Biochemistry, 1988 May 31, 27(11), 4153 - 61 Structure elucidation of the core regions from Citrobacter O4 and O36 lipopolysaccharides by chemical and enzymatic methods, gas chromatography/mass spectrometry, and NMR spectroscopy at 500 MHz; Romanowska E et al.; Novel enterobacterial core oligosaccharides were isolated from Citrobacter O4 and O36 lipopolysaccharides, and their structures were determined by methylation analysis, Smith degradation and enzymatic degradations, gas chromatography/mass spectrometry, and two-dimensional phase-sensitive correlated, relayed coherence transfer, double-quantum, triple-quantum-filtered, and nuclear Overhauser effect (NOE) 1H NMR spectroscopy at 500 MHz . In the formulas, all hexose residues are D-hexopyranoses, and heptoses are L-glycero-D-manno-heptopyranoses; the alternative locations of the side-chain heptose and pyrophosphorylethanolamine (PPEtN) residues are marked by dashed lines; dOclA stands for 3-deoxy-D-manno-octulosonic acid . (formula; see text) Along with these complete cores, incomplete ones, lacking the hexosamine trisaccharides, occur in the lipopolysaccharides of both types . Qualitative NOE data were in good agreement with the minimum energy conformation of the above O36 oligosaccharide, calculated with the aid of the SUGAR program {Sundin, A., Carter, R . E., & Liljefors, T . (1988) J . Mol . Graphics (in press)}. FEBS Lett, 1988 May 23, 232(2), 381 - 2 Crystallization and crystal data on tyrosine phenol-lyase; Demidkina TV et al.; Crystals of the apoenzyme of tyrosine phenol-lyase (EC 4.1.99.2), a pyridoxal 5'-phosphate-dependent enzyme from Citrobacter intermedius, have been grown by vapor diffusion of an ammonium sulfate solution to a protein solution . The crystals belong to space group P2(1)2(1)2, with dimensions of a = 75.5 A, b = 138.4 A and c = 94.1 A and diffract up to 2.7 A resolution . The asymmetric unit contains one half of the enzyme tetrameric molecule . Two heavy-atom derivatives of the crystals have been obtained. Transfusion, 1988 May-Jun, 28(3), 229 - 32 Kell blood group activity of gram-negative bacteria; Savalonis JM et al.; To understand better the relationships between blood-group antigens and bacterial constituents, examples of 23 gram-negative bacteria (representing the 10 genera Citrobacter, Edwardsiella, Enterobacter, Escherichia, Klebsiella, Proteus, Pseudomonas, Salmonella, Serratia, and Shigella) were tested for the presence of Kl-like antigens by hemagglutination-inhibition (HAI) assays against both IgG and IgM anti-Kl . Saline-suspended whole organisms, cell-free culture media, and disrupted organisms were used to test for such antigens in, on, and secreted by the microorganisms examined . Disrupted organisms of an isolate of Shigella sonnei nonspecifically inhibited IgG anti-Kl as well as IgG antibodies of the specificities Kpb, Fya, S, and c . However, only Escherichia coli 0125:B15, subtype 12808, had specific K1-like activity (no activity with other IgG {(k, Kpb, Jka, Fya, S, c} and IgM {A, B, M, P1} antibodies) . Disrupted organisms inhibited IgM but not IgG anti-K1 in the HAI assay . A second subtype, E . coli 0125:B15, subtype 12809, exhibited no K1-like activity . These findings support the report of K1 activity in cell-free broth cultures of E . coli 0125:B15 (subtype unspecified) . Thus, although not all E . coli 0125:B15 possesses K1-like activity, the finding of such activity in at least one E . coli subtype confirms the idea that bacterial components may play a role in the production of naturally occurring antibodies directed against non-ABO red cell antigens. Antimicrob Agents Chemother, 1988 May, 32(5), 671 - 7 In vitro activity of an oral iminomethoxy aminothiazolyl cephalosporin, R-3746; Chin NX et al.; The in vitro activity of R-3746, an iminomethoxy aminothiazolyl cephalosporin with a CH2OCH3 moiety at position 3, was compared with those of other antibiotics . R-3746 inhibited the majority of hemolytic streptococci (groups A, B, C, F, and G) and Streptococcus pneumoniae at less than 0.06 micrograms/ml, which was comparable to the activity of amoxicillin, 2- to 8-fold more active than cefixime, and 16- to 64-fold more active than cefaclor and cephalexin . Ninety percent of beta-lactamase-producing Haemophilus influenzae and Neisseria gonorrhoeae were inhibited at a concentration 0.25 micrograms/ml, but it was less active against Branhamella spp . It did not inhibit (MIC, greater than 16 micrograms/ml) enterococci, viridans group streptococci, or methicillin-resistant staphylococci . The MICs of R-3746 for 90% of strains tested for Escherichia coli; Klebsiella pneumoniae; Citrobacter diversus; Proteus mirabilis; and Salmonella, Shigella, and Yersinia spp . were less than or equal to 1 micrograms/ml . It was two- to eightfold less active than cefixime but was markedly superior to cefaclor, cephalexin, amoxicillin-clavulanate, and trimethoprimsulfamethoxazole . R-3746 inhibited 50% of Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, Morganella spp., Providencia spp., Proteus vulgaris, and Serratia marcescens at less than or equal to 8 micrograms/ml . Pseudomonas spp . were resistant . Fifty percent of Clostridium spp . were inhibited by 0.5 micrograms/ml, but MICs for Bacteroides spp . were greater than 128 micrograms/ml . R-3746 was not appreciably hydrolyzed by most chromosomal and plasmid-mediated beta-lactamases. Jpn J Antibiot, 1988 May, 41(5), 594 - 601 {In vitro synergy between cefotaxime and its main metabolite, desacetylcefotaxime}; Kobayashi S et al.; In vitro synergistic interaction between cefotaxime (CTX) and its main metabolite, desacetyl-cefotaxime (DCTX), against 7 species of clinical isolates (23-27 strains per species) was examined . Complete or partial synergy was noted with a 1:1 combination of CTX and DCTX against 22-78% of the Bacteroides fragilis, Staphylococcus aureus, Citrobacter freundii, Pseudomonas cepacia and Enterobacter cloacae isolates examined . Antagonistic effects of the drugs appeared against 11% of Proteus vulgaris and 4% of Serratia marcescens . When combined at various ratios by the checkerboard method and tested against B . fragilis, CTX and DCTX were found to act synergistically, and no antagonism occurred . The combined use of CTX and DCTX exhibited strong bactericidal activity against B . fragilis and inhibited bacterial regrowth . An experiment with concentrations of CTX and DCTX simulating human serum levels after intravenous administration also showed that the coexistence of DCTX augmented bactericidal activity of CTX against B . fragilis and brought inhibitory effects on bacterial regrowth . It is presumed from the present results that clinically applied CTX would have more potent effects than expected from in vitro sensitivity test data. Antimicrob Agents Chemother, 1988 May, 32(5), 656 - 62 In vitro activity of lomefloxacin (SC-47111; NY-198), a difluoroquinolone 3-carboxylic acid, compared with those of other quinolones; Chin NX et al.; Lomefloxacin (SC-47111; NY-198) is a new difluoroquinolone agent . It inhibited 90% of Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., Proteus mirabilis, Morganella morganii, Proteus vulgaris, Serratia marcescens, Salmonella spp., Shigella spp., Aeromonas spp., Yersinia spp., Haemophilus influenzae, and Neisseria gonorrhoeae at less than or equal to 2 micrograms/ml . Lomefloxacin inhibited 90% of Pseudomonas aeruginosa at 4 micrograms/ml . Lomefloxacin was equal in activity to norfloxacin against Escherichia coli, Klebsiella spp., Enterobacter spp., Haemophilus influenzae, and Neisseria gonorrhoeae but was twofold less active against Proteus spp., Providencia spp., Serratia marcescens, Salmonella spp., and Shigella spp . Ofloxacin was generally 2- to 4-fold more active, and ciprofloxacin was 4- to 16-fold more active . Lomefloxacin inhibited Staphylococcus aureus, including methicillin-resistant isolates, but MICs for 90% of streptococcal species tested were 8 micrograms/ml . In the presence of 9 mM Mg2+, MICs for Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, and Pseudomonas aeruginosa were increased, as they were when they were tested in urine . A single-step increase in resistance to eightfold above the MIC occurred at a frequency of less than 10(-10), but serial transfer of bacteria in the presence of the agent produced MIC increases . Lomefloxacin had activity and properties comparable to those of many of the new quinolones. Pathol Biol (Paris), 1988 May, 36(5), 425 - 9 {Activity of 9 beta-lactam antibiotics combined with clavulanic acid or sulbactam against the strains of broad-spectrum beta-lactamase (CTX-1) producing Enterobacteriaceae isolated at the Henri Mondor Hospital}; Legrand P et al.; Minimal inhibitory concentrations (MICs) of seven cephalosporins: cefotaxime (CTX), ceftriaxone (CRO), ceftazidime (CAZ), latamoxef (MOX), cefoxitin (FOX), cefotetan (CTT) and CM 40876 (CM), of aztreonam (ATM) and imipenem (IPM) were evaluated by agar dilution with and without 5 mg/l of clavulanic acid (AC) or sulbactam (SB) for 28 strains isolated in 1986 (15 K . pneumoniae, 3 . K . oxytoca, 4 E . coli, 4 E . cloacae, 1 E . aerogenes and 1 C . freundii) . Comparatively to MICs of sensitive strains and to those of cured variants, MICs of these strains were very increased for CTX, CRO, ATM (mode MIC: 1 mg/l), and CAZ (2); weakly increased for MOX and CTT (0.25), and identical for IMP (0.12-0.25), CM (0.06) and FOX (2-4), except for Enterobacter and Citrobacter (64) . Association with AC or SB did not modify MICs of FOX, CM and IMP . For the other antibiotics, MICs were reduced by addition of AC: Klebsiella: 5 log2 for CTX and CRO, 4 for CAZ and ATM, 2 for MOX and CTT; E . coli: 4 log2 for CTX and ATM, 3 for CRO and CAZ, 1 for MOX and CTT; Enterobacter and Citrobacter 2 log2 for CTX, CRO, CAZ and ATM, 1 for MOX and CTT . With SB, decrease of MICs was two to for fold lesser than with AC . AC, and less efficiently SB, restored activity of CTX, CRO, CAZ and ATM on CTX-1 producing Enterobacteriaceae, particularly Klebsiella and E . coli . It was the same for MOX and CTT, weakly affected by this resistance . AC and SB had not effect on FOX, CM and IPM which remained active on these strains. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 May, 268(3), 306 - 17 Further differentiation of Enterobacteriaceae by means of siderophore-pattern analysis; Reissbrodt R et al.; By means of a combination of 5 siderophore bioassays using several indicator strains, genera, species and subspecies of Enterobacteriaceae can be further differentiated . Enterobactin, aerobactin and other siderophores produced can be detected . Each strain shows specific pattern which we called siderophore-pattern . It is easy to separate Morganella, Proteus, Providencia, Yersinia strains from the genera Salmonella, Shigella, Escherichia coli, Enterobacter, Citrobacter, Klebsiella, Serratia . Enterobacter agglomerans strains differ from other Enterobacter species with respect to their siderophore pattern . In Salmonella strains there are differences between the subspecies I and IV . Additionally the most strains of Salmonella subspecies I from nosocomial infections produced aerobactin, in the most cases determined by plasmids . Among Shigella strains different siderophore pattern exist according to other epidemiological markers . S . flexneri strains of serovar 6 produced contrary to the strains of other serovars enterobactin . By means of the siderophore-pattern analysis E . coli strains of serovars 01; 02; 018 can be further differentiated . E . coli 01:K1 strains containing the fimbrial antigen F11 produced aerobactin whereas the F9 strains did not . All Hafnia alvei strains produced a uniform siderophore pattern, different from all other members of the enterobacteriaceae family . With this aim Hafnia alvei strains can be easily separated under practical conditions. J Hosp Infect, 1988 May, 11(4), 321 - 7 Prior antimicrobial therapy and resistance of Enterobacter Citrobacter and Serratia to third generation cephalosporins; Nicolle LE; During a 6-month period all inpatients from whom Enterobacter, Citrobacter or Serratia . had been isolated were reviewed and information on selected variables recorded . Two groups, one including 19 patients with organisms resistant to third generation cephalosporins and the other 111 patients with susceptible organisms were compared . In the initial analysis, the mean number of antimicrobials received in the prior 2 months was the variable most strongly associated with isolation of resistant organisms (2.6 +/- 1.5 vs 1.5 +/- 1.6; P = 0.002) . When patients who had received no antimicrobials were omitted from the analysis, the mean number of antimicrobials was similar (2.6 +/- 1.5 vs 2.3 +/- 1.5; P = 0.19) . Comparisons of antimicrobials received in the prior 2 months showed only cefoxitin (9/70 vs 7/19; P = 0.016) and cefotaxime (4/70 vs 5/19; P = 0.008) to be associated with isolation of resistant organisms . These data suggest that, at our institution, antimicrobial therapy with an extended spectrum cephalosporin is an important risk factor for subsequent acquisition of an organism resistant to third generation cephalosporins. Bioorg Khim, 1988 May, 14(5), 697 - 700 {The structure of O-specific polysaccharide chains of lipopolysaccharides from Citrobacter 032 and Salmonella arizonae 064 (Arizona 29)}; Kocharova NA et al.; On the basis of acid hydrolysis, methylation, Smith degradation, selective cleavage with anhydrous hydrogen fluoride, and 13C NMR analysis, the repeating unit of the O-specific polysaccharide of Citrobacter O32 was concluded to have the following structure: (Formula: see text) . The repeating unit of the Salmonella arizonae O64 O-specific polysaccharide has the same structure lacking the O-acetyl group. J Biol Chem, 1988 Apr 15, 263(11), 5217 - 23 Lipid A precursor from Pseudomonas aeruginosa is completely acylated prior to addition of 