Staphylococcus

Clin Nephrol, 1985 Feb, 23(2), 81 - 4
Intraperitoneal vancomycin and ceftazidime in the treatment of CAPD peritonitis; Gray HH et al.; The use of intraperitoneal vancomycin and ceftazidime in the treatment of 64 episodes of CAPD peritonitis is reported . Serum and dialysate antibiotic concentrations were measured in 19 of these and the maximum serum vancomycin level recorded was 30 mg/l . Culture of the dialysate was sterile in 52% of the cases, staphylococci were isolated in 30% and the infection rate during 1983 was 2.22 episodes per patient-year . This antibiotic combination has proven safe and effective and easily administered by the patients.

Aust N Z J Surg, 1985 Feb, 55(1), 13 - 7
Postoperative wound infection with methicillin-resistant staphylococci in general surgical patients; Ross H; A prospective survey of 1757 general surgical patients undergoing operation was performed comparing 35 patients with wound infection yielding methicillin-resistant Staphylococcus aureus (MRSA) with 184 patients developing wound infections due to other organisms . The following parameters were statistically significantly increased in the patients with MRSA wound infection; MRSA infection or colonization at other sites, 37% versus 2%, severe wound infection 31% versus 12%, wound drain tubes 23% versus 10%, multiple operations 37% versus 6%, malignant disease 43% versus 23%, postoperative complications 46% versus 16%, intensive care admissions 23% versus 5% and prophylactic antibiotics 51% versus 30% . There was no difference in postoperative mortality 11% versus 7%; mean age, 58 years versus 56 years; sex; diabetes, 11% versus 9%; or emergency operations 40% versus 39% . There were 18 patients with single organism MRSA wound infection who were compared with 35 patients with single organism methicillin-sensitive S . aureus (MSSA) wound infection . The patients with MRSA wound infections had a statistically significant increase in the following parameters: mean preoperative stay in hospital 8 days versus 4 days; prophylactic antibiotics 39% versus 3%; MRSA infection or colonization at other sites 39% versus 6%; and malignant disease 44% versus 17% . There were no deaths in either group and there was no statistically significant difference in other parameters, namely, multiple operations 11% versus 3%; intensive care admissions 6% in each group; wound drain tube 17% versus 11%; severe infections 22% versus 6%; and postoperative complications 22% versus 9% . These latter parameters were statistically significantly increased when all MRSA wound infections were compared with all wound infections due to other organisms.

Antimicrob Agents Chemother, 1985 Feb, 27(2), 234 - 8
Relatedness of tetracycline resistance plasmids among species of coagulase-negative staphylococci; Cooksey RC et al.; Four isolates of Staphylococcus aureus and 98 isolates of coagulase-negative staphylococci representing six species all obtained from endocervical cultures were examined for antimicrobial susceptibility and for the presence of plasmids . More than 80% of the isolates were susceptible to each of 12 antimicrobial agents tested, whereas only 33% were susceptible to penicillin G, 30% were susceptible to cadmium chloride, and 41% were susceptible to tetracycline . Although no species-related susceptibility or plasmid patterns were detected, 77 isolates contained at least one plasmid and 43 contained a plasmid similar in mass to a 2.7-megadalton tetracycline resistance plasmid previously reported in staphylococci . Association of tetracycline resistance with plasmids of this size in four species was determined from curing experiments . No plasmids homologous with the tetracycline resistance locus of the Escherichia coli plasmid pBR322 were found among 11 isolates examined by DNA hybridization . Homology with a 2.7-megadalton plasmids (pRC701) from an endocervical isolate of S . aureus, however, was apparent for 2.7-megadalton plasmids harbored by six isolates as well as with larger plasmids harbored by three isolates . Restriction analysis revealed that pRC701 shared structural identity with two plasmids of a similar mass from two species of coagulase-negative staphylococci as well as with a previously characterized tetracycline resistance plasmid originating in S . aureus.

Am J Obstet Gynecol, 1985 Feb 1, 151(3), 325 - 9
Collagen sponge as vaginal contraceptive barrier: critical summary of seven years of research; Chvapil M et al.; Extensive testing of collagen sponge as a vaginal contraceptive (mechanical and chemical) showed that the original expectations regarding the safety, convenience, and efficacy were not met . The collagen sponge was tested both as a cylinder and as a diaphragm and used as such or impregnated with spermicidal detergent or with zinc salt . The collagen sponge must be larger than 6 cm in diameter in order to serve as a mechanical barrier that will not be dislodged during physical activity . This creates problems with the ease of insertion and with the partners' awareness of the barrier . When the collagen sponge containing ejaculate is left in the vagina greater than 48 hours, it develops an offensive odor . The original acidity of the collagen sponge (pH 3.5, 0.1 mol/L) is soon neutralized by the large volume of alkaline vaginal secretions . In vitro studies showed that up to 10 mg of nonoxynol 9 per milliliter of growth medium did not inhibit the growth of Staphylococcus aureus . These effects, as well as the large surface area of the resilient sponge, present a potential risk for growing staphylococci within the collagen sponge . The capacity of the collagen sponge to absorb a large volume of cervical and vaginal fluid produced two symptoms that were annoying to the volunteers: an awareness of either vaginal dryness during intercourse or, conversely, saturation of the sponge from the vagina . Postcoital studies showed viable spermatozoa in the cervical mucus in 25% of the tests with the nonmedicated cylindrical sponge but in only 6% of tests with the sponge containing nonoxynol 9 . The results of clinical trials conducted at four centers support the view that collagen sponge as a vaginal contraceptive barrier method is inconvenient to both partners, not effective enough to compete with present methods of vaginal contraception, and possibly might be unsafe because of the capacity to grow bacteria . Despite the negative end result of this goal-oriented research, we believe that our studies have contributed to a better understanding of vaginal physiologic features, the safety and effectiveness of spermicidal detergents, and the mechanisms of vaginal malodor . Although the acceptability study showed some advantages of the collagen sponge over the rubber diaphragm, the overall acceptability of the collagen sponge diaphragm was no better than that of the rubber diaphragm . For all these reasons, including the possible risk of an increased incidence of toxic shock syndrome, we have discontinued further testing of either type of collagen sponge as a vaginal barrier method.

J Infect Dis, 1985 Feb, 151(2), 243 - 51
Molecular epidemiology of transmissible gentamicin resistance among coagulase-negative staphylococci in a cardiac surgery unit; Archer GL et al.; The prevalence of colonization of patients in a cardiac surgery unit with gentamicin-resistant, coagulase-negative staphylococci increased from 20% to 68% over a period of four years . Gentamicin resistance was found to be plasmid associated and transmissible from wild-type coagulase-negative staphylococcal donors to a Staphylococcus aureus recipient by filter mating (conjugative) . These plasmids were present in isolates from 50 (74%) of 69 individuals examined . This figure included isolates from colonized patients, colonized staff, and patients with prosthetic valve endocarditis . A common restriction-endonuclease digestion pattern (pG02; 50 kilobases) was seen in only 19 (38%) of the 50 conjugative plasmids . However, filter hybridization, restriction-endonuclease mapping, and transposon insertional mutagenesis showed that representatives of the other 10 restriction-endonuclease digestion patterns were physically related to pG02 over greater than 80% of their genome, with differences largely due to deletions or insertions of DNA in three areas, and that their gentamicin-resistance genes were identical . Molecular analysis may be required to ascertain the physical similarity among phenotypically and epidemiologically related plasmids.

Vet Rec, 1985 Jan 12, 116(2), 33 - 6
Clavulanate-potentiated amoxycillin: activity in vitro and bioavailability in the dog; Bywater RJ et al.; Clavulanic acid is an inhibitor of beta-lactamase (penicillinase) and when used with amoxycillin the resulting combination becomes active against most bacteria resistant to amoxycillin through production of beta-lactamase . A total of 551 bacterial isolates from dogs and cats were examined by disc sensitivity testing, which showed that there was amoxycillin resistance particularly among staphylococci (50 per cent), Klebsiella species (97 per cent) and Escherichia coli (28 per cent) . A combination of potassium clavulanate and amoxycillin reduced the incidence of resistance to 0.3, 3 and 7 per cent, respectively . Minimum inhibitory concentrations were determined for a number of the isolates and showed marked reductions in the presence of potassium clavulanate . A formulation containing amoxycillin trihydrate and potassium clavulanate (4:1) was dosed to beagles at 12.5 mg/kg . Concentrations of the drugs in blood, tissue fluid and skin showed that both drugs were sufficiently well absorbed and distributed to allow a prediction of efficacy against infections caused by beta-lactamase producing bacteria.

Pediatr Med Chir, 1985 Jan-Feb, 7(1), 69 - 72
{Neonatal sepsis caused by coagulase-negative staphylococci}; Curro V et al.; All cases of neonatal bacteremia occurring at Neonatal Department of Pediatric Clinic, Catholic University of Rome, from January 1976 to December 1983 were examined retrospectively . Twenty-seven (30%) newborn infants with positive blood cultures for coagulase-negative staphylococcus were identified . Seven (25.9%) of the 27 infants were born at term, 4 AGA and 3 SGA; mean birth weight was 2,804 gm (range 2,280-3,670) . All of these neonates had clinical evidence and laboratory signs of sepsis, and one had the cerebrospinal-fluid culture positive for coagulase-negative staphylococcus . In the remaining 20 infants (74.1%) the mean birth weight was 1,445 gm (range 810 - 2,400) and mean gestational age was 32 weeks (range 27 - 36) . In 15 of the 20 preterm infants clinical signs of septicemia were associated with positive blood culture, and sixty percent of these had received an umbilical artery catheter . An half of coagulase-negative staphylococci isolated from our neonatal sepsis were DNAse-positive and/or phosphatase-positive and/or mannitol-positive . Two full-term infants, one with Down syndrome and one with cardiac malformation, died at 9 days and at 2 weeks of age, respectively . Three of 15 preterm infants with coagulas-negative staphylococcal septicemia died; deaths were among infants of very low birth weights and immature gestations who had severe respiratory syndrome . These data show that coagulase-negative staphylococcus can be important cause of septicemia in patients with compromised host defenses as newborn infants, and especially in the premature babies receiving invasive procedures.

Med Microbiol Immunol (Berl), 1985, 174(5), 275 - 9
Positive camp-phenomenon elicited by coagulase-negative staphylococci; Bhakdi S; Fifty out of sixty-five isolates of coagulase-negative staphylococci displayed a positive CAMP-reaction due to synergism of an extracellular toxin with S . aureus beta-toxin on sheep erythrocytes . Of the CAMP-positive isolates, 40 were identified as S . epidermidis, 8 as S . hemolyticus, and 2 each as S . hominis and S . saprophyticus . CAMP-positivity did not appear to be an indication of pathogenicity, and the incidence of CAMP-positive strains derived from wound infections did not differ from that found in clinically insignificant isolates . In five cases of mixed wound infection with S . aureus and a CAMP-positive S . epidermidis, no synergism between the toxins of the respective, paired isolates could be demonstrated since the S . aureus strains in these cases did not produce beta-toxin . The results show that most coagulase-negative staphylococci produce one or more toxins, possibly delta-toxin, detectable by the CAMP-reaction . The biological significance of toxin production remains to be elucidated.

Acta Microbiol Hung, 1985, 32(3), 241 - 8
Resistance plasmids for inducible macrolide-lincosamide resistance in Staphylococcus simulans and Staphylococcus epidermidis; Barcs I; Localization and genetic nature of inducible macrolide resistance determinants in some coagulase negative staphylococci (CNS) were studied and compared with those in Staphylococcus aureus . An 1.7-megadalton R-plasmid, pEI 1107, mediating inducible resistance to macrolides and lincosamides was present in part of Staphylococcus simulans and Staphylococcus epidermidis strains isolated in the Central Hospital for Infectious Diseases . Two other plasmids were harboured by S . simulans LK 6108 strain . One of these plasmids, pEI 6108 (molecular mass 5.2 Md) was encoded for inducible macrolide-lincosamide resistance, and the second one, pE 6108 (molecular mass 4.9 Md) for constitutive marcolide resistance . The similarity in size and phenotype of small plasmids in CNS and S . aureus suggest a common origin of these resistance determinants.

Scan Electron Microsc, 1985, (Pt 3), 1231 - 7
Scanning electron microscopy studies of staphylococcal adherence to heart valve endothelial cells in organ culture: an in vitro model of acute endocarditis; Cooper MD et al.; Organ cultures of human heart valves were used as a model to study the initial pathobiology of acute infective bacterial endocarditis . We used Staphylococcus aureus isolated from a case of infective endocarditis to infect the in vitro culture of the heart valves . Using scanning electron microscopy, we assessed the initial damage, attachment to and invasion of the endothelial cell layer by staphylococci . Our results indicate there is initial damage to the endothelium prior to observation of staphylococci attaching to the endothelial cell . By 12 h post infection, there is significant attachment and damage . At 24 h after infection, destruction of the heart valve endothelium is complete . The attachment and destruction are progressive events and can be correlated quantitatively with bacterial numbers from the culture medium and those attached to the valves . This is correlated with increasing adherence ratios of the attaching staphylococci.

Int J Tissue React, 1985, 7(4), 255 - 61
Persistence of staphylococcal cell-wall components in inflammatory sites may be due to the modulation by sulphated polyelectrolytes of autolytic wall enzymes: a working hypothesis; Ginsburg I et al.; The interaction of leucocytes with Staphylococcus aureus results in killing of the bacterial cells, but large portions of the bacterial cell walls persist apparently phagocytic cells for long periods . The mechanisms of biodegradation of staphylococci by leucocyte factors have shown that degradation of cell walls in vitro may be the result of the activation, by leucocyte kationic proteins, of the bacterial autolytic wall enzymes that are responsible for degrading the cell walls from within . This process is markedly inhibited by sulphated polysaccharides like dextran sulphate, by heparin, or by polyanetholesulfonate (liquoid) . These anionic polyelectrolytes have also been shown to inhibit the lysis of staphylococci treated with bacteriolytic concentrations of penicillin G . Staphylococci injected intraarticularly into the knee joint of rats underwent massive plasmolysis, but structures compatible with cell walls (peptidoglycan) persisted within macrophages in the inflammatory sites, for long periods . It is postulated that the inability of leucocytes to degrade staphylococcal cell-wall components may be the result of the interference, by anionic polyelectrolytes likely to accumulate in the inflammatory sites, with the activation of the autolytic systems . Alternatively, anionic polyelectrolytes may coat the bacterial cells and interfere with the binding of the autolytic enzymes with their corresponding substrates.

Nephron, 1985, 41(3), 279 - 82
Vancomycin and tobramycin in the treatment of CAPD peritonitis; Gruer LD et al.; Seventy-five episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied during a 1 year period at the Queen Elizabeth Hospital, Birmingham . When two simple culture methods were used in parallel, the causative organisms were identified in 97% of cases . Nearly two thirds of episodes of peritonitis were caused by coagulase-negative staphylococci (C-NS), many of which were multiply antibiotic-resistant . On the basis of detailed antibiotic sensitivities, intraperitoneal vancomycin and tobramycin were chosen for the initial treatment of CAPD peritonitis . With this regime, a cure was achieved in 32 of 38 episodes, compared with 15 of 27 episodes when cefuroxime was used . All but 1 of 24 episodes caused by C-NS were cured by vancomycin.

Infection, 1985, 13 Suppl 1, S34 - 6
Staphylococcus aureus septicaemia treated with cefotaxime; Shah PM; Staphylococcus aureus strains were exposed in vitro to continuously decreasing cefotaxime concentrations . The initial concentration was approximately 4 X MIC and decreased at t1/2 = 60 min . A reduction in the colony count was seen even after the concentration had dropped below the MIC level . Sixteen patients with blood cultures positive for S . aureus were treated with cefotaxime . Four patient died of underlying diseases . The condition of one patient with staphylococcal endocarditis under treatment with vancomycin in combination with cefotaxime deteriorated when cefotaxime was discontinued, suggesting possible synergism between these two drugs against staphylococci.

Vet Med Nauki, 1985, 22(6), 68 - 72
{Microbiological research on the production and storage of fast-frozen semiproducts}; Kuner Zh et al.; Studies were carried out to find the sources of microbiologic contamination, and the quantitative and qualitative composition of microflora and its changes following various periods of storing of rapidly frozen meat-balls obtained under productional conditions . The investigations were performed with regard to the total count of aerobic organisms, coli forms, staphylococci, sulfite-reducing Clostridia, Salmonellae, and moulds . It was established that the machines, equipment, units, and package had no effect on the bacteriologic contamination of meat-balls . Storage at--18 degrees C in the course of six months had no effect whatever on the residual microflora and the organoleptic indices of this product . It is stated that the standard requirements concerning the total numbers of anaerobic mesophilic organisms should not exceed 5 X 10(3)/g at a coli titer of 1.0.

