nosocomial infections, in addition to their role in community-acquired infections . The incidence of resistance to penicillinase-resistant penicillins (methicillin, oxacillin, nafcillin, and the cloxacillins) is steadily increasing . These methicillin-resistant staphylococci are usually resistant to several classes of antimicrobial agents.

Arch Intern Med, 1989 Jun, 149(6), 1258 - 62
Staphylococcus aureus nasal carriage in hemodialysis patients . Its role in infection and approaches to prophylaxis; Chow JW et al.; Staphylococcus aureus infections remain a major cause of morbidity in hemodialysis patients . Chronic dialysis patients are more prone to staphylococcal infections because of their decreased immunity, increased skin colonization by staphylococci, and the multiple needle punctures required for dialysis . The source of the staphylococci is the anterior nares . Elimination of staphylococcal nasal carriage results in a significantly lower infection rate . Selected clinical studies of topical and oral therapy for eradication of staphylococcal nasal carriage are reviewed . Rifampin has been the most consistently efficacious agent, although emergence of resistance is a potential problem . Trials utilizing newer topical and oral agents for prophylactic eradication of S aureus from the nose are indicated . Promising antibiotics include topical mupirocin, the oral quinolones, and clindamycin.

Proc Soc Exp Biol Med, 1989 Jun, 191(2), 163 - 9
In vivo localization of Staphylococcus aureus in nasal tissues of healthy and influenza A virus-infected ferrets; Sanford BA et al.; An in vivo ferret model was used to study the association of Staphylococcus aureus with specific tissues of the nasal cavity in both control and influenza A virus-infected animals . Ferrets were inoculated intranasally with various doses of influenza A3/Hong Kong/1/68 virus . On Days 2, 5, 9 and 14, four or five virus-inoculated and two uninoculated controls were challenged intranasally with a 1-ml volume of radiolabeled S . aureus (3 mg dry wt), a clinical isolate of low passage history . Ferrets were allowed to clear the staphylococci in vivo for 60 to 90 min before sacrifice . The animals were anesthetized, exsanguinated, and decapitated, and the lower jaw was removed . The nasal fossae were exposed by dissection and turbinates from the left nasal fossa were used for virus isolation . The median septum and tissues from the right nasal fossa, which included vestibule and anterior and posterior turbinates, were harvested and processed for radioassay . The percentage of recoverable staphylococci from virus-infected ferrets (Days 2 and 5) was greater than or equal to 10-fold higher compared with controls and animals infected with suboptimal doses of virus; greater than or equal to 76% of the recoverable staphylococci, whether from controls or virus-infected animals, was associated with the anterior turbinates . Histologic examination of the anterior turbinates from virus-infected ferrets, particularly on Days 2 and 5 postexposure to virus, showed that the staphylococci were adhering to desquamating respiratory epithelial cells . In contrast, the anterior turbinates from control ferrets uninoculated with virus and posterior turbinates from both control and virus-infected animals showed no evidence of bacteria adhering to host cells; instead, the staphylococci were found in association with the mucus gel layer of respiratory mucosa . Examination of vestibular tissue showed staphylococci in association with cells of the stratum granulosum in both virus-infected and control animals . Results of this study suggest that the early events of S . aureus interaction with different sites of ferret nasal tissues are effected by different mechanisms, and that the interaction is significantly enhanced by virus-infection.

Diagn Microbiol Infect Dis, 1989 May-Jun, 12(3), 261 - 3
Vertebral osteomyelitis and native valve endocarditis caused by Staphylococcus warneri; Wood CA et al.; Coagulase-negative staphylococci almost invariably cause significant clinical infections in the setting of prosthetic devices or severely compromised host defenses . Hematogenous osteomyelitis and native valve endocarditis due to these pathogens in any setting is rare . We report a case of community-acquired vertebral osteomyelitis and native valve endocarditis due to Staphylococcus warneri in a patient with none of the usual risk factors.

Diagn Microbiol Infect Dis, 1989 May-Jun, 12(3), 253 - 5
In vitro activity of minocycline and rifampin against staphylococci; Segreti J et al.; We tested the in vitro inhibitory and bactericidal activity of minocycline against 26 methicillin-susceptible Staphylococcus aureus, 24 methicillin-resistant S . aureus, 1 methicillin-susceptible coagulase-negative staphylococci, and 33 methicillin-resistant coagulase-negative staphylococci . Minocycline and rifampin had MIC90 results in the susceptible range, but MBCs were markedly elevated for minocycline alone (MBC50 greater than 32 micrograms/ml) . The combination of minocycline and rifampin was synergistic for 30% of the isolates with the highest rates of synergy being against methicillin-resistant isolates.

Zentralbl Bakteriol, 1989 May, 271(1), 104 - 13
Granulocyte activation by a cell surface complex of Staphylococcus saprophyticus: a receptor-mediated phenomenon; Ko HL et al.; High molecular weight cell surface complex (CSC) from Staphylococcus saprophyticus strain S 1 could be shown to be a potent stimulator of human polymorphonuclear leukocyte (PMN) chemiluminescence whereas human monocytes were not activated . Heating of the CSC (100 degrees C for 5 min) as well as protease treatment significantly (p less than 0.001) inhibited the PMN activating process suggesting that the protein part of the molecule mediates its biological activity . Data on the biochemical character of the CSC are given . Preincubation of PMNs with CSC inhibited another chemiluminescence response to this substance and to homologous opsonized S . saprophyticus, respectively . However, restimulation with formylmethionyl peptides (fMLP) or non-opsonized staphylococci suggested that the PMN function is a receptor-mediated phenomenon . These data were substantiated since fMLP activated PMNs could be evidently re-stimulated with CSC but not with analogue peptides . Evaluation of the bactericidal capacity of human PMNs yielded comparable results.

Vet Med (Praha), 1989 May, 34(5), 275 - 86
{Immunologic skin tests in piglets}; Raszyk J et al.; Immunological skin tests were carried out in 213 weanling piglets at the weight of 5 to 30 kg . Immediate hypersensitivity was evaluated by help of diagnostic allergens (mould, yeast and bacterial ones), delayed hypersensitivity by help of staphylococcus lysate, cellular immunity (tests de novo) by help of phytohemagglutinin and as common recall antigens were used tuberculin, toxoplasmin, candidic and tetanic antigen . The above substances were applied intradermally to the back of the piglets . For an evaluation of non-specific inflammatory response, sodium lauryl sulphate applied epicutaneously was used . The average reaction to diagnostic allergens (50 PNU in 0.05 ml) evaluated after 20 minutes was characterized as light dermal reactions (the papule size of 3-5 mm); in 22% of piglets moderate dermal reactions (the papule larger than 6 mm) to the diagnostic bacterial allergen (Staphylococcus aureus, Staphylococcus epidermidis) were determined . After an intradermal implantation of histamine (50 micrograms in 0.05 ml) the average size of the papule was 13 mm in 20 minutes . After the application of 0.1 ml of staphylococcus lysate (STAVA), the induration exceeding 10 mm was observed in 13% of piglets in 24 hours . After the application of phytohemagglutinin (100 micrograms in 0.1 ml), the induration exceeding 5 mm in 24 hours was determined in 93% of piglets and in 48 hours in 59% of piglets . Common recall antigens were applied at the volume of 0.1 ml . Forty-eight hours after the application no palpable induration was determined: in 91% of piglets after the application of tuberculin (2 TU PPD in 0.1 ml); in 75% of piglets after toxoplasmin (according to PNY 30-33-74); in 98% of piglets after candidic antigen (100 PNU in 0.1 ml) and in 86% of piglets after tetanic antigen implantations (0.03 Lf in 0.1 ml) . The epicutaneously applied sodium lauryl sulphate (at 2.5% and 5% concentrations) caused no inflammatory dermal reactions (erythema or induration) after 24 hours . In piglets it is best to apply phytohemagglutinin for evaluating cellular immunity, staphylococcus lysate for evaluating delayed hypersensitivity to staphylococci and histamine for obtaining the information on a disposition of piglets to allergic diseases.

Dtsch Tierarztl Wochenschr, 1989 May, 96(5), 256 - 8
{The occurrence and significance of plasma coagulase negative staphylococci from the genital tract of horses}; Huthwohl H et al.; Classification based on biochemical characteristics of 389 strains of plasma-coagulase-negative (plc-) staphylococci isolated from the genital tract of mares and stallions resulted in the following distribution of species: St . sciuri 130 (33.4%), St . equorum 42 (10.8%), St . xylosus 16 (4.1%), St . epidermidis 35 (9.0%), St . simulans 24 (6.2%), St . haemolyticus 33 (8.5%), St . warneri 18 (4.6%), St . lentus 12 (3.1%), St . hyicus 11 (2.8%) . Strains of St . cohnii, St . capitis, St . gallinarum, St . saprophyticus and St . hominis have only been found sporadically (a . 1%) . 48 (12.3%) strains could not be classified . With regard to species distribution of isolates from stallions and mares . 63.7% of the isolates from stallions belonged to St . sciuri and 9.3% to St . lentus, whereas in isolates of mares these species numbered only 24.9% and 0.4%, respectively . On the other hand the species St . equorum (14.9% vs . 6.8%), St . epidermidis (14.5% vs . 1.7%), St . haemolyticus (14.0% vs . 1.7%), St . warneri (7.7% vs . 0.8%) and St . xylosus (5.9% vs . 2.5%) predominated in mares . St . simulans was found occurring equally in mares and stallions (7.7% vs . 5.9%) . Comparing the staphylococcal species of healthy mares and of mares which have not become pregnant after copulation no indication was found for a significant role of certain plc- staphylococci in infertility . All of the 389 isolates were tested for production of protein A, i.e . Fc-fragment binding receptors, using a microenzyme-assay with peroxidase-labelled rabbit immunoglobulin G . With this method cell-bound or extracellular Fc-receptors could not be detected in anyone of the plc- staphylococcal strains.(ABSTRACT TRUNCATED AT 250 WORDS)

J Dairy Sci, 1989 May, 72(5), 1308 - 12
Premilking udder hygiene; Pankey JW; Incidence of intramammary infection is highly correlated to the number of mastitis pathogens on the teat end at milking . The objective of premilking teat sanitation is to reduce the microbial population in order to minimize the probability of mastitis . Milking time hygiene is extremely important due to the potential interaction between milking machine functions and microflora of teat skin . Current recommended procedures for premilking udder preparation range from water hose wash, manual drying, wet paper towel wash plus paper towel dry, to predipping alone plus paper towel dry . Regardless of udder cleaning procedure, manual drying of teats is a significant factor in reduction of total bacteria counts . Predipping with iodine-based sanitizers, .1 to .25% iodine concentration, reduced intramammary infection with environmental pathogens 51% compared with good udder preparation in a field trial on four commercial dairy farms . Infections by coagulase-negative staphylococci were not reduced by predipping . Effective premilking udder hygiene is essential for the production of high quality milk . Bacteria, preincubation and pasteurized milk counts are reduced . Sediment is minimized . Incidence of mastitis is reduced . Proper udder hygiene procedures should be practiced at every milking.

Immunology, 1989 May, 67(1), 120 - 5
Complement-mediated enhancement of IgA-induced H2O2 release by human polymorphonuclear leucocytes; Gorter A et al.; In a previous study we have demonstrated that heat-killed Staphylococcus aureus opsonized with either purified human serum IgA or secretory IgA (sIgA) can induce a respiratory burst (measured as H2O2 release) in human polymorphonuclear leucocytes (PMN; Gorter et al., 1987) . In the present study we have investigated whether opsonization of IgA-coated staphylococci with complement has an additional effect on the H2O2 release of PMN . It was demonstrated that staphylococci coated with IgA (or sIgA) and subsequently opsonized with complement induced at least a two-fold increase in the specific H2O2 release compared with bacteria coated with IgA (or sIgA) alone (P less than 0.05 and P less than 0.02, respectively) . The co-operative effect of IgA and complement was also observed in the presence of 10 mM ethyleneglycoltetraacetic acid containing 5 mM MgCl2 (MgEGTA), suggesting that activation of the alternative pathway of complement is sufficient to exert this effect . Using D-deficient serum as a source of complement we could demonstrate that activation of the alternative pathway is essential for the co-operative effect of complement and IgA . The increase in specific H2O2 release caused by complement was found to be dependent on the amount of IgA initially used to opsonize the bacteria . Finally the co-operative effect of IgA and complement was not restricted to one IgA subclass, because an additional opsonization of S . aureus coated with sIgA1 or sIgA2 with complement resulted in both cases in a statistically significant enhanced specific H2O2 release by PMN (P less than 0.05).

J Am Acad Dermatol, 1989 May, 20(5 Pt 2), 932 - 4
Staphylococcus aureus induction of inflammatory plaques of nipples and areolae; Paslin D; A 30-year-old atopic lactating woman developed a peculiar plaquelike dermatitis of nipples and areolae after infection with Staphylococcus aureus . Histologic examination showed an eosinophilic and plasma cellular edematous psoriasiform dermatitis . This constellation of findings seems distinct from other clinicopathologic states induced by staphylococci.

J Med Chem, 1989 May, 32(5), 1062 - 9
Aromatic dienoyl tetramic acids . Novel antibacterial agents with activity against anaerobes and staphylococci; Rosen T et al.; Streptolydigin (1) and tirandamycin A (2) are typical members of the naturally occurring class of 3-dienoyl tetramic acids . These compounds, which possess potent antibacterial activity particularly against anaerobes, have been shown to inhibit bacterial RNA polymerase . In contrast, tenuazonic acid (5), which lacks a complex dioxabicyclononane moiety and diene chromophore present in 1 and 2, exhibits essentially no antimicrobial activity and has no effect on bacterial RNA polymerase, suggesting that one or both of these structural features may be critical for antibacterial activity . In this paper, we report on a novel series of synthetic dienoyl tetramic acids that lack a complex dioxabicyclononane unit . Several of these compounds, particularly 8T-W, exhibit potent antimicrobial activity against Gram-positive and Gram-negative anaerobes as well as staphylococci . We will discuss the structure-activity relationship for this series of compounds which, in contrast to their natural counterparts, do not inhibit significantly RNA polymerase . We will also discuss preliminary results on the biochemical and microbiological properties of this series of compounds, several of which moderately inhibit supercoiling by DNA gyrase isolated from E . coli H560, although this enzyme has not been established as their target in whole cells . Compound 8W, which is not cross-resistant with DNA gyrase subunit A or B inhibitors or tirandamycin, has also been demonstrated to be rapidly bactericidal.

Diagn Microbiol Infect Dis, 1989 May-Jun, 12(3), 205 - 9
A comparison of the rapid thermonuclease test and the lysostaphin susceptibility test in the presumptive identification of Staphylococcus aureus from positive Bactec blood cultures; Forward KR et al.; We compared the ability of a rapid 2-hour thermonuclease test and a Gram-stained lysostaphin susceptibility test to presumptively identify Staphylococcus aureus from 72 blood cultures . The thermonuclease test identified 25 of 27 S . aureus; there were no false positives . The predictive values of positive and negative thermonuclease tests were 100% and 95.7%, respectively . The lysostaphin test correctly identified 24 of 27 S . aureus; however, there were eight false positives . The predictive values of positive and negative lysostaphin tests were 75% and 95.2%, respectively . Lysostaphin MICs were greater than or equal to 1.6 micrograms/ml for only 28 of 41 coagulase negative staphylococci strains . We now routinely apply the thermonuclease test in the clinical laboratory . Of the first 304 blood cultures tested in this setting, the thermonuclease test correctly identified 63 of 68 S . aureus . There have been no false positives . The thermonuclease test is superior to the lysostaphin test and accurately identifies S . aureus in blood cultures within 2 hours of the first positive reading.

Pathol Biol (Paris), 1989 May, 37(5), 465 - 7
{Efficacy of injectable ofloxacin in treating septicemia . Multicenter study}; Doco-Lecompte T et al.; To evaluate the efficacy and safety of parenteral ofloxacin in the treatment of septicemia, a multicenter study was carried out in 88 patients, 53 men and 35 women, hospitalized either in intensive care units (41 patients) or in medical wards (47 patients) . Ofloxacin was administered at a dose of 200 mg every 12 hours for a mean duration of ten days . Ofloxacin was administered as single agent to 62 patients . A clinical cure was obtained in 81 patients . Death occurred in 3 cases, relapse in 2, superinfection in one, and persistence of the infecting organism in another case (with acquired resistance to ofloxacin) . 89 of the 94 isolated organisms (75% Gram negative-bacilli and 20% staphylococci) were eradicated . The adverse effects were rare, mild or moderate in severity, and always reversible . We conclude that I.V . ofloxacin is efficacious and safe in the treatment of septicemia due to Gram-negative bacilli or staphylococci.

Srp Arh Celok Lek, 1989 May-Jun, 117(5-6), 341 - 9
{Rapid agglutination tests for the identification of Staphylococcus aureus}; Petreska-Sibinovska D et al.; The article deals with rapid agglutination tests for Staphylococcus aureus identification which detect clumping factor and protein A . The tests were compared with standard diagnostic methods: free coagulase, bound coagulase and thermostable deoxyribonuclease, 190 Staphylococcus aureus strains have been examined of which, 105 methicillin susceptible strains, 85 methicillin resistant strains, and 32 coagulase negative staphylococci strains strains . The presence of clumping factor was detected in 100% of examined Staphylococcus aureus strains . No difference between methicillin susceptible strains and methicillin resistant strains was observed . Protein A was present in 96.1% of methicillin susceptible strains and in 90.6% of methicillin resistant Staphylococcus aureus strains . The same test showed false negative results in 12 strains: 4 of which methicillin susceptible and 8 methicillin resistant strains . Coagulase test slide method and protein A detecting test hand one false positive result each for coagulase negative staphylococci examined . The specificity of all tests used was 100% and 99.5% respectively . The authors suggest latex or hemagglutination tests detecting clumping factor and/or protein A for rapid Staphylococcus aureus strains identification in hospital environment . It is important to point out the possibility of getting false negative protein A detecting results in methicillin resistant strains.

J Clin Microbiol, 1989 May, 27(5), 1127 - 9
Comparison of methods for determining DNase and phosphatase activities of staphylococci; Langlois BE et al.; A greater percentage of DNase-positive strains was detected with DNase test agar than with DNase test agar containing 0.005% methyl green or 0.005% toluidine blue (P less than 0.01) . No significant differences were obtained in the percentage of phosphatase-positive strains with the four methods compared . On the basis of ease of use, P agar containing para-nitrophenylphosphate disodium (0.495 mg/ml) would be the preferred method for determining phosphatase activity of staphylococci.

JPEN J Parenter Enteral Nutr, 1989 May-Jun, 13(3), 306 - 8
Enteral feeding contamination: comparison of diluents and feeding bag usage; Perez SK et al.; This quasi-experimental study compared bacterial growth in enteral feeding solution in six Kangaroo feeding bags filled with enteral formula diluted with sterile water vs six of the same diluted with tap water . Feeding bags, which were on continuous pumps in patient-occupied rooms, were rinsed and refilled every 8 hours, and formula cultures were obtained at 0, 24, and 48 hr . Acceptability of cultures was based on published recommended standards . Low levels of nonpathogenic staphylococci were found in sterile water bags; high levels of bacilli and Gram negative rods were found in tap water bags . No significant differences were found in the relationship between type of formula diluent and outcomes . Type of water diluent and acceptability were not related . There was a systematic relationship between length of use and outcome; with both diluents, bags used over 24 hr became unacceptably contaminated . Further study with a larger sample is needed to determine the effects of using tap water rather than sterile water as diluent.

Experientia, 1989 Apr 15, 45(4), 322 - 5
Flow microcalorimetry as a tool for an improved analysis of antibiotic activity: the different stages of chloramphenicol action; Kruger D et al.; Flow microcalorimetry in combination with photometric mass determination of staphylococci in suspension was used to reveal alterations in the intensity, extent and efficiency of bacterial metabolism during inhibition of protein synthesis by chloramphenicol . It could be demonstrated that these three parameters of metabolic activity were distinctly affected by this drug, and that the method described promises to be a more reliable tool for assaying the degree and the mode of bacteriostatic inhibition than the conventional determination of the minimum inhibitory concentration.

J Med Microbiol, 1989 Apr, 28(4), 249 - 57
Adherence of staphylococci to intravascular catheters; Kristinsson KG; Adherence of seven strains of Staphylococcus epidermidis and three strains of S . aureus to three types of intravascular catheters was assessed by ATP bioluminescence, by culture after ultrasonication and by scanning electronmicroscopy . The catheter materials studied were silicone elastomer, thermoplastic polyurethane and polyurethane coated with Hydromer, a coating which absorbs water and provides a hydrophilic sheath around the catheter . The adherence assays were performed in phosphate-buffered saline on a rotary shaker at 37 degrees C, with the catheters precoated with serum and uncoated, and the results were correlated with bacterial hydrophobicity . There was wide strain-to-strain variation in bacterial adherence; S . aureus and slime-producing S . epidermidis strains adhered better than did non-slime-producing strains . Overall, there was less bacterial adherence to Hydromer-coated catheters than to polyurethane and silicone catheters but it was unrelated to bacterial hydrophobicity . Serum coating of catheters resulted in marked reduction of bacterial adherence.

J Bacteriol, 1989 Apr, 171(4), 2252 - 7
Onset of penicillin-induced bacteriolysis in staphylococci is cell cycle dependent; Maidhof H et al.; Synchronously growing staphylococci were treated with "lytic" concentrations of penicillin at different stages of their division cycle . Coulter Counter measurements and light microscopy were used to determine the onset of bacteriolysis . Independent of the stage of the division cycle at which penicillin was added, (i) the cells were always able to perform the next cell division; (ii) the following division, however, did not take place; and (iii) instead, at this time, when the onset of the subsequent cell separation was observed in control cultures, lysis of the penicillin-treated cells occurred . These results support a recent model (P . Giesbrecht, H . Labischinski, and J . Wecke, Arch . Microbiol . 141:315-324, 1985) explaining penicillin-induced bacteriolysis of staphylococci as the result of a special morphogenetic mistake during cross wall formation.

Appl Environ Microbiol, 1989 Apr, 55(4), 778 - 87
Microcolony epifluorescence microscopy for selective enumeration of injured bacteria in frozen and heat-treated foods; Rodrigues UM et al.; A rapid (less than 6 h) method for selectively enumerating coliforms, pseudomonads, and staphylococci has been developed which involves counting microcolonies grown on the surface of polycarbonate membranes under selective conditions . The method was not directly applicable to foods containing injured bacteria due to the poor formation of or an inability to form microcolonies under selective conditions . However, the introduction of a 3- to 5-h resuscitation step in tryptone soya broth allowed the method to give reliable estimates of these organisms in a variety of frozen and heat-processed foods . Under nonselective conditions, i.e., for total counts, the microcolony method enabled a rapid count to be made of viable bacteria in heat-treated foods, but these results were also made more consistent by the introduction of a resuscitation step . This method makes results from these foods available far faster than conventional enumeration methods.

Mikrobiyol Bul, 1989 Apr, 23(2), 157 - 62
{In vitro antibiotic susceptibility of staphylococci}; Baykal M et al.; In this study in vitro activities of different antimicrobial drugs against 1000 staphylococci were evaluated . Tested staphylococci were isolated from the clinical material of out patient and in patient sections . Susceptibility tests were done according to NCCLS Disk Diffusion Technic . The antimicrobial drugs evaluated in this study were; Vancomycin, ofloxacin, sulbactam-ampicillin, co-trimoxazole, tetracycline, erythromycin, tobramycin, methicillin, first and third generation cephalosporins and penicillin . Vancomycin was the drug of choice against resistant staphylococci . Ofloxacin, sulbactam-ampicillin, first generation cephalosporins and some aminoglycosides were more effective than others.

Mikrobiyol Bul, 1989 Apr, 23(2), 150 - 6
{Detection of gram-positive bacteria isolated from wound infections and their susceptibility to various antibiotics}; Ozkuyumcu C et al.; In this study gram positive pathogens isolated from wound infections and antibiotic susceptibilities of these bacteria were evaluated by using sceptor (BBL) microdilution system . According to our experimental results, it was observed that the staphylococci found to be major causative agent with the ratio of 72% . The sensitivity of gram positive bacteria have been found aminoglycosides 88%, trimethoprim/sulphamethoxazole 67% . The sensitivity of these bacteria to the other antibiotics have been found 13-59%.

J Gen Microbiol, 1989 Apr, 135 ( Pt 4), 825 - 30
Mechanism of staphylococcal resistance to non-oxidative antimicrobial action of neutrophils: importance of pH and ionic strength in determining the bactericidal action of cathepsin G; Shafer WM et al.; The staphylococcalcidal action of highly purified, enzymically inactive human lysosomal cathepsin G was studied . The bactericidal action of cathepsin G was optimal at pH 7.5 and was inhibited by NaCl; concentrations greater than 0.15 M NaCl completely inhibited killing of Staphylococcus aureus . Under optimal conditions (pH, temperature and NaCl concentration) the ED50 (effective dose) of cathepsin G against S . aureus strain 8325-4 was about 3.1 micrograms ml-1 . Polymeric teichoic acid may serve as a binding site for cathepsin G by promoting electrostatic interactions since a mutant lacking this surface component exhibited enhanced resistance to the lethal action of cathepsin G, compared to the teichoic-acid-positive parental strain . These results suggest that (i) the ability of cathepsin G to kill intraphagosomal staphylococci may be regulated in part by the ionic strength of the environment and the pH of the maturing phagolysosome, and (ii) that strategies which retard acidification of the developing phagolysosome would promote the staphylococcalcidal action of cathepsin G.

