Pathol Biol (Paris), 1988 May, 36(5), 557 - 61 {Our experience with ofloxacin in the treatment of osteoarticular infections}; Lopitaux R et al.; Twenty patients with osteoarticular infections, fourteen post-arthroplasty and six with osteitis, were treated with ofloxacin, usually in combination . Sixteen staphylococcus strains including eight aureus and eight coagulase negative (modal MIC and MBC: 0.5 micrograms/ml), three Escherichia coli (modal MIC and MBC: 0.06 micrograms/ml) and one Peptococcus (MIC: 0.25, MBC: 0.5) were isolated . Treatment was given at a mean dose of 9.81 +/- 2.46 mg/kg for a mean duration of 100 days . The serum concentration of ofloxacin was measured at 3.73 +/- 2.13 micrograms/ml for a dosage of 8.23 +/- 0.94 mg/kg (25 assays) and 7.42 +/- 4 micrograms/ml for 11.46 +/- 1.3 mg/kg (23 assays) . Bacteriological control was carried out nineteen times; in one case of staphylococcal osteitis, a relapse occurred on the 43rd day of treatment when the strain isolated was resistant to ofloxacin . Three patients presented adverse effects: two cases of bone and muscle pain and one cutaneous allergic reaction: treatment was withdrawn after two restarts . The antibacterial action, the good tolerance and the easy administration of ofloxacin make it a useful antibiotic in the treatment of osteoarticular infections, where a dosage of 8 mg/kg appears to be necessary, particularly in infections due to staphylococci. Pathol Biol (Paris), 1988 May, 36(5), 386 - 8 {Detection of heterogeneous Staphylococci by the Autobac system using a nafcillin disk}; Mathieu D et al.; Detection of Methicillin Resistant Staphylococcus aureus (MRSA) is still a problem for automated system users . Forty-nine strains were studied--two kinds of tests were performed: the first by using a 1.0 microgram nafcillin disk with the Autobac system, the second by testing an oxacillin disk by diffusion on Mueller-Hinton agar base complemented with natrium chloride incubated at 37 degrees C . Between the two tests, we observed a concordance for 87.8% of the strains . Six strains showed a discrepancy with the reference method . But for five of them, the Light Scattering Index (LSI) showed a decreasing sensibility near for the cut off . Whereas, only one strain is considered as susceptible . The 1.0 micrograms nafcillin disk allow better results than the 5.0 micrograms oxacillin disk in the automated system, Autobac. Biochem J, 1988 May 1, 251(3), 887 - 91 The effect of the NADPH oxidase inhibitor diphenyleneiodonium on aerobic and anaerobic microbicidal activities of human neutrophils; Ellis JA et al.; NADPH-dependent superoxide production by intact human neutrophils is inhibited by DPI (diphenyleneiodonium), when stimulated by either FMLP (N-formylmethionyl-leucyl-phenylalanine) or PMA (phorbol 12-myristate 13-acetate) . Addition of 10 microM-DPI abolished the reduction of both the FAD and the cytochrome b components of the NADPH oxidase . DPI inhibition of the oxidase was associated with defective aerobic killing of staphylococci by human neutrophils . Anaerobic killing, phagocytosis, chemotaxis and motility were relatively unaffected by 10 microM-DPI . Degranulation of the azurophil and specific granules, induced by the soluble stimuli FMLP or PMA, and by particulate stimuli was decreased by the presence of DPI . The above effects of DPI on human neutrophils are similar to those found in chronic granulomatous disease. Antibiot Khimioter, 1988 May, 33(5), 362 - 7 {Immunostimulating and protective effects of terrilytin preparations in staphylococcal infection}; Chalyi GA et al.; In mice infected with staphylococci there was observed less pronounced development of the immune response to sheep red blood cells (SRBC) than in intact animals subjected only to immunization . Administration of free terrilytin to the infected mice increased the immune response development induced by SRBC while the use of immobilized terrilytin normalized it . The supernatant liquid of the spleen cells (SLSC) from the mice treated with the free of immobilized terrilytins stimulated development of the immune response to SRBC in the infected animals and inhibited the function of the suppressor cells in the spleen . The immunomodulating and protective effects of the SLSC fractions isolated with column chromatography on Sephadex G-150 were investigated . Substances of the low molecular fraction of the SLSC proteins (molecular weight of 10-15 kD) from the mice treated with the terrilytins showed immunostimulating and protective properties . The factors inducing both the activity types included peptides and the ribonucleotide component playing a significant role in realization of the immunostimulating and protective effects of the free and immobilized proteases. Microbiologica, 1988 Apr, 11(2), 159 - 63 Activity of several antibiotics against staphylococci; Aceti A et al.; The activity of ten antibiotics was determined against methicillin-susceptible and methicillin-resistant Staphylococcus isolates . Vancomycin, cephalothin, rifampicin and clindamycin were the most active antimicrobial agents . Considering the potential toxicity problems of vancomycin and the ability of clindamycin to increase opsonization, our data suggest that clindamycin may have a potential therapeutic use in the treatment of infections caused by methicillin-resistant staphylococci. Antibiot Khimioter, 1988 Apr, 33(4), 271 - 5 {Lytic ability, in relation to gram-positive microorganisms, of a preparation isolated from a Pseudomonas lytica culture}; Tauson EL et al.; A lytic enzyme isolated from P . lytica was studied with respect to its effect on pathogenic grampositive and gramnegative organisms . All the grampositive organisms were lyzed by the enzyme to this or that extent . The cells of staphylococci were the most sensitive . The gramnegative organisms were resistant . It was suggested that the lytic enzyme could be used in preparing drugs for treating certain skin diseases caused by pathogenic staphylococci. J Antimicrob Chemother, 1988 Apr, 21 Suppl C, 133 - 8 Molecular epidemiology of multiresistant Staphylococcus epidermidis; Archer GL; Molecular epidemiology has provided several clues about the antimicrobial resistance genes of nosocomial, multiresistant coagulase-negative staphylococci . First, it has shown that a huge reservoir of resistance genes is maintained in these organisms on the bodies of both patients and the hospital personnel who care for them . In turn, extensive use of antimicrobial agents within specific sectors of the hospital probably provides selection pressure for the evolution and amplification of these genes . Secondly, indirect evidence suggests that Staphylococcus epidermidis may itself serve as a reservoir for antimicrobial resistance genes that are transferred to S . aureus. J Clin Microbiol, 1988 Apr, 26(4), 713 - 8 Fifteen-year experience with bloodstream isolates of coagulase-negative staphylococci in neonatal intensive care; Sidebottom DG et al.; Investigators worldwide, as well as the neonatologists and infection control team at our hospital, have reported that the incidence of coagulase-negative staphylococcal bacteremia in critically ill neonates has increased dramatically in recent years . To investigate these claims, we examined the results of all blood cultures obtained from 1970 to 1984 in our neonatal intensive care unit . Throughout this study period, coagulase-negative staphylococci were prominent blood culture isolates (crude overall incidence of 4.4 positive bacteremia workups per 100 neonates admitted; range, 2.5 to 6.7), representing 26.3 to 69.6% of all positive cultures . There was no significant increase in incidence over time by analysis of linear trend . Detailed analysis of data from 1976 and 1982 (two selected years for which complete information concerning culturing practices and patient characteristics was available) revealed that these observations were not explained by changes in the frequency of blood culturing . In both 1976 and 1982, the probability that a blood culture would grow coagulase-negative staphylococci increased steadily from 2 to 3% shortly after admission to reach a level of about 12% in week 3 of hospitalization, before declining to an intermediate level thereafter . This pattern is more consistent with nosocomial bacteremia than with contamination of blood cultures . Contrary to clinical reports, coagulase-negative staphylococci have been the principal pathogens isolated from blood cultures in our neonatal intensive care unit since at least 1970, with no measurable increase over the subsequent 14 years. J Infect Dis, 1988 Apr, 157(4), 723 - 30 Purified capsular polysaccharide-induced immunity to Staphylococcus aureus infection; Lee JC et al.; In this study, we determined that immunization with capsular polysaccharide from Staphylococcus aureus could protect mice against nonlethal infections induced by encapsulated staphylococci . We immunized mice with either formalin-killed bacteria or purified capsular polysaccharide (PCP) and challenged them with one of three related S . aureus strains that varied in capsule size . Quantitative cultures of blood and kidney from the animals were performed to evaluate protection . Immunization with whole bacteria protected mice against infection with the homologous strain . Mice immunized with PCP were protected when challenged intravenously with either a highly encapsulated S . aureus strain or a microencapsulated mutant but not with an unencapsulated mutant . Protection correlated with capsular antibody levels in the immunized animals . Immunity to staphylococcal infection could be passively transferred to naive animals by using immune serum . These experiments suggest that the S . aureus capsular polysaccharide merits further study as a potential vaccine candidate for preventing staphylococcal infection. J Pediatr Surg, 1988 Apr, 23(4), 359 - 61 Acute suppurative thyroiditis caused by Eikenella corrodens; Queen JS et al.; Eikenella corrodens is a slow-growing facultative anaerobe present in the normal oral flora . Two children have been described with acute suppurative thyroiditis with E corrodens as the major pathogen . Staphylococci are the most frequently identified pathogens in acute suppurative thyroiditis . Penicillin or ampicillin are the drugs of choice for infections caused by E corrodens . Anatomic defects should be searched for in children with acute suppurative thyroiditis. J Antimicrob Chemother, 1988 Apr, 21 Suppl C, 9 - 17 The development of antimicrobial resistance in staphylococci; Thornsberry C; Staphylococci are among the most important aetiological agents of both community- and hospital-acquired infections . Staphylococcus aureus isolates resistant to penicillin because they produced beta-lactamase were isolated soon after the introduction of penicillin as a therapeutic agent . The production of beta-lactamase was mediated by a plasmid . The incidence of penicillin resistance in S . aureus increased during the succeeding decades until most clinical isolates were resistant to penicillin . During the 1940s and 1950s resistance to other antimicrobial agents was also demonstrated, usually in combination with penicillin resistance, thus creating multi-resistant strains . Methicillin, a penicillin that was essentially resistant to staphylococcal beta-lactamase, was introduced into clinical use in the early 1960s and this alleviated much of the problem of antimicrobial resistance in S . aureus, but methicillin-resistant strains were soon isolated . Although methicillin-resistant staphylococci had been a nosocomial problem in Europe in the 1960s and early-1970s, it was not until the mid-1970s that they became a problem in the United States . Since then the incidence of methicillin-resistant S . aureus has steadily increased . The methicillin-resistant S . aureus strains are usually multi-resistant including the beta-lactams and one or more of the following: aminoglycosides, macrolides, lincosamides, tetracyclines (usually not minocycline), and chloramphenicol . The methicillin-resistant S . aureus are generally susceptible to vancomycin, teicoplanin, rifampicin, coumermycin, minocycline, the quinolones, and sulphamethoxazole-trimethoprim . The coagulase-negative staphylococci are also important aetiological agents of nosocomial infections and the incidence of these infections has increased in recent years.