Am J Clin Pathol, 1986 Nov, 86(5), 665 - 9 Rapid, direct antibiotic susceptibility testing of blood culture isolates using the Abbott Avantage system; Nolte FS et al.; The Abbott Avantage (AV) is an updated version of the MS-2 system that provides antibiotic-susceptibility results in four to six hours . Although the system compared favorably with reference methods in several laboratory evaluations, little information exists regarding its performance with inocula obtained directly from blood cultures . The authors compared AV and a modified disk-diffusion test using standardized inocula obtained directly from the blood culture bottles for 58 isolates (46 patients) . All isolates were also tested by the National Committee for Clinical Laboratory Standards standard disk-diffusion method, using inocula obtained from subcultures of the positive bottles . AV results for 553 antibiotic tests agreed with the direct disk results in 92.6% of the tests, and the agreement with the standard disk results was 88.2% . The concordance between direct and standard disk results was 93.5% . There were 2.2% very major, 1.8% major, and 7.8% minor discrepancies between results obtained with direct AV and standard disk methods . False sensitivity of Klebsiella pneumoniae to ampicillin and carbenicillin and induced clindamycin resistance in staphylococci were noted with AV . When one considers only the clinically meaningful antibiotic-organism combinations, direct AV is an acceptable, rapid alternative to direct disk susceptibility testing. Antimicrob Agents Chemother, 1986 Nov, 30(5), 813 - 5 In vitro activity of imipenem against enterococci and staphylococci and evidence for high rates of synergism with teicoplanin, fosfomycin, and rifampin; Debbia E et al.; The in vitro activities of imipenem alone and in combination with teicoplanin, fosfomycin, and rifampin were tested against clinical isolates of enterococci and staphylococci . In both groups of organisms, the three combinations demonstrated high rates of synergism in both checkerboard and time-kill studies. J Hosp Infect, 1986 Nov, 8(3), 233 - 41 Serious postoperative infections caused by coagulase-negative staphylococci: an epidemiological and clinical study; Dandalides PC et al.; We have reviewed all 3577 nosocomial infections occurring at our institution over a 49-month period and found coagulase-negative staphylococci (CNS) associated with 297 . Seventy-eight of 193 CNS tested for antibiotic sensitivity were multiple-drug resistant (MR-CNS) . There were 19 well-documented serious postoperative CNS infections including nine ventricular, seven bloodstream and three peritoneal infections . Each was associated with an indwelling device and 11 of the infections involved MR-CNS . Antibiotic therapy with or without removal of the device resulted in cure of all patients . Air samples taken during various surgical procedures frequently were positive for CNS but rarely revealed MR-CNS . Our results cause concern regarding current antibiotic prophylaxis regimens. J Hosp Infect, 1986 Nov, 8(3), 224 - 32 Problems in the investigation of an apparent outbreak of coagulase-negative staphylococcal septicaemia following cardiac surgery; Houang ET et al.; Two hundred and twenty-six hospital staff and patients were investigated for the carriage of gentamicin-resistant coagulase-negative staphylococci (CNS) during an apparent outbreak of infection after cardiac surgery . Of the four index strains from infected wounds, three were indistinguishable . The carriage of similar organisms was widespread, particularly among ITU staff (72%) and patients . Ninety-one of the 296 gentamicin-resistant isolates were further investigated, and of these 33 were indistinguishable from index strains even with the use of specialized techniques . Our experience indicates that in outbreaks of infection caused by gentamicin-resistant CNS, resources should be focused on the interruption of transmission and prevention of introduction of these organisms to susceptible patients. Presse Med, 1986 Oct 18, 15(36), 1805 - 8 {Ventricular staphylococcal infections . Treatment with vancomycin by continuous venous infusion}; Barois A et al.; Thirteen cases of meningeal and/or ventricular infection and 1 case of septicaemia, all caused by staphylococci, were treated with continuous intravenous infusions of vancomycin . Repeated measurements of vancomycin plasma and CSF levels by microbiological assay or by high performance liquid chromatography showed that the antibiotic entered the CSF after 48 hours of treatment and that its concentrations in CSF remained stable at 1 to 4 micrograms/ml (mean: 2 micrograms/ml) throughout the 3 weeks' treatment period . After treatment was discontinued, vancomycin became undetectable in CSF within less than 24 hours . All the children were cured. Zh Mikrobiol Epidemiol Immunobiol, 1986 Oct, (10), 93 - 5 {Immunologic memory for Staphylococcus studied by adoptive transfer}; Liashchenko KP et al.; The basic regularities of the formation and realization of immunological memory to staphylococcal corpuscular antigen were studied in adoptive transfer experiments on CBA mice . The capacity of spleen cells for generating anamnestic response to staphylococci in the body of irradiated syngeneic recipients appeared on day 3 after the immunization of donors . The formation of immunological memory to staphylococci in mice was shown to be directly related to the dose of the antigen . The study also revealed that intact splenocytes did not suppress the realization of immunological memory to staphylococci in the system of adoptive transfer . The conclusion of the absence of the "isogeneic barrier" for memory cells specific to staphylococcal corpuscular antigen was made. J Antibiot (Tokyo), 1986 Oct, 39(10), 1386 - 94 Kibdelins, novel glycopeptide antibiotics . I . Discovery, production, and biological evaluation; Shearer MC et al.; A new subspecies of Kibdelosporangium aridum subsp . largum (SK&F AAD-609), was isolated and shown to produce novel glycopeptides related to aridicins, but containing a homologous series of glycolipids based on N-acylglucosamine . These compounds showed improvements over the aridicins in in vitro activity and were effective in mouse protection studies against a range of Gram-positive bacteria, including methicillin resistant staphylococci . Pharmacokinetic studies indicated that they have high serum concentrations and long-acting potential . The kibdelin complex modified rumen metabolism in a manner favorable for growth promotion. J Clin Microbiol, 1986 Oct, 24(4), 629 - 32 Staphylococcal resistance to aminoglycosides before and after introduction of amikacin in two teaching hospitals; Hammerberg O et al.; A prospective study was conducted to determine the prevalence of aminoglycoside-resistant Staphylococcus aureus and coagulase-negative staphylococci before and after the introduction of amikacin as the sole aminoglycoside used in our burn unit, adult intensive care unit, and neonatal intensive care unit . Pharyngeal or endotracheal cultures, as well as superficial surveillance cultures, were collected weekly during the following four study periods: all units for 4 months before amikacin introduction, all units 4 to 8 months after, all units 12 to 13 months after, and the neonatal intensive care unit 30 months after . A total of 2,613 strains of coagulase-negative staphylococci and 316 strains of S . aureus were obtained from 916 patients . During the course of the study, amikacin-resistant coagulase-negative staphylococci increased from 0 to 22%, colonizing 43% of patients, whereas no amikacin-resistant S . aureus was detected . During the preamikacin survey, 68% of the coagulase-negative staphylococci and 12% of the S . aureus strains were resistant to tobramycin and gentamicin . This resistance did not decrease after amikacin was introduced . Initially, 83% of the aminoglycoside-resistant coagulase-negative staphylococci were resistant to both tobramycin and gentamicin . During the last surveillance this value dropped to 40%, and 48% of the strains had become resistant to all three aminoglycosides . Resistance to aminoglycosides, including amikacin, develops quickly in coagulase-negative staphylococci from clinical areas where these antimicrobial agents are widely used . However, aminoglycoside resistance in S . aureus is much less frequent. J Clin Microbiol, 1986 Oct, 24(4), 559 - 61 Persistent in vitro survival of coagulase-negative staphylococci adherent to intravascular catheters in the absence of conventional nutrients; Franson TR et al.; The in vitro survival of coagulase-negative staphylococci in media devoid of routine nutritional supplementation was assessed in the presence and absence of catheter materials to evaluate bacterium-device interactions . Strains of slime- and non-slime-producing coagulase-negative staphylococci were suspended in phosphate-buffered saline together with multiple segments of polyvinyl chloride (PVC), Teflon, Silastic, and polyurethane catheters and in control suspensions without catheters . Catheters were removed at 2 min and 24, 48, 72, and 96 h of incubation and washed thoroughly, and semiquantitative roll cultures were performed on blood agar . In addition, after 96 h catheters were introduced into tryptic soy broth (TSB), and roll cultures were performed after 18 h of incubation . Results demonstrated that after 96 h, 6 of 32 catheter specimens (4 PVC) had greater than 10 CFU of coagulase-negative staphylococci per catheter; after TSB addition, 18 of 32 catheter specimens had greater than or equal to 100 CFU per catheter (8 of 8 PVC catheters had greater than 1,000 CFU per catheter) . In control suspensions, no growth was seen at 96 h or after TSB addition . No differences in the survival of slime- versus non-slime-producing strains were observed in control or catheter studies . These findings suggest that both slime- and non-slime-producing coagulase-negative staphylococci survive in vitro on catheters (especially PVC) in the absence of conventional nutrients and can proliferate on catheters when nutrients are added . Catheter-adherent coagulase-negative staphylococci appear to possess survival mechanisms under adverse conditions which may relate to the genesis of occult foreign-body-associated infections. Immunopharmacology, 1986 Oct, 12(2), 167 - 72 Selenium effects on human neutrophilic granulocyte function in vitro; Urban T et al.; The effects of an inorganic selenium salt on phagocytic functions of human neutrophilic granulocytes from donors with a low activity of glutathione peroxidase have been investigated . Granulocytes were exposed for 60 min in vitro to sodium selenite in two physiological concentrations (100 and 200 ng Se/ml) and one unphysiologically high concentration (2000 ng/ml) . The spontaneous and chemotactic migration, the nitroblue tetrazolium reduction, the phagocytosis of fluorescein-labeled yeast particles and the intracellular killing of staphylococci were then studied in such granulocytes and compared to control cells, which had not been exposed to selenium . The migration and nitroblue tetrazolium reduction abilities of granulocytes were not affected by selenium exposure . The phagocytic and bactericidal activities were significantly increased in granulocytes exposed to selenium in physiological concentrations . However, at 2000 ng Se/ml these activities were found to be equal to or lower than control levels . Thus selenium supplementation might enhance phagocytic and bactericidal functions of human granulocytes, thereby improving the host defense against bacterial infections. J Thorac Cardiovasc Surg, 1986 Oct, 92(4), 776 - 83 Prosthetic valve endocarditis . Analysis of factors affecting outcome of therapy; Calderwood SB et al.; We analyzed the outcome of 116 patients with prosthetic valve endocarditis treated between 1975 and 1983 and used multivariate analysis to identify risk factors for in-hospital mortality and bad outcome during follow-up . Complicated prosthetic valve endocarditis was defined as the presence of a new or changing heart murmur, new or worsening heart failure, new or progressive cardiac conduction abnormalities, or prolonged fever during therapy . Complicated prosthetic valve endocarditis was present in 64% of patients; factors associated with complicated prosthetic valve endocarditis included aortic valve infection (odds ratio 4.3, p = 0.002) and onset of endocarditis within 12 months of the cardiac operation (odds ratio 5.5, p = 0.0001) . The in-hospital mortality rate for prosthetic valve endocarditis was 23%; patients with complicated prosthetic valve endocarditis had a higher mortality than patients with uncomplicated infection (odds ratio 6.4, p = 0.0009) . Combined medical-surgical therapy was used in 39% of patients; surgical therapy was more common in patients with complicated prosthetic valve endocarditis (odds ratio 16, p less than 0.0001) and in patients infected with coagulase-negative staphylococci (odds ratio 3.9, p = 0.003) . Survival after initially successful therapy for prosthetic valve endocarditis was adversely affected by the presence of moderate or severe congestive heart failure at hospital discharge (p = 0.03) . Bad outcome during follow-up (death, relapse of prosthetic valve endocarditis, or subsequent cardiac operation related to sequelae of the original infection) was more common in the medical than the medical-surgical