Antimicrob Agents Chemother, 1989 Apr, 33(4), 541 - 50
Characterization of a novel insertion of the macrolides-lincosamides-streptogramin B resistance transposon Tn554 in methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis; Tillotson LE et al.; Macrolides-lincosamides-streptogramin B resistance in staphylococci can result from a gene, ermA, that comprises part of transposon Tn554 . Tn554 is unusual in (i) its high specificity for a primary chromosomal attachment site, att554, and (ii) the variability of its 3'-terminal six or seven nucleotides, which appear to copy the six or seven chromosomal nucleotides 5' to the parent transposon during transposition . We characterized a novel Tn554 insert in the chromosomes of methicillin-resistant Staphylococcus aureus strains involved in a current outbreak . This insert was found to resemble an insert recently discovered in S . epidermidis in its junctional fragment restriction pattern . Sequence analysis of the junctional regions showed that the attachment site, att155, exhibited 78% similarity to att554 (39 of the 50 nucleotides flanking the insertion sites) for both S . aureus and S . epidermidis inserts and that the 3' hexanucleotide of the S . epidermidis transposon (GACATC) resembled the reverse complement (TACATC) of its commonly occurring S . aureus counterpart (GATGTA) . Epidemiologic and molecular data indicated that att155 is harbored by extra DNA characteristic of methicillin-resistant strains and absent from methicillin-susceptible ones . Further, Southern hybridization showed that, even in the absence of Tn554 inserts, some methicillin-resistant strains contain DNA related to att155 and Tn554.

J Antimicrob Chemother, 1989 Apr, 23(4), 613 - 7
Serum and tissue levels of teicoplanin during cardiac surgery: the effect of a high dose regimen; Wilson AP et al.; Two prospective trials suggested that teicoplanin was less effective in preventing Gram-positive wound infections after cardiac surgery than a combination of flucloxacillin and an aminoglycoside . The initial dose of 400 mg was associated with a subinhibitory concentration of teicoplanin in fat at the end of operation . In this study, the behaviour of a higher initial dose (12 mg/kg) was investigated in ten patients during coronary artery surgery . As in the earlier trials, a second dose (400 mg) was given after 24 h . The mean concentration at the end of cardiopulmonary bypass was 15 mg/l in serum, 6 mg/kg in fat and 9 mg/kg in skin, all in excess of the expected break-point for staphylococci (4 mg/l) . The higher dose regimen might be more successful in surgical prophylaxis.

Spine, 1989 Apr, 14(4), 417 - 9
Occult infections causing persistent low-back pain; Schofferman L et al.; Occult infections caused by indolent organisms may produce persistent back pain that may be difficult to diagnose . The usual findings considered indicative of spinal infection are not reliable in these cases . The authors describe nine patients who presented with occult infections of the lumbar spine . Two of the nine had no antecedent lumbar surgeries nor open wounds . The predominant organisms were diptheroids and coagulase-negative staphylococci . The diagnosis was established by the clinical course, pathologic tissue changes at surgery, cultures, and response to antibiotic therapy . Normal Westergren sedimentation rates were noted in seven of nine patients, and normal white blood cell counts in six of nine patients . With the exception of two positive computed tomography (CT) scans, one positive gallium scan, and one positive magnetic resonance imaging (MRI) scan, all remaining imaging studies were negative for infection . In many cases, the infection neither was limited to nor involved the disc space.

J Cardiothorac Anesth, 1989 Apr, 3(2), 163 - 7
Oxacillin and tobramycin serum levels during cardiopulmonary bypass; Lehot JJ et al.; Antibiotic prophylaxis in cardiac surgery is recommended to combat acquired infections caused by staphylococci and gram-negative bacilli . Prophylaxis seems effective provided blood levels are greater than minimal inhibitory concentrations (MIC) . In this study, two doses of antibiotics were compared in 45 patients with normal renal function during cardiopulmonary bypass (CPB) . All patients received 50 mg/kg of oxacillin . Group 1 (30 patients) also received 1 mg/kg of tobramycin, while group 2 (15 patients) received 2 mg/kg of tobramycin . Blood samples were taken after the administration of antibiotics, as well as at the onset and conclusion of CPB . Additional samples were taken before and after heparin injection before CPB, and from the arterial and venous cannulae of the bubble oxygenator during CPB . In both groups, oxacillin serum levels were constantly greater than MIC for susceptible bacteria . In group 1, tobramycin levels less than 2 micrograms/mL (MIC for most susceptible bacteria) occurred in four patients before CPB, in 14 patients at the onset of CPB, and in 19 patients at the conclusion of CPB . These low levels were not explained by heparin administration or absorption onto the CPB circuit, but were the result of hemodilution . In group 2, in which all the tobramycin levels were higher than 2 micrograms/mL, serum levels decreased from 9.9 +/- 3.4 (mean +/- SD) to 3.7 +/- 0.7 micrograms/mL throughout the procedure . Plasma creatinine did not change significantly in either group . It is concluded that in patients with normal renal function, doses as high as 50 mg/kg of oxacillin and 2 mg/kg of tobramycin may be necessary before CPB to provide adequate serum levels throughout CPB.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Apr, (4), 57 - 60
{The effect of alpha/beta and gamma interferon preparations on the functional activity of macrophages in experimental staphylococcal infections}; Vikhot' NE et al.; The preparations of alpha/beta- and gamma-interferons have been shown to stimulate the functional activity characteristics of mouse macrophages (phagocytosis, spreading, contacts with lymphocytes, bactericidal properties) obtained from the peritoneal exudate of intact animals and those infected with staphylococci . The immunomodulating action of gamma-interferon is more pronounced than that of the preparation of alpha/beta-interferon.

Tijdschr Diergeneeskd, 1989 Mar 1, 114(5), 260 - 9
{Sensitivity pattern of Staphylococcus aureus isolated from quarter milk from cattle}; Vecht U et al.; Strains of Staphylococcus aureus (n = 319) from bovine quarter milk were tested for susceptibility to antimicrobial drugs . The minimum inhibitory concentration (MIC), was determined by agar dilution methods, and the diameter of the inhibition area was determined by agar diffusion methods . In addition beta-lactamase production was tested . The strains tested showed resistance to penicillin, (38.4%), oxytetracyclin (21.2%), and streptomycin (11.5%) . Little or no resistance was found to the other antimicrobials in this study . A strong correlation between dilution and diffusion methods was calculated for oxytetracyclin: r = 0.88, and for streptomycin: r = -0.90; correlation for penicillin was weaker: r = -0.66 . Since 17% of the strains with an MIC for penicillin less than 0.16 mg/L are still able to produce beta-lactamase, we recommend that when antibiotic susceptibility of staphylococci is examined, beta-lactamase production should also be tested . Dapsone, a sulfone compound, formerly not considered a chemotherapeutical drug under Dutch law, had an MIC less than or equal to 0.64 mg/L for 85% of the strains . Therefore, we recommend that sulfone compounds should be registered under the new Veterinary Medicines Act . Since the resistance patterns of S . aureus strains to most antimicrobial drugs were the same as those seen in earlier studies, we find no reason to resort to new generations of broad-spectrum antibiotics in routine prevention and treatment of mastitis.

Nippon Ganka Gakkai Zasshi, 1989 Mar, 93(3), 351 - 7
{Role of Staphylococcus epidermidis in outer eye infections}; Asaoka I; Coagulase-negative staphylococci (CNS) from 57 patients with outer eye infections and healthy control eyes were isolated according to the Schleifer and Cloos classification and the sensitivity to antibiotics of the isolated CNS was examined . The pathogenicity of CNS in rabbit cornea was studied by direct inoculation of CNS . The results showed that of 57 strains of CNS, 25 strains (43.9%) belonged to S . epidermidis, 22 (38.6%) belonged to non-detectable strains, 4 (7%) belonged to S . capitis, 3 (5.3%) belonged to S . hominis and 2 (3.5%) belonged to S . saprophyticus . Furthermore these CNS were resistant to aminoglycoside and machloride antibiotics which are commonly used as eye drops for ocular infectious diseases . Control rabbit corneas inoculated with CNS almost became clear within 24 hours . Therefore, it was suggested that ocular CNS infections can occur in immunologically compromised host patients.

J Clin Microbiol, 1989 Mar, 27(3), 540 - 4
Effect of milk on fibronectin and collagen type I binding to Staphylococcus aureus and coagulase-negative staphylococci isolated from bovine mastitis; Miedzobrodzki J et al.; Tryptic soy broth (TSB)-grown cells of Staphylococcus aureus isolated from acute and chronic bovine mastitis bound mainly 125I-fibronectin (Fn) {corrected}, whereas strains of nine species of coagulase-negative staphylococci showed a predominant interaction with 125I-collagen (Cn) {corrected} type I . A particle agglutination assay (PAA) was used to examine the interaction of coagulase-negative staphylococci with 125I-Fn and 125I-Cn immobilized on latex . All 368 coagulase-negative staphylococci demonstrated high 125I-Cn and moderate to low 125I-Fn interactions in the PAA . Cn-PAA reactivity was high among strains of Staphylococcus xylosus (84.2%), Staphylococcus simulans (77.8%), Staphylococcus epidermidis (76.7%), and Staphylococcus hyicus (74.3%), whereas all six Staphylococcus capitis strains clumped Cn-PAA reagent . Incubating TSB-grown cells in 10% skim milk for 1 h decreased the 125I-Fn- and 125I-Cn-binding affinity in most of the S . aureus and coagulase-negative staphylococci, while growth in 10% skim milk for 18 h resulted in more than 90% decrease or complete loss of interaction with these proteins . Decreased 125I-Fn binding in the presence of milk was correlated with protease production but not with 125I-Cn binding.

Zentralbl Veterinarmed B, 1989 Mar, 36(2), 154 - 6
Phagocytosis and intracellular killing of Staphylococcus aureus by bovine blood polymorphonuclear leukocytes after migration in vitro; Niemialtowski M et al.; Phagocytic activity and intracellular killing of opsonized staphylococci (Smith strain) by bovine blood polymorphonuclear leukocytes (PMNL) was studied after their migration in vitro in blind well chambers . The results indicate that migration of PMNL to RPMI-1640 medium without chemotactic factor significantly (P less than 0.01) increased the percentage of rosette-forming PMNL (from 11 +/- 2 to 49 +/- 4%), as well as phagocytic activity mediated through Fc receptors (FcRs) (from 25 +/- 3 to 81 +/- 4% phagocytizing PMNL and from 151 +/- 22 to 942 +/- 54 number of phagocytized staphylococci/100 PMNL), and intracellular killing of bacteria (from 13 +/- 2 to 59 +/- 7%) . On the other hand, PMNL migration to RPMI-1640 medium with the chemotactic factor (serum activated with zymosan {AS} or lipopolysaccharide {LPS} or formyl-L-methionyl-L-leucyl-L-phenylalanine {fMLP}) did not significantly (p greater than 0.05) increase either the FcRs number on the PMNL surface or the phagocytic and bactericidal activity connected with these receptors . The possible mechanisms are discussed.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Mar, (3), 16 - 20
{Changes in the clonal structure of staphylococcal populations in a kidney infection model in mice}; Bel'skii VV et al.; The intraperitoneal infection of mice with previously titered doses of staphylococci has been found to regularly induce the formation of the foci of inflammation in the kidneys of mice, from which staphylococcal cultures has been obtained by the inoculation of the kidney material for 8 days (the term of observation) . The use of this model has made it possible to carry out the dynamic study of structural changes in the populations of staphylococci by studying the biological properties of 100 subcultures isolated from the kidneys of the infected animals dissected every 24 hours . A decrease in the heterogeneity of the initial population, occurring due to a drop in the number of clones with hemolytic activity, lecithinase activity and smooth variants, has been registered . Thus, the proposed model permits the study of changes in the clonal structure of the populations of the infective agent, appearing under the influence of the protective capacity of the body in the dynamics of the infectious process.

Mol Cell Probes, 1989 Mar, 3(1), 27 - 38
Calibration of target amounts of DNA in hybridization experiments using monoclonal anti-nucleoside antibodies; Traincard F et al.; Two anti-nucleoside monoclonal antibodies (A-16 and G-K21) were raised after immunizing mice with adenosine or guanosine coupled to bovine serum albumin by periodate oxidation . They were selected for their ability to detect these immunogens and single-stranded DNA in an enzyme-linked immunosorbent assay test . The antibodies were purified from ascitic fluids, their isotypes were determined and their ability to detect DNAs and RNAs on nitrocellulose membranes was tested . They belonged to the IgG1 subclass and were both able to recognize picogram amounts of single-stranded DNAs on nitrocellulose sheets, whatever the origin of the nucleic acid, but were unable to detect RNA efficiently . The same monoclonal antibodies were used to estimate minute amounts of target staphylococci DNAs to permit standardization of non-radioactive hybridization experiments for detection of antibiotic resistance genes.

J Clin Microbiol, 1989 Mar, 27(3), 507 - 11
Comparative virulence of human isolates of coagulase-negative staphylococci tested in an infant mouse weight retardation model; Gunn BA; Human infections caused by coagulase-negative staphylococci have steadily increased in numbers and severity . Causes may be the use of artificial prostheses, immunocompromising chemotherapy and radiation therapy, and sophisticated surgical techniques, to name a few . Although the infectivity of coagulase-negative staphylococci as a group has been well documented for humans, attempts to study the pathogenesis of infections caused by individual species of coagulase-negative staphylococci have been hampered by the lack of an animal model that is not refractory to infection by these organisms . In the study reported here, a 2-day-old-mouse weight retardation test was used to assay the virulence of 60 clinical and reference strains of coagulase-negative staphylococci . These strains represented eight species of coagulase-negative staphylococci . The most virulent strains were demonstrated to be of the species Staphylococcus haemolyticus, S . saprophyticus, and S . epidermidis . The data further suggest that production of slime is a marker of virulence in S . epidermidis and that intraspecies differences in virulence occur.

J Clin Microbiol, 1989 Mar, 27(3), 504 - 6
Synthetic exfoliative toxin A and B DNA probes for detection of toxigenic Staphylococcus aureus strains; Rifai S et al.; Two methods for the detection of exfoliative toxin (ET) from Staphylococcus aureus were compared: (i) a phenotypic assay, electrosyneresis, and (ii) a genotypic assay, staphylococcal DNA hybridization with oligodeoxynucleotide probes . The probes were chosen from the previously determined sequences of serotype A and B of ET, one probe for serotype A and another for serotype B . Strains exhibiting ET production in electrosyneresis always possessed the ET gene(s) . Conversely, some strains not exhibiting ET production in electrosyneresis harbored the ET gene(s) . The latter strains produced levels of ET . ET-negative phage group 2 strains of S . aureus as well as tested coagulase-negative staphylococci did not possess the ET gene(s) . The sensitivity of the DNA hybridization technique was 10(6) bacteria or 100 ng of genomic DNA.

Infection, 1989 Mar-Apr, 17(2), 90 - 6
Antimicrobial prophylaxis of experimental endocarditis caused by Staphylococcus epidermidis; Baddour LM et al.; Using two different strains of Staphylococcus epidermidis in a rat model of experimental endocarditis, we examined the prophylactic efficacy of cefamandole (200 mg/kg/dose), cefazolin (200 mg/kg/dose), nafcillin (200 mg/kg/dose), and vancomycin (20 mg/kg/dose) . In vitro susceptibility testing demonstrated that both test strains were resistant to methicillin and cefazolin and susceptible to cefamandole and vancomycin . A 10(6) cfu inoculum was used for both strains, an inoculum which produced endocardial infections in greater than 90% of rats . Initial doses of each antibiotic were given 45 min to 1 h prior to bacterial challenge and were followed by six additional doses of each antibiotic administered subcutaneously every 6 h . The efficacy rates of cefamandole (84.0%) and cefazolin (70.8%) were exactly the same for rats infected with either S . epidermidis strain . Similar efficacy rates were seen in rats infected with either strain and treated with vancomycin (94.4% and 86.7%) . Unlike the other three drugs, the efficacy of nafcillin was quite different in rats challenged with the two strains (62.5% and 38.5%, p = 0.19) . It appears that cefamandole and cefazolin may have considerable prophylactic efficacy against certain infecting strains of methicillin-resistant, coagulase-negative staphylococci when relatively large doses of cephalosporins are administered subcutaneously in this animal model.

Clin Exp Immunol, 1989 Mar, 75(3), 392 - 5
Polymorphonuclear neutrophils function in splenectomized patients; Wysocki H et al.; Some essential functions of polymorphonuclear neutrophils (PMN) were evaluated in 30 patients splenectomized because of rupture of the spleen . These cells revealed normal random migration, adherence, unstimulated O2- and H2O2 production . Phagocytosis of viable staphylococci was higher than in controls, whereas chemotaxis, bactericidal capacity, aggregation and stimulated O2- and H2O2 production were significantly impaired . PMN from splenectomized patients manifested also the decreased intracellular myeloperoxidase activity . The percentage of cells with receptor for Fc IgG in peripheral blood was markedly decreased . Plasma of these patients induced increased adherence of autologous as well as control neutrophils . The possible mechanisms leading to the observed events are discussed.

Pediatr Infect Dis J, 1989 Mar, 8(3), 140 - 2
Analysis of enteric coagulase-negative staphylococci from neonates with necrotizing enterocolitis; Rotbart HA et al.; We investigated the possible role of coagulase-negative staphylococci in necrotizing enterocolitis . Stool coagulase-negative staphylococci isolated from neonates during an outbreak of rotavirus-associated necrotizing enterocolitis were analyzed by a variety of techniques, including speciation, semiquantitative culturing, antimicrobial susceptibility, plasmid profiling and cytotoxicity assays . No differences were observed between the coagulase-negative staphylococci of symptomatic babies and those of asymptomatic controls.

Infect Control Hosp Epidemiol, 1989 Mar, 10(3), 111 - 7
Coagulase-negative staphylococcal infections in vascular surgery: epidemiology and pathogenesis; Edmiston CE Jr et al.; Staphylococcal infection of a vascular prosthesis is a relatively uncommon complication of peripheral vascular surgery; however, these infections and their sequelae can be catastrophic . The majority of prosthetic graft infections are caused by mucin-producing strains of Staphylococcus epidermidis, which express varying degrees of adherence to the synthetic substrates . Studies have demonstrated that the components and construction characteristics of the graft, implantation site, administration of antimicrobial agents, and endogenous microbial flora are all identifiable risk factors in vascular graft infections . Mucin production, a known virulence factor, has recently been shown to occur in endogenous coagulase-negative staphylococci (CNS) at the time of hospital admission . While mucin production plays an important role in the persistence of graft infections, there is no evidence that suggests a relationship between mucin and antimicrobial resistance . Identifying characteristics of (CNS) graft infections may include a draining wound sinus, poor graft incorporation, a perigraft exudate or a pseudoaneurysm at the anastomotic site . The occult nature of these infections, in which the patient is often asymptomatic, makes diagnosis and treatment difficult . The graft or graft exudate may be negative when routine culture methods are employed . The recognition of CNS graft infections requires a high index of suspicion and the treatment of these infections requires understanding of the pathogenic process, individualized surgical management, and the judicious use of antimicrobial agents.

Trans R Soc Trop Med Hyg, 1989 Mar-Apr, 83(2), 275 - 8
Tropical pyomyositis in the Solomon Islands: clinical and aetiological features; Eason R et al.; A prospective study of tropical pyomyositis (TP) in the Solomon Islands' Western Province followed 48 cases (mean age 10.6 years) from a population of 20,000 Melanesians over a two-year period . 32 patients were under 10 years and the male:female ratio was 1.7 . Affected muscle was painful, swollen and often fluctuant but hard and indurated in presuppurative lesions . Abscesses, single in 40 and multiple in 8 subjects, were sited in the large muscles of the buttock, thigh, shoulder, arm and back on 52 occasions (90%) . They contained 5-200 ml of pus which invariably grew penicillin-resistant Staphylococcus aureus sensitive to cloxacillin and erythromycin . All phage typable strains were identified as group 2 in contrast to the wider range of types found at carrier sites in otherwise healthy controls . TP was preceded by trauma in 30 cases (63%) and 26 (55%) of the patients had pre-existing pyoderma . Histological examination of clinically unaffected muscle biopsies from 10 subjects with solitary (7) or multiple (3) abscesses showed no abnormality . Serological evidence of previous infection with adenoviruses or myxoviruses was present in the same proportion (41-42%) of controls as of 22 patients tested . The results provide no evidence for antecedent diffuse myositis, viral or parasitic infections or nutritional deficiencies but support the role of trauma in localizing haematogenous skin staphylococci into damaged muscle.

Afr J Med Med Sci, 1989 Mar, 18(1), 33 - 4
Pyomyositis: a report on two cases from a region with a temperate climate; Espersen GT; Two cases of pyomyositis in Caucasians, from a region with temperate coastal climate is reported . The identification of staphylococci as an aetiological factor in both temperate and tropical regions is mentioned, and so are other possible identical aetiological factors.

DICP, 1989 Mar, 23(3), 210 - 3
Survival of beta-lactamase-producing and -nonproducing bacteria in intravenous solutions; Hugbo PG et al.; The survival of beta-lactamase-producing (beta-lac+) and non-beta-lactamase-producing (beta-lac-) Bacillus and Staphylococcus spp . has been investigated in dextrose 5% injection, NaCl 0.9%, and dextrose 5% in NaCl 0.9% solutions . Tests were performed under static and turbulent conditions of incubation, with and without antibiotics added to the fluids, and with or without 1% citrated blood . All solutions were inoculated with about 1000 organisms/mL, and sampled for viable bacteria at specific time intervals . Under static conditions, there was no significant decrease in viability (p greater than 0.01) of the bacilli, except for the staphylococci (p less than 0.01) . However, when cultures were agitated, all species showed significant decline in viability (p less than 0.01) . When antibiotics were present, S . aureus (beta-lac+) declined gradually throughout 24 hours (p greater than 0.01) . B . cereus (beta-lac+) concentrations were static in all solutions . All organisms multiplied rapidly in solutions containing blood . The results suggest that the growth characteristics of both beta-lac+ and beta-lac- bacteria in intravenous fluids are essentially similar, except in solutions containing beta-lactamase-sensitive antibiotics in which beta-lac+ bacteria tend to survive.

Acta Otolaryngol, 1989 Mar-Apr, 107(3-4), 244 - 8
How long do middle ear pathogens survive in mucoid effusion material?
Stenfors LE, Raisanen S.
Middle ear pathogens (S . pneumoniae, H . influenzae, B . catarrhalis, S . aureus and coagulase-negative staphylococci) were injected into 28 samples of mucoid effusion materials taken from 17 patients suffering from secretory otitis media . In every case the effusion material was sticky, hydrophilic and thick and contained no bacteria . S . pneumoniae and H . influenzae survived for only 1-2 days in mucoid effusion material incubated at 37 degrees C, while B . catarrhalis and staphylococci survived for at least 18-36 days when incubated in this medium . It seems that mucoid effusion material filling the middle ear cavity during secretory otitis media has a dual function in providing protection against middle ear infections . Thanks to its physical properties the effusion material hinders bacteria from ascending from the nasopharynx and is a poor substrate for some microorganisms . In contrast, mucoid effusion material is a superior medium for B . catarrhalis and staphylococci.

Ugeskr Laeger, 1989 Feb 27, 151(9), 563 - 6
{Peritonitis in continuous ambulatory peritoneal dialysis . Experiences after 7 years}; Ejlersen E et al.; A retrospective study of CAPD-related peritonitis revealed a frequency of 1.7 episodes per treatment year among 121 patients during a period of 7 years . Life-table methodology estimated a 44% probability of still remaining peritonitis-free after six months on CAPD, with no differences between subgroup populations according to sex, age (younger/older than 60 years) and primary disease (diabetic/non-diabetic) . A marked improvement in probability of remaining peritonitis-free was evident in the last calendar period (1983-86) . The predominant etiological microorganisms in peritonitis episodes were staphylococci . In 25% of the episodes, no microorganism could be isolated . One patient died from peritonitis; lethality 0.7% per year . Ten patients (8%) were transferred from CAPD because of either repeated episodes of peritonitis or a single complicated episode.

Res Microbiol, 1989 Feb, 140(2), 107 - 18
Clinical isolates of Staphylococcus lugdunensis and S . schleiferi: bacteriological characteristics and susceptibility to antimicrobial agents; Fleurette J et al.; The bacteriological characteristics and susceptibility to antimicrobial agents of 108 clinical isolates of Staphylococcus lugdunensis and Staphylococcus schleiferi are described . Fifty out of 108 isolates were considered to be responsible for 16 documented infections, including some severe infections (endocarditis, bacteraemia, osteitis) . A number of bacteriological characteristics enabled the identification of these species in the clinical microbiology laboratory: the absence of coagulase and protein A, and the presence of a fibrinogen affinity factor and thermonuclease along with other biochemical characteristics (ornithine and arginine decarboxylases, carbohydrate acidification, novobiocin susceptibility) differentiated these new species from other staphylococci; however, they did not possess virulence markers such as toxins or haemagglutinin, but were haemolytic . In this series, almost all isolates were susceptible to 22 antibiotics and 4 antiseptics representative of the main groups of antimicrobial agents . More information is needed on the ecology and epidemiology of these new opportunistic pathogens.

East Afr Med J, 1989 Feb, 66(2), 141 - 7
A study of synergism between cloxacillin and gentamicin on resistant staphylococci (penicillinase producing and gentamicin resistant); Coker AO; Twelve strains of Staphylococcus aureus were studied . All the strains were tested for penicillinase production by the iodometric and starch-paper methods . Ten out of 12 strains produced penicillinase . A strain which was gentamicin resistant and penicillinase producer was tested for synergism using the killing growth method . Synergism was observed between cloxacillin and gentamicin . These two antibiotics can now be used to treat infection by Staphylococcus aureus especially those that produce penicillinase and gentamicin resistant.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Feb, (2), 92 - 6
{Immunocompetent cells in organs of local and systemic immunity in intact and sensitized guinea pigs upon specific intranasal immunotherapy}; Nugmanova ZhS et al.; The normal levels of some lymphocyte populations and subpopulations in the lungs and lymph nodes draining the respiratory tract have been determined . The influence of systemic delayed hypersensitivity (DH) to staphylococci and the multiple introduction of staphylococcal antigen into intact and sensitized guinea pigs on the distribution of lymphocyte subpopulations in the central, peripheral and respiratory lymphoid organs has been studied . Systemic DH has been found to affect the level of immunocytes in the thymus and peripheral lymphoid organs; the local introduction of the allergen and the intranasal immunotherapy of systemic DH produce both local (the lungs and their lymph nodes) and systemic effect.