(ABSTRACT TRUNCATED AT 250 WORDS) J Antimicrob Chemother, 1988 Apr, 21 Suppl C, 139 - 48 New considerations in the pathogenesis of coagulase-negative staphylococcal foreign body infections; Peters G; Coagulase-negative staphylococci are the predominant cause of foreign body infections . The pathogenesis is related to the ability of these staphylococci to adhere to and grow on polymer surfaces and to produce an extracellular slime substance . The exact chemical nature of this extracellular slime substance is still not known, although there is some evidence that it may be a complex glycoconjugate . On the basis of in-vitro and animal data, the extracellular slime substance seems to interfere with various host-protective mechanisms and with the action of antistaphylococcal antibiotics . These factors can explain several clinical characteristics of coagulase-negative staphylococcal foreign body infections. J Infect Dis, 1988 Apr, 157(4), 713 - 22 Isolation and characterization of a capsular polysaccharide adhesin from Staphylococcus epidermidis; Tojo M et al.; We isolated a polysaccharide adhesin from Staphylococcus epidermidis strain RP-62A . The adhesin was composed of a complex mix of monosaccharides (with galactose and glucosamine predominating), bound well to silastic catheter tubing, inhibited adherence of strain RP-62A to catheters, and elicited antibodies that both blocked adherence and stabilized an extracellular structure (visualized by transmission electron microscopy) that appeared to be a capsule . Two of three heterologous, highly adherent strains of coagulase-negative staphylococci also produced this adhesin, and their adherence to catheters was inhibited by both purified adhesin and antibody to adhesin . In contrast, the adherence of one highly adherent and two poorly adherent heterologous strains was unaffected by the RP-62A purified adhesin or antibody, a result suggesting the expression of alternate adhesins by these strains . We conclude that the capsular polysaccharide of some strains of coagulase-negative staphylococci is an important factor in adherence to catheter tubing. Chemioterapia, 1988 Apr, 7(2), 89 - 95 Activities of human alveolar macrophages (HAMs) . Note 1: Observations on phagocytosis and bacterial killing in the presence of miocamycin; Capelli A et al.; We studied the activity of human alveolar macrophages (HAMs) obtained by bronchoalveolar lavage (BAL) from human lungs . In particular, we studied in vitro phagocytosis and bacterial killing in basal conditions and in the presence of miocamycin (MOM), a macrolide antibiotic . At a dose of 600 mg every 12 hours, MOM concentrations in the serum were 2.60 micrograms/ml 1 hour after administration and 0.75 microgram/ml 8 h after . The antibiotic cannot be assayed by the microbiological method in the acellular liquid of alveolar lavage . After penetrating the HAMs, it can be detected at a concentration of about 0.4 mcirograms/1.10(6) HAMs . MOM was able to penetrate HAM cytoplasm without altering their vitality . As a matter of fact, the Trypan blue exclusion dye test was not modified after long incubation in the presence of MOM . The HAMs, resuspended in a RPMI 1640 enriched medium, were able to phagocytize either live Staphylococci or inert Latex beads of 1 micron . MOM stimulated the HAM phagocytosis on both Staphylococci and Latex beads . The increase in Latex phagocytosis, a relatively inert substance on which MOM should not be active, is a confirmation of the antibiotic's directed stimulation of the HAMs . Finally, we have seen that the HAMs, which were noteworthy in killing the phagocytized bacteria, were stimulated by MOM after only 30 minutes of contact with the antibiotic. J Biomater Appl, 1988 Apr, 2(4), 520 - 43 Mechanisms and clinical relevance of bacterial adhesion to polymers; Jansen B et al.; The mechanisms of bacterial adhesion to polymers with regard to their significance in the development of foreign-body infections are discussed . The morphological, physico-chemical and biological aspects are treated with special emphasis on the adhesion of coagulase-negative staphylococci to medical polymers . Strategies for the prevention of bacterial adhesion to biomaterials by developing antiadhesive polymers are given. Eur J Clin Microbiol Infect Dis, 1988 Apr, 7(2), 270 - 3 Typing of coagulase-negative staphylococci isolated from foreign body infections; Schumacher-Perdreau F et al.; Twenty-six coagulase-negative staphylococci isolated from patients with various foreign body infections were characterised using different typing systems . Staphylococcus epidermidis was the most predominant species found . Phage typability was below 50% in all strains . The strains showed differences in surface properties--relative hydrophobicity or hydrophilicity--and ability to adhere to polystyrene with subsequent slime production (adherence tube test) . Protein and polypeptide profiles as well as plasmid profiles demonstrated the heterogeneity of the strains . Thus, this preliminary study indicates that all coagulase-negative staphylococci of human origin may become involved in foreign body infections. Eur J Clin Microbiol Infect Dis, 1988 Apr, 7(2), 161 - 6 Surface hydrophobicity and opsonic requirements of coagulase-negative staphylococci in suspension and adhering to a polymer substratum; Pascual A et al.; The opsonic requirements for phagocytosis in suspension of 38 clinical isolates of coagulase-negative staphylococci recovered from neonates with septicemia were found to be related to the degree of surface hydrophobicity of these strains . Sixteen isolates were adequately opsonized only in the presence of complement; this group was significant more hydrophobic (p less than 0.001) than the 22 strains not requiring complement for efficient uptake in suspension . Evidence showed that hydrophobic groups present on the bacterial surface may interfere with IgG opsonization . In contrast, IgG sufficed as an opsonin without complement being required for the efficient uptake of these hydrophobic strains when adhering to a polymer surface. Clin Microbiol Rev, 1988 Apr, 1(2), 173 - 86 Methicillin-resistant staphylococci; Chambers HF; Strains of staphylococci resistant to methicillin were identified immediately after introduction of this drug . Methicillin-resistant strains have unusual properties, the most notable of which is extreme variability in expression of the resistance trait . The conditions associated with this heterogeneous expression of resistance are described . Methicillin resistance is associated with production of a unique penicillin-binding protein (PBP), 2a, which is bound and inactivated only at high concentrations of beta-lactam antibiotics . PBP2a appears to be encoded by the mec determinant, which also is unique to methicillin-resistant strains . The relationships between PBP2a and expression of resistance and implications for the mechanism of resistance are discussed . The heterogeneous expression of methicillin resistance by staphylococci poses problems in the detection of resistant strains . Experience with several susceptibility test methods is reviewed and guidelines for performance of these tests are given . Treatment of infections caused by methicillin-resistant staphylococci is discussed . Vancomycin is the treatment of choice . Alternatives have been few because methicillin-resistant strains often are resistant to multiple antibiotics in addition to beta-lactam antibiotics . New agents which are active against methicillin-resistant staphylococci are becoming available, and their potential role in treatment is discussed. J Antimicrob Chemother, 1988 Apr, 21 Suppl C, 107 - 14 Current concepts in the treatment of staphylococcal meningitis; Quintiliani R et al.; As natural host defences are suboptimal in cerebrospinal fluid (CSF), and since antibiotics often penetrate poorly into this body site, meningitis remains one of the most difficult infections to cure . When the responsible pathogen is killed only by a relatively high concentration of an antibiotic, or is susceptible only to drugs with moderate penetration into the CSF, then treatment becomes even more complicated . Therapy of staphylococcal meningitis poses all these problems, and is even further complicated by its frequent development in the presence of a foreign body, such as a ventriculoperitoneal or ventriculoatrial shunt . In this review, we discuss the various options open to the clinician in the treatment of meningitis caused by methicillin-susceptible and methicillin-resistant staphylococci, both in the presence and in the absence of a foreign device. J Antimicrob Chemother, 1988 Apr, 21(4), 417 - 24 In-vitro teicoplanin-resistance in coagulase-negative staphylococci from patients with endocarditis and from a cardiac surgery unit; Moore EP et al.; Among 31 strains of coagulase-negative staphylococcus (CNS) causing endocarditis in individual patients, 16 had MIC of teicoplanin greater than or equal to 8 mg/l (MIC50, 8; MIC90, 8; MIC range, 0.5-32 mg/l); and 24 had MBC greater than or equal to 16 mg/l (MBC50, 32; MBC90, 64; MBC range, 4-128 mg/l) . Greater sensitivity was shown to vancomycin (MIC50, 2; MIC90, 4; MIC range, 1-8 mg/l; MBC50, 2; MBC90, 4; MBC range, 0.5-8 mg/l) . Teicoplanin-resistant CNS (MIC, greater than or equal to 8 mg/l) were detected in the anterior nares of two of three patients and six of nine staff, and in the air, of a cardiac surgery unit, and in other series of CNS of clinical origin . The results of in-vitro sensitivity testing of CNS to teicoplanin are dependent on the media and conditions used, and their clinical significance has not been determined . Nevertheless, the findings reported here put in question the use of teicoplanin alone as prophylaxis during valve replacement surgery. J Hosp Infect, 1988 Apr, 11 Suppl B, 21 - 6 Studies on perioperative skin flora; Newsom SW et al.; Chlorhexidine in spirit is used to reduce the skin bacterial load before surgery; and recently prewashing with chlorhexidine scrub has been advocated . We describe three studies on cardio-thoracic surgical patients--particularly those having coronary artery grafts with long leg and sternal wounds . Two studies compared prewashes with chlorhexidine scrub (Hibiscrub-ICI) or soap . Study Number One (250 patients per group) was of wound infections; and Number Two (25 patients per group) was of alterations in skin flora for 10 days postoperation . Chlorhexidine scrub failed to reduce overall wound infection rates in Study 1, although leg wounds healed more quickly with less inflammation . Study Two showed that the scrub had a significant effect on skin flora that lasted at least 3 days postoperation . Study Number Three was of 100 patients (no chlorhexidine scrub) examined for methicillin-resistant coagulase-negative staphylococci (MRSE) by cultures of swabs from the leg, sternum and chest drain site before and after operation on methicillin agar . Three per cent of patients had MRSE preoperation (1 doctor) and 23% postoperation . One thousand strains were tested by agar dilution against methicillin and chlorhexidine . MRSE had a 2-8-fold increased resistance to chlorhexidine compared to a greater than 256-fold to methicillin . Thus although chlorhexidine has a marked persistent effect on skin flora, emergence of major resistance is unlikely . Use of postoperative chlorhexidine should be investigated further. J Immunol, 1988 Apr 1, 140(7), 2334 - 9 The superoxide generating system of B cell lines . Structural homology with the phagocytic oxidase and triggering via surface Ig; Maly FE et al.; EBV-transformed B lymphocyte cell lines (EBV-BLCL) produce superoxide after stimulation with phorbol ester, a capacity unique among nonmyeloid cells . The superoxide producing system of EBV-BLCL (B cell oxidase) was compared with the phagocytic NADPH-oxidase and the relationship of the capacity to produce superoxide to the presence of the EBV-genome was analyzed . The two EBV-transformed B cell lines F1 and HELL generated superoxide in response to PMA (2.3 nmol/10(6) F1 cells x 1 h and 6.27 nmol/10(6) HELL cells x 1 h with 1 microgram/ml of PMA), whereas no superoxide release was detected with the EBV-positive Burkitt lymphoma line WIL-2 and the EBV-negative plasmocytoma line U-266 . Also, F1 and HELL showed lucigenin-dependent chemiluminescence (CL) after PMA-treatment, whereas no CL responses were detected from WIL-2 or U-266 . Further, F1 and HELL cells contained a low potential cytochrome b-245 (10.9 and 61.0 pmol/mg protein, respectively) and also a 45 kDa diphenylene-iodonium (DPI)-binding peptide, both components of the phagocytic NADPH-oxidase . In contrast, neither the cytochrome b-245 nor the 45 kDa DPI-binding peptide were detected in WIL-2 and U-266 . In addition, DPI inhibited O2- production by PMA-stimulated EBV-BLCL and polymorphonuclear granulocytes . Further, F1 line cells showed superoxide dismutase-inhibitable lucigenin-dependent CL when triggered by protein A-bearing staphylococci (Cowan strain I) or by a mAb directed against human IgG in the presence of solid-phase goat anti-mouse-Ig antibody . From a panel of eight EBV-BLCL, only five responded with CL when exposed to protein A-bearing staphylococci, whereas all showed CL when treated with phorbol ester . Inasmuch as all eight EBV-BLCL possessed surface Ig and a "functional" oxidase, their differential response to cross-linking of surface Ig may be determined by differences in signal transduction . Superoxide production by EBV-BLCL appears thus related to expression of an electron transport chain structurally homologous, if not identical, with the "phagocytic" NADPH-oxidase . Apparently, the presence of EBV-genome in B cell lines does not per se lead to expression of this oxidase . This suggests that nontransformed B cells may, at a certain differentiation stage, also express a superoxide-generating chain . From the finding of stimulation of superoxide production of EBV-BLCL via surface Ig it appears possible that also Ag may be able to trigger such B cells to production of superoxide which might have an important role in the physiology of B cells. Res Vet Sci, 1988 Mar, 44(2), 242 - 6 Biochemical properties and differentiation of coagulase-positive staphylococci from rooks and gulls; Hajek V et al.; Coagulase-positive staphylococci were found in the throats of 46 rooks (69 per cent) and 47 gulls (21 per cent) out of totals of 67 and 229 birds, respectively . Of 111 strains isolated from throat swabs 86 (77.5 per cent) were classified as Staphylococcus aureus and 25 strains (22.5 per cent) as Staphylococcus