therapy group (p = 0.02) . The difference in long-term outcome between patients treated initially with medical or with medical-surgical therapy was particularly evident in those with complicated prosthetic valve endocarditis (p = 0.008) . The presence of complicated prosthetic valve endocarditis is a central variable in assessing prognosis and planning therapy; the majority of patients with complicated prosthetic valve endocarditis are best treated with medical-surgical therapy . Those who are not treated surgically during their initial hospitalization are at high risk for progressive prosthesis dysfunction and require careful follow-up. J Infect Dis, 1986 Oct, 154(4), 579 - 89 A prospective study of the mechanisms of infection associated with hemodialysis catheters; Cheesbrough JS et al.; Seventy-four subclavian hemodialysis catheters inserted into 53 patients were studied prospectively . Sixteen of 64 assessable catheterization periods were complicated by clinically documented catheter-related sepsis, and 13 had an associated bacteremia . One patient died from catheter-related sepsis, and in two others, sepsis contributed to death . Staphylococci accounted for 11 bacteremias . Semiquantitative culture of the catheters indicated that 28 were significantly colonized . Comparison of these isolates with skin cultures from the insertion site suggested that the origin of the colonizing organisms was the skin (10 cases), intralumenal contamination (16 cases), or both routes (2 cases) . Comparison of cultures taken during catheter insertion with those at removal rarely suggested that organisms introduced at insertion caused subsequent colonization . This study has demonstrated that infectious complications from using subclavian hemodialysis catheters exceed reported rates for all other modes of vascular access used for hemodialysis, as well as other indications for central venous catheterization. Chemioterapia, 1986 Oct, 5(5), 297 - 301 Studies on lincosamide antibiotic resistance in methicillin-susceptible and -resistant staphylococci; Stefani S et al.; Lincomycin and clindamycin are still effective against anaerobic bacteria, and their antibacterial activity has also been indicated against gram-positive aerobic cocci, chiefly Staphylococcus aureus . The present emergency due to epidemiological circulation of Staphylococci, especially coagulase-negative, methicillin-resistant, and the question of the current validity of the lincosamides, induced us to study the activity of lincomycin and clindamycin against staphylococci belonging to different lyogroups in comparison to erythromycin . Clindamycin showed good antibacterial activity while methicillan-resistant strains showed an increase in resistance to erythromycin and lincomycin. Jpn J Antibiot, 1986 Oct, 39(10), 2587 - 94 {A study of the disc sensitivity test for cephapirin}; Kanazawa Y et al.; Susceptibility of 203 strains of 34 bacterial species or subspecies to cephapirin (CEPR) was determined by the 2-fold agar dilution method in parallel with the determination of inhibition zone diameter in the single-disc method . These experiments demonstrated a significant correlation between the MIC by the dilution method and the diameter of inhibition zone determined by the conventional assay using an over-night (about 16 hours) incubation, the delayed assay (about 24 hours incubation), or the rapid assay (after 3-4 or 5-6 hours incubation), hence applicability of the single-disc assay for CEPR was confirmed . An analysis of the data obtained using CEPR discs (each containing 30 micrograms) revealed that primary regression equations were as follows: D (diameter, mm) = 25.8-9.7 log MIC (microgram/ml) in the conventional assay; D = 31.2-12.3 log MIC in the delayed assay; D = 21.7-7.1 log MIC in the 5-6-hour rapid assay and D = 17.9-5.0 log MIC in the 3-4-hour rapid assay, and especially for beta-lactamase producing Staphylococci, they were: D = 24.9-9.2 log MIC in the conventional assay, D = 20.4-7.4 log MIC in the 5-6-hour rapid assay and D = 17.5-5.8 log MIC in the 3-4-hour rapid assay.(ABSTRACT TRUNCATED AT 250 WORDS) J Antimicrob Chemother, 1986 Oct, 18 Suppl C, 207 - 14 Epidemiology of antibiotic resistance in Staphylococcus aureus; Lacey RW et al.; The genetic equipment of Staphylococcus aureus is at least as comprehensive as other organisms . Transposons provide the potential for reassortment of genes between plasmids and the chromosome . At least six different mechanisms of gene transfer between cells are documented in vitro . Phage-mediated conjugation is the transfer mechanism most likely to occur between staphylococci in nature . MRSA have evolved from a single clone and are now heterogeneous in properties . Some may show decreased virulence . The origin of new resistant determinants is likely to be other human cultures of Staph . aureus rather than an animal staphylococcal reservoir. Antimicrob Agents Chemother, 1986 Oct, 30(4), 577 - 83 Beta-lactam-specific resistant mutants of Staphylococcus aureus; Tonin E et al.; In an approach to understanding the origin of methicillin resistance in clinical isolates of staphylococci, a series of Staphylococcus aureus mutants resistant to various beta-lactam antibiotics were isolated in the laboratory by antibiotic selection . Mutants with low- and intermediate-level resistance showed considerable specificity for the particular antibiotic used in the selection process (methicillin, cefotaxime, cephalexin, and amdinocillin), and resistance in such mutants also showed alterations in the antibiotic binding capacities of penicillin-binding proteins (PBPs) . In each case the isolation of mutants resistant to high concentrations of antibiotics required sequential passage in gradually increasing concentrations of the drug . The acquisition of increasing levels of methicillin resistance was paralleled by a gradual decrease in the binding capacities of PBPs 2, 3, and, possibly, 1 . In a highly methicillin-resistant mutant (MIC, 150 micrograms/ml), PBPs 2 and 3 were no longer detectable by the penicillin binding assay . Instead, a new PBP of poor binding capacity and anomalous molecular size (about 78 kilodaltons {kDa}) appeared in these cells . This corresponds to the molecular size of PBP 2a, the unique PBP that appears to be the biochemical correlate of resistance in clinical isolates of methicillin-resistant S . aureus . Also, similar to the case of resistant clinical isolates, high-level beta-lactam resistance was highly pH dependent in the laboratory mutants . We compared the patterns of radioactive peptides generated by partial proteolysis from the penicillin-labeled PBP 2 of antibiotic-susceptible staphylococci and from the 78-kDa PBP 2a of a resistant clinical strain . Although the patterns were clearly different, seven of the eight characteristic peptides generated from PBP 2 of the susceptible strain were also detectable among the peptides released from PBP 2a . The results suggest that the 78-kDa PBP 2a of the resistant clinical strain evolved from PBP 2 of antibiotic-susceptible staphylococci and that in PBP 2a of the clinical isolate mutational changes have resulted in extensive alterations near the beta-lactam binding site. Antimicrob Agents Chemother, 1986 Oct, 30(4), 545 - 52 In vitro susceptibilities of four species of coagulase-negative staphylococci; Fass RJ et al.; The in vitro susceptibilities of 260 strains of coagulase-negative staphylococci to penicillin G, oxacillin, nafcillin, methicillin, cephalothin, and seven non-beta-lactam antimicrobial agents were determined and compared with the susceptibilities of 54 strains of Staphylococcus aureus with known patterns of susceptibility . Penicillin G susceptibility for S . aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus hominis was readily determined by using beta-lactamase tests with induced cells and with a standardized microdilution test . MIC criteria for susceptibility used for S . aureus were applicable to the coagulase-negative species . Percentages of organisms susceptible were as follows: S . epidermidis, 7%; S . haemolyticus, 5%; and S . hominis, 47% . Oxacillin susceptibility for these four species was readily determined by using a modification of the microdilution test . MIC criteria for susceptibility used for S . aureus were applicable to S . haemolyticus and S . hominis, but alternate criteria were necessary for S . epidermidis . Percentages of organisms susceptible were as follows: S . epidermidis, 29%; S . haemolyticus, 36%; and S . hominis, 97% . Staphylococcus saprophyticus differed from the other staphylococcal species; all strains were beta-lactamase negative and were penicillin susceptible but had higher penicillin G MICs than did susceptible strains of the other species . There was total cross resistance among the penicillinase-resistant penicillins and cephalothin for the coagulase-negative staphylococci as well as for S . aureus; oxacillin MICs were more reliable than MICs of the other drugs or a standardized disk diffusion test for distinguishing resistant from susceptible strains . Vancomycin, rifampin, and ciprofloxacin were consistently active against all staphylococci . Erythromycin, clindamycin, gentamicin, and trimethoprim-sulfamethoxazole were more active against oxacillin-susceptible staphylococci than against oxacillin-resistant staphylococci. Acta Pathol Microbiol Immunol Scand {B}, 1986 Oct, 94(5), 369 - 71 Continuous ambulatory peritoneal dialysis: microbiological diagnosis in peritonitis; Kjaeldgaard P et al.; Dialysate samples from 29 Continuous Ambulatory Peritoneal Patients (CAPD)-patients were taken in periods with and without peritonitis and cultured simultaneously in the Hemobact system and on conventional plate media, using a standard technique . Bacteria were demonstrated in 23 (92%) of 25 CAPD-patients with peritonitis by the Hemobact method and only in 6 (24%) by the standard technique . Sixty-four (100%) of the 64 samples taken during periods without peritonitis were negative by the standard technique . Sixty-two (97%) of the 64 samples were negative in the Hemobact system . In the remaining two samples coagulase negative staphylococci were demonstrated on the third day in only one of the bottles . In conclusion, blood cultivation systems should be preferred to conventional standard methods for adequate microbiological diagnosis in CAPD-patients with peritonitis. Proc Soc Exp Biol Med, 1986 Oct, 183(1), 74 - 80 Rapid separation and quantitation of mixed microorganisms by filtration and bioluminescence; Tsai TS et al.; A membrane filtration/bioluminescence system was developed for the differentiation and quantitation of mixed populations of microorganisms . Samples containing microorganisms were filtered through two membrane filters of descending pore size . The microorganisms retained on the filter contain ATP that can be extracted and measured on the filter via the firefly luciferase-luciferin bioluminescence assay . Results, obtained in less than 20 min, show a good correlation (r greater than or equal to 0.95) between the light produced and the number of organisms in the sample . Using these techniques, Escherichia coli can be separated from yeast or mold and measured in samples containing both microorganisms . When lysostaphin is used to selectively lyse Staphylococci on the filter, the specific quantification of these bacteria among other microorganisms can also be accomplished . The filtration/bioluminescence technique offers the potential of being a rapid and sensitive method to differentiate and detect microorganisms, by selective sizing or lysing, in a variety of samples. Eur J Clin Microbiol, 1986 Oct, 5(5), 518 - 22 Modulation of adherence of coagulase-negative staphylococci to Teflon catheters in vitro; Pascual A et al.; The mechanism of adherence of Staphylococcus epidermidis to commercially available catheters was studied in vitro in a quantitative assay employing 3H-labelled bacteria . It was found that adherence to Teflon catheters was significantly related to the degree of hydrophobicity of the strains . When hydrophobic groups were removed from Staphylococcus epidermidis by pepsin treatment, adhesion was almost completely abolished . Preincubation of catheters in human serum also caused a 80-90% reduction of adherence . Preincubation of Staphylococcus epidermidis in serum similarly decreased adhesion . This effect of serum was mainly due to albumin, while IgG and fibronectin were less effective . Culture of Staphylococcus epidermidis in subinhibitory concentrations (0.5 MIC) of cephalothin, clindamycin and vancomycin resulted in a 30-80% reduction in adhesion. J Hyg (Lond), 1986 Oct, 97(2), 211 - 8 Plasmid profiling of epidemic staphylococci from around 1960: a comparison of epidemiological techniques; Noble WC et al.; Plasmid profiles have been established for 68 isolates of Staphylococcus aureus from 13 episodes of epidemic spread in hospital wards between 1958 and 1962 . Despite the original lack of care in preservation of strains the profiles give, in general, the same epidemiological patterns as were established originally on the basis of phage type, antibiotic sensitivity, ward and date of isolation. Eur J Epidemiol, 1986 Sep, 2(3), 208 - 14 Epidemiologic study of Staphylococcus strains isolated from clinical material in 24 Italian hospitals; Varaldo PE; A nationwide epidemiologic study of clinical Staphylococcus isolates was performed