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 The use of antibiotics is now rapidly changing and the state of the art in 1989 is likely to be outdated very soon as new pathogens emerge and new drugs are developed .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 antibiot