Antibiot Khimioter, 1989 Feb, 34(2), 112 - 6
{Antibiotic sensitivity of Staphylococci populating the breast skin of nursing women}; Sytnik SI; Sensitivity to penicillins, tetracycline, erythromycin and lincomycin was tested in 1513 staphylococcal strains isolated from the skin of various anatomic areas of the breast of nursing mothers . It was shown that 82.9, 78.4 and 33.9 per cent of the isolated cultures were highly sensitive to lincomycin, erythromycin and methicillin respectively . Sensitivity to tetracycline and benzylpenicillin was detected in 33.1 and 19.8 per cent of the cultures respectively . The study of the resistance spectra of 1343 strains resistant to certain antibiotics revealed that 498 cultures (37.1 per cent) were polyresistant . None of the tested antibiotics could be used for selective decontamination of the breast skin with respect to S . aureus in prophylaxis of lactic mastitis.

Antimicrob Agents Chemother, 1989 Feb, 33(2), 245 - 7
In vitro interaction between rifampin and clindamycin against pathogenic coagulase-negative staphylococci; Arditi M et al.; The MICs and MBCs for 90% of strains tested (MIC90 and MBC90, respectively) of rifampin for 75 clinical isolates of pathogenic coagulase-negative staphylococci (PCNS) were 0.03 and 0.25 microgram/ml, respectively, while the MIC90 and MBC90 of clindamycin were both greater than 25 micrograms/ml . Although no synergy between rifampicin and clindamycin was found among the 15 strains studied by the checkerboard method, 6 of 12 selected strains showed synergy by the kill-curve method . No antagonism was observed by either method . All 30 strains rapidly developed resistance to rifampin in vitro, and this could be prevented by the simultaneous presence of 1.0 microgram of clindamycin per ml in the 24 methicillin-susceptible PCNS strains . The synergy between rifampin and clindamycin observed in vitro for some strains of PCNS, together with the prevention of emergence of resistance to rifampin by clindamycin, suggests that this antibiotic combination may be useful for the treatment of infections caused by methicillin-susceptible PCNS.

J Antimicrob Chemother, 1989 Feb, 23(2), 179 - 88
Natural methicillin resistance in comparison with that selected by in-vitro drug exposure in Staphylococcus aureus; Berger-Bachi B et al.; Methicillin resistant staphylococci selected during serial passage in increasing concentrations of methicillin were compared with an isogenic methicillin resistant strain carrying the methicillin resistance determinant (mec) found in clinical isolates of Staphylococcus aureus . Selection for methicillin resistance was followed by changes in the binding characteristic of penicillin binding proteins (PBPs) 2 and 4 . There was no immunological nor genetic relationship between the mec-determined low affinity PBP2' and the PBPs of the in-vitro selected mutants . The Tn551 insertion omega 2003, which inactivates mec determined methicillin resistance, but which is not linked to mec, also partially reduced in-vitro selected methicillin resistance . This suggests that this methicillin resistance controlling factor contributes at least partially to methicillin resistance selected in vitro.

Infect Immun, 1989 Feb, 57(2), 404 - 12
Antibody response to Staphylococcus aureus surface proteins in rabbits with persistent osteomyelitis after treatment with demineralized bone implants; Thomas VL et al.; A rabbit model was used to study the effect of allogeneic demineralized bone powder (DBP) implants on the persistence of Staphylococcus aureus osteomyelitis . Thirty-one rabbits with chronic osteomyelitis of the tibia established by day 21, were started on systemic antibiotics followed by either no additional treatment or debridement plus either DBP (with or without supplemental antibiotics) or supplemental antibiotics only . On day 21, cultures showed a mean of 2 x 10(4) CFU/mg of debrided osseous material . By day 70, the treatment most effective in clearing infection was found in animals treated with supplemental antibiotics only (mean of 142 +/- 116 CFU/mg) . In contrast, infection persisted at a 7- to 10-fold-higher level in animals receiving DBP with and without supplemental antibiotics; these results suggest that DBP contributed to persistence of infection . Longitudinal sera were tested again staphylococcal sonic extracts by immunoblot . Detection of numerous probe-positive bands indicated complex but remarkably similar antibody responses among infected animals . Antibodies attached directly to the cell surfaces of staphylococci as shown by immunogold and blocked the binding of organisms to HEp-2 and human fetal lung cells in a radioadherence assay . Antibodies could be absorbed out by intact organisms and were unreactive by immunoblot against antigens derived from cells pretreated with pronase, proteinase K, or lysostaphin . These results indicate that the major response was directed against staphylococcal cell surface proteins . Surprisingly, only one major band (molecular weight, approximately 12,000) was detected when a homologous in vivo antigen preparation was studied by immunoblot . Antibody reactive against this peptide did not appear to react with staphylococci grown in vitro.

J Clin Invest, 1989 Feb, 83(2), 728 - 32
Cryopreservable neutrophil surrogates . Stored cytoplasts from human polymorphonuclear leukocytes retain chemotactic, phagocytic, and microbicidal function; Malawista SE et al.; Cryopreservation of polymorphonuclear leukocytes (PMN) has largely failed, probably because of their rich content of granular (lysosomal) enzymes . We have been developing granule-poor cytoplasts (anucleate fragments) from PMN which retain motile functions of the parent cell . The two types studied here were induced either by brief heating on surfaces (cytokineplasts) or by discontinuous gradient centrifugation (Ficoll) without heat or drugs (U-cytoplasts) . Freshly made, these cytoplasts respond chemotactically to formyl peptide (fMet-Leu-Phe), and they take up and kill roughly half as many Staphylococcus aureus as their (larger, granular) parent PMN . Unlike their parent cells, after cryopreservation both cytoplasts remain chemotactic, and in matched experiments they take up and kill staphylococci with undiminished avidity . These findings are the first indications that PMN cytoplasts suitable for clinical use may be feasible.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Feb, (2), 17 - 20
{The effect of valinomycin and nigericin on the efficacy of bacteriophage infection of staphylococcal cells}; Vinnikov AI et al.; The effect of ionophore antibiotics, valinomycin and nigericin, on the generation of the membrane potential, the pH gradient and the efficacy of phage infection in tetracycline-resistant staphylococci has been studied . Valinomycin at a concentration of 0.5 microM induces the dissipation of the membrane potential, and nigericin at a concentration of 12.0 microM decreases the value of the pH gradient on the membrane of staphylococci . The separate use of antibiotics has no essential influence on the efficacy of phage infection . The combined use of valinomycin and nigerimycin produces the maximum inhibition of phage infection (64.5%) at the stage of the introduction of DNA into the bacterial cell, which is indicative of a definite role played by the membrane potential and the pH gradient in the transport of phage DNA into staphylococcal cells.

Vrach Delo, 1989 Feb, (2), 102 - 5
{Ways of transmitting wound infection pathogens at a hospital}; Filippenko LI et al.; The authors studied the epidemiological situation in a surgical clinic on the basis of examination of 12,000 case histories in the course of several years . Microbiological examinations were carried out of 1438 samples with the purpose of assessing the microbial picture of the wounds of patients and all factors of the environment which could participate in infection due to pathogens of conventional nature . The most frequent pathogens of the wounds were staphylococci--65.6 +/- 6.0% . In the course of observation one established a continuous chain of infections due to presence of sources of pathogens of wound infections, the carriers of which were medical staff, medical students and patients in 19 +/- 2.8%.

Acta Otolaryngol, 1989 Jan-Feb, 107(1-2), 104 - 10
Colonization of middle ear pathogens in the nasopharyngeal opening of the Eustachian tube during secretory otitis media; Stenfors LE et al.; Colonization of middle ear pathogens (S . pneumoniae, H . influenzae and B . catarrhalis) in the nasopharyngeal opening of the Eustachian tube (NO) was charted in 94 patients (170 ears) suffering from secretory otitis media (SOM) . Subsequent determination of microorganisms in the middle ear effusion was performed . 76% of the patients had colonization of pathogens in the NO, while pathogens colonized the middle ear cavity (MEC) in 30% of the cases . Predominant pathogen was S . pneumoniae, followed by B . catarrhalis and H . influenzae . When colonizing the MEC, there was a 100% correlation to NO regarding B . catarrhalis, 81% correlation for S . pneumoniae and 57% for H . influenzae . S . aureus and/or coagulase-negative staphylococci were only occasionally found in the NO . Accumulation of a sticky glue effusion material in the middle ear cavity may serve as a barrier against ascending pathogens from the nasopharynx.

Rev Infect Dis, 1989 Jan-Feb, 11 Suppl 1, S8 - 13
Risk of developing toxic shock syndrome associated with toxic shock syndrome toxin 1 following nongenital staphylococcal infection; Jacobson JA et al.; Few risk factors for nonmenstrual toxic shock syndrome (TSS) have been identified . This study sought to determine at what rate and under what circumstances nongenital toxigenic Staphylococcus aureus infections led to TSS . Clinical isolates of S . aureus were examined for the production of TSS toxin 1 (TSST-1), and available sera from infected patients were tested for antibody to this toxin . Twenty-six percent of 810 isolates produced TSST-1 . Isolates from children were more likely to be positive for TSST-1 than were those from adults . None of 57 patients with TSST-1-positive staphylococcal infection and a TSST-1 antibody titer of greater than or equal to 1:100 developed TSS . Eight of 65 tested patients with TSST-1-positive isolates had antibody below the presumably protective level of 1:100 . Two of these patients had definite TSS, three had probable or possible TSS, and three probably did not have TSS . In patients lacking protective antibody to TSST-1, the interval between acquisition and infection with staphylococci, the type and amount of toxins produced, the site of infection, and still-unclarified aspects of host susceptibility may all affect the rate and severity of TSS.

Rev Infect Dis, 1989 Jan-Feb, 11 Suppl 1, S294 - 304
Characteristics of toxic shock syndrome toxin 1-induced lectin-like activity and inhibitor(s) in rabbit serum; Arko RJ et al.; In adult rabbits intravenously injected with toxic shock syndrome toxin 1 (TSST-1) or staphylococcal enterotoxin B, serum lectin-like activity (detectable by cation-dependent agglutination of bacteria) developed . This activity was sensitive to heat, trypsin, and formaldehyde but resistant to neuraminidase or galactose oxidase . Formaldehyde-fixed Propionibacterium acnes or Escherichia coli cells reactive with plant lectins provided sensitive targets for titration of serum agglutination activity that was competitively blocked with D-galactose, D-glucose, D-mannose, and alpha-L-fucose . The lectin-like activity, partially purified by affinity chromatography, was a protein of approximately 76,000 Da with an isoelectric point of 5.4 . Both lectin-positive and normal serum contained agglutination inhibitors that were absorbed by protein A-producing staphylococci . S protein may be the origin of this lectin-like activity . In vitro exposure of peripheral-blood mononuclear cells to TSST-1 (1.0 micrograms/mL) and to lectin-positive serum induced rapid cell clumping and subsequent "activation" to a larger blast form expressing receptors for buccal epithelial cells . The interaction of toxin/lymphokine-activated mononuclear cells with glycoproteins and/or other antigens selectively expressed by tissues in various organ systems may play a role in target cell pathology in rabbits dying with toxic shock syndrome.

Rev Infect Dis, 1989 Jan-Feb, 11 Suppl 1, S238 - 46; discussion S246-7
Vaginal tampon model for toxic shock syndrome; Melish ME et al.; The effects of tampon composition, inoculum size, and simulated menses on production of toxic shock syndrome toxin 1 (TSST-1) and toxic shock syndrome (TSS) were evaluated in a rabbit model that simulates tampon use in humans . Three small generic compressed-fiber tampons were successively inserted vaginally (remained in place 4.5 hours x 2; overnight x 1) . Tampon no . 1 was inoculated with live TSST-1-positive staphylococci plus 5 mL of saline or simulated menses (defibrinated rabbit blood plus 2.5 g of bovine serum albumin/dL) immediately after insertion; saline or simulated menses alone were used with tampons no . 2 and 3 . The vagina was washed after removal of tampon no . 3 . TSS-like illness was produced consistently in animals with carboxymethyl cellulose/polyester foam tampons, which supported higher organism counts and greater TSST-1 production in association with subsequent tampons . Cotton and rayon tampons were not associated with as much clinical illness, organism growth, or TSST-1 production . Simulated menses supported toxin production and clinical illness when the inoculum was one-tenth that required for controls . Sham tampon insertion was associated with TSS-like illness in two of 10 rabbits; thus, other factors may promote TSS in the absence of vaginal tampons . This model reliability reproduces menstrual TSS, since one-time vaginal inoculation with TSST-1-positive staphylococci in the presence of blood and certain tampons leads to TSS, and may be useful in evaluating catamenial products and in understanding other factors important in TSST-1 production in vivo and the development of TSS.

Rev Infect Dis, 1989 Jan-Feb, 11 Suppl 1, S219 - 28; discussion S228-30
Endotoxin is not an essential mediator in toxic shock syndrome; Melish ME et al.; The hypothesis that toxic shock syndrome toxin 1 (TSST-1) exerts its deleterious effects in toxic shock syndrome (TSS) primarily by enhancing the lethality of small amounts of endogenous endotoxin derived from mucosal colonization with gram-negative bacteria was assessed by evaluating two means of inactivating endotoxin in rabbit models of TSS . In both of these models, toxins and TSST-1 are allowed to diffuse constantly from a subcutaneous depot . Immunologic inactivation of endotoxin with antiserum to the core lipopolysaccharide did not change the clinical course or mortality among animals infected with live TSS-associated staphylococci or among animals with a subcutaneous depot of TSST-1 . Anti-TSST-1 was successful in preventing disease and death in these models . Pharmacologic inactivation of endotoxin by pretreatment or continuous treatment with polymyxin B did not prevent illness or mortality in the toxin depot model . Endotoxin thus appears not to be an essential mediator in TSS, since TSS-like illness develops and progresses despite inactivation of endotoxin in animal model systems that are faithful both physiologically and clinically to TSS in humans.

Rev Infect Dis, 1989 Jan-Feb, 11 Suppl 1, S176 - 81
Role of air in growth and production of toxic shock syndrome toxin 1 by Staphylococcus aureus in experimental cotton and rayon tampons; Fischetti VA et al.; Rayon and cotton fibers of the type used in the manufacture of tampons were extracted for 6 hours in isopropyl alcohol in a soxhlet apparatus to remove all finishes from the fiber surface . The fibers were used to produce experimental tampons of commercial design . Using a syringe method, the tampons were saturated with diluted staphylococci in brain-heart infusion medium and incubated at 37 degrees C . Spent medium was expressed from the tampons and analyzed for growth of staphylococci and production of toxic shock syndrome toxin 1 (TSST-1) . Results revealed no statistical difference in the production of TSST-1 by cells grown in rayon or cotton . However, a significant increase in TSST-1 production was observed in tampon cultures when compared with medium controls . When similar experiments were performed with tampons saturated with nitrogen, a significant decrease in TSST-1 production was observed when compared with air-saturated tampons . The results indicate that the oxygen normally present in tampons plays a significant role in modulating the production of TSST-1.

Rev Infect Dis, 1989 Jan-Feb, 11 Suppl 1, S167 - 73; discussion S173-5
Magnesium and the pathogenesis of toxic shock syndrome; Kass EH; Excess production of toxic shock syndrome toxin 1 by appropriate strains of Staphylococcus aureus occurs when the organisms are grown in an environment deficient in Mg++ . Since many of the fibers previously used in tampons combine with Mg++, an explanation for the pathogenesis of menstrually related toxic shock syndrome presents itself . Pitfalls in the reproduction of these experiments have been investigated and include attention to inoculum size, to the effect of washing the inoculum to rid it of magnesium from the parent culture, and related variables . The growth of staphylococci in magnesium-deficient medium is slower than in the usual culture media, making it necessary that the effect of magnesium deficiency be examined after sufficient incubation to permit maximal toxin production to occur . When these variables are taken into account, a coherent theory to explain the pathogenesis of menstrual TSS emerges . Absorbency of tampons, which correlates with the capacity to absorb Mg++, becomes, as has been suggested, a surrogate for the magnesium effect . The observations raise the possibility of a safer tampon, one in which the magnesium content is regulated to cause the staphylococci not to be in a magnesium-deficient environment.

J Dairy Sci, 1989 Jan, 72(1), 228 - 40
Pathology of Staphylococcus aureus mastitis during lactogenesis: relationships with bovine mammary structure and function; Sordillo LM et al.; Pathological alterations of mammary parenchymal tissue from 5 dairy cows with Staphylococcus aureus mastitis were studied . Tissue from infected quarters exhibited less synthetic and secretory ability during lactogenesis, as indicated by lower percentages of luminal area, but higher percentages of stromal area compared with control tissue . Ultrastructural analysis of alveolar epithelium demonstrated decreased numbers of organelles associated with milk synthesis and secretion . Mammary secretion from 12 additional cows confirmed the loss of secretory potential in infected quarters as concentrations of alpha-lactalbumin were lower during the first 14 d of lactation compared with concentrations from controls . Higher concentrations of serum alpha-lactalbumin from cows with Staphylococcus aureus mastitis suggest leakage of mammary secretion through gaps left by damaged or sloughed alveolar epithelium . Macrophages and lymphocytes were observed frequently in large gaps between basal plasma membrane of secretory cells and the basal lamina which may contribute to epithelial damage . Ability of neutrophils and macrophages to phagocytize staphylococci may have been compromised in the prelactating gland due to the indiscriminate ingestion of accumulated fat and casein.

Infection, 1989 Jan-Feb, 17(1), 35 - 7
The microbiological efficacy of the combination of fosfomycin and vancomycin against clinically relevant staphylococci; Gatermann S et al.; Infections with multiresistant strains of Staphylococcus aureus and Staphylococcus epidermidis pose severe clinical problems . The drug of choice in such cases, vancomycin, is potentially ototoxic and nephrotoxic and this may give rise to additional problems in the patient . Fosfomycin has been shown to be nephroprotective when given with vancomycin and with other nephrotoxic drugs . We report the inhibitory and bactericidal activity of fosfomycin and vancomycin alone and in combination against 26 clinically relevant strains of S . aureus and 48 strains of S . epidermidis . In most instances these two drugs showed indifferent or additive effects, synergism or antagonism was only rarely observed . Assessment of the bactericidal action of the combination revealed similar effects . The combination of fosfomycin and vancomycin may, therefore, be beneficial in clinical situations where the nephrotoxic effect of vancomycin cannot be tolerated.

J Clin Microbiol, 1989 Jan, 27(1), 78 - 81
Staphylococcus intermedius in canine gingiva and canine-inflicted human wound infections: laboratory characterization of a newly recognized zoonotic pathogen; Talan DA et al.; Staphylococcal gingival flora was characterized in cultures from 135 dogs . Staphylococcus intermedius was isolated in 39% of the cultures, S . aureus was isolated in 10%, and both were isolated in 2.0% . S . aureus was isolated more often from dogs of working breeds with weights of greater than 40 lb (ca . 18 kg) and with outdoor habitats than was S . intermedius, which was associated with dogs of nonworking breeds with weights of less than 40 lb and indoor habitats . S . intermedius was distinguished from S . aureus by the following characteristics: coagulation of rabbit plasma at 4 h (26 versus 100%, respectively), hemolysis of sheep blood at 24 h (30 versus 79%, respectively), and mannitol fermentation at 24 h (4 versus 93%, respectively) . A clear separation of the two species was apparent only with the acetoin (modified Voges-Proskauer) reaction (100% of the S . aureus isolates versus 0% of the S . intermedius isolates) and beta-galactosidase activity on the API Staph-Ident strip (0% of the S . aureus isolates and 100% of the S . intermedius isolates) . Susceptibilities of S . intermedius and S . aureus were 72 and 7%, respectively, to penicillin G, and 100% of both species to oxacillin . Fourteen previously collected strains of coagulase-positive staphylococci from infected canine-inflicted human wounds were reanalyzed; 3 of 14 (21%) isolates were S . intermedius . We conclude that S . intermedius is a common canine gingival flora and is responsible for some canine-inflicted human wound infections, thus representing a newly recognized zoonotic pathogen.

J Oral Maxillofac Surg, 1989 Jan, 47(1), 69 - 71
Anaphylactoid reaction to vancomycin: report of a case; Roelofse JA et al.; Although vancomycin produces excellent prophylaxis against staphylococci, the danger of hypotension, whether secondary to anaphylactoid response or myocardial depression, exists . Therefore, recommendation for the use of vancomycin before dental procedures must include the precaution of administration in a dilute solution over 30 minutes, with frequent monitoring of BP and heart rate.

Ann Intern Med, 1989 Jan 1, 110(1), 9 - 16
Coagulase-negative staphylococcal bacteremia . Mortality and hospital stay; Martin MA et al.; OBJECTIVE: To determine the attributable mortality and the excess length of hospital stay resulting from coagulase-negative staphylococcal bacteremia . DESIGN: Matched historical cohort study . SETTING: Large university-based tertiary care center . PATIENTS: Of 171 patients with hospital-acquired coagulase-negative staphylococcal bacteremia identified by prospective surveillance of nosocomial infections from 1 July 1984 to 30 June 1987, 118 met criteria for the study and were matched to a control patient by age, sex, primary diagnoses, operative procedures, and date of admission . MEASUREMENTS AND RESULTS: Success was achieved in 621 of 650 (96%) variables used for matching . Staphylococcus epidermidis accounted for 92% of the bacteremias . Twenty cases (17%) had evidence of septic shock, and 10 had disseminated intravascular coagulation . The mortality rate in cases was 36 of 118 (30.5%) compared with 20 of 118 (16.9%) in controls . The attributable mortality was 13.6% (95% CI, 4.2 to 22.9) and the risk ratio for dying was 1.8 (95% CI, 1.2 to 2.7; P = 0.006) . The median length of stay was 46 days for cases and 37.5 for controls (P = 0.0002) . CONCLUSIONS: Coagulase-negative staphylococci, the leading organisms causing hospital-acquired bacteremias, are associated with mortality in excess of that due to the underlying diseases alone . Moreover, they significantly prolong the length of hospital stay . These findings show the importance of coagulase-negative staphylococcal bacteremia in hospitalized patients.

Ann Fr Anesth Reanim, 1989, 8(4), 316 - 20
{Plasma and tissue concentrations of cefamandole during cardiac surgery}; Clavey M et al.; This study aimed to determine plasma (CPC) and tissue concentrations of cefamandole during cardiac surgery, so as to compare them with the minimal inhibitory concentration (MIC) for staphylococci (0.25 - 1 microgram.ml-1 for S . aureus; 2 micrograms.ml-1 for S . epidermidis) . Cefamandole was given prophylactically to 8 consecutive patients as a single intravenous dose of 60 mg.kg-1 . Tissue concentrations were measured in presternal subcutaneous loose tissue and sternal marrow . Average CPC was 233.75 +/- 58 micrograms.ml-1, 15 min after drug administration, 187 +/- 6.4 micrograms.ml-1 at the time of sternotomy, 57.9 +/- 36.5 micrograms.ml-1 10 min after the start of bypass and 36.4 +/- 18.4 micrograms.ml-1 at its end, and 15.5 +/- 5.9 micrograms.ml-1 at the end of the procedure . Sternal subcutaneous tissue and marrow concentrations were respectively 24.4 +/- 13.3 micrograms.g-1 and 31 +/- 5.6 micrograms.g-1 at the time of sternotomy, and 9.4 +/- 5.5 micrograms.g-1 and 9.2 +/- 3.5 micrograms.g-1 at the end of the procedure . Giving a high dose of cefamandole preoperatively appeared to have an effective prophylactic antibiotic action, as the plasma and tissue concentrations were always higher than the MIC for staphylococci.

Med Lab Sci, 1989 Jan, 46(1), 2 - 5
Methicillin resistance in staphylococci: an evaluation of conditions for detection; Jolly J et al.; Ninety-four strains of coagulase positive staphylococci and 73 strains of coagulase negative staphylococci were tested for their susceptibility to methicillin, using agar dilution and disc diffusion techniques with Diagnostic Sensitivity Test agar (DST) and DST supplemented with salt, incubated at 30 degrees C and 37 degrees C . Disc diffusion on salt-incorporated DST at 30 degrees C was most reliable for detecting methicillin resistance in both types of staphylococci . The agar dilution methods were particularly poor for detecting resistance with coagulase negative staphylococci . The simultaneous testing of coagulase positive and negative staphylococci by this method indicated the need for both DST and salt-incorporated DST agar plates, incubated at 30 degrees C . However, sensitive strains should still be tested by disc diffusion for confirmation.

Pathology, 1989 Jan, 21(1), 19 - 22
A study of coagulase-negative staphylococci isolated from clinically significant infections at an Australian teaching hospital; Large M et al.; Some 151 isolates of coagulase-negative staphylococci isolated from patients at an Australian teaching hospital were characterized by biochemical analysis, antibiotic sensitivity patterns and slime production . S . epidermidis was the predominant species (64%) isolated from clinically significant infections, and all S . epidermidis isolates from true bacteremias produced slime . Forty-nine per cent were resistant to methicillin and 61% to gentamicin . S . haemolyticus isolates from clinically significant infections also showed antibiotic resistance and 80% were resistant to more than five antibiotics . The importance of coagulase-negative staphylococci as pathogens in this large teaching hospital was confirmed.