in Italy by 24 operative units distributed throughout the country . A total of 7,017 Staphylococcus strains were examined according to a standard protocol . Three species of acknowledged importance in human infections (namely S . aureus, S . epidermidis, and S . saprophyticus) were identified singly, whereas the other staphylococci were considered as a whole and designated Staphylococcus spp . S . aureus totalled 55% of total isolates and was reported by most operative units as the predominant species among isolates both from various inpatient departments and from outpatients . S . saprophyticus was twofold more frequent among isolates from out- than from inpatients . Susceptibility to methicillin varied considerably from hospital to hospital, but a general tendency toward an increasing spread of resistance was noted . The overall incidence of methicillin resistance (29%) resulted from a wide range of values generally higher in isolates from inpatients (35%) than from outpatients (21%) . Particularly high percentages of resistance (45%) were recorded in isolates from intensive care departments . Susceptibility testing to four additional beta-lactams (cefoxitin, cefuroxime, cefotaxime, and piperacillin) and to four aminoglycosides (gentamicin, tobramycin, amikacin, and netilmicin) indicated that antibiotic resistance was widespread and in all species more frequent among methicillin-resistant than among methicillin-sensitive staphylococci . Netilmicin proved more active than the other antibiotics tested; its greater activity was most evident against methicillin-resistant strains . Coagulase-negative staphylococci were more resistant than S . aureus to methicillin and most of the other antibiotics, suggesting their increasing involvement in human infections. Immun Infekt, 1986 Sep, 14(5), 165 - 9 {Infections caused by coagulase-negative Staphylococci in immunocompromised patients}; Peters G et al.; Coagulase-negative staphylococci are important members of the normal aerobic microflora of human skin and mucous membranes . Normally they are not pathogenic for men . But the increase in patients with implanted plastic foreign bodies or intravascular catheters had led to a dramatic change . In these patients, coagulase-negative staphylococci are the predominant organisms causing septicemia . Special pathomechanisms are involved in the colonization of polymers by staphylococci leading to a "plastic infection" . Intravascular catheters are also important factors in the origin of septicemia in premature neonates and in patients with malignant diseases, especially under cytostatic therapy . Premature or suppressed opsonophagocytosis mechanisms are responsible for the origin and maintainance of septicemia. J Vet Pharmacol Ther, 1986 Sep, 9(3), 303 - 9 The effect of incorporation of cloxacillin in liposomes on treatment of experimental staphylococcal mastitis in mice; Anderson JC et al.; The effect of incorporation of cloxacillin in liposomes on the treatment of staphylococcal mastitis was assessed bacteriologically 18 h after treatment of experimental infections in mice caused by two strains of Staphylococcus aureus . Intramammary treatments were cloxacillin incorporated in liposomes, cloxacillin in combination with liposomes, empty liposomes, cloxacillin in saline and saline alone . In none of the experiments did entrapment of cloxacillin within liposomes enhance its antibacterial effects . Electron microscopic studies demonstrated the presence of liposomes in neutrophils which also contained staphylococci . The results support the hypothesis that intracellular staphylococci are metabolically dormant and therefore not susceptible to the action of inhibitors of cell wall synthesis such as cloxacillin. J Pediatr Orthop, 1986 Sep-Oct, 6(5), 622 - 6 Primary osteomyelitis caused by coagulase-negative staphylococci; Paley D et al.; Coagulase-negative staphylococci (CONS) are occasionally cultured from foci of osteomyelitis in otherwise healthy individuals and are usually regarded as contaminants . The present report describes two children with subacute osteomyelitis of the distal tibia in which pure cultures of CONS were obtained from bone . In one patient, the infection was multifocal, and CONS were isolated from two anatomical sites at two different times . In the other patient, the infection was unifocal, and CONS were cultured from two separate specimens obtained from the same site . In both patients, the symptoms progressed until appropriate antibiotic treatment was initiated . CONS isolated from cultures of bone should not automatically be disregarded . Appropriate antibiotic therapy may result in clinical resolution. Diagn Microbiol Infect Dis, 1986 Sep, 5(3), 197 - 205 Comparison of microbiologic characteristics of pathogenic and saprophytic coagulase-negative staphylococci from patients on continuous ambulatory peritoneal dialysis; Baddour LM et al.; Twenty-one microbiologically documented episodes of coagulase-negative staphylococcal peritonitis occurred in 21 continuous ambulatory peritoneal dialysis patients . All strains involved in these infections were tested for antimicrobial susceptibility and in vitro adherence assays . Twenty of the strains were species identified using two commercially available systems . For comparison, 20 saprophytic strains of coagulase-negative staphylococci obtained from the nares and axillae of 10 uninfected, peritoneal dialysis patients were included for in vitro characterization . Staphylococcus epidermidis was the species most often identified for both clinical and saprophytic strains . Eighteen of the 21 (86%) clinical strains were resistant to penicillin G . Methicillin resistance, which was present in five clinical strains, was not found in saprophytic strains . Adherence assay determinations showed marked differences between clinical versus colonization strains, with the clinical isolates significantly more adherent (p less than 0.025) than colonization strains . Electron microscopic examination of silastic catheter segments incubated with a strain of S . epidermidis in used and unused dialysis fluids demonstrated marked differences in attachment of bacteria to catheter material. J Med Microbiol, 1986 Sep, 22(2), 179 - 82 A simplified system for the identification of staphylococci by multipoint inoculation of test media; Reuther JW; Most hospital bacteriologists have divided staphylococci into two groups: Staphylococcus aureus and the coagulase-negative staphylococci of which the novobiocin-resistant varieties are termed S . saprophyticus . The identification of S . aureus has been easy but that of the other staphylococci has provided some difficulties and most currently available methods are expensive or time consuming . Multipoint inoculation of a set of test media provides a convenient way of identifying large numbers of staphylococcal isolates . In tests with 118 isolates, mainly clinical but including some environmental isolates and some from the National Collection of Type Cultures, there was 90.7% agreement between identifications by the API-Staph system and by the multipoint system . The remaining 9.3% of strains was identified by the multipoint system but could not be identified by use of the data supplied in the API-Staph kit. Zh Mikrobiol Epidemiol Immunobiol, 1986 Sep, (9), 53 - 7 {Lymphocyte subpopulations in sensitization and specific immunotherapy in an experiment . Lymphocyte subpopulations in the specific immunotherapy of microbial allergy and subsequent heterologous pollen sensitization}; Nugmanova DS et al.; The influence exerted by the specific immunotherapy (SIT) of delayed hypersensitivity (DH) to staphylococci and subsequent sensitization with tarragon pollen on the level of immunocompetent cells in the blood and lymphoid organs of guinea pigs was studied . On the whole, SIT normalized the characteristics of T- and B-lymphocytes, altered as the result of experimentally induced DH: the content of T-cells in the peripheral blood and the lymph nodes increased, while the number of B-cells in the blood and T gamma-suppressors increased . The subsequent heterologous sensitization with pollen abolished the effect of SIT, inducing the general decrease of the level of T gamma-lymphocytes and enhancing the number of T-lymphocytes in the lymph nodes. Zh Mikrobiol Epidemiol Immunobiol, 1986 Sep, (9), 48 - 53 {Lymphocyte subpopulations in sensitization and specific immunotherapy in an experiment . Lymphocyte subpopulations in sensitization to staphylococci, Artemisia pollen and their combinations}; Nugmanova ZhS et al.; The distribution of T- and B-lymphocytes in the body of guinea pigs was studied in different groups of the animals . As shown in this study, in delayed hypersensitivity to staphylococci the number of PE- and E-rosette-forming cells increased in the blood, the spleen, and the lymph nodes and decreased in the thymus; the number of EA- and EAC-rosette-forming cells decreased in the bone marrow and the spleen, the number of T gamma-suppressors decreased in the bone marrow and the distant lymph node . Immediate hypersensitivity to tarragon pollen induced the general increase of the content of T- and B-lymphocytes; the number of T gamma-cells decreased in the thymus, the bone marrow, and the lymph nodes and increased in the spleen . The characteristic features of combined microbial-pollen sensitization were the high content of B-cells in all lymphoid organs (except the thymus), a low level of T-lymphocytes in the blood and the peripheral lymphoid organs, the decreased number of T gamma-cells in most of the immunogenetic organs. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1986 Sep, 262(3), 361 - 9 In vitro additive effect of imipenem combined with vancomycin against multiple-drug resistant, coagulase-negative Staphylococci; Traub WH et al.; Imipenem combined with vancomycin resulted in a marked additive effect in vitro against 9 clinical isolates of multiple-drug resistant (MDR), coagulase-negative staphylococci, including strains resistant against imipenem . The additive effect was documented with the aid of checkerboard MIC determinations and with time kill curve experiments . In contrast, imipenem combined with vancomycin merely yielded weak additive or indifferent effects against 10 MDR isolates of Staphylococcus aureus, all of which were susceptible to imipenem. J Clin Microbiol, 1986 Sep, 24(3), 462 - 4 Modification of the Sceptor system for rapid detection of methicillin-resistant staphylococci; Denys GA et al.; The 24-h Sceptor MIC system (Johnston Laboratories, Inc., Towson, Md.) was modified to allow rapid (6 h) detection of methicillin-resistant staphylococci . For 105 methicillin-resistant staphylococci tested, 90% of the results obtained by the 6-h method agreed with those obtained by disk agar diffusion . In comparison, 88 and 93% of the results obtained by the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) and the 24-h conventional Sceptor system, respectively, agreed with disk agar diffusion results . No false-resistant results were observed with 52 methicillin-susceptible staphylococci tested by any of the three methods. J Hosp Infect, 1986 Sep, 8(2), 184 - 92 Per-operative antibiotic treatment in cardiovascular surgery: the influence of methicillin versus cephalothin on post-operative infections and bacterial colonization; Hansen BG; This paper reports the results of a prospective study of antibiotic prophylaxis in 543 patients undergoing open-heart surgery . All patients were given per-operatively either methicillin, 1 g four times a day, or cephalothin, 1 g four times a day . There was no significant difference in the frequency of postoperative infections between the two groups . It was established that per-operative antibiotic prophylaxis selected resistant coagulase-negative staphylococci (CNS) in the nasal flora of cardiac surgery patients, that this change occurred to the same degree whether methicillin or cephalothin was used, that cephalothin favoured colonization with antibiotic resistant species other than CNS . It was found that the staff of the intensive care unit formed a reservoir of multi-resistant CNS. Q J Med, 1986 Aug, 60(232), 773 - 9 Serious infection in the intensive therapy unit: a 15-year study of bacteraemia; Forgacs IC et al.; A 15-year prospective study identified 468 episodes of bacteraemia in patients in the intensive therapy unit (containing 12 beds) . The mortality was 60.4 per cent compared with 13.1 per cent in those without detectable bacteraemia . The pattern of microbial isolates was similar to that in bacteraemia elsewhere in the hospital except for a relative excess of pseudomonas and yeasts . The commonest isolates were staphylococci; the source of these organisms was an infected intravenous line in two-thirds of hospital-acquired episodes of bacteraemia in the unit . Antibiotic resistance patterns were largely predictable with gentamicin resistance being especially uncommon . Although bacteraemia poses a serious threat to patients in an intensive therapy unit, the treatment of such infection seldom requires new and expensive antibiotics. J Appl Bacteriol, 1986 Aug, 61(2), 149 - 55 The toxicity of potassium tellurite to Staphylococcus aureus in rabbit plasma fibrinogen agar; Sawhney D; The potassium tellurite concentration, 0.01% w/v, in Baird-Parker agar has been recommended for plasma coagulase media such as pig or rabbit fibrinogen agar . Comparative tests have shown that with some strains of Staphylococcus aureus this level of potassium tellurite is too inhibitory and it should be reduced four-fold to 0.0025% w/v to maximize the isolation rate . It is postulated that egg yolk in Baird-Parker agar has a protective effect on staphylococci against the inhibitory action of tellurite. Zh Mikrobiol Epidemiol Immunobiol, 1986 Aug, (8), 75 - 9 {Formation of pollen-induced allergy in guinea pigs after specific immunotherapy with a bacterial allergen}; Sukhodoeva GS et al.; The investigation was aimed at elucidating the process of the development of allergy to exoallergens (e.g., to linear-leaf wormwood pollen) in the body after desensitization by specific immunotherapy (SIT) with heterologous (staphylococcal) allergen . The study revealed that in staphylococcal allergy the subsequent development of pollen sensitization occurred with greater intensity, and SIT was found to exert no influence on this process . For the first time pollen allergy was found to produce an unfavorable effect on the quality and effectiveness of SIT with heterologous staphylococcal allergen, this effect consisting in the acceleration and intensification of the process leading to the recovery of sensitization to staphylococci . The importance of measures for limiting contacts with heterologous allergens and their elimination during SIT is emphasized. Zh Mikrobiol Epidemiol Immunobiol, 1986 Aug, (8), 48 - 52 {Immunosuppressor role of staphylococcal protein A}; Bobrovnik SA; The removal of protein A from the surface of staphylococci by means of proteolytic enzymes increases the immunogenic properties of staphylococci . Staphylococci containing protein A are less effective in mediating the immunological memory than those treated with proteolytic enzymes . The conjugation of protein A with staphylococci treated with proteolytic enzymes leads to the decrease of the immunogenic properties of staphylococci . Protein A not bound to staphylococci also suppresses antistaphylococcal immune response . The protective properties of corpuscular staphylococcal antigen are increased after the removal of protein A from the surface of staphylococci by proteolysis. Acta Pathol Microbiol Immunol Scand {B}, 1986 Aug, 94(4), 291 - 2 Same-day confirmation of Staphylococcus aureus bacteraemia by a thermonuclease test; Bergh K et al.; A test to detect thermostable DNase activity (TDNase test) was evaluated for rapid confirmation of S . aureus bacteraemia, using toluidine blue O DNA agar plates for the testing . A total of 226 blood cultures which grew bacteria were examined . S . aureus was identified in 76 of the cultures . All of the S . aureus isolates showed positive TDNase test after 2 h of incubation of the test plates . The remaining isolates examined, most of them coagulase-negative staphylococci, showed a negative test . The TDNase test enables reliable same-day confirmation of S . aureus bacteraemia. Biull Eksp Biol Med, 1986 Aug, 102(8), 194 - 7 {Mechanism of formation of antibody production stimulating ability of bone marrow cells of mice immunized with staphylococci}; Liashchenko KP et al.; The mechanism of the increase in immune response to particular staphylococcal antigen was studied in CBA and BALB/c mice injected by primed bone marrow cells (BMC) . It was found that immunostimulatory effect of immune BMC is not mediated by macrophages or T cells, but is associated with staphylococcus-specific B memory cells present in the pool of primed BMC . Splenectomy performed in donor animals prior to immunization did not abolish the induction of stimulating BMC activity . It was concluded that primed B lymphocyte migration from spleen into bone marrow is not obligatory for the induction of staphylococcus-specific immunological memory in the bone marrow. J Trauma, 1986 Aug, 26(8), 757 - 61 Infectious morbidity in extremity fractures; Roth AI et al.; To review infectious morbidity in extremity fractures, 265 patients with 280 open fractures and 573 patients with closed fractures requiring open reduction and internal fixation (ORIF) were reviewed . Among open fractures, 32 (11%) became infected . Significantly fewer infections occurred in open fractures secondary to gunshot wounds (p less than 0.01) and in the upper extremity regardless of cause (p less than 0.05) . Preventive preoperative antibiotics did not appear to affect infection rates . Open fracture infections were consistently with hospital-acquired organisms, and these were consistently resistant to the preventive antibiotic employed . Closed fractures had only 18 (3%) infections after ORIF . Preoperative antibiotics did reduce infection rates compared to rates in patients with no preoperative systemic antibiotics (p less than 0.05) . Pathogens in ORIF patients showed a greater preponderance of Staphylococci . In conclusion, preventive antibiotics were only effective in the prevention of infection in the ORIF patients . Open fracture patients consistently develop infections with hospital-acquired pathogens, suggesting that contamination after hospitalization rather than at the time of injury is a major factor. J Antimicrob Chemother, 1986 Aug, 18(2), 171 - 5 In-vitro activity of coumermycin against methicillin-resistant staphylococci: a comparison with six other agents; Thomas MG et al.; The in-vitro activity of coumermycin was compared with that of vancomycin, rifampicin, fusidic acid, trimethoprim-sulphamethoxazole, norfloxacin and cefamandole against seven isolates of methicillin-resistant Staphylococcus aureus and 97 isolates of methicillin-resistant coagulase negative staphylococci . Apart from one strain of methicillin-resistant S . aureus all isolates were inhibited by less than or equal to 0.06 mg/l of coumermycin . Cefamandole was more active against strains of S . epidermidis than against other coagulase negative staphylococci. J Clin Microbiol, 1986 Aug, 24(2), 173 - 6 Comparative evaluation of identification systems for testing methicillin-resistant strains of Staphylococcus aureus; Smith SM et al.; Several commercial systems are available to distinguish between Staphylococcus aureus and the coagulase-negative species of the Micrococcaceae family . Four latex agglutination systems (Accu-Staph, SeroSTAT, Staphaurex, and Staphylatex) and two hemagglutination systems (Hemastaph and Staphyloslide) were compared for their performance in the rapid identification of 232 isolates of staphylococci, including 114 of methicillin-resistant S . aureus . Accu-Staph, Staphaurex, and Staphyloslide correctly identified 100% of the methicillin-resistant S . aureus isolates; Hemastaph and Staphylatex, 99.1%; and SeroSTAT, 94.7% . Most reactions were easy to interpret, although 15% of the SeroSTAT reactions were weak . Autoagglutination occurred only with isolates of coagulase-negative staphylococci . False-positive reactions were rare and occurred only with systems which did not detect autoagglutination . Five of these six systems appear to be adequate for the rapid identification of S . aureus, including methicillin-resistant isolates. J Rheumatol, 1986 Aug, 13(4), 700 - 6 Circulating immune complexes in rheumatoid arthritis: a prospective study using five immunoassays; Reynolds WJ et al.; We evaluated 257 patients with rheumatoid arthritis (RA) to determine the frequency of circulating immune complexes (CIC) in the serum, relationships between the presence of CIC, clinical indices of disease activity and other laboratory features, and relationships between changes in CIC levels and changes in disease activity . CIC were detected by fluid phase Clq binding activity, conglutinin binding activity, anti-C3 assay, staphylococci protein A binding assay and the precipitation of cryoglobulins . CIC in the serum were found to correlate with indices of disease activity, extraarticular features and the presence of rheumatoid factor . A change in Clq binding activity correlated with a parallel change in the joint count. J Med Microbiol, 1986 Aug, 22(1), 79 - 84 Characterisation of chloramphenicol resistance plasmids of Staphylococcus aureus and S . epidermidis by restriction enzyme mapping techniques; Tennent JM et al.; Chloramphenicol resistance (Cmr) plasmids pSK2 and pSK5 from Staphylococcus aureus and pSK102 and pSK103 from S . epidermidis have been characterised and detailed restriction endonuclease cleavage maps constructed . TaqI digestion profiles illustrated the identity of pSK5 and pSK102 and also revealed a high degree of similarity between these four Cmr plasmids from Australian staphylococci and three Cmr plasmids from S . aureus strains of geographically unrelated origin . DNA-DNA hybridisation indicated that the chloramphenicol acetyltransferase determinant carried by pSK5/pSK102 could be found on other structurally-distinct Cmr plasmids . The role of S . epidermidis as a reservoir for Cmr plasmids found in S . aureus is discussed. Antimicrob Agents Chemother, 1986 Jul, 30(1), 174 - 5 Interaction between rifampin and fusidic acid against methicillin-resistant coagulase-positive and -negative staphylococci; Farber BF et al.; We studied the interaction between rifampin and fusidic acid against a group of staphylococci . Of the 20 coagulase-positive strains studied, checkerboard studies revealed synergy in 3 and indifference in 17; time-kill studies revealed synergy in 18 of 19 coagulase-positive strains at both 24 and 48 h . Of the 19 coagulase-negative strains, checkerboard studies revealed synergy in 6 and indifference in 13; time-kill studies revealed synergy in 6 of 18 coagulase-negative strains at 24 h and in 17 of 18 coagulase-negative strains at 48 h . The combination of rifampin and fusidic acid warrants further evaluation in the therapy of staphylococcal disease. Infect Control, 1986 Jul, 7(7), 370 - 2 Viability of staphylococci in various diluents; Essiain R et al.; Standardized suspensions of 78 staphylococci and micrococci were stored in different diluents and tested periodically for 3 weeks to determine their ability to maintain viability . In 92% of the tests, diluent suspensions yielded viable organisms for at least 21 days . Organism survival was maintained in the following order, from best to worst: skim milk, tap water, 0.9% NaCl, deionized water, Dianeal (peritoneal dialysis) fluid, 0.2% bovine serum albumin and 5% glycerol . In 81% of the instances, oxacillin-susceptible staphylococci survived better than oxacillin-resistant staphylococci. Zh Mikrobiol Epidemiol Immunobiol, 1986 Jul, (7), 97 - 100 {Bacteriosorption reaction on a smooth surface for detecting antibodies and antigens}; Nikolaev VL et al.; The solid-phase technique for the detection of antibodies and antigens has been developed and named the bacteriosorption test . The test is based on binding staphylococci containing protein A with the Fc-regions of IgG-antibodies attached to antigens immobilized on polystyrene . The possibilities of this technique have been analyzed with the use of diphtheria toxoid, house-dust allergen and homologous rabbit antisera . In the detection of antibodies the proposed test is not inferior to the passive hemagglutination test, and its sensitivity in the detection of antigens by the sandwich technique reaches 0.05-0.1 micrograms/ml . The specificity of the technique has been experimentally confirmed by the inhibition of the reaction with soluble antigen and staphylococcal protein A . The variability factor of the technique does not exceed 10%. Vet Microbiol, 1986 Jul, 12(2), 179 - 87 A comparison of the STAPH-Ident and STAPH-Trac systems to conventional methods in the identification of staphylococci isolated from bovine udders; Watts JL et al.; The STAPH-Ident and STAPH-Trac systems (Analytab Products, Plainview, N.Y.) were compared to conventional methods for identification of staphylococci isolated from bovine udders . The STAPH-Ident system identified 80.5% of isolates correctly . An additional 7.6% of Staphylococcus hyicus strains were delineated from S . epidermidis by characterizing acetoin and pigment production . Final accuracy of the STAPH-Ident system was 88.1% . The STAPH-Trac system identified 66.1% of isolates . Negative phosphatase tests for 42.3% of S . hyicus strains resulted in misidentification as S . simulans . Consequently, only 45.5% of S . hyicus isolates were identified correctly by the STAPH-Trac system . Minor modification of each system would permit accurate, rapid identification of staphylococci isolated from bovine udders. Am J Med, 1986 Jul, 81(1), 166 - 8 Fatal bacterial endocarditis as a complication of permanent indwelling catheters . Report of two cases; Power J et al.; Two cases of endocarditis secondary to permanent indwelling catheters are described . In both cases, the catheters were used for parenteral nutrition and became infected with Staphylococci . Secondary endocarditis developed on the tricuspid and aortic valves . Despite removal of the catheters and appropriate antibiotics, both patients died. J Hosp Infect, 1986 Jul, 8(1), 64 - 71 Biotyping and phage typing of coagulase-negative staphylococci from blood cultures of neonates; Alvarez JS et al.; One hundred coagulase-negative staphylococci isolated from blood cultures of neonates have been biotyped and phage typed . These results have been compared with previous reports . The susceptibility of the strains to antimicrobial drugs has also been examined and a rise in resistance rates towards