Vet Med Nauki, 1985, 22(6), 62 - 7
{Production of enterotoxins A, B and C in staphylococcal strains isolated from animal food products and other sources}; Gogov I; Studies were carried out on the production of enterotoxins A, B, and C by a total of 654 strains of Staphylococcus aureus . Of these, 326 were isolated from food products of animal origin (and had no connection with intoxications); 190 were isolated from personnel working in the food industry; and 138 were isolated from milk animals, containers, and equipment at productional enterprises . Thirty strains of S . epidermidis, isolated from food products and workers were likewise tested for the production of the same enterotoxins . The enterotoxins were obtained by the modified method of Hallander, and their demonstration was performed by a variant technique of the double gel diffusion test after Ouchterlony . It was found that the Staphylococcus aureus strains isolated from food products produced enterotoxins in 12.3 per cent of the cases; was found in 6.1% of the strains, C--in 3.1%, and B--in 2.5% . Types A and C were found simultaneously in 0.6% of the strains . Enterotoxins were found in 16.6% of the strains isolated from workers and in 1.7% of those isolated from the udder of cows . The incidence of toxin production and the relative share of the three types of enterotoxins depended on the origin of staphylococci and their capacity to produce them in amounts that could be demonstrated by the methods employed . Under optimal conditions the amounts varied: for strains that produced type A they ranged from 1 to 20 micrograms/cm3; for those that produced type B they were from 1 up to 100 micrograms/cm3; and for those that produced type C they were from 1 to 40 micrograms/cm3 . No production of enterotoxins A, B, and C was established with S . epidermidis strains.

Vet Med Nauki, 1985, 22(5), 37 - 42
{Microorganisms of the fam . Micrococcaceae in the production and storage of prepackaged veal}; Donzo M et al.; Studies were carried out on the numbers and composition of organisms belonging to family Micrococcaceae in the production and storing of calf meat on a dressing combine supplied with modern equipment . Investigated were a total of 60 samples taken from small cuts of veal of the various carcass parts . The samples were packed either under vacuum or without such, and were studied immediately after cutting in small parts or after storing for 48 and 72 hours at 4 to 6 degrees C . It was found that the amount of Micrococcaceae organisms on the surface of cut meat packed out or in vacuum was within the range of 10(3) up to 10(4)/g, and it was shown to be in close relation to the microbial contamination of the initial raw material . There was no rise of the numbers of micrococci and staphylococci of veal that was cut and packed out of vacuum and kept for 48 hours at 4 to 6 degrees C . At refrigerator storing of veal that was packed under vacuum there was no increase in the microbial numbers at the 72nd hour . This pointed to the advantage of using the introduced technology of packing the meat under vacuum . Micrococcus luteus (56.7%), Micrococcus varians (41.8%), and Staphylococcus saprophyticus (1.5%) were isolated from cuts of veal packed both in and out of vacuum . No pathogenic staphylococci were found.

Boll Ist Sieroter Milan, 1985, 64(2), 115 - 8
{Production of coagulase and thermonuclease in 366 strains of staphylococci belonging to different lyogroups}; Pannelli F et al.; 366 human staphylococci were tested for the production of coagulase and thermonuclease and were subdivided into lyogroups . 98% of the isolates showed uniformly positive or uniformly negative results for the production of two enzymes . All uniformly positive strains belonged to the species Staphylococcus aureus, whereas coagulase-thermonuclease negative strains were easily subdivided into five lyogroups . Seven strains produced only one of two enzymes and were identified by analysis of their bacteriolytic activity . Two of these strains were identified as Staphylococcus aureus, one was coagulase negative and the other thermonuclease negative.

J Hyg Epidemiol Microbiol Immunol, 1985, 29(2), 147 - 54
Antagonistic activities of coagulase-positive staphylococci; Balusek J et al.; Antagonistic activities were investigated by Frederioq's plate method in 1,014 coagulase-positive staphylococcal strains of different species and origins . Staphylococcin effect was demonstrated in 12 (2%) of the 559 Staphylococcus aureus strains, in 51 (18%) of the 283 S . intermedius strains, and in 1 (3%) of the 36 S . hyicus subsp . chromogenes strains . Lysostaphin was identified in the 15 (5%) S . intermedius strains . In addition, heat-stable bacteriostatic agent was detected in 45 (33%) and heat-labile bacteriolytic agent in 7 (5%) of the 136 S . hyicus subsp . hyicus strains . An attempt was made at antagonistic activity typing in all of the active staphylococcal strains.

Scand J Thorac Cardiovasc Surg, 1985, 19(1), 49 - 53
Penetration of penicillins into cardiac valves and auricles of patients undergoing open-heart surgery; Pieper R et al.; Prophylactic use of antibiotics in open-heart surgery for insertion of prosthetic valves is common, because of the serious consequences of postoperative staphylococcal infections, most notably prosthetic valve endocarditis . To ensure effective antibiotic cover during surgery, the penetration of cloxacillin and benzylpenicillin into the heart muscle and valves was studied intraoperatively . Both antibiotics were given intravenously (respective initial doses 2 g and 6 g) at induction of anesthesia to ten patients undergoing replacement of aortic or mitral valve, and the same doses were repeated after 4 hours . Serial serum samples and tissue samples from the right atrial auricle and the excised heart valve were analyzed for antibiotic concentrations . The mean serum concentrations of cloxacillin were 204 +/- 93 mg/l 10 min after the initial dose and less than or equal to 26 mg/l 30 min before the second dose . The corresponding values for benzylpenicillin were 323 +/- 145 and 43 +/- 24 mg/l . The cloxacillin concentrations in the auricle just before the start of extracorporeal circulation ranged from 4.5 to 80 mg/kg and (later) in the excised heart valves they were 8.5 to 45 mg/kg . The benzylpenicillin range was 16 to 153 mg/kg in auricle and 13 to 87 mg/kg in valve tissue . The authors conclude that the employed doses of the penicillins are adequate cover against the staphylococci which may be implicated in postoperative infections.

Methods Find Exp Clin Pharmacol, 1985 Jan, 7(1), 49 - 54
Evaluation of a new germicidal hand creme; Reynolds WO et al.; A new germicidal hand creme (Wash & Heal, Med-Chem Labs, Okemos, MI) was evaluated for its ability to reduce bacterial levels on the hands . Colony counts of coagulase-negative staphylococci were significantly reduced immediately after use, with notable antimicrobial activity present for the next 90-120 minutes . The germicidal creme was more active against staphylococci than gram negative bacilli . The creme's germicidal activity occurred rapidly and was targeted against gram positive cocci found on the skin; whereas the bar soap's activity occurred more slowly and had a broader target . This creme could be used between hand washings to further reduce microbial flora of the hands.

Antimicrob Agents Chemother, 1985 Jan, 27(1), 128 - 31
Comparative in vitro antibacterial activity of Sch 34343, a novel penem antibiotic; Norrby SR et al.; Using agar and broth dilutions, Sch 34343 was found to be highly active against gram-positive and gram-negative aerobic, facultatively anaerobic, and anaerobic bacteria, with the exceptions of enterococci, methicillin-resistant staphylococci, and Pseudomonas spp., which were resistant . Comparisons were made with imipenem, cefuroxime, cefotaxime, gentamicin, clindamycin, and metronidazole.

Acta Obstet Gynecol Scand, 1985, 64(2), 163 - 6
Experimental mastitis in mice induced by coagulase-negative staphylococci isolated from cases of mastitis in nursing women; Thomsen AC et al.; Coagulase-negative staphylococci are frequently isolated from the milk of women with signs of puerperal mastitis . In order to evaluate the pathogenicity of these bacteria, strains of S . epidermidis and S . saprophyticus isolated from cases of mastitis in nursing women were inoculated into the mammary glands of lactating mice . Although clinical signs of mastitis were absent, by histological examination, mastitis was demonstrated in 78-93% of the glands . Abscesses were found in a few cases only . The inoculated bacteria were re-isolated in 41-61% of the cases, and when inoculated in numbers of 10(2) to 10(4) c.f.u . the bacteria multiplied above input levels in several cases . It is concluded that coagulase-negative staphylococci isolated from the milk of women with puerperal mastitis can produce mastitis in mice and should be considered as a possible etiologic agent of mastitis in nursing women.

J Appl Bacteriol, 1985 Jan, 58(1), 45 - 55
Identification of coagulase-negative staphylococci from farm animals; Devriese LA et al.; The species identify of 661 strains of coagulase-negative staphylococci isolated from the skin and nares of cattle, pigs, poultry, goats and sheep was determined . They belonged either to the novobiocin-sensitive species Staphylococcus hyicus, Staph . simulans, Staph . epidermidis, Staph . haemolyticus and Staph . warneri or to the novobiocin-resistant species Staph . sciuri, Staph . lentus, Staph . xylosus, Staph . cohnii, Staph . saprophyticus and Staph . gallinarum; twenty-one strains remained unidentified . The staphylococcal flora of the farm animals studied differed markedly from that associated with man; several species which do not occur in man were isolated and novobiocin-resistant strains, which occur infrequently in man, were present in large numbers in animals . Two simplified schemes for the identification of staphylococci from farm animals and man are presented.

Pediatr Res, 1985 Jan, 19(1), 38 - 44
Chronic granulomatous disease: uptake and intracellular activity of fosfomycin in granulocytes; Hoger PH et al.; In chronic granulomatous disease (CGD) polymorphonuclear leukocytes (PMN) are unable to kill phagocytized catalase-positive bacteria . Therefore, patients with CGD are prone to infections and dependent on antimicrobial agents able to penetrate PMN membranes and to act intracellularly . Owing to their good lipid solubility, trimethoprim/sulfamethoxazole and rifampicin passively diffuse the membrane . In contrast, fosfomycin is transported actively into the cell . In normal PMN, it reaches cellular-to-extracellular ratios of 1.83 after 15 min, in CGD-PMN 2.18 after 30 min . At concentrations between 16 and 200 mg/liter, fosfomycin was able to kill staphylococci surviving within CGD-PMN, thus compensating for the bactericidal deficiency in CGD . A combination of low concentrations of fosfomycin (8 mg/liter) plus rifampicin (0.06 mg/liter) was more effective at the intracellular level than either agent alone . Apart from a stimulation of PMN-chemiluminescence of yet unknown significance, the agent did not interfere with other neutrophil functions . Clinical investigations are indicated to study whether fosfomycin can be added to the small number of antibiotics useful in CGD.

Clin Orthop, 1985 Jan-Feb, (192), 284 - 90
Local administration of antibiotics with an implantable osmotic pump; Perry CR et al.; A totally implantable drug pump was evaluated as a delivery system in the treatment of osteomyelitis . Gentamicin levels in rabbit serum and bone obtained by systemic administration are compared with levels in rabbit serum and bone obtained by local administration via an implantable drug pump . Systemic administration gave mean gentamicin bone levels ranging from less than 1 microgram/gm to 3.6 micrograms/gm, while drug pump administration gave bone levels ranging from 10.8 micrograms/gm to 64.0 micrograms/gm (micrograms = microgram, or 10(-6) gram) . To evaluate the drug pump as a mode of therapy, acute staphylococcal osteomyelitis was induced in ten rabbits . Drug pumps filled with amikacin were inserted in five of the infected animals . Three of these were culture-negative at one week . One had a scant growth of Staphylococcus from the pump, and one had scant growth from the pump and the wound . Clinically, none of these five rabbits appeared infected at seven days . The remaining five rabbits were all culture-positive, with heavy growths of staphylococci from their wounds, and clinically, all appeared grossly infected at seven days . These data demonstrate that high local and low systemic levels of antibiotics can be achieved with an implantable drug pump and that this method can sterilize an infected musculoskeletal wound . Therefore, antibiotic administration via an implantable drug pump is an important potential mode of therapy in the treatment of osteomyelitis.

J Pediatr, 1985 Jan, 106(1), 50 - 5
Recurrent severe infections in a girl with apparently variable expression of mosaicism for chronic granulomatous disease; Johnston RB 3rd et al.; A carrier of chronic granulomatous disease (CGD) has had recurrent severe purulent infections like those characteristic of CGD . The carrier state was demonstrated by the presence of both normal and CGD granulocytes in her blood; the percentage of normal granulocytes varied from 4% to 44% over 4 years . In addition, her granulocytes were partially defective in killing Escherichia coli and staphylococci and in the release of superoxide anion during stimulation . Extensive evaluation of her immune system and phagocyte function failed to reveal a second abnormality . The course in this child indicates that the carrier state for X-linked CGD cannot be considered a benign condition and might be more properly conceptualized as a continuum in expression of the full disease . Screening assays for CGD should possess the capacity to diagnose carriers of the X-linked form of the disease.

Infect Immun, 1985 Jan, 47(1), 41 - 6
Decomplementation antigen, a possible determinant of staphylococcal pathogenicity; Bhakdi S et al.; We report the existence of an extracellular staphylococcal product, designated staphylococcal decomplementation antigen (DA), that causes rapid consumption of early-reacting complement components up to and including C5 in human serum . Complement activation occurs as a consequence of immune complex formation between DA and specific human immunoglobulin G antibodies and proceeds primarily via the classical pathway . The terminal components C7, C8, and C9 are not consumed during the process . Levels of DA production do not correlate with the expression of classical pathogenic factors, such as coagulase, clumping factor, protein A, or alpha-toxin . DA is a nondialyzable macromolecule eluting in a molecular-weight region of 70,000 to 120,000 on Sephacryl S-300 and displaying an apparent sedimentation coefficient of 3 to 4 S on sucrose density gradients . The molecule is remarkably stable and resists destruction upon boiling for 30 min or by treatment with pronase, lysostaphin, DNase, or RNase . We anticipate that DA protects staphylococci from complement attack through induction of abortive, complement-consuming reactions in the fluid phase.

Postgrad Med J, 1985, 61 Suppl 1, 35 - 8
Toxic shock syndrome--the role of the toxin; Bergdoll MS et al.; From isolates of Staphylococcus aureus derived from patients suffering from toxic shock syndrome a toxin was identified by tests in monkeys and was found to be distinct from the enterotoxin responsible for staphylococcal food poisoning . When purified, this TSS toxin (TSST-1) was characterised and used to generate antibodies in rabbits . Only a small proportion of routine staphylococcal isolates produce TSST-1, though it is clear that this toxin has existed for some years . At the same time, TSST-1 producing staphylococci have been isolated in every continent, yet very few cases of toxic shock syndrome have been recognised in developing countries . Using the purified TSST-1, human sera have been examined for the presence of antibodies . Patients with the disease had either no antibodies, or low titres.

G Batteriol Virol Immunol, 1985 Jan-Jun, 78(1-6), 95 - 106
{Frequency of methicillin resistance varies with conditions, in a population of staphylococci from a hospital environment}; Pessione E et al.; The incidence of methicillin-resistant Strains is increasing in these last years . This increase is particularly evident in Strains isolated from hospital environments . In this work we evaluated the methicillin-resistance of 58 Staphylococcus Strains, isolated from a surgical intensive care ward, in various experimental conditions, which changing in: culture medium, inoculum, incubation period and antibiotic concentration . Besides this we took in consideration various factors which can influence the frequency of methicillin-resistance and can also lead to errors in the evaluation itself . From our study we can conclude that the factors are: survey "in vitro" of the resistance or of the sensitivity, exclusion or inclusion of staphylococci different from Staphylococcus aureus, double count of the same Strains isolated in different times.

Drugs Exp Clin Res, 1985, 11(3), 149 - 53
Effect of pH on the morphology of Staphylococcus aureus; Mirza J et al.; Nineteen strains of Staphylococcus aureus (10 sensitive and 9 resistant to oxacillin) were grown for four hours on membranes placed on trypticase soy agar at pH 5, 5.5, 6, 6.5, 7.1, 7.5, 7.8 and 8.3 . The morphology was observed by interference phase contrast and by electron microscopy . All strains grown at pH 6 to 7.5 produced cocci of normal size . When grown at pH 5, 5.5, 7.8 and 8.3, however, seven of the oxacillin-resistant strains and seven of the oxacillin-sensitive strains produced bacterial cells 1.5 to 2 micron in diameter . These cells consist of a cluster of staphylococci held together by multiple thick cross walls . Their structure is similar to that of staphylococci grown in the presence of subminimum inhibitory concentrations of beta-lactam antibiotics, which inhibit autolysis of cross walls . It appears that autolysis of cross walls of S . aureus is also inhibited by a low or a high pH.