Microbios, 1989, 58(234), 17 - 25
Comparative effects of roxithromycin and erythromycin on cellular immune functions in vitro . 2 . Chemotaxis and phagocytosis of 3H-Staphylococcus aureus by human macrophages; Carlone NA et al.; The in vitro effects of roxithromycin on human macrophage activity were compared with those of erythromycin . Half the MIC of roxithromycin significantly enhanced the phagocytosis of 3H-labelled Staphylococcus aureus by human macrophages . Bacterial phagocytosis was also increased after pre-incubation of staphylococci with roxithromycin . Erythromycin displayed a less stimulating effect . Pre-incubation of macrophages with the drugs caused a depression of staphylococcal uptake by phagocytes . Macrophage chemotaxis was unchanged in the presence of both macrolides.

Antibiot Khimioter, 1989 Jan, 34(1), 38 - 42
{Sensitivity to antibiotics and the disinfectant chloramine of Staphylococci isolated from healthy and sick persons}; Balakliets NI et al.; Five hundred and twenty seven strains of Staphylococcus aureus with massive contamination of at least 10(3) when estimated quantitatively were tested for their sensitivity to antibiotics and chloramine B . The staphylococcal strains were isolated from patients, air and stock of rooms in medical institutions, from medical personnel and healthy persons having no long-term contacts with hospital media i . e . from pregnant women and workers of confectionery plants . Among the isolates there were strains simultaneously sensitive to antibiotics and chloramine B (16.6 per cent), sensitive to antibiotics but resistant to chloramine B (5.5 per cent), resistant to antibiotics but sensitive to chloramine B (63.1 per cent) and resistant to antibiotics and chloramine B (15.3 per cent) . Staphylococci resistant simultaneously to antibiotics and chloramine B were isolated from the persons of all the groups and from the air and stock of the rooms in the medical institutions . This showed the necessity of controlling sensitivity or staphylococci circulating in hospital media not only to antibiotics but also to disinfectants for providing more efficient prophylaxis of intrahospital infections.

Antibiot Khimioter, 1989 Jan, 34(1), 34 - 8
{Features of glycolysis and pentose phosphate pathway in novobiocin sensitive and novobiocin resistant staphylococci}; Vinnikov AI et al.; Intensity of glycolysis and the pentose phosphate cycle in staphylococci sensitive and resistant to novobiocin was studied . The resistant variants did not practically store lactate and the activity of glycolytic enzymes i.e . hexokinase and aldolase was lowered by 15-20 and 53-59 per cent, respectively . Monoiodoacetate, a glycolysis inhibitor suppressed the glucose oxidation rate by 53.3-66.9 per cent in the sensitive variants and by 16-21.8 per cent in the resistant variants . At the same time it was characteristic of the resistant variants to increase the activity of the pentose phosphate cycle enzymes; glucose-6-phosphate dehydrogenase by 25-38.1 per cent transketolase by 21.5-27.3 per cent and transaldolase by 30-57.1 per cent . No differences in the transhydrogenase reaction kinetics of both the novobiocin sensitive and the novobiocin resistant variants were observed.

Mikrobiol Zh, 1989 Jan-Feb, 51(1), 22 - 5
{The enzyme activity of energy metabolism in antibiotic-resistant staphylococci}; Vinnikov AI et al.; The rates of lactate accumulation and glucose oxidation by the clinic strains of Staphylococcus aureus were determined . The inhibition grade of the glucose oxidation by cyanide indicates that respiratory chain of staphylococci participates in the oxidizing processes . During glucose oxidation the respiratory chain generates the difference of electric potentials -156 divided by -179 mV . The comparative assessment have shown that the antibiotic-resistant staphylococci are characterized by a higher rate of glucose oxidation as well as by value of the greater transmembrane difference of electric potentials.

Chemotherapy, 1989, 35(1), 17 - 22
Effect of ciprofloxacin and ofloxacin on human polymorphonuclear leukocyte activity against staphylococci; Pascual A et al.; The interaction of ciprofloxacin and ofloxacin with the bactericidal capability of human polymorphonuclear leukocytes against staphylococci was investigated . Exposure of Staphylococcus aureus and Staphylococcus epidermidis to subinhibitory concentrations of ciprofloxacin and ofloxacin did not significantly affect the uptake and killing by human polymorphonuclear leukocytes . In our assay, ciprofloxacin and ofloxacin in concentrations of one time the minimal inhibitory concentration induced a significant reduction in viable intraphagocytic S . aureus (percentages of survival: 43 and 51%, respectively) compared to the controls without antibiotic (percentage of survival: 65%) . In contrast, both antimicrobials failed to produce a reduction in viable intraphagocytic S . epidermidis.

Padiatr Padol, 1989, 24(1), 43 - 8
{Infections of the cerebrospinal fluid shunt}; Menardi G; The treatment of infectious complications of implanted foreign bodies into the CNS is unsatisfactory . In the majority of these patients staphylococci are responsible for these infections which elicit only a smoldering inflammatory response with poor penetration of antibiotics into the CSF . It is also very difficult to eradicate staphylococci from the surface of silastic material by antibiotics . Fosfomycin was investigated in the treatment of CSF infections in patients with infected ventriculoatrial shunts . Fosfomycin exhibits a potent antimicrobial activity against staphylococci; this drug also showed a favourable penetration into the CSF in moderately inflamed meninges . A 10 days therapeutic course with fosfomycin plus oxacillin or cefamandole and gentamycin in combination with external drainage of the CSF into a closed system made it possible to exchange all parts of the system in one session without reinfection . This procedure was followed by the same antibiotic regimen postoperatively for 10-14 days . Under this treatment schedule therapeutic results have been considerably better compared to previous treatment modalities.

Padiatr Padol, 1989, 24(1), 21 - 32
{Resistance of staphylococci to intracellular killing by macrophages--a new pathophysiologic concept of acute hematogenous osteomyelitis in childhood and its therapeutic consequences}; Guggenbichler JP et al.; The pathophysiologic mechanism of acute hematogenous osteomyelitis in children has been further elucidated . Investigations revealed, that certain strains of staphylococcus aureus, responsible for the majority of infections, can resist intracellular killing after phagocytosis . Beta-lactam-antibiotics don't penetrate well into phagocytes and are unable to eradicate staphylococci surviving intracellularly . Fosfomycin, clindamycin and combinations of these antibiotics with beta-lactam-antibiotics are able to eradicate staphylococci also in phagocytic vacuoles . In a therapeutic investigation 36 patients have been treated with fosfomycin in combination with cefamandole intravenously for 10-14 days followed by clindamycin orally for 3-6 weeks . With this treatment schedule the therapeutic outcome was superior to previously employed therapeutic regimen.

Zh Mikrobiol Epidemiol Immunobiol, 1989 Jan, (1), 69 - 71
{The role of the bone marrow in forming an immunological memory to Staphylococcus}; Bobrovnik SA et al.; The dynamic study of antibody formation in the bone marrow tissue of mice immunized with corpuscular staphylococcal antigen was made . A single intravenous injection of this antigen to the animals produced no essential changes in the number of antibody-forming cells in the bone marrow, their repeated immunization led to the involvement of the bone marrow in the anamnetic reaction, which was manifested by the accumulation of a great number of plasmocytes synthesizing antibodies to staphylococci in bone marrow tissue . The relative contribution of the bone marrow to systemic antibody formation essentially increased at later stages of secondary immune response . The possible biological significance of the regularities and the practical importance of the data revealed in this investigation are discussed.

Kosm Biol Aviakosm Med, 1989 Jan-Feb, 23(1), 67 - 70
{Hygienic aspects of wash water reclamation systems}; Pak ZP et al.; The quality of reclaimed wash water and the composition of used wash water can be best determined by pH, oxygen chemical index, electric conductivity and chlorides that show individual variations but are sex-independent . Wash water contained mostly staphylococci and small amounts of sarcines, diplococci and micrococci . The use of washing and disinfecting agents may significantly modify the microbial characteristics of wash water, reducing noticeably its microbial content and increasing the content of organic substances and chlorides due to chemicals they include and due to more effective removal of sebaceous secretion . It is indicated that chemical components of washing and disinfecting agents that produce organic contaminants should be given special attention when developing a wash water reclamation system.

Acta Paediatr Scand Suppl, 1989, 363, 66 - 72; discussion 72-3
Strategies and perspectives in treatment of respiratory infections; Neijens HJ; Bronchopulmonary infections in CF have a number of special features . The pathophysiology is determined by consequences of the basic CF defect and interactions with host defence systems, leading to chronic inflammation induced by Staphylococci and subsequently Pseudomonas . This results in lung tissue damage, various complications and eventually respiratory insufficiency . Policy of treatment is to combat infectious exacerbations and lung tissue destruction as much as possible . Factors in optimal treatment such as strategies, indications for therapy and selection of antibiotics are discussed.

Mikrobiyol Bul, 1989 Jan, 23(1), 58 - 63
{Postoperative wound infections}; Karabiber N et al.; Between July 1987 and October 1988, 400 postoperative wound infection material sent to Microbiology Laboratory from various surgery clinics were examined bacteriologically . Staphylococcus aureus was the predominant organism . E . coli and coagulase negative Staphylococci were second and third in frequency respectively.

Padiatr Padol, 1989, 24(3), 227 - 36
{Treatment of diaper rash with Parfenac lipid ointment (bufexamac) . A study by Austrian pediatricians}; Lubec G; 447 children between 0 and 24 months with diaper dermatitis were treated by topical application of Parfenac-Fettsalbe (Bufexamac) . This panel was selected out of 844 patients which were originally in the protocol . The Parfenac-Fettsalbe was well tolerated, 7 children presented local side effects . 62.71% of treated girls showed very good results, whereas 59.89% of boys showed this outcome . Good results were obtained in 24.35% of girls and 21.93% of boys . Very good (no efflorescences remaining) and good results (some remaining efflorescences) were thus found in more than 80% of patients treated: with respect to corticosteroid advoidance this can be regarded as an effective antiphlogistic medication for diaper dermatitis . Non responders might have been superinfected with microorganisms as candida and staphylococci . In addition, epidemiological considerations are reported in that study.

Dermatol Monatsschr, 1989, 175(7), 450 - 3
{Typing of skin staphylococci using the commercial identification system Staphy-Test}; Pospisil L et al.; The authors examined 150 strains of S . aureus and 180 strains of S . epidermidis isolated from different dermatoses . The determination of S . aureus and S . epidermidis was based on common routine tests as plasmacoagulase, production of hemolysin, acid production from mannitol and production of pigment . This determination was verified with the aid of a new identification system STAPHYtest . The STAPHYtest confirmed the previous diagnosis of S . aureus in 60.66% and that of S . epidermidis in 31.66% of strains only . The remaining strains were identified by means of STAPHYtest as S . simulans, S . xylosus, S . hominis, S . haemolyticus, S . warneri, S . auricularis, S . sciuri and Micrococcus sp . The authors discuss the importance of an curate identification of skin staphylococci by means of STAPHYtest for taxonomic purposes and for classification of staphylococci influence on different dermatoses.

Ann Dent, 1989 Summer, 48(1), 28 - 9
Facial cellulitis responsive to flucloxacillin in acute leukemia; Barrett AP; A severely neutropenic patient, undergoing bone marrow transplantation for acute leukemia, experienced bilateral facial cellulitis accompanied by high fever and a facial folliculitis . All resolved with the addition of flucloxacillin to existing antibiotics suggesting a causal role for staphylococci.

Pediatriia, 1989, (6), 46 - 9
{Leukinferon in the combined therapy of infection in neonates and infants}; Nizharadze GI et al.; Leikinferon was used in multimodality treatment of sepsis caused by gram-negative microorganisms and staphylococci in 33 neonates and infants . It was injected in a dose of 10,000 IU and was given in courses of 4-6 intramuscular administrations with an interval of 48 hours . The treatment with leikinferon promoted a steady improvement of the clinical status, associated with pronounced activation of the interferon system and neutrophilic phagocytosis . The use of the drug in septic shock did not produce any noticeable affect . Fever was the only side effect induced by drug administration . In some children, the temperature rose by 1-1.5 degrees C . It returned to normal after 10-14 hours.

Langenbecks Arch Chir, 1989, 374(4), 214 - 20
{The role of coagulase negative staphylococci in mixed infections: association testing as an in vitro model}; Manncke KH et al.; Infections due to coagulase negative staphylococci (CNS) are of growing concern mainly in patients hospitalized in intensive care units (ICU) . The ability of CNS to adhere and to grow on plastic devices and resistance to many antibiotics, including oxacillin, contributes to their pathogenicity . Using the computer assisted system of the Medical Microbiology Department, the incidences of different pathogens and the coincidence of CNS with other bacteria were evaluated in a surgical department . Staphylococcus aureus revealed to be the predominant pathogen; however, CNS showed an increasing incidence in wound specimens and blood cultures of patients on the ICU . Coincidence of CNS with S . aureus and the nine most frequent species of gram negative bacteria could be shown in 6% . To investigate the influence of beta-lactamases produced by CNS in mixed infections, association experiments were performed . Association means a controlled growth of two or even more bacteria in a susceptibility testing system, either a broth dilution method or an automated broth disk elution method (Cobas Bact) . The association experiments showed a significant increase of amoxicillin MIC's of the pathogen associated with CNS . Addition of clavulanic acid restored activity of amoxicillin . It could be shown that in mixed infections CNS may contribute to the failure of antibiotic regimens by production of beta-lactamases.

Microbiologica, 1989 Jan, 12(1), 35 - 41
Klebocin activity of Klebsiella pneumoniae strains and its heterologous effect on Staphylococcus sp; Albesa I et al.; Thirty six Klebsiella pneumoniae strains were assayed in a test to determine bacterial interference; two of them had bacteriocinic effects on homologous species, strains 6 and 150 inhibited sensitive K . pneumoniae and they also acted on positive and negative Staphylococci coagulase . All cocci were sensitive to the bacteriocinogenic K . pneumoniae and none of the non-bacteriocinogenic strains inhibited them . Klebocin with homologous activity on K . pneumoniae seemed to be undistinguishable from the compound with heterologous action on Staphylococci in the aspects that were characterized in this work; both were heat labile to the same degree; optimum pH was 7, acidity decreased klebocin activity more intensely than alkaline pH . The antagonistic substance was not produced in the synthetic medium employed and was developed in tryptic soy, nutrient agar, brain heart agar and blood agar; tryptone-beef extract agar complex medium neither permitted the homologous activity nor allowed the interference on Staphylococci . The compound (or compounds) responsible for homologous antimicrobial effect had a low molecular weight as demonstrated by the fact that it pierces a dialysis membrane with molecular weight of 10,000 D cut-offs . Ethidium bromide treatment of strains 6 and 150 produced five strains without bacteriocinic activity which simultaneously lost their homologous and heterologous inhibitory capacity.

Nephron, 1989, 51(1), 51 - 5
Vancomycin and ceftazidime in the treatment of CAPD peritonitis; Beaman M et al.; 102 episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied prospectively during a 288-day period at The Queen Elizabeth Hospital, Birmingham . Organisms were isolated from 76% of the episodes, with coagulase-negative staphylococci, being the most commonly encountered organism (55%) . Initial treatment consisted of intraperitoneal vancomycin and ceftazidime with subsequent adjustment on the basis of antibiotic sensitivities . With this regimen, 83% of the positive cultures became negative by 72 h, 9.8% of cases relapsed and removal of the CAPD catheter was necessary in 8 patients (7.8%) . Overall, 92% of cases were cured . No adverse drug reactions were seen . This combination of antibiotics appears effective and safe in the treatment of CAPD peritonitis.

Acta Paediatr Scand Suppl, 1989, 360, 127 - 34
Septicaemia with coagulase negative staphylococci in a neonatal intensive care unit . Risk factors for infection, and antimicrobial susceptibility of the bacterial strains; Eshali H et al.; Septicaemia caused by coagulase negative staphylococci is a problem in the neonatal intensive care units (NICU) . The very low birthweight (VLBW) infants are at a special high risk because of their immature host defense . In this study the potential risk factors were compared between the VLBW septicaemia patients and the VLBW infants who had not contracted septicaemia in the NICU . The factor most clearly related with septicaemia was the use of umbilical artery catheters . The strategy against neonatal septicaemia includes restriction of the use of intravascular catheters . Also enhancement of the host defense by immunoglobulin therapy is considered . The coagulase negative staphylococci were multiresistant to antibiotics . The combination of netilmicin and benzylpenicillin covered the bacteria found in septicaemia cases in the NICU, and is now the standard treatment in suspected cases . Coagulase negative staphylococci are treated with vancomycin or netilmicin.

Acta Microbiol Hung, 1989, 36(4), 415 - 24
Clinical occurrence and virulence testing of coagulase-negative staphylococci; Barcs I et al.; A total of 650 coagulase-negative staphylococcal strains of miscellaneous clinical origin were isolated and identified during a 7-year-period . In all kinds of samples Staphylococcus epidermidis was the most frequently found species . In wounds the incidence of haemolytic species (S . cohnii, S . epidermidis, S . haemolyticus, S . simulans, S . warneri) was 79.3% . Among strains derived from male genitals (urethra, semen, etc.) S . epidermidis and S . simulans predominated . Only 8.2% of the strains were found not to harbour resistance determinants, while 63% proved to be multiply resistant . Only the incidence of resistance to oxacillin and first and second generation cephalosporins was low (12.8, 14.9 and 4.5%, respectively) . Vancomycin was the only drug effective against all strains . Extracellular slime was produced by 42.2% of the strains . The frequency of slime-positivity among isolates causing clinical infection was twice as high as among contaminations . Slime production seems to be a stable characteristic of the isolates . The comparison of two methods used for detection of slime factor showed that incubation in test tube in Tryptone Soya Broth, or its application to microtiter plates evaluated by photometry are of equal diagnostic value.

Acta Microbiol Hung, 1989, 36(1), 7 - 12
Risk involvement with Staphylococcus aureus exotoxins among pyogenic skin infections with special reference to toxic shock syndrome; Naidu S et al.; The sera of three patients involved in a non-menstrual toxic shock syndrome outbreak showed TSST-1 at a concentration above 40 ng/ml and no antibodies of IgG class against the toxin . A Staphylococcus aureus strain producing TSST-1 was isolated from one of the patients . S . aureus strains showing similar phage type and biotype patterns were isolated from 473 out of 876 close contacts with the patients involved in this outbreak . This carriage and spread was traced to pyogenic skin infections (mainly "folliculitis") among this population . Serological studies indicated that during the early phase of the outbreak anti TSST-1 titres were low then rose gradually . In a further related study the frequency of enterotoxin production was found 48.5% among staphylococci isolated from pyogenic skin infections . Our data indicated that pyogenic skin infections are potential source for toxic shock syndrome.

J Orthop Trauma, 1989, 3(4), 283 - 6
Microbiologic flora contaminating open fractures: its significance in the choice of primary antibiotic agents and the likelihood of deep wound infection; Robinson D et al.; A clear understanding of the significance of wound contamination as well as knowledge of the microbial flora that could be expected are needed in order to administer a rational and effective antibiotic treatment for open fractures . We have conducted a prospective study of the contaminating microbial flora in 89 open fractures . In addition, two more cultures were taken of all wounds not primarily closed . Wound and fracture healing were followed in all patients . Most fractures were Gustilo grade II (58.4%) caused by work-related accidents . Wound cultures were positive in 83% of all fractures, and a total of 84 strains of bacteria were isolated . In 39.3% of cultures, various species of aerobic Gram-negative rods (most commonly Pseudomaonas aeruginosa) were retrieved, followed by Staphylococcus epidermidis (34.5%) and Staphylococcus aureus (26.1%) . Repeat cultures were mostly either negative (59.5%) or grew saprophytic organisms that were usually nonpathogenic (such as various species of saprophytic Bacillus bacteria) . The only cases that developed deep wound infection were those where a repeat culture 1 day after debridement grew the same organisms as the initial organisms . We conclude that (a) most open fractures are already contaminated upon the patient's arrival at the emergency department, in many cases by potentially pathogenic staphylococci and Gram-negative organisms; (b) contaminating organisms are community acquired and, as such, are sensitive to most routine antibiotics; and (c) persistence of the same organisms in a repeat culture taken 1 day after debridement signifies technical failure of debridement and a subsequent very high risk of infection . Therefore, achieving adequate wound asepsis immediately following debridement is of the utmost importance.

Drugs Exp Clin Res, 1989, 15(6-7), 303 - 8
In vitro activity of netilmicin alone and in combination with azlocillin, mezlocillin and imipenem against 149 coagulase-negative staphylococci; Piccolomini R et al.; Coagulase-negative staphylococci (CNS) have long been regarded as innocuous skin commensals with little pathogenic potential but they have recently become, under appropriate conditions, an important cause of infections . In fact, infections caused by CNS are an increasing problem especially, but not exclusively, in immuno-compromised patients . A total of 149 strains of CNS were identified from 47 patients admitted to the Haematology Department of Pescara Hospital from October 1986 to November 1987 . The strains, isolated from different parts of the body and characterized by their methicillin susceptibility, were classified by API-Staph in 11 different groups . MICs and MBCs of netilmicin alone and combined with azlocillin, mezlocillin and imipenem were studied . For all combinations FIC and FBC indices were determined . The killing kinetics of the drugs mentioned above were also determined . Except for a few microorganisms (less than 5%), the associations showed a synergic or additive effect.

Med Dosw Mikrobiol, 1989, 41(2), 73 - 80
{Bacteriocinogenic properties of Staphylococci isolated from the oral cavity}; Raczynska A; Two hundred ninety two staphylococcal strains were isolated out of 130 saliva samples taken from children and adults, among which 116 were coagulase-positive and 176 coagulase negative . Bacteriocinogenic activity against Staphylococcus aureus strain Oxford 209P was found in 13 (4.5%) of the strains only . On the other hand, when a set of 15 sensitive staphylococcal strains selected by cross checking was used for the study 260 (89.0%) strains were found to be bacteriocinogenic . It was found that a higher percentage of coagulase-positive staphylococcal strains is sensitive to staphylococcins than of coagulase-negative strains . However, mean zone of inhibition is smaller in the case of former than of the latter strains . It was shown, that in the case of active strains a positive correlation exists between a percentage of coagulase-positive and negative strains inhibited by them and also between a percentage of all inhibited strains and a mean diameter if the growth inhibition zone . Simultaneous occurrence in saliva of two or more staphylococcal strains was found in 106 persons examined . In 93.4% of those cases coexisting strains did not show antagonistic properties: in remaining 6.6% despite of the number of simultaneously existing strains in oral cavity only one strain showed antagonistic properties against the remaining strains.

Acta Virol, 1989 Jan, 33(1), 24 - 31
A rapid method for detection of flavivirus antigens: staphylococcal co-agglutination test using monoclonal antibodies to Japanese encephalitis virus; Zhang YH et al.; Staphylococcus aureus rich in protein A when coated with monoclonal antibodies (MoAb) to Japanese encephalitis virus (JEV) gave a highly specific reaction with flavivirus antigens . The bacteria coated with JEV species-specific MoAb gave a strong co-agglutination with fifty-six JEV isolates from various parts of China, but no co-agglutination with Murray Valley encephalitis (MVE) and Kunjin (Kun) virus antigens . The flavivirus- and subgroup-specific MoAbs were reactive with MVE and Kun, as well as with the majority of the JEV strains . Blocking test with homologous MoAbs abolished co-agglutination further confirming its specificity . Numerous virus particles were observed on the surface of MoAb-coated staphylococci under the electron microscope after co-agglutination . The test appeared rapid, specific, simple to perform, and useful for rapid detection and identification of flaviviruses.

Chemotherapy, 1989, 35(5), 333 - 7
Newer agents against methicillin and/or gentamicin-resistant and -susceptible staphylococci; Chandrasekar PH et al.; The in vitro activities of the newer agents Deptomycin, Difloxacin, A-56620 and Ciprofloxacin were compared with those of vancomycin, rifampin and gentamicin against methicillin-susceptible and -resistant Staphylococcus aureus and coagulase-negative staphylococci . All isolates were susceptible to vancomycin, rifampin, deptomycin and the quinolones tested . Newer agents had activity superior to that of vancomycin, whereas the activity of the newer agents and rifampin was comparable . Gentamicin resistance was frequent, however, the resistant staphylococci were susceptible to other antibiotics tested.

Biokhimiia, 1989 Jan, 54(1), 149 - 53
{Magnitude of the proton moving force of Staphylococcus aureus cells and features of the interaction of staphylococci with phages}; Vinnikov AI et al.; The magnitude of the transmembrane electrical potential difference and the proton gradient across the energy-transducing membrane of Staphylococcus aureus were determined . The delta psi value was shown to rise from 100 to 160 mV upon alkalinization of the medium within the pH range of 5.0-8.0; at the same time, the pH value dropped from 90 to 40 mV . The proton motive force magnitude remained within the range of 191-198 mV at the pH values under study . Membrane potential generation took place, when the respiratory chain and H+-ATPase were operative . An addition of phages to cell suspensions resulted in a decrease of the membrane potential magnitude . Phage infection was effectively suppressed by inhibitors which affect the proton motive force generation in cell membranes of staphylococci.