the end of the study was documented . The possible causes of this finding are discussed. Am J Med, 1986 Jun 30, 80(6B), 161 - 5 Coagulase-negative staphylococci as nosocomial pathogens in neonates . The role of host defense, artificial devices, and bacterial hydrophobicity; Fleer A et al.; In contrast to the well-established pathogen Staphylococcus aureus, the coagulase-negative staphylococci--formerly collectively called Staphylococcus epidermidis--were until recently regarded as harmless commensals . During the last two decades, however, the coagulase-negative staphylococci have clearly emerged as pathogens in patients who have artificial devices implanted, such as prosthetic heart valves, hip prostheses, and cerebrospinal fluid shunts, and in those with compromised host defenses such as premature neonates, cancer patients, and transplant recipients . Recently, an increasing incidence of septicemia due to coagulase-negative staphylococci was detected in our neonatal intensive care unit . More than 90 percent of cases occurred in premature infants of low birth weight (less than 2,500 g) . All septicemic infants were receiving intravenous therapy, and total parenteral nutrition solutions had been administered to nearly 80 percent just before or during the septic episode . This led us to examine the role of host defense factors in neonates and the possible significance of bacterial surface characteristics in the pathogenesis of catheter-associated infections. Antibiot Med Biotekhnol, 1986 Jun, 31(6), 440 - 5 {Colonizing resistance of rats born of animals with experimental dysbacteriosis}; Shenderov BA et al.; It was shown that long-term oral administration of rifampicin (40 mg/kg) to rats was accompanied by a marked decrease in the number of enterococci and staphylococci in their large intestine . A significant decrease in the number of colibacilli and anaerobic nonsporulating gramnegative bacteria was also observed . Discontinuation of the antibiotic administration resulted in rapid recovery of the intestinal flora with respect to all the indices tested . It was found for the first time that pregany of rats with experimental disbacteriosis was characterized by lowered colon resistance in spite of similarity in the intestinal flora of the experimental and control pregany . This was evident from increased periods of indicator microorganism retention in the animal intestine. Infect Immun, 1986 Jun, 52(3), 798 - 802 Appearance of Fc receptors on polymorphonuclear leukocytes after migration and their role in phagocytosis; Targowski SP et al.; The effect of the migration of bovine blood polymorphonuclear leukocytes (PMNs) in vitro on their phagocytic activity was studied . PMNs were examined before and after migration through various membranes for rosette formation with sensitized sheep erythrocytes to detect Fc receptors (FcRs), phagocytic activity mediated through FcRs with opsonized staphylococci (Smith strain), and phagocytic activity mediated through nonimmunological receptors with unopsonized staphylococci (strain 305) . Migration of PMNs was observed from the upper to the lower compartment of the blind well chamber through Millipore and Nuclepore membranes; through Millipore, Nuclepore, and nylon membranes coated with collagen; and through collagen-coated Millipore, Nuclepore, and nylon membranes overlaid with MA-104, BHK-21, MDBK-99, TB, or FBHE cells . Random migration of PMNs toward the plain medium (the same medium in the upper and lower compartments) through the membranes with and without a monolayer of cells increased the percentage of PMNs forming rosettes . In contrast, migration toward the medium containing lipopolysaccharide (LPS), formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP), or zymosan-activated serum (Act . serum) did not change the percentage of PMNs forming rosettes . The increased percentage of PMNs forming rosettes was associated with the enhanced phagocytosis of opsonized staphylococci (mediated by FcRs) . In contrast, migration of PMNs toward LPS, FMLP, or Act . serum did not enhance phagocytosis mediated through FcRs . However, PMNs after migration toward LPS, FMLP, Act . serum, and plain medium enhanced phagocytosis of unopsonized staphylococci (mediated through the nonimmunological receptors). Pathol Biol (Paris), 1986 Jun, 34(5 Pt 2), 600 - 3 {Evaluation of the Rapid-ATB system for testing the sensitivity of staphylococci to antibiotics . Comparison with the agar dilution reference method}; Le Noc P et al.; Rapid ATB Staph is a new, automated, four-hour procedure for testing the susceptibility to antibiotics of staphylococci . Results obtained with this method were compared to those recorded using agar dilution . For all tested antibiotics as a group (5 on 201 strains, 8 on 100 strains), overall agreement between the two sets of results was 96% . 1,809 susceptibility tests were performed, with only 24 minor discrepancies (1.3%) mainly involving cotrimoxazole, and 50 major discrepancies (2.7%) mainly involving doxycycline and chloramphenicol . Rapid ATB Staph clearly demonstrates the heterogeneous oxacillin-resistance of staphylococci as well as their inducible resistance to erythromycin . Our results show that this new system is a very accurate means for testing the susceptibility to antibiotics of staphylococci. Eur J Clin Microbiol, 1986 Jun, 5(3), 277 - 81 Current problems of chemotherapy of infections with coagulase-negative staphylococci; Davies AJ et al.; A review is given of current problems in the chemotherapy of infections caused by coagulase-negative staphylococci . Along with the recent increase in the number of these infections has come the realisation that such infections may be difficult to treat . The sites of infection caused by coagulase-negative staphylococci are considered and recent advances in the understanding of the molecular biology of these organisms reviewed . Appropriate antibiotic therapy for individual infections is discussed, likewise the contribution the laboratory can make to ensure that the most effective antibiotics are used. Antimicrob Agents Chemother, 1986 May, 29(5), 803 - 6 Antimicrobial activity of borate-buffered solutions; Houlsby RD et al.; A minimal salts medium adjusted to physiological pH and osmolality was buffered with either 0.3% phosphate or 1.2% borate and evaluated for antimicrobial activity . The borate-buffered medium, either with or without a carbon source, exhibited significant antimicrobial activity against 15 Pseudomonas strains, 12 strains of enteric bacteria, and 7 strains of staphylococci . The borate-buffered system appears suitable for use as a generic vehicle for ophthalmic pharmaceutical agents. Antimicrob Agents Chemother, 1986 May, 29(5), 733 - 40 Plasmid-encoded trimethoprim resistance in staphylococci; Archer GL et al.; High-level (greater than 1,000 micrograms/ml) resistance to the antimicrobial agent trimethoprim was found in 17 of 101 (17%) coagulase-negative staphylococci and 5 of 51 (10%) Staphylococcus aureus from a number of different hospitals in the United States . Resistance was plasmid encoded and could be transferred by conjugation in 4 of the 17 (24%) Tpr coagulase-negative staphylococci and 3 of the 5 (60%) Tpr S . aureus . A 1.2-kilobase segment of plasmid DNA from one of the plasmids (pG01) was cloned on a high-copy-number vector in Escherichia coli and expressed high-level Tpr (MIC, 1,025 micrograms/ml) in the gram-negative host . In situ filter hybridization demonstrated homology between the cloned Tpr gene probe and plasmid DNA from each conjugative Tpr plasmid, a single nonconjugative plasmid from a United States Staphylococcus epidermidis isolate, a nonconjugative plasmid from an Australian methicillin-resistant S . aureus isolate, and chromosomal DNA from three Tpr S . epidermidis isolates that did not contain any plasmid DNA that was homologous with the probe . No homology was seen between the probe and staphylococcal plasmids not mediating Tpr, plasmid DNA from 12 Tpr S . epidermidis isolates not transferring Tpr by conjugation, or plasmid-encoded Tpr genes derived from gram-negative bacteria . Plasmid-encoded Tpr appears to be a relatively new gene in staphylococci and, because it can be transferred by conjugation, could become more prevalent in nonsocomial isolates. Antibiot Med Biotekhnol, 1986 May, 31(5), 362 - 5 {Effect of antibiotic AL-87 on the growth and ultrastructure of staphylococci}; Churkina LN et al.; The effect of antibiotic Al-87 on the ultrastructure of staphylococcal cells was studied . The cells of a control culture of a sensitive strain of S . aureus, 209P at the early exponential growth phase were characterized by thin walls (20-22 nm) and septa (30 nm) . In the presence of the subbacteriostatic concentration of antibiotic AL-87 (0.02 microgram/ml) the thickness of the cell walls and septa increased up to 80-90 and 150 nm, respectively . Segregation of the septa was retarded and 4 cell conglomerates formed . The cell division appeared to be highly active: the septa were detected in 80-90 per cent of the sections against 40 per cent in the control . Therefore, antibiotic AL-87 induced significant thickening of the cell walls and impairment of the cell division regulation . Investigation of the staphylococcal variant resistant to the antibiotic showed that there were no significant differences between the cells grown in the absence and presence of antibiotic AL-87 (in a concentration of 200 micrograms/ml) . In both the experiments there were detected cells in their majority with thinner walls, L-form-like structures, protoplasts and single conglomerates of the cells with thicker walls and anomalous division and the cells at the moment of lysis . It suggested that the effect of antibiotic AL-87 on the cell wall structure was not direct i . e . by inhibition of protein synthesis but mediated i . e . due to shifts in lipid synthesis inducing changes in lipid-dependent synthesis of the cell wall polymers. Zh Mikrobiol Epidemiol Immunobiol, 1986 May, (5), 37 - 41 {Staphylococcal adherence to rabbit epithelial cells}; Vershigora AE et al.; The adherence of Staphylococcus aureus strains to rabbit epithelial cells has been studied . The strains have been shown to possess similar adhesiveness with respect to the epithelium of the mouth cavity of rabbits . The investigation, carried out with the use of one staphylococcal strain taken as a model, has revealed that the cells of this strain adhere to different areas of the epithelium in the mouth cavity in varying amounts, the amount of adhering bacteria depending on the age of rabbits . The data presented in this work suggest that in staphylococci adhering to rabbit epithelial cells the adhesive function is performed by thermostable and trypsin-resistant staphylococcal cell-wall surface structures of nonprotein nature. J Clin Microbiol, 1986 May, 23(5), 963 - 4 Variations in bacitracin susceptibility observed in Staphylococcus and Micrococcus species; Baker JS et al.; Bacitracin susceptibility was evaluated as a laboratory method to differentiate staphylococci from micrococci . A total of 317 staphylococcal isolates and 108 micrococcal isolates were each tested for susceptibility to bacitracin by a disk-diffusion method using disks of three different potencies (0.04, 2.0, and 10.0 U) and a broth dilution method to obtain MICs . When a growth inhibition zone diameter breakpoint of greater than 10 mm was used to establish susceptibility with a 0.04-U disk, all micrococci were bacitracin susceptible and 94.6% of the staphylococci were resistant . Testing with disks of higher potency did not improve the specificity of the disk-diffusion method. J Clin Microbiol, 1986 May, 23(5), 873 - 5 Evaluation of the Minitek gram-positive set for identification of staphylococci isolated from the bovine mammary gland; Watts JL et al.; The Minitek Gram-Positive Set was evaluated as a means of identifying staphylococci isolated from bovine mammary glands . Initial accuracy was 79.2% . Misidentification of isolates due to data base deficiencies resulted with the animal-associated species Staphylococcus intermedius and S . hyicus . Minor modification to account for data base deficiencies permitted recognition of 87.7% of the isolates . Incorporation of additional veterinary isolates into the data base would improve the accuracy of the Minitek system and enhance acceptance by veterinary microbiologists. J Clin Microbiol, 1986 May, 23(5), 858 - 62 Slime production by bovine milk Staphylococcus aureus and identification of coagulase-negative staphylococcal isolates; Rather PN et al.; Staphylococcus aureus isolates from bovine milk were assessed for capsule or slime production . When pure S . aureus cultures in milk were inoculated directly into serum-soft agar constituted with a modified staphylococcus 110 medium, 100% of the isolates grew with diffuse colony morphology . Diffuse colony morphology was rapidly lost on subculture and was more rapidly lost in brain heart infusion-serum-soft agar . No evidence was seen for encapsulation in India ink preparations or by the clumping factor test . It was concluded that freshly isolated S . aureus strains produce slime, not true capsules . During examination of the 84 milk samples that grew staphylococci in addition to S . aureus (27.4%), a significant number of coagulase-negative staphylococcal species were encountered and identified by conventional tests as