Clin Invest Med, 1985, 8(4), 272 - 85
Emergence of tobramycin-resistant S . epidermidis possessing aminoglycoside modifying enzymes and bacteremic superinfection during empiric therapy of febrile neutropenic episodes; Riben PD et al.; During a randomized clinical trial comparing tobramycin plus ticarcillin to netilmicin plus ticarcillin as empiric therapy of febrile neutropenic patients, Staphylococcus epidermidis emerged as the predominate superinfecting pathogen in tobramycin recipients . Overall clinical response was 68% (44/65 responding) in tobramycin/ticarcillin recipients and 73% (45/62) in netilmicin/ticarcillin recipients . However, 5/65 tobramycin/ticarcillin treated episodes were complicated by bacteremic superinfection with Staphylococcus epidermidis, as compared to 0/62 netilmicin/ticarcillin treated episodes (p less than 0.05) . Four of the five bacteremic strains produced aminoglycoside adenylating enzyme ANT 4', 4'' . Prior colonization of patients with identical strains was demonstrated by plasmid profile analysis, antibiograms and biotyping with the API Staph-Ident system . During the trial, 36 consecutive patients were studied for colonization patterns with coagulase-negative staphylococci . S . epidermidis accounted for 566/831 (68%) isolates of coagulase-negative staphylococci recovered from surveillance cultures . Tobramycin-resistant strains were acquired in 2/17, 4/12 and 9/14 patients during trimethoprim/sulfamethoxazole, netilmicin/ticarcillin and tobramycin/ticarcillin therapy, respectively . Prior to aminoglycoside therapy, 77% of strains were susceptible to less than or equal to 8 micrograms/ml of tobramycin, but only 35% and 28% were susceptible to tobramycin after initiation of tobramycin/ticarcillin and netilmicin/ticarcillin therapy, respectively . In contrast, greater than or equal to 93% of isolates were susceptible to netilmicin before and after aminoglycoside therapy . Absence of several sites susceptible to modification by aminoglycoside inactivating enzymes produced by staphylococci may give netilmicin a therapeutic advantage in the therapy of febrile neutropenic patients.

Acta Med Scand Suppl, 1985, 699, 1 - 62
Pacemaker infections . A clinical study with special reference to prophylactic use of some isoxazolyl penicillins; Bluhm G; Infection is a major complication of pacemaker treatment . Antibiotic prophylaxis has been used in association with pacemaker surgery with conflicting results, and conclusive prospective trials are lacking . This investigation indicated that systemic antibiotic prophylaxis was of benefit when infections occurred frequently . The effect of local antibiotic prophylaxis was comparable with that of systemic prophylaxis at generator replacements . No serious adverse effects of the prophylaxis were noted . However, with modern surgical methods and hygienic principles, antibiotic prophylaxis did not seem to be necessary at implantation of new cardiac pacemakers . Once infection had developed it was difficult to eradicate and serious complications sometimes occurred . Most infections commenced in the pacemaker pocket . A few cases were cured by antibiotic treatment alone but, particularly if the infection spread along the electrode, surgery was strongly needed and in the presence of endocarditis and/or septicemia all foreign material should be removed if possible . The most common causal microorganisms of pacemaker infections were Staphylococcus aureus and Staphylococcus epidermidis . Routinely performed pre-, per- and postoperative cultures were of no prognostic value . Persistent use of antibiotics could select for methicillin-resistant coagulase-negative staphylococci, therefore bacteriological monitoring of wound infections was considered important . The dosage schedules used for cloxacillin and flucloxacillin gave satisfactory serum concentrations peroperatively . Local treatment with cloxacillin in the pacemaker pocket peroperatively gave adequate concentrations in tissue fluid from the pocket 24 h after the operation, as did systemic administration of flucloxacillin . The pharmacokinetics of flucloxacillin in these elderly patients differed in some respects from that found in healthy volunteers . Plasma elimination half-life was almost twice as long . Despite the high degree of plasma protein binding, flucloxacillin appeared to pass rapidly and efficiently to extravascular compartments, such as a pacemaker pocket.

Curr Med Res Opin, 1985, 9(9), 587 - 90
Fusidic acid in orthopaedic infections due to coagulase-negative staphylococci; Coombs RR et al.; Twenty orthopaedic in-patients who developed an acute infection due to coagulase-negative staphylococci, and which was associated with a foreign body in 11 cases, were treated with fusidic acid . All patients were given oral medication, except for 1 child with acute osteomyelitis who was treated intravenously for the first 7 days . The mean daily dose was 21 mg/kg and the mean duration of treatment 20 days . Fusidic acid was given alone in 5 patients and concurrently with another antibiotic in the other 15 patients . All patients responded satisfactorily with resolution of the relevant signs and symptoms, although 1 patient relapsed subsequently . Mild side-effects were observed in 3 patients.

Arch Androl, 1985, 14(1), 81 - 7
Value of intraprostatic injection of zinc and vitamin C and of ultrasound application in infertile men with chronic prostatitis; Fahim MS et al.; Seventy infertile men with chronic prostatitis were treated by prostatic massage and wide-spectrum chemotherapy as basic treatment to which intraprostatic injection of zinc or vitamin C with or without ultrasound application was added as a new line of treatment . Comparison showed no significant improvement of the additive treatment over the conventional treatment used alone . Pus cells in the expressed prostatic smear diminished significantly after treatment, which was associated with significant increase of percentage of motile spermatozoa and significant decrease of abnormal forms . Bacterial flora was studied in comparison with findings in 20 cases of infertile males without prostatitis; staphylococci predominated in both patient and control groups.

Chemotherapy, 1985, 31(2), 119 - 23
Divergent disk susceptibility of coagulase-negative staphylococci to penicillinase-resistant penicillins and augmentin (amoxycillin/clavulanic acid); Traub WH; 30 representative intrinsically penicillin-resistant coagulase-negative staphylococcal (CONS) isolates yielded discrepant agar disk diffusion test (Bauer-Kirby) results for augmentin . Clavulanic acid (2.5 micrograms/ml) enhanced the activity of amoxycillin from 8- to greater than or equal to 128-fold (mean = 26-fold); MICs of amoxycillin (combined with 2.5 micrograms/ml clavulanate) ranged from 1-16 (mean = 3) micrograms/ml . It is recommended that clinical microbiology laboratories withhold 'susceptible' augmentin disk tests results from their reports regarding intrinsically penicillin-resistant CONS isolates . No such discrepancies were encountered among clinical isolates of Staphylococcus aureus.

Antimicrob Agents Chemother, 1985 Jan, 27(1), 137 - 9
Enhanced liposome-mediated activity of piperacillin against staphylococci; Nacucchio MC et al.; This study showed that encapsulation of the beta-lactam antibiotic piperacillin (PIP) by liposomes prepared with phosphatidylcholine and cholesterol (1:1) protected the drug from hydrolysis by staphylococcal beta-lactamase . This was demonstrated by growth inhibition of Staphylococcus aureus in the presence of the liposomal preparation containing PIP at a 50% MIC . Growth inhibition was also seen when exogenous beta-lactamase was added . Furthermore, adsorption of PIP onto the surface of liposomes containing buffer conferred a significant degree of protection against enzymatic hydrolysis of the drug, thus enhancing its antistaphylococcal activity.

J Antimicrob Chemother, 1985 Jan, 15 Suppl A, 121 - 3
A model to show the role of extracellular beta-lactamases in mediating staphylococcal resistance; Haller I; Considerable amounts of extracellular beta-lactamase are liberated from penicillin-resistant staphylococci into the surrounding medium . The accumulation of exoenzyme in conventional in-vitro test systems may result in rapid inactivation of hydrolysable antibiotics, while in vivo the concentration of extracellular beta-lactamase varies depending on the site of infection . Using a new open test model designed to eliminate the effect of exoenzyme, it could be shown that resistance of beta-lactamase-producing staphylococci to mezlocillin as seen in the broth dilution test was mediated predominantly by the extracellular beta-lactamase fraction . Animal experiments suggested that mezlocillin may exhibit a therapeutic effect against beta-lactamase-producing staphylococci under certain conditions in vivo which prevent build-up of exoenzyme.

Eur J Respir Dis Suppl, 1985, 139, 82 - 5
Mechanisms of tobacco smoke toxicity on pulmonary macrophage cells; Green GM; The enhanced morbidity from nonspecific respiratory infections found in smokers may be attributable to chemically-induced defects in the respiratory tract defense mechanisms that are organized around the alveolar macrophage . We have isolated by filtration and gas chromatography several cytotoxic components and single chemicals of the vapor phase of tobacco smoke and studied their cytotoxic effects on pulmonary alveolar macrophages . The filtered gas phase of cigarette smoke or acrolein suppresses phagocytic uptake and intracellular digestion of staphylococci when exposed in vitro; produces marked morphologic changes in the cytoplasmic membrane; inhibits cellular adhesion; disturbs glycolysis and arachidonic metabolism; inhibits calcium and magnesium ATPase, glyceraldehyde 3-phosphate dehydrogenase, and probably endoperoxide E-isomerase, but not sodium and potassium ATPase, glucose 6-phosphate dehydrogenase or lactic dehydrogenase in a dose-response fashion . Furthermore, in vivo studies show that acrolein exposure suppresses antibacterial defenses of the lung . These cellular deficiencies may be responsible for a significant component of altered host resistance in smokers who suffer increased morbidity from nonspecific respiratory infections.

Infection, 1985, 13 Suppl 1, S123 - 8
Cefotaxime in combination with other antibiotics for the treatment of severe methicillin-resistant staphylococcal infections; Portier H et al.; Methicillin-resistant staphylococci (M-R staphylococci) represent 30% of the staphylococcal strains isolated in our hospital and pose important therapeutic problems . In a preliminary in vitro checkerboard study the bactericidal effect of various cephalosporins (cephalothin, cefamandole, cefotaxime and cefoperazone) in combination with other antibiotics (netilmicin, amikacin, vancomycin and fosfomycin) was studied on ten M-R staphylococcal strains . The combinations of cefoperazone with amikacin, cephalothin with vancomycin and of the four cephalosporins with fosfomycin were synergistic on the ten strains (FBC indexes less than or equal to 0.75) . According to the CSF and bone levels achieved by these antibiotics and their bactericidal concentrations in combination, the combination of cefotaxime and fosfomycin was the most interesting, a concentration of less than or equal to 2 mg/l cefotaxime being bactericidal on five homogeneous M-R Staphylococcus aureus when combined with 4 mg/l of fosfomycin . This combination of cefotaxime (25 mg/kg, i.v . infusion over 30 min) and fosfomycin (50 mg/kg, i.v . infusion over three hours) three to four times daily was used to treat 16 patients: three patients with meningitis, six with bone and joint infections and seven with persistent bacteremia . The FBC indexes were less than or equal to 0.625 for the 12 strains studied . All the patients were cured without relapses . The concentrations of cefotaxime, desacetyl cefotaxime and fosfomycin in the CSF during meningitis three hours after the end of the infusion on the second day of treatment were 8.76, 6.82 and 58.0 mg/l, respectively, for patient one and 2.0, 0.53 and 31.0 mg/l, respectively, for patient two.(ABSTRACT TRUNCATED AT 250 WORDS)

G Batteriol Virol Immunol, 1985 Jan-Jun, 78(1-6), 23 - 33
{Epidemiological study of a group of staphylococci isolated in a hospital environment}; Muresu E et al.; A survey has been carried out on 336 strains of staphylococci isolated in a hospital environment in order to assess the validity of the lyogroup classifying method, to know their epidemiological behavior in our territory and to test their sensitivity to various antibiotics . The findings of the survey can be summed up as follows: the practical test for bacteriolysis activity appears to be a valid method of identifying staphylococci in so far as it allows to classify them, but also to differentiate them from micrococci; lyogroup VI appears to be prevalent both as a whole and in nearly all materials of origin; the incidence of resistance is highest for piperacillin (47%), gentamicin (20%), tobramycin (19%); it is lowest for netilmicin (1.2%) and amikacin (2.6%); among meticilline resistant strains (18%) there is a marked resistance towards nearly all antibiotics tested.

Drugs Exp Clin Res, 1985, 11(6), 357 - 60
Ultrastructure of staphylococci in respiratory infections treated with nafcillin; Ernst J et al.; A patient with a pleural effusion containing Staphylococcus aureus was treated with nafcillin . Another patient with bilateral upper lobe infiltrates which grew S . aureus from a catheter inserted through a fiberoptic bronchoscope into the lesion was also treated with nafcillin . Electron microscopy of organisms grown while the patients were receiving nafcillin showed staphylococci which were twice as large as normal and contained multiple cross-walls and normal peripheral cell walls . Such abnormal staphylococci result from exposure to subminimum inhibitory concentrations of beta-lactam antibiotics.

Antonie Van Leeuwenhoek, 1985, 51(1), 25 - 32
Investigation by pyrolysis mass spectrometry, phage pattern and plasmid analysis of staphylococci that have reverted from 'L'-phase to bacterial phase; Schonfeld JK et al.; No major differences have been found in series of Staphylococcus aureus strains which reverted from 'L'-phase, either by pyrolysis mass spectrometry or by phage-typing or sensitivity testing . In 'L'-phase they have been subcultured for a long time or transformed/reverted many times into/from 'L'-phase . Plasmids were lost during transformations/reversions, but there was some difference between the tetracycline-connected plasmids on the one hand and the erythromycin-connected ones on the other.

Biol Neonate, 1985, 48(1), 15 - 20
Polymorphonuclear leukocyte function in term and preterm newborn infants; Gahr M et al.; Bacterial infections are a major problem in the care for newborn infants . In search for immunological deficits we investigated phagocytosis and killing of staphylococci using polymorphonuclear leukocytes (PMN) isolated from 2 ml of venous blood . Phagocytosis of PMN from preterm (n = 10) and newborn infants (n = 9; mean birth weights 1,949 and 3,523 g, respectively) was not different from that of adult PMN (n = 14) . Killing capacity of PMN from preterm infants was markedly impaired compared to term newborn infants and to adult PMN . We found similar rates of superoxide anion production and similar times for activation in response to phorbolmyristate acetate stimulation . Our study gives further evidence that PMN from term newborn infants have normal phagocytotic and bactericidal capacity . In PMN from preterm newborn infants, however, the bactericidal capacity is diminished similar to newborn infants under stress as described earlier by others.

Vopr Med Khim, 1985 Jan-Feb, 31(1), 121 - 5
{Modification of the modification-restriction system in staphylococci}; Kvachadze LI et al.; A new system of host specificity of DNA, called Sau67 according to the available nomenclature, was identified in Staphylococcus aureus 6782 strain by means of cross titration with staphylophage 729 considering that the phage exhibited the highly effective absorption properties . A total preparation of Sau67 methylases was isolated using ammonium sulfate fractionation . The enzyme preparation contained methylases of cytosine and adenine, where the activity of adenine methylases constituted only for 5% of the total methylase activity . As shown by kinetics of methylation low content of unspecific cellular nucleases was found in the St . aureus 6782 strain; these reasons are important for isolation of restricting endonucleases containing in the strain . 100 micrograms of protein of the total enzymatic fraction enabled to methylate the acceptory DNA at the maximal rate within 1.5 hr of incubation in phosphate buffer, pH 7.9 . The fraction of cytosine methylases free of adenine methylating activity was obtained after chromatography on Sepharose blue with NaCl concentration stepwise gradient.

G Batteriol Virol Immunol, 1985 Jan-Jun, 78(1-6), 86 - 94
{Microbiological-clinical study on the efficacy of a new antibiotic: teicoplanin}; Martinetto P et al.; Teicoplanin is a new antibiotic isolated from the fermentation broth of Actinoplanes teichomyceticus nov . sp . It's a glycopeptide antibiotic belonging to the same family as vancomycin, active against Gram-positive bacteria . The antimicrobial activity of this drug was evaluated in 32 patients suffering from different infections due to Gram-positive bacteria . Among the 36 Gram-positive microorganisms isolated, 15 staphylococci were methicillin resistant, 10 were sensitive, 1 was intermediate and for another one the methicillin susceptibility was not evaluated . After the treatment with teicoplanin, cure and improvement occurred in 26 cases (81%), in 2 cases the therapy failed (6%), in 2 cases there was a relapse and 2 cases were not evaluable . From this clinical study Teicoplanin results safe and effective in the therapy of Gram-positive infections.

Folia Haematol Int Mag Klin Morphol Blutforsch, 1985, 112(5), 658 - 68
Phagocytosis, bactericidal capacity, and superoxide anion (O2-) production by polymorphonuclear neutrophils from patients with diabetes mellitus; Wierusz-Wysocka B et al.; Phagocytosis, bactericidal capacity and superoxide anion production of polymorphonuclear neutrophils (PMN) were estimated in 30 patients with well-controlled insulin-dependent diabetes (IDD) and in 50 patients with non insulin-dependent diabetes (NIDD) . The estimations were additionally done in 20 elderly patients without glucose intolerance . The estimations of bactericidal capacity were performed in autologous-, zymosan activated-, inactivated- and control plasma . The phagocytosis of viable staphylococci was unchanged in all evaluated groups . The bactericidal capacity in all diabetic patients was significantly reduced . It was fully correctable in patients with IDD by suspension of cells in control or zymosan activated plasma . The improvement of PMN bactericidal capacity in patients with NIDD in similar conditions was less distinct . The superoxide anion production in patients with IDD was similar to values noticed in healthy persons . Whereas, the O2- production in patients with NIDD as well as in elderly patients were significantly reduced and correlated significantly with bactericidal capacity impairment . The possible mechanism of noticed disturbances were discussed.