Boll Ist Sieroter Milan, 1989, 68(2), 101 - 7
Technical factors influencing the bactericidal activity of teicoplanin against staphylococci; Pasticci MB et al.; Considering 99.9% Killing after 24h of incubation, mean bactericidal activity of teicoplanin against 48 clinical isolates of Staphylococci resulted to be 67.7 micrograms/ml . Fortyfour out of 48 strains (91.7%) resulted tolerant . The high percentage of tolerant was dependent on survivors above the 0.1% allowed in several tube dilutions . Prolonged incubation consistently reduced this number . Only 37.5% of our strains remained tolerant after 48h of incubation . Bactericidal activity of teicoplanin was also significantly influenced by other technical factors . Human serum enhanced the killing of teicoplanin . For 9 strains of Staphylococcus aureus geometric mean MBC decreased from 49.9 muug/ml to 3.9 micrograms/ml (p less than 0.05); also actively growing bacteria demonstrated a higher killing rate, resulting in lower MBCs (mean 3.8 micrograms/ml) . Micromethod technique was greatly influenced by the carryover phenomenon . The spot subculture technique is not accurate for bactericidal studies . A standardized technique for determining the minimal bactericidal activity is needed.

Boll Ist Sieroter Milan, 1989, 68(1), 5 - 6
Susceptibility of gram positive cocci to teicoplanin . Three year survey (1984-1986) at Perugia University; Pasticci MB et al.; From 1984 to 1986, 1038 Gram positive cocci (865 Staphylococci and 173 Enterococci) have been tested for sensitivity to teicoplanin by the agar diffusion method: only one strain (Staphylococcus haemolyticus) resulted to have no zone of inhibition around the teicoplanin disk . All Staphylococcus haemolyticus strains showed higher MIC: 2.79 mcg/ml after 24h of incubation and 20.50 mcg/ml after 48h . The reduced teicoplanin sensitivity of Staphylococcus haemolyticus was not detected by the agar diffusion test.

Vestn Dermatol Venerol, 1989, (3), 15 - 9
{Structuro-functional properties of staphylococci in patients with pyoderma}; Shakhabiddinov TT et al.; Electron-microscopic and ultra-cytochemical studies have shown the structural and functional features of pyoderma agents--staphylococci isolated from patients with acute and chronic pyoderma . The studies have revealed magnesium-activated ATPase and adenylate cyclase in these bacteria; the authors have tried to trace a correlation between these enzymes' activities and location and the disease pattern . This may help assess the bacterial population status and choose the drugs for purposeful pathogenetic therapy.

Zentralbl Chir, 1989, 114(3), 169 - 74
{Anastomotic aneurysm}; Harnoss BM et al.; The incidence of postoperative suture aneurysms shows a generally regressive tendency . Within the last 10 years, we diagnosed anastomotic aneurysms in 66 of a total of 2,494 patients undergoing vascular reconstruction with implantation of alloplastic material at our clinic . Aneurysms were primarily located in the inguinal region (88%); intraabdominal suture aneurysms were diagnosed in 9% of all cases . Infection was the cause of postoperative anastomotic insufficiency in eleven cases (17%) with staphylococci and E . coli being the dominant pathogens.

Chemotherapy, 1989, 35(5), 351 - 4
In vitro activity of fleroxacin and 14 other antimicrobials against slime- and non-slime-producing Staphylococcus epidermidis; Kropec A et al.; The in vitro activity of the 4-quinolone compound fleroxacin (Ro-23-6240) was compared with that of 14 other antimicrobials against a total of 50 recent clinical isolates of 25 slime- and 25 non-slime-producing coagulase-negative staphylococci . Susceptibility testing (MIC/MBC) was performed by a microtiter broth dilution technique and the combination effect of fleroxacin plus rifampin was studied by checkerboard titration in microtiter trays . Fleroxacin inhibited the most slime- and non-slime producing coagulase-negative staphylococci at MIC90 0.25 and I micrograms/ml, respectively . Overall fleroxacin was as active or even better as ofloxacin, cefotiam, cefazolin, cefamandole, clindamycin or vancomycin but 2- to 8-fold less active than rifampin . The fleroxacin-rifampin combination was indifferent in 17%, additive in 78.7% and synergistic in 4.3%.

Nephrol Dial Transplant, 1989, 4(1), 62 - 5
Urokinase: a treatment for relapsing peritonitis due to coagulase-negative staphylococci; Pickering SJ et al.; Four consecutive patients with relapsing peritonitis due to coagulase-negative staphylococci have been successfully treated by the addition of urokinase to their treatment regime, having failed to respond to appropriate antibiotic therapy alone . The organisms isolated from each episode of peritonitis in an individual patient were shown to be identical by antibiotic sensitivity, phage typing, slime production and immunoblot analysis . The action of urokinase is unknown but it may act by fibrinolysis, allowing antibiotics access to a source of infection previously protected by fibrin . The technique described is a simple, safe and effective treatment of relapsing peritonitis due to coagulase-negative staphylococci, and its use can markedly reduce the morbidity associated with this infection.

Boll Ist Sieroter Milan, 1989, 68(3), 296 - 9
{Carriers of enterotoxic Staphylococcus aureus during a 2 month period in Sienese workers}; Zanda M et al.; From the period of October 1987 to January 1988, 9 samples were taken from 16 workers in company canteens situated in the Sienna area . The study of enterotoxin staphylococci strains was carried out of the pharynx, nose, skin of the face and the hands . The investigation required the use of the Staphylo-Zyme P.B.I . kit and RPLA Oxoid set . The most frequently found enterotoxins were A and D, either alone or together.

Boll Ist Sieroter Milan, 1989, 68(1), 10 - 6
In vitro antimicrobial sensitivity of staphylococci isolated in the Santa Cruz region of Bolivia; Bartoloni A et al.; The in vitro antimicrobial susceptibility of staphylococci isolated in two different communities, Camiri and Javillo, of the Santa Cruz region in south-eastern Bolivia was tested by the agar diffusion technique and by a micro dilution susceptibility test to determine the Minimum Inhibitory Concentrations . Staphylococcal strains isolated from hospital staff of the Camiri Hospital were compared to that isolated from healthy people of Javillo, a very small community isolated in the jungle . In the Camiri Hospital, staphylococci showed a high prevalence of penicillin resistance, 100% for S . aureus strains and 73.5% for coagulase-negative staphylococci . Among coagulase-negative strains we found a high rate of multiresistant strains, mainly to ampicillin, tetracycline and chloramphenicol . In the rural population of Javillo we found staphylococcal strains highly susceptible to all the antibiotics tested.

Perit Dial Int, 1989, 9(4), 333 - 9
Strain differences in the opsonisation of Staphylococcus epidermidis; Bennett-Jones DN et al.; Ten isolates of coagulase-negative staphylococci, collected from patients receiving treatment with continuous ambulatory peritoneal dialysis (CAPD), exhibited marked differences in the degree of opsonisation when incubated in 10% and 1% pooled human serum, 10% and 1% heat-treated serum, Hanks' Balanced Salt Solution, and timed peritoneal dialysis (PD) effluent . The addition of exogenous IgG to PD effluent results in a greater increase in opsonisation in those fluids with the weakest inherent opsonic activity, but is ineffective against the majority of isolates in the absence of heat-labile opsonic activity . The results of this in vitro study suggest that host resistance to CAPD peritonitis due to coagulase-negative staphylococci may be determined as much by the characteristics of the contaminating strain, as by the opsonising activity of PD effluent.

Perit Dial Int, 1989, 9(3), 179 - 90
Peritonitis in continuous ambulatory peritoneal dialysis (CAPD): diagnostic findings, therapeutic outcome and complications; Tranaeus A et al.; The analysis of all episodes of peritonitis occurring in a uniformly treated continuous ambulatory peritoneal dialysis (CAPD) population (N = 128) at one centre during a six-year period showed the following major findings . The initial white cell count (WCC) of the dialysate was less than 100 x 10(6)/L in 10% of the episodes and showed a predominance of mononuclear cells in 15% . The Gram stain results were consistent with the findings of the culture in 28% of the episodes and influenced the initial therapy in only 7% of the cases . Between 9% and 31% of all episodes would not have been classified as peritonitis if positive culture, a WCC of greater than 100 x 10(6)/L in the dialysate, or clinical symptoms had been required for the diagnosis . The proportion of negative dialysate cultures was 2% after the introduction of pre-culture membrane filtration . Tunnel infection as a cause of peritonitis was more frequent in episodes due to Staphylococcus aureus than in episodes due to coagulase-negative staphylococci (p = 0.009) . Peritonitis caused by coagulase negative staphylococci were followed by a milder course than other organisms (p = 0.02) . Of all episodes initially treated with cephradine only 62% were cured with this antibiotic (or cloxacillin) and 35% were followed by recurrency, protracted course or catheter loss, despite intermediate or full in vitro susceptibility . In only 53% of all episodes no complication was observed . Complications were more frequent in women and diabetics than in men (p = 0.01) and non-diabetics (p = 0.03), and were more common in episodes with clinical symptoms (p = 0.02) . Peritonitis resulted in drop-out from CAPD in 6% of all episodes . Hospital care was needed in 68% of all episodes . We conclude that turbidity can be used as the sole criterion for the initial diagnosis of peritonitis, and that a first generation cephalosporin should not be used as a first line antibiotic in the treatment of CAPD peritonitis.

Perit Dial Int, 1989, 9(2), 103 - 5
Continuous ambulatory peritoneal dialysis (CAPD) peritonitis: the effect of antibiotic on the adherence of coagulase-negative staphylococci to silicone rubber catheter material; Finch RG et al.; Peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and is caused predominantly by coagulase-negative staphylococci (CNS) . Adherence to the silicone rubber Tenckhoff catheter has been identified as one factor in the pathogenesis and persistence of these infections . We have studied the adherence of CNS from patients and controls to silicone rubber in an in vitro model to determine whether this phenomenon can be modified by antibiotics . Adherence was strong for 7/27 (26%) CAPD isolates and for 3/27 (11%) of control strains . The strongly adherent CAPD isolates, when exposed to subinhibitory concentrations of vancomycin, cefuroxime, and ciprofloxacin, showed minimal alteration in adherence with vancomycin in both broth and used dialysate, whereas cefuroxime and ciprofloxacin both significantly reduced it . These observations may have implications for drug selection and prevention of CAPD peritonitis caused by CNS.

Perit Dial Int, 1989, 9(1), 61 - 4
Staphylococcus aureus nasal carriage, exit-site infection and catheter loss in patients treated with continuous ambulatory peritoneal dialysis (CAPD); Davies SJ et al.; Over a three-year period, 217 episodes of bacterial peritonitis occurred in 183 patient years . Thirty-seven episodes were due to Staphylococcus aureus and 19 (51%) of these required removal of the catheter to eradicate infection . This compared with catheter loss in 4/63 (6.3%) coagulase negative staphylococci infections (p less than 0.001); 7/67 (9.5%) culture negative peritonitis (p less than 0.001); and 10/30 (33.3%) episodes due to gram-negative organisms (p less than 0.05) . Over half (51.3%) the episodes due to S . aureus were associated with exit-site infections, and this rose to 100% (10/10) with recurrent peritonitis (p less than 0.01) . A prospective analysis of nasal carriage and exit-site infections due to S . aureus was carried out in 87 patients . Exit-site infections were present in 21 (24%), almost entirely due to different strains as judged by sensitivity patterns and phage typing . Nasal carriage, defined as two positive swabs within the study period, was present in 20 (23%) patients . Fourteen (70%) of these had exit-site infections due to the same strain as that isolated from the nose, whereas no patient grew different strains from either site . Nasal carriage increased the risk of infection sixfold (p less than 0.001).

J Invest Surg, 1989, 2(4), 361 - 80
New aspects in the pathogenesis and prevention of polymer-associated foreign-body infections caused by coagulase-negative staphylococci; Jansen B et al.; The significance of polymer-associated infections caused by coagulase-negative staphylococci is discussed . The aspects of bacterial adhesion to polymeric materials as the first important pathogenetic step in the development of such infections are treated . The role of extracellular slime substance (ESS) produced by the bacteria in the pathogenesis is elucidated and newer results concerning the interference of ESS with host defense mechanisms and antibiotic therapy are presented . As an approach to the prevention of polymer-associated foreign-body infections, the modification of the polymeric materials is introduced . Results of recent studies to achieve antiadhesive materials by radiation modification of polymers as well as the development of antimicrobial surfaces by incorporating or bonding antibiotics to polymers are presented.

Lab Delo, 1989, (7), 66 - 7
{The validity of identifying Staphylococcus aureus}; Nechmirev AB et al.; The validity of the microorganism identification is recommended to be tested by recognizing S . aureus among other species of staphylococci.

Acta Microbiol Pol, 1989, 38(1), 55 - 62
The metabolic heterogeneity of pathogenic and nonpathogenic coagulase negative staphylococci; Mikucki J et al.; The coagulase negative staphylococci are a metabolically heterogenous group of strains . The investigated pathogenic and nonpathogenic strains differed markedly in respiration activity and character of endogenous metabolism.

Langenbecks Arch Chir, 1989, 374(3), 181 - 4
{In vitro virulence of wound infecting staphylococcal isolates from severely burned patients}; Winkler M et al.; The hemolysin and histamine releasing activity of 30 S . aureus strains isolated from third degree burns of heavily burned patients was detected . The culture supernatants (cs) of Staphylococcus aureus isolated during episodes of invasive burn wound infection displayed significantly lower amounts of hemolysin and histamine releasing activity as compared to cs of bacteria isolated when no sign of septicemia was present . In contrast, when washed bacterial cells were analysed, a reversed ratio could be observed . These data clearly indicate that in strains isolated during invasive burn wound infection pathogenicity factors remain attached to the bacterial surface of the staphylococci investigated.

Lab Delo, 1989, (4), 65 - 7
{The use of passive hemagglutination for determining the fibronectin-binding properties of microorganisms}; Sokurenko EV et al.; The authors present the data that evidence in favour of employing fibronectin sensitized formalin-treated red cells for the indication of fibronectin-binding microorganisms (as exemplified by staphylococci) in the passive hemagglutination test (PHAT) . The possibility of a quantitative estimation of fibronectin binding by the PHAT is shown . PHAT will help detect higher numbers of fibronectin-binding staphylococci than flocculation on the glass.

Lab Delo, 1989, (4), 62 - 4
{A rapid method of detecting the staphylococcal exotoxin of toxic shock}; Fluer FS et al.; The authors suggest a simple and rapid technique, staphylococci coagglutination, for rapid detection of the toxic shock exotoxin (TSE)-producing S . aureus strains . The method is based on the sensitization of formalin-treated Cowan-1 S . aureus cells with immunoglobulins to TSE . The reagent thus obtained coagglutinates with the supernatant of TSE-producing S . aureus tested strains . This method is more sensitive than the routinely used gel immunoprecipitation . The technique for preparing the supernatant of S . aureus tested cultures is also described.

Lab Delo, 1989, (2), 55 - 6
{Possibilities of using nuclear filters in microbiological studies}; Kapitonenko NA et al.; The authors have examined the regularities of the staphylococcal culture filtration through nuclear membranes with pore diameters of up to 0.6 microns, as well as the possibility of sterilization and multiple use of these filters . S . aureus strain No . S . 593 isolated from pathological material has been used as the test bacterium . Routine milk-yolk salt agar and meat-peptone salt broth with 10% NaCl have been employed for the cultivation of the test strain . The filters could be fairly well sterilized with Nikiforov's mixture; then they were dried under a UV bactericidal lamp . The studies have demonstrated that staphylococci can pass through nuclear membranes with pores 0.6 microns in diameter . For sterilization of biologic media membranes with pore diameters of 0.1-0.3 microns are preferable.

Antimicrob Agents Chemother, 1988 Dec, 32(12), 1754 - 7
Role of beta-lactamase and different testing conditions in oxacillin-borderline-susceptible staphylococci; Sierra-Madero JG et al.; A group of staphylococcal isolates for which oxacillin MICs were intermediate (1 to 4 micrograms/ml) were studied to establish the role of beta-lactamase in this phenomenon . MICs and MBCs of oxacillin and penicillin with and without clavulanic acid or sulbactam (4 or 16 micrograms/ml, respectively) were determined for 11 Staphylococcus aureus and 2 coagulase-negative Staphylococcus isolates for which oxacillin MICs were 1 to 4 micrograms/ml . The susceptibility studies were done with incubation at 35 and 30 degrees C, and the MICs were read at 24 and 48 h . Of the 13 isolates, 4 became resistant when longer incubation or 30 degrees C incubation was used, and the MICs for 9 remained in the intermediate range . Only three of these strains were susceptible to penicillin, and beta-lactamase was not detected . For 6 of 10 beta-lactamase-positive strains, there was a greater-than-twofold-dilution reduction in oxacillin MICs with the addition of clavulanic acid or sulbactam . Of the four strains that became resistant with incubation at the lower temperature, a clavulanic acid effect was observed in three but only at 35 degrees C . The oxacillin MIC for one of the beta-lactamase-negative strains was also reduced with clavulanic acid; however, this strain was inhibited by 1 microgram of clavulanic acid per ml alone . Bactericidal activity was observed with two or four times the oxacillin MIC in eight strains tested at both temperatures, and the combination with clavulanic acid was bactericidal at higher than four times the MIC in five of the strains at 30 degrees C . Our results suggest that oxacillin intermediate MICs for staphylococcal isolates are due not only to beta-lactamase hyperproduction but also some other unidentified factor . The reduction in oxacillin MIC observed when clavulanic acid was added to one strain was probably due to the intrinsic inhibitory activity of clavulanic acid.

J Virol Methods, 1988 Dec, 22(2-3), 239 - 46
Detection of cell surface rubella virus antigens in Vero cells with Staphylococcus aureus rich in protein A; Montero MT et al.; The presence of cell surface rubella antigen was used to verify and monitor viral replication in Vero cell monolayers . Viral antigen was observed in infected cells by the adherence of Staphylococcus aureus sensitized with immune anti-rubella sera . The staphylococci specifically bound to infected cells were Gram-stained and observed using light microscopy . The minimum titer of IgG antiviral hemagglutinin required for sensitizing the bacteria was 3.9 IU/ml . The specificity of the assay was demonstrated by treating the infected cells with bacteria sensitized with normal sera, by treating the mock-infected cells with staphylococci sensitized with either immune or normal sera, and by sensitizing the bacteria with immune sera from which anti-rubella antibodies had been removed . Viral antigens were detected from day 2-9 post-infection . The sensitivity of the assay in verifying and monitoring viral propagation was comparable to the titration of viral particles of hemagglutination . The assay is specific, rapid, simple and can be performed in laboratories with minimal equipment.

Chemioterapia, 1988 Dec, 7(6), 378 - 81
Microbiological indications for the treatment of Staphylococcus aureus infections; Fabbri A et al.; The Authors report microbiological data on the inhibitory activity of cephalothin, cefamandole, FCE 22101, gentamicin, netilmicin, amikacin, rifampicin, clindamycin, josamycin, ofloxacin, ciprofloxacin, vancomycin and teicoplanin against 165 clinically isolated Staphylococcus aureus strains . 34 of the study strains, i.e . 20.6%, were methicillin- and oxacillin-resistant . The activity of the tested drugs was good; the presence of nosocomial strains resistant to rifampicin (12.13%), clindamycin (13.94%), josamycin (18.2%), ofloxacin (4.85%), ciprofloxacin (12.7%), gentamicin (27.3%), amikacin (9.7%), netilmicin (7.9%) was noted . The Authors emphasize the good inhibitory activity of tested beta-lactam drugs against methicillin-sensitive Staphylococci, but also the limits of these drugs against methicillin-resistant strains . The activity of vancomycin and teicoplanin on all study strains was very good.

Epidemiol Infect, 1988 Dec, 101(3), 623 - 9
Hospital-acquired infection with methicillin-resistant and methicillin-sensitive staphylococci; Law MR et al.; In-patients at a London hospital over one year from whom the south-east England strain of 'epidemic' methicillin-resistant Staphylococcus aureus (MRSA) was isolated were compared with in-patients with strains of methicillin-sensitive Staphylococcus aureus (MSSA) . MRSA were virtually entirely hospital-acquired; isolates before 10 days were uncommon and related to recent previous admission . Thereafter first isolates occurred at a fairly constant daily rate of about 1.9 per 1,000 in-patients . Acquisition of MSSA after more than 4 days in hospital occurred at a similar constant rate . Such strains were less likely to be penicillin-sensitive than strains isolated in the first 4 days after admission (11 vs . 22%) and were considered to be hospital-acquired . The single MRSA strain caused 40 infections in a year, about half of all hospital-acquired staphylococcal infections . Patients prescribed anti-staphylococcal antibiotics and patients with indwelling cannulae both had about a ninefold increased risk of acquiring MRSA . There was no reciprocal increase in MSSA infections after control measures had substantially reduced the number of MRSA infections.

J Med Microbiol, 1988 Dec, 27(4), 271 - 6
Plasmid profiles and restriction enzyme fragmentation patterns of plasmids of methicillin-sensitive and methicillin-resistant isolates of Staphylococcus aureus from hospital and the community; Coia JE et al.; The number, frequency distribution and restriction enzyme fragmentation patterns of plasmids harboured by 163 methicillin-sensitive isolates of Staphylococcus aureus (MSSA) and 53 methicillin-resistant isolates (MRSA) were compared . Plasmids were demonstrated in less than half of the MSSA isolates; their frequency distribution did not differ from that predicted by a simple model of plasmid distributions . In contrast, all the MRSA isolates harboured plasmids, their distribution suggesting dissemination of a limited number of clones within the hospital . Among 72 MSSA isolates harbouring plasmids, 38 different restriction patterns were identified . There were fewer patterns among MRSA isolates; 11 were observed, and two predominant patterns accounted for 68% of those identified . These restriction patterns correlated with the presence or absence of aminoglycoside resistance . A multicopy plasmid of 2.6 kb was present in both MSSA and MRSA isolates that harboured more than one plasmid; it had the same restriction pattern irrespective of its source . The importance of these results in choosing a method of studying the spread of staphylococci is discussed.

Mol Cell Probes, 1988 Dec, 2(4), 321 - 30
Non-radioactive gene probes for the detection of tetracycline and/or minocycline resistance in staphylococci; Sakamoto H et al.; This report describes the development of a non-radioactive gene probe for the characterization of tetracycline and/or minocycline resistant staphylococci . Both radio-labelled and non-radioactive gene probes yielded a better characterization of the strains than the determination of minimal inhibitory concentration (MIC) . A 100% correlation was found between radioactive and non-radioactive hybridization tests . The latter technique detected genes present in a single copy per bacterial genome, could be performed in 8 h, avoided radioactive hazards and autoradiography delay, and appeared therefore to be a useful tool for clinical and epidemiological studies.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Dec, (12), 13 - 6
{Fibronectin-binding capacity of staphylococci}; Sokurenko EV et al.; The fibronectin-binding capacity of clinical isolates of the genus Staphylococcus has been studied in the flake-formation test on glass and by inoculation into agar with human fibronectin added . Most of 58 S . aureus strains have been found capable of binding fibronectin . None of coagulase-negative staphylococci has given flake formation with fibronectin . The possibilities of the quantitative evaluation of the fibronectin-binding by the above-mentioned methods have been shown . In the analysis of the monomers of bovine fibronectin its capacity for inducing the growth of compact colonies in semiliquid agar has been shown.

J Clin Microbiol, 1988 Nov, 26(11), 2427 - 8
Characterization of staphylococci from patients with toxic shock syndrome; Aliu B et al.; Fifty staphylococcal strains that produced toxic shock syndrome (TSS) toxin 1 and that were isolated from patients with TSS were characterized . One strain had more properties that were characteristic of Staphylococcus hyicus than of Staphylococcus aureus . Forty-four strains had the same properties or differed in only one property . Thirty-five of the 50 strains produced either enterotoxin A or C or both in addition to TSS toxin 1.

Methods Find Exp Clin Pharmacol, 1988 Nov, 10(11), 695 - 7
A comparison of disc agar diffusion and agar dilution for the detection of methicillin resistant staphylococci; Diller DL et al.; Ninety two consecutively occurring clinical isolates of Staphylococcus aureus and 71 coagulase negative staphylococci (CONS) were tested by disc agar diffusion (DAD) and agar dilution (Mueller Hinton agar with 4% sodium chloride and 6 mcg/ml oxacillin) for methicillin resistance . There were 6 S . aureus and 33 CONS which were resistant to oxacillin . Five discrepancies (CONS) occurred between the two methods, with all indicating susceptibility by DAD and resistance by agar dilution . Four discrepancies were resolved by minimal inhibitory concentration (MIC) tests . In two of the CONS, the MIC agreed with the DAD results, and in the other two, the MIC agreed with the agar dilution results . Results of this study indicate that DAD is an accurate and acceptable method of detecting methicillin resistance in staphylococci (especially S . aureus) at this institution.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Nov, (11), 23 - 7
{Staphylococci in skin microbiocenosis of the breasts in nursing women}; Sytnik SI; The levels of the bacterial contamination of the nipple, the areola and the surrounding skin, the occurrence and species composition of staphylococci in 120 nursing women on days 4-5 after parturition have been studied . S . aureus contaminate the surface of the nipple and the areola in 75% of the examined women, and in 57.5% of these women the massive contamination of the above-mentioned areas (greater than or equal to 10(3) colony-forming units per sq . cm) is observed . In 80% of puerperae the occurrence of S . epidermidis on the nipple, the areola and the surrounding skin has proved to be practically the same . The population of S . aureus colonizing the mammary glands consists mainly of hospital strains; of these, 75.97% belong to phage type 75.

J Antibiot (Tokyo), 1988 Nov, 41(11), 1617 - 28
Synthesis and structure-activity studies of new 4''-O-acyltylosin derivatives of therapeutic interest; Yoshioka T et al.; Eleven 4''-O-acyltylosin derivatives were synthesized and subjected to a two-step screening system consisting of antimicrobial activity and esterase stability assays . The new derivatives were all active against macrolide-resistant Staphylococci and mycoplasmas, but only 4''-O-(4-methoxy)phenylacetyltylosin and 4''-O-(4-acetyl)phenylacetyltylosin showed better resistance to mouse liver esterase than 4''-O-phenylacetyltylosin (reference compound C).