intermedius . Of the S aureus strains 82 per cent from rooks and 50 per cent from gulls were biotyped . Most of them were identified as biotypes D and B, only a few as biotype A, and none as biotype C . Moreover, among the 24 S intermedius strains (96 per cent) biotypes 1 and 2 could be differentiated according to the type of growth on crystal violet agar and their ability to produce acetoin and acid from maltose, mannitol and trehalose. Onderstepoort J Vet Res, 1988 Mar, 55(1), 73 - 4 Aerobic metabolism of trehalose in the taxonomy of coagulase negative staphylococci; Erasmus JA; Comparative assays demonstrated that the probability of error was 12.1% when testing the aerobic fermentation of trehalose by coagulase negative staphylococci when this carbohydrate was added to the medium prior to sterilization whereas the error was only 2.7% in media if filtered trehalose was added subsequent to steam sterilization of the medium. Res Vet Sci, 1988 Mar, 44(2), 247 - 50 Phage typing coagulase-positive staphylococci from rooks and gulls; Hajek V et al.; Phage typing was performed on 86 strains of Staphylococcus aureus and 25 strains of Staphylococcus intermedius from rooks and gulls with human, bovine, chicken and canine phages . Eighty per cent of the S aureus strains and 64 per cent of the S intermedius strains were typable . The S aureus biotype D strains of rook origin were specifically lysed at routine test dilution (RTD) by chicken phages from groups I or I + IV, by human phages belonging to groups I and M, and partly by canine phage 58 . The other rook and gull S aureus strains did not show characteristic phage patterns . The S intermedius strains isolated from both species of birds could be typed only with canine phages and this correlated with their classification into biotypes . All the biotype 1 strains tested but only two of 12 biotype 2 strains were lysed with canine phages at RTD. J Dairy Sci, 1988 Mar, 71(3), 780 - 7 Phagocytic activity of milk leukocytes during chronic staphylococcal mastitis; Niemialtowski M et al.; Receptors for IgG on milk leukocytes were detected by rosette formation using sensitized erythrocytes . The percentage (41) of milk leukocytes from uninfected glands forming sensitized erythrocyte rosettes was significantly greater than the percentage (13) of leukocytes from glands with chronic staphylococcal mastitis . A greater percentage of polymorphonuclear leukocytes than macrophages formed sensitized erythrocyte rosettes, regardless of the infection status of the gland from which they were obtained . Both IgG-receptor and nonimmunologic receptor-mediated phagocytosis were greater for milk leukocytes from uninfected glands than for milk leukocytes from chronically infected glands . Preincubation of normal milk leukocytes in whey prepared from mastitic milk resulted in a decrease in their capacity to form sensitized erythrocyte rosettes as well as a reduction in their phagocytic capacity . Immune complexes prepared in vitro also reduced the phagocytic capacity of normal milk leukocytes and inhibited their capacity to form sensitized erythrocyte rosettes . These data indicate a factor, possibly consisting of immune complexes, was present in secretions from glands chronically infected with staphylococci . This factor reduced the phagocytic capacity of milk leukocytes. Chemioterapia, 1988 Feb, 7(1), 46 - 8 The treatment of staphylococcus peritonitis in patients on continuous ambulatory peritoneal dialysis; Drinovec J et al.; The aim of this prospective, randomized, open study was to survey the frequency course and to evaluate the therapy of peritonitis induced by staphylococci in patients on continuous ambulatory peritoneal dialysis (CAPD) . From June 1983 to November 1986, 20 patients (9 men, 11 women) aged from 25 to 73 were treated . During 258 months of the CAPD treatment they had 54 episodes of peritonitis . Staphylococcus saprophyticus was the most frequent offender of peritonitis, isolated from peritoneal effluent in 44% of the cases, Staphylococcus epidermidis was isolated in 7% of the cases . Staphylococcus aureus was isolated in 5% of the cases and caused a more severe form of peritonitis . The combination of gentamicin and methicillin was used in 14 cases, in 2 cases this treatment was unsuccessful . A combination of gentamicin and cloxacillin was used in 5 cases and a combination of clindamycin and mezlocillin in 12 cases of peritonitis, giving good results in all cases . The last combination seemed to be the most effective in the treatment of staphylococcus induced peritonitis. Appl Environ Microbiol, 1988 Feb, 54(2), 566 - 9 A quantitative study of enterotoxin production by sheep milk staphylococci; Bautista L et al.; Of 124 staphylococcal strains isolated from sheep milk, 78 produced enterotoxin A, B, C, or D when evaluated by an enzyme-linked immunosorbent assay . Enterotoxins A and D, elaborated by 44 and 43 strains, respectively, showed the highest incidence . Enterotoxin production by coagulase-negative strains (one Staphylococcus cohnii, three S . epidermidis, five S . haemolyticus, and four S . xylosus) was detected . Linear and logarithmic-logarithmic regressions of optical density on enterotoxin concentration yielded the best-fitting equations for enterotoxin quantitation . A significantly higher incidence of enterotoxin producers and significantly higher levels of enterotoxins produced were recorded for coagulase-positive, thermostable nuclease-positive, hemolysis-positive, or mannitol-positive strains . Mannitol utilization was the best test for discriminating between enterotoxigenic and nonenterotoxigenic staphylococci. Br J Surg, 1988 Feb, 75(2), 168 - 70 Staphylococcus epidermidis as a cause of postoperative wound infection after cardiac surgery: assessment of pathogenicity by a wound-scoring method; Wilson AP et al.; Wound infection after clean surgery prolongs hospital stay but the organism most commonly isolated from wound discharge, Staphylococcus epidermidis, is often dismissed as a contaminant or commensal . The wounds of 517 patients were assessed, after cardiac surgery, by a wound-scoring method ('ASEPSIS') and a close comparison was made of the appearance and clinical outcome of 89 wounds, from which bacteria were isolated . There was no significant difference in the scores of 49 wounds, where S . epidermidis was the sole isolate (9.5 per cent of all wounds, 95 per cent CI 6.9-12.0 per cent), and 13 wounds infected with Staphylococcus aureus (2.5 per cent, 95 per cent CI 1.2-3.9 per cent) . Repeat cultures were obtained from 21 of the 49 wounds and, in 16 of these, the second isolate showed the same biochemical reactions and antibiotic resistance pattern as the first . Infection of sternal wounds is commoner with coagulase-negative staphylococci than with S . aureus and, clinically, is just as severe. APMIS, 1988 Feb, 96(2), 133 - 40 Studies on clinical isolates of coagulase-negative staphylococci resistant to methicillin . Evidence of cross-resistance between methicillin and cephalothin; Hansen-Nord M et al.; The in vitro susceptibility to cephalothin and cefuroxime of 195 isolates of methicillin-resistant coagulase-negative staphylococci was determined by the agar-diffusion test, using 7.5% NaCl-supplemented agar . The distribution of the inhibition zone diameters for isolates of S . epidermidis (S . biotype 1) as well as for S . haemolyticus (S . biotype 4) was trimodal . While 4% of the isolates were found susceptible to cefuroxime, 39% of the S . epidermidis/S . hominis (S . biotype 1) isolates and 34% of the S . haemolyticus (S . biotype 4) isolates were found susceptible to cephalothin by this method . Eight of these isolates (six S . epidermidis, two S . haemolyticus) were selected for susceptibility testing by the tube-dilution method, together with four isolates (three S . haemolyticus, one S . epidermidis) found resistant to cephalothin by the agar-diffusion test . The first-mentioned isolates were all found susceptible to cephalothin with MICs less than or equal to 2 micrograms/l, while the last-named all were resistant with MICs greater than or equal to 16 micrograms/ml . Population analyses revealed sub-populations of highly resistant bacteria in all methicillin-resistant isolates of S . epidermidis (S . biotype 1), as well as in all isolates of S . haemolyticus (S . biotype 4) . We thus concluded that methicillin-resistance in isolates of coagulase-negative staphylococci implies resistance to cephalosporins and that the difference between S . epidermidis and S . haemolyticus as regards cephalosporin-susceptibility is quantitative and not qualitative . Eighty-nine per cent of the 195 methicillin-resistant isolates in this study were resistant to penicillin and at least one more antibiotic . We therefore think that resistance to penicillin and one or more non-beta-lactam antibiotics strongly suggests methicillin-resistance and that such isolates should be further tested on hypertonic media. Arch Dermatol, 1988 Feb, 124(2), 209 - 15 In vitro and in vivo antistaphylococcal activity of human stratum corneum lipids; Miller SJ et al.; Despite the assumption that sebum-derived fatty acids are responsible for cutaneous antimicrobial defense, no studies have assessed the contribution of epidermis-derived lipids . Herein, we tested the antistaphylococcal effects of human stratum corneum lipids, enriched in endogenous, keratinocyte-derived species obtained by lipid extraction and thin-layer chromatography, for antimicrobial activity in both in vitro and in vivo systems . Whereas the most potent species in vitro were the free fatty acids, polar lipids and glycosphingolipids also demonstrated antistaphylococcal activity in vitro, while other neutral lipids displayed virtually none, results that were confirmed with authentic standards in vitro . In a pilot study on delipidized forearm test sites in human volunteers, naturally occurring free fatty acids, polar lipids, and glycosphingolipids exhibited significantly more antistaphylococcal activity than other stratum corneum lipids or vehicle controls . Finally, biopsy specimens of incubated skin sites demonstrated penetration of staphylococci through lipid-enriched intercellular domains . These results provide the first evidence that endogenous, epidermis-derived skin lipids may contribute to cutaneous antimicrobial resistance. J Immunol, 1988 Feb 1, 140(3), 949 - 53 Nonpurulent response to toxic shock syndrome toxin 1-producing Staphylococcus aureus . Relationship to toxin-stimulated production of tumor necrosis factor; Fast DJ et al.; Infection of surgical wounds with toxic shock syndrome toxin 1 (TSST-1)-producing Staphylococcus aureus does not usually elicit a purulent response from the host . Because S . aureus is normally a pyogenic pathogen, this phenomenon suggests that strains of staphylococci that produce the exotoxin are able to inhibit the migration of polymorphonuclear neutrophils (PMN) to sites of infection . We have considered that inhibition of leukocyte migration may be an effect of secreted TSST-1 and have studied direct and indirect effects of the exotoxin on migratory functions of PMN in vitro . Preincubation of PMN with TSST-1 produced no inhibition of random motility or FMLP- or C5a-stimulated chemotaxis under agarose . Supernatant fluids from mononuclear leukocytes incubated with TSST-1, however, were potently inhibitory for both PMN random and chemotactic migratory functions . The inhibitor of migration was identified as TNF based upon neutralization by anti-TNF antiserum and its presence in the culture supernatant fluids assayed in terms of cytotoxicity for murine TNF-sensitive L-929 cell line cells . Preincubation of PMN with recombinant human TNF also inhibited subsequent PMN random and chemotactic migratory functions . We propose that TSST-1 inhibits the mobilization of PMN to sites of infection by stimulation of monocyte/macrophage TNF production and suggest that TNF may also contribute to some other effects of toxic shock syndrome. Pathol Biol (Paris), 1988 Feb, 36(2), 121 - 6 {Use of cultured epidermis of human origin for demonstrating the acantholytic action of staphylococcal exfoliatin A}; Gentilhomme E et al.; Cultured human epithelia obtained from epidermal cells in vitro were used to assay the activity of staphylococcal epidermolytic toxin and develop an in vitro experimental model for the staphylococcal scalded skin syndrome . Human epidermal cells were grown from single epidermal cell suspensions obtained through trypsinization of adult normal skin into multilayered epithelia (with a basal cell layer, several intermediate and one or two upper layers) on mouse 3T3 feeder cells . First passage cultures were incubated with exfoliative toxin A from phage Group II staphylococci at various concentrations in DMEM . They were examined at various time intervals by direct microscopic and histological examination of respectively the culture plates or the epidermal sheets after their detachment from the plates with dispase grad II . A total exfoliation could be obtained at 24 hour at concentrations of Img and 500 micrograms/ml, only local areas of epidermolysis noted at 100 micrograms/ml . The intraepithelial separation was noted to occur between the basal layer and the lowest intermediate layer . No exfoliation could be observed at lower concentrations . Up to 4-5 hours few changes were evident, but at this time small areas of epidermolysis developed . With exfoliatin 100 micrograms/ml, intraepidermal