Acta Chir Scand, 1985, 151(4), 313 - 8
Granulation tissue formation in experimental wounds inoculated with Staphylococcus aureus; Laato M et al.; The effects of inoculated Staphylococcus aureus microorganisms on developing granulation tissue were studied in rats . Hollow cylindrical viscose cellulose sponges were implanted subcutaneously as an inductive matrix for the growth of granulation tissue . The control implants were injected immediately after implantation with 1 ml of physiological saline while the experimental implants were injected with a corresponding volume of saline solution containing live staphylococci in the following concentrations: 10(2), 10(3), 10(4) or 10(5) microorganisms per milliliter . Analyses of wound fluid and granulation tissue were carried out two weeks after implantation . Implants inoculated with 10(3) or more organisms reproducibly developed infection which delayed healing while implants inoculated with 10(2) bacteria showed no infection and were usually able to clear themselves from the organisms . In the latter implants the number of wound fluid monocytes and macrophages was markedly elevated and the mean amount of collagen hydroxyproline exceeded the control level by 55% . This demonstrates that wound healing can be accelerated to a certain extent by inoculation of live staphylococci . The acceleration concerns only such bacterial concentrations which are able to promote a local inflammatory response but which can be governed by wound defence mechanisms.

J Antimicrob Chemother, 1984 Dec, 14 Suppl D, 35 - 41
In-vitro effects of vancomycin and rifampicin, alone and in combination, against methicillin-sensitive and methicillin-resistant staphylococci; Varaldo PE et al.; The in-vitro inhibitory and bactericidal activities of vancomycin and rifampicin were tested against several Staphylococcus strains recently isolated from clinical material . All strains were first tested for their susceptibility to methicillin, and typed by lyogroup . With vancomycin, minimum inhibitory concentrations (MICs) fell within a narrow range (0.62-2.5 mg/l), and significant differences were not observed both among different lyogroups and between methicillin-sensitive (M-S) and methicillin-resistant (M-R) strains . Minimum bactericidal concentrations (MBCs) of vancomycin either equalled or exceeded by twofold the MICs . With rifampicin, MICs were found to be distributed over a wide range (0.002 to greater than 5 mg/l), and susceptibility appeared to be less in M-R than in M-S isolates . Although MICs greater than or equal to mg/l were only observed in three of the six lyogroups, data appeared insufficient to substantiate definite interspecies differences in staphylococcal susceptibility to rifampicin . MBCs of rifampicin either equalled or exceeded by two- to eightfold the MICs . In-vitro interactions between vancomycin and rifampicin, were investigated both by checkerboard and time-kill tests . By both methods, indifference was observed with the great majority of isolates . Synergism was a rare event, and antagonism was never observed.

Am Rev Respir Dis, 1984 Dec, 130(6), 1177 - 9
Human lung lavage surfactant enhances staphylococcal phagocytosis by alveolar macrophages; O'Neill SJ et al.; We tested the effect of a preparation of human lung lavage surfactant (SAM) on phagocytosis and intracellular killing of Staphylococcus aureus by human alveolar macrophages (AM) . When staphylococci were incubated with 100 to 300 micrograms of SAM, AM phagocytosis but not intracellular killing efficiency was enhanced . The mean numbers of intracellular staphylococci/AM were 36.0 +/- 2.7 and 23.3 +/- 2.8 in the SAM and control groups, respectively (p less than 0.001) . The AM intracellular killing efficiency was 40.9 +/- 3.3% and 39.5 +/- 3.9% in the SAM and control groups, respectively (p greater than 0.05) . Our results suggest that SAM is an important nonimmune opsonin for bacterial phagocytosis by human AM.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(4), 472 - 9
Characterization of immunoglobulin G binding to Staphylococcus aureus strain Wood 46; Amend A et al.; Protein A (PA)-activity was detected in Staphylococcus aureus strain Wood 46 which had been considered to be PA-negative . This staphylococcal strain bound 28% of 125I-labelled IgG, compared with 89% by strain Cowan I . The binding activities of both S . aureus strains were saturable, time-dependent and specific . The dissociation constants of 1.6 X 10(-9) M for Wood 46 and 9.3 X 10(-8) M for Cowan I indicated a similar affinity for human IgG in both strains . The number of IgG-binding sites were estimated to be 16,970 for Wood 46 and 41,200 for Cowan I . Exposure to heat and ultrasonication reduced PA-activities of strain Cowan I, but not that of strain Wood 46 . Extraction of the staphylococci with guanidine and formic acid resulted in a reduction of IgG-binding activities only in strain Wood 46 . Photooxidation, trypsinization and lysozyme treatment also diminished IgG-binding of strain Wood 46 to a larger extent than that of strain Cowan I . Extracellular PA from S . aureus strains Wood 46 and Cowan I could be purified by affinity chromatography on IgG-sepharose . The purified PA preparations gave single protein bands upon SDS-polyacrylamide gel electrophoresis . Their molecular weights were 42,000 and their isoelectric points approximated 5.0.

Vestn Khir Im I I Grek, 1984 Dec, 133(12), 3 - 7
{Features of the current stage in the study of surgical infection}; Kolesov AP et al.; The article analyzes scientific problems for studying infection . Attention is paid to another role than that attributed by surgeons to staphylococci, gram-negative bacillus flora and anaerobes . A revision of the routinely used classification of surgical infections is shown to be necessary since their traditional division into purulent, putrifactive, anaerobic and specific ones is not up to the present state of science . It is noted that anaerobes take part in the appearance of 87% of postoperative complications and similar hospital infections.

Tijdschr Diergeneeskd, 1984 Dec 1, 109(23), 978 - 86
{A new treatment possibility for dogs with chronic or recurrent pyoderma}; van den Bogaard AE Jr et al.; Effective treatment of chronic or recurrent pyodermas in dogs is often found to be difficult . The disease apparently results from a change in the balance between the infecting microorganism: Staphylococcus aureus, and the host . This change in the normal equilibrium could be due to enhanced virulence of the infecting strain of staphylococci, but is more likely to have been caused by host factors such as disturbed non-specific defence mechanisms (of the skin) or malfunction of the immune response, e.g . hypersensitivity . When conventional forms of treatment such as grooming, skin-hygienic measures and antibiotics fail or relapses occur, immunotherapy with a staphylococcal vaccine or toxoid might be considered . In studies with experimental animals it was shown alpha-toxoid was superior to other staphylococcal toxoids or vaccines in preventing skin lesions . Four dogs with deep-seated chronic pyodermas were treated with staphylococcal alpha-toxoid emulsified in Freund's adjuvant . Three of these animals recovered, but because of severe unwanted side-effects, this form of therapy was abandoned . Ten dogs with deep-seated chronic primary pyodermas were treated with a commercially available alpha- and beta-toxoid preparation (Isopyos) . Nine of these patients recovered . In two cases, however, relapses occurred several months later, but the symptoms disappeared again after a booster injection . One dog did not respond; its condition deteriorated and it had to be euthanised . As the dogs received toxoid intracutaneously as well as intramuscularly, the positive effect might be due to desensitization of the animals rather than to immunisation.

J Hyg (Lond), 1984 Dec, 93(3), 567 - 73
Airborne contamination in an operating suite: report of a five-year survey; Suzuki A et al.; Airborne contamination in an operating suite was studied with a slit sampler, settle plates and a light-scattering particle counter . In conventional operating rooms there was a significant difference between the empty rooms and rooms in use; the mean total bacterial count by a slit sampler changed from 1.1 in empty to 42.5 c.f.u./m3 in use (39 times increase), the settle plates count changed from 1.5 to 17.4 c.f.u./m2/min (12 times increase), and the mean total particle count changed from 56.9 to 546.7/l (10 times increase) respectively . The increase was caused mainly by persons present in the room . Another difference was found between zones in the operating suite; the bacterial count in the clean area doubled in the semi-clean area and further doubled in the dirty area in slit sampler count as well as settle plates count, and particle count in the clean area increased by 14 times in the semi-clean and dirty areas . This difference resulted from the different quality of the ventilating system . Air cleanliness of operating rooms in use by persons present in the room dropped to a level between the clean and the semi-clean area in spite of the high quality of the ventilating system . Bacterial species identified were mostly coagulase negative staphylococci and micrococci . Our study indicates that reduction of airborne contamination in an operating suite is accomplished by the combination of an efficient ventilating system and the restriction of the number of persons present in the room.

J Hyg (Lond), 1984 Dec, 93(3), 559 - 66
Bacterial contamination of floors and other surfaces in operating rooms: a five-year survey; Suzuki A et al.; Bacterial contamination of floors and other surfaces in the operating suite has been investigated by contact impression plates during the past five years . Colony counts of the floors of operating rooms, cleaned with disinfectant, were 3.3 c.f.u./10 cm2; on the floors of semi-clean and dirty areas, cleaned with detergent, colony counts were 44.8 and 71.4 c.f.u./10 cm2 respectively . The highest colony counts of 487.4 c.f.u./10 cm2 were found in the dressing rooms, the floors of which were covered with carpets, cleaned with a vacuum cleaner . Mean bacterial numbers on surfaces of various equipment in operating rooms, cleaned with disinfectant, were 2.8 c.f.u./10 cm2 . Bacterial numbers on surfaces decreased markedly from 253.2 to 11.9 c.f.u./10 cm2 following the use of disinfectant . Bacterial species found from various surfaces were mainly coagulase-negative staphylococci, derived from human beings . In the light of these findings the regular use of disinfectant for cleaning of the floors and other surfaces in operating rooms is advisable.

J Hyg (Lond), 1984 Dec, 93(3), 531 - 8
Frequency of isolation of enterotoxigenic staphylococci from milk of nursing mothers in Kaduna, Nigeria; Adekeye JD et al.; Milk samples from 251 nursing mothers were screened for enterotoxigenic staphylococci . The incidence of staphylococci in milk samples was 71.3% . Two hundred and sixteen strains were isolated from 179 mothers . Eighty-six (39.8%) of the 216 strains were found to be toxigenic . Enterotoxin type A (SEA) predominated, with 41 strains (19.0%) elaborating it . Twenty-one strains (9.7%) produced enterotoxin B (SEB) while only eight (3.7%) produced enterotoxin C (SEC) . Ten strains (4.6%) produced all three types . Enterotoxigenic strains usually produced coagulase, thermonuclease and alpha haemolysin . In this series breast-feeding alone was more common than combined breast and bottle feeding, especially among mothers less than 30 years old . The incidence of reported infantile diarrhoea decreased with increasing age of the mother . Of 16 babies with diarrhoea, 10 (62.5%) had mothers whose milk yielded staphylococci . Six of these were toxigenic . Although no direct relationship between enterotoxigenic staphylococci in the milk of nursing mothers and infantile diarrhoea could be demonstrated, these findings reveal a potential health risk to these infants.

Am J Dis Child, 1984 Dec, 138(12), 1103 - 8
CSF shunt infections in pediatrics . A seven-year experience; Odio C et al.; The medical records of children who had had CSF shunt procedures were reviewed for the seven-year period from 1975 through 1981 . There were 516 procedures performed in 297 patients . Only three were ventriculoatrial shunts; the remainder were ventriculoperitoneal shunts . Fifty-nine infectious episodes (11%) occurred in 50 patients (17%); there were three relapses and six reinfections . The infecting pathogen was staphylococci in 75% of the infections and gram-negative bacilli in 19%, and there were two or more pathogens in 15% of the infections . The onset of the infection was within 15 days of surgery in 53% of the cases . The main symptoms were fever, irritability, and shunt malfunction . Gram's stain of the CSF was positive in 46% of the episodes and blood cultures were positive in 29% . Nineteen percent of patients had wound infection and 7% had peritonitis; in most of these cases there were no neurologic signs or symptoms . Thirteen episodes were managed with antibiotic therapy alone; among these, there were three relapses and two reinfections . Thirty-seven episodes were treated with antibiotics and immediate removal of the shunt; there were no relapses and three reinfections . Nine episodes were managed with antibiotics and delayed removal of the shunt; there was one reinfection . The median duration of antibiotic treatment was 15 days, and the time to defervescence was 24 hours in those with immediate removal of the shunt and six days in those in whom the shunt was not removed.

Infect Immun, 1984 Dec, 46(3), 727 - 32
Enhanced susceptibility of male rabbits to infection with a toxic shock strain of Staphylococcus aureus; Best GK et al.; Artificial infection chambers in rabbits were infected with a toxic shock strain of Staphylococcus aureus in an attempt to determine the nature of the enhanced virulence of toxic shock strains relative to non-toxic shock strains of staphylococci . The results showed that rabbits immunized with either neutral or acidic proteins were protected from the lethal effects of these infections . Male rabbits were found to be significantly more susceptible to these infections than female rabbits . Castration rendered both sexes equally susceptible to lethal infections . Numerous tissues from all infected rabbits were examined histologically, and most of the pathological findings involved lymphoid tissue . Of special interest was the observation that unprotected male rabbits which died had evidence of lymphoid depletion and that surviving rabbits, both male and female, usually manifested lymphoid hyperplasia . No other pathological response was noted which would characterize these infections, but immunized rabbits had a diminished level of thymic cortex involution that was not different between the sexes.

Br J Exp Pathol, 1984 Dec, 65(6), 725 - 30
Cellular uptake of clindamycin and lincomycin; Easmon CS et al.; Neither clindamycin nor lincomycin killed intracellular Staphylococcus aureus over a 4-h period . Bio-assay of neutrophil sonicates after exposure to antibiotic showed the presence of active clindamycin at approximately 20 times the extracellular concentration . Clindamycin and lincomycin kill staphylococci relatively slowly, particularly in cell culture medium and balanced salt solution . This might account for their failure to kill intracellular staphylococci despite intracellular accumulation . The neutrophil experiments could not be extended to a time period (20 h) over which the antibiotics would kill S . aureus, as the presence of these bacteria within neutrophils for this length of time resulted in considerable cell lysis.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(2-3), 256 - 67
Investigation on extracellular slime substance produced by Staphylococcus epidermidis; Ludwicka A et al.; The extracellular slime substance produced by Staphylococcus epidermidis was investigated . Slime production was assessed by bacterial agglutination in the presence of concanavalin A (Con A) or poly-L-lysine and by bacterial adherence to polyethylene . Media for slime production was optimized using these criteria . A phenol-saline extract of crude slime was separated into four fractions on a DEAE-sepharose column . Total protein and sugar content and the monosaccharide constituents were determined . Crude slime and the phenol-saline extract showed a strong precipitation reaction with Con A and poly-L-lysine (double diffusion) . Fractions I and II containing mannose as the most abundant sugar reacted with Con A and two other mannose-specific lectins (Lens culinaris, Pisum sativum) . This reaction could be inhibited by mannose . Fractions III and IV were precipitated by poly-L-lysine, probably due to a reaction with glucuronic acid which was only present in these fractions . Precoating of polyethylene with crude slime, phenol-saline extract and fractions III and IV resulted in a marked inhibition of attachment of staphylococcal cells . Production of the extracellular slime substance was completely inhibited by subinhibitory concentrations of the glycosylation inhibitor tunicamycin, whereas penicillin had no influence . Extracellular slime substance produced by S . epidermidis seems to be a complex of glycoconjugate character and plays an important role in the attachment to synthetic polymers . The production of slime by staphylococci can be easily determined using mannose specific lectins and poly-L-lysine.

J Antimicrob Chemother, 1984 Dec, 14 Suppl D, 73 - 8
Vancomycin therapy of severe staphylococcal infections; Kirby WM; Vancomycin, introduced clinically about 30 years ago, has been used widely over the past decade because of the increasing incidence of methicillin-resistant staphylococci . Its bactericidal action, high and prolonged blood levels, the lack of development of resistant strains, and decreased adverse reactions with the more purified preparation now available, make it an excellent agent for staphylococcal infections due to strains resistant to the beta-lactam antibiotics . Recent articles reviewing the efficacy of vancomycin are summarized.

J Clin Microbiol, 1984 Dec, 20(6), 1200 - 1
beta-Lactamase detection in nine staphylococcal species; Selepak ST et al.; Detection of beta-lactamase by four different techniques (two acidometric, one chromogenic cephalosporin, and one iodometric) was evaluated with 79 isolates of nine different species of staphylococci . Overall, each technique detected more positive isolates when beta-lactamase production had been induced with oxacillin before testing, and each technique performed equally well when organisms were tested after induction.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(2-3), 368 - 73
Characterization of coagulase-negative staphylococci from patients with a malignancy compared with those from other sources; Hamilton-Miller JM et al.; 170 strains of coagulase-negative staphylococci isolated from different patient groups have been characterized: 74% were Staphylococcus epidermidis, 18% S . haemolyticus and 7% S . simulans . There were no differences in rates of isolation of the various species from patients with and without a malignancy . Phage typing was not a useful epidemiological tool, but biotyping was possible using the API Staph system . Slime production, a characteristic said to predispose to colonization of catheters, was found to be most common in S . epidermidis strains.