J Am Vet Med Assoc, 1988 Nov 1, 193(9), 1080 - 1
Frequency and antimicrobial susceptibility of Staphylococcus spp isolated from feline skin lesions; Medleau L et al.; Swab specimens obtained from skin lesions of 45 cats were cultured bacteriologically for staphylococci . Thirty-two staphylococcal isolates were recovered from 30 cats and were biotyped, using biochemical tests contained in a staphylococcal identification system . Of 23 isolates considered coagulase-positive, 16 were identified as Staphylococcus aureus, 5 as S intermedius, and 2 as S hyicus . Of 9 isolates considered coagulase-negative, 6 were identified as S simulans, 2 as S epidermidis, and 1 as S xylosus . Antimicrobial susceptibility tests were done on all staphylococcal isolates, using a disk-diffusion method . Staphylococcal isolates were susceptible to clavulanic acid-amoxicillin, cloxacillin, cephalothin, chloramphenicol, gentamicin, erythromycin, and trimethoprim-sulfamethoxazole . Resistance to penicillin G, ampicillin, and tetracycline was frequent.

J Med Microbiol, 1988 Nov, 27(3), 207 - 13
The role of extracellular slime in opsonophagocytosis of Staphylococcus epidermidis; Kristinsson KG et al.; Infections caused by coagulase-negative staphylococci (CNS) are a major problem in immunocompromised patients . It has been claimed that extracellular slime production by CNS predicts pathogenicity and inhibits host defences . Luminol-enhanced neutrophil chemiluminescence (CL) and bacterial killing assays were used to assess the effect of slime production on opsonophagocytosis and killing by polymorphonuclear leucocytes in vitro . There was wide variation in CL induction amongst the 43 strains of Staphylococcus epidermidis examined . The presence of slime had no influence either on the requirement or on the efficiency of opsonisation . Slime-producing and non-slime-producing strains showed a stepwise increase in induced CL up to a serum concentration of 10%, and were dependent on complement for efficient phagocytosis . The bacterial killing assays confirmed the CL results . Our data suggest that extracellular staphylococcal slime has no specific anti-opsonic property in vitro . Opsonophagocytosis may still be hampered in vivo by the physical presence of slime.

Antimicrob Agents Chemother, 1988 Nov, 32(11), 1627 - 31
Inhibitory effect of disodium EDTA upon the growth of Staphylococcus epidermidis in vitro: relation to infection prophylaxis of Hickman catheters; Root JL et al.; Granulocytopenic patients with an intravascular catheter are at increased risk for infection with Staphylococcus epidermidis . During the intervals when the catheters are not being used for infusions, it is customary to maintain patency of the catheter lumen with a solution containing heparin . We show that heparin does not inhibit the growth of S . epidermidis isolated from the catheter of an infected patient . A 20-mg/ml solution of disodium EDTA, a chelating agent which effectively anticoagulates blood at this concentration, was shown to be bactericidal for an initial inoculum of 10(3) CFU of staphylococci per ml in 24 h . Vancomycin, an antibiotic which is often employed to treat Staphylococcus infections, was also bactericidal for initial inocula of 10(3) CFU/ml at doses of 6.7 micrograms/ml, a drug concentration in the therapeutic range . When 10(3) staphylococci per ml were cultured in the presence of catheter segments and disodium EDTA or vancomycin, subcultures of the catheters showed minimal or no growth, respectively . In contrast, when cultured with heparin alone, subcultures showed abundant growth . In view of its low cost, effectiveness as an anticoagulant, and bactericidal activity, EDTA should be studied as a replacement for heparin solutions for the maintenance of intravenous catheters in granulocytopenic patients.

Antibiot Khimioter, 1988 Nov, 33(11), 820 - 3
{Effect of an interferon preparation on increasing bacterial sensitivity to antibiotics}; Maleeva LI et al.; Under the effect of human leukocytic alpha-interferon-II for injections there was observed an increase in sensitivity of bacteria to benzylpenicillin, ristomycin, novobiocin, streptomycin, kanamycin, monomycin and erythromycin . A higher antibacterial effect of the penicillin and erythromycin was recorded only with respect to initially resistant strains of staphylococci . For the antibiotic resistant strains of staphylococci the MICs of the penicillin and erythromycin decreased on the average 17.8 and 208 times (p less than 0.001) respectively . The interferon had no effect on sensitivity of bacteria to chloramphenicol.

J Hosp Infect, 1988 Nov, 12(4), 295 - 9
The laboratory interpretation of coagulase-negative staphylococcal bacteraemia in neonates; Marshall RJ et al.; In an attempt to detect markers of significance of coagulase-negative staphylococci (CNS) isolated from neonatal blood cultures, epidemiological data and the rate of appearance of positive blood cultures were examined . The main epidemiological factor studied was the relative abundance of the different biotypes of CNS in blood cultures, on neonatal skin and the hands of neonatal unit staff . Our results showed that the relative recovery rates of biotypes found from these sources showed no significant differences . The number of positive blood culture bottles in each set and the number of days taken for growth to appear showed wide variations . A higher proportion of aminoglycoside-resistant strains were found in the group showing both blood culture bottles positive and in the group where isolates were obtained by 24 h of incubation . We conclude that there is no advantage in biotyping CNS in assessing clinical significance, but the association of aminoglycoside resistance with the isolation pattern of CNS in neonatal blood cultures requires further examination.

Presse Med, 1988 Oct 26, 17(37), 1977 - 80
{Empirical antibiotic therapy and ceftazidime}; Modai J; Ceftazidime is indicated mainly for the empirical treatment of severe infections treated in hospital and of hospital-acquired infections . It can be used alone in numerous severe infections and it offers a good alternative to aminoglycosides and antibiotic combinations . However, there are frequent clinical situations where this drug must be used in combination with vancomycin to cover Staphylococci and Enterococci, and/or with an imidazole derivative to cover anaerobic species . Similarly, when the pathogens are known to be multiresistant the ceftazidime-aminoglycoside combination has a synergistic bactericidal activity and prevents the emergence of resistant strains . This combination is also recommended in cases where the site of infection is difficult to reach or in immunocompromised patients.

Presse Med, 1988 Oct 26, 17(37), 1904 - 7
{Importance of antibiotic combinations with ceftazidime and usefulness in the prevention of resistance}; Gutmann L et al.; Different antibiotics can be used in combinations to extend the antibacterial spectrum, to obtain a synergistic bactericidal effect or to prevent bacterial resistance . Ceftazidime may be combined with other antibiotic to extend its spectrum to Staphylococci and Enterococci, or even anaerobes . A synergistic effect is mainly obtained with aminoglycosides . To prevent the emergence of resistant strains, ceftazidime may be combined with aminoglycosides and the new quinolones.

Vet Microbiol, 1988 Oct, 18(2), 163 - 76
Interaction of sub-epithelial connective tissue components with Staphylococcus aureus and coagulase-negative staphylococci from bovine mastitis; Mamo W et al.; Staphylococcus aureus and coagulase-negative staphylococci (CNS) isolated from bovine mastitis were examined for their ability to interact with 125I-labelled fibronectin, fibrinogen and type II collagen . Their relative surface hydrophobicity and production of extracellular capsule were also investigated . Almost all S . aureus strains bound fibronectin (mean value 23%), fibrinogen (mean value 12%) and type II collagen (mean value 16%) . CNS bound fibronectin (mean value 6%) and type II collagen (mean value 7%), but not fibrinogen (mean value 2%) . The specificity of binding of these proteins to S . aureus strain F1440 and to coagulase-negative Staphylococcus chromogenes strain BO52 was studied by adding an excess of unlabelled proteins . Fibronectin and collagen binding were observed to be specific, varying between 50 and 75%, whereas the specificity of fibrinogen binding to S . aureus strain F1440 was lower (26%) . Most of the S . aureus strains (63%) showed very high surface hydrophobicity (autoaggregation) or lower hydrophobicity (29% of the strains) and the rest were hydrophilic . None of the CNS strains autoaggregated, 44% were classified as hydrophilic strains . Hydrophilic strains (except the reference strains) did not show extracellular capsule production . However, the encapsulated (reference) strains showed low binding to these proteins as compared to their unencapsulated variants . Pre-treatment of S . aureus strain F1440 and S . chromogenes strain BO52 with trypsin decreased their fibronectin binding capacity and surface hydrophobicity, whereas pre-treatment with bovine milk (except on collagen binding to strain F1440) did not significantly affect binding to these proteins . These data indicate that S . aureus and CNS isolated from bovine udder infection have the ability to bind to tissue matrix and plasma proteins which may be exposed in the traumatized or toxin-damaged udder epithelial lesions.

J Infect Dis, 1988 Oct, 158(4), 693 - 701
Fibronectin, fibrinogen, and laminin act as mediators of adherence of clinical staphylococcal isolates to foreign material; Herrmann M et al.; Bacterial adherence to polymer surfaces is a required early step in intravenous (iv) device infection . We collected eight strains of Staphylococcus aureus and 19 of coagulase-negative staphylococci from patients with proven iv device bacteremia and studied the role of plasma or connective-tissue proteins in promoting bacterial adherence to polymethylmethacrylate (PMMA) coverslips . Although only a negligible percentage of organisms adhered to albumin-coated PMMA, surface-bound fibronectin significantly promoted adherence of all isolates . Fibrinogen markedly promoted adherence of all S . aureus strains but of only four coagulase-negative strains . Thus, coagulase-negative staphylococci revealed a marked heterogeneity in adherence to fibrinogen-coated surfaces, a result suggesting the existence of heretofore unknown receptors for fibrinogen . Laminin promoted adherence of staphylococci to a much lower extent . Although strain specific, adherence of clinical staphylococcal isolates to foreign surfaces is significantly increased by fibronectin, fibrinogen, and laminin, an observation suggesting the possible contribution of these proteins to the pathogenesis of iv device infection.

J Antimicrob Chemother, 1988 Oct, 22 Suppl D, 35 - 41
In-vitro susceptibility of staphylococci to fleroxacin in comparison with six other quinolones; Pohlod DJ et al.; Susceptibilities of methicillin-resistant Staphylococcus aureus (MRSA, n = 32), methicillin-sensitive S . aureus (MSSA, n = 32), and S . epidermidis (SE, n = 24) were determined to fleroxacin, amifloxacin, ciprofloxacin, difloxacin, enoxacin, norfloxacin, and ofloxacin . All organisms were isolated from the blood of patients with infective endocarditis . MRSA and MSSA MIC90s were less than 1.0 mg/l of fleroxacin, ciprofloxacin, difloxacin, and ofloxacin while amifloxacin and norfloxacin produced MIC90s of less than 2.0 mg/l and enoxacin MIC90s of less than 4.0 mg/l . For S . epidermidis MIC90s were less than 1.0 mg/l of all quinolones except amifloxacin whose MIC90 was less than 2.0 mg/l . Two strains from each staphylococcal group were used in time-kill trials performed with all seven quinolones . Within 8 h, all quinolones colony counts were decreased by one log . At 24 h, most quinolones decreased MRSA, MSSA, and SE colony counts by two to four logs; however, exceptions were found with (1) difloxacin, enoxacin, and norfloxacin against MRSA, (2) ciprofloxacin and enoxacin against MSSA, and (3) ciprofloxacin against SE in which all colony counts increased one to three logs in 24 h . When quinolone time-kill trials did not show a decrease in colony counts at 24 h, the MIC's for the 24 h growth showed a four- to 250-fold increase when compared with pre-trial MICs . No selection or emergence of resistant organisms was found with fleroxacin, amifloxacin or ofloxacin.

Infect Control Hosp Epidemiol, 1988 Oct, 9(10), 441 - 6
Evaluation of the variety of plasmid profiles in S epidermidis isolates from hospital patients and staff; Valentine CR et al.; Plasmid profiling was used to determine the variability of normal flora isolates of Staphylococcus epidermidis in order to evaluate the usefulness of plasmid profiling for identifying pathogens . Fifteen hospital staff members and patients repeatedly had cultures taken from the hands and nares, and multiple isolates were examined for plasmid profiles . S epidermidis isolated from the nares of 15 neonates were also examined . The total number of isolates examined for plasmid profiles was 726 . Repetition of profiles was common among the different isolates from a single sampling (one swab) . The frequency of re-isolating similar profiles on different days varied from 7% to 13% . Simultaneous isolation of similar profiles from nares and hands on the same individual varied from 0% to 11%, the percentage being lower for personnel . Isolation of the same plasmid profile from different individuals occurred only twice and resulted in an assignment probability of Pa = 0.002 for isolates obtained from different individuals . Significantly more isolates from nares contained plasmids (97%) compared with isolates from hands (89%) . Patients who had two or more isolates of coagulase-negative staphylococci with similar profiles were judged, clinically, to have infections in 12 of 13 cases . However, the likelihood of re-isolating an S epidermidis strain with a similar plasmid profile twice from the same person at different times was sufficiently high to prevent plasmid profiling from being used as an absolute criterion for infection.

J Clin Microbiol, 1988 Oct, 26(10), 1950 - 6
Biotyping coagulase-negative staphylococci; Hebert GA et al.; The biochemical profiles obtained with Staph-Ident (Analytab Products, Plainview, N.Y.) panels were combined with the results of adherence and synergistic hemolysis tests to define biotypes among 1,064 clinical isolates representing eight species of coagulase-negative staphylococci . The 672 isolates of Staphylococcus epidermidis were aligned in 69 of 144 potential biotypes in our scheme because of 18 different biochemical profiles and the eight physiologic subtypes . Isolates of most other species were in fewer biotypes because of more uniform adherence and synergistic hemolysis data, as well as fewer biochemical profiles . Since adherence and synergistic hemolysis may prove to be related to virulence and pathogenicity, biotyping with these test results would help evaluate the reliability of adherence and synergistic hemolysis as possible indices of the clinical significance of some of these organisms . When the antimicrobial susceptibility and plasmid profiles obtained on two clusters of S . epidermidis isolates were compared with the biotyping results, one cluster was not further differentiated by plasmid profiles, but was by antimicrobial profiles; the other cluster with only two biotypes was further divided into five distinct types by plasmid profiles but was not separated at all by antimicrobial profiles.

Epidemiol Infect, 1988 Oct, 101(2), 203 - 12
A comparison of DNA and immunoblot fingerprinting of the SII biotype of coagulase negative staphylococci; Burnie JP et al.; Thirty-eight isolates of the SII biotype of coagulase negative staphylococci were examined by phase typing, antibiograms, DNA and immunoblot fingerprinting . Multiple isolates were available from 5 patients with clinically proven infections and from 12 further patients who were epidemiologically distinct . Only 3 of the isolates were phage typable and antibiograms produced only 9 types . All isolates were typable by both DNA and immunoblot fingerprinting and reproducibility was excellent provided the conditions were standardized . Discrimination was better with immunoblot fingerprinting (17 types) than DNA fingerprinting (11 types) . Both techniques were successful in assessing the significance of multiple isolates from a single patient.

Antimicrob Agents Chemother, 1988 Oct, 32(10), 1494 - 9
Cloning and expression of methicillin resistance from Staphylococcus epidermidis in Staphylococcus carnosus; Tesch W et al.; A 6.2-kilobase chromosomal DNA fragment from a methicillin-resistant Staphylococcus epidermidis strain was cloned into Staphylococcus carnosus by using staphylococcal plasmid pCA44 as the vector . The recombinant plasmid obtained, pBBB21, conferred methicillin resistance on its host and was responsible for the synthesis of a low-affinity penicillin-binding protein (PBP), PBP 2' . PBP 2' determined by the S . epidermidis DNA and expressed as a membrane-bound PBP in S . carnosus reacted with monoclonal antibodies directed against PBP 2' of Staphylococcus aureus origin, and the cloned S . epidermidis DNA hybridized to the methicillin (mec)-specific DNA from S . aureus . These findings point to a common origin of the methicillin resistance determinant in staphylococci.

J Clin Microbiol, 1988 Oct, 26(10), 1939 - 49
Characteristics of coagulase-negative staphylococci that help differentiate these species and other members of the family Micrococcaceae; Hebert GA et al.; One hundred reference strains and 1,240 clinical isolates representing 26 species of the family Micrococcaceae were used to evaluate the potential of tests for synergistic hemolysis, adherence to glass, pyroglutamyl-beta-naphthylamide hydrolysis, and susceptibility to a set of five antimicrobial agents for differentiating these species and strains within the species . Sixty-eight percent of the clinical isolates exhibited synergistic hemolysis; 69% of the clinical staphylococci but none of the micrococci or stomatococci were adherence positive, and 92% of the strong positive adherence reactions were produced by strains of Staphylococcus epidermidis . Strains from 15 of the species were pyroglutamyl-beta-naphthylamide positive, but this test separated Staphylococcus xylosus from other novobiocin-resistant staphylococci and Staphylococcus intermedius from other coagulase-positive species . A polymyxin B disk helped differentiate S . epidermidis from most other coagulase-negative staphylococci, and a bacitracin disk (10 U) helped differentiate Staphylococcus haemolyticus from most other novobiocin-susceptible staphylococci . All strains that were susceptible to furazolidone and resistant to Taxo A disks (bacitracin, 0.04 U; BBL Microbiology Systems, Cockeysville, Md.) were staphylococci . We observed a 91% correlation between species identification obtained with the Staph-Ident system (Analytab Products, Plainview, N.Y.) and conventional methods; but the micrococci and stomatococci were incorrectly identified as staphylococci with Staph-Ident, and several isolates of S . epidermidis were misidentified as Staphylococcus hominis because they were alkaline phosphatase negative . Both these problems can be prevented by adding the simple tests we describe to those already recommended when the Staph-Ident system is used to identify isolates of gram-positive, catalase-positive cocci.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Oct, (10), 49 - 51
{Specificity of suppressor cells of the delayed hypersensitivity type for Staphylococcus studied by immunoadsorption}; Bekhalo VA et al.; The immunological specificity of T-suppressors obtained from mice after intravenous immunization with corpuscular antigen was shown . The splenocytes of such a mice suppressed DH to staphylococcal antigens, but not to sheep red blood cells . The suppressor cells under study were specifically adhesive to staphylococci.

Med J Aust, 1988 Sep 5, 149(5), 272 - 5
Late-onset neonatal sepsis due to multiply-resistant coagulase-negative staphylococci; McIntyre P et al.; A cluster of septic episodes that were caused by coagulase-negative staphylococci occurred in eight patients, over a six-month period from August 1, 1984 to January 31, 1985, in a Brisbane neonatal intensive-care unit where sepsis which was due to these organisms previously was uncommon . The organisms were universally-resistant to tobramycin (the aminoglycoside agent that was used at that time) and were variably-resistant to gentamicin, flucloxacillin and cephalothin . All organisms were sensitive to netilmicin, vancomycin, fusidic acid and rifampicin . The affected infants were all of 32 weeks' or less gestation and most of them weighed less than 1500 g at birth . All neonates had been ventilated artificially and had had long intravascular lines . Two infants had ventriculoperitoneal shunts that had been infected with coagulase-negative staphylococci--a potentially-important problem that has not been noted in premature infants in previous reports . Our experience demonstrates that it is important to consider the patterns of resistance to aminoglycoside as well as to beta-lactam antibiotic agents for the empirical therapy of septic episodes and for neurosurgical prophylaxis in nurseries where coagulase-negative staphylococci are emerging as common nosocomial pathogens.

Am J Med, 1988 Sep, 85(3), 292 - 300
Infections of the cardiac suture line after left ventricular surgery; McHenry MC et al.; PURPOSE: Infections of the cardiac suture line after left ventricular surgery are rare but may be fatal if not diagnosed promptly and treated effectively . In order to alert physicians to this entity, we reviewed data from three patients who presented at the Cleveland Clinic Hospital and from 22 patients in the literature . PATIENTS AND METHODS: The three patients in the current report underwent treatment at the Cleveland Clinic Hospital . Additional cases of infection of the left ventricular suture line were identified by reviewing the English literature pertaining to surgery for left ventricular aneurysms, pseudoaneurysms, and postoperative cardiac infections . RESULTS: Infection presented on average 16 months after surgery with cardiocutaneous fistulae, chest wall masses, hemoptysis or other pleuropulmonary symptoms, or systemic illness with bacteremia resembling endocarditis . Staphylococci and gram-negative bacilli were the most frequent pathogens . Diagnosis was often delayed and mortality was high . Left ventricular false aneurysms were identified in 15 of the 25 patients . Bleeding from sinuses in the chest wall or epigastrium or repeated hemoptysis were important clinical clues . In some instances, ill-advised surgical or instrumental procedures precipitated life-threatening hemorrhage . Treatment with antibiotics alone was insufficient . Excision of all infected sutures and Teflon pledgets and adequate debridement of the infected suture line were required to achieve cures . CONCLUSION: Since infection of the left ventricular suture line has protean clinical manifestations and may present months or years after the initial surgery, a high index of suspicion is of paramount importance in diagnosing the condition . Institution of cardiopulmonary bypass and reoperation through median sternotomy is recommended to achieve a cure.

Antibiot Khimioter, 1988 Sep, 33(9), 690 - 3
{Partial purification and various characteristics of antibacterial factor in preparations of interferon}; Maleeva LI et al.; A factor showing antibacterial activity was isolated from human alpha-interferon native preparations with affinity chromatography on immobilized cells of staphylococci . The antibacterial activity was found to be stable to the effect of nucleases and heating . Exposure to trypsin activated the antibacterial activity while exposure to pepsin somewhat destroyed it . Growth of the staphylococcal culture resistant to antibiotics was inhibited by the factor.

Antimicrob Agents Chemother, 1988 Sep, 32(9), 1320 - 2
Vancomycin concentrations in infected and noninfected human bone; Graziani AL et al.; Concentrations of vancomycin in bones of 14 patients undergoing total hip arthroplasty (group 1) and 5 patients with osteomyelitis (group 2) were studied . Group 1 received vancomycin, 15 mg/kg intravenously, 1 h prior to anesthesia . Group 2 received doses adjusted to achieve peak levels in serum of 20 to 30 micrograms/ml and trough levels of less than 12 micrograms/ml; bone specimens were collected during surgical debridement . The specimens were pulverized and eluted into phosphate buffer, and the supernatants were analyzed for vancomycin content by fluorescence polarization immunoassay . In group 1, vancomycin was detectable in all cancellous specimens with a mean concentration of 2.3 +/- 4.0 micrograms/g (range, 0.5 to 16 micrograms/g); 10 of 14 cortical specimens had detectable vancomycin; the mean cortical concentration was 1.1 +/- 0.8 micrograms/g (range, not detectable to 2.6 micrograms/g) . In group 2, vancomycin was detectable in only two of five cortical bone specimens (mean concentration, 5.9 +/- 3.5 micrograms/g) . Cancellous bone was obtained in one patient; the vancomycin concentration was 3.6 micrograms/g . In most patients the vancomycin levels in bones were higher than the MIC for susceptible staphylococci following single prophylactic doses . In the few infected patients studied, penetration was variable and deserves further study.

J Clin Microbiol, 1988 Sep, 26(9), 1907 - 9
Efficacies of rapid agglutination tests for identification of methicillin-resistant staphylococcal strains as Staphylococcus aureus; Piper J et al.; Four commercially available rapid agglutination tests for the identification of Staphylococcus aureus were compared with the tube coagulase test for the identification of 300 methicillin-resistant isolates of staphylococci . Isolates tested included 207 methicillin-resistant S . aureus and 93 coagulase-negative staphylococci, collected from five medical centers . Strain variability was documented by phage typing and antimicrobial susceptibility patterns . Results of rapid identification tests ranged between 82 and 86% sensitivity, significantly poorer than the 98% sensitivity which the tube coagulase test provided.

Antibiot Khimioter, 1988 Sep, 33(9), 684 - 6
{Effect of combinations of immunomodulators on phagocytosis}; Medvedev IuA et al.; The effect of levamisole, prodigiozan and lithium carbonate combinations on antimicrobial activity of blood neutrophils and peritoneal macrophages was studied on mice . The combinations were used in single doses . An increase in stimulation of phagocytosis with respect to staphylococci was observed after the use of prodigiozan in combination with lithium carbonate . Levamisole and lithium carbonate were antagonistic with respect to macrophagal phagocytosis . No advantage of the combined use of prodigiozan and levamisole to their use alone was shown.

JPEN J Parenter Enteral Nutr, 1988 Sep-Oct, 12(5), 462 - 4
Effect of frequent guidewire changes on triple-lumen catheter sepsis; Powell C et al.; Frequent guidewire changes of single-lumen (SLC) and triple-lumen (TLC) catheters have been proposed to decrease catheter sepsis . We placed TLC in 126 patients needing total parenteral nutrition (TPN) and multiple venous access, prospectively randomizing them to two groups: group I received a guidewire change every 3 days, and group II received guidewire changes for mechanical or septic complications only . Tips were cultured at each line change and tips and blood for each septic episode . Catheter sepsis was defined by the criteria of the Association for Practitioners in Infection Control (APIC) . There were 67 positive cultures in 52 patients, but most produced very few colonies or grew the same organisms in other infection sites . Forty-seven% of all cultures grew Staphylococci, and 23% grew Candida . APIC-defined catheter sepsis was detected in 12.7% of group I and 15.9% of group II . Although we observed no statistically significant difference in the two techniques, if we assume that a 20% difference in the incidence of catheter-induced sepsis would be important to detect, the probability of failing to detect such a difference is 0.24 with an 0.05 level of significance (two-sided) . Prophylactic guidewire changes did not alter the incidence of catheter sepsis in patients with TLC who required TPN . The high rate of sepsis and Candida infection may be due to the critical illness of the immunocompromised population studied.