S . simulans (41.7%), S . xylosus (11.9%), S . epidermidis (3.6%), S . saprophyticus (3.6%), S . hyicus (2.9%), S . cohnii (1.2%), S . haemolyticus (1.2%), and S . warneri (1.2%) . Five isolates (6.0%) were not identified . Attempts were also made to identify the isolates by the API Staph-Ident system, which gave an overall accuracy of 45.2% . The susceptibilities of the isolates to a variety of antibiotics were determined, and they appeared to be less resistant than human clinical isolates. J Clin Microbiol, 1986 May, 23(5), 809 - 12 Staphylococcal peritonitis in patients on continuous peritoneal dialysis; West TE et al.; During 1984, 35 patients undergoing continuous peritoneal dialysis experienced 77 cases of peritonitis with 55 cases (71.4%) related to staphylococci . Coagulase-negative staphylococci were isolated in 41 cases, while Staphylococcus aureus was found in 14 . A coexisting tunnel infection was more often associated with S . aureus (7/14) than with coagulase-negative staphylococci (2/41) (P less than 0.01) . Likewise, eradication of the infection necessitated catheter removal more frequently with S . aureus (5/14) than with coagulase-negative staphylococci (2/41) (P less than 0.01) . Of the 41 coagulase-negative staphylococci, 35 were characterized as to species, adherence, and production of two exopolysaccharides . Staphylococcus epidermidis was the most frequent coagulase-negative species (29/35) . Peritonitis cases caused by coagulase-negative staphylococci that lacked adherence and exopolysaccharides were more frequently associated with complications (4/6) than were those organisms with either or both properties of adherence or exopolysaccharide production (5/29) . There were no appreciable differences in antibiotic susceptibilities . Staphylococcal peritonitis remains a significant cause of morbidity in continuous peritoneal dialysis patients . The incidence of complications was not directly linked to staphylococcal properties of adherence or exopolysaccharide production. J Pediatr, 1986 May, 108(5 Pt 2), 835 - 40 Kinetics of antimicrobial activity; Vogelman B et al.; Assessment of antimicrobial activity from standard in vitro minimum inhibitory and minimum bactericidal concentration determinations alone is incomplete . Rate of bacterial killing, effect of increasing concentration, sub-MIC effects, and degree of suppression of bacterial growth after limited exposure (post-antibiotic effect) more precisely describe the course of antimicrobial activity . Aminoglycoside antibiotics exhibit concentration-dependent bactericidal activity and a prolonged post-antibiotic effect . beta-Lactam antibiotics demonstrate more time-dependent killing and lack post-antibiotic effects, except with staphylococci . Most bacteriostatic antimicrobial agents also produce post-antibiotic suppression of growth . Studies in different animal infection models with a variety of organisms suggest that beta-lactams are more efficacious with continuous dosing, whereas the efficacy of aminoglycosides is relatively independent of dosing regimen, even when administered once daily . Knowledge of the kinetics of antimicrobial action is useful in predicting optimal dosage regimens. J Clin Oncol, 1986 May, 4(5), 784 - 8 Long-term use of indwelling multipurpose silastic catheters in pediatric cancer patients treated with aggressive chemotherapy; Cairo MS et al.; We studied the complications related to the use of 53 multipurpose silastic catheters (MSC) placed in 46 pediatric cancer patients over a 1-year period . We documented the longest duration of catheter placement in the pediatric oncology literature . There were 7,650 Broviac days (range, 9 to 365 days; mean, 163 days) with 255 patient months of catheter use and a mean of 5.5 months per catheter . Of the 53 MSCs, 90% were Broviacs (72% adult size, 18% pediatric size) and 10% Hickman . There were 23 episodes of bacteremias or 0.31 episodes per 100 days of catheter use . Coagulase-negative staphylococci were isolated in 20% of the episodes of bacteremia . Only 34% had an absolute granulocyte count (AGC) (Polymorphonuclear cells {PMN} + band cells) less than 500 in the 23 MSCs with bacteremia . Ten percent were removed: 4% for mechanical problems, 6% for bacteremia unresponsive to appropriate antibiotic therapy . There were no deaths related to bacteremia, embolism, or vascular damage . This study demonstrated that despite the recent use of more aggressive immunosuppressive therapy, the incidence of MSC bacteremias was 43%, similar to earlier National Cancer Institute studies (39%) American Society of Clinical Oncology, (abstract C-219, 1982) . Based on these findings, we have currently modified our MSC care and have recently throughout the past 6 months reduced our infectious complication rate by 50%. Diagn Microbiol Infect Dis, 1986 May, 5(1), 1 - 8 Bactericidal action of nafcillin, vancomycin, and three cephalosporins against nafcillin-susceptible and nafcillin-resistant coagulase-negative staphylococci; Mordenti JJ et al.; Coagulase-negative staphylococci (S . epidermidis, 43 strains; S . warneri, 16 strains; S . haemolyticus, five strains; and others, four strains) were tested by the agar dilution method for nafcillin susceptibility: 53 were susceptible with a minimal inhibitory concentration (MIC) of less than or equal to 2 micrograms/ml; four were of indeterminate susceptibility, MIC = 4-16 micrograms/ml; and 11 were resistant, MIC greater than or equal to 32 micrograms/ml . The bactericidal activities from 0 to 24 hr for nafcillin, vancomycin, cephalothin, cefazolin, and cefamandole, each at 16 micrograms/ml in broth, were determined for all the isolates . The data indicate that a nafcillin agar dilution susceptibility test result of resistance does not consistently predict lack of killing activity by the cephalosporins . It is likely that each cephalosporin would have to be tested against individual coagulase-negative staphylococci in order to determine a suitable therapeutic or prophylactic cephalosporin, if a cephalosporin were to be used . Vancomycin was bactericidal for all the nafcillin-resistant coagulase-negative organisms tested. J Pediatr, 1986 May, 108(5 Pt 2), 796 - 9 Staphylococcus aureus: biology, mechanisms of virulence, epidemiology; Cohen ML; The prominence of Staphylococcus aureus as a cause of serious human infection has prompted extensive studies of the microbiology, pathogenesis, and epidemiology of staphylococci and staphylococcal infections . Staphylococci are of the family Micrococcaceae, although there are diverse genetic and phenotypic differences between them and other members of this family . Of the more than 20 species of staphylococci, only three are clinically significant: S . aureus, S . epidermidis, and S . saprophyticus . These species can be distinguished by coagulase production and novobiocin resistance . Staphylococci produce a variety of structural, enzymatic, and toxic products, which are associated with adherence, invasion, toxicity, and avoidance of host defense mechanisms . In addition, a variety of host characteristics increase susceptibility to staphylococcal infection . Staphylococci are an important cause of infection in hospitals and the community . Following the introduction of antimicrobials, staphylococci rapidly developed resistance . A penicillin-resistant specific phage type, designated 80/81, caused severe outbreaks of nosocomial disease in the 1950s and 1960s . Staphylococci recently acquired resistance to methicillin and other antimicrobials, and persist as important nosocomial pathogens . Although S . aureus is one of the earliest recognized and most studied human pathogens, it is a perplexing, ever-changing, recurring public health problem. Pathol Biol (Paris), 1986 May, 34(5), 521 - 4 {Cloxacillin concentration in suction fluid following flash antibiotic therapy during insertion of a hip prosthesis}; Loulergue J et al.; Since 1982 we have administered cloxacillin intraoperatively during total hip replacement . 1 g cloxacillin is injected intravenously at induction of anesthesia, followed by 1g every hour until the end of the procedure or a total of 6 g . In our study, cloxacillin concentrations were determined in the fluid collected from the deep suction catheter inserted at the end of the surgical procedure . Fluid samples were collected 2 h, 4 h, 6 h, 8 h and 24 hours after the last injection of cloxacillin . Serum samples were taken 2 h, 6 h and 24 hours after the last injection . Cloxacillin was assayed using an agar-diffusion microbiologic method . 18 patients were studied . Each had received 3 to 5 g cloxacillin over 3 to 5 hours . Mean suction catheter fluid concentrations were to 69.7 micrograms/ml, 37.6 micrograms/ml, 24.2 micrograms/ml, 15.5 micrograms/ml, and 6.8 micrograms/ml respectively in the samples collected 2 h, 4 h, 6 h, 8 h and 24 hours after the last injection of cloxacillin . Mean serum concentrations were 34.1 micrograms/ml, 4.2 micrograms/ml, and 0 microgram/ml respectively 2 h, 6 h and 24 hours after the last injection . Our results indicate that cloxacillin concentrations within the hip joint are probably effective against staphylococci for 8 to 12 hours. Pathol Biol (Paris), 1986 May, 34(5), 517 - 20 {Antibiotic sensitivity of bacteria isolated from pathological specimens and utilization of beta-lactams in an orthopedic surgery service}; Laudat P et al.; From 1980 to 1984, computerized data on the sensitivity to the main antibiotics of 1991 strains isolated from clinical specimens were evaluated in relation to beta-lactam use and hospital activity in a unit of orthopedic surgery . No major variations were found in distribution of species throughout the study period, whereas sensitivity to antimicrobial agents changed . From 1980 to 1982, patients had postoperative prophylactic treatment with cephalosporin (cefazolin) for two days; during the same period, 59% of 557 Gram negative organisms were resistant to cefazolin and 31% of Staphylococci were resistant to methicillin (and to other antibiotics) . In 1983 and 1984, cefazolin was replaced by intraoperative flash therapy with a penicillin-M (cloxacillin); concomitantly, sensitivity to cefazolin increased among Gram negative organisms (38% of 485 isolates were cefazolin-resistant; p less than 0.001) and Staphylococci (16% of 342 isolates were methicillin-resistant; p less than 0.001) . Phage typing of S . aureus failed to disclose any epidemic outbreak . Since hospital activity remained the same throughout the period under study, it seems justified to correlate the increase in bacterial sensitivity observed to the decrease in use of cephalosporin, although other factors (microepidemic, isolation techniques) may be involved. Pathol Biol (Paris), 1986 May, 34(5), 368 - 71 {Sensitivity of 858 strains of staphylococci to 27 antibiotics}; Gayral JP et al.; Susceptibility to 27 antimicrobial agents of 858 strains of staphylococci was determined . Tested strains belonged to the following species: S . epidermidis, S . saprophyticus, S . haemolyticus, S . hominis, S . simulans, S . warneri, S . cohnii, S . xylosus and S . intermedius . The antibiotics were: penicillin G, amoxycillin, augmentin, oxacillin, streptomycin, kanamycin, tobramycin, dibekacin, amikacin, gentamicin, sisomycin, netilmicin, doxycycline, minocycline, chloramphenicol, erythromycin, josamycin, clindamycin, pristinamycin, rifampin, fusidic acid, fosfomycin, trimethoprim, sulfamethoxazole, cotrimoxazole, and vancomycin . The ATB system was used, with the criteria for categorization recommended by the Antibiotic Sensitivity Testing Committee . Penicillin-resistance, that was found in all species, was high for hospital-acquired strains (67 to 75%) but also for some other strains (32% for S . simulans) . Oxacillin-resistance varied across species (0% for the least prevalent hospital strains, 6% for S . epidermidis and 28% for S . haemolyticus) . All strains were susceptible to vancomycin . For some drugs, resistance was a characteristic of the species: resistance to fosfomycin was often found for S . saprophyticus, S . haemolyticus, S . warneri, S . cohnii, and S . capitis; resistance to trimethoprim was common for S . simulans, and S . haemolyticus . S . haemolyticus was the most resistant species, a fact that justifies routine identification of this pathogen in clinical specimens. Clin Exp Immunol, 1986 May, 64(2), 382 - 91 Characterization of two distinct antigens expressed on either resting or activated human B cells as defined by monoclonal antibodies; Kokai Y et al.; Two antigen systems (L29 & L30) expressed on two distinct human B cell subpopulations were identified by using BL1-4D6 and TB3-7D5 monoclonal antibodies, respectively . L29 was expressed on approximately one-third of B cells in human lymphoid tissues . These B cells associated with L29 were large activated B cells located in the germinal centres of lymphoid follicles . L30, on the other hand, existed on approximately two-thirds of B cells mainly located in the mantle zone of lymphoid follicles, most of which also expressed IgM and IgD on their cell membrane . In addition, L30 was shared on mature granulocytes . With the use of polyclonal activators such as pokeweek mitogen (PWM) and protein A-bearing staphylococci (SAC), L29 antigen was inducible on PWM- or SAC-stimulated B cells in correspondence with the emergence of Tac and T10 antigens of these B cells . In