J Hosp Infect, 1984 Dec, 5(4), 391 - 7
Analysis of an outbreak of staphylococcal scalded skin syndrome: strategies for typing 'non-typable' strains; Dowsett EG et al.; Thirteen newborn babies were studied during an outbreak of scalded skin syndrome . Staphylococci isolated from seven babies were non-typable using the international set of typing phages; the remainder were of phage group II . In only one instance was there transmission of phage group II strains other than within families . However, 'heat treatment' and plasmid profiles of the non-typable strains showed that five of the seven babies were infected by strains which were indistinguishable . These five strains were more closely related to phage III staphylococci than to phage group II . The identity of the epidermolytic toxin has not been established.

J Hosp Infect, 1984 Dec, 5 Suppl A, 51 - 5
The role of typing of coagulase-negative staphylococci in hospital-acquired infection; Marples RR; Coagulase-negative staphylococcal infections of prosthetic heart valves, orthopaedic implants, shunts for drainage of hydrocephalus and of the peritoneum for dialysis are increasingly diagnosed . The problems of strain characterization are discussed.

J Hosp Infect, 1984 Dec, 5 Suppl A, 45 - 9
Three strategies in the control of staphylococci including methicillin-resistant Staphylococcus aureus; Spicer WJ; Three general strategies for the control of Staphylococcus aureus, particularly methicillin-resistant Staph . aureus (MRSA), are described based on experience in Melbourne, Australia from 1975 to 1984, when such strains have been common . The strategies have been named (1) the Scutari Strategy, based on simple hygienic measures and barrier nursing, (2) the search and destroy technique, with strict isolation of all infected and colonized patients, and attempts to eradicate MRSA from the environment, and (3) the SALT strategy (Staph . aureus limitation techniques) with isolation only for non-containable infections, and 'infectious precautions' for other MRSA infections and for colonized patients.

J Dairy Res, 1984 Nov, 51(4), 513 - 23
Phagocytosis of Staphylococcus aureus by bovine mammary gland macrophages and intracellular protection from antibiotic action in vitro and in vivo; Craven N et al.; Macrophages isolated from the involuted bovine mammary gland were cultured in vitro . Phagocytosis of opsonized Staphylococcus aureus occurred rapidly, but intracellular killing of bacteria was slow . Many intracellular staphylococci survived for up to 4 d exposure to extracellular cloxacillin and emerged from within the macrophages to multiply extracellularly when the antibiotic was inactivated . Rifampicin was significantly more efficient than cloxacillin in killing intracellular S . aureus after 18 h incubation, but it too failed to sterilize the cultures within 3 d . Staphylococci, which had remained viable within macrophages during 20 h incubation with extracellular cloxacillin, showed an increased sensitivity to dilute lysostaphin on subsequent exposure . A 3 d course of intramammary therapy with cloxacillin, commencing simultaneously with an infecting inoculum of approximately 10(8) colony forming units (c.f.u.) S . aureus, apparently eliminated the infection from one quarter of the udders of each of three lactating cows, but bacteria were re-isolated from two cows after a delay of several days . However, when other quarters of the same cows were infected with approximately 10(8) c.f.u . S . aureus which had been phagocytosed by autologous mammary macrophages, similar simultaneous antibiotic therapy failed to affect these infections . The in vitro and in vivo findings indicate the significance of intracellular survival of S . aureus as a factor contributing to failure of antibiotic therapy.

J Infect, 1984 Nov, 9(3), 271 - 6
A model of catheter colonisation in vitro and its relationship to clinical catheter infections; Bayston R; A laboratory model for colonisation of silicone-rubber catheters by staphylococci is described . The criteria for true colonisation that involves adhesion of the organisms to the luminal surface are discussed . Light and scanning electron micrographs of the microcolonies produced in the laboratory model suggest that the same mechanisms of adhesion, involving extracellular slime, apply as in clinically colonised catheters . Potential uses of the model, for studying further the mechanisms of colonisation and particularly its prevention and treatment, are discussed.

Antibiotiki, 1984 Nov, 29(11), 848 - 51
{Modulation of phagocytic activity with prodigiozan and obsidan}; Medvedev IuA et al.; Neutrophils and peritoneal macrophages of mice treated with prodigiozan and propranolol were studied for their capacity to reduce nitroblue tetrazolium and absorption and inactivation of the cells of staphylococci and dermatophytes . It was shown that prodigiozan stimulated bactericidal activity of phagocytes, amplified macrophage fungicidity, and decreased neutrophil fungicidity in respect to the dermatophytes . Propranolol increased the prodigiozan capacity for stimulation of the oxygen-dependent metabolism of phagocytes and absorption and inactivation of staphylococci . However, it inhibited inactivation of dermatophytes by phagocytes.

J Infect Dis, 1984 Nov, 150(5), 721 - 7
Production of experimental endocarditis by coagulase-negative staphylococci: variability in species virulence; Baddour LM et al.; The abilities of 11 coagulase-negative staphylococcal isolates of human origin to establish infective endocarditis in a rat model were compared . Seven of the strains were Staphylococcus epidermidis, the species most commonly causing endocarditis in humans . The other four strains were Staphylococcus hominis, an infrequent cause of endocarditis . Four of the seven strains of S . epidermidis and two of the four strains of S . hominis elaborated surface slime . With an inoculum of 10(7) colony-forming units, endocarditis was established in all of 77 rats injected with S . epidermidis but in only five (12.5%) of 40 animals injected with S . hominis (P less than .001) . Strains of S . epidermidis were significantly more resistant to phagocytic killing in vitro than were strains of S . hominis . These data indicate that there are major differences in the virulence of various species of coagulase-negative staphylococci, both in vivo and in vitro, and that these differences are reflected in the observed incidence of disease caused in humans by the respective species.

JPEN J Parenter Enteral Nutr, 1984 Nov-Dec, 8(6), 668 - 72
Hub colonization as the initial step in an outbreak of catheter-related sepsis due to coagulase negative staphylococci during parenteral nutrition; Sitges-Serra A et al.; A prospective study was carried out to determine the pathogenesis of coagulase negative staphylococci catheter-related sepsis during parenteral nutrition . Forty-three catheters were cultured by semiquantitative and quantitative methods . The skin around the puncture site was cultured at the time of catheter removal and three segments of the catheter were cultured apart: the hub, the proximal subcutaneous segment, and the tip . Skin cultures were negative (89%) or yielded different coagulase negative staphylococci from those recovered in catheter and/or blood . Seventeen catheters were the source of sepsis . In 15 cases an infected hub was associated with an infected tip . In two cases the hub was negative (one sepsis due to mixture contamination and the other due to hematogenous seeding of the catheter tip) . Sixteen cases of sepsis were due to coagulase negative staphylococci . Staphylococcus epidermidis has been the species most commonly isolated, followed by Staphylococcus haemolyticus, Staphylococcus saprophyticus, and Staphylococcus hominis . In our patients most catheter sepsis have their origin in an infected hub and are not due to migration of skin bacteria along catheter subcutaneous tunnel.

J Clin Microbiol, 1984 Nov, 20(5), 977 - 80
Use of trehalose-mannitol-phosphatase agar to differentiate Staphylococcus epidermidis and Staphylococcus saprophyticus from other coagulase-negative staphylococci; Stevens DL et al.; Using a plate medium containing trehalose, mannitol, and phenolphthalein diphosphate (TMPA), we differentiated significant clinical isolates of Staphylococcus epidermidis by their lack of acid production in 18 h from other coagulase-negative staphylococci, with our results having a sensitivity (R . S . Galen and S . R . Gambino, Beyond Normality: The Predictive Value and Efficiency of Medical Diagnoses) of 100%, a specificity of 89.9%, and a positive predictive value of 94.8% . With a Taxo A bacitracin disk, which differentiates Staphylococcus species from Micrococcus species, no zone of inhibition was seen for 96% of all staphylococcal strains, with 5 of 26 strains of Staphylococcus saprophyticus exhibiting zone diameters up to 10 mm . By using resistance to a 5-microgram novobiocin disk, we differentiated S . saprophyticus, with our results having a sensitivity of 100%, a specificity of 97.1%, and a positive predictive value of 83.9% on TMPA . These two species represented 77.8% of coagulase-negative staphylococci isolated . Reference strains fo Staphylococcus and Micrococcus species were differentiated by TMPA . The cost of TMPA was compared with that of another method . TMPA was found to offer an inexpensive, sensitive method for rapidly differentiating coagulase-negative Staphylococcus isolates.

J Exp Med, 1984 Nov 1, 160(5), 1597 - 602
Detection and functional studies of p60-65 (Tac antigen) on activated human B cells; Jung LK et al.; A monoclonal antibody, AT-1, is shown to precipitate a p60-65 molecule identical to the Tac antigen . With AT-1, the expression of IL-2 receptors by normal activated human B cells from peripheral blood and tonsils is documented by biosynthetic and immunofluorescence studies . AT-1 precipitated a p60-65 protein from {35S}methionine-labeled activated B cells, similar to that from activated T cells . The interleukin 2 (IL-2) receptor appeared shortly after activation with anti-IgM and B cell-stimulatory factor(s) . Its expression reached its peak at 60-72 h with approximately 50% of the B blasts stained by AT-1 . Other modes of activation of B cells, by T cell-independent, formalin-treated staphylococci and Epstein-Barr virus, and by T cell-dependent pokeweed mitogen, also induced IL-2 receptor expression . The functional significance of this finding was investigated using recombinant IL-2 (rIL-2) . While rIL-2 did not induce resting B cells to proliferate in the presence of anti-IgM, it induced activated B cells to proliferate in the absence of other factors . On the other hand, rIL-2 did not induce the differentiation of these activated B lymphocytes . These data suggest that IL-2 may play a significant role in B cell activation.

J Appl Bacteriol, 1984 Oct, 57(2), 325 - 32
The adhesion of coagulase negative staphylococci to human skin and its relevance to the bacterial flora of milk; Brooker BE et al.; Twenty-eight isolates of coagulase negative staphylococci were obtained from nipple swabs provided by one non-lactating woman and five nursing mothers . All but two of these isolates were shown by scanning electron microscopy to adhere to the surface of human skin . Experiments with frozen sections of human skin confirmed and extended these results by showing that isolates exhibited one of three patterns of adhesion, suggesting that there are three different adhesion receptors on epidermal cells . It is proposed that adhesion of staphylococci to the nipple and areolar epidermis provides a mechanism whereby large numbers of bacteria, nourished by residues of milk and saliva, are maintained on the surface of the skin.

Am J Vet Res, 1984 Oct, 45(10), 2039 - 42
Antimicrobial susceptibility of coagulase-positive staphylococci isolated from Louisiana dogs; Cox HU et al.; Disk diffusion susceptibility tests were done on 1,178 clinical strains of coagulase-positive staphylococci (CPS) isolated from dogs during a 7-year period . Relative decreases of 7% to 33% were found in the percentages of CPS sensitive to 8 antimicrobics . Relative percentages of CPS sensitive to 9 other antimicrobics were increased or decreased less than 5% . Sensitivity to the beta-lactam antibiotics showed the least relative change . Regression analysis demonstrated that the greatest change in percentage sensitivity of CPS occurred to gentamicin and cephalothin and the least change occurred to penicillin and ampicillin . Recent canine clinical isolates of CPS, specifically identified as Staphylococcus intermedius (n = 109), were uniformly sensitive to novobiocin, amikacin, tobramycin, spectinomycin, and amoxicillin-clavulanic acid . Twenty-two isolates were also sensitive to 17 other antimicrobics . Eighty-seven isolates were resistant to 1 or more antimicrobics tested . Resistance was most common to sulfonamides, penicillin G, ampicillin, tetracycline, and streptomycin . Differences in susceptibility results between S intermedius and unspecified CPS were not statistically significant.

Am J Med, 1984 Oct, 77(4), 639 - 44
Hospital-acquired bloodstream infections with Staphylococcus epidermidis . Review of 100 cases; Ponce de Leon S et al.; During a seven-year study period, 1976 to 1982, this prospective surveillance program detected 108 episodes of nosocomial bacteremia caused by coagulase-negative staphylococci (seven per 10,000 admissions) . Chart reviews were subsequently performed in 100 patients primarily to define the patient population and determine outcome of infection . Seventy-two patients had at least two culture bottles that showed growth of coagulase-negative staphylococci plus one or more cultures that showed growth at another site or on a vascular catheter . Most of the patients were in the early or later stages of life: 20 were premature infants, 20 additional infants were under one year of age, and 35 patients were 50 years of age or older . Seventy-three patients were in intensive care areas at the time of the infection . The mortality for the 100 patients studied was 34 percent, with a rate of 9 percent per week after infection . Ninety-three patients had arterial or central lines in place prior to bacteremia and, in 36 reviewed, the mean duration of use of each type of catheter (5.1 days or more) was longer than recommended . In 56 percent of 46 catheters cultured semiquantitatively, there was growth of coagulase-negative staphylococci . The presence of coagulase-negative staphylococci in the blood is associated with significant mortality in hospitalized patients . No longer can their presence in the blood be disregarded as mere contaminants, especially in patients in critical care units.

J Lab Clin Med, 1984 Oct, 104(4), 455 - 69
Fibronectin-induced agglutination of Staphylococcus aureus correlates with invasiveness; Proctor RA et al.; Studies on the interactions of staphylococci with fibrinogen, fibrin split products, and prothrombin have formed the basis for the clumping tests for coagulase and fibrin degradation products . We investigated the role of another circulating protein, fibronectin, in clumping Staphylococcus aureus . Fibronectin is a dimeric glycoprotein with high molecular weight that is present in both blood and tissue and is involved in opsonization, clotting, healing of wounds, cell-to-cell attachment, and differentiation . Each fibronectin molecule has two S . aureus binding sites, thus allowing lattice formation . We defined conditions under which fibronectin will cause agglutination of S . aureus . Strains of S . aureus that were most easily clumped had the largest number of fibronectin receptors . Trypsinization or gentle sonication removed the fibronectin binding and agglutinating receptors from S . aureus . These treatments did not alter viability, which suggests that binding is a superficial component of the organisms . Invasive fibronectin-binding strains were from a wide variety of phage types . Twenty two S . aureus isolates from patients with invasive disease were more readily agglutinated and had a greater number of fibronectin binding sites than 19 noninvasive strains (p less than 2.5 X 10(-4)) . This suggests that the pathogenicity of S . aureus invasion may be enhanced by binding of bacteria to tissue fibronectin or by agglutination of bacteria by plasma fibronectin . Thus, the fibronectin receptors on S . aureus that mediate agglutination might also permit invasion of host tissues.

Clin Pediatr (Phila), 1984 Oct, 23(10), 542 - 4
Coagulase-negative staphylococcal bacteremia in newborns; Calnen G et al.; Coagulase-negative staphylococci (C-NS) recently have been identified as common causes of septicemia in high-risk newborns . In this review of the incidence and clinical significance of C-NS blood culture isolates from infants with suspected septicemia in a newborn intensive care unit (NICU), 2.2 percent of blood cultures in an 18-month period yielded C-NS . Based on the criterion of growth in multiple blood cultures as evidence of bacteremia, six of 30 infants (20%) were bacteremic, 17 (57%) represented probable contaminants (on the basis of growth in only one of two paired blood cultures with CN-S), and seven cases (23%) were indeterminant (only one culture was obtained) . In those infants considered bacteremic, onset occurred between 12 and 51 days of age . In those with probable contaminants, all but three occurred in the first week of life . All infants had manifestations of suspected sepsis and survived the clinical episode . These findings indicate that C-NS growth can be due to nosocomial bacteremia but frequently represents blood culture contamination, especially in infants in the first week of life . At least two paired peripheral blood cultures should be obtained in infants with suspected septicemia to differentiate bacteremia from contamination.

Biochim Biophys Acta, 1984 Sep 28, 801(2), 206 - 14
Differences in the effect of arachidonic acid on polymorphonuclear and mononuclear leukocyte function; Henricks PA et al.; Incubation of human polymorphonuclear leukocytes with arachidonic acid resulted in a stimulation of the oxidative metabolism of the cells . Upon stimulation with 80 microM arachidonic acid, neutrophils (5 X 10(6) cells/ml) produced superoxide (53 +/- 8 nmol/5 X 10(6) cells per 15 min), generated chemiluminescence (1211 100 +/- 157 000 cpm) and consumed oxygen (20 +/- 1 nmol/10(6) cells per 5 min) . The stimulation of the cell metabolism could be reduced 40-60% by prior incubation of the cells with 10 microM indomethacin . Incubating polymorphonuclear leukocytes with arachidonic acid also resulted in a diminished chemotaxis towards an attractant, a decreased uptake of opsonized staphylococci and aggregation of the cells . This may be due to inhibitory products of arachidonic acid metabolism and toxic oxygen species produced during stimulated oxidative metabolism . The effects of arachidonic acid are specific for neutrophils, as mononuclear phagocytes only produced 17 +/- 8 nmol superoxide/5 X 10(6) cells per 15 min and generated 27 000 +/- 15 000 cpm chemiluminescence when stimulated with 80 microM arachidonic acid . When monocytes and neutrophils were stimulated with particles such as opsonized staphylococci, the amount of superoxide produced, oxygen consumed and chemiluminescence generated were similar . The phagocytic activity of the monocytes was also not affected by prior incubation with arachidonic acid . We conclude that in contrast to monocytes, neutrophil metabolism can be stimulated with arachidonic acid and this stimulation resulted in a decreased phagocytic activity of these cells.