Pathol Biol (Paris), 1988 Sep, 36(7), 899 - 901
{Early septicemia episodes in 143 bone marrow grafts}; Marit G et al.; Twenty-one early bacteremias have occurred before engraftment in 143 allogeneic bone marrow transplantation recipients . In the majority of cases (13/21) Gram positive cocci were isolated with a predominance of coagulase-negative staphylococci (62%) . The analysis of the infection prevention program showed that: 1) the adjunction of vancomycin to a total gut decontamination did not decrease significantly the incidence of bacteremia caused by Gram positive cocci . 2) The isolation in laminar air flow room seems to decrease the severity of infections but does not influence their frequency.

J Antimicrob Chemother, 1988 Sep, 22 Suppl C, 1 - 8
Bactericidal mechanisms of ofloxacin; Lewin CS et al.; Ciprofloxacin and ofloxacin are known to exert a second bactericidal mechanism (termed B) against Escherichia coli which functions even when protein synthesis is inhibited by chloramphenicol or when RNA synthesis is inhibited by rifampicin . However, the bactericidal activity of ciprofloxacin against a coagulase-negative staphylococcus (Staphylococcus warneri) was found to be abolished by chloramphenicol so the 4-quinolone does not exert mechanism B against this species . On the other hand, ofloxacin did exhibit mechanism B against S . warneri because the drug remained bactericidal in the presence of chloramphenicol . When S . aureus was investigated results similar to those observed in S . warneri were obtained throughout the range of clinically achievable concentrations of ofloxacin and ciprofloxacin . Ofloxacin seems to exhibit mechanism B against the staphylococci while ciprofloxacin does not . This may explain why ciprofloxacin is more potent than ofloxacin against Gram-negative bacteria but against staphylococci both drugs are equipotent.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Sep, (9), 19 - 24
{Experimental phages for differentiating nontypable methicillin-resistant Staphylococcus aureus}; Zueva EA et al.; The possibility of using phages, isolated from the lysogenic cultures of methicillin-resistant staphylococci and modified in methicillin-resistant cultures of phage 85, for the differentiation of nontypable staphylococcal strains has been studied . The variants of phage 85 cannot be used for the determination of differences between the strains of methicillin-resistant cultures; they are not suited for typing . For this purpose the collection of phages isolated from lysogenic methicillin-resistant cultures should be used.

J Antimicrob Chemother, 1988 Sep, 22(3), 321 - 4
In-vitro induction of resistance in coagulase-negative staphylococci to vancomycin and teicoplanin; Watanakunakorn C; Twenty strains of coagulase-negative staphylococci (18 strains of Staphylococcus haemolyticus and two of S . epidermidis) were serially subcultured in broth media containing subinhibitory concentrations (half the MIC) of either vancomycin or teicoplanin . The MIC of the antibiotic was again measured after five passages in antibiotic-containing broth . The organisms were then subcultured in broth containing antibiotic concentrations half of the new MIC value . The experiment was terminated after 25 passages . Only one strain developed a four-fold increase in vancomycin MIC . On the other hand, 16 strains developed four-fold MIC increases to teicoplanin.

Orthopedics, 1988 Sep, 11(9), 1285 - 9
The effect of anaerobiosis on antistaphylococcal antibiotics; Tsukayama DT et al.; The activity of eight antimicrobial agents which might be used in the treatment of staphylococcal osteomyelitis was tested under anaerobic conditions similar to those found in chronically infected bone . An agar-dilution method was employed to determine the minimum inhibitory concentrations of tobramycin, vancomycin, teicoplanin, ciprofloxacin, clindamycin, ceftriaxone, ticarcillin-clavulanic acid, and amoxicillin-clavulanic acid against 25 coagulase-positive and 25 coagulase-negative staphylococcal strains . The activity of tobramycin against coagulase-positive staphylococci, and of amoxicillin-clavulanic acid and ticarcillin-clavulanic acid against coagulase-negative staphylococci was markedly decreased with anaerobiosis . Vancomycin, teicoplanin, and ciprofloxacin were active against coagulase-positive and coagulase-negative staphylococci under both aerobic and anaerobic conditions . It was also found that antibiotic concentrations comparable to the high levels which might be achieved with local antibiotic therapy of osteomyelitis were not sufficient to overcome the level of resistance (100 micrograms/ml) of staphylococci which were not susceptible to tobramycin, clindamycin, ceftriaxone, and ticarcillin-clavulanic acid.

Epidemiol Infect, 1988 Aug, 101(1), 99 - 113
Species identification, antibiotic sensitivity and slime production of coagulase-negative staphylococci isolated from clinical specimens; Deighton MA et al.; Two hundred and seventy-five consecutive clinical isolates of coagulase-negative staphylococci, including strains associated with disease, contaminants and skin colonizers, were speciated, tested for slime production and for their sensitivity to a range of antibiotics . Staphylococcus epidermidis was the most commonly identified species, comprising 63% of all isolates . Slime production was detected in half the strains of Staph . epidermidis, Staph . haemolyticus and Staph . saprophyticus but was rare in other species . Most Staph . haemolyticus strains and approximately half of the Staph . epidermidis strains were resistant to five or more antibiotics . A significant association was found between slime production and multiple antibiotic resistance . For catheter-associated strains, clinical relevance was predictable by species i.e . Staph . epidermidis . Multi-resistant slime-positive Staph . haemolyticus strains, although infrequently associated with disease, were common skin colonizers, presumably acquired from the hospital environment . We describe a practical and inexpensive scheme for the speciation of human coagulase-negative staphylococcal isolates.

Pediatrics, 1988 Aug, 82(2), 234 - 9
Neonatal Staphylococcus epidermidis right-sided endocarditis: description of five catheterized infants; Noel GJ et al.; Coagulase-negative staphylococci are important causes of bacteremia and focal infections in infants hospitalized in neonatal intensive care units . The medical records and echocardiograms of 58 newborns with persistent Staphylococcus epidermidis bacteremia who were hospitalized in the neonatal intensive care unit at The New York Hospital during the past 5 1/2 years were reviewed, and five infants were identified as having S epidermidis right-sided infective endocarditis . These episodes were associated with placement of umbilical venous catheters in the right atrium, slow resolution of bacteremia, and persistent thrombocytopenia . This experience suggests the role of endocardial trauma resulting from the placement of umbilical venous catheters in the pathogenesis of endocarditis . The increasing importance of coagulase-negative staphylococci as a cause of bacteremia in the newborn may explain the emergence of S epidermidis as an important cause of infective endocarditis in the neonatal intensive care unit . These cases underscore the potential severity of S epidermidis infection in the premature newborn.

J Antimicrob Chemother, 1988 Aug, 22(2), 119 - 25
In-vitro activity and beta-lactamase stability of methicillin, isoxazolyl penicillins and cephalothin against coagulase-negative staphylococci; Jarlov JO et al.; Forty-nine clinical strains of coagulase-negative staphylococci were investigated for susceptibility to methicillin, oxacillin, cloxacillin, dicloxacillin, flucloxacillin and cephalothin . The highest level of resistance was found to methicillin and the lowest to cephalothin . The resistance-level of the isoxazolyl penicillins showed a high degree of uniformity . However more strains were resistant to cloxacillin and oxacillin than to dicloxacillin and flucloxacillin . Only a weak correlation was found between beta-lactamase production, and resistance to the six antibiotics . Methicillin was the most stable . The inactivation of cephalothin differed from that of the other antibiotics.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Aug, 269(2), 179 - 87
Deoxyribonucleic acid relatedness amongst Staphylococcus epidermidis and Staphylococcus saprophyticus strains; Zakrzewska-Czerwinska J et al.; The degree of binding was determined between DNA preparations from 65 staphylococci representing cluster defined in a numerical phenetic survey and 3H-labelled DNA from reference strains of S . epidermidis, S . haemolyticus, S . hominis, S . saprophyticus and S . warneri . The congruence between the DNA pairing and numerical phenetic data was good with S . epidermidis and S . saprophyticus being shown to be genomic species . However, some strains identified as S . epidermidis using recommended diagnostic procedures were found to belong to other taxa, notably S . simulans and S . warneri . The moles percent guanine plus cytosine content of the DNA of the test strains was within the range 27 to 34.

J Antimicrob Chemother, 1988 Aug, 22(2), 127 - 33
Time course of the antibacterial activity of erythromycin stearate and erythromycin acistrate against two Staphylococcus aureus strains in vitro; Korkeala H et al.; The antibacterial efficacy of erythromycin stearate (ES) and a new erythromycin prodrug, erythromycin acistrate (EA, 2'-acetyl erythromycin stearate), was compared in two Staphylococcus aureus strains, one sensitive and the other resistant to erythromycin . The growth was continuously monitored turbidometrically for 24 h . With the sensitive S . aureus, the inhibitory effects of both ES and EA were visible within 1-2 h when the antibiotics were added at 0 or 1.5 h after the beginning of the incubation . When they were added at 3 h, their action was immediate at 0.5 and 1 mg/l, and 5 mg/l caused a complete inhibition of the growth . At 0.5 and 1 mg/l, however, ES was much more effective than EA . When EA and ES (1, 5 or 10 mg/l) were added at 0 or 1.5 h to the resistant staphylococcal culture, the lag phases (no detectable growth) were prolonged as a function of drug concentration but eventually the growth was restored . The action of EA was weaker and the lag phases were 2-5 h shorter than those after ES . When the compounds were added at 3 h, the antibacterial effect was visible immediately . The increase of absorbance was slowed down even by 1 mg/l of ES and almost prevented by 5 mg/l . At these concentrations EA was less effective than ES, but the two erythromycins were equally active at 10 mg/l . These results show that addition of EA acts on both staphylococci as rapidly as addition of ES but to a lesser extent . Evidently EA is antibacterially weaker than ES, or rapidly hydrolyzed to erythromycin after it has been added to the test system.

Am J Vet Res, 1988 Aug, 49(8), 1205 - 9
Effects of intracisternal bead devices on lacteal secretion components, plaque formation, and bacterial infection during the nonlactating period; Nickerson SC et al.; Effects of placing intracisternal bead devices (ICB) into teat cisterns of 6 dairy cows, from the end of lactation through parturition, were studied . Lacteal secretion samples were collected weekly from each mammary quarter during the nonlactating period to monitor composition changes in ICB-fitted and nonfitted quarters . In quarters remaining uninfected (n = 15), there were significantly higher mean somatic cell counts (P less than 0.05), percentage of neutrophils (P less than 0.019), and cell viability (P less than 0.038), but significantly lower percentage of macrophages (P less than 0.013) in ICB-fitted quarters compared with those in nonfitted quarters . The ICB had no significant effect on mean weekly values for percentage of lymphocytes, pH, lactoferrin, citrate, citrate/lactoferrin molar ratio, serum albumin, alpha-lactalbumin, and N-acetyl-beta-D-glucosaminidase . In infected quarters (n = 9), pH of mammary secretions was significantly (P less than 0.004) higher in ICB-fitted quarters, but concentrations of lactoferrin (P less than 0.004), alpha-lactalbumin (P less than 0.013), and N-acetyl-beta-D-glucosaminidase (P less than 0.028) were significantly lower, compared with those in nonfitted quarters . Coagulase-negative staphylococci comprised approximately 90% of all infections . Over the nonlactating period, 16.4 and 41.5% of samples from nonfitted and ICB-fitted quarters, respectively, contained coagulase-negative staphylococci . Microscopic examination of ICB from uninfected quarters revealed a thin coating of plaque with adhering neutrophils, macrophages, and multinucleated giant cells . Microscopic examination of plaque on devices from ICB-fitted quarters harboring coagulase-negative staphylococci revealed numerous adherent cocci and neutrophils.

Pediatr Infect Dis J, 1988 Aug, 7(8), 556 - 60
Role of Broviac catheters in infections in children with cancer; Viscoli C et al.; In a 3-year period 157 single lumen Broviac catheters were inserted in 145 children with various neoplastic diseases . The overall duration of the catheter courses was 30,533 days (median, 171; range, 2 to 647) . Sixty-five percent of the catheter courses (102 of 157) were complicated by at least 1 febrile episode, for a total of 157 episodes . According to European Organization for Research on Treatment of Cancer criteria, 79 febrile episodes (50%) were classified as microbiologically documented infections, 57 (36%) with and 22 (14%) without septicemia; 31 (20%) as clinically documented infections; and 47 (30%) as possible infections . Of the 79 microbiologically documented infections 21 were catheter-related infections (CRI), 32 were catheter-unrelated infections and 26 were infections of unknown source . Only 48% of CRI occurred during neutropenia (less than 1000 neutrophils/mm3), compared with 88% of catheter-unrelated infections and 96% of infections of unknown origin (P = 0.00007) . Gram-positive microorganisms (56% staphylococci) accounted for 78% of all isolates in CRI, 47% in catheter-unrelated infections and 43% in infections of unknown origins (P = 0.03) . Fungi represented 12% of all isolates . Clinical and microbiologic resolution without removal of the catheter was achieved in 12 of 21 CRI (57%) and no patient died from a CRI . This study indicates that over 3 of 4 of CRI are caused by Gram-positive bacteria, occur in neutropenic and non-neutropenic patients (approximately 50%) and can be successfully treated without removing the catheter.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1988 Aug, 186(5-6), 536 - 44
Effect of the application of an anionic detergent combined with FABRY's tincture and its components on human skin resident flora . Part 2: Dermofug solution combined with either salicylic acid tincture or phenol acid tincture; Hartmann AA et al.; Using the forehead skin test, we investigated the combined application of 10 v/v% Dermofug solution and 3 w/v% salicylic acid tincture or 1 v/v% phenol acid tincture . The former combination showed better antibacterial efficacy against the coagulase-negative staphylococci and Propionibacterium spp . in the stratum corneum/acroinfundibulum as well as in the infrainfundibulum of the sebaceous glands . No antibacterial efficacy could be determined against Propionibacterium spp . in the infrainfundibulum of the sebaceous glands after the combined application of Dermofug solution and 1 v/v% phenol acid tincture . In contrast, the combined application of Dermofug solution and 3 w/v% salicylic acid tincture led to a long-term reduction of the cfu-counts of Propionibacterium spp . in the infrainfundibulum of the sebaceous glands . The following conclusions can be drawn from our study and applied to external therapy: a detergent like Dermofug should be used instead of an alcohol to enhance the penetration of a drug into the infrainfundibulum of the sebaceous glands, since the former can block the growth of Propionibacterium spp . in the infrainfundibulum . Secondly, it should be kept in mind that the addition of salicylic acid to a topical antibiotic ointment does not only enhance the penetration of the antibiotic into the infrainfundibulum of the sebacous glands, but that the antibacterial effect of the salicylic acid itself may be the reason for the better clinical antibacterial efficacy of such combinations.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1988 Aug, 186(5-6), 526 - 35
Effect of the application of an anionic detergent combined with FABRY's tincture and its components on human skin resident flora . Part 1: Dermofug solution combined with either FABRY's tincture or 50 v/v% isopropanol; Hartmann AA et al.; The aim of the study was to investigate the antimicrobial longterm efficacy of the combined application of an anionic detergent (Dermofug) either with 50 v/v% isopropanol or FABRY's tincture (3 w/v% salicylic acid, 1 v/v% liquefied phenol containing 50 v/v% isopropanol) on the resident flora of the human forehead skin after repeated applications using the forehead skin test . The test results show that both combinations tested are able to penetrate the infrainfundibulum of the sebaceous glands . The combined application of 10 v/v% Dermofug solution (D) and FABRY's tincture (F) showed better antibacterial efficacy than the combination of D and 50 v/v% isopropanol (I) against the coagulase-negative-staphylococci in the stratum corneum/acroinfundibulum as well as in the infrainfundibulum of the sebaceous glands . Against Propionibacterium spp., D and F showed better efficacy than D and I in the stratum corneum/acroinfundibulum, and equal efficacy in the infrainfundibulum of the sebaceous glands . It remains to be clarified in further investigations, which of the components of FABRY's tincture leads to the better antibacterial efficacy of the combined application of D and F in comparison to D and I, the salicylic acid or the phenol acid component.

Jpn J Antibiot, 1988 Aug, 41(8), 971 - 96
{Pharmacokinetic, bacteriological and clinical studies of cefuzonam in the field of obstetrics and gynecology . Study group of cefuzonam in the field of obstetrics and gynecological infections}; Matsuda S et al.; A multi-center open study was conducted to investigate cefuzonam (CZON, L-105) regarding to its pharmacokinetic, bacteriological and clinical aspects in the field of obstetrics and gynecology with the participation of 31 medical institutions and the related facilities . The results are summarized as follows . 1 . Peak MICs of CZON for Staphylococcus aureus, coagulase (-) staphylococci, Escherichia coli, Klebsiella pneumoniae, Bacteroides fragilis group, Peptostreptococcus spp . isolated from obstetrical and gynecological infections with relatively high frequencies were 0.39, 0.20, 0.024, 0.024-0.05, 12.5, 0.20 microgram/ml, respectively, with an inoculum size of 10(6) CFU/ml . 2 . When 1 g of CZON was given through bolus injection, the maximum concentration (Cmax) of CZON in pelvic dead space exudate was 18.7 micrograms/ml at 60.9 minutes (Tmax) after the injection; Cmax's in all female genital tissues were observed at 0.6-27.9 minutes and ranged from 11.9-26.3 micrograms/g . The Cmax 8.3 micrograms/ml, in the pelvic dead space exudate was noted at 97.0 minutes after the end of the intravenous drip infusion of 1 g over 1 hour, and Cmax's in genital tissues were 14.3-30.0 micrograms/g at the end of infusion . With 1 hour drip infusion of 2 g, Cmax's in genital tissues were 35.0-53.9 micrograms/g at the end of infusion . 3 . The clinical efficacy of CZON was evaluated in 206 evaluable patients with obstetric and gynecologic infections . Efficacy rates classified by types of infections were 97.1% (67/69) for intrauterine infections, 81.6% (31/38) for intrapelvic infections, 91.8% (45/49) for adnexitis, 95.2% (20/21) for infections of the external genital organs and 86.2% (25/29) for other infections . 4 . Side effects were observed in 7 of the 262 patients: eruption in 6 cases, itching in 2, diarrhea in 1 . Abnormal laboratory test values were noted in 9 of the 256 patients . Most of them were slight elevation of hepatic function values . CZON showed satisfactory clinical efficacy and potent antibacterial activity, hence it appears that CZON will be a very useful antibiotic for obstetric and gynecologic infections.

J Hosp Infect, 1988 Aug, 12(2), 103 - 8
Antibiotic resistance of coagulase-negative staphylococci in an orthopaedic department; Sanzen L et al.; Coagulase-negative staphylococci (CNS) were cultured from the anterior nares of surgeons, theatre and ward staff, and from patients before and 2 weeks after a total hip replacement . The CNS found in ward staff were more resistant to antibiotics than those in surgeons and theatre staff . Methicillin resistance of CNS in patients increased from 4 to 31% following surgery . Gentamicin-resistant CNS were only found postoperatively, in 20% of patients, in most of whom gentamicin-loaded acrylic bone cement was used.

Antimicrob Agents Chemother, 1988 Aug, 32(8), 1164 - 9
Tn4201, a beta-lactamase transposon in Staphylococcus aureus; Weber DA et al.; We report the preliminary characterization of a 6.7-kilobase transposon, Tn4201, encoding resistance to penicillin associated with the conjugative plasmid pCRG1600 in Staphylococcus aureus . Tn4201 is capable of inverting in orientation (frequently observed in derivatives of pCRG1600) and is expressed equally well in either orientation . The element is also capable of movement to alternative plasmid and chromosomal sites . Tn4201 exhibits rec-independent transposition in an apparent site-specific manner and may play an important role in the resistance of staphylococci to beta-lactam compounds.

Antimicrob Agents Chemother, 1988 Aug, 32(8), 1218 - 22
Mechanism of action of DuP 721: inhibition of an early event during initiation of protein synthesis; Eustice DC et al.; The mode of action of DuP 721 was investigated . This compound was active primarily against gram-positive bacteria, including multiply resistant strains of staphylococci . Although inactive against wild-type Escherichia coli, DuP 721 did inhibit E . coli when the outer membrane was perturbed by genetic or chemical means . Pulse-labeling studies with E . coli PLB-3252, a membrane-defective strain, showed that DuP 721 inhibited amino acid incorporation into proteins . The 50% inhibitory concentration of DuP 721 for protein synthesis was 3.8 micrograms/ml, but it was greater than 64 micrograms/ml for RNA and DNA syntheses . The direct addition of DuP 721 to cell-free systems did not inhibit any of the reactions of protein synthesis from chain initiation through chain elongation with either synthetic or natural mRNA as template . However, cell extracts prepared from DuP 721 growth-arrested cells were defective in initiation-dependent polypeptide synthesis directed by MS2 bacteriophage RNA . These cell-free extracts were not defective in polypeptide elongation or in fMet-tRNA(fMet)-dependent polypeptide synthesis stimulated by poly(G.U) . We conclude, therefore, that DuP 721 exerts its primary action at a step preceding the interaction of fMet-tRNA(fMet) and 30S ribosomal subunits with the initiator codon.

Am J Med, 1988 Jul 25, 85(1A), 52 - 5
Comparative susceptibility patterns of common clinical isolates to cefoperazone: 1981 to 1987; Jenkins SG; It has been postulated that the widespread use of broad-spectrum cephalosporins might lead to increased bacterial resistance to such agents . To determine if such increased resistance to cefoperazone might be detectable, the susceptibility patterns of common clinical isolates to cefoperazone were examined from the Pathology Laboratories at Baptist Medical Center, Jacksonville, Florida, from 1981, prior to approval by the Food and Drug Administration, to the present . Gram-negative aerobic and facultative anaerobic organisms, staphylococci, and members of the Bacteroides fragilis group were included in the analysis . The data obtained were compared with results of similar published studies nationwide . No significant decrease in susceptibility to cefoperazone was detected for any gram-negative species examined . A steady increase in the percentage of staphylococci (both coagulase positive and especially coagulase negative) resistant to cefoperazone was demonstrable at this institution . This was a direct function of the concomitant rise in the percentages of staphylococci resistant to methicillin observed over the testing interval . Anaerobic susceptibility patterns of the members of the B . fragilis group were also relatively constant during this period of time . The concentrations of antibiotic inhibiting 50 percent (MIC50) and 90 percent (MIC90) of B . fragilis isolates as determined by an agar dilution technique were 16 micrograms/ml and 64 micrograms/ml, respectively, both in 1981 and in 1987 . No change in the national susceptibility patterns of common bacterial isolates to cefoperazone was demonstrable in the five-year period during which the antibiotic has been available for clinical use.

Am J Med, 1988 Jul 25, 85(1A), 36 - 43
Cefoperazone plus piperacillin versus mezlocillin plus tobramycin as empiric therapy for febrile episodes in neutropenic patients; Rotstein C et al.; The double beta-lactam combination of cefoperazone plus piperacillin was compared with an aminoglycoside-containing regimen of mezlocillin plus tobramycin in a prospective, randomized trial of empiric therapy for febrile neutropenic patients (neutrophils no more than 1,000/mm3) . Thirty febrile episodes were treated with cefoperazone plus piperacillin and mezlocillin plus tobramycin, respectively . There was no significant difference between the two groups with respect to age, sex, pretherapy neutrophil count, and mean duration of therapy . The majority of patients had neutrophil counts of no more than 200/mm3 at the initiation of therapy . Only microbiologically and clinically documented infections were evaluated for efficacy . The cefoperazone plus piperacillin regimen appeared to have a comparable response rate with the mezlocillin plus tobramycin regimen (20 of 24 patients {83 percent} versus 16 of 23 patients {70 percent}) . Gram-positive micro-organisms were seen predominantly in this study, with the cefoperazone plus piperacillin regimen achieving a bacteriologic response in 84 percent, as opposed to 60 percent for those organisms treated with the mezlocillin plus tobramycin regimen . Neither regimen was totally effective against coagulase-negative staphylococci . Eight superinfections occurred in the cefoperazone plus piperacillin arm, whereas 11 superinfections occurred in the mezlocillin plus tobramycin arm . Although fungal superinfections were most common, the number of gram-positive superinfections in the mezlocillin plus tobramycin arm exceeded those seen in the cefoperazone plus piperacillin arm . The incidence of antibiotic-related side effects was similar in the two groups . Hypokalemia was most frequently seen . Both skin rashes and nephrotoxicity were more common with mezlocillin plus tobramycin . Cefoperazone plus piperacillin was found to be effective empiric therapy in febrile neutropenic patients . This double beta-lactam combination may be particularly useful for patients who have or are at high risk for the development of renal insufficiency.

N Z Med J, 1988 Jul 13, 101(849), 453 - 5
A comparison of umbilical cord treatment in the control of superficial infection; Smales O; Owing to a high incidence of superficial infection in the newborn period the existing cord care treatment of Iodosan 10% in surgical spirit was compared with 4% chlorhexidine detergent solution . A prospective crossover study was performed between two comparable maternity units . Cord bacteriology was assessed at the time of discharge from hospital and the day of cord separation recorded . The number of infections involving skin, eyes and umbilical cord occurring in hospital and at home were recorded . Chlorhexidine treatment of the cord was associated with an overall reduction in bacterial colonisation of the cord . This was most marked for coagulase positive staphylococci and was not associated with an increase in gram negative organisms . Cord separation occurred at a mean of 10 days with Iodosan and 20 days with chlorhexidine . Chlorhexidine treatment was associated with fewer infections overall; 21% of babies v 38% of babies treated with Iodosan . Conjunctival infection was most commonly recorded; 48 babies being affected in the Iodosan group and 20 in the chlorhexidine group . The use of 4% chlorhexidine detergent solution is supported, but the length of treatment may have to be limited in order to encourage cord separation.