blisters were clearly visible, occurring either between the basal cells and the lowest intermediate layer or between the first two intermediate cell layers . At the ultrastructural level, desmosomes were sparse and altered, with enlargement of the intercellular spaces and condensation of tonofilaments . These data indicate that human epidermal cell cultures, although their differentiation in culture only mimics what occurs in vivo, can be used as an in vitro model of the staphylococcal TEN to further investigate the site of action of such a toxin and the cellular mechanism responsible for the syndrome. Am J Kidney Dis, 1988 Feb, 11(2), 176 - 9 Evaluation of the lysis-centrifugation system for culturing dialysates from continuous ambulatory peritoneal dialysis patients with peritonitis; Forbes BA et al.; Recovery of organisms from continuous ambulatory peritoneal dialysis (CAPD) patients with peritonitis presents special problems to the laboratory . The Isolator (Dupont Co, Wilmington, DE), based on lysis and centrifugation, is generally used for the recovery of blood isolates . This study determined the efficacy of the Isolator relative to the Bactec System (Johnston Laboratories, Inc, Towson, MD) for the culture of dialysates from CAPD patients with peritonitis . On the basis of clinical criteria, 31 episodes of peritonitis were included for our study . Dialysate was inoculated into an Isolator and Bactec 6B and 7D bottles . A causative agent was isolated by the Isolator in 29 of 31 episodes, by the Bactec in 29 of 31, and by one or both techniques in 30 of 31 episodes (overall sensitivity 97%) . The Isolator failed to detect a Pseudomonas luteola and the Bactec failed to detect a coagulase-negative staphylococcus . Coagulase-positive and negative staphylococci represented 58.1% of the isolates . The Isolator detected 21.4% (six of 28) of the isolates 24 to 72 hours earlier than the Bactec; the Bactec was faster in this regard in 3.6% (one of 28) . Time to positivity for the remaining 21 cultures was the same in both systems . Isolate identification and antimicrobial sensitivity was available 24 hours earlier using the Isolator in 96.4% (27 of 28) . The Isolator was more rapid and as sensitive as the Bactec system in detecting causative organisms of peritonitis in CAPD patients. Eur J Clin Microbiol Infect Dis, 1988 Feb, 7(1), 30 - 3 Development of the quantitative micro-test for slime production by coagulase-negative staphylococci; Pfaller M et al.; The macro-test for slime production by coagulase-negative staphylococci was adapted to a spectrophotometric micro-test assay to obtain more objective and quantitative information on slime production . A total of 135 isolates of coagulase-negative staphylococci (70 macro-test-positive and 65 macro-test-negative) were tested by both methods . The quantitative micro-test optical density readings were (mean +/- SD) 1.176 +/- 0.294 and 0.130 +/- 0.095 for the macro-test-positive and -negative groups, respectively . The micro-test was reproducible and demonstrated quantitative differences in slime production among the different species of coagulase-negative staphylococci . Aside from Staphylococcus epidermidis, the majority of the coagulase-negative staphylococci had very low optical density readings, indicating little or no slime production under the conditions employed in this assay . This test allows one to study the relative production of slime by different strains and species of coagulase-negative staphylococci, and may be useful in studying the effects of different conditions, such as antibiotic exposure, on slime production. Antimicrob Agents Chemother, 1988 Feb, 32(2), 202 - 8 Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antimicrobial prophylaxis; Kernodle DS et al.; By use of techniques that have been developed to detect small numbers of methicillin-resistant staphylococci, we cultured samples from the nares and subclavian and inguinal areas of 29 patients before and after cardiac surgery and 10 patients before and after coronary angioplasty . Methicillin-resistant coagulase-negative staphylococci were recovered before the surgical or angioplasty procedure from 74% of patients . The quantitative recovery of methicillin-resistant isolates before cardiac surgery or coronary angioplasty was compared with the number of methicillin-resistant staphylococci detected at the same site 3 days after the procedure . In cardiac surgery patients (who received antibiotic prophylaxis), 17 of the 28 sites (61%) in which low-level colonization with methicillin-resistant strains was detected preoperatively contained high levels of methicillin-resistant staphylococci postoperatively . In contrast, coronary angioplasty patients (who did not receive antibiotic prophylaxis) did not have any of the 14 sites containing low levels of methicillin-resistant strains before angioplasty emerge to harbor high levels of methicillin-resistant staphylococci after angioplasty . Methicillin-resistant coagulase-negative staphylococci from each site in which high levels of methicillin-resistant staphylococci emerged postoperatively were paired with preoperative isolates from the same site . Identical antibiograms and plasmid profile patterns were demonstrated for seven of the pre- and postoperative isolate pairs, suggesting that the high levels of methicillin-resistant coagulase-negative staphylococci detected on the skin or in the nares after cardiac surgery were derived from methicillin-resistant organisms present at the site preoperatively in much smaller numbers. Br J Dermatol, 1988 Feb, 118(2), 203 - 8 The microbial colonization of inflamed acne vulgaris lesions; Leeming JP et al.; Seventy one papules in the early stages of inflammatory development were isolated from acne vulgaris affected skin and their content of micro-organisms characterized . The progress of lesions prior to excision was monitored by tracing an area of the upper back onto a transparent acetate sheet . This template was used the next day, and in some cases after 3 days, to identify inflamed lesions of less than 1 day and 2-3 days duration . These were biopsied, and pilosebaceous units isolated by micro-dissection, homogenized and microbial populations studied by viable counting and microscopy . Propionibacteria colonised 68% of '1 day' duration lesions and 79% of '3 day' duration lesions; staphylococci colonized 19% and 32% respectively and Pityrosporum spp . (Malassezia furfur) were found in 52% and 68% . Although the prevalence of each microbial group was higher in the more chronic lesions, these differences were not statistically significant . The microbial profile of inflamed lesions was similar both qualitatively and quantitatively to non-inflamed lesions studied previously . These results call into question the role of micro-organisms as the initiators of inflammation in acne vulgaris. J Hosp Infect, 1988 Feb, 11 Suppl A, 109 - 15 Staphylococcal infections in hospital: the Greek experience; Kosmidis J et al.; Resistance rates of various species to many antimicrobials are very high in Greece . Mean resistance rates of Staphylococcus aureus isolated in 12 Athens hospitals in the second half of 1986 were 80% for penicillin, 32% for methicillin, 22% for gentamicin, 27% for erythromycin, 17% for lincomycin and 16% for co-trimoxazole . In a prospective study in the General Hospital of Athens from May to July 1987, 40 coagulase-positive staphylococcal strains were isolated from various materials from inpatients . Of these 78% were resistant to penicillin, 50% to methicillin at 37 degrees C, 62% to methicillin at 30 degrees C, 38% to erythromycin, 32% to tobramycin, 15% to clindamycin, 15% to fusidic acid, 9% to amikacin, 5% to netilmicin and 0% to vancomycin . Ten of these strains (seven methicillin-resistant) were responsible for severe infections and three of the affected patients died (two nosocomial pneumonias, one infected burn, all due to methicillin-resistant strains) . Another 11 strains (eight methicillin-resistant) were responsible for mild infections . From 41 coagulase-negative staphylococci isolated from inpatients, seven (five methicillin-resistant) were held responsible for mild infections . Of the 20 patients with infections due to methicillin-resistant strains, nine had previously received a beta- lactam antibiotic . Staphylococci are not responsible, however, for a large proportion of infections in our hospital at the moment . High resistance rates in Greece are due to overuse of antibiotics, a phenomenon attributed to a consumer's society behaviour of doctors and patients. J Hosp Infect, 1988 Feb, 11 Suppl A, 103 - 8 Staphylococcal infection in Malaysian hospitals; Lim VK; Staphylococcal infection is common in Malaysian hospitals . A recent survey of 22 Malaysian hospitals revealed that staphylococci were isolated from almost 40% of positive blood cultures . A more detailed analysis of such cases in our own hospital showed that almost 70% of Staphylococcus aureus and about 16% of coagulase-negative staphylococcal isolates were associated with clinically-significant disease . Staphylococcal bacteraemia was seen mainly in neonatal sepsis, skin and soft tissue infections, pneumonia, arthritis, osteomyelitis, endocarditis and postoperative sepsis . Multiply-resistant S . aureus were encountered in all the hospitals surveyed . Resistance rates to penicillin ranged from 40% to almost 100% while methicillin resistance rates of up to 25% were reported from several hospitals. Zentralbl Mikrobiol, 1988, 143(2), 157 - 71 {Coagulase-negative Staphylococcus species in mixed fodder and on grain}; Pioch G et al.; For valuation of microbially-altered combined fodder from the veterinary point of view beside the total number of germs also the diagnosis of the species of veterinary relevant indicator germs is of importance . Coagulase-negative staphylococci are the main and indicator flora in spoiling of combined fodder . According to the biochemical and physiological characterization the majority of the coagulase-negative staphylococci occurring in connection with spoiling of combined fodder belongs to the species S . xylosus . Beside the species also other coagulase-negative species as S . sciuri, S . cohnii, S, warneri and S . saprophyticus have been demonstrated . These bacterial species were also found in the single components of combined fodder as ripe grain, green unripe cereal plants, in soil samples and in the dust inside the mills for combined fodder production. J Hyg Epidemiol Microbiol Immunol, 1988, 32(1), 59 - 69 Staphylococcus aureus at a maternity ward . II . Characterization of isolates by enterotoxigenicity and toxic shock syndrome toxin (TSST-1) production; Petras P et al.; Tests for enterotoxins A, B, C, D, E and TSST-1 production were carried out on 775 S . aureus strains isolated from various sources (50 mothers and neonates studied periodically, mothers and infants treated for various acute inflammatory conditions, members of hospital staff, environmental swabs) during the period 1981-1983 at a maternity ward chosen for a 3-year systematic study and on additional 97 isolates obtained in 1985 from another maternity ward . This had contributed to a better classification of strains within certain phage type groups . It was found that the distribution of S . aureus types in the particular sub-sets varied, depending on the source of isolates . At the maternity ward followed for 3 years there was a clear-cut trend towards the spread of phage-untypable isolates producing enterotoxin C whereas at ward examined for comparative purposes B enterotoxin producers of phage type 95 were predominant . The tests for enterotoxigenicity has also proved to be useful as the epidemiological marker characterizing the predominantly circulating S . aureus strain . It has been confirmed that the majority role in the spread of maternity-ward-staphylococci is played by the neonates and the factors of hospital environment. J Infect, 1988 Jan, 16(1), 87 - 103 Outbreak of staphylococcal scalded skin syndrome among neonates; Dancer SJ et al.; Over a period of 2 months, 12 babies born in the maternity unit at Guy's Hospital developed staphylococcal scalded skin syndrome in two distinct outbreaks . Staphylococci isolated from the babies, together with those from the mothers and attending medical staff were phage-typed . All isolates from the babies were of type 3A/3C . During the first outbreak only one carrier of the epidemic strain (a paediatrician) was found but a further 12 persons were identified as possible carriers during the second outbreak . In order to confirm the link between outbreaks, all phage group II isolates were subjected to reverse phage-typing, testing for metal-ion resistance, plasmid profiling and in-vivo testing for production of epidermolytic toxin . It was shown that the same epidemic strain of toxin-producing Staphylococcus aureus was responsible for both outbreaks . The affected neonates responded rapidly to a short course of intravenous flucloxacillin . The outbreak ceased after appropriate treatment of all carriers and the implementation of an extensive disinfection policy within the maternity unit. Biomaterials, 1988 Jan, 9(1), 107 - 10 Staphylococcal adhesion to collagen in intra-articular sepsis; Voytek A et al.; Ultrastructural studies of the cartilaginous articular surfaces of human and rabbit joints have shown that cartilage is the target substratum for adhesion by Staphylococcus aureus, leading to intra-articular sepsis . Transmission and scanning electron microscope studies demonstrated bacteria in intimate contact with acellular cartilage matrix surfaces, particularly with collagen fibres . Certain strains of Staphylococcus aureus used in these experiments reveal a high binding capacity to collagen that is derived from a cartilage matrix . These studies indicate that the pathogenesis of intra-articular sepsis is based on the ability of certain strains of staphylococci to bind preferentially to a cartilage matrix. Antimicrob Agents Chemother, 1988 Jan, 32(1), 150 - 2 In vitro evaluation of DuP 105 and DuP 721, two new oxazolidinone antimicrobial agents; Barry AL; DuP 105 and DuP 721 are two members of the oxazolidinones, a new class of synthetic antimicrobial agents with activity against gram-positive bacteria . In vitro tests compared the two new drugs with five other antimicrobial agents against 216 gram-positive isolates representing 4 genera and 10 species . DuP 721 MICs for 50% of the strains tested (MIC50s) ranged from 2.0 to 8.0 micrograms/ml, DuP 105 MIC50S ranged from 4.0 to 16 micrograms/ml, and vancomycin MIC50S ranged from 0.25 to 1.0 microgram/ml . Methicillin-resistant and -susceptible staphylococci were susceptible to ciprofloxacin, vancomycin, and DuP 721. APMIS, 1988 Jan, 96(1), 43 - 9 A rapid assay for protein-A in Staph . aureus strains, using immunomagnetic monosized polymer particles; Johne B et al.; Monosized magnetic polystyrene beads, Dynabeads M-450, coated with sheep IgG were used in an agglutination test for the detection of cell-surface protein-A, based on Fc-protein-A binding . Ninety-three per cent of the bovine Staphylococcus aureus strains isolated from clinical mastitis expressed surface protein-A . The agglutination test was rapid compared to FITC-labelled IgG binding or dog-serum agar precipitation test for protein-A, and was significantly correlated with these methods . Scanning electron micrographs demonstrated binding of protein-A positive bacteria to the particle surface, thus bridging the beads and forming the agglutination lattice . The microsphere agglutination assay described is a quick, simple and reproducible method for detecting surface protein-A in staphylococci. Pediatr Infect Dis J, 1988 Jan, 7(1), 34 - 7 Sepsis in febrile neutropenic children with cancer; Langley J et al.; Infection is the leading cause of death in children with cancer . A retrospective review of 100 episodes of sepsis in 80 children with cancer for a 21-month period showed that 74% of isolates were Gram-positive bacteria . Coagulase-negative staphylococci were the most common pathogens, accounting for 35% of all isolates . Initial empiric antibiotic therapy of fever in neutrogenic cancer patients was piperacillin and tobramycin . All but 12% of the Gram-negative isolates were susceptible to one or both of the antibiotics . However, 31% of the Gram-positive isolates were resistant to both antibiotics and 38% of the coagulase-negative staphylococci were methicillin-resistant . All of the latter were susceptible to vancomycin . The increasing incidence of coagulase-negative staphylococci as causes of sepsis in cancer patients suggests that the choice of antibiotics for initial empiric therapy may need to include vancomycin or an antistaphylococcal penicillin depending on the local incidence of methicillin resistance. Ann Thorac Surg, 1988 Jan, 45(1), 35 - 8 Influence of preoperative showers on staphylococcal skin colonization: a comparative trial of antiseptic skin cleansers; Kaiser AB et al.; We undertook a prospective randomized observer-blinded study comparing the ability of preoperative showers with chlorhexidine gluconate (Hibiclens), povidone-iodine (Betadine), and a lotion soap (Safe 'N Sure) to diminish the staphylococcal skin flora of patients . By block randomization, patients scheduled for an elective cardiac operation or coronary artery angioplasty were assigned to shower with one of the study skin cleansers either once (evening only) or twice (both evening and morning) before the procedure . Semiquantitative samples for culture were obtained from the subclavian and inguinal sites on the evening before the procedure (baseline culture) and again the next morning before the operation . The chlorhexidine skin cleanser consistently reduced staphylococcal colony counts at both the subclavian and inguinal sites before the procedure . This reduction was significant for patients showering both evening and morning (p less than 0.05) . The use of the povidone-iodine skin cleanser inconsistently affected skin flora . Patients using lotion soap either experienced no change or had an increase in colony counts . Chlorhexidine is more effective than povidone-iodine in diminishing skin colonization with staphylococci in patients before operation . Repeated applications of chlorhexidine are superior to a single shower with this agent. J Infect Dis, 1988 Jan, 157(1), 71 - 7 Characteristics of adherence to plastic tissue culture plates of coagulase-negative staphylococci exposed to subinhibitory concentrations of antimicrobial agents; Schadow KH et al.; Adherence and hydrophobic properties characteristic of 6-h cultures of coagulase-negative staphylococci on plastic tissue culture plates were determined after the organisms had been treated for up to an additional 6 h with subinhibitory concentrations of antimicrobial agents . Clindamycin, erythromycin, norfloxacin, tunicamycin, and vancomycin had no effect . Cephalothin, chloramphenicol, gentamicin, imipenem, methicillin, novobiocin, polymyxin B, rifampin, and tobramycin had varied effects . Most changes induced by these agents resulted in differing degrees of inhibition of adherence . However, an increase in adherence of 65% was observed for one strain, RP14 (ATCC 35981), with rifampin treatment . Hydrophobicity of coagulase-negative staphylococci treated with antimicrobial agents measured by using a biphasic system with hexadecane showed excellent correlation with adherence (r = .958, P less than .0005), a result suggesting that adherence of these bacteria in this system depends heavily on hydrophobic surface moieties . Transmission electron microscopy of drug-treated coagulase-negative staphylococci revealed only an increase in cell-wall thickness, regardless of whether adherence was increased or decreased. J Appl Bacteriol, 1988 Jan, 64(1), 65 - 78 Rapid selective enumeration of bacteria in foods using a microcolony epifluorescence microscopy technique; Rodrigues UM et al.; The growth patterns of microcolonies of 59 different pure cultures were studied on eight selective solid media . A method of growing microcolonies on the surface of polycarbonate membrane filters, placed on the selective agar media, followed by staining and examination by epifluorescent microscopy was developed . The patterns of growth of the pure cultures as microcolonies were studied on the eight selective media . Only four media proved to be reliable for this purpose and the relationship between the microcolony count and plate count was studied on these media together with nutrient agar . Microcolony counts using three of these media (enriched lauryl sulphate aniline blue, pseudomonas selective agar (C-F-C) and Baird-Parker medium) were capable of giving reliable estimates of coliforms (r = 0.89), pseudomonads (r = 0.93) and staphylococci (r = 0.92) after incubation at 30 degrees C for 3 or 6 h (staphylococci) at contamination levels of above 10(3) bacteria/g in a variety of foods . The results are available within a working day and should allow the more efficient management of food supplies. Acta Microbiol Hung, 1988, 35(4), 379 - 82 Staphylococcus aureus and Staphylococcus epidermidis strains differ in interleukin 2 inducing activity; Nagy ZN et al.; Heat-killed preparations of different Staphylococcus aureus and Staphylococcus epidermidis strains were compared for interleukin 2 (IL-2) inducing activity in cultures of human mononuclear cells (MNC) . S . aureus strains exhibited a strong individual variation, but they induced considerably more IL-2 than did S . epidermidis strains . Enterotoxin production, coagulase production, pigment formation and the phage type of the staphylococci showed no strict correlation of any of these properties with the IL-2 inducer activity . The results indicate that the IL-2 inducing activity may be a differential feature of S . aureus and S . epidermidis. Drugs, 1988, 35 Suppl 7, 46 - 52 Sulbactam/ampicillin versus cefotaxime as initial therapy in serious soft tissue, joint and bone infections; Loffler L et al.; In an open, randomised comparative study, 23 patients with bone, joint or soft tissue infections were treated with ampicillin 2g plus sulbactam 1g 3 times a day or cefotaxime 2g 3 times a day as an initial 2-week therapy . Monoinfections with Staphylococcus aureus were the most common bone or joint infections . Clinical cure or improvement 2 weeks after the end of therapy was observed in all 13 patients treated with sulbactam/ampicillin and in 7 of the 8 patients evaluated for efficacy after treatment with cefotaxime . Most organisms identified before the onset of therapy were susceptible to the antibiotic randomly selected for therapy, although the majority of infections due to beta-lactamase-producing staphylococci could not have been treated with ampicillin without sulbactam . Treatment failed to eradicate S . aureus in 1 patient from each group . In addition, S . aureus infection recurred in 2 patients in the cefotaxime group within 2 weeks after the end of therapy . No serious side effects were observed. Drugs Exp Clin Res, 1988, 14(12), 735 - 40 The relevance of in vitro measurements of opsonophagocytosis to the study of antibiotic-PMN-bacterium interactions in vivo; Gemmell CG; There is increasing evidence that the outcome of therapy of serious bacterial infections especially in the immuno-compromised patient depends to some extent on the efficacy of the host's reticuloendothelial system . The ability of circulating leukocytes to eradicate foci of bacteria can be influenced directly or indirectly by antibiotics . However, the measurement of such an interaction in vivo is difficult and reliance is placed on in vitro studies . Such models only partly mirror the in vivo situation but, nevertheless, their study improves our understanding of the antibiotic-bacterium-leukocyte interaction . Examples will be drawn from studies of the interaction of staphylococci with host defences under in vitro situations resembling tissue abscesses, valvular endocarditis and catheter-associated infections. Acta Obstet Gynecol Scand, 1988, 67(8), 723 - 6 Bacteriological findings and clinical symptoms in relation to clinical outcome in puerperal mastitis; Matheson I et al.; Clinical symptoms, bacterial content in breast milk and treatment were recorded in 43 women in Oslo with puerperal mastitis . Patients with a favorable (n = 35) and unfavorable outcome (n = 8) (defined as abscess formation and/or symptom relief after more than 7 days) were compared . The group with unfavorable outcome was characterized by increased delay between symptoms and time for consultation, higher score of clinical symptoms and higher frequency of Staphylococcus aureus . A higher frequency of S . aureus was found in the affected breasts than in the unaffected breasts . There was no difference concerning the frequency of coagulase-negative staphylococci and overall bacterial counts, either between milk from affected and non-affected breasts, or between milk from non-affected breasts and milk from healthy donors . The present investigation indicates that penicillin treatment is questionable when considering that untreated cases healed almost as quickly as treated ones, and that 70% of the S . aureus strains were resistant to phenoxymethylpenicillin . It is concluded that present bacterial examinations in breast milk are of limited help in deciding who needs antibiotic treatment. Chemotherapy, 1988, 34(6), 553 - 61 Study on the efficacy of nosocomial infection control (SENIC Project): results and implications for the future; Hughes JM; The purpose of the Study on the Efficacy of Nosocomial Infection Control (SENIC Project) was to evaluate nosocomial infection prevention and control programs in hospitals in the United States . The overall plan was to assess the surveillance and control activities in hospitals in the United States in 1970 and 1976, to measure the change in the nosocomial infection rates from 1970 to 1976 as determined from a carefully conducted retrospective chart review, and to assess the influence of changes in these programs on infection rates after controlling for other important changes that occurred during the interval . The SENIC 'bottom line' was that 32% of infections that would have occurred in the absence of well-organized infection surveillance and control programs were potentially preventable . However, only 6% of infections were actually being prevented by programs that existed in 1976 . The critical components of an effective program were a balance between surveillance and control efforts, one infection control nurse for every 250 beds, a trained hospital epidemiologist, and feedback of surgical wound infection rates to practicing surgeons . In the United States, priorities for nosocomial infection prevention and control efforts include infections caused by emerging pathogens such as coagulase-negative staphylococci, enterococci, and Candida species; infections of the blood stream and