3-deoxy-D-manno-octulosonate; Goldman RC et al.; Inhibition of lipopolysaccharide (LPS) synthesis in Pseudomonas aeruginosa at the stage of incorporation of 3-deoxy-D-manno-octulosonate (KDO) caused accumulation of a lipid A precursor which contained all of the fatty acids present on the lipid A of mature LPS . The enzyme CTP:CMP-3-deoxy-D-manno-octulosonate cytidylyltransferase (CMP-KDO synthetase) from P . aeruginosa is inhibited by the KDO analog alpha-C-{1,5-anhydro-8-amino-2,7,8-trideoxy-D-manno-octopyranosyl} carboxylate (I), and I is effectively delivered to P . aeruginosa following attachment by amide linkage to the carboxyl terminus of alanylalanine . Intracellular hydrolysis releases the free inhibitor (I) which then inhibits activation of KDO by CMP-KDO synthetase causing accumulation of lipid A precursor and subsequent growth stasis . The major lipid A precursor species accumulated was purified and found to contain glucosamine, phosphate, C12:O, 2OH-C12:O and 3OH-C10:0 (in ester linkage), and 3OH-C12:0 (in amide linkage) in molar ratios of 1:1:0.5:0.5:1:1 . Analysis of precursor by fast atom bombardment mass spectroscopy yielded a major ion (M - H)- of mass 1616 and fragments which were consistent with the structure of lipid A from P . aeruginosa . In contrast, Salmonella typhimurium, Escherichia coli, Citrobacter sp., Serratia marcescens, Enterobacter aerogenes, and Enterobacter cloacae all accumulated underacylated lipid A precursors which only contained 3-OH-C14:0, glucosamine, and phosphate . This difference and species-specific patterns of major and minor precursor species show that early steps in the assembly of lipid A are similar, but not identical in enteric and nonenteric Gram-negative bacteria. J Clin Microbiol, 1988 Apr, 26(4), 719 - 25 Application of optical properties of the Vi capsular polysaccharide for quantitation of the Vi antigen in vaccines for typhoid fever; Stone AL et al.; The capsular polysaccharide of Salmonella typhi and of Citrobacter freundii (Vi) is a linear homopolymer of alpha 1,4-linked N-acetylgalactosaminuronic acid, variably O-acetylated at the C-3 position . Vaccines composed of Vi confer protection against typhoid fever with an efficacy of about 70%; Vi has recently been conjugated to proteins to increase its immunogenicity and effectiveness (I.L . Acharya, R . Tapa, V.L . Gurubacharya, M.B . Shrestha, C.U . Lowe, D.D . Bryla, R . Schneerson, J.B . Robbins, T . Crampton, B . Trollfors, M . Cadoz, D . Schulz, and J . Armand, N . Engl . J . Med . 317:1101-1104, 1987; K.P . Klugman, I . Gilbertson, H.J . Kornhof, J.B . Robbins, R . Schneerson, D . Schulz, M . Cadoz, and J . Armand, Lancet ii:1165-1169, 1987; S.C . Szu, A.L . Stone, J.D . Robbins, R . Schneerson, and J.B . Robbins, J . Exp . Med . 166:1510-1524, 1987) . Vi, however, cannot be measured by conventional colorimetric methods . Two optical techniques were adapted to quantitate Vi in vaccines . The first, Fourier-transformed infrared spectroscopy, was performed on salt-free, freeze-dried samples . The intensities of the absorbance peaks of Vi were proportional to the amount of Vi within the range of 0.25 to 2.0 mg . The amount of Vi was determined from integrated absorptions at the 1,235- or 1,417-cm-1 band . The second technique, spectrophotometric titration, was more sensitive than the Fourier-transformed infrared spectroscopy and could be performed on dilute solutions . The metachromatic effect of the reaction between the aromatic cationic dye acridine orange and the carboxyl groups of Vi was quantitative within +/- 2% in the range of 20 to 700 micrograms of Vi per ml . The accuracy of the titration of Vi in the vaccines was within +/- 8% . These two methods may be applicable to measure other capsular polysaccharides in vaccines. Mikrobiyol Bul, 1988 Apr, 22(2), 164 - 71 {Microbiological analysis of well water samples in the rural areas near Ankara}; Yulug N et al.; The water from wells and running water in different rural parts of Ankara were analyzed microbiologically with the thought in mind that the use of unhealthy well water could cause infections, as shown in other cities . We found that of the 50 running water samples all (100%) were drinkable from the microbiological point of view regard to coliform bacteria and total germ count, while only 20 of the 150 well water samples (13.3%) met these standards . It was pointed out by the users that chlorination was carried out in only 22 of the wells (14.6%) and only irregularly; no coliform bacteria were found in water samples from these wells . In 117 well water samples (78%) 120 coliform bacteria strains were isolated, of these 80 were E . coli, 27 Enterobacter and 13 Citrobacter . All samples were analyzed for Giardia intestinalis cysts but found to be negative. J Bacteriol, 1988 Apr, 170(4), 1775 - 82 Distribution and diversity of hsd genes in Escherichia coli and other enteric bacteria; Daniel AS et al.; We screened Salmonella typhimurium, Citrobacter freundii, Klebsiella pneumoniae, Shigella boydii, and many isolates of Escherichia coli for DNA sequences homologous to those encoding each of two unrelated type I restriction and modification systems (EcoK and EcoA) . Both K- and A-related hsd genes were identified, but never both in the same strain . S . typhimurium encodes three restriction and modification systems, but its DNA hybridized only to the K-specific probe which we know to identify the StySB system . No homology to either probe was detected in the majority of E . coli strains, but in C . freundii, we identified homology to the A-specific probe . We cloned this region of the C . freundii genome and showed that it encoded a functional, A-related restriction system whose specificity differs from those of known type I enzymes . Sequences immediately flanking the hsd K genes of E . coli K-12 and the hsd A genes of E . coli 15T- were shown to be homologous, indicating similar or even identical positions in their respective chromosomes . E . coli C has no known restriction system, and the organization of its chromosome is consistent with deletion of the three hsd genes and their neighbor, mcrB. Biochem J, 1988 Mar 15, 250(3), 753 - 60 Sequence and comparative analysis of three Enterobacter cloacae ampC beta-lactamase genes and their products; Galleni M et al.; The sequences of three Enterobacter cloacae ampC beta-lactamase genes have been determined . The deduced amino acid sequences are very similar: out of a total of 361 residues, only eight positions were found to be variable, and several mutations yielded residues with very similar properties . The kinetic properties of two of the enzymes were not significantly different . The three enzymes also exhibited a high degree of homology (greater than 70%) with the ampC beta-lactamases of Escherichia coli K12 and Citrobacter freundii, confirming the homogeneity of class-C beta-lactamases. J Clin Pharmacol, 1988 Feb, 28(2), 179 - 89 A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial; Arcieri G et al.; Ciprofloxacin is a new quinolone antimicrobial agent with activity against a broad spectrum of gram-negative and gram-positive organisms, including Pseudomonas aeruginosa and methicillin-resistant strains of staphylococci . The efficacy and safety results of 80 clinical studies of the oral form of ciprofloxacin are reported . Drug safety was assessed in 2236 courses in 2203 adult patients treated primarily in the United States . Data from 1676 courses were suitable for analysis of drug efficacy . The unit dose for most patients ranged from 250 mg to 750 mg (median, 500 mg), usually given every 12 hours . The duration of treatment ranged from 3 to 231 days (median, 10 days) . Predominant among 1722 infections were those of the urinary tract (43%), skin structures (29%), and respiratory tract (19%); the remainder were bone and joint infections (5%), bacteremias (2%), and intra-abdominal (1%), gastrointestinal (1%), and pelvic infections (less than 1%) . Signs and symptoms of infection resolved in 79% of all cases; a further 15% improved, and 5% failed to improve . Pathogens were eradicated in 89% of urinary tract infections and persisted in 5%; 80% of patients still had sterile urine at the 3-to 6-week follow-up . In 81% of nonurinary tract infections, pathogens were eradicated; they persisted in 11%, and superinfection occurred in less than 5% . After treatment, 89% of the 2253 causative organisms were eradicated and 2% were reduced to clinically insignificant counts; 8% persisted . Of 411 isolates of P . aeruginosa, 77% were eradicated, as were 97% of 421 Escherichia coli and 80% of 248 Staphylococcus aureus isolates . Also eradicated were 95% of 166 Klebsiella, 96% of 139 Proteus mirabilis, 100% of 20 other Proteus, 94% of 123 Enterobacter, 100% of 68 Haemophilus influenzae, 96% of 49 Citrobacter, 89% of 45 Serratia, 95% of 41 Streptococcus pneumoniae, 91% of 43 Salmonella, 100% of 38 Morganella morganii, and 100% of 35 Providencia isolates . Adverse reactions were judged probably or possibly drug-related in 14.8% of courses; drug treatment had to be stopped prematurely in 3.5% . The most frequent reactions were gastrointestinal complaints (chiefly nausea, diarrhea, and vomiting), metabolic disorders (elevated SGOT, SGPT, serum creatinine, or blood urea nitrogen), and nervous system effects (dizziness, light-headedness, restlessness, tremor, and headache) . Crystalluria, judged to be related to ciprofloxacin, occurred in two patients.(ABSTRACT TRUNCATED AT 400 WORDS) Chemioterapia, 1988 Feb, 7(1), 3 - 9 Carumonam's in-vitro activity against gram-negative bacteria and its stability to their beta-lactamases; Raimondi A et al.; The in vitro activity of the novel monobactam carumonam (RO17-2301) was evaluated on 311 gram-negative clinical isolates in comparison to aztreonam, cefotaxime, ceftazidime, cefotetan and ceftriaxone . Carumonam showed an antibacterial potency equal to or higher than any other reference compound; in particular it was the most effective against Proteus indole positive and Klebsiella sp . Its antipseudomonal activity was comparable to that of ceftazidime and it showed, together with aztreonam, the highest activity against the Citrobacter, Enterobacter and Escherichia coli isolates . The minimal inhibitory concentrations performed on permeability altered organisms indicated that carumonam has a penetration rate comparable to aztreonam and higher than cefotetan and ceftriaxone . Carumonam demonstrated excellent stability to chromosomal and plasmid-mediated beta-lactamases and that correlated with its antibacterial activity against the producing strains and inoculum size effect. Jpn J Antibiot, 1988 Feb, 41(2), 152 - 64 {Clinical evaluation of ceftriaxone in the treatment of neonatal infections}; Okura K et al.; Ceftriaxone (CTRX) was administered to the newborn and its clinical effectiveness as well as its blood and cerebrospinal fluid levels were studied . 1 . Average blood levels of CTRX 1 hour after single intravenous administration were 39 micrograms/ml in 2 cases receiving about 10 mg/kg, 70 micrograms/ml in 2 other cases receiving 20 mg/kg and 208 micrograms/ml in one receiving 52.6 mg/kg . As is apparent from these cases data, blood levels of CTRX were dose dependent . Blood levels of the drug were between 3.7 to 12.4 micrograms/ml 24 hours later . Half-lives of the drug in blood in the 5 newborns ranged from 7.13 to 10.6 hours . In a 53-day-old patient receiving 43.4 mg/kg of CTRX via intravenous injection, the one-hour blood level of the drug was 140 micrograms/ml and the half-life was 3.68 hours . The blood level of the drug 36 hours after single intravenous administration with 17.3 to 20.0 micrograms/ml to 5 other cases 0 to 5 days of age ranged from 4.6 to 13.7 micrograms/ml . 2 . The cerebrospinal fluid level of CTRX 4 hours after intravenous administration with 49.6 mg/kg to cases of Escherichia coli meningitis was 9.7 micrograms/ml on the first day following the start of the treatment . It increased to 23.6, 25.2 and 31.0 micrograms/ml on the third, fourth and fifth days, respectively, and then gradually decreased . Cerebrospinal level was still 5.8 micrograms/ml on the 22nd day during the recovery period . These levels were far more than 1,000 times as much as the MIC for the pathogen at the highest level, and more than 100 times even at the lowest level . 3 . CTRX was administered via intravenous injection once or twice a day (11.0-39.5 mg/kg in total) to 13 newborns and 3 infants . The efficacy of CTRX was good to excellent in 10 cases for treatment of 11 diseases (sepsis 1, pneumonia 4, urinary tract infection 4 and fetal infection 2) and all the pathogens (Streptococcus agalactiae 1, E . coli 3, Klebsiella pneumoniae 2, Citrobacter diversus 1) disappeared . In 6 cases where CTRX was used prophylactically, infection did not occur at all . The efficacy was excellent in another newborn with E . coli meningitis intravenously receiving 49.6 mg/kg of CTRX twice daily for 25 days . 4 . No adverse reactions were observed . Mild eosinophilia was observed in 4 cases . Follow-up examinations of 3 of the 4 cases showed that these abnormal levels were returned to normal.