J Dairy Sci, 1988 Jul, 71(7), 1940 - 6
Use of latex teat dip with germicide during the prepartum period; Matthews KR et al.; The efficacy of an acrylic latex barrier teat dip with germicide on new infections at parturition was tested on 113 cows and heifers during the prepartum period . A split udder design was used in which right quarters were undipped controls and left quarters were dipped with latex dip once daily for approximately 14 d prior to parturition . Distal streak canal swabs were taken from all quarters prior to the beginning of dipping, and all cows were quarter sampled in duplicate at drying off, parturition, and the first 5 consecutive wk of lactation . All quarters received antibiotic therapy at drying off . Excluding infections detected by distal streak canal swabs, the number of new infections at parturition in control and dipped quarters was 32 and 36 . New infections at parturition in control and dipped quarters were Staphylococcus aureus, 2 and 2; coagulase-negative staphylococci, 8 and 9; stretptococci, 10 and 12; coliforms, 8 and 8; and others, 4 and 5 . Differences were not significant . These results suggest no benefit to use of prepartum latex teat dip with germicide on new infections at parturition.

J Clin Microbiol, 1988 Jul, 26(7), 1404 - 5
Evaluation of a direct identification method for Staphylococcus aureus from blood culture broth; Hamoudi AC et al.; We evaluated the reliability of Staphaurex (Wellcome Diagnostics, Dartford, England) for the direct identification of staphylococci from blood culture broth with evidence of positivity and a suggestive Gram-stained smear . Our evaluation indicates that this application is of limited sensitivity, thus reducing the value of a negative test . However, since the test is highly specific, a positive test is significant in predicting the isolation of Staphylococcus aureus.

Arch Surg, 1988 Jul, 123(7), 908 - 11
A prospective study of the microflora of nonpuerperal breast abscess; Walker AP et al.; The majority of reports concerning nonpuerperal breast abscess (NPBA) identify aerobic and facultative bacterial isolates as the predominant flora in this disease . In the present study, fine-needle aspiration was performed in 29 women with NPBA; 12 (41%) of the patients had a history of chronic NPBA . The mean age of patients was 39.2 years . The aspirated material was cultured both anaerobically and aerobically . A total of 108 bacterial strains were recovered from 32 specimens; two specimens yielded no bacterial growth . A mean of 3.6 different bacteria were recovered from each culture-positive specimen . Anaerobic recovery outweighed aerobic-facultative recovery by a factor of 2:1 . Significantly, 37 strains (five aerobes and 32 anaerobes) were harvested only from enriched broth subcultured for four to 14 days after initial culture processing . Coagulase-negative staphylococci (60% of total aerobes) and peptostreptococci (47% of total anaerobes) were the predominant bacterial isolates . These findings indicate that NPBA is due to a mixed flora with a major anaerobic component . Furthermore, the results suggest that routine cultures often overlook the involvement of anaerobes in these infections.

J Dairy Sci, 1988 Jul, 71(7), 1934 - 9
Antimicrobial susceptibility and beta-lactamase testing of staphylococci isolated from dairy herds; Owens WE et al.; Evaluation of 722 staphylococcal isolates from seven dairy herds revealed marked herd differences in antimicrobial susceptibility patterns . A low overall resistance to penicillin was noted for Staphylococcus aureus, although isolates from three herds had greater than or equal to 16% penicillin resistance . Other staphylococcal species demonstrated a higher resistance to penicillin than did S . aureus . The predominant staphylococci other than S . aureus were S . hyicus and S . chromogenes for six of the seven herds while S . simulans and S . epidermidis predominated in one herd . beta-Lactamase testing using a commercially available chromogenic cephalosporin was an accurate predictor of penicillin resistance for S . aureus . Staphylococcus hyicus, S . chromogenes, and S . epidermidis that were penicillin resistant by susceptibility testing demonstrated negative beta-lactamase results of 35, 11, and 9%, respectively . Retesting of these isolates after exposure to penicillin resulted in positive beta-lactamase results, indicating induction of beta-lactamase . These results indicate the variability in antimicrobial susceptibility patterns for staphylococci and suggest the importance of epidemiologic knowledge of a dairy herd to guide initial therapy.

Can J Microbiol, 1988 Jul, 34(7), 913 - 5
Cross protection between a strain of Staphylococcus epidermidis and eight other species of coagulase-negative staphylococci; Yoshida K et al.; Passive protective activity of rabbit antiserum prepared by a representative capsular type II strain of Staphylococcus epidermidis in mice was absorbed out with homologous capsular type strains of S . simulans, S . cohnii, S . xylosus, S . hominis, S . capitis, S . hyicus, S . haemolyticus, and S . saprophyticus in addition to the homologous strain . The minimum amount of the strains required for absorption differed greatly, depending upon the strain . No absorption of the activity was shown with a strain of capsular type I and III of S . epidermidis, S . simulans, and S . cohnii, and a strain of capsular type III of S . hominis . These results suggest a possible capsular type specificity in the cross protection between strains of S . epidermidis and other species of coagulase-negative staphylococci.

Can J Microbiol, 1988 Jul, 34(7), 901 - 5
Proposed virulence factors among coagulase-negative staphylococci isolated from two healthy populations; Baddour LM et al.; Proposed virulence factors, including multiple antibiotic resistance and slime-mediated adherence, among coagulase-negative staphylococci colonizing healthy individuals from two different study populations were examined . Resistance to methicillin was more commonly seen than initially anticipated . In addition, adherence characteristics, as quantitated by a microtiter plate method, were very similar to those of strains of coagulase-negative staphylococci causing nosocomial infections.

Antibiot Khimioter, 1988 Jul, 33(7), 536 - 9
{Antibiotic sensitivity of staphylococci isolated from the surface of the skin of the breasts in pregnant women}; Sytnik SI; Nine hundred and fourty coagulase-positive and coagulase-negative strains of staphylococci isolated from the skin surface of the mammary glands of 94 pregnant women were tested by the disc agar diffusion method for their sensitivity to five antibiotics . The highest number of the isolates were sensitive to erythromycin and lincomycin (87.7 and 89.7 per cent, respectively) . The highest number of moderately resistant strains were detected with respect to methicillin . 19 out of 42 cultures of Staph . aureus were resistant to benzylpenicillin and 24 cultures were resistant to tetracycline . Among staphylococci 130 strains or 13.8 per cent were polyresistant.

J Antimicrob Chemother, 1988 Jul, 22 Suppl B, 33 - 9
Sub-inhibitory and post-antibiotic effects of spiramycin and erythromycin on Staphylococcus aureus; Webster C et al.; The antibacterial responses of clinical isolates of Staphylococcus aureus to spiramycin and erythromycin were compared . Conventional MICs showed erythromycin-sensitive strains to be 16-32 times less sensitive to spiramycin . MBCs were only four to eight times higher for spiramycin . Erythromycin resistant S . aureus were more frequently encountered . Concentrations of both macrolides at 1/4 MIC produced antibacterial effects . Post-antibiotic effects were more marked with spiramycin . After 3 h exposure to 4 x MIC of antibiotic the delay in regrowth of S . aureus was 5 h for erythromycin and 9 h for spiramycin . In a continuous cultivation model, spiramycin produced an inhibitory effect on S . aureus for 12 h whereas the effect of erythromycin was only apparent for 6 h . In conclusion, spiramycin is more active against staphylococci in vitro than would be expected by its modest MICs.

Clin Microbiol Rev, 1988 Jul, 1(3), 281 - 99
Laboratory, clinical, and epidemiological aspects of coagulase-negative staphylococci; Pfaller MA et al.; Coagulase-negative staphylococci, particularly Staphylococcus epidermidis, are increasingly important causes of nosocomial infection . Microbiologists and clinicians no longer can afford to disregard clinical isolates of coagulase-negative staphylococci as contaminants . Accurate species identification and antimicrobial susceptibility testing, in a clinically relevant time frame, are important aids in the diagnosis and management of serious coagulase-negative staphylococcal infections . Emphasis in the clinical laboratory should be placed on the routine identification of S . epidermidis and Staphylococcus saprophyticus, with identification of other species of coagulase-negative staphylococci as clinically indicated . The application of newer techniques, such as plasmid analysis and tests for slime production and adherence, contribute to our understanding of the epidemiology and pathogenesis of coagulase-negative staphylococci and may also be helpful in establishing the diagnosis of infection.

J Clin Immunol, 1988 Jul, 8(4), 275 - 84
Differentiation of human B lymphocyte subpopulations induced by an alloreactive helper T-cell clone; Anderson SJ et al.; We have used cloned alloreactive helper T cells to determine if direct T cell-B cell interaction can induce differentiation of human peripheral blood B cells which do not respond to pokeweed mitogen (PWM) . T-cell clone 2F8 was derived from a one-way mixed lymphocyte reaction . 2F8 cells are T3+T4+T8-IL-2R+ and proliferate in response to irradiated stimulator cells, but not autologous cells, in the absence of exogenous interleukin-2 . 2F8 cells provide allospecific help for polyclonal proliferation and differentiation of B cells in the absence of any other stimulus . The magnitude of this response is comparable to that of the response of the same B cells to PWM and fresh autologous T cells . 2F8 cells could also provide nonspecific help for unrelated donor B cells in the presence of PWM, with no requirement for costimulation by irradiated stimulator cells . Allospecific stimulation of B cells was completely inhibited by antibodies to class II major histocompatibility complex (MHC) framework determinants and was abrogated by 1000-rad irradiation . Cloned 2F8 T cells stimulated differentiation of both small, high-density B cells and larger B cells, generating up to 30% plasma cells with either fraction . B cells forming rosettes with mouse erythrocytes were also induced to differentiate by the helper T cell clone . As found previously, neither small, high-density B cells nor mouse rosette+ B cells responded well to PWM . Direct interaction with allospecific T cells induces differentiation of a broader spectrum of B cells than soluble growth and differentiation factors in conjunction with polyclonal activators such as PWM and protein A containing staphylococci.

J Hosp Infect, 1988 Jul, 12(1), 35 - 42
Contamination of blood during cardiopulmonary bypass: the effect of antibiotic prophylaxis; Wilson AP et al.; Despite antibiotic prophylaxis in cardiac surgery, gram-positive bacteria can be isolated in up to 10% of intraoperative blood cultures . During a prospective randomized trial, blood was collected from the oxygenator at the end of bypass in 58 patients given teicoplanin and in 60 others given flucloxacillin and tobramycin . Coagulase-negative staphylococci were cultured from 16 patients given teicoplanin but in only four cases after flucloxacillin and tobramycin (Fisher's exact test, P = 0.005) . In contrast, Propionibacterium spp . or coryneforms were isolated from 22 patients given flucloxacillin and tobramycin and from only one patient in the teicoplanin group . There were no cases of prosthetic valve endocarditis . After 3 h exposure to 4 x MIC of teicoplanin there was only a 10-60 fold reduction in cfus of Staphylococcus epidermidis, which may partly explain the excess of these organisms.

Am J Vet Res, 1988 Jun, 49(6), 747 - 51
Temporal study of staphylococcal species on healthy dogs; Cox HU et al.; During a 1-year period, specimens were obtained monthly from 5 hair coat and 7 mucous membrane sites of 11 healthy dogs . Among 804 isolates of staphylococci, 13 species were identified . Staphylococcus intermedius was the most frequently isolated (40.2% of total isolates) coagulase-positive species, and S xylosus was the most frequently isolated (17.3%) coagulase-negative species . Moreover, S intermedius was the most frequently isolated species from the 12 sites evaluated and was isolated persistently from 8 of the 9 dogs that completed the 1-year study . On the basis of a commercial identification system, 14 profile numbers were identified for isolates of S intermedius . However, 2 profile numbers accounted for a majority (70.9%) of the isolates . Specific S intermedius biotypes identified on the basis of hemolysis, coagulase production, beta-lactamase activity, and antimicrobial susceptibility patterns were found repeatedly in 3 dogs . Seemingly, S intermedius was a resident of the normal bacterial microflora of these dogs; however, the inability to isolate S intermedius from 1 dog during the study year indicated that not all dogs harbor S intermedius as a resident microorganism.

Arch Dis Child, 1988 Jun, 63(6), 639 - 43
Comparison of five tests used in diagnosis of neonatal bacteraemia; Kite P et al.; The neutrophil count, immature:total neutrophil ratio, C reactive protein assay, nitroblue tetrazolium test and an acridine orange leucocyte cytospin test were evaluated for the diagnosis of neonatal bacteraemia . The acridine orange leucocyte cytospin test gave the highest specificity and positive predictive accuracy, but was less sensitive than the neutrophil count, C reactive protein assay or nitroblue tetrazolium test, particularly for the diagnosis of bacteraemia caused by coagulase negative staphylococci . No single test gave the sensitivity, specificity, and positive predictive accuracy of the combined results of the acridine orange leucocyte cytospin, C reactive protein, and nitroblue tetrazolium tests.

J Clin Microbiol, 1988 Jun, 26(6), 1175 - 80
Staphylococcus aureus antigens reactive with milk immunoglobulin G of naturally infected dairy cows; Adams DS et al.; A 14- to 26-kilodalton fraction of Staphylococcus aureus exoproteins isolated by molecular sieve chromatography and electroelution from polyacrylamide gels was shown to specifically react with antibodies in milk of naturally infected dairy cows . Silver staining of the antigen preparation electrophoresed in polyacrylamide gels showed the strongest reactivity in the 24- to 26-kilodalton region with lesser staining at lower apparent molecular sizes . An enzyme-linked immunosorbent assay was developed to differentiate infected from uninfected cows for diagnostic purposes . Samples from S . aureus-infected cows reacted in the assay, and samples from uninfected cows did not . There was no correlation between numbers of somatic cells in the samples and reactivity to the antigens . Samples from cows infected with coagulase-negative staphylococci did not react with the antigens . It was found, however, that some samples from uninfected cows that were recently postpartum or producing low amounts of milk contained antibodies which bound the antigens . This was believed to be due to transport from blood to the mammary gland of antibodies which were generated by previous intramammary infections or infections at other sites.

Chemioterapia, 1988 Jun, 7(3), 151 - 5
In vitro interaction between cefotetan and aminoglycosides on Staphylococcus aureus and coagulase negative staphylococci, both methicillin-susceptible and -resistant; Stefani S et al.; The authors have evaluated the behavior of the interaction between cefotetan, a new cephalosporin with long acting resistance to the action of beta-lactamases, and gentamicin, amikacin and netilmicin against methicillin-susceptible and -resistant staphylococci . In 65.8% of the cases, drug combinations showed synergic effects . Results were subdivided for susceptibility or resistance to the drugs used in combination . In general, when both drugs were tested against methicillin-susceptible strains the results showed synergism.

Pathol Biol (Paris), 1988 Jun, 36(5 Pt 2), 613 - 8
{In vitro activity of roxithromycin compared to 5 other macrolides against staphylococci}; Brun Y et al.; This study aimed to compare the bacteriostatic activity of roxithromycin (RU) to those of erythromycin (ERY), troleandomycin (TAO), spiramycin (SPI), josamycin (JOS) and midekamycin (MID) against staphylococci strains . 239 strains of hospital origin were analysed: S . aureus (139), coagulase negative staphylococci (CNS) (100) . The MIC were determined by the agar dilution method . The modal MIC, the MIC 50 and 90 observed for the both groups of strains are given according to species and antibiotics . This study gives the opportunity to classify the 6 antibiotics in a decreasing order considering their antistaphylococcal activity: RU = ERY, TAO = SPI, JOS = MID . No difference was noticeable between S . aureus and CNS strains.

Antibiot Khimioter, 1988 May, 33(5), 342 - 5
{Study of the activity of a new glycopeptide antibiotic eremomycin combined with tobramycin against Staphylococci in vitro}; Iakushkina IV et al.; Eremomycin is an original natural antibiotic with glycopeptide structure isolated at the Institute of New Antibiotics, the USSR Academy of Medical Sciences . Activity of eremomycin alone or in combination with tobramycin was studied with using 25 clinical strains of staphylococci . 56 and 88 per cent of the strains were respectively resistant to gentamicin and kanamycin, two aminoglycoside antibiotics . All the staphylococcal strains were sensitive to eremomycin in concentrations of 0.12 to 1 microgram/ml . The MIC of tobramycin for 10 (40 per cent) sensitive strains ranged within 0.25-2 micrograms/ml . For 60 per cent of the strains the MIC was equal to or higher than 16 micrograms/ml . When eremomycin was used in combination with tobramycin the antibacterial effect with respect to 17 strains (68 per cent) increased . In 32 per cent of the strains the effect was synergistic and in 36 per cent of the strains it was additive . Indifference and antagonism were detected with respect to 7 (28 per cent) and 1 (4% per cent) strains respectively . No significant difference was shown in manifestation of the synergistic-additive nature of eremomycin and tobramycin interaction with respect to the tobramycin sensitive and resistant strains.

Ukr Biokhim Zh, 1988 May-Jun, 60(3), 98 - 101
{Energy-dependent transport of tetraphenylphosphonium ions in Staphylococcus aureus}; Syrtsov VV et al.; Transmembrane potential differences on the membrane of staphylococci were measured using tetraphenylphosphonium selective electrodes . When rising pH from 6.0 to 8.0 the transmembrane potential difference values vary from -118 to -155 mV . At 37 degrees C glucose exerts at first a hyperpolarizable and then a depolarizable effect . At the temperature below 27 degrees C its evokes only membrane hyperpolarization . The depolarizable effect of gramicidin is observed at all the studied temperatures.

J Clin Microbiol, 1988 May, 26(5), 950 - 3
Composition and density of microflora in the subungual space of the hand; McGinley KJ et al.; There were significant quantitative differences in the composition and density of microflora in different areas of the hands of 26 adult volunteers . The subungual spaces had an average log10 CFU of 5.39, compared with a range from 2.55 to 3.53 for other hand sites . In quantitative cultures from five subungual spaces in 26 subjects, coagulase-negative staphylococci were the dominant organisms, with Staphylococcus epidermidis, S . haemolyticus and S . hominis being the most frequently isolated species . Other bacteria recovered from subungual spaces included gram-negative bacilli in 42.3% of subjects, with Pseudomonas species composing 31.3% of this group, and coryneforms in 42.3% of subjects, with multiply resistant JK group coryneforms making up 12.5% . Yeasts were isolated from 69.0% of subjects sampled, with 51.3% of the yeasts identified as Candida parapsilosis . The subungual coagulase-negative staphylococci were susceptible to most antibiotics, with resistance to penicillin, ampicillin, and erythromycin detected in 23 to 38% of isolates.

J Clin Microbiol, 1988 May, 26(5), 816 - 20
Evaluation of MicroScan MIC panels for detection of oxacillin-resistant staphylococci; Woods GL et al.; Clinical isolates of staphylococci (420 Staphylococcus aureus isolates and 248 coagulase-negative staphylococci) were tested by both MicroScan MIC panels (MicroScan, West Sacramento, Calif.) and an oxacillin agar screen (Mueller-Hinton agar {Difco Laboratories, Detroit, Mich.} containing 6 micrograms of oxacillin per ml and 4% NaCl) to evaluate the ability of MicroScan to detect oxacillin-resistant strains . MicroScan panels and oxacillin agar screen plates were incubated at 35 degrees C for 24 h and at 30 degrees C for an additional 24 h . Endpoints were recorded at 24 and 48 h . By MicroScan, 23 (5.5%) and 30 (7%) S . aureus isolates and 161 (65%) and 162 (65%) coagulase-negative staphylococci were oxacillin resistant at 24 and 48 h, respectively . At both 24 and 48 h, 23 (5.5%) S . aureus isolates and 162 (65%) coagulase-negative staphylococci were resistant by the oxacillin agar screen . Five strains for which the oxacillin MIC was 2 or 4 micrograms/ml and eight strains resistant to oxacillin only at 48 h were further evaluated by broth macrodilution testing for oxacillin with and without clavulanic acid, by oxacillin and amoxicillin-clavulanic acid disk diffusion, and by oxacillin agar screen comparing Mueller-Hinton agars purchased from Difco and BBL Microbiology Systems, Cockeysville, Md . By this additional testing, all 10 S . aureus isolates and 1 of 3 coagulase-negative staphylococci examined produced increased amounts of beta-lactamase . One coagulase-negative staphylococcus appeared to be truly intermediately oxacillin susceptible . There was no significant difference in the rate of detection of oxacillin resistance between MicroScan and the agar screen . MicroScan panels should be incubated for 24 h only, because prolonged incubation caused strains producing excessive amounts of beta-lactamase to appear to be falsely oxacillin resistant.

J Antibiot (Tokyo), 1988 May, 41(5), 660 - 6
Augmentation of serum bactericidal activity by paldimycin; Cialdella JI et al.; At concentrations below the MIC, paldimycin induced changes in Staphylococcus aureus 502A (UC 9116, ATCC 28417) which increased its sensitivity to serum . The enhanced sensitivity to serum was concentration dependent with the maximal sensitivity found when bacteria were grown in approximately 1/10 MIC of paldimycin . Within an 1-hour incubation, S . aureus 502A typically grew 1.5-2-fold in serum . Following exposure to paldimycin, however, approximately 30-50% of the bacteria were killed in serum . The paldimycin treated bacteria were not more susceptible to phagocytosis and killing by polymorphonuclear leukocytes . At the concentrations utilized, the Staphylococci were enlarged and had thickened cell walls . The organisms were still viable and replicating, but irregularities in cell division were observed in transmission electron micrographs.

Pediatr Infect Dis J, 1988 May, 7(5), 313 - 5
Microbiologic characteristics of exfoliative toxin-producing Staphylococcus aureus; Murono K et al.; Exfoliative toxin (ET) production, phage types and antibiotic susceptibilities of 74 strains of Staphylococcus aureus isolated from patients with generalized staphylococcal scalded skin syndrome or bullous impetigo were studied . Of 74 staphylococcal isolates, 61 strains were found to produce ET by the newborn mouse assay method and the latex agglutination method . Fifteen strains were positive for ET-A, 32 for ET-B and 14 for both ET-A and ET-B . Among 61 ET-producing strains 27 (44%) were classified as Phage Group II, 16 (26%) as Group III, and 14 (23%) as Groups I and III . Of 27 Phage Group II strains 14 produced ET-A and 13 produced both ET-A and ET-B, but no strain was positive solely for ET-B . On the other hand 15 of 16 Phage Group III strains and all 14 Phage Group I and III strains produced only ET-B . It was demonstrated that the phage types of staphylococci were closely related to ET types . Characteristically the minimal inhibitory concentrations of penicillin G against ET-producing strains were less than 2 micrograms/ml, in contrast to other pathogenic staphylococci, 60 to 70% of which are highly penicillin G-resistant.

J Med Microbiol, 1988 May, 26(1), 67 - 73
Trimethoprim resistance determinants encoding a dihydrofolate reductase in clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci; Tennent JM et al.; The molecular and biochemical basis of resistance to high concentrations (MIC greater than or equal to 1000 mg/L) of trimethoprim (Tpr(H} was examined in Australian isolates of Staphylococcus aureus and coagulase-negative staphylococci . The Tpr(H) determinant (dfr A) was located within a 2.75-Kb Bg/II fragment on the S . aureus aminoglycoside-resistance plasmids pSK1 and pSK16 as judged by comparative restriction mapping with two naturally-occurring variants, pSK9 and pSK14, which did not encode trimethoprim resistance . This was confirmed in DNA-DNA hybridisation experiments in which a 0.9-Kb sequence of pSK1 DNA was used as a specific probe for the Tpr(H) gene . Plasmid DNA from three strains of coagulase-negative staphylococci, and the chromosomal material of one other isolate, were found to share homology with the probe DNA . Dihydrofolate reductases produced by these strains were virtually identical to the type S1 enzyme encoded by the S . aureus plasmid pSK1 . Interspecies transfer may have been responsible for the conservation of Tpr(H) gene sequences among staphylococci.

Infect Control Hosp Epidemiol, 1988 May, 9(5), 189 - 93
Microbial flora on the hands of health care personnel: differences in composition and antibacterial resistance; Horn WA et al.; The composition and antibiotic sensitivity pattern of bacteria recovered from the hands of nurses and physicians in two service units of a major teaching hospital were compared with those found in a control population . Significant differences in the composition of bacteria were found in dermatology and oncology unit personnel . Staphylococcus aureus was recovered from 31% of dermatology nurses and 37% of dermatology physicians compared with 20% of oncology nurses, 15% of oncology physicians, and 17% of controls . Oncology personnel had a significantly higher carriage of gram-negative bacteria, yeasts, and multiple antibiotic-resistant, aerobic coryneforms (group JK bacteria) . Both dermatology and oncology nursing personnel were colonized by organisms resistant to multiple antibiotics . Methicillin resistance was found in 26% and 66% of the staphylococci recovered from dermatology and oncology nurses respectively . Flora from physicians on the two units had sensitivity patterns similar to controls.

Infect Immun, 1988 May, 56(5), 1061 - 5
Variation in the expression of cell wall proteins of Staphylococcus aureus grown on solid and liquid media; Cheung AL et al.; To evaluate the variation in the expression of cell wall antigens between Staphylococcus aureus grown in liquid medium and solid support, bacteria were harvested from liquid chemically defined medium and chemically defined medium in a 1% agar base . Cell wall proteins were then extracted by lysostaphin in a protoplast-stabilizing medium (30% raffinose) . After separation of the cell wall antigens by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blots, they were probed with chicken antiserum to an S . aureus strain grown on a solid support . For each of the 15 clinical strains analyzed, high-molecular-size bands (molecular size range, 120 to 220 kilodaltons) were either enhanced or distinctly present when compared with those from the cell wall extract of the same strain grown in liquid medium . Results of enzymatic treatment of whole staphylococci grown on solid medium suggested the proteinaceous nature and the surface location of these antigens . Limited passage studies demonstrated the ability of the staphylococci to alter these surface proteins when passaged alternately on liquid and solid media . These observations suggested the importance of the microenvironment to the expression of cell wall proteins in S . aureus . Correlations with observations in vivo may help identify the determinants of microbial pathogenicity in S . aureus.

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