surgical wounds; and infections in critical-care units . In addition, there is a critical need for timely analysis and dissemination of surveillance data and for continued training of infection control practitioners and physicians to maximize the effectiveness of prevention and control efforts. Chemotherapy, 1988, 34(6), 467 - 71 Staphylococcus haemolyticus: cocarde growth around imipenem disks; Traub WH et al.; Twelve multiple-drug-resistant isolates of coagulase-negative staphylococci from diverse clinical sources, which had yielded cocarde growths (double zones of inhibition) around 10 micrograms imipenem disks, were identified as Staphylococcus haemolyticus . This was the only staphylococcal species which exhibited this unusual phenotypic trait at our institution during a 7-month observation period. J Perinatol, 1988 Summer, 8(3), 215 - 21 Colonization with slime-positive coagulase-negative staphylococci as a risk factor for invasive coagulase-negative staphylococci infections in neonates; Hall SL et al.; Mucocutaneous cultures obtained at admission and subsequent weekly nasopharyngeal cultures were obtained on 182 infants in the neonatal intensive care unit (NICU) over 3 months to assess whether a relationship existed between colonization with coagulase-negative staphylococci and invasive infection, particularly with respect to slime production . Nasopharyngeal colonization by coagulase-negative staphylococci occurred in a mean of 58% of infants weekly, with an equal prevalence of slime-positive and slime-negative isolates over time . Colonization of the nasopharynx on admission increased from 8.9% of those admitted within the first day of life to 33% of those admitted thereafter (p less than 0.005) . The presence of slime-positive coagulase-negative staphylococci on admission was not predictive of later patterns of colonization with respect to slime . Of infants not colonized on admission who had subsequent cultures, 72% became colonized with coagulase-negative staphylococci that were equally likely to be slime-positive or slime-negative . The incidence of invasive infections was 4.4% . Infants with slime-positive mucocutaneous colonization were more likely to develop invasive coagulase-negative staphylococci disease than infants with slime-negative or no colonization (8.4% versus 1.1%; p less than 0.025) . The incidence of slime-positive coagulase-negative staphylococci isolates from blood cultures was 6/7 (86%) whereas those from mucocutaneous cultures was 131/260 (50%) (p = 0.06) . Colonization with slime-positive coagulase-negative staphylococci is a significant risk factor for developing invasive coagulase-negative staphylococci disease and these organisms are responsible for the majority of coagulase-negative staphylococci invasive infections. Arkh Patol, 1988, 50(7), 17 - 23 {Effect of serum on the intra- and extracellular bactericidal capacity of neutrophils}; Sarkisov DS et al.; Donors' neutrophils are capable for inhibiting the growth of and killing staphylococci both intra- and extracellularly . In the absence of serum the rate of extracellular killing of microbes by donors' neutrophils is reaching that of killing phagocytized bacteria, while in the serum introduction the rate of intracellular killing overwhelms that of extracellular . Burnt patients' neutrophils fail to control the microbes multiplication either intra- or extracellularly without serum, while in combination with it both intra- and extracellular killing activity of neutrophils of the burnt sharply increases being superior to relevant combination of healthy subjects. APMIS Suppl, 1988, 3, 63 - 4 Pattern of bacterial resistance in the western region of Saudi Arabia; Kassimi MA; Common organisms which were isolated from patients attending the King Abdulaziz University Hospital in Jeddah were tested against antibiotics commonly used for their eradication . About 500 isolates of each bacterium were tested, showing a different resistance pattern from that obtained in Western countries . For example, methicillin resistance by staphylococci was different from that found in the United Kingdom, 100% of pneumococci were sensitive to penicillin and pseudomonas resistance to carbenicillin was only about 3% . S . typhi resistance of Chloramphenical was nil . This paper emphasizes the most appropriate antibiotic for each organism and the different pattern of bacterial resistance in Saudi Arabia as compared to that in Western countries. Microbiol Immunol, 1988, 32(5), 535 - 40 Luminol-dependent chemiluminescence in antibody-sensitized neutrophils stimulated with protein A-bearing staphylococci; Nishihara S et al.; When mouse polymorphonuclear leukocytes (PMNs) sensitized with rabbit antibody to mouse Ehrlich ascites tumor cells were stimulated by Staphylococcus aureus Cowan I cells, a conspicuous luminol-dependent chemiluminescence was observed in the absence of opsonin . The profile of the chemiluminescence (CL) response evoked by staphylococcal cells from antibody-sensitized PMNs had two peaks . An initial peak, observed within 1 min after stimulation, was sharp and high and a second peak, observed about 5 min after stimulation, was low and extended . The CL response of antibody-sensitized PMNs stimulated by S . aureus Cowan I cells was dose-dependently blocked by preincubation with soluble SpA . Cells of a mutant derived from S . aureus Cowan I strain with trace amounts of cell-bound SpA failed to stimulate the antibody-sensitized PMNs to generate the CL response . The antibody-sensitized PMNs were found to phagocytize SpA-bearing S . aureus cells even in the absence of opsonic serum . These results suggest that the observation presented here might provide a useful tool for the investigation of CL response of PMNs. Eur Surg Res, 1988, 20(1), 33 - 8 Inflammatory reaction and blood flow in experimental wounds inoculated with Staphylococcus aureus; Laato M et al.; Wound healing and granulation tissue formation can be accelerated by inoculation with live pathogenic microorganisms . For further elucidation of this phenomenon the present work was undertaken to study the effects of Staphylococcus aureus microorganisms on the inflammatory reaction and blood flow in developing granulation tissue in rats . Cylindrical hollow sponge implants were used as an inductive matrix for the growth of granulation tissue . In control animals 1 ml of wound fluid was withdrawn from the central dead space of the implant immediately after implantation and replaced with 1 ml of physiological saline . In experimental animals the implants were injected with live staphylococci, 10(2) or 10(5) microorganisms/ml . Wound fluid was analyzed 3, 7, 10 and 14 days after implantation, whereas measurements of local blood flow and albumin extravasation in the granulation tissue were made after 7 days . Implants inoculated with 10(5) organisms developed infection with pus formation while implants contaminated with 10(2) organisms showed no infection . In wound fluid specimens collected from the infected implants correlation between the number of polymorphonuclear leukocytes and prostaglandin E2 concentration was statistically significant . The most prominent finding in contaminated but uninfected implants was an enhanced local blood flow . This may explain some of the mechanisms leading to S . aureus-induced acceleration of wound healing. Nauchnye Doki Vyss Shkoly Biol Nauki, 1988, (10), 86 - 9 {Activity and characteristics of the regulation of glycolytic proteins in Staphylococcus aureus}; Vinnikov AI; Lactate has been determined to be the ground glyucolysis product in the staphylococci strains under study . Acetate and CO2 are produced in small quantities . Considerable differences in storing lactate under aerobic and unaerobic conditions have not been found . Pasteur effect reaches 20.5--23.3% . The controlling glycoysis unit study has shown that it may locate on the different sections of Embden-Meyergof-Parnas pathway . The key regulation enzyme activity of hexokinase, phosphofructokinase and pyruvatekinase has been determined. J Int Med Res, 1988 Jan-Feb, 16(1), 66 - 70 An evaluation of topical mupirocin in moderately severe primary and secondary skin infections; Buchvald J; Five days' treatment with topical mupirocin, applied twice daily, in 36 patients with moderately severe primary and secondary skin infections, resulted in resolution/much improvement of skin lesions in 75.0% of patients and bacterial eradication in 83.9% of cases . Penicillin-resistant and penicillin-sensitive staphylococci were most commonly implicated . No adverse effects were reported in any of the patients treated . Physicians' assessment of cure/improvement was recorded in 91.7% of patients. Pharmacotherapy, 1988, 8(6 Pt 2), 14S - 18S Therapeutic considerations for infections caused by Staphylococcus epidermidis; Rodvold KA; Most institutions are experiencing increased numbers of methicillin-resistant S . epidermidis infections . Currently, vancomycin is the only antibiotic that provides reliable bactericidal activity against this microorganism, including methicillin-resistant strains . Vancomycin is the treatment of choice for infections caused by methicillin-resistant staphylococci and for serious gram-positive infections in penicillin-allergic patients . With the emergence of more numerous and more serious gram-positive infections, this agent either alone or in combination with other antibiotics will clearly assume greater importance in the management of gram-positive infections, independent of host allergy or bacterial resistance . It is assuming a pivotal role in the treatment of gram-positive infections of central nervous system or dialysis shunts, endocarditis, meningitis, and septicemia . Except in patients with confirmed allergy to a beta-lactam antibiotic, vancomycin is not indicated for routine surgical prophylaxis . The current upsurge in methicillin-resistant staphylococcal infections as a complication of implant surgery may necessitate its use as a prophylactic agent, however. Drugs Exp Clin Res, 1988, 14(8), 495 - 500 Cefpodoxime proxetil, its in vitro antibacterial activity, affinity to bacterial penicillin-binding proteins, and synergy of bactericidal activity with serum complement and mouse-cultured macrophages; Yokota T et al.; Cefpodoxime proxetil (CS-807) is an orally active prodrug of an oxime-type cephem antibiotic . The MIC60 values of cefpodoxime (R-3746) the active form of CS-807, were 3.13, 6.25, 0.05, 0.38, 0.2, 0.1, 3.13, 3.13, 6.25, 6.25, 0.1 and 12.5 micrograms/ml against S . aureus, coagulase-negative staphylococci, S . pneumoniae, E . coli carrying R plasmids, P . vulgaris, P . rettgeri, C . freundii, S . marcescens, A . calcoaceticus, P . cepacia, ampicillin-resistant H . influenzae and B . fragilis, respectively . Its activity was stronger than that of cefaclor and ampicillin . R-3746 manifested little activity against P . aeruginosa, methicillin-resistant S . aureus, and Enterococcus spp . R-3746 showed stronger binding affinity than cefaclor with the PBP2 of S . aureus, PBPs 1a, 1bs, 2 and 3 of E . coli, PBPs 1b, 1c and 3 of P . rettgeri, and the PBP3 of P . aeruginosa than cefaclor . Synergy of the bactericidal effect between R-3746 and serum complement was moderate, although the cells of E . coli NIHJ-JC2 and S . aureus 209P were well engulfed and rapidly digested by mouse-cultured macrophages in the presence of greater than 1/8 MIC of R-3746 . Good clinical efficacy can be expected of CS-807 provided its pharmacokinetics prove to be good. Folia Microbiol (Praha), 1988, 33(6), 500 - 6 Enterotoxigenicity, klebocinogeny and antibiotic resistance pattern of food isolates of Klebsiella pneumoniae; Kaur J et al.; The enterotoxigenicity, klebocinogeny and susceptibility to antibiotics for 100 strains of Klebsiella pneumoniae isolated from various food samples is reported . 49% of the samples supported growth of K . pneumoniae: a high proportion of these strains were isolated from sweets and snacks (51%) . Enterotoxigenicity as determined by a coagglutination test with anti-LT4 coated staphylococci was observed in 61 of 100 Klebsiella isolates . 