(ABSTRACT TRUNCATED AT 400 WORDS) J Hosp Infect, 1988 Feb, 11 Suppl A, 367 - 73 Infections with gram-negative bacilli in a cardiac surgery intensive care unit: the relative role of enterobacter; Flynn DM et al.; A 7-month prospective survey for cefazolin-resistant Gram-negative bacilli in cardiac surgery patients, receiving cefazolin prophylaxis, showed that 58 (67%) of 87 were colonized with enterobacter, 37 (64%) with citrobacter, 33 (57%) with Pseudomonas aeruginosa, and seven (2%) with Serratia marcescens . About 50% of colonization occurred before cefazolin prophylaxis and was present on admission to the intensive care unit . Typing of strains showed that horizontal transmission accounted for at most 14% of carriage . Cefazolin prophylaxis (and high gastric pH) were associated with increased levels of postoperative colonization, most notably for enterobacter . About 25% of colonization with enterobacter, pseudomonas, and serratia was followed by clinical infection . Enterobacter cloacae was the most common pathogen and pneumonia the most common infection . Infections contributed to eight of 11 deaths; four of the eight involved enterobacter . Potential control measures include eliminating endogenous Gram-negative flora by gut decontamination or at least stemming the increase in level of colonization that occurred after surgery. J Hosp Infect, 1988 Feb, 11 Suppl A, 340 - 51 The bacterial flora of neonates in intensive care-monitoring and manipulation; Goldmann DA; Unlike healthy babies, newborns hospitalized in the neonatal intensive care unit (NICU) are colonized with bacterial flora that reflects their exposure to pathogens in the NICU, not bacterial acquired from mother in the perinatal period . For example, nosocomial Gram-negative bacilli, such as klebsiella, enterobacter, and citrobacter but not Escherichia coli tend to colonize the gastrointestinal tract . Colonization with Gram-negative bacilli generally is a prerequisite for nosocomial infection with these pathogens, but surveillance cultures may not be a cost effective approach to predicting which babies will ultimately become ill . However, screening cultures to detect the emergence of antibiotic-resistant Gram-negative bacilli facilitate containment and guide empiric antibiotic therapy, and surveillance cultures are necessary to detect colonized babies when nosocomial Gram-negative bacilli become epidemic in the NICU . Such cultures are inexpensive and easy to perform if appropriate selective media are used . Surveillance cultures to detect coagulase-negative staphylococci, which numerous investigators claim are increasingly important NICU pathogens, are of little value since colonization is virtually universal in the first week of life . Documentation of colonization with group B streptococci or Staphylococcus aureus also cannot be justified on a routine basis . Screening for methicillin-resistant S . aureus, however, may be indicated since early detection of these strains can limit dissemination in the NICU . Research aimed at restoring colonization resistance with elements of normal bacterial flora or preventing colonization by nosocomial pathogens is in its infancy. Drugs, 1988, 35 Suppl 2, 1 - 5 Activity of cefotaxime and amikacin against 14,272 gram-negative bacteria from clinical samples in the period 1980 to 1985; Damaso D et al.; The sensitivity to cefotaxime and amikacin of 14,272 Gram-negative bacilli (Enterobacteriaceae and non-fermenting Gram-negative bacilli) isolated from clinical samples was studied during the period 1980 to 1985 . The minimum inhibitory concentration (MIC) was determined by means of diffusion in agar . Strains were considered resistant to cefotaxime and amikacin if the MIC values were greater than 16 mg/L and greater than 8 mg/L, respectively . The MIC90 reached the critical value for cefotaxime in the case of Citrobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Salmonella spp . and Shigella spp., and for amikacin in the case of Citrobacter spp., Enterobacter spp., E . coli, Klebsiella spp., P . mirabilis, Proteus vulgaris, Salmonella spp . and Serratia spp . Only Shigella spp . were sensitive to cefotaxime but not to amikacin, and only strains of Enterobacter spp . and Serratia spp . were sensitive to amikacin but not to cefotaxime. Mol Biol (Mosk), 1988 Jan-Feb, 22(1), 249 - 56 {Interaction of tyrosine-phenol-lyase from Citrobacter intermedius with amino acids and their derivatives: factors determining the effectiveness of binding}; Faleev NG et al.; The inhibition by L-amino acids and their derivatives of tyrosine phenol-lyase is investigated . Tyramine, alpha-phenylethylamine and tryptamine have no detectable inhibition effect and hence are weakly bonded by an active site . The aromatic amino acid amides are competitive inhibitors but do not manifest an enzymatic isotope exchange of alpha-proton in D2O . Free amino acids however are competitive inhibitors and in the majority of cases exchange alpha-proton . The presence of COOH-group is therefore an important feature which determines the binding efficiency and causes the "active" conformation of the amino acid-PLP complex labelising alpha-proton . In the absence of functional and bulky groups in the amino acid side chain the hydrophobicity is found to be the main factor determining the binding efficiency . For these amino acids a correlation exists between-RTlnKi and side chain hydrophobicity . The amino acids bearing the bulky groups, i . e . valine, leucine and isoleucine have reduced binding efficiency . Lysine and arginine bearing positively charged functional groups possess no inhibition effect . Aspartic and glutamic acids are anomalously strong inhibitors taking into consideration low hydrophobicity of their side chains . One can assume that the electrophilic group able to interact with the terminal COO- -group of aspartic and glutamic acids is located in the active site of tyrosine phenollyase. J Infect Dis, 1988 Jan, 157(1), 106 - 12 Pathogenesis of brain abscess formation in an infant rat model of Citrobacter diversus bacteremia and meningitis; Kline MW et al.; The pathogenesis of Citrobacter diversus meningitis and brain abscess was studied in infant rats . Two-day-old rats were inoculated intraperitoneally and intranasally with C . diversus . C . diversus strain 4277, lacking the 32,000-molecular-weight outer membrane protein that appears to be a marker for strains causing meningitis in human neonates, was more likely to produce bacteremia, meningitis, and death in rats than was strain 4036, which possesses this outer membrane protein . Strain 4036 was, however, more likely than strain 4277 to produce ventriculitis and brain abscess . In the infant rat, central nervous system involvement by C . diversus begins with bacteremia and leptomeningitis, followed by ventriculitis and direct extension of infection into periventricular brain parenchyma . Large numbers of bacteria persist inside inflammatory cells, an observation suggesting resistance to intraphagocytic killing . Bacterial strain differences, possibly related to the presence of a 32,000-molecular-weight outer membrane protein, may account for histopathologic differences in the brains of infant rats with C . diversus meningitis. J Antibiot (Tokyo), 1988 Jan, 41(1), 86 - 93 Cephalosporinase interactions and antimicrobial activity of BMY-28142, ceftazidime and cefotaxime; Hiraoka M et al.; Cephalosporinases of Enterobacter cloacae and Citrobacter freundii were responsible for resistance to newer cephalosporins such as cefotaxime and ceftazidime but not BMY-28142 . Interaction of these cephalosporins including hydrolysis, binding, inhibition, and inactivation with cephalosporinases from E . cloacae GN7471 and C . freundii GN7391 were studied . BMY-28142 was much more stable against the both enzymes than cephalothin, but more hydrolyzable than cefotaxime and ceftazidime at higher concentration such as 100 microM . Because of low affinity for the enzymes, i.e . large Km and Ki, the calculated hydrolysis rate of BMY-28142 at 0.1 microM was smaller than those of cefotaxime and ceftazidime, that explained the difference in activity against cephalosporinase-producing strains between BMY-28142 and cefotaxime or ceftazidime . The effects of cephalosporinase production on susceptibility of Escherichia coli omp mutants were examined using a plasmid having cephalosporinase gene of C . freundii GN346 . Decrease in susceptibility of E . coli by cephalosporinase production was larger in the strain lacking outer membrane proteins (Omp) F and C, and smaller in the strain producing OmpF constitutively. J Clin Microbiol, 1988 Jan, 26(1), 151 - 2 RAPIDEC UR, a 2-h miniaturized system for pinpointing uropathogens; von Graevenitz A et al.; A miniaturized 2-h system (RAPIDEC UR; API System, la Balme-les-Grottes, Montalieu-Vercieu, France) that uses nine enzymatic tests for the diagnosis of most uropathogens was challenged with 330 strains . With few exceptions (Citrobacter, Enterobacter, and Providencia spp., Morganella morganii, and staphylococci other than Staphylococcus saprophyticus), there were distinct patterns that allowed at least a preliminary species diagnosis. Am J Perinatol, 1988 Jan, 5(1), 37 - 9 Sonography of brain abscesses complicating Citrobacter neonatal meningitis; Wilson DA et al.; The incidence of cerebral complications from citrobacter meningitis is high, and these problems are often difficult to diagnose clinically . Cranial sonography provides the ideal imaging modality to detect the early complications of meningitis and the problems that may occur during or after treatment . Early and serial use of cranial sonography should help to preserve brain tissue and minimize the long-term neurologic deficits that arise from this disease. Drugs Exp Clin Res, 1988, 14(1), 25 - 30 On the kinetic interaction between ceftriaxone and some beta-lactamases; Amicosante G et al.; The activity of beta-lactamases from Citrobacter diversus ULA-27 on ceftriaxone, a widely recognized third-generation cephalosporin, has been examined and compared to the activity of various other beta-lactamases from different sources . Ceftriaxone (Roche S.p.A . Milan) was found to be resistant to hydrolysis by beta-lactamases from Enterobacter cloacae and Bacillus cereus, but susceptible to beta-lactamases from Mycobacterium fortuitum strain Cow 18 and, mostly, to beta-lactamases from various strains of Citrobacter diversus . Derivatives with substituents in the 3-position of ceftriaxone, namely cefotaxime (Roussel Maestretti S.p.A., Milan) and ceftizoxime (Farmitalia Carlo Erba, Milan), were much less susceptible to hydrolysis by C . diversus ULA-27 enzymes (22 and 6% of ceftriaxone hydrolysis, respectively), the hydrolysis rate being paralleled by differences in MIC values . Ceftriaxone inhibited the activity of E . cloacae beta-lactamases toward cefazolin as substrate, but the inhibition was totally abolished by preincubation of ceftriaxone with the enzyme before addition of the substrate . Overall, the data point to a relevance of C . diversus ULA-27 beta-lactamases in the mechanism of resistance of this strain to the various third-generation cephalosporins. Diagn Microbiol Infect Dis, 1988 Jan, 9(1), 11 - 26 BMY-28100, a new oral cephalosporin: antimicrobial activity against nearly 7,000 recent clinical isolates, comparative potency with other oral agents, and activity against beta-lactamase producing isolates; Jones RN et al.; The antimicrobial activity of BMY-28100 was tested against approximately 7,000 bacterial pathogens in a multicenter, multiphased collaborative investigation . The BMY-28100 spectrum and antimicrobial potency was most similar to that of cefaclor and superior to that of cephalexin among currently available cephalosporins . Species that had greater than or equal to 90% of clinical strains inhibited by BMY-28100 (less than or equal to 8.0 micrograms/ml) were: Citrobacter diversus, Escherichia coli, Klebsiella spp., Proteus mirabilis, Salmonella spp., Branhamella catarrhalis, Haemophilus influenzae, Neisseria gonorrhoeae, N . meningitidis, methicillin-susceptible Staphylococcus supp., Streptococcus pneumoniae, S . pyogenes, S . agalactiae, S . bovis, serogroup C and G streptococci, Listeria monocytogenes and gm-positive anaerobes . BMY-28100 inhibited 9% more of the 6286 fresh clinical isolates at less than or equal to 8.0 micrograms/ml than cefaclor at the same concentration . BMY-28100 was generally bactericidal, but MICs for some species were markedly increased when an inoculum concentration of 10(7) CFU/ml was used . Strains producing plasmid-mediated beta-lactamases (TEM, OXA, SHV, HMS) were susceptible to BMY-28100, cefaclor, and cefuroxime . BMY-28100 was less active against strains producing chromosomal-mediated beta-lactamases (Types I and IV) . BMY-28100 was not hydrolyzed significantly by the tested plasmid-mediated beta-lactamases, but was destroyed by Type I cephalosporinases and Klebsiella K1 enzymes. Drugs Exp Clin Res, 1988, 14(10), 665 - 7 Clinical efficacy of carumonam; Drabu YJ et al.; Carumonam is a new N-sulfo-beta-lactam antibiotic active against aerobic Gram-negative bacteria . An open study was carried out to evaluate the efficacy, safety and tolerance of carumonam with either 1 g t.i.d . (group A) or 2 g t.i.d . (group B) in bacterial septicaemia or severe sepsis . A total of 24 patients (14 men and 10 women) were included in the study, their ages ranged from 48-87 years (mean age 59) . Eighteen patients were treated for bacteraemia, three for bronchopneumonia, two for urinary tract infection and one for a subphrenic abscess; seven were in group A and fourteen in group B; three were treated with a variable regimen . The pathogens isolated included E . coli {10}, Klebsiella aerogenes {9}, Enterobacter cloacae {3}, Citrobacter freundii {2}, Pseudomonas spp . {4}, Providence stuartii {2}, Serratia marcescens {1} and Haemophilus influenzae {1} . Clinical improvement occurred in all patients in both groups . One patient in group A and four patients in group B required further antibiotic therapy . The overall clinical cure rate was 84% and the bacteriological cure rate was 72% . Supra-infection occurred in three patients and adverse reactions attributable to carumonam were seen in two patients: diarrhoea (in one), and aggravation of renal failure in the other . Carumonam is well tolerated at both the dosage regimens; it is effective in the treatment of aerobic Gram-negative sepsis. J Antimicrob Chemother, 1988 Jan, 21(1), 9 - 16 Induction of chromosomal beta-lactamases by different concentrations of clavulanic acid in combination with ticarcillin; Stobberingh EE; The effect of different concentrations of clavulanic