Dtsch Med Wochenschr, 1984 Sep 7, 109(36), 1361 - 3
{Percutaneous transluminal extraction of an embolized central venous catheter}; Erdmann E; Despite all precautions in two cases a large fragment of a transvenously placed central-venous catheter broke off and became lodged in the right atrium . In both the fragments were removed successfully and without complication with the Dotter intravascular retriever catheter, percutaneously introduced into the femoral vein . Staphylococci were grown from both catheter fragments after removal . These cases illustrate once again the value of radio-opaque venous catheters.

Jpn J Antibiot, 1984 Sep, 37(9), 1661 - 8
{A study on the disc sensitivity test for amoxicillin}; Kanazawa Y et al.; Susceptibilities of 101 strains of 25 bacterial species or subspecies to amoxicillin (AMPC) were determined by the 2-fold agar dilution method in parallel with the diameter of inhibition zone by the single-disc method, under the experimental conditions established by Kanazawa . The experiments demonstrated significant correlation between the MIC by the dilution method and the diameter of inhibition zone in each of conventional assay of the over-night (about 16 hours) incubation, delayed assay (about 24 hours incubation), and rapid assay (after 3 approximately 4 or 5 approximately 6 hours incubation), thus confirming applicability of the single-disc assay for AMPC . Analysis of the data obtained by using AMPC disc containing 30 micrograms revealed the primary regression equation to be: D (diameter, mm) = 27.1-9.9 log MIC (micrograms/ml) in conventional assay, D = 32.2-12.8 log MIC (micrograms/ml) in delayed assay, D = 19.8-6.2 log MIC (micrograms/ml) in 3 approximately 4 hours rapid assay, and D = 24.0-7.8 log MIC (micrograms/ml) in 5 approximately 6 hours rapid assay, and particularly for beta-lactamase producing Staphylococci, D = 23.7-8.1 log MIC (micrograms/ml) in conventional assay, D = 16.7-9.0 log MIC (micrograms/ml) in 3 approximately 4 hours rapid assay, and D = 20.7-9.2 log MIC (micrograms/ml) in 5 approximately 6 hours rapid assay, respectively . The range of variations in MICs estimated from the diameter of inhibition zone by the disc test was then calculated in comparison with that in MIC determined by the 2-fold agar dilution assays, as reference for the experimental errors which may be involved in the estimation of MIC of AMPC by the single-disc assay.

Zh Mikrobiol Epidemiol Immunobiol, 1984 Sep, (9), 21 - 5
{Biological properties and ecological variants of Staphylococcus aureus strains isolated from Macaca rhesus monkeys}; Trots AA et al.; The biological properties of staphylococci isolated from 38 healthy M . rhesus and 28 dead ones were studied . Of 90 isolated staphylococcal strains, 62 proved to be S . aureus strains belonging to 6 different ecological variants.

J Gen Microbiol, 1984 Sep, 130 ( Pt 9), 2427 - 37
Polar lipid and isoprenoid quinone composition in the classification of Staphylococcus; Nahaie MR et al.; Representatives of 13 species of Staphylococcus were examined using a small-scale procedure for the sequential extraction of isoprenoid quinones and polar lipids . Menaquinones were the only isoprenoid quinones found in the 77 test strains which were divided into three groups based upon the predominant isoprenologue detected: (i) S . hyicus subsp . hyicus, S . sciuri subsp . lentus and S . sciuri subsp . sciuri contained unsaturated menaquinones with six isoprene units; (ii) S . capitis, S . cohnii, S . epidermidis, S . haemolyticus, S . hominis, S . hyicus subsp . chromogenes, S . intermedius, S . saprophyticus, S . simulans, S . warneri and S . xylosus contained unsaturated menaquinones with seven isoprene units and (iii) S . aureus contained unsaturated menaquinones with eight isoprene units and varying amounts of the corresponding lower isoprenologue . All of the organisms contained very similar polar lipid patterns consisting of diphosphatidylglycerol, phosphatidylglycerol, beta-gentiobiosyl diacylglycerol and a number of glycolipids and phospholipids . One of the glycolipids was chromatographically indistinguishable from beta-gentiotriosyl diacylglycerol . Lysylphosphatidylglycerol was a major component in S . aureus and S . intermedius but was usually present in minor amounts in the coagulase-negative strains . The polar lipid data underline the homogeneity of the genus Staphylococcus and distinguish staphylococci from aerobic, Gram-positive cocci and from the phylogenetically related aerobic, endospore-forming bacteria . Menaquinone composition can also be used to separate staphylococci from other aerobic, Gram-positive cocci.

Andrologia, 1984 Sep-Oct, 16(5), 417 - 22
Infertility and chronic prostatitis; Giamarellou H et al.; Long term treatment of chronic prostatitis with antimicrobials and their influence on semen quality and infertility were studied in 30 men with mean age of 36.7 +/- 6 years . The infection was symptomatic only in 50% of the patients with abnormal prostatic physical findings in 66.7% . Cardinal findings in the spermatogram were leukocytosis in 100% and oligoasthenozoospermia in 66.5% of the patients . E . coli and Staphylococci presented the most commonly isolated bacteria in prostatic secretion cultures . Various treatment schedules, including mostly co-trimoxazole, doxycycline and erythromycin, were given alternatively for 6-8 months . Symptoms were cured or improved in 79.7%, with elimination or improvement of abnormal physical findings in 85%, while the isolated pathogens were eradicated in all . Spermatograms were normalized or improved in 70% of the patients, while among them 9 impregnated their wives and in 2 of them twice . It is concluded that male infertility in the presence of semen leukocytosis and oligoasthenozoospermia should be investigated for underlying chronic prostatitis, while whenever proved, long term treatment with the proper antimicrobials not only cures or improves chronic prostatitis, but subsequently cures or improves male infertility.

J Clin Microbiol, 1984 Sep, 20(3), 500 - 5
Scanning electron microscopy of bacteria adherent to intravascular catheters; Franson TR et al.; Scanning electron microscopy was used to assess the morphological features of coagulase-negative staphylococci adherent to polyvinylchloride intravascular catheter specimens . Clinical specimens were obtained by using patient catheters from which coagulase-negative staphylococci (greater than or equal to 15 colonies per catheter) grew on semiquantitative blood agar roll cultures . In vitro specimens were prepared by a previously published technique in which sterile polyvinylchloride catheters were immersed in 10(6) CFU of coagulase-negative staphylococci per ml suspended in phosphate-buffered saline . Unused sterile polyvinylchloride catheters were also examined . Scanning electron microscopy of unused sterile polyvinylchloride catheters demonstrated multiple linear surface irregularities . Scanning electron microscopy of infected patient catheters showed a diffuse amorphous material covering the entire surface and the presence of bacteria which appeared anchored to that surface by several different means . These included a slime layer, "foot" processes, and lodgement in surface irregularities . Scanning electron microscopy of in vitro specimens demonstrated no background surface coating, but it did show attachment of cocci to the surface by the same mechanisms as described for clinical specimens . These observations of similar means of attachment in clinical and in vitro specimens suggest that intrinsic catheter surface properties, bacterial surface features, and perhaps coating with host substances may all play a role in bacterial attachment to intravascular catheters . More sophisticated analysis of these interactions may clarify mechanisms of pathogenesis.

J Clin Microbiol, 1984 Sep, 20(3), 473 - 7
Rapid antimicrobial susceptibility testing of isolates from blood cultures by direct inoculation and early reading of disk diffusion tests; Coyle MB et al.; Disk diffusion tests, inoculated directly from positive blood cultures, were evaluated for accuracy of reading zone diameters after 4- and 6-h and overnight incubation . In comparisons with results from standard disk diffusion tests, the 4-h results were in agreement for 83% of tests with gram-positive organisms and 64% of tests with gram-negative organisms . When minor discrepancies were ignored, the 4-h readings were in agreement for 98% of the tests with gram-positive organisms and 95% of the tests with gram-negative organisms . After 6 h of incubation, 91% of the tests with gram-positive organisms and 86% of the tests with gram-negative organisms agreed with standard results . The agreement was 99% for tests with both gram-positive and gram-negative organisms when minor discrepancies were excluded . Very major discrepancies occurred in two tests (0.1%) with gram-positive organisms and were not observed in tests with gram-negative organisms . The frequencies of major discrepancies were 3.5% after 4 h, 0.6% after 6 h, and 0.7% after overnight incubation . Ampicillin and cephalothin tests with Escherichia coli and Klebsiella spp . accounted for 81% of the major discrepancies in tests with gram-negative organisms . Oxacillin tests accounted for more than half of the major discrepancies in tests with staphylococci . The results of this study, which did not include the newer antibiotics, indicate that direct susceptibility tests from blood cultures read after 6 h of incubation are more reliable than 4-h results and produce less than 1% major errors in comparisons with standard susceptibility tests.

J Infect Dis, 1984 Sep, 150(3), 366 - 71
Increased energy expenditure by granulocytes during phagocytosis of Staphylococcus aureus compared with other staphylococci; Eftimiadi C et al.; The heat produced by human neutrophils during phagocytosis of different strains of Staphylococcus was analyzed by a flow calorimetric technique . At the same bacteria/leukocyte ratio Staphylococcus aureus yielded heat effects about twice that of other saprophytic staphylococci tested . In parallel experiments the degree of phagocytosis of radiolabeled bacteria was evaluated: S . aureus strains were the least phagocytosed . These data indicate that, for a single phagocytosed bacterium, S . aureus strains yield heat effects three to four times greater than do the saprophytic staphylococci tested (P less than .001) . Previous studies have shown that the heat produced by activated neutrophils derives essentially from the aerobic catabolism of glucose involved in the production of bactericidal O2 metabolites and is directly proportional to O2 consumption . The results reported here indicate that less efficient internalization of a staphylococcal strain is correlated with a greater energy expenditure for O2 metabolite formation during the metabolic burst.

J Clin Microbiol, 1984 Sep, 20(3), 448 - 52
Evaluation of the Staph-Ident and STAPHase systems for identification of staphylococci from bovine intramammary infections; Watts JL et al.; The Staph-Ident and STAPHase systems (Analytab Products, Plainview, N.Y.) were compared with conventional methods for identification of staphylococci isolated from bovine intramammary infections . Adjunct testing by colony morphology, pigmentation, and biochemical tests was conducted to resolve discrepant identifications . The initial accuracies of the conventional scheme and Staph-Ident were 92.1 and 89.2%, respectively . Staphylococcus hyicus subsp . chromogenes could not be identified by means of the Staph-Ident test, but the addition of pigment production as a key character permitted identification of most strains . The final accuracy of the Staph-Ident was 94.3% . The STAPHase system was as accurate as the conventional tube coagulase method . The Staph-Ident and STAPHase systems are acceptable alternatives to conventional methods for identification of staphylococcal species isolated from bovine intramammary infections.

Ann Microbiol (Paris), 1984 Sep-Oct, 135B(2), 165 - 76
{New bacteriophages of Staphylococcus epidermidis: evaluation of their epidemiological value}; Bes M et al.; Coagulase-negative staphylococci, and in particular Staphylococcus epidermidis, are now being recognized as causing human infections with increasing frequency; the absence of an internationally accepted system of phage-typing for coagulase-negative staphylococci led us to isolate new phages . Fifty strains of S . epidermidis isolated from human infections were induced with mitomycin C: eight phages (41, 63, 118-II, 138, 245, 336, 392 and 550) were isolated . These phages were propagated on five different strains of S . epidermidis . Their phages were propagated on five different strains of S . epidermidis . Their lytic activity as studied on 561 strains . Phages 336, 392 and 550 had a different host-range and different propagative strains; they typed 93% of the strains susceptible to the 8 phages . The other phages had an activity similar to that of phage 336 . Twenty-one per cent of non-epidemic strains were susceptible to at least one of the three phages . The reproducibility, specificity and discriminatory power of these phages suggest they may be a useful addition to previously recognized phages.

J Hosp Infect, 1984 Sep, 5(3), 305 - 12
Disinfection of hands and tubing of CAPD patients; Gruer LD et al.; During a 3 month study the effectiveness of two methods of handwashing was assessed in a group of 31 patients undergoing continuous ambulatory peritoneal dialysis . A defined, double rinse with alcohol, prior to bag exchange, was found to be more convenient and significantly more effective than povidone-iodine alone or povidone-iodine followed by alcohol . Spraying the tubing around the bag connector with 70 per cent ethanol reduced the numbers of adherent skin organisms so reducing the likelihood of bacteria being drawn into the dialysate . Although there was no difference in the overall incidence of peritonitis in the two groups of patients studied, there was an unexpected drop in the incidence of peritonitis caused by coagulase-negative skin staphylococci . This was attributed to an overall awareness of the importance of handwashing and aseptic procedures during bag exchange . Monitoring the bacteriology of the catheter exit site may give some prior indication as to the likelihood of subsequent peritonitis especially with Staphylococcus aureus and Gram-negative bacilli.

J Hosp Infect, 1984 Sep, 5(3), 260 - 9
Is coagulase-negative staphylococcal bacteraemia in neonates a consequence of mechanical ventilation?
Davies AJ, Ward-Platt M, Kirk R, Marshall R, Speidel BD, Reeves DS.
The clinical symptoms associated with coagulase-negative staphylococcal bacteraemia in infants on a Special Care Baby Unit were investigated . They were compared with those of blood culture-negative controls matched for age and weight . Infants with positive cultures were further sub-divided by judging the isolate to be a contaminant or a pathogen . There was a high incidence of respiratory symptoms in the latter patients, particularly in infants of less than 37 weeks gestation . These symptoms often responded to antimicrobial chemotherapy, particularly in infants given correct antibiotics, as demonstrated by laboratory sensitivity testing . Bacteraemia was usually detected shortly after starting mechanical ventilation, and may be its consequence in premature infants . Gentamicin-resistance occurred in over 50 per cent of blood culture isolates of coagulase-negative staphylococci . We postulate that coagulase-negative staphylococci can be a neonatal pathogen requiring appropriate antimicrobial chemotherapy.

JAMA, 1984 Aug 24-31, 252(8), 1019 - 22
Staphylococcal food poisoning associated with an Easter egg hunt; Merrill GA et al.; Staphylococcal contamination of intact, hard-boiled eggs resulted in the food poisoning of an estimated 300 children out of 850 who had participated in an Easter egg hunt . Enterotoxigenic staphylococci that were isolated from the Easter eggs matched that obtained from an infected cook who prepared the eggs three to five days before the hunt and which he left unrefrigerated . Experimental studies demonstrated that heated eggs can absorb 2 mL of contaminated cool water through intact eggshells . When water was inoculated with pathogenic staphylococci at even low contamination levels, rapid growth and enterotoxin production within cooked eggs could be easily duplicated . This is the first large outbreak of its type; safeguards can and should be employed to prevent future ones.

J Hyg (Lond), 1984 Aug, 93(1), 59 - 66
Interspecific co-transfer of antibiotic resistance plasmids in staphylococci in vivo; Naidoo J; The co-transfer of plasmid-borne genes governing resistance to gentamicin, tetracycline, erythromycin and chloramphenicol has been demonstrated on human and mouse skin . Two different gentamicin resistance plasmids have been studied in detail; both appear to have the ability to mobilize in vivo otherwise non-transferable resistance plasmids from coagulase-negative to coagulase-positive staphylococci . This emphasis the role of the skin in maintaining a pool of resistance genes available to pathogenic staphylococci.

Can Med Assoc J, 1984 Aug 1, 131(3), 211 - 3
Endocarditis caused by Staphylococcus warneri on a normal aortic valve following vasectomy; Dan M et al.; PIP: Endocarditis caused by Staphylococcus warneri and necessitating valve replacement occurred in a previously health 32 year old patient following vasectomy . No sign of an underlying valvular defect was noted during the operation . S . warneri is a recently identified species of coagulase-negative staphylococci . Endocarditis caused by coagulase-negative staphylococci is uncommon in young, healthy patients with normal heart valves and has not previously been described as a complication of vasectomy . Similarly, infections caused by S . warneri have not previously been described in humans . author's modified

Antimicrob Agents Chemother, 1984 Aug, 26(2), 220 - 3
Disparity between timed-kill and checkerboard methods for determination of in vitro bactericidal interactions of vancomycin plus rifampin versus methicillin-susceptible and -resistant Staphylococcus aureus; Bayer AS et al.; The role of rifampin as an adjunctive agent to vancomycin in the therapy of serious systemic staphylococcal infections remains controversial . Several in vitro studies utilizing differing methodologies to define the bactericidal interactions of vancomycin plus rifampin versus Staphylococcus aureus have yielded markedly disparate results . The in vitro bactericidal synergistic activities of vancomycin plus rifampin were examined versus 48 clinical isolates of S . aureus, both methicillin susceptible and resistant . Each strain was tested simultaneously in timed-kill curve and checkerboard systems . By timed-kill curve, vancomycin plus rifampin usually had either an indifferent (67%) or synergistic (19 to 29%) effect, with a frequency dependent on sampling times; bactericidal antagonism was infrequently noted after 48 h of incubation (4%) . Indifference was seen as a prevention of rifampin resistance by vancomycin . Synergy was more commonly noted at 48 than at 24 h of incubation . The bactericidal interaction results were similar for both methicillin-susceptible and -resistant strains . In contrast to the killing curve data, the checkerboard technique uniformly demonstrated bactericidal antagonism of vancomycin plus rifampin against all 48 staphylococci . We conclude that the nature of the in vitro bactericidal interactions of vancomycin plus rifampin against S . aureus is difficult to establish in vitro . This fact relates to the markedly disparate findings, which depended on both the synergy technique utilized and the test system conditions employed . In vivo studies are required to delineate the bactericidal interaction potentials of vancomycin plus rifampin versus S . aureus.