21% of the strains were found to be klebocin producers against the K . pneumoniae WC indicator strain . A significant correlation was observed between klebocinogeny and enterotoxigenicity (p less than 0.05) . Most strains (91 and 74% respectively) were inhibited by gentamicin and nalidixic acid . Most of the strains were multiply drug-resistant. Ann Biol Clin (Paris), 1988, 46(10), 800 - 3 {Identification of coagulase-negative Staphylococci . Significance of miniaturized systems}; Granjon V et al.; To evaluate accuracy of API Staph . and Staph . Ident . systems for identification of coagulase-negative Staphylococci, the authors have tested 235 clinical and environmental isolates . The results obtained were compared with those of conventional method of Kloos and Schleifer . API Staph . and Staph . Ident . correctly identified respectively 64 and 53 p . cent of the strains . Diagnosis ability coefficient (Descamps and Veron) are close . It should be necessary to compare identification obtained using analytical profile index with described characteristics of species. Rev Pneumol Clin, 1988, 44(3), 113 - 21 {Lung diseases during therapeutic aplasia: diagnostic and therapeutic strategy}; Mayaud C et al.; Lung diseases that occur in patients with drug-induced bone marrow aplasia are part of a wider group of lung diseases in immunocompromised patients . Their most common causes are infections due to Gram-negative bacilli, staphylococci or Aspergillus spp . and intra-alveolar haemorrhages . Their diagnostic approach is often limited by disorders of coagulation, risks of infection by bronchial or pulmonary seeding during endoscopy and the lethal risk of mechanical ventilation after bronchoalveolar lavage in patients with respiratory failure . The therapeutic approach is frequently empirical due to the fact that antibiotic therapy cannot be delayed, even for a few hours, and to the aforementioned diagnostic problems . In practice, the diagnostic and therapeutic approaches usually result from a rational compromise depending on whether the lung disease has occurred at the onset or at the end of an episode of bone marrow aplasia. Recent Results Cancer Res, 1988, 108, 71 - 81 Aspects of infections in children with cancer; Viscoli C; There are some differences between pediatric and adult cancer patients in terms of the problem of infection but it is doubtful whether such discrepancies justify different therapeutic approaches . For example, according to the results of EORTC trial IV, children seem to show lower overall (3% vs 19%) and infectious (2% vs 8%) mortality than adults, probably due to differences in underlying diseases and to a basic better physical integrity . Central intravenous catheters appear to be indispensable in the modern management of neoplastic diseases, especially in pediatric oncology . A prospective study performed in our institution on 157 Broviac catheters, has shown: 1 . Of all microbiologically documented infections, occurring in children undergoing cancer chemotherapy and radiotherapy, 27% are related to the catheter 2 . Gram-positive cocci are the leading pathogens (78%) of such infections 3 . Catheter-related infections often occur in non-neutropenic patients 4 . Such infections can be successfully treated without removing the intravenous device . The experience of the EORTC Cooperative Group and of other centers throughout the world shows that gram-positive cocci are increasingly being isolated as the cause of infections in cancer patients . This phenomenon is probably multifactorial in origin and appears to be more evident in pediatrics . For example, in our institution, during the last 5 years gram-positive organisms have caused 69% of all bacteremias . Moreover, these organisms, while responding poorly to the presently used empirical antibiotic regimens, seem not to be as aggressive as gram-negative organisms and cause lower mortality . There is therefore controversy over whether or not to include anti-gram-positive coverage in early empirical regimens . In our institution, a pilot study comparing ceftazidime + amikacin (C + A) and ceftazidime + vancomycin (C + V) seems to show an overall advantage for C + V . This advantage, however, is not statistically significant . One finding to be pointed out is that five of ten staphylococcal infections failed to respond to C + V and that in these cases a third antibiotic had to be added . Therefore, it is likely that, at least in institutions in which methicillin-resistant staphylococci are prevalent, a triple antibiotic empirical regimen will provide the best coverage, but this can result in overtreatment . However, only prospective, randomized and multicenter trials will be able to answer such questions definitely. APMIS Suppl, 1988, 3, 68 - 70 Antistaphylococcal activity of teicoplanin in Riyadh, Saudi Arabia; Shibl AM et al.; The antistaphylococcal activity of teicoplanin, a new glycopeptide antibiotic, has been evaluated in vitro and compared with that of vancomycin, fucidin, rifampicin and gentamicin . Teicoplanin was found to be as active as vancomycin against clinical isolates of Staphylococcus aureus (both methicillin-resistant and methicillin-sensitive strains) . Teicoplanin was found to be more active than vancomycin against Staphylococcus epidermidis . The minimum inhibitory concentration (MIC) of teicoplanin was 2- to 4-fold lower than that of other drugs tested . The minimum bactericidal concentration (MBC) of both teicoplanin and vancomycin either equalled or exceeded by 2-fold the respective MIC's . The rate at which staphylococci were killed showed that teicoplanin at 4 X MIC produced rapid killing in 10 h and no growth was detected after 24 h. J Hyg Epidemiol Microbiol Immunol, 1988, 32(1), 49 - 57 Staphylococcus aureus at a maternity ward . I . Colonization of mothers and neonates and survival of various S . aureus types in colonized individuals; Zdrazilek J et al.; Colonization by Staphylococcus aureus, characterized by phage type or production of enterotoxins and toxic-shock-syndrome-toxin, was followed in 50 mothers and their babies . Types or groups of staphylococci predominating during the particular period at the maternity department were evaluated according to survival rates in the colonized subjects . S . aureus frequently colonized nipples at the start of lactation and was found regularly on umbilical stump and in eye and mouth corners of the babies . During the second stage of the study phage untypable staphylococci producing enterotoxin C (NT/C) strongly predominated . These microorganisms colonized in the greatest extent both mothers and neonates . The majority of NT/C complex originated probably from one or two clones characterized, among others, by high biological activity. J Antimicrob Chemother, 1988 Jan, 21 Suppl A, 93 - 103 Teicoplanin in the treatment of infections caused by coagulase-negative staphylococci; Harding I et al.; A total of 88 patients were treated with teicoplanin for infections caused by coagulase-negative staphylococci in open clinical studies in France and the UK . Teicoplanin was administered once daily, with a mean dose of 323 mg, for a mean duration of 16 days . Thirty-nine patients received teicoplanin alone while 49 received combination treatment . Clinical cure or improvement occurred in 79 of 82 evaluable cases (96.3%) and bacteriological elimination in 82 cases (95.1%) . Treatment with teicoplanin alone was clinically successful in all cases, including 20 septicaemias, and the elimination rate was 93% . There was no apparent correlation between clinical and bacteriological outcomes and results of in-vitro testing . The variation in MICs between France and the UK was attributed to differences in the methods used. J Antimicrob Chemother, 1988 Jan, 21 Suppl A, 89 - 92 Teicoplanin in infections caused by methicillin-resistant staphylococci; Drabu YJ et al.; Serious infections by methicillin-resistant staphylococci, 26 caused by Staphylococcus aureus and two by coagulase-negative staphylococci, were treated with teicoplanin 200-800 mg daily, in eight cases supplemented with another antibiotic . The overall rate of clinical cure or improvement was 75%, and that of bacterial eradication 67%. J Antimicrob Chemother, 1988 Jan, 21 Suppl A, 113 - 6 Teicoplanin in combination therapy for febrile episodes in neutropenic and non-neutropenic paediatric patients; Lemerle S et al.; The aim of this study was to assess the efficacy and safety of teicoplanin in combination with other antimicrobial agents for therapy of severe suspected or proven Gram-positive infection in children and also to determine a dosage regimen for paediatric patients . Twenty children were given 23 courses of teicoplanin therapy for 11 septicaemias, one erysipelas, one cellulitis and 11 cases of fever of unknown origin . Eighteen of the 20 patients had severe underlying disease: one solid tumour, 15 acute lymphoblastic leukaemias, two acute myeloblastic leukaemias; 15 were neutropenic; 19 had a central line . Thirteen Gram-positive bacteria were isolated from the blood cultures in eleven patients . There were eight coagulase-negative staphylococci (CNS), (five methicillin-resistant) and four Staphylococcus aureus isolates . Teicoplanin was given as a 30 min infusion twice on the first day then once a day . The mean unit dose was 6 mg/kg for first eight patients . One clinical failure and lower serum concentrations than expected led us to increase the dosage to 10 mg/kg daily for the remaining patients . Tolerability remained excellent . It is concluded that antistaphylococcal treatment for febrile episodes in neutropenic patients can be satisfactorily provided by teicoplanin 10 mg/kg iv daily with a second loading dose on the first day . One injection a day is a convenient schedule in paediatrics. J Hosp Infect, 1988 Jan, 11(1), 36 - 43 Epidemiology of macrolide and lincosamide resistance in species of staphylococci in a general hospital; Fidalgo S et al.; During a 1-year period resistance to macrolides and lincosamides among staphylococci in a general hospital was studied . The macrolide-lincosamide resistance phenotype was found in 36.7% of coagulase-negative and in 3.7% of coagulase-positive species . Isolates showing this phenotype were more abundant from indwelling artificial devices, blood, respiratory tract and sterile fluids . The surgery and intensive care units of the hospital provided the highest proportion of such strains . Methicillin resistance was present in 13.9% of the staphylococci but no relationship between methicillin and macrolide-lincosamide resistance was observed. J Hosp Infect, 1988 Jan, 11(1), 26 - 35 Observations on multiple drug resistance in coagulase-negative staphylococci isolated in hospitals from 1975 to 1985; Moller JK; Drug resistance in coagulase-negative staphylococci (CNS) isolated in hospitals since 1975 was analysed using routine laboratory data registered on a microcomputer . Resistance increased substantially in CNS during the years, especially in Staphylococcus epidermidis isolates, of which more than 50% were multiply drug resistant by 1985 . Among the methicillin-resistant CNS strains, resistance to gentamicin rose from 0% in 1975 to 76% in 1985 . Co-resistance to kanamycin, gentamicin, and in some cases netilmicin seemed to replace co-resistance to kanamycin and streptomycin in S . epidermidis . Gentamicin and netilmicin usage in hospital increased tenfold from 1976 to 1985. Microbiol Immunol, 1988, 32(8), 795 - 805 Opsonic effect of fibronectin on staphylococcal phagocytosis by human polymorphonuclear leukocytes: its relative inefficiency in post-phagocytic metabolic activities and in intracellular killing; Yonemasu K et al.; The binding of 125I-labeled human plasma fibronectin (FN) to two strains of live Staphylococcus aureus (S . aureus) (a coagulase-positive Cowan I and a coagulase-negative Newman D2C) and the opsonic effect of FN on phagocytosis of these bacteria by human polymorphonuclear leukocytes (PMN) have been studied . 125I-FN bound to a similar extent in both staphylococcal strains . The 125I-FN-binding was significantly inhibited by human fibrinogen as well as unlabeled FN . The FN-binding was also reduced markedly by trypsinization of these bacteria, but the extent of its decrease did not correlate with their tryptic susceptibility of protein A and clumping factor . FN enhanced the uptake of these bacteria by PMN . However, its binding had no effect on superoxide anion (O2-) generation . The FN-binding definitely stimulated staphylococcal ingestion and intracellular killing by PMN, but the extent of such promotion was dissimilar between these two strains of bacteria . These results suggest that post-phagocytic metabolic activities as well as intracellular killing of these Staphylococci may also be greatly influenced by FN-unrelated factors as are other bacteria having no FN-receptors. J Exp Med, 1988 Jan 1, 167(1), 30 - 42 The effect of phenolic glycolipid-1 from Mycobacterium leprae on the antimicrobial activity of human macrophages; Neill MA et al.; Purified PGL-1 and dPGL from M . leprae can prevent bacterial killing by intact phagocytes and cell-free antimicrobial systems . Both glycolipids completely abolished the antimicrobial effect of the acetaldehyde-XO-Fe2+ system . Because the cytotoxicity of this system is inhibited by catalase, SOD, mannitol, and ethanol, but not by heated SOD or catalase, these data suggest that toxicity is due to OH . generated by the Haber-Weiss reaction . That the antimicrobial killing in the XO system is completely blocked by the addition of PGL-1 or dPGL suggests that these glycolipids can act as OH . scavengers . A modest protective effect against the cytotoxicity of the MPO-H2O2-halide system by both PGL-1 and dPGL was also observed . The antimicrobial activity of the MPO system was abolished with chloride, but not iodide, as the halide . The effect of the M . leprae-derived glycolipid on bacterial killing by intact phagocytes was examined . Two linking antibodies were used to bind the dPGL to a rapidly growing test organism, S . aureus, a murine IgM mAb specific for the terminal glycoside of PGL-1, and a rabbit IgG anti-mouse IgM which bound the staphylococcal protein A via its Fc region . Examination by transmission EM of human monocyte-derived macrophages which had ingested staphylococci either coated with both antibodies and dPGL, or coated only with the IgG and IgM antibodies, demonstrated the presence of bacteria in phagosomes of control and IFN-gamma-activated macrophages . Activation of the macrophage monolayers by pretreatment with IFN-gamma markedly increased their staphylocidal activity . When dPGL coated staphylococci were ingested, killing by both control and IFN-gamma-activated macrophages was completely blocked . These results, suggesting that PGL-1 can scavenge reactive oxygen species and