acid (CA) in combination with ticarcillin on beta-lactamase production and ticarcillin MIC was studied in four clinical isolates of Pseudomonas aeruginosa, Enterobacter cloacae, Serratia marcescens, Citrobacter freundii and indole positive Proteus strains . Ticarcillin alone showed a low inducing effect for all species tested, Ser . marcescens excepted . The increase in beta-lactamase activity after addition of CA (2-10 mg/l) was strain and species dependent . No synergy or antagonism was observed on the ticarcillin MIC for the micro-organisms producing only a chromosomally mediated beta-lactamase, though the susceptibility to ticarcillin strongly increased if the strains also produced a plasmid-mediated beta-lactamase . Addition of 50 or 100 mg/l CA resulted in all strains . C . freundii excepted, in a strong increase in beta-lactamase activity and in a strong synergistic effect on the ticarcillin MIC . However, these concentrations are unlikely to be achieved at clinical doses . Thus, irrespective of the inducing effect of ticarcillin and CA (2-10 mg/l) combinations, induction of the chromosomal beta-lactamase did not result in a decrease in ticarcillin susceptibility. J Infect Dis, 1988 Jan, 157(1), 101 - 5 Characterization of Citrobacter diversus strains causing neonatal meningitis; Kline MW et al.; We studied 17 strains of Citrobacter diversus isolated from the cerebrospinal fluid of infants with meningitis and compared these strains with 21 strains isolated from other body sites . The two groups of strains were similar with respect to biotype, piliation, hemolysin production, and resistance to the killing effects of serum . By using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, we found that 14 (82%) of 17 strains from cerebrospinal fluid, but only two (10%) of 21 strains isolated from other body sites, possessed a minor outer membrane protein with a molecular weight of 32,000 (P less than .0001) . This protein may serve as a marker for strains of C . diversus that are likely to cause meningitis or brain abscess in human neonates. Chemotherapy, 1988, 34(4), 318 - 25 Beta-lactamase inhibition by acetylmethylene penicillanic acid compared to that of clavulanate and sulbactam; Chin NX et al.; The beta-lactamase inhibitory properties of 6-acetylmethylene penicillanic acid (6-AMPA) were investigated and compared with those of other beta-lactamase inhibitors . 6-AMPA inhibited the TEM-1, TEM-2, SHV-1, PSE-1, PSE-2, PSE-3, PSE-4, OXA-2, OXA-3, and Staphylococcus aureus beta-lactamases . It also inhibited the chromosomally-mediated beta-lactamases of the Richmond-Sykes type Ia, Ic and Id type and the type IV Klebsiella enzymes . Beta-lactamases of Branhamella catarrhalis and Bacteroides fragilis were inhibited . The 6-AMPA I50 values for various enzymes were less than 0.01 microgram/ml TEM-1 and PSE-4, and 0.01 microgram/ml SHV-1, 0.02 microgram/ml S . aureus, 0.04 microgram/ml Proteus vulgaris, 0.04 microgram/ml K . oxytoca, 6.8 micrograms/ml P99, and 9.7 micrograms/ml Sabath-Abraham Pseudomonas enzyme . With isolated beta-lactamases 6-AMPA was a more potent inhibitor than clavulanate or sulbactam . 6-AMPA was an irreversible inhibitor of beta-lactamases . The penetration index for Escherichia coli JT4 was 23 compared to 3 for clavulanate . 6-AMPA at 10 micrograms/ml acted synergistically with ampicillin against beta-lactamase containing bacteria, but it was less active than clavulanate and did not act synergistically with ampicillin against Enterobacter, Citrobacter or Pseudomonas . Although 6-AMPA has excellent beta-lactamase inhibitory properties with isolated enzymes, it is less useful with intact organisms. Antimicrob Agents Chemother, 1988 Jan, 32(1), 104 - 9 Purification of Citrobacter freundii DNA gyrase and inhibition by quinolones; Aoyama H et al.; DNA gyrase is a bacterial enzyme which catalyzes the ATP-dependent negative supercoiling of DNA . It is the accepted target of quinolones . The enzyme from Citrobacter freundii IID976 was purified by affinity chromatography on novobiocin-Sepharose and heparin-Sepharose . It had two subunits, designated A and B, which closely resembled those of the enzyme from Escherichia coli and Micrococcus luteus in enzymatic requirements . The inhibitory effects of the quinolones on the supercoiling activities of the enzyme correlated with their antibacterial activities . New quinolones were better inhibitors of DNA gyrase than nalidixic acid and pipemidic acid . We also purified DNA gyrase from a spontaneous nalidixic acid-resistant mutant (M2-5) . The gyrases from IID976 and M2-5 were defined as mixtures of subunits As+Bs (s, susceptible) and Ar+Br (r, resistant), respectively . The supercoiling activities of reconstituted Ar+Br and Ar+Bs were more resistant to quinolones than As+Bs and As+Br . These findings indicate that one mechanism of C . freundii resistance against quinolones is resistance modification of the A subunit protein. J Bacteriol, 1988 Jan, 170(1), 471 - 3 Cloning and sequencing of a gene encoding an aminoglycoside 6'-N-acetyltransferase from an R factor of Citrobacter diversus; Tenover FC et al.; The aacA1 gene, which encodes a 6'-N-acetyltransferase {AAC(6')-I} mediating resistance to kanamycin, tobramycin, and amikacin, was cloned from the Citrobacter diversus R plasmid pBWH100 into the Escherichia coli vector pBR322 . The complete nucleotide sequence of the gene and flanking regions was determined . A protein of approximately 21 kilodaltons was identified when the chimeric plasmid encoding the aacA1 gene was introduced into E . coli maxicells . This value is consistent with the size predicted for a protein translated from the open reading frame of the gene. Arch Immunol Ther Exp (Warsz), 1988, 36(2), 119 - 28 The heterogeneity of lipopolysaccharides from Citrobacter 023 serotype; Katzenellenbogen E; Chemical studies on carbohydrate part of lipopolysaccharides isolated from Citrobacter 87/57 and Citrobacter 1556 strains (serotype 023) were carried out . Lipopolysaccharides (LPS) were hydrolyzed with 1% acetic acid and the carbohydrate material was fractionated on Sephadex G-50 and Bio-Gel P-4 columns . All fractions obtained were subjected to chemical analysis by colorimetric methods and by gas-liquid chromatography . It was found that O-specific polysaccharide from LPS 87/57 is composed of mannose and N-acetylgalactosamine in the molar ratio of 3:1 . Both lipopolysaccharides contain unsubstituted core oligosaccharides (built of heptose, glucose and galactose in molar ratio of 3:3:1) as well as core oligosaccharides substituted with shorter (LPS 87/57 and LPS 1556) and longer (LPS 87/57) O-specific oligosaccharides . Strain 87/57 is of S (smooth) type and strain 1556 lacking O-specific polysaccharide is of SR (semi-rough) type . The data of Sephadex G-100 chromatography showed that O-antigen from Citrobacter 87/57 is heterogeneous; it contains polysaccharide chains of different length but the same composition . The heterogeneity of Citrobacter 023 lipopolysaccharides has been also detected by SDS-polyacrylamide gel electrophoresis. J Infect Dis, 1988 Jan, 157(1), 54 - 64 Failure of antisera to J5 and R595 rough mutants to reduce endotoxemic lethality; Greisman SE et al.; Rabbit antisera to J5 (Rc) Escherichia coli and R595 (Re) Salmonella minnesota rough mutants were selected for the highest content of hemagglutinating antibodies to their respective core glycolipids . Despite titers of 1:2560 vs . J5 and 1:640 vs . R595 core glycolipids, the antisera failed to passively protect ICR or CF-1 mice against lethality induced by endotoxins from a variety of wild-type, smooth enterobacteria: E . coli O111:B4, E . coli O127:B8, Salmonella typhimurium, S . minnesota, and Citrobacter freundii . J5 antisera, however, reduced lethality from J5 core glycolipid . In contrast, O-specific rabbit antisera were consistently protective against the lethal activity of wild-type, smooth enterobacterial endotoxins, but such protection was limited to the homologous endotoxin . These findings are consistent with in vitro demonstrations of a highly restricted ability of antibodies to J5 and R595 core glycolipids to bind to endotoxins from wild-type, smooth enterobacteria. Eur J Biochem, 1987 Dec 30, 170(1-2), 311 - 6 Transamination catalysed by tyrosine phenol-lyase from Citrobacter intermedius; Demidkina TV et al.; The interactions of tyrosine phenol-lyase with its substrates: L-tyrosine and L-serine, and the competitive inhibitors: L-alanine, L-phenylalanine, L-m-tyrosine, were studied . It was demonstrated that the enzyme catalyzed a half-transamination reaction between substrates or inhibitors and the protein-bound pyridoxal phosphate . The products of this side-reaction, pyridoxamine phosphate and the respective keto acids, were identified . The kinetic parameters were determined for beta-elimination of L-tyrosine and of L-serine, and for the transamination of L-serine and the inhibitors used . The transfer of the amino group to the coenzyme takes place in the direction from amino acid to pyridoxal phosphate, but not in the opposite direction, i.e . the transamination is irreversible. Jpn J Antibiot, 1987 Dec, 40(12), 2026 - 142 {Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1985) . III . Secular changes in susceptibility}; Kosakai N et al.; Sensitivities to antimicrobial agents of Escherichia coli, Klebsiella spp., Citrobacter spp., Enterobacter spp., Proteus spp., Pseudomonas aeruginosa and Serratia marcescens isolated from infected patients were evaluated and compared according to the types of their infections, i.e., simple and complicated urinary tract infections with or without indwelling catheter . There were no apparent decreases in the sensitivity of E . coli isolated from patients with simple urinary tract infections . When data obtained in 1982-1985 were summarized, it was found that a new quinoline derivative, ofloxacin (OFLX), showed the strongest activity among oral antimicrobial and antibiotic agents . This agent inhibited 100% of bacterial growth at MIC of 1.56 micrograms/ml . The next strongest activity was found with mecillinam (MPC) which showed 89.3% growth inhibition at the same concentration . Cefaclor (CCL) also showed 84.9% growth inhibition at the same concentration . When sensitivities of E . coli isolated from patients with complicated urinary tract infections with or without indwelling catheter to first and second generation cephems were determined, cefotiam (CTM), which inhibited 88.9%: 91.4% bacterial growth at MIC of 0.39 micrograms/ml, had the strongest activity among CTM, cefazolin (CEZ), cefoxitin (CFX) and cefmetazole (CMZ) . Among third generation cephems, including cefmenoxime (CMX), latamoxef (LMOX), ceftizoxime (CZX), cefotaxime (CTX) and cefoperazone (CPZ), the strongest activity was observed with CZX, and the agent having the next strongest activity was CMX . LMOX and CPZ showed relatively low activities . Carumonam (CRMN) and aztreonam (AZT), monobactams, showed strong activities against E . coli . As for Klebsiella spp., activities of pencillins against these strains were low . When activities of oral cephems (cephalexin (CEX) and CCL) and of a quinoline derivative OFLX against these strains were determined, OFLX showed strong activity; i.e., the growth of Klebsiella spp . isolated from complicated urinary tract infections was inhibited at 87.2%: 82.1% at MIC of 0.20 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS) Jpn J Antibiot, 1987 Dec, 40(12), 1975 - 2011 {Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1985) . I . Susceptibility distribution}; Kosakai N et al.; The results of determinations of sensitivities of bacterial strains to various antibiotics are summarized as follows: 1 . Against Escherichia coli, ofloxacin (OFLX) showed the strongest activity among oral antibacterial and antibiotic agents . Its MIC90 was below 0.10 micrograms/ml . The next strongest activity was found in mecillinam (MPC), cefaclor (CCL) and pipemidic acid (PPA); MIC90's of these agents 3.13 micrograms/ml . Cefotiam (CTM), cefotaxime (CTX), ceftizoxime (CZX), cefmenoxime (CMX) and latamoxef (LMOX) had MIC90 below 0.39 micrograms/ml . MIC90's of cefmetazole (CMZ) and cefoperazone (CPZ) were 1.56 micrograms/ml . Aztreonam (AZT) and carumonam (CRMN) in the monobactam group showed strong activities with MIC90's at 0.20 micrograms/ml . 2 . Although Klebsiella pneumoniae had a strong resistance to ampicillin (ABPC) and showed relatively low sensitivities to other oral antibacterial and antibiotic agents, OFLX maintained high activity against this species and showed MIC90 of 0.39 micrograms/ml . Among injectable antibiotics, third generation cephems showed the strongest activity to this species with MIC90 of CZX below 0.10 micrograms/ml, of CTX and CMX 0.20 micrograms/ml, and of LMOX 0.78 micrograms/ml . MIC90 of CPZ was 6.25 micrograms/ml, which was the same as those of cefazolin (CEZ) and cefoxitin (CFX) . CTM had similar MIC90 to LMOX, namely, 1.56 micrograms/ml . MIC90 of CMZ was 3.13 micrograms/ml . Monobactams AZT and CRMN showed strong activities to this species; their MIC90's were below 0.10 micrograms/ml and 0.20 micrograms/ml . 3 . Although Citrobacter freundii generally exhibited low sensitivities to antibacterial and antibiotic agents examined, it showed high sensitivity to OFLX, at MIC80 of 0.78 micrograms/ml . This species showed low sensitivities to MPC, nalidixic acid (NA), PPA, and sulfamethoxazole-trimethoprim (ST) . Among injectable antibiotics, LMOX and CMX had activities against this species; namely, MIC80's were 6.25 and 3.13 micrograms/ml, respectively . Among monobactams, AZT showed MIC80 of 12.5 micrograms/ml, and CRMN had that of 6.25 micrograms/ml . 