Am Rev Respir Dis, 1984 Aug, 130(2), 225 - 30
Rat lung lavage surfactant enhances bacterial phagocytosis and intracellular killing by alveolar macrophages; O'Neill S et al.; We have tested the effect of a preparation of rat lung lavage surfactant (SAM) on phagocytosis and intracellular killing of Staphylococcus aureus by rat alveolar macrophages (AMs) . The SAM was isolated and purified by density gradient centrifugation . It was highly enriched in disaturated phosphatidylcholine, and invariably lowered the surface tension of a clean saline solution to less than 10 dynes/cm at 37 degrees C . We used a radiometric assay to measure phagocytosis as uptake by AMs of 14C phenylalanine labelled staphylococci, and intracellular killing as incorporation of 3H thymidine by viable staphylococci from the lysed AMs . When staphylococci were incubated with 100 to 300 micrograms of SAM, both phagocytosis and intracellular killing efficiency were enhanced . The mean numbers of intracellular staphylococci/AM were 24.3 +/- 3.8 and 18.3 +/- 3.0 in the SAM and control groups, respectively (p less than 0.001) . The mean intracellular killing efficiency was 59.6 +/- 6.76% and 39.7 +/- 7.17% in the SAM and control groups, respectively (p less than 0.001) . Previous studies have shown that unpurified rat lung lavage fluid enhances intracellular killing of staphylococci by AMs . Our results suggest that SAM may be the active principle in lung lavage fluid that enhances intracellular killing . In addition, in our test system, SAM enhanced staphylococcal phagocytosis by AMs.

J Clin Microbiol, 1984 Aug, 20(2), 141 - 4
Detection of encapsulation in Staphylococcus aureus by use of antiserum agar; West TE et al.; We examined an antiserum agar method to study its reliability in screening Staphylococcus aureus strains for capsule production . The encapsulated S . aureus Smith diffuse strain was compared with its nonencapsulated variant, Smith compact, in CCY medium containing 0.5% NaCl and 5.0% Smith diffuse rabbit antiserum . A halo was visible surrounding colonies of the Smith diffuse strain but not the Smith compact strain . On this same medium, the protein A-producing Cowan I strain possessed a halo that was visible on photographs . Single high-salt medium is known to inhibit protein A production, halo formation by the strains was also compared in 7.5% NaCl medium . The halo surrounding the Cowan I strain was not present when the salt content of the medium was increased . In contrast, the halo surrounding the Smith diffuse strain persisted in the 7.5% NaCl medium . By use of this medium, the antiserum agar technique may be valuable for the identification of encapsulated staphylococci without appreciable interference from protein A.

Scand J Haematol, 1984 Aug, 33(2), 212 - 4
Differences in phagocytic/adherence properties between normal neutrophils; Stavem P et al.; Neutrophils, serum opsonins and staphylococci were incubated at 37 degrees C with continuous end-over-end rotation . The observed frequency of neutrophils with 0, 1, 2.. . staphylococci deviated systematically from that expected for a Poisson distribution . This suggests marked differences in phagocytosis/adherence between the neutrophils, indicating different neutrophil populations.

Am Heart J, 1984 Aug, 108(2), 359 - 65
Investigations on staphylococcal infection of transvenous endocardial pacemaker electrodes; Peters G et al.; Infections of pacemaker electrodes and/or aggregate pockets are usually caused by staphylococci, primarily Staphylococcus epidermidis . From in vitro experiments it can be demonstrated that staphylococci are able to adhere to the plastic electrode sheath, to multiply there, and to form microcolonies . Furthermore, the staphylococci produce a slimy amorphous substance with which they are completely covered after a 24-hour incubation . No difference was noticed between the in vitro experiment situation and that occurring in pacemaker infection in humans . This slimy material may be responsible for the maintenance of the infection and the protection of the enclosed bacterial cells against natural host defense mechanisms and antibiotic treatment.

Toxicol Appl Pharmacol, 1984 Aug, 75(1), 60 - 8
T-2 toxin effect on bacterial infection and leukocyte functions; Yarom R et al.; The effects of T-2 toxin on bacterial infection and leukocyte function and structure were examined in vivo and in vitro . Rats were innoculated with staphylococci after pretreatment with or without T-2 toxin . The T-2 pretreated rats failed to mount a cellular response to the bacteria . Blood and bone marrow cells were markedly suppressed by the T-2 toxin, the myeloid series being the most affected . In vitro studies with human leukocytes showed that small, nonkilling doses of T-2 toxin inhibited chemotaxis, chemiluminescence stimulated by bacteria, and phagocytosis of bacteria . It was concluded that this inhibition may contribute towards sepsis and rapid onset of death in T-2 toxin poisoning.

J Clin Microbiol, 1984 Aug, 20(2), 227 - 30
Identification of Staphylococcus species of bovine origin with the DMS Staph-Trac system; Langlois BE et al.; The DMS Staph-Trac system was evaluated as a means for identifying the species of bovine strains of staphylococci routinely isolated from quarter-milk samples . The species identity of 83 of 91 (91.2%) isolates of staphylococci was correctly determined by this method . One isolate could not be identified by this system . The Staph-Trac system was able to distinguish between Staphylococcus hyicus and Staphylococcus epidermidis . We obtained a higher percentage of correct identifications with the DMS Staph-Trac system (91.2%) than we did in a previous study with the API Staph-Ident system (45.1%), using the same isolates (Langlois et al., J . Clin . Microbiol . 18:1212-1219, 1983).

J Clin Microbiol, 1984 Aug, 20(2), 199 - 203
Bacterial growth and killing in chronic ambulatory peritoneal dialysis fluids; Verbrugh HA et al.; We determined the ability of Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli to survive and grow in peritoneal dialysis fluids from patients undergoing chronic ambulatory peritoneal dialysis . Staphylococci did not survive in commercially available dialysis solutions but grew readily in peritoneal effluents obtained from patients after the dialysis dwell time . The number of CFU doubled 6 and 13 times in 24 h for S . epidermidis and S . aureus, respectively . E . coli grew well in both the pre- and postdialysis peritoneal fluid . Peritoneal macrophages as well as peripheral blood leukocytes inhibited bacterial growth in peritoneal dialysis fluid . However, 10(6) phagocytes per ml were minimally required to obtain a bacteriostatic effect . The addition of serum to peritoneal dialysis fluid increased the antibacterial activity of macrophages and blood leukocytes . The capacity of the aminoglycoside antibiotic tobramycin to reduce bacterial CFU in peritoneal dialysis fluid was only 10% of its bactericidal capacity in standard Mueller-Hinton brush . Peritoneal dialysis fluid had no effect on the antibacterial activity of imipenem.

Antimicrob Agents Chemother, 1984 Aug, 26(2), 149 - 54
Therapeutic relevance of penicillin-induced hypersensitivity of Staphylococcus aureus to killing by polymorphonuclear leukocytes; Lam C et al.; There is an overwhelming body of evidence that certain Staphylococcus aureus strains become more sensitive to killing by polymorphonuclear leukocytes after their growth in media containing subinhibitory concentrations of penicillin . However, it is not clear to what extent this phenomenon contributes to the curative effect of penicillin in vivo . To explore its therapeutic relevance, we evaluated the interaction of staphylococci pretreated with penicillin in vitro with leukocytes in cell-proof diffusion chambers (porosity, 0.22 micron) implanted subcutaneously in rabbits . Under this in vivo environment, staphylococci pretreated with penicillin remained hypersensitive to leukocyte killing as under in vitro conditions . Furthermore, when the staphylococci were mixed with the leukocytes in chambers implanted intraperitoneally in mice which subsequently received intravenously a suboptimal dose of penicillin, they also became hypersensitive to leukocytic killing . However, because the staphylococcal growth rate was considerably reduced in vivo, the degree of penicillin-induced sensitivity to leukocytic killing was smaller than that obtained in test tube cultures; nevertheless, the enhanced killing was significant . Additional support that the curative effect of penicillin partly depends on its synergistic action with the leukocytes was provided by the relative decrease in virulence of staphylococci pretreated with penicillin in mice in which the cellular host defenses were already recruited at the focus of inoculation . These observations indicate that penicillin-induced hypersensitivity of staphylococci to leukocytic killing is not only an in vitro phenomenon, but an effect which has therapeutic relevance.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Aug, 257(3), 388 - 99
{Effect of colchicine and indomethacin on leukocytic phagocytosis of Staphylococcus aureus and E . coli}; Schleef H et al.; The phagocytosis of S . aureus SG 511 and E . coli O4/K31 by human polymorphonuclear leucocytes is inhibited by colchicine in concentrations of 0.05 and 0.04% . In comparison to the controls the growth of bacteria was reduced but not stopped . If human blood is added to the culture medium, staphylococci multiply in the presence of all colchicine concentrations tested . In contrast E . coli grows only at a concentration of colchicine of 0.02-0.03% . Indomethacin dissolved in ethanol inhibited clearly the phagocytosis of S . aureus and E . coli . This inhibition was significant for concentrations of 2 X 10(-4) and 1 X 10(-4) mol/l . The behavior of the tested bacteria with respect to growth and multiplications was not affected . Indomethacin, however, retarded the bacterial growth in concentrations from 2 X 10(-4) up to 3.75 X 10(-5) mol/l . The multiplication of E . coli was stopped by indomethacin at a concentration of 2 X 10(-4) mol/l . If human blood is added to the phagocytosis test system with S . aureus and indomethacin, the bacteria will show a little reduction in the rate of the multiplication in concentrations of the compound from 2 X 10(-4) up to 3.75 X 10(-5) mol/l . At a concentration of 2 X 10(-4) mol/l, the growth of E . coli was inhibited . It is concluded that for the inhibition of phagocytosis--f . e . in blood culture systems--the concentration of colchicine must be 0.03-0.02%; for indomethacin an optimal concentration of 1 X 10(-4) mol/l is recommended.

Zh Mikrobiol Epidemiol Immunobiol, 1984 Aug, (8), 34 - 7
{Therapy of experimental staphylococcal infection with a hyperimmune antistaphylococcal plasma}; Snastina TI et al.; Generalized nonlethal infection was induced in guinea pigs by the intramuscular injection of 10(10) S . aureus cells, and on days 1, 3 and 5 after inoculation a half of the animals received antistaphylococcal hyperimmune human plasma intraperitoneally in a dose of 2 ml (6 AU/ml) per animal . This plasma decreased the number of staphylococcal colonies in the spleen and affected mainly the system of phagocytes (neutrophils): on day 3 the percentage of neutrophils with Fc gamma R increased in the treated guinea pigs in comparison with the controls and with the initial level; from day 6 the percentage of active neutrophils with Fc gamma R increased in the treated animals in comparison with the controls; on day 14 the percentage of such neutrophils increased in comparison with the initial level as well, and the treated guinea pigs also showed an increase in the content of lymphocytes with receptors for staphylococci in comparison with the controls . There was little difference in the content of neutrophils with CR, as well as in the percentage of active phagocytes with these receptors, in the treated animals and in the controls . By the moment of the resolution of generalization (day 14) the content of active T-lymphocytes increased in the treated guinea pigs in comparison with the controls and with the initial level; simultaneously the levels of B-lymphocytes and B-lymphocytes with receptors for mouse red blood cells returned to their initial values.

J Antimicrob Chemother, 1984 Aug, 14(2), 115 - 24
Transposition of gentamicin resistance to staphylococcal plasmids encoding resistance to cationic agents; Townsend DE et al.; Plasmid pWG115 isolated from a methicillin-resistant Staphylococcus aureus encodes resistance to cationic surface-active agents and trimethoprim . It has a molecular weight of ca 14.6 megadaltons and can be transferred to other strains of staphylococci in mixed-culture transfer with propamidine isethionate as a selective agent . Gentamicin resistance in Australian methicillin-resistant Staph . aureus isolates can be either chromosomal or plasmid-borne . The most common gentamicin resistance plasmid is 18.0 megadaltons and also encodes resistance to trimethoprim and cationic surface-active agents . This suggested that pWG115 was related to gentamicin resistance plasmids and that it may provide a target for the postulated gentamicin resistance transposon . This paper demonstrates that the chromosomal gentamicin resistance determinant from WG523 can transpose into pWG115 to generate an 18.0 megadalton plasmid, phenotypically indistinguishable from the naturally occurring gentamicin resistance plasmids such as pWG53 . EcoR1 restriction enzyme analysis demonstrated that gentamicin resistance can transpose into at least two sites on pWG115 . One of these sites generates EcoR1 restriction fragments identical to pWG53 . The 5.2 kilobase pair (3.4 megadalton) element involved confers low-level resistance to gentamicin, cross resistance to tobramycin and kanamycin, and has been designated Tn3851.

J Bacteriol, 1984 Aug, 159(2), 713 - 9
Expression of the gene encoding protein A in Staphylococcus aureus and coagulase-negative staphylococci; Uhlen M et al.; Two shuttle vectors containing the gene for protein A (spa) from Staphylococcus aureus have been constructed to study expression of the gene in various strains of S . aureus and in the coagulase-negative species Staphylococcus epidermidis, Staphylococcus capitis, and Staphylococcus xylosus . One plasmid, pSPA15, contains the complete structural gene for protein A, which binds to the cell wall in various Staphylococcus species . The other plasmid, pSPA16, codes for a truncated protein A lacking the C-terminal part called region X . The latter is exclusively extracellular in all Staphylococcus species tested, which confirms the importance of region X for cell wall binding . The expression of the plasmid-coded protein A in various strains of S . aureus is strongly correlated to the expression of the chromosomal spa gene . The coagulase-negative species expressing plasmid-encoded protein A produce 12 to 30% of the amount coded by the chromosomal spa gene in S . aureus strains Cowan I and A676.

Am J Med, 1984 Jul, 77(1), 47 - 53
Clinical and microbial features of prosthetic joint infection; Inman RD et al.; A one-year experience with prosthetic joint infection, in which 63 cases were identified, is reviewed . Thirty cases (48 percent) were early infections, in the first postoperative year, and 33 cases (52 percent) were late, occurring more than one year after implantation . Pain was the predominant symptom, but clinical clues suggesting infection were frequently absent, with fever in 43 percent and leukocytosis in only 10 percent . The radiographic appearance was more frequently abnormal in late infections (67 versus 37 percent, p less than 0.02) . Staphylococci were predominant organisms, constituting 59 percent of prosthetic joint infections, and S . epidermidis was the predominant species in both early and later infections . Of the hematogenous infections, 11 of 13 occurred in the group with late infections; these were mostly nonstaphylococcal . Antigenic proteins of S . epidermidis were characterized by gel electrophoresis, but no infection-specific antigens could be identified when patient serum was compared with normal samples . Precipitating antibodies to the extracellular proteins of S . epidermidis were present in 50 percent of patients with S . epidermidis prosthetic joint infections, 27 percent of patients with nonstaphylococcal infections, 20 percent of patients with S . aureus infections, and 11 percent of normal subjects . In view of the increasing importance of prosthetic joint infection, further study of the pathogenesis of the infection and the host immune response is warranted.