prevent microbial death within the phagosome, may in part explain the intracellular survival of M . leprae in certain cell types. J Lab Clin Med, 1987 Dec, 110(6), 753 - 66 Extracellular killing of inhaled pneumococci in rats; Coonrod JD et al.; Early clearance of inhaled Staphylococcus aureus is believed to be caused by phagocytosis by alveolar macrophages . In murine models inhaled pneumococci are cleared even more rapidly than S . aureus . Conventional opsonins appear to play no role in this clearance, and recently it has been shown that murine alveolar lining material contains free fatty acids and other soluble factors that are directly bactericidal for pneumococci . To determine whether non-phagocytic factors are involved in pneumococcal clearance, we compared the site of killing of inhaled pneumococci and S . aureus in rats using histologic methods and bronchoalveolar lavage . Spontaneous lysis of pneumococci was prevented by use of autolysin-defective pneumococci or by substitution of ethanolamine for choline in the cell wall . Histologic studies showed that the percent of inhaled staphylococci associated with alveolar macrophages always exceeded the percent of staphylococci cleared, whereas there was little association of pneumococci with macrophages during clearance . Analysis of the intracellular or extracellular location of iron 59 in bronchoalveolar lavage fluid of rats that had inhaled aerosols of 59Fe-labeled bacteria suggested that staphylococci were killed predominantly in macrophages and pneumococci in the extracellular space . When 59Fe-labeled pneumococci or staphylococci were ingested and killed by macrophages in vitro, the 59Fe remained with the macrophages, suggesting that the extracellular location of 59Fe during pneumococcal killing in vivo was not caused by rapid turnover of 59Fe in macrophages . Studies of the site of killing of inhaled type 25 pneumococci labeled exclusively in the cell wall with carbon 14-ethanolamine confirmed the results obtained with 59Fe-labeled pneumococci . Thus, early killing of inhaled pneumococci, unlike staphylococci, appears to take place outside of macrophages. Infect Immun, 1987 Dec, 55(12), 2870 - 7 Phenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo; Christensen GD et al.; Clinical studies performed by us and others have found an association between slime production and strains of coagulase-negative staphylococci that infect indwelling medical devices . By serial low-speed centrifugation of broth cultures we have isolated a stable, weakly adherent strain (RP62A-NA) from a strongly adherent, slime-producing, pathogenic strain of Staphylococcus epidermidis sensu stricto (RP62A, ATCC 35984) . We obtained a second strain from RP62A-NA (RP62A-NAR) by serial subculture of glass-adherent cells of RP62A-NA . All three strains had the same pattern of biochemical reactions, antimicrobial susceptibilities, and plasmid analysis . Transmission electron micrograph sections stained with the mucopolysaccharide-specific stain alcian blue demonstrated that the adherent strains RP62A and RP62A-NAR were covered with an extracellular coat of polysaccharide-rich material . In contrast, the nonadherent RP62A-NA strain lacked this external coat . All three strains were used in a mouse model of foreign body infection and a rat model of catheter-induced infective endocarditis . The adherence characteristics of isolates of RP62A and RP62A-NA recovered from experimental animals were relatively stable, although we noted a slight but a significant increase in the adherence of RP62A-NA isolates recovered from the foreign body model . The adherence characteristics of RP62A-NAR isolates recovered from infected animals were variable; in general these isolates were less adherent than the laboratory strain of RP62A-NAR . In both models the 50% infective dose (calculated by the Reed and Muench method) was three times greater for the RP62A-NA strain than for the RP62A strain . The phenotypic expression of slime production is subject to both in vitro and in vivo variation and could play a role in the pathogenesis of foreign body infection. Am J Med, 1987 Dec, 83(6), 1091 - 7 Relationship of serum antibiotic concentrations to nephrotoxicity in cancer patients receiving concurrent aminoglycoside and vancomycin therapy; Cimino MA et al.; Methicillin-resistant coagulase-negative staphylococci have become increasingly responsible for febrile episodes in cancer patients, often necessitating the addition of vancomycin to an aminoglycoside-containing broad-spectrum antibiotic regimen . A total of 229 courses of antibiotic therapy in 229 patients were evaluated for nephrotoxicity associated with the administration of an aminoglycoside and/or vancomycin . The incidence of nephrotoxicity observed in patients administered an aminoglycoside (Group A) was 18 percent; vancomycin (Group B) 15 percent; and an aminoglycoside concurrently with vancomycin (Group C) 15 percent . The following pharmacokinetic/dosing factors were significantly associated with increased nephrotoxicity in the groups: baseline serum creatinine level, mean daily dose during the first three days of therapy (Group B), and elevated serum trough aminoglycoside or vancomycin concentrations (2 micrograms/ml or more or 10 micrograms/ml or more, respectively) . No cumulative nephrotoxicity was demonstrated with the concurrent administration of vancomycin and an aminoglycoside . A higher incidence of nephrotoxicity was seen in Group C (42 percent) and Group B (27 percent) patients, in whom trough serum vancomycin concentrations were 10 micrograms/ml or more. Diagn Microbiol Infect Dis, 1987 Dec, 8(4), 215 - 20 Lack of correlation of slime production with pathogenicity in continuous ambulatory peritoneal dialysis peritonitis caused by coagulase negative staphylococci; Alexander W et al.; In order to evaluate the association of slime production by coagulase-negative staphylococci (CNS) and pathogenicity in the setting of continuous ambulatory peritoneal dialysis (CAPD), we prospectively studied 23 CAPD patients with positive dialysate cultures for CNS during a 12-mo period . Patients were categorized into groups with peritonitis or contaminants . In addition, 24 skin flora isolates of CNS from nine uninfected CAPD patients were compared to the other two groups . We found 14 patients with peritonitis and nine with contaminants . Fifty percent of the peritonitis isolates produced slime, compared to 67% of the contaminants (p = 0.72) and 54% of the skin flora isolates (p = 0.93) . Slime production was not associated with specific antibiotic susceptibility patterns or speciation . In this prospective study, slime production was not associated with pathogenicity in CAPD peritonitis caused by coagulase-negative staphylococci. J Dairy Sci, 1987 Dec, 70(12), 2648 - 57 Dynamics and significance of coagulase-negative staphylococcal intramammary infections; Timms LL et al.; Cows (n = 139) were sampled within 17 d postpartum and monthly thereafter to examine dynamics of mammary infections and relationships between infection status, milk yield, SCC, NAGase activity, and chloride concentration . Forty-eight and 67% of cows and 19.5 and 30.5% of quarters were infected at first test and lactation end, respectively, with 51% of all infections present at first test . Coagulase-negative staphylococci accounted for 67 and 65% of first test and total infections with 85% persisting to lactation end . Animals with coagulase-negative staphylococci infections had significantly elevated quarter SCC and NAGase activity and a decrease of 821 kg mature equivalent lactation milk production compared with uninfected animals . Clinical cases with no bacterial isolation or major pathogen infections were associated with significant elevations in bucket and quarter milk SCC, NAGase activity, chloride concentration in quarters, and a decrease of 1153 kg mature equivalent lactation milk production as compared with uninfected animals . Correlations between milk production and in SCC and ln NAGase and between ln SCC and ln NAGase were -.15, -.25, and .55 (-.23, -.28, and .41 for first lactation only). Zh Mikrobiol Epidemiol Immunobiol, 1987 Dec, (12), 37 - 9 {Frequency of the isolation of staphylococci from domestic animals and strain identification}; Satorov SS et al.; Staphylococci occur in donkeys more frequently than in other animals, and only from donkeys coagulase-negative staphylococci, characteristic of humans (S . hominis, S . capitis, S . cohnii), were isolated . Least frequently staphylococcal carrier state was registered in cats; in these animals only coagulase-negative strains were found to occur . From 30 donkeys coagulase-positive staphylococci belonging to 47 S . aureus strains were isolated . These strains differed from known ecological variants in their biological properties, thus suggesting the existence of S . aureus ecovar specific for donkeys . These strains did not coagulate human, bovine and ovine plasma, but coagulated rabbit plasma in 100% of cases and donkey plasma only in 53% of cases; at the same time they relatively often produced delta hemolysin, rarely phosphatase and hyaluronidase and never fibrinolysin . These strains were typed by KPC phages, mainly 116 and 117. Zh Mikrobiol Epidemiol Immunobiol, 1987 Dec, (12), 28 - 33 {Comparative study of the binding of human blood plasma fibronectin with clinical strains of staphylococci}; Buchwald F et al.; The interaction of 62 S . aureus clinical strains and, respectively, 20 and 17 isolated S . epidermidis and S . saprophyticus strains with human blood plasma fibronectin (FN) has been studied . The specific interaction of FN with bacteria has been evaluated simultaneously by the binding of 125I with FN (method 1), the FN-mediated agglutination of staphylococci (method 2) and the character of colonies formed in 0.15% agar medium containing FN (method 3) . The data obtained in this investigation indicated that all S . aureus strains under study react with FN to a different extent . When evaluating the binding of FN with bacteria, the most pronounced correlation was observed between methods 1 and 3 . None of the methods used in this investigation has revealed interaction between FN and S . epidermidis and S . saprophyticus strains under study . The authors suggest that a preliminary inference on the capacity of the isolated clinical strains of staphylococci for reaction with FN may be made from the character of colonies formed in 0.15% agar medium containing FN. Antimicrob Agents Chemother, 1987 Dec, 31(12), 1919 - 24 Coagulase-negative staphylococci resistant to beta-lactam antibiotics in vivo produce penicillin-binding protein 2a; Chambers HF; Strains of coagulase-negative staphylococci were tested for in vivo resistance in a rabbit model of prophylaxis of endocarditis . Regimens of nafcillin, cefazolin, cefamandole, and vancomycin were compared for efficacy in the prevention of infection caused by two methicillin-resistant strains and a susceptible strain . For the two resistant strains, vancomycin was the most effective drug tested . All regimens were effective against the susceptible strain . The two strains for which prophylaxis with beta-lactam antibiotics failed produced a beta-lactam antibiotic-inducible penicillin-binding protein (PBP) that comigrated in sodium dodecyl sulfate-polyacrylamide gels with the low-affinity PBP 2a that is associated with methicillin resistance in strains of Staphylococcus aureus . Like PBP 2a, this PBP had low binding affinity for beta-lactam antibiotics . Peptide maps after either V8 protease or chymotrypsin digestion of radiolabeled PBP 2a or silver-stained preparations were virtually identical to one another and to maps of PBP 2a from a heterogeneous and a homogeneous strain of S . aureus . Methicillin resistance in coagulase-negative staphylococci and therapeutic failure with beta-lactam antibiotics in vivo is associated with production of PBP 2a, which appears to be highly conserved structurally among different species of staphylococci. Epidemiol Infect, 1987 Dec, 99(3), 603 - 12 Multiply- and methicillin-resistant Staphylococcus aureus strains isolated in the German Democratic Republic in 1985 and 1986; Witte W et al.; Multiply- and methicillin-resistant Staphylococcus aureus (MRSA) strains have been isolated from five small outbreaks of nosocomial infection in five different hospitals . The MRSA were typed by phage patterns, biochemical traits, resistance phenotypes and plasmid patterns . Three different groups of strains can be distinguished . The MRSA from three outbreaks in one country share identical characters . Phage typing by the use of the International Basic Set for Phage Typing staphylococci as well as experimental phages does not completely discriminate between the strains . Attribution of several resistance determinants to plasmids in two of the described strain groups proved valuable for strain differentiation . These multiply-resistant strains are sensitive to vancomycin and to rifampicin. Am J Med Sci, 1987 Dec, 294(6), 403 - 7 Low incidence of toxic shock syndrome in children with staphylococcal infection; Jacobson JA et al.; Children have frequent staphylococcal infections, and many lack antibody to TSST-1, a toxin associated with the toxic shock syndrome (TSS) . To determine why there have been no nonmenstrual cases of TSS reported in children in Utah, the authors tested S . aureus isolated from children for TSST-1 by radial immunodiffusion and sera from other hospitali