4 . Against Enterobacter cloacae, the strongest antibacterial activity was found with OFLX which had MIC90 of 0.39 micrograms/ml . A relatively strong activity was seen with MPC . MIC80 of MPC was 1.56 micrograms/ml . Except to CTM, this species had poor sensitivities to injectable first and second generation cephems, and their MIC80's were over 200 micrograms/ml . MIC80 of CTM was 25 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS) Neurosurgery, 1987 Dec, 21(6), 923 - 7 Brain abscesses and ischemic necrotic lesions during early childhood; Tavora L et al.; The cases of seven children, all under 6 months of age, with cerebral abscesses are presented . In four cases, there was previous meningitis; the others presented with expanding mass lesions . The infectious agent was Proteus in four cases and Escherichia coli and Citrobacter in one each; in another patient, no agent was isolated . In six children, there were multiple areas of ischemic necrosis . In one instance, these areas were in the hemisphere contralateral to the purulent collection . The peculiar clinical, diagnostic, and therapeutic aspects of brain abscesses in this age group are discussed. South Med J, 1987 Nov, 80(11), 1439 - 41 Citrobacter freundii endocarditis in an intravenous drug abuser; Plantholt SJ et al.; We have reported the third case of Citrobacter endocarditis . Echocardiograms were invaluable in establishing the diagnosis . Ours is the first reported case of Citrobacter endocarditis to be cured by antimicrobial therapy alone. Jpn J Antibiot, 1987 Nov, 40(11), 1895 - 905 {The antimicrobial activity of sisomicin against fresh clinical isolates}; Deguchi K et al.; Antimicrobial activities of sisomicin (SISO) against clinical isolates obtained in the second half of 1986 were investigated together with other 4 aminoglycosides (AGs) (gentamicin (GM), tobramycin (TOB), dibekacin (DKB), amikacin (AMK} and 2 cephems (cefotiam, cefotaxime), and were compared to the results reported in the period of late 1970's through early 1980's in Japan . 1 . The incidence of SISO-resistant Staphylococcus aureus in the present study was 18% and is comparable to that of the other studies suggesting that the incidence of SISO resistant strains remains on the stable level . The incidence of SISO-resistant Pseudomonas aeruginosa showed the tendency of slight increase . 2 . SISO-resistant strains of Enterobacter spp., Serratia marcescens and Citrobacter freundii did not show increase from the 1970/1980 levels . 3 . Isolation rates of SISO-resistant indole(+) Proteus varied depending on strains . Isolation rates of SISO-resistant P . vulgaris and Morganella morganii were both as low as 4%, but that of Providencia rettgeri was as high as 60% . Refering to an American study reporting that the Genus Providencia including P . rettgeri showed high incidence of resistance to SISO as well as to GM or TOB, we pointed out that the antimicrobial activity of AGs against Genus Providencia should be evaluated separately from those of other indole(+) Proteus strains . 4 . No SISO-resistant strains of Escherichia coli, Klebsiella pneumoniae or P . mirabilis were found . 5 . SISO had good antimicrobial activity against most of the investigated species and SISO may still be regarded as one of the clinically useful AGs. Ann Inst Pasteur Microbiol, 1987 Nov-Dec, 138(6), 693 - 707 {Demonstration of glycocalyx formation in vitro in Citrobacter freundii, Proteus mirabilis and Planococcus sp.: the effect of polyosidases}; Richelle-Maurer E et al.; Three bacterial species of different origin, Citrobacter freundii, Proteus mirabilis and Planococcus sp., formed glycocalyx in vitro and thereby showed that the phenomena does not only occur in vivo contrary to the opinion of many authors . The glycocalyx was produced in the attachment processes used or both extra- and intercellular attachment . The aggregates formed caused large errors in bacterial counts and led to questioning of the very principle of the counting procedures . The glycocalyx was not destroyed by the polyosidases utilized nor by ultrasound treatment . The glycocalyx structure differed only according to the bacterial species of origin and was unchanged by culture media or nutrient deprivation. J Appl Bacteriol, 1987 Nov, 63(5), 459 - 64 A modified conductance medium for the detection of Salmonella spp; Ogden ID et al.; Selenite-cystine/trimethylamine oxide/dulcitol medium has been used in conjunction with conductance instruments to detect the presence of Salmonella spp . in foods and faeces . However, a small but significant number of salmonella strains were missed by this method . The majority of these strains were detected when dulcitol was substituted by mannitol and tested on two separate Malthus conductance instruments . Some strains of Citrobacter freundii and Escherichia coli continued to give false positive results . Attempts are made to explain why the substitution of mannitol for dulcitol gives an improved medium. Jpn J Antibiot, 1987 Oct, 40(10), 1752 - 61 {Antimicrobial activity of sulbactam/cefoperazone . Comparison with other new cephems}; Deguchi K et al.; Antimicrobial activities of sulbactam/cefoperazone (SBT/CPZ) against 50 fresh clinical isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter spp., Serratia marcescens, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were compared to those of CPZ, Cefotiam (CTM), Cefotaxime (CTX) and Latamoxef (LMOX) . Minimal inhibitory concentrations (MIC's) of SBT and CPZ mixed in a ratio of 1:1 were determined by the dilution method using Mueller-Hinton agar and expressed by absolute concentrations of CPZ . Antimicrobial activities of SBT/CPZ against principally penicillinase (PCase) producing bacteria, i.e., S . aureus, E . coli, K . pneumoniae, P . mirabilis, were superior to those of CPZ alone . The presence of SBT in concentrations around 0.39 approximately 1.56 micrograms/ml clearly enhanced CPZ's antimicrobial activities against these PCase producing strains . The synergistic antimicrobial effects of SBT in combination with CPZ were less pronounced against principally cephalosporinase (CEPase) producing bacteria, i.e., C . freundii, Enterobacter spp., S . marcescens, P . vulgaris, and P . aeruginosa, and exerted with SBT at concentrations around 3.13 approximately 12.5 micrograms/ml . Comparative antimicrobial activities indicated by MIC80's of tested agents showed that SBT/CPZ had more stable activities against bacteria ranging from Gram-positive to Gram-negative bacteria than CTM, CTX and LMOX . MIC's of SBT/CPZ were higher than 25 micrograms/ml against 8% of S . aureus, 18% of C . freundii, 10% of Enterobacter spp., 26% of S . marcescens, 2% of P . vulgaris, and 18% of P . aeruginosa . These resistant strains against which the addition of SBT showed no synergism, may possess other mechanism of resistance than beta-lactamase production . It is concluded that the presence of CPZ resistant strains is an actual current problem and not an imaginary future problem, and that the number of resistant strains against other new cephems which have different chemical structure from CPZ is increasing . When these present bacteriological environments are considered, the appearance of SBT/CPZ in the clinical practice is timely and meaningful. Chemioterapia, 1987 Oct, 6(5), 315 - 8 In vitro susceptibility of nosocomial Pseudomonas aeruginosa, enterobacteriaceae, and staphylococci to ciprofloxacin and ten other broad-spectrum antibiotics; Weinstein RA et al.; We determined microdilution minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) for ciprofloxacin and 10 beta-lactam and aminoglycoside antibiotics against 329 unique nosocomial isolates of Pseudomonas aeruginosa, citrobacter, enterobacter, serratia, and staphylococci . All were susceptible to ciprofloxacin, including 109 aminoglycoside-resistant gram-negative bacilli and 59 oxacillin-resistant staphylococci . Ciprofloxacin was generally 2-4 fold less active against aminoglycoside-resistant isolates than against their aminoglycoside-susceptible counterparts. Infect Immun, 1987 Sep, 55(9), 2183 - 90 Identification of two different hemolysin determinants in uropathogenic Proteus isolates; Welch RA; DNA sequences similar to those of the Escherichia coli hemolysin genes were detected among uropathogenic isolates of Proteus vulgaris and Morganella morganii by using the Southern blotting technique and hly gene-specific DNA probe . Immunoblotting revealed that among the hemolytic P . vulgaris and M . morganii isolates there was expressed a polypeptide species similar in molecular size (110 kilodaltons) and antigenicity to Escherichia coli HlyA . A plasmid-mediated P . vulgaris hemolysin determinant identified by Southern blotting analysis was molecularly cloned, and the recombinant plasmid (pWPV100) was characterized by restriction endonuclease fragment mapping . A second recombinant library of genomic DNA prepared from a hemolytic, urinary tract isolate of Proteus mirabilis was constructed in E . coli . A 5.5-kilobase XhoI fragment encoding an extracellular hemolytic activity was molecularly cloned (pWPM100), and this plasmid was subjected to transposon-mediated mutagenesis with TnphoA . The P . mirabilis hemolytic phenotype was determined to be encoded by a polypeptide species (HpmA) with an estimated molecular size of 140 kilodaltons based on minicell polypeptide analysis of pWPM100 and its mutant derivatives . Southern blotting analysis with a HpmA-specific DNA probe revealed that this novel determinant is commonly found in both Proteus species but is not present in hemolytic isolates of M . morganii, E . coli, Citrobacter freundii, and Serratia marcescens. Jpn J Antibiot, 1987 Sep, 40(9), 1698 - 706 {Susceptibility of clinical bacterial isolates to aztreonam}; Murase M et al.; In vitro activities of 7 antimicrobial agents against organisms (474 strains) isolated from patients with various infections in Ehime University Hospital from May to July 1986 were investigated . Summarized results are as follows: 1 . Aztreonam (AZT) showed potent activities against Escherichia coli, Citrobacter sp., Klebsiella pneumoniae, Serratia marcescens, Proteus sp., Pseudomonas aeruginosa and Haemophilus influenzae . 2 . Antimicrobial activities of AZT were especially superior against Proteus sp . to the third generation cephem antibiotics . 3 . Enterobacter sp . seemed more susceptible to AZT than to cephem antibiotics, but minimum inhibitory concentrations of AZT against may isolates of Enterobacter sp . were in wide ranges. J Clin Microbiol, 1987 Sep, 25(9), 1668 - 74 Epidemiologic factors affecting antimicrobial resistance of common bacterial isolates; Ellner PD et al.; The pattern of antimicrobial resistance of common bacterial isolates obtained from various groups of patients at a large tertiary-care center was compared with the pattern of resistance seen at a primary-care community hospital . At the tertiary-care center, significant differences in susceptibility were seen between pediatric and adult groups . In the tertiary-care center, the inpatients were more likely than the outpatients to have resistant staphylococcal and enterobacterial strains . Comparison of the overall resistance at the tertiary-care center and the primary-care hospital showed that resistance to cephalosporins, piperacillin, and aminoglycosides was significantly higher at the tertiary-care hospital than at the community hospital . Striking differences were noted in the resistance of nosocomial Enterobacter and Citrobacter isolates . Hospitals should be cautious in extrapolating nationwide data to their particular institutions. Eur J Clin Microbiol, 1987 Aug, 6(4), 439 - 45 Clinical significance of beta-lactamase induction and stable derepression in gram-negative rods; Livermore DM; Most strains of enterobacteria and Pseudomonas aeruginosa produce chromosomally-determined Class I beta-lactamases . When synthesized copiously these enzymes cause resistance to almost all beta-lactams, except imipenem and, sometimes, carbenicillin and tenocillin . Elevated beta-lactamase production arises transiently, via induction, in Pseudomonas aeruginosa and Enterobacter, Citrobacter, Morganella, indole-positive Proteus and Serratia spp . when these organisms are exposed to beta-lactams . Permanent high-level enzyme production arises via mutation, in the stably-derepressed mutants of these species . These mutants arise spontaneously at high frequency (10(-5) -10(-8) . Most early penicillins and first-generation cephalosporins are strong inducers of Class I enzymes at sub-inhibitory concentrations, as are cefoxitin and imipenem . Consequently their MICs reflect what lability these antibiotics have to inducibly-expressed beta-lactamase . Except with imipenem this lability usually is so great that the inducible enzyme causes clinical resistance . Although most other newer cephalosporins and ureidopenicillins are labile to the Class I enzymes they induce poorly below the MIC, and their lability is not reflected in resistance unless secondary inducers (e.g . cefoxitin or imipenem) are present . Although the weak inducer activity of these agents helps to maintain their activity against the inducible cells it renders the drugs highly selective for the pre-existing stably-derepressed mutants . Many cases have been reported where stably-derepressed mutants have overrun inducible populations of bacteria in patients undergoing therapy with beta-lactamase-labile weak inducers such as ureidopenicillin and third-generation cephalosporins. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1987 Aug, 184(6), 459 - 69 {Bacteriologic quality of water from the Rhine and its tributaries in the Rhine-Neckar region . I . Bacterial count and Enterobacteriaceae of the current status of pollution}; Mersch-Sundermann V et al.; During the period of May 1982 to January 1983 and March 1986 to May 1986, 164 water-specimens had been collected along the river Rhine and its affluxes in the overcrowded Rhine-Neckar-Region from 34 collecting-sites on 8 different days . The specimens were tested for the total-germ-count and the titers of different Enterobacteriaceae-species . The total-germ-count examined concentrations of several hundreds up to 1.8 million germ in 1 ml river-water . Extremely high concentrations were found along the waste-water-influxes (purification-plants) and the overloaded Rhine-affluences (Leimbach, Kraichbach, Speyerbach, Rehbach, Neckar) . The waste-water-samples from the central flow of the Rhine-river showed germ-concentrations of less than 10.000/ml, due to the mix-up of the waste water with the Rhine-water . Enterobacteriaceae--549 isolates together--could be found mainly in specimens from all collected sites in low titers . E . coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia liquefaciens and Citrobacter freundii had been the highest recovery rate . The isolation of Salmonellae was examined because of specific methods in a separate study (2 . Communication) . Based on these data, it has to be concluded, that the water of the Rhine-river and its affluxes in the Rhine-Neckar-Region is an uncontrolled germ-reservoir . The use of this water for bathing, unprocessed drinking-water or for agriculture purpose has to be refused from the hygienic point of view. Eur J Clin Microbiol, 1987 Aug, 6(4), 460 - 6 Incidence of inducible beta-lactamases in gram-negative septicemia isolates from twenty-nine European laboratories . European Study Group on Antibiotic Resistance; Clinical consequences of development of resistance to third generation cephalosporins; Department of Medicine, University Hospital (Kantonspital), Basel, SwitzerlandEighteen patients are described in whom initially sensitive microorganisms were replaced by resistant isolates during administration of ceftriaxone (n = 8), cefoperazone (n = 5), moxalactam (n = 4), cefotaxime (n = 2) or ceftazidime (n = 1), despite combination with aminoglycosides . All patients had documented gram-negative infections; in 12 patients underlying haematological diseases were present . Resistant strains of Enterobacter cloacae (14), Serratia marcescens (4), Klebsiella oxytoca (3), Pseudomonas aeruginosa (2) and Citrobacter freundii (2) emerged within 2 to 19 (mean 9) days after the beginning of treatment . In 12 patients relapse or secondary infections occurred . Seven of the patients with haematological disorders died . Resistance development was seen in 8 of 29 patients on ceftriaxone and 4 of 10 patients on moxalactam during prospective evaluations; the other drugs were used sporadically . Thus, selection of resistant bacteria is relatively frequent and may have serious clinical consequences in patients with impaired host-defense mechanisms. Appl Biochem Biotechnol, 1987 Aug, 15(2), 97 - 106 Basic studies of hydrogen evolution by Escherichia coli containing a cloned Citrobacter freundii hydrogenase gene; Kanayama H et al.; Citrobacter freundii genes that complemented Escherichia coli hyd-(hydrogenase activity) mutation were cloned in plasmids pCBH4 (6.2 kb) and pCBH6(5.7 kb) . Hydrogen evolution by the transformant E . coli HK-8(pCBH4 or pCBH6) was investigated . The optimum culture temperature of recombinant E . coli cells for hydrogen evolution from glucose was in the neighborhood of 18 degrees C . The recombinant E . coli cells cultured at this condition showed a several-fold increase of hydrogen evolution, as compared with that of the wild-type cells . The plasmid-retention stability of this recombinant E . coli was extremely high, especially plasmid pCBH4, which was completely retained during 2 wk without any restriction . Hydrogen production by immobilized recombinant E . coli was then investigated using cells cultured at 18 degrees C . The hydrogen evolution rate from glucose and Lennox-broth were about twofold higher than that of E . coli C600, and this high hydrogen evolution rate was maintained for more than 1 mo. J Antimicrob Chemother, 1987 Jul, 20(1), 23 - 35 Citrobacter diversus ULA27 produces two forms of a chromosomal beta-lactamase; Oliva B et al.; A multi-resistant clinical isolate of Citrobacter diversus, particularly resistant to penicillins and cephalosporins, has been studied . The strain produced constitutively high levels of beta-lactamase which efficiently hydrolysed cephaloridine but not ampicillin . The apparent Km value for cephaloridine (125 +/- 25 microM) was within the range usually observed for beta-lactamases in similar bacteria . The strain possessed two forms of the enzyme as indicated by isoelectric focusing patterns, HPLC analysis and two pH optima . SDS-PAGE analysis indicated a single protein responsible for both forms . The strain possessed a single plasmid, as revealed by agarose gel electrophoresis, but beta-lactamase production was not plasmid encoded . The available data indicate the beta-lactamase(s) of C . diversus ULA27 to be chromosomally encoded. Antimicrob Agents Chemother, 1987 Jul, 31(7), 1085 - 92 In vitro and in vivo antibacterial activities of CS-807, a new oral cephalosporin; Utsui Y et al.; CS-807 is a new oral prodrug of R-3746, a cephalosporin derivative, with potent in vitro and in vivo antibacterial activity against both gram-positive and gram-negative bacteria . The susceptibility of about 1,200 clinical isolates to R-3746 was determined by the agar dilution method . Ninety percent or more of pathogens such as Staphylococcus aureus, streptococci, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, indole-positive and indole-negative Proteus spp., Providencia rettgeri, and Haemophilus influenzae were inhibited at concentrations ranging less than or equal to 0.01 to 1.56 micrograms/ml . Furthermore, at a concentration of 3.13 micrograms/ml, 50% or more of Staphylococcus epidermidis, Morganella morganii, Citrobacter freundii, and Serratia marcescens strains were also inhibited . Pseudomonas aeruginosa and Xanthomonas maltophilia were resistant to R-3746 . The activity of R-3746 was scarcely influenced by several growth conditions . R-3746 was highly resistant to hydrolysis by beta-lactamases derived from various species of bacteria . Killing-curve studies demonstrated bactericidal activity of R-3746 at concentrations above the MIC . R-3746 showed high affinity for penicillin-binding proteins 1, 3, and 4 of Staphylococcus aureus and 1A, 1Bs, and 3 of Escherichia coli . Systemic infections in mice caused by various pathogens, including beta-lactamase-producing strains, responded well to therapy with oral doses of CS-807. Prev Med, 1987 Jul, 16(4), 580 - 5 Cell turnover and colon tumor development; Deschner EE; The proliferative characteristics of the large bowel are determined genetically and can vary over a wide range, the lower range being resistant to chemically induced tumors and the upper range expressing susceptibility . Basically, the colon has a relatively high level of cell renewal . It can be further elevated or depressed by a number of dietary and environmental conditions . A hyperproliferative state has been induced by the presence of carrageenan, Citrobacter freundii, nonspecific injury, or dietary factors such as high levels of bile acids . The effect of high proliferation levels is to produce more S-phase cells, which are sensitive to DNA damage, to increase the risk of neoplastic transformation and to shorten the tumor latency period . In animal models, hyperactivity has meant enhanced tumor incidence . A hypoproliferative state has been induced in the colon of man and mouse . Experimentally, the net effect of lower proliferative levels has been to reduce colon tumor incidence . It remains to be determined whether clinical trials involving hypoproliferation can be maintained chronically and are an effective means of reducing colon tumor incidence in high-risk groups. FEBS Lett, 1987 Jun 22, 218(1), 126 - 30 Identification of the active site of Citrobacter freundii beta-lactamase using dansyl-penicillin; Yamaguchi A et al.; The active site sequence of a beta-lactamase encoded by chromosomal gene(s) in Citrobacter freundii GN346 was determined using dansyl-penicillin as a fluorescent probe . The tryptic digest of the labelled enzyme gave a fluorescent peptide containing 22 amino acids . The sequence of this peptide was identical to the consensus sequence of class C beta-lactamases, Gly-Ser-X-Ser-Lys . The residue labelled was the serine adjacent to the glycine . The active site sequence corresponded to positions 46-67 of the entire sequence of the Citrobacter freundii beta-lactamase determined on the basis of the DNA sequence of the structural gene {(1986) Eur . J . Biochem . 156, 441-445} . The labelled serine corresponded to Ser-64. Infect Control, 1987 Jun, 8(6), 241 - 4 In vitro activity of cefixime and six other agents against nosocomial pathogens of the Enterobacteriaceae family; Mulligan ME; Cefixime, a broad-spectrum, orally active cephalosporin, was more active in vitro than ampicillin, cefaclor, cephalothin, and trimethoprim/sulfamethoxazole against 194 nosocomial pathogens of the family Enterobacteriaceae . Activity was especially good against Klebsiella spp, Proteus spp, Serratia spp, and Providencia stuartii . Although gentamicin had equivalent or better activity against Citrobacter spp, Enterobacter spp, Escherichia coli, and Morganella morganii, all 23 of the gentamicin-resistant strains studied were susceptible to cefixime . Isolates tested were from urinary tract infections, abdominal infections, wounds, vascular infections, and respiratory infections; they were sequentially collected nosocomial pathogens from a single institution . This orally active cephalosporin should be considered for therapy of a variety of nosocomial infections involving gram-negative bacillary pathogens. Epidemiol Infect, 1987 Jun, 98(3), 311 - 22 Inhibition of colonization of the chicken alimentary tract with Salmonella typhimurium gram-negative facultatively anaerobic bacteria; Barrow PA et al.; Oral administration of strains of food poisoning salmonellas to day-old chickens produced a profound inhibition in the subsequent colonization of the caeca by a strain of Salmonella typhimurium given one day later . Closely related genera were unable to produce a similar inhibition . The inhibition was not the result of bacteriophages produced by the first strain . Neither was it the result of an immunological response by the host induced by the first strain . In additional experiments in day-old chickens, inhibition of an Escherichia coli Nalr strain and of a Citrobacter sp . Nalr strain was produced by the antibiotic-sensitive forms of the homologous strains while strains from other genera did not produce any inhibition . When an avirulent mutant of S . typhimurium was used for pre-treatment a statistically significant reduction in the excretion of the super-infecting S . typhimurium Nalr strain over several weeks was produced . A genus specific inhibition was reproduced in vitro by mixed culture experiments . Live cultures were necessary for in vitro inhibition . Killed cells or a culture supernatant produced no inhibition. Minerva Med, 1987 May 15, 78(9), 617 - 22 {In vitro chemo-antibiotic sensitivity of gram-negative bacteria from various biological materials . Comparison between aztreonam and other agents}; Monaci E et al.; 527 Gram negative bacterial strains isolated from different biological substances were studied by chemo-antibiotic sensitivity . The examination was carried out by the agar diffusion test (Kirby-Bauer) . A very good sensitivity to aztreonam (E . coli, Serratia spp., Klebsiella spp., Proteus spp.), to amikacin (Pseudomonas spp., Enterobacter spp., Citrobacter spp.) and to norfloxacin (Citrobacter spp.) was found . Even when it was not the best, aztreonam was the second (Citrobacter spp.) or the third choice (Pseudomonas spp.), always near to the drug of first choice. J Antimicrob Chemother, 1987 May, 19(5), 685 - 93 Enteric colonization with antibiotic resistant bacteria in nurses working in intensive care units; Chambers ST et al.; To determine whether nurses who worked in an intensive care unit (ICU) might acquire enteric colonization with Gram-negative aerobic bacteria from their patients, rectal swabs were obtained from the patients and nurses in the ICU, from nurses working in a coronary care unit (CCU) and from young women with urinary tract infection who had not been exposed to the hospital environment . The healthy women differed from the patients in that their enteric flora contained greater numbers of lactose fermenting bacteria, they were less often colonized by resistant organisms and when resistant bacteria were present they were less abundant than in the patients . Nurses who had been treated with antimicrobial agents during the preceding six months were colonized more often with antibiotic resistant enteric bacteria . There was no evidence of transmission of antibiotic resistant Escherichia coli from patients to nurses largely because this species had been virtually eliminated from the patients by intensive use of antimicrobial agents . Instead, several multiresistant species of Klebsiella, Citrobacter and Pseudomonas were isolated from the patients and ICU nurses . It was difficult, however, to define clearly patient-nurse controls who had no exposure to the ICU patients . These observations and those of other investigators emphasize the need for examination of control populations and of therapeutic use of antibiotics when examining the issue of environmental acquisition of antibiotic resistant bacteria. Antimicrob Agents Chemother, 1987 May, 31(5), 829 - 30 In vitro susceptibility of Citrobacter species to various antimicrobial agents; Samonis G et al.; The in vitro activities of 16 antimicrobial agents against 14 clinical isolates of Citrobacter diversus and 27 isolates of Citrobacter freundii were studied . C . freundii isolates were more resistant, being susceptible only to amikacin, netilmicin, gentamicin, imipenem, ciprofloxacin, and enoxacin . C . diversus isolates were susceptible to many more of the agents tested. Pediatr Neurol, 1987 May-Jun, 3(3), 