Dent Clin North Am, 1984 Jul, 28(3), 433 - 53
Use of antibiotics in dental practice; Montgomery EH et al.; Penicillin G administered parenterally or penicillin V administered orally are currently the antibiotics of choice for treatment of dental infections of usual etiology . Infections caused by penicillinase-producing staphylococci or those involving gram-negative bacteria should be treated with a penicillinase-resistant penicillin or an ampicillin-like derivative, respectively . Erythromycin is a second-choice bacteriostatic antibiotic, becoming first choice for treating dental infections in patients allergic to penicillin . The cephalosporins, similar in action to ampicillin-like penicillin derivatives, may be used with caution in patients who have exhibited delayed-type allergic reactions to penicillin and when erythromycin cannot be used . Their lack of advantage over other agents, and their cost, precludes routine use for usual dental infections . Clindamycin administered orally or lincomycin administered parenterally are reserve antibiotics indicated for treatment of bone infections and/or anaerobic infections refractory to commonly used antibiotics . Tetracyclines are, at best, third-choice agents for usual dental infections . However, they are useful for cases of acute necrotizing ulcerative gingivitis requiring systemic antibiotic therapy when penicillin is precluded . Vancomycin and streptomycin are used prophylactically for prevention of infective endocarditis in patients with prosthetic heart valves . Nystatin remains a first-choice agent for treatment of oral candidal infections . Ketoconazole, an orally active systemic antifungal agent, may be used for monilial infections of the oral cavity refractory to nystatin . Chemotherapy of viral infections is difficult because of the timing of events of the disease process versus appearance of clinical symptoms and lack of effective agents with selective toxicity . Herpes infections of the oral cavity have been treated--with limited success--with idoxuridine . Acyclovir, a newer antiviral drug, offers little clinical benefit for herpes infections in usually healthy patients but may be of value for treating such infections in immunocompromised patients . All antimicrobial agents may cause adverse reactions of varying degrees of severity . Most orally administered antibiotics may cause gastrointestinal disturbances . Superinfections occur with broad-spectrum antibiotics and a severe form of superinfection, antibiotic-associated colitis, has occurred with almost all antibiotics . Allergic reactions of all degrees of severity can occur with most antibiotics . The penicillins, followed by the cephalosporins and tetracyclines, are most frequently implicated in these reactions.(ABSTRACT TRUNCATED AT 400 WORDS)

Pathology, 1984 Jul, 16(3), 250 - 5
Multiple antibiotic resistance in Staphylococcus aureus and Staphylococcus epidermidis: plasmids in strains associated with nosocomial infection; Tennent JM et al.; The plasmid DNA profiles were compared to phenotypically-similar, antibiotic-resistant strains of Staphylococcus aureus and Staphylococcus epidermidis associated with nosocomial infections in a Melbourne hospital . Whereas resistance to gentamicin, tobramycin and kanamycin was encoded by one of 3 plasmids {pSK1, 18 megadalton (Md); pSK4, 22 Md; pSK9, 17 Md} in S . aureus, no similar plasmids were detected in S . epidermidis . Mediated exclusively by the chromosome in S . aureus, tetracycline resistance was encoded either by the chromosome or by a 2.8 Md plasmid in strains of S . epidermidis . The inability to detect common resistance plasmids in strains of S . aureus and S . epidermidis recovered from this outbreak is in contrast to recent observations with staphylococci from other geographic areas; nevertheless, on the basis of restriction endonuclease analyses of 3 Md chloramphenicol resistance plasmids, it is suggested that a common gene pool does exist within isolates of S . aureus and S . epidermidis from Melbourne hospitals.

Infection, 1984 Jul-Aug, 12(4), 235 - 9
{Pathogenesis of staphylococcal infections of implanted plastics and intravascular catheters}; Peters G; Coagulase-negative staphylococci are the predominant organisms causing infection of intravasal catheters and implanted plastic material . They are able to adhere to and grow on polymer surfaces . During the course of colonization they produce large amounts of an extracellular slime substance by which they are finally covered completely . It is supposed that this matrix of slime protects the embedded staphylococci against antibacterial substances and natural host defenses . The slime substance is not a true capsule but is loosely bound to the staphylococcal cells . It seems to have interesting biological properties such as an adhesin-like function and the ability to inhibit the lymphoproliferative response of mononuclear cells.

Vet Microbiol, 1984 Jul, 9(3), 279 - 85
Identification and characterization of staphylococci isolated from cats; Devriese LA et al.; Staphylococcus simulans was found to be the most common staphylococcal species present on the healthy skin and in the nares of cats . S . aureus was the most frequent Staphylococcus species in lesions . Most of the S . aureus strains showed the characteristics of the human ecovar . Other strains isolated formed a heterogenic collection in which not less than 13 species were represented . One of these, S . epidermidis, was almost exclusively associated with lesions . It was concluded that coagulase-positive staphylococci are not endogenous to cats . Staphylococci from other sources, most frequently from man, are often associated with lesions in these animals.

Tijdschr Diergeneeskd, 1984 Jul 1, 109(13), 554 - 6
{Spiramycin and the antibacterial therapy of mastitis}; Verheijden JH et al.; The Minimum Inhibitory Concentrations (MIC) for 18 strains of staphylococci isolated from the national randomized mastitis surveys were determined . The antibiotics used were penicillin-G, cloxacillin and spiramycin . On the basis of these findings in addition to literature data concerning clinical efficacy trials it is concluded, that spiramycin is indicated for the treatment of persistent chronic udder infections caused by peniciline-G resistant strains of Staphylococcus aureus.

Br J Surg, 1984 Jul, 71(7), 540 - 2
Wound sepsis after low risk elective cholecystectomy: the effect of cefuroxime; Morran CG et al.; A prospective randomized double-blind study was performed to assess the value of a single intravenous injection of 1.5 g cefuroxime in the prevention of wound sepsis after low risk elective cholecystectomy . Wound infection developed in 10 of 81 control patients compared with 2 of 79 treated patients (P less than 0.05) . Wound sepsis occurred more commonly in patients with infected bile or with a positive culture from a closing wound swab . Cefuroxime significantly reduced the isolation of staphylococci but not other organisms from the closing wound swab and also produced a significant reduction in wound infection in patients with sterile bile.

Immunology, 1984 Jul, 52(3), 427 - 35
Interaction between human polymorphonuclear leucocytes and Staphylococcus aureus in the presence and absence of opsonins; Vandenbroucke-Grauls CM et al.; Phagocytosis of Staphylococcus aureus by human polymorphonuclear leucocytes (PMN) in the presence and absence of opsonins was studied with an assay which allows interaction between PMN and bacteria on a surface . The kinetics of uptake, the activity of the metabolic burst, and the degranulation during phagocytosis of opsonized and unopsonized bacteria were compared . Uptake of unopsonized S . aureus proceeded at a slower rate, but unopsonized staphylococci induced metabolic activity and degranulation in the PMN to the same extent as opsonized bacteria . Treatment of PMN with a metabolic inhibitor (2-deoxy-D-glucose) or with an inhibitor of microfilament function (cytochalasin B) totally inhibited the capacity of PMN to ingest unopsonized S . aureus, whereas uptake of opsonized bacteria was much less affected . Treatment of the PMN with pronase prevented uptake of unopsonized bacteria, but had no effect on the uptake of opsonized bacteria . Uptake was not inhibited by mannose . Recognition of S . aureus by the PMN was not dependent on the presence of the cell wall components protein A or teichoic acid . The presence of a capsule inhibited uptake.

Am J Med, 1984 Jun, 76(6), 1035 - 40
Intraleukocytic sequestration as a cause of persistent Staphylococcus aureus peritonitis in continuous ambulatory peritoneal dialysis; Buggy BP et al.; Peritonitis caused by Staphylococcus aureus in four patients undergoing continuous ambulatory peritoneal dialysis failed to respond to, or relapsed immediately after cessation of, intraperitoneal antibiotic therapy with vancomycin or cephalothin and tobramycin . Sequestration of viable staphylococci within polymorphonuclear leukocytes in the peritoneal fluid was suspected for two reasons: (1) staphylococci could still be grown after treatment of the dialysate cell fraction with lysostaphin, a procedure that kills only extracellular staphylococci, and (2) diminished polymorphonuclear leukocyte bactericidal activity was demonstrated in peritoneal dialysis effluent . Addition of rifampin, which readily penetrates polymorphonuclear leukocytes, to the treatment regimen of all patients led to prompt resolution of peritonitis without relapse.

Antibiotiki, 1984 Jun, 29(6), 421 - 7
{Interrelation of the antibiotic sensitivity (resistance) of staphylococci, clinical forms of the infection and production of protein A}; Fomenko GA; Two hundred and thirty-two strains of Staph . aureus isolated from patients with staphylococcal infections were studied . The strains were isolated from the blood of patients with sepsis, from the purulent foci on the skin and in the subcutaneous fat, from the nasopharyngeal mucosa of patients with tonsillitis and inflammation of the upper respiratory tract, from the sputum of patients with the pneumonia signs and from the pus of patients with otitis . The pathogens were identified with the routine methods . The quantitative content of protein A in the strains was determined by the method of indirect hemagglutination with red blood cells sensitized with the hemolytic serum . The data obtained were analysed with regard to the strain group and characteristics of the strain resistance or sensitivity to benzylpenicillin, erythromycin, oleandomycin, chloramphenicol, streptomycin, neomycin, kanamycin, monomycin, ristomycin and furagin K . Statistically significant differences in the protein A content in certain strain groups were observed . These differences might be correlated with the strain antibiotic resistance but not sensitivity . Pronounced changes in the levels of protein A were detected in the staphylococcal hemocultures resistant to erythromycin and streptomycin . The cultures resistant to erythromycin were characterized by decreased content of protein A and those resistant to streptomycin were characterized by increased content of protein A . Comparison of the antibiotic sensitivity of the strains of 5 groups by variation statistics revealed significant differences in the levels of sensitivity to streptomycin, neomycin, kanamycin, monomycin, ristomycin and furagin K but not to erythromycin, oleandomycin and chloramphenicol in the strains of certain groups . The staphylococcal hemocultures isolated from patients with sepsis proved to be the most sensitive to the antibiotics.

Antibiotiki, 1984 Jun, 29(6), 417 - 21
{Prevention of the formation of drug resistance in bacterial populations by using biologically active substances}; Afinogenov GE et al.; The patients with infected wounds of the extremities were treated with kanamycin electrophoresis in combination with chlorhexidine bigluconate, an antiseptic . As compared to the patients treated with kanamycin alone, the rate of the wound size decrease in such patients was 2 times higher . The levels of microbial contamination in these patients were much lower . The contamination level with the aerobic flora was 4.8 times lower, including staphylococci, the level of contamination with which was 5.9 times lower . The contamination level with the kanamycin-resistant bacteria was 22 times lower . The treatment with kanamycin alone resulted in a 2.6-fold increase in the number of the antibiotic-resistant variants in the microbial populations of the wounds . In 48.2 per cent of the patients, this was accompanied by development of resistance to kanamycin in the whole microbial population of the wound . The development of the kanamycin resistance in the staphylococcal populations of 18.1 per cent of the patients was associated with changed sensitivity of the initial strains and in 81.9 per cent of the patients, with superinfection by the resistant strains . No changes in the kanamycin sensitivity of the initial gram-negative organisms during the treatment were observed . The use of chlorhexidine bigluconate, as a biologically active substance in combination with kanamycin potentiated the action of the antibiotic, prevented development and accumulation of the antibiotic-resistant variants in the microbial populations of the wounds and development of the drug resistance in these populations.

J Antimicrob Chemother, 1984 Jun, 13 Suppl C, 23 - 9
Rifampicin in the treatment of osteoarticular infections due to staphylococci; Cluzel RA et al.; Rifampicin is a suitable drug for treating staphylococcal bone and articular infections, because high levels are obtained in the human tissues . The best oral dose is 600 mg 12 hourly . The serum levels range from 10 to 15 mg/l at the peak concentration and from 0.2 to 0.6 mg/l 8 h after oral administration of 600 mg . The ratio for cancellous bone/serum is 0.41 at 3 h and 0.39 at 12 h, and for cortical bone/serum is 0.20 at 3 h after a dose of 600 mg . In every case, tissue levels paralleled serum levels; cancellous bone levels are greater than the MIC of Staphylococcus aureus strains until 12 h after a dose of 600 mg . Rifampicin is always used in combination with another antibacterial substance . Results are excellent in most cases . The average duration of antibiotic treatment is 3 months for osteo-arthritis, 6 months for spondylitis and osteitis.

Pathol Biol (Paris), 1984 Jun, 32(5 Pt 2), 596 - 8
{Qualitative and quantitative analysis of the residual hand flora after hygienic-type washing with a soap and a foaming antiseptic solution}; Greil JD et al.; Activity of a liquid soap and of a 4% povidone iodine detergent solution on hand skin flora after application for one minute ("hygienic type" handwashing) was studied . Samples were taken using a "bag" washing method . Total aerobic flora was determined quantitatively . Transient flora (Gram negative bacilli and mannitol positive Staphylococci) was determined both quantitatively and qualitatively . 54 determinations were performed (29 with liquid soap and 25 with povidone iodine) on 17 volunteers of the staff of the hospital bacteriology laboratory . After application of liquid soap, total flora, i.e . 10(6) bacteria per hand, was not reduced and the number of mannitol positive Staphylococci was increased . With povidone iodine, the reduction in total flora was 0.2-0.3 log 10 and the number of mannitol positive Staphylococci was decreased . With both products, Gram negative bacilli were eliminated in 60% of cases and greatly reduced in the remainder.

Pathol Biol (Paris), 1984 Jun, 32(5 Pt 2), 528 - 31
{In vitro study of the cefamandole-fosfomycin combination against methicillin-resistant staphylococci}; Fosse T et al.; In vitro antibacterial activity of cefamandole-fosfomycin (CFM-FOS) combination was studied on 50 methicillin-resistant staphylococci strains . Anti-bacterial effects were evaluated with a bactericidal microtiter checkerboard method . CFM-FOS was compared with other combinations known to be potent against staphylococci . Synergy was consistently recorded with CFM-FOS . Mean MBC of CFM combined with FOS was 1 microgram/ml . Vancomycin-fosfomycin combination was infrequently synergistic (20%) . Rifampin-fosfomycin, cefamandole-fusidic acid, and cloxacillin-fusidic acid combinations were usually antagonistic at bactericidal levels . Rifampicin-fusidic acid combination usually yielded additive effects . CFM-FOS killed most methicillin-resistant staphylococci studied at therapeutic concentrations.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 Jun, 179(3), 198 - 216
{Incidence of Bacillus cereus and various pathogenic microorganisms in food for infants and small children}; Becker H et al.; 206 samples of commercially available infant food and their ingredients were examined for the content of B . cereus and coagulase-positive staphylococci as well as for the presence of salmonellae . B . cereus could be isolated from 64 samples with numbers between 3 and 460/g (only 2 samples greater than 100/g) . Two samples contained coagulase-positive staphylococci (4/g each), and no sample salmonellae . Growth of B . cereus in reconstituted samples with counts of less than or equal to 100/g incubated at 20 and 25 degrees C, reached counts of 10(3)-10(4)/g after 6-9 h and 3-6 h, respectively . With regard to productivity and selectivity no differences between the media used (mannitol-egg yolk-phenolred-polymyxin-agar according to Mossel, Koopman and Jongerius, and polymyxin-pyruvate-egg yolk-mannitol-bromthymol blue-agar according to Holbrook and Anderson) could be observed.

J Clin Microbiol, 1984 Jun, 19(6), 875 - 9
Comparison of various methods for differentiation of staphylococci and micrococci; Baker JS; A modified oxidase test (Remel, Lenexa, Kans.) and susceptibility to furazolidone and lysostaphin (Remel) were evaluated in conjunction with the Staph-Ident strip (Analytab Products, Plainview, N.Y.) to accurately differentiate between staphylococci and micrococci . A total of 414 clinical isolates of catalase-positive, gram-positive cocci were each tested with the Staph-Ident strip and by glucose fermentation, acid production from glycerol, susceptibility to furazolidone and lysostaphin, and the oxidase test . Based on the reference methods of glucose fermentation and acid production from glycerol, 396 (95.6%) of the organisms were classified as Staphylococcus species and 18 (4.4%) were classified as Micrococcus species . Of the staphylococci, 99% were oxidase negative and susceptible to furazolidone; 82% were susceptible to lysostaphin . All of the micrococci were oxidase-positive and resistant to furazolidone and lysostaphin . Of the staphylococci, 99% were identified to species by the Staph-Ident strip . However, six (33%) of the micrococci were incorrectly identified as Staphylococcus species (three each of Staphylococcus hominis and Staphylococcus saprophyticus) . Because of the demonstrated sensitivity and specificity of the oxidase and furazolidone susceptibility tests, it is suggested that either of these methods be used in the clinical laboratory to accurately differentiate between staphylococci and micrococci . It is also suggested that when working with the Staph-Ident strip, additional testing such as furazolidone susceptibility or oxidase activity should be performed to provide increased accuracy in the differentiation and characterization of members of the family Micrococcaceae.

J Antimicrob Chemother, 1984 Jun, 13(6), 577 - 83
Species identification and antibiotic sensitivity of coagulase-negative staphylococci from CAPD peritonitis; Gruer LD et al.; Forty-three strains of coagulase-negative staphylococci were obtained from dialysis effluent during 41 episodes of CAPD peritonitis . Eighty per cent of these were found to be Staphylococcus epidermidis but several other species also occurred . A recurrent infection lasting 15 weeks was caused by Staph . haemolyticus . Multiple antibiotic resistance was found to be common . Of 13 antibiotics tested, only vancomycin was active against all strains although most strains were also sensitive to rifampicin, netilmicin and cefamandole . Vancomycin was chosen for the initial treatment of CAPD peritonitis caused by coagulase-negative staphylococci and eradicated the organism in 29 of 