contrast, L30 antigen on the B cells stimulated by the polyclonal activators was decreased in its expression and was finally lost from these B cells . Although none of L29 and L30 was expressed on normal, non-activated human thymus and peripheral T cells, L29 but not L30 was expressed on concanavalin A-activated T cells . Immunochemical studies showed that L30 consist of a single polypeptide with mol . wt of 40,000 . L29 antigen is presently under study. Scand J Gastroenterol, 1986 May, 21(4), 455 - 60 Catheter-related septicaemia in patients receiving home parenteral nutrition; Rannem T et al.; Forty-three patients received home parenteral nutrition (HPN) for 4 to 13 months (median, 30 months) with a total treatment period of 153 patient-years . All patients had central venous catheters; 71 PVC subclavian catheters, 138 Broviac catheters, and 16 other catheters were used . Broviac catheters were introduced into the central veins via a tunnel on the chest (94 catheters) or on the thigh (44 catheters) . Eighty-two episodes of catheter septicaemia occurred in 28 (65%) of the patients, corresponding to an incidence of catheter septicaemia of 1 in 1.9 patient-years . The commonest microorganisms grown from the blood were coagulase-negative staphylococci, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, and Candida species . Septicaemia incidence was 1 in 2.6 catheter-years with the Broviac catheter on the chest and 1 in 1.6 catheter-years with the Broviac catheter on the thigh . In 49 cases the patient was treated with both antibiotics and change of the catheters, in 26 cases with antibiotics alone, and in 5 cases with change of the catheter alone . The antibiotic therapy was given for 3 to 15 days (median, 7 days) . No patient died of catheter septicaemia . The relapse rate was low (less than 10%) and did not differ significantly between the three treatment groups . It is concluded that catheter septicaemia is a common complication of HPN . In most cases it runs a mild course . Bacteriaemia can often be eradicated by a brief antibiotic therapy without catheter exchange. Crit Care Med, 1986 May, 14(5), 503 - 4 Evaluation of the sterility of thermodilution room-temperature injectate preparations; Burke KG et al.; This study assessed the bacteriologic safety of room-temperature injectate used for cardiac output measurement in a surgical ICU, and compared its cost/benefit relationship to that of prefilled packaged syringes and a closed-loop injectate system . Ninety-five samples of injectate were obtained at four time intervals from staff-prepared syringes, and cultured for microbiologic growth . About 29% (27/95) of samples yielded bacterial growth, ranging from two colony-forming units to those too numerous to count . All positive samples contained skin flora, including coagulase-negative staphylococci and coryneforms . Additionally, five plates contained colonies of Gram-negative bacteria . Extended storage time increased the risk of contamination: 16.2% were contaminated within the first 24 h, whereas 45% were contaminated when stored for more than 72 h . Switching to a closed injectate system significantly (p less than .001) decreased the incidence of contamination by 1.2%, and also allowed a cost savings of $1.52/patient. Zh Mikrobiol Epidemiol Immunobiol, 1986 May, (5), 77 - 82 {Delayed hypersensitivity and nonspecific cellular immunity . The conditions determining the maximally expressed immunity activity}; Gordienko SM; In vivo experiments on the infection of mice with influenza A virus and Francisella tularensis and in vitro experiments on the bactericidal activity of macrophages have demonstrated the conditions leading to the maximally pronounced activation of immunity by means of preparations inducing delayed hypersensitivity (DH) . The following conditions have been determined: the presence of pronounced DH previously to the injection of old tuberculin (OT) and staphylococcal phagolysate (SP) used as challenge antigens, the specificity and peculiar features of the antigenic structure of the challenge agent, the time of its administration after the course of multiple sensitizing injections of BCG and staphylococci, the dosage of OT and SP and the scheme of their administration, the desirability of their local use . The time of the maximum activation of cell-mediated immunity after the injection of OT and SP to sensitized animals with a high level of DH and the duration of such activation have been established. Invest Ophthalmol Vis Sci, 1986 Apr, 27(4), 486 - 91 Bacterial lipases and chronic blepharitis; Dougherty JM et al.; Eyelids and conjunctivae of 36 normal individuals and 60 patients from six clinical groups of chronic blepharitis were cultured for aerobic and anaerobic bacteria . The most common species isolated were coagulase-negative staphylococci (C-NS) and Propionibacterium acnes . All strains of these species, and all Staphylococcus aureus strains isolated were tested for the ability to break down triglycerides, cholesterol esters, and fatty waxes . Each strain was incubated independently with appropriate substrates in nutrient media . Each medium was then extracted and assayed for the presence of substrate hydrolysis products by thin-layer chromatography . The percentage of strains capable of hydrolyzing a particular substrate was determined for each individual . S . aureus was a consistent and strong lipase producer, able to hydrolyze all three substrates . P . acnes was able to hydrolyze triolein and behenyl oleate but not cholesteryl oleate . No differences were observed among groups for P . acnes or S . aureus . C-NS showed a high degree of strain variability . Eighty-three percent of C-NS strains could hydrolyze triolein, 82% behenyl oleate, and 40% cholesteryl oleate . Significant group differences were seen in the percentage of lipase positive C-NS strains isolated per individual . Patients in the mixed staphylococcal/seborrheic, meibomian seborrheic, secondary meibomitis, and the meibomian keratoconjunctivitis (MKC) groups harbored significantly more C-NS strains capable of hydrolyzing cholesteryl oleate than did normal individuals . Patients in the meibomian seborrheic, secondary meibomitis, and MKC groups harbored significantly more C-NS strains capable of hydrolyzing behenyl oleate than did normals . No group differences were seen among groups with triolein hydrolyzing C-NS strains. Can J Vet Res, 1986 Apr, 50(2), 272 - 4 The normal microflora of the female rabbit's genital tract; Jacques M et al.; Microorganisms associated with the vagina, cervix and uterus of rabbits were isolated and identified . The predominant microorganisms isolated from the vaginas and cervices were coagulase-negative staphylococci, micrococci, and nonfermentative bacilli . Coagulase-negative staphylococci were isolated frequently, but in small numbers, from the uteri . The pH of the rabbit vagina was found to be near neutrality . Our data indicate that the genital flora of female rabbits is relatively simple, regarding the number and type of microorganisms. Antimicrob Agents Chemother, 1986 Apr, 29(4), 608 - 10 Activity of coumermycin against clinical isolates of staphylococci; Guillemin MN et al.; Staphylococci, particularly methicillin-resistant strains of Staphylococcus aureus, are major nosocomial pathogens in large hospitals in eastern Australia . At present vancomycin is the drug of choice for the treatment of life-threatening methicillin-resistant S . aureus infections . A possible alternative drug is coumermycin, a bis-hydroxy coumarin which inhibits DNA gyrase . Coumermycin activity was determined against clinical isolates from the Royal Melbourne Hospital . MICs of 639 staphylococcal isolates were determined by agar dilution . MICs and MBCs of 100 staphylococcal isolates were also determined by microdilution methods . The results showed that coumermycin was bactericidal, with MBCs of less than or equal to 4 micrograms/ml against all isolates tested . The results indicate that coumermycin is a potential alternative to vancomycin in the treatment of severe staphylococcal infections. J Biomed Mater Res, 1986 Apr, 20(4), 533 - 45 Adhesion of coagulase-negative staphylococci to methacrylate polymers and copolymers; Hogt AH et al.; Adhesion of coagulase-negative staphylococci (CNS) was studied onto a homologous series of methacrylate polymers and copolymers . The materials varied in wettability (contact angles) and were either positively or negatively charged (zeta-potential) . Bacterial adhesion experiments performed in a parallel-plate perfusion system showed that positively charged TMAEMA-Cl copolymers significantly promoted the adhesion of CNS as compared with all other methacrylate (co)polymers tested . The bacterial adhesion rates onto the positively charged surfaces are diffusion-controlled, whereas those onto the surfaces with a negative zeta-potential are more surface-reaction-controlled due to the presence of a potential energy barrier . The bacterial adhesion rates onto various poly (alkyl methacrylates) were similar . The number of adhering bacteria onto the negatively charged MMA/MAA copolymer did not differ from that onto pMMA, indicating that sufficient sites on the copolymer surface with the same potential energy barrier as that on pMMA, were available for adhesion . Decreasing rates of adhesion of CNS were observed onto MMA/HEMA copolymers with increasing HEMA content coinciding with increasing hydrophilicity . Low plateau values for the bacterial adhesion were observed on 50MMA/50HEMA, pHEMA, and 85HEMA/15MAA, indicating that the adhesion onto these materials was reversible . Four CNS strains with different surface characteristics all showed higher numbers of adhering bacteria onto 85MMA/15TMAEMA-Cl than onto 85MMA/15MAA and pMMA. Chemioterapia, 1986 Apr, 5(2), 116 - 9 New trends in the chemotherapy of staphylococcal infections; Russo G et al.; The authors evaluated the susceptibility of some antibiotics against several Staphylococci subdivided in lyogroups and different resistance patterns: methicillin-susceptible/penicillin-susceptible (MS/PS), methicillin-susceptible/penicillin-resistant (MS/PR), methicillin-resistant/penicillin-resistant (MR/PR) and methicillin-resistant/penicillin-susceptible (MR/PS) . The antimicrobial agents used were: methicillin, penicillin, rifampin, tetracycline, lincomycin, erythromycin, gentamicin and netilmicin . Netilmicin showed better activity against all Staphylococcus strains tested, particularly against coagulase-negative. Am J Infect Control, 1986 Apr, 14(2), 51 - 9 Physiologic, microbiologic, and seasonal effects of handwashing on the skin of health care personnel; Larson E et al.; The handwashing practices of 22 personnel on an oncology unit in an urban medical center were studied for 2 months . During 891 person-hours of observation, 986 handwashes were observed . Subjects washed a mean of 1.1 times an hour for a mean of 13.2 seconds . Reported and observed handwashing behavior was only moderately correlated (p = 0.05 for frequency, 0.30 for duration of handwashing) . Physicians washed significantly less often (p less than 0.001), but more thoroughly (p less than 0.001), than did nurses . Nurses washed more often after minimal or no patient contact than did physicians (p less than 0.001) . Individuals were very consistent in their handwashing technique . A total of 558 isolates were recovered from 158 hand cultures . The mean log count was 4.88, with no significant difference between physicians and nurses . Coagulase-negative staphylococci isolated from hands of physicians and nurses were significantly more resistant to antimicrobial agents than those of personnel with minimal patient contact (p less than 0.01) . Subjects had more skin damage in winter than in summer, as indicated by increased shedding of skin squames (p less than 0.05) . We conclude that handwashing practices vary significantly by profession and that reporting of handwashing practices by personnel is inaccurate. Can J Microbiol, 1986 Apr, 32(4), 359 - 61 Identification of staphylococci from bovine udders: evaluation of the API 20GP system; Watts JL et al.; The API 20GP system (Analytab Products, Plainview, NY) correctly identified 56.1% of staphylococci isolated from the bovine mammary gland . The system identified 90.2% of Staphylococcus aureus strains, but failed to recognize strains of Staphylcoccus hyicus and others . Poor performance was attributed to the limited number of veterinary strains contained in the profile index data base . The API 20GP was determined to be an unacceptable method for identification of staphylococci isolated from the bovine mammary gland. J Antimicrob Chemother, 1986 Apr, 17(4), 481 - 7 The neutralization of antibiotic action by metallic cations and iron chelators; Miles AA et al.; The neutralization of the action of a variety of antibiotics on klebsiellae by moderate doses of di- and tri-valent metallic cations, was measured in vitro . Some beta-lactams tested were affected by Mg++ and by Cu++ . Of six tetracyclines one was moderately neutralized by Ca++, two by Mg++, three by Cu++, and all, strongly, by Fe+++ . Erythromycin was affected by Ca++, lincomycin by Ca++, Mg++ and Cu++ . Aminoglycosides were affected by Ca++ and Mg++ and strongly by Fe+++ . Five antibiotics (three beta-lactams and two macrolides) with high MICs for klebsiellae were tested against staphylococci: most of the reversing