178 - 80 Citrobacter diversus and neonatal brain abscess; Kline MW et al.; A 23-day-old infant presented with apnea and was found to have Citrobacter diversus meningitis and brain abscess . The organism persisted in brain abscess fluid for over 4 weeks despite adequate antibiotic therapy . Cranial computed tomography demonstrated persistent radiolucencies in both frontal lobes, and midline shift, long after completion of antibiotic therapy . Effective therapy of C . diversus meningitis and brain abscess may require use of an antibiotic active within phagocytes, and judicious surgical drainage . A high prevalence of brain abscess mandates cranial computed tomography for any infant with C . diversus meningitis. Appl Environ Microbiol, 1987 May, 53(5), 1073 - 7 Coagglutination and enzyme capture tests for detection of Escherichia coli beta-galactosidase, beta-glucuronidase, and glutamate decarboxylase; Kaspar CW et al.; Polyclonal antibodies to Escherichia coli beta-galactosidase, beta-glucuronidase, and glutamate decarboxylase were used in coagglutination tests for identification of these three enzymes in cell lysates . Enzyme capture assays were also developed for the detection of E . coli beta-galactosidase and beta-glucuronidase . The enzymes were released by using a gentle lysis procedure that did not interfere with antibody-enzyme interactions . All three enzymes were detected in 93% (51 of 55) of the E . coli strains tested by coagglutination; two of the three enzymes were identified in the remaining 7% . Of 42 non-E . coli tested by coagglutination, only four nonspecifically agglutinated either two or three of the anti-enzyme conjugates . Thirty-two (76%) non-E . coli isolates were negative by coagglutination for all three enzymes . The enzyme capture assay detected the presence of beta-galactosidase in seven of eight and beta-glucuronidase in all eight strains of E . coli tested . Some strains of beta-galactosidase-positive Citrobacter freundii and Enterobacter cloacae were also positive by the enzyme capture assay, indicating that the antibodies were not entirely specific for E . coli beta-galactosidase; however, five other gas-positive non-E . coli isolates were negative by the enzyme capture assay . The coagglutination tests and enzyme capture assays were rapid and sensitive methods for the detection of E . coli beta-galactosidase, beta-glucuronidase, and glutamate decarboxylase. Ann Clin Lab Sci, 1987 May-Jun, 17(3), 171 - 7 In vitro antimicrobial activity of diethyldithiocarbamate and dimethyldithiocarbamate against methicillin-resistant Staphylococcus; Taylor EH et al.; Staphylococcus aureus has appeared which is highly resistant to both methicillin and aminoglycosides . Current therapy involves long-term intravenous therapy of vancomycin . Since vancomycin is currently the only drug used to treat these patients, there is a need to develop additional antimicrobial therapy . The in vitro antimicrobial effect of the metal chelator, diethyldithiocarbamate (DDTC) and its structural analog dimethyldithiocarbamate (DMTC) were investigated . Both DDTC and DMTC were effective against S . aureus including methicillin-resistant S . aureus (MRSA) . By agar diffusion, DDTC at 10 micrograms per disk produced zone sizes of 12 to 21 mm and at 100 micrograms per disk produced zone sizes of 26 to 34 mm against MRSA . The DMTC produced slightly greater zone sizes against MRSA of 16 to 24 mm and 24 to 37 mm for 10 micrograms per disk and 100 micrograms per disk, respectively . The minimum inhibitory concentration (MIC) for DMTC against MRSA was 6 micrograms per ml . Both DDTC and DMTC were also effective against enterococci, Proteus mirabilis, Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Salmonella species, Serratia marcescens and Citrobacter freundii at 100 micrograms per disk . The MICs of DMTC for Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, Salmonella and Citrobacter freundii were approximately 128 micrograms per ml while the MICs for Proteus vulgaris, Proteus mirabilis, Pseudomonas aeruginosa and Serratia marcescens was greater than or equal to 256 micrograms per ml . In addition, DMTC was synergistic with gentamicin against MRSA and coagulase-negative staphylococcus species, Enterobacter cloacae, Klebsiella pneumoniae and Pseudomonas aeruginosa . Additive and synergistic effects of DMTC were displayed with gentamicin against S . aureus including methicillin-resistant S . aureus.(ABSTRACT TRUNCATED AT 250 WORDS) J Bacteriol, 1987 May, 169(5), 1923 - 8 Inactivation of the ampD gene causes semiconstitutive overproduction of the inducible Citrobacter freundii beta-lactamase; Lindberg F et al.; In Citrobacter freundii and Enterobacter cloacae, synthesis of AmpC beta-lactamase is inducible by the addition of beta-lactams to the growth medium . Spontaneous mutants that constitutively overproduce the enzyme occur at a high frequency . When the C . freundii ampC beta-lactamase gene is cloned into Escherichia coli together with the regulatory gene ampR, beta-lactamase expression from the clone is inducible . Spontaneous cefotaxime-resistant mutants were selected from an E . coli strain carrying the cloned C . freundii ampC and ampR genes on a plasmid . Virtually all isolates had chromosomal mutations leading to semiconstitutive overproduction of beta-lactamase . The mutation ampD2 in one such mutant was caused by an IS1 insertion into the hitherto unknown ampD gene, located between nadC and aroP at minute 2.4 on the E . coli chromosome . The wild-type ampD allele cloned on a plasmid could fully trans-complement beta-lactamase-overproducing mutants of both E . coli and C . freundii, restoring the wild-type phenotype of highly inducible enzyme synthesis . This indicates that these E . coli and C . freundii mutants have their lesions in ampD . We hypothesize that induction of beta-lactamase synthesis is caused by blocking of the AmpD function by the beta-lactam inducer and that this leads directly or indirectly to an AmpR-mediated stimulation of ampC expression. Am J Med, 1987 Apr 27, 82(4A), 295 - 300 Oral ciprofloxacin in the treatment of elderly patients with complicated urinary tract infections due to trimethoprim/sulfamethoxazole-resistant bacteria; Preheim LC et al.; The effectiveness and safety of ciprofloxacin, a new quinolone antibiotic, were prospectively evaluated in the treatment of patients with complicated urinary tract infections caused by gram-negative organisms resistant to trimethoprim/sulfamethoxazole . Twenty-five elderly (mean age, 70.4 years) patients (24 men and one woman) were enrolled . Initial pathogens included Pseudomonas aeruginosa (15 isolates), Escherichia coli (five isolates), Enterobacter aerogenes (one isolate), Citrobacter freundii (one isolate), Serratia species (two isolates), Proteus vulgaris (one isolate), and enterococcus (one isolate) . Patients received 500 mg of ciprofloxacin orally twice daily for one week (mean, 6.98 days) . Results of urine cultures obtained during therapy were negative in all cases, and at one week post-therapy, 21 of 25 (84 percent) infections were cured . Four patients experienced a relapse with P . aeruginosa . Repeat urine culture specimens were obtained at four to six weeks from 14 patients who had cures at one week post-therapy, and seven continued to have cures . Three patients had late relapses with P . aeruginosa, E . coli, or Serratia marcescens, and four were reinfected with new strains . Five patients who received concomitant oral antacids had lower mean peak and trough serum ciprofloxacin levels than did patients not receiving antacids (p less than 0.05, Wilcoxon rank sum test) . Mild adverse effects were seen in seven patients: eosinophilia (one patient), eosinophilia and reduced white blood cell count (one patient), crystalluria (one patient), granular casts (one patient), elevation of serum creatinine and blood urea nitrogen levels (one patient), and nausea (two patients), but none warranted discontinuation of ciprofloxacin therapy . P . aeruginosa isolates from two patients who experienced a relapse showed increases in minimal inhibitory concentrations from 0.13 to 0.5 and 2.0 micrograms/ml, respectively, to ciprofloxacin and other antibiotics . Orally administered ciprofloxacin was a safe and effective therapy for complicated urinary tract infections in elderly patients. Chemioterapia, 1987 Apr, 6(2), 79 - 81 A comparative study of the sensitivity of bacteria of various origin to ofloxacin; Gubina M; The sensitivity of 6 antimicrobials (chloramphenicol, tetracycline, ampicillin, cephalothin, trimethoprim/sulfamethoxazole and ofloxacin) was tested on 174 bacteria isolated from three sources: 60 from wounds, 84 from urine and 30 from bronchial excretions . Hospital-borne bacteria were compared to those of non-hospital origin for their susceptibility . Consecutively, Pseudomonas aeruginosa (24 strains), Escherichia coli (58), Klebsiella sp . (13), Enterobacter sp . (3), Citrobacter sp . (3), Enterococcus sp . (25) and Staphylococcus sp . (48) were tested . With the exception of 7.1% of bacteria (Enterococcus) isolated from urine, 96.6% of all strains tested were sensitive to ofloxacin. J Clin Microbiol, 1987 Mar, 25(3), 531 - 5 Production of Vi monoclonal antibodies and their application as diagnostic reagents; Tsang RS et al.; Serum antibodies to Vi antigen were detected in mice immunized with the purified antigen but not with Vi-bearing Salmonella typhi whole cells . Fusion of the spleen cells from one of the Vi antibody-producing mice with NSI myeloma cells produced four stable hybridomas that secreted antibodies to Vi . Monoclonal antibodies from these four clones were all of the immunoglobulin G class and, as determined by competition, appeared to have the same epitope specificity . Despite their immunoglobulin G nature, mouse ascitic fluids induced by one of the hybridomas strongly agglutinated the Vi-positive strains of S . typhi, S . dublin, and Citrobacter strain 5396/38 . Thus, 10 clinical isolates of S . typhi but not 98 strains of other bacteria were reactive in slide agglutination tests with the monoclonal antibodies. Am J Dis Child, 1987 Mar, 141(3), 335 - 42 Imipenem and cilastatin in acute osteomyelitis and suppurative arthritis . Therapy in infants and children; Freij BJ et al.; Twenty-five infants and children with acute osteomyelitis (n = 7), suppurative arthritis (n = 11), or both (n = 7) were treated with imipenem and cilastatin sodium . Patients ranged in age from 5 months to 11.3 years . Needle aspiration of infected sites was performed in all patients, and 11 (44%) required further surgical drainage . Imipenem and cilastatin sodium in a dosage of 100 mg/kg/d was used for children 3 years of age or younger, while older ones received 60 mg/kg/d intravenously, divided in four equal doses . Bacterial pathogens were identified in 15 patients (60%): Staphylococcus aureus in five, Haemophilus influenzae b in four, Pseudomonas aeruginosa in two, Streptococcus pneumoniae in one, group A Streptococcus in one, Kingella kingae in one, and Citrobacter amalonaticus in one . All isolates were susceptible to imipenem in vitro . Imipenem and cilastatin therapy was continued for a median of six days followed by treatment with appropriate orally administered antibiotics . Median peak serum bactericidal titers after imipenem and cilastatin infusions were 1:512 for S aureus, 1:32 for H influenzae b, 1:512 for streptococci, and 1:16 for gram-negative rods . All but one patient with P aeruginosa osteomyelitis responded favorably to imipenem and cilastatin . The median duration until resolution of symptoms was six days . Imipenem and cilastatin infusions were well tolerated, and side effects included maculopapular rash in one patient, watery diarrhea in one, and mild transient elevation of alanine aminotransferase levels in three . Because of imipenem and cilastatin's unusually broad spectrum of activity and its relative safety, this drug combination can be used for the initial, empiric therapy of acute bone and joint infections in pediatric patients. Klin Monatsbl Augenheilkd, 1987 Mar, 190(3), 161 - 6 {Etiology of corneal ulcers with special reference to bacterial genesis}; Bialasiewicz AA et al.; The authors report on 134 patients (141 eyes) seen between May 1982 and December 1985 with corneal ulcers with or without hypopyon . Eight patients (11 eyes) had a facial palsy, 7 (7 eyes) a varicella zoster infection, 1 (2 eyes) a marginal ulcer ("furrow keratitis") associated with collagenosis, 29 (29 eyes) an ulcerative keratitis with endophthalmitis, 1 (2 eyes) a pemphigoid-associated ulcer and 90 (92 eyes) a herpetic infection . Pathogenic bacterial strains were isolated from 20 patients: 10 coagulase-positive Staphylococcus aureus (4 coinfections), 3 Pseudomonas aeruginosa (1 coinfection), 2 Proteus mirabilis (1 coinfection), 2 Escherichia coli and Enterobacter cloacae, Citrobacter freundii and beta-hemolyzing streptococci as well as enterococci in one case each, and non-hemolyzing streptococci and alpha-hemolyzing streptococci in two cases each as coinfections . A comparison of the range of bacterial strains of postoperative endophthalmitis and kerato-/conjunctivitis with bacterial corneal ulcers revealed a high percentage of gram-negative organisms in the latter . Laboratory work-up should include microscopy, agar plating and differentiation as well as antibiotic sensitivity testing and modern immunofluorescent direct techniques . Management includes bactericidal topical and systemic antibiotic regimens as well as surgical procedures if necessary, e.g., perforating tectonic and mini-keratoplasty, and conjunctival flapping followed by lamellar keratoplasty. Prikl Biokhim Mikrobiol, 1987 Mar-Apr, 23(2), 192 - 8 {Kinetic study of 3,4-dihydroxyphenyl-L-alanine synthesis in Citrobacter freundii cells immobilized in carrageenan}; Voivodov KI et al.; A kinetic study was carried out of the