agents were ineffective . The microbial iron chelators, desferrioxamine and enterochelin were largely inactive, affecting only two aminoglycosides. Eur J Immunol, 1986 Apr, 16(4), 381 - 7 Functional and mechanistic studies on the toxicity of deoxyguanosine for the in vitro proliferation and differentiation of human peripheral blood B lymphocytes; Scharenberg JG et al.; Deoxyguanosine (dGuo) has been implicated as the toxic metabolite causing a severe impairment of cellular immunity in children with a genetic deficiency of purine nucleoside phosphorylase (PNP) . In peripheral blood T cells of normal donors both the pathway which leads to phosphorylation of dGuo (ultimately resulting in deoxyguanosine triphosphate, dGTP) and the salvage pathway which starts with degradation of dGuo by PNP (resulting in the formation of guanosine triphosphate, GTP) contribute to the inhibition of proliferation . In normal peripheral blood B cells, addition of dGuo leads to an inhibition of proliferation and differentiation . The concentrations of dGuo needed to cause a 50% inhibition are equivalent for peripheral blood T cells and B cells . Inhibition of B cell differentiation can be observed at the level of intracytoplasmic as well as secreted Ig and concerns all Ig isotypes . The early phase of B cell activation which takes place during a 24-h preculture with formalinized Cowan I Staphylococci is not affected by dGuo; it is not until proliferation and differentiation of B cells, brought about by culturing in the presence of crude concanavalin A supernatant, occurs that inhibitory effects of dGuo become evident . Addition of dGuo to B cell cultures results in an intracellular accumulation of GTP and dGTP . Addition of 8-aminoguanosine, a PNP inhibitor, next to dGuo, completely prevents the dGuo-mediated inhibition . Under these circumstances the dGuo-mediated increase in intracellular GTP is abrogated while dGTP accumulation still occurs . This indicates that the inhibitory effect of dGuo on the proliferation and differentiation of peripheral blood B lymphocytes of normal donors is independent of dGTP accumulation. Zh Mikrobiol Epidemiol Immunobiol, 1986 Apr, (4), 44 - 9 {Effect of a staphylococcaL infection on the development of an immune response after physical loading}; Omeliusik IL et al.; The infection of rats with staphylococci enhances the suppressing effect of physical loading on the development of immune response induced by the injection of sheep red blood cells . Intensive physical loading is accompanied by the release of the substance activating the function of splenic suppressor cells into the blood . Staphylococcal infection increases the action of the serum substance of rats performing physical work on splenic suppressor cells, as well as on the action of the suppressor factor released by these cells on immunocompetent cells. S Afr Med J, 1986 Mar 29, 69(7), 441 - 5 Prosthetic valve endocarditis . A clinicopathological study of 31 cases; Rose AG; Prosthetic valve infective endocarditis was found in 31 out of 275 autopsies on patients with valvular prostheses . Mean postoperative survival was 332 days . Thirty patients had mechanical valves and only 1 had an infected tissue valve . The commonest pathogens were staphylococci, followed by Gram-negative bacilli and fungi . In all the patients with mechanical valves the infection was situated at the host-prosthesis sewing ring interface, and most also had vegetations on the prosthetic struts or cage . The infected tissue valve had vegetations on the prosthetic cusps only . Ring abscesses were present in one-third of cases and had destroyed the bundle of His in 1 patient . Clinically recognized pre-operative infective endocarditis was present in only 3 out of the 31 patients . Seven of the 31 patients died because of malfunction of the prosthesis, 10 died of systemic embolism, 4 of ruptured mycotic aneurysms, and the remaining 10 of other causes including myocardial failure, pyaemic abscesses and toxaemia. Cesk Patol, 1986 Mar, 22(1), 30 - 4 {Generalized infection caused by coagulase-negative staphylococci}; Peychl L et al.; The pathogenicity of coagulase-negative staphylococci was shown in two patients--one died on bacterial endocarditis, the second was a diabetic woman after gastroectomy. Z Kardiol, 1986 Mar, 75(3), 151 - 5 {Surgical therapy of intracardiac infected pacemaker electrodes and catheter remnants}; Schuler S et al.; With the increase of pacemaker and central venous catheter implantation the number of intracardiac infections now constitutes a significant problem . Twenty patients between 22 and 77 years of age admitted for intracardial infected pacemaker probes or central venous catheter remnants presented with recurring attacks of endocarditic fever; in one case multiple pulmonary abscesses resulted from septic embolization . Staphylococci were the most frequently involved organism (75%) . Risk factors leading to intracardiac infection were local reoperations and diabetes mellitus . Removal of the foreign body was achieved by cardiotomy in all cases . Twelve patients were operated upon without the use of the heart-lung machine, but extracorporeal circulation was necessary in 8 patients . There was one fatality in each of the 2 techniques, for a total mortality rate of 10% . In all cases the foreign bodies were removed without intracardial damage and the endocarditis was cured . When attempts at external extraction fail, the foreign body should be removed by either open or closed cardiotomy . This limits the danger of injury to the heart and of embolization of septic or thrombotic material . The use of the heart-lung machine is especially indicated in the presence of widespread, firm adhesions, or large bacterial vegetations and thrombi. J Clin Microbiol, 1986 Mar, 23(3), 629 - 30 Evaluation of the AutoMicrobic system Gram-Positive Susceptibility-MIC card for detection of oxacillin-resistant coagulase-negative staphylococci; Woolfrey BF et al.; A total of 398 consecutive clinical staphylococcus isolates, of which 205 were coagulase negative and 193 were coagulase positive, were tested in parallel by using AutoMicrobic system Gram-Positive Susceptibility-MIC cards and modified Mueller-Hinton agar containing 4% NaCl and oxacillin (6 micrograms/ml) . The AutoMicrobic system cards correctly detected 103 of 104 (99%) oxacillin-resistant coagulase-negative isolates with no reports of false resistance. Arch Microbiol, 1986 Mar, 144(2), 110 - 5 Inhibition of wall autolysis of staphylococci by sodium polyanethole sulfonate "liquoid"; Wecke J et al.; Liquoid (polyanethole sulfonate) was neither capable of influencing the growth nor the viability of staphylococci . But liquoid induced a suppression of the activity of different autolytic wall systems of normally growing staphylococci, i.e., autolysins which participate in cross wall separation as well as autolysins which are responsible for cell wall turnover . Additionally, the lysostaphin-induced wall disintegration of staphylococci was inhibited by liquoid . However, no indication could be found for a direct inhibition of lytic wall enzymes by liquoid; rather an interaction of liquoid with the target structure for the autolytic wall enzymes, the cell wall itself, was postulated . On the basis of the experimental data with the teichoic acid- mutant S . aureus 52A5 the sites of wall teichoic acid were supposed to be an important target for the binding of liquoid to the staphylococcal cell wall. Inflammation, 1986 Mar, 10(1), 37 - 47 Human polymorphonuclear leukocytes release leukotriene B4 during phagocytosis of Staphylococcus aureus; Henricks PA et al.; We studied release of leukotriene B4 (LTB4) by human polymorphonuclear leukocytes (PMNs) during phagocytosis of staphylococci in the presence or absence of arachidonic acid . The 12 X 10(7) PMNs incubated with 3 X 10(9) opsonized S . aureus and 50 microM arachidonic acid released 1.45 +/- 0.42 nmol LTB4 . No LTB4 was detected after stimulation of PMNs with S . aureus or arachidonic acid by themselves . However, by increasing the concentration of arachidonic acid to 200 or 400 microM, 1.22 +/- 0.45 and 1.98 +/- 0.49 nmol LTB4, respectively, was released by PMNs . The effect of different bacteria-PMN ratios on LTB4 production was also studied . LTB4 varied from 0.3 to 2.0 nmol when bacteria/PMN ratios increased from 5 to 50 (respectively) in the presence of 50 microM arachidonic acid . Thus, phagocytizing PMNs produce LTB4 in the presence of arachidonic acid, and its production is dependent on the number of bacteria phagocytized. J Antimicrob Chemother, 1986 Mar, 17 Suppl A, 19 - 24 Cephalosporins, vancomycin, aminoglycosides and other drugs, especially in combination, for the treatment of methicillin-resistant staphylococcal infections; Klastersky J et al.; Methicillin-resistant staphylococci (MRS) have become major nosocomial pathogens during the last decade . The infections caused by these organisms occur predominantly in intensive care units, where extensive use of antibiotics takes place . Because of their multiresistant nature, these microorganisms frequently pose difficult therapeutic problems . Emergence of resistance during single-drug therapy further complicates the management of these infections . The use of combination therapy provides theoretically, at least, an answer to some of these difficulties; however, in-vitro and experimental studies need to be confirmed by adequately-controlled clinical trials . Aminoglycosides occasionally may play an important role as companion drugs for cephalosporins or vancomycin in the management of MRS infections . Other drugs such as rifampicin, teicoplanin, fluoroquinolones, and imipenem are to be more extensively investigated, as single-drug therapy or part of a combination regimen, for these difficult staphylococcal infections. J Antimicrob Chemother, 1986 Mar, 17(3), 287 - 95 The effect of ciprofloxacin on methicillin-resistant Staphylococcus aureus; Smith SM et al.; Ciprofloxacin exhibited good in-vitro activity for methicillin-resistant Staphylococcus aureus with a MIC90 of 0.5 mg/l . The postantibiotic effect was 2.16 h . When ciprofloxacin was evaluated in combination studies with an aminoglycoside, none of the strains met the criterion of synergy as defined by FIC or FBC interaction indices of less than or equal to 0.25 . However, killing kinetic experiments indicated that the combination of ciprofloxacin was synergistic for two of 12 strains with gentamicin and three of 12 strains with amikacin . Although the inoculum size had no effect on the rate of killing by ciprofloxacin, an increase in turbidity was noted when a high inoculum was tested . This increase in turbidity was due to the swelling of the staphylococci to several times their normal size and the formation of clusters of multicellular, incompletely divided staphylococci . If a high inoculum is used for susceptibility testing, this increase in turbidity could be misinterpreted as bacterial growth and could result in a false report of an elevated MIC. J Hosp Infect, 1986 Mar, 7 Suppl A, 73 - 7 In vitro interactions between teicoplanin and other antibiotics against enterococci and staphylococci; Debbia E et al.; In this study we have evaluated the in vitro activity of teicoplanin, a potent anti-staphylococcal and anti-enterococcal agent, in combination with rifampicin, netilmicin, amikacin, fosfomycin and imipenem . Drug interactions were assessed using a microtitre checkerboard dilution method and a time-kill test . With rifampicin, indifference or an additive effect was the prevalent outcome with both methods . With netilmicin and amikacin synergism was seen against half of the enterococcal strains, whereas indifference was more common with staphylococcal isolates . Synergism predominated when teicoplanin was combined with fosfomycin and imipenem . Under no circumstances and with no combination of drugs were we able to detect antagonistic effects. J Hosp Infect, 1986 Mar, 7(2), 121 - 9 Microbiologic studies of coagulase-negative staphylococci isolated from patients with nosocomial bacteraemias; Ponce de Leon S et al.; We studied 50 strains of coagulase-negative staphylococci (CNS) isolated from 50 patients with hospital-acquired bacteraemia, identified by prospective surveillance at the University of Virginia Hospital between March 1981 and September 1982 . Using the Staph-Ident System for speciation, we found that 37 strains (74%) were Staphylococcus epidermidis, 7 (14%) Staph . hominis, 3 (6%) Staph . haemolyticus and 3 (6%) Staph . warneri . 33 (66%) of the strains produced slime and a higher proportion of the Staph . epidermidis group (75%) than the non-epidermidis group (46%), did so . Minimal inhibitory concentrations (MIC) were determined by a microdilution technique with 20 different antibiotics . There was no difference in geometric mean MICs between slime producers and non-slime producers within either the epidermidis or non-epidermidis group . The most potent antibiotics against Staph . epidermidis (MIC90 mg l-1) were rifampin (0.05), netilmicin (0.05), amikacin (2.9), thienamycin (0.75), teichomycin (0.85), vancomycin (1.0) and nafcillin (0.39) . On the other hand strains were resistant to tobramycin (15), moxalactam (50), fosfomycin (greater than 64), and clindamycin (greater than 64) . Overall, eight (16%) of the CNS strains were resistant to methicillin, three of which were Staph . haemolyticus