enzymatic synthesis of 3,4-dihydroxyphenyl-L-alanine (DOPA) by the Citrobacter freundii 62 cells, possessing tyrosine-phenol-lyase (TPL) activity, immobilized in carrageenan, and optimum conditions of the reaction were found . The dependence of the TPL activity and its stability on the conditions of the DOPA synthesis was investigated . The TPL activity was higher and more stable in the immobilized cells as compared to free ones. J Clin Microbiol, 1987 Feb, 25(2), 439 - 41 Rapid catalase supplemental test for identification of members of the family Enterobacteriaceae; Chester B et al.; A simple, rapid, semiquantitative slide catalase test useful for differentiating members of the family Enterobacteriaceae is described . Judging by the time required for appearance of oxygen bubbles in 3% hydrogen peroxide, the immediate catalase reactors were Yersinia, Serratia, Proteus, Morganella, Providencia, Cedecea, and Hafnia spp . The delayed catalase reactors were Escherichia, Shigella, Klebsiella, Enterobacter, Salmonella, Citrobacter, Edwardsiella, Kluyvera, and Tatumella spp . This information is especially useful for differentiating Serratia from Enterobacter spp . and Yersinia from Escherichia and Shigella spp. J Antimicrob Chemother, 1987 Feb, 19(2), 175 - 85 In-vitro activity of two new quinolone antimicrobial agents, S-25930 and S-25932 compared with that of other agents; Neu HC et al.; S-25930 and S-25932, two new 4-quinolones, were compared to ciprofloxacin, enoxacin, ofloxacin, norfloxacin, cefotaxime, gentamicin, trimethoprim, and ampicillin . S-25930 and S-25932 inhibited 90% of Enterobacteriaceae at less than or equal to 1 mg/l, usually differing only two-fold . The MIC90 for Pseudomonas aeruginosa was 8 mg/l for S-25930 and 16 mg/l for S-25932, compared to MICs of 1 to 8 for the other four quinolones . Both drugs inhibited Enterobacter cloacae, Serratia marcescens and Citrobacter freundii resistant to cefotaxime and Klebsiella species resistant to gentamicin and trimethoprim . The MICs90 were 0.125 and 0.25 mg/l against staphylococci, including methicillin-resistant Staphylococcus aureus and were superior to the MICs of other quinolones; activity against haemolytic streptococci at 1-2 mg/l was also superior . S-25930 and S-25932 showed rapid bactericidal activity at the MBC concentration and both agents showed post-antibiotic suppression of growth of bacteria . The agents were active in acid medium, but activity was reduced by magnesium at 9 mM . A stepwise increase in resistance was produced by serial passage in increasing concentrations of drug. Am Ind Hyg Assoc J, 1987 Feb, 48(2), 106 - 10 Seasonal variation in aerobic bacterial populations and endotoxin concentrations in grain dusts; DeLucca AJ 2nd et al.; Settled and respirable grain dust samples were collected at intervals over a 16-month period at two grain terminals on the lower Mississippi River . Total and gram-negative aerobic bacterial (GNB) populations, as well as endotoxin concentrations, were studied . Plate counts indicated that no viable bacteria were found to be present in the respirable samples . Endotoxin concentrations ranged from 0.0 to 6.4 ng (0.0 to 7.9 ng/m3 air) per respirable sample, indicating that bacteria were once viable in dust of respirable size or contamination occurred from larger, non-respirable particles . Numbers of bacteria from settled dusts, both total and GNB, remained relatively stable; however, the genera of the GNB populations varied . Enterobacter agglomerans was the predominant species in warm months, but not in winter . Pseudomonas and Klebsiella species increased in winter and decreased in summer . Other genera found were Citrobacter and Serratia . Endotoxin concentrations in settled dust samples ranged from 1.7 to 5.6 ng/mg dust. Acta Pathol Microbiol Immunol Scand {B}, 1987 Feb, 95(1), 85 - 7 Failure to detect hydrogen-sulphide production in lactose/sucrose-fermenting Enterobacteriaceae, using triple sugar iron agar; Kolmos HJ et al.; Triple Sugar Iron agar failed to detect hydrogen sulphide in 44 out of 69 hydrogen-sulphide producing strains of Enterobacteriaceae, which at the same time fermented lactose and/or sucrose . The species involved were Salmonella typhi, Salmonella enteritidis, Citrobacter freundii, Escherichia coli, and Proteus vulgaris . By contrast, no false-negative reactions were observed in 74 strains, which fermented neither lactose nor sucrose . Failure to detect hydrogen sulphide was probably due to acidification of the medium following the fermentation of carbohydrates . A medium without carbohydrates is preferable in diagnostic situations where hydrogen-sulphide detection is of great importance. J Bacteriol, 1987 Feb, 169(2), 687 - 93 Cloning of genes from members of the family Enterobacteriaceae with mini-Mu bacteriophage containing plasmid replicons; Groisman EA et al.; An in vivo cloning system that uses derivatives of the Escherichia coli bacteriophage Mu with plasmid replicons has been extended to five different species of the family Enterobacteriaceae . Mu and these mini-Mu replicon elements were introduced into strains of E . coli, Shigella flexneri, Salmonella typhimurium, Citrobacter freundii, and Proteus mirabilis by infection, by transformation, or by conjugation with newly constructed broad-host-range plasmids containing insertions of these elements . Lysates from these cells, lysogenic for Mu and mini-Mu elements, were used to infect sensitive recipient strains of E . coli, S . typhimurium, and C . freundii . Drug-resistant transductants had mini-Mu replicon elements with inserts of different DNA sequences . All of the lysogens made could be induced to yield high phage titers, including those coming from strains that were resistant to Mu and Mu derivatives . Clones of 10 particular genes were isolated by their ability to complement specific mutations in the recipient strains, even in the presence of the E . coli K-12 restriction system . Some of the mini-Mu replicon elements used contained lac gene fusing segments and resulted in fusions of the lac operon to control regions in the cloned sequences. J Bacteriol, 1987 Feb, 169(2), 758 - 63 Common mechanism of ampC beta-lactamase induction in enterobacteria: regulation of the cloned Enterobacter cloacae P99 beta-lactamase gene; Lindberg F et al.; Expression of the chromosomal beta-lactamase from the ampC gene in inducible in both Enterobacter cloacae and Citrobacter freundii . Cloning of ampC as well as its regulatory gene, ampR, from E . cloacae P99 revealed a gene organization indentical to that of C . freundii in the corresponding region . Although almost no similarities could be found between the restriction maps of ampC and ampR in the two species, the genes cross-hybridize . Also, both ampR gene products have a size of about 31,000 . The regulatory features of E . cloacae beta-lactamase induction are very similar to those in C . freundii, i.e., beta-lactamase synthesis is repressed by AmpR in the absence, and stimulated in the presence, of inducer . The AmpR function can be transcomplemented between the two species, but there are quantitative regulatory aberrations in such hybrids, in contrast to the total complementation obtained within each system . These results suggest that the mechanism of beta-lactamase induction is the same in E . cloacae, C . freundii, and other gram-negative bacteria with inducible chromosomal beta-lactamase expression. FEBS Lett, 1987 Jan 26, 211(2), 175 - 8 Structure determination of the O-specific polysaccharides from Citrobacter O4- and O27-lipopolysaccharides by methylation analysis and one- and two-dimensional 1H-NMR spectroscopy; Romanowska E et al.; Using sugar and methylation analyses, and one- and two-dimensional 1H-NMR spectroscopy at 500 MHz it was established that poly-beta-1,2-4-deoxy-D-arabinohexopyranose occurs as O-specific chains of lipopolysaccharides in Citrobacter serotypes O4, O27 and O36 . Strong serological cross-reactivity between these serotypes is in full agreement with the chemical identity of their O-specific polysaccharides. Pediatr Infect Dis J, 1987 Jan, 6(1), 50 - 5 Outbreak of neonatal Citrobacter diversus meningitis in a suburban hospital; Lin FC et al.; Between February and June, 1983, four cases of Citrobacter diversus neonatal meningitis were identified at a suburban Baltimore hospital . One of the 4 infants died at age 13 months, 2 (both of whom had brain abscesses) have evidence of developmental delay and 1 appears to be normal after 33 months of follow-up . A review of microbiology records revealed that C . diversus had been present in the hospital nursery prior to identification of the first infant with meningitis, with isolation from infants born 7 months, 4 months and 4 days, respectively, before the first meningitis case . C . diversus was isolated from 21 infants born during the outbreak period and from hand or rectal cultures of 5 nursing personnel . All isolates were biotype E, with two distinct clusters of cases identified on the basis of plasmid profile and serotype . In a case-control study isolation of C . diversus was significantly associated with male sex, low birth weight and care by house pediatricians . The outbreak was controlled by stringent infection control measures and exclusion of personnel carriers . During the 24 months following the outbreak 3431 babies discharged from the nursery were cultured for C . diversus; 3 were colonized with the organism. Arkh Patol, 1987, 49(7), 80 - 2 {Practical recommendations for examining the pulmonary pleura of fetuses and newborn infants using contact microscopy}; Andreeva TV; It has been found that the pleura visceralis of fetuses and neonates is consistently involved in inflammatory processes occurring in pneumonias caused by Gram-negative organisms (Citrobacter sp., Escherichia coli, Klebsiella sp., Serratia marcescens) and may display signs of infection when the pneumonia is not yet apparent . This property of the pleura as a filtration membrane may help the pathologist in the early diagnosis of infectious disorders in neonates . Recommendations are given on the excision of pulmonary pleura and the staining of its preparations for contact microscopy whereby these can be examined during or shortly after the autopsy . Morphologic features of the infections caused by the indicated organisms are detailed . Citrobacter infections, for example, show a preponderance of macrophage responses, Klebsiella-caused lesions are characterized by involvement of the lymphatic bed, while those due to S . marcescens have hemolysis in the lung tissue and pleura as their main feature. Chemotherapy, 1987, 33(3), 165 - 71 Comparative in vitro activity of carumonam (Ro 17-2301/AMA-1080), a new monobactam, and ceftriaxone against aerobic or facultative gram-negative isolates; Barclay CA et al.; Carumonam (Ro 17-2301/AMA-1080) is a new monobactam antibiotic . A comparative in vitro evaluation with ceftriaxone was undertaken against 153 gram-negative clinical aerobic or facultative bacteria, both producers and nonproducers of beta-lactamase . Results indicated that carumonam had an enhancement of activity for Pseudomonas aeruginosa, Klebsiella oxytoca, Citrobacter freundii and Enterobacter cloacae and parallelled that of ceftriaxone against Escherichia coli, Klebsiella pneumoniae, Proteus spp . and Serratia marcescens . It can be concluded that carumonam could be an alternative of interest for the treatment of patients with infections due to gram-negative strains presumably or proven to be multiresistant. Chemotherapy, 1987, 33(2), 103 - 9 Comparative in vitro antimicrobial activity of carumonam (Ro 17-2301) and its influence on the activity of other antibiotics; Hoepelman IM et al.; The antimicrobial activity of carumonam (Ro 17-2301) was compared with that of 20 antibiotics against 338 clinical isolates . Carumonam did not possess activity against gram-positive cocci, MIC90 of carumonam were less than or equal to 0.5 mg/l for Enterobacteriaceae, except for Citrobacter (less than or equal to 8 mg/l) and less than or equal to 32 mg/l for nonfermenters . It was slightly more active than aztreonam against gentamicin-resistant bacilli (MIC90 less than or equal to 64 vs greater than or equal to 256) . Combinations of carumonam with antibiotics with activity against gram-positive microorganisms were indifferent. Chemotherapy, 1987, 33(1), 28 - 39 In vitro activity of two new aryl-fluoroquinolone antimicrobial agents, difloxacin (A-56619) and A-56620 compared to that of other antimicrobial agents; Hirschhorn L et al.; The in vitro activity of difloxacin (A-56619) and A-56620, two new aryl-difluoroquinolones, was compared to that of other new quinolones and several parenteral and oral antimicrobial agents . A-56620 inhibited 90% of Enterobacteriaceae at less than or equal to 1 microgram/ml, Staphylococcus aureus 0.25 micrograms/ml, hemolytic streptococci 2 micrograms/ml, Pseudomonas aeruginosa 2 micrograms/ml, Bacteroides sp . and Clostridium at 8 micrograms/ml . A-56620 was equal or 2-fold more active than norfloxacin and ofloxacin, and 2-8-fold less active than ciprofloxacin . Difloxacin had similar in vitro activity with many isolates but usually was 2-8-fold less active than A-56620 . Both agents inhibited beta-lactamase positive Haemophilus influenzae (MIC 0.015 micrograms/ml) and Neisseria gonorrhoeae (MK less than or equal to 0.008 micrograms/ml) . Both agents were more active against streptococci and Streptococcus pneumoniae than norfloxacin, ofloxacin and enoxacin, but not more active than ciprofloxacin . They inhibited Enterobacter cloacae, Citrobacter freundii and Serratia marcescens resistant to cephalosporins and methicillin-resistant S . aureus and Staphylococcus epidermidis . Spontaneously resistant mutants were seen with Enterobacteriaceae, P . aeruginosa and S . aureus at a frequency similar to that found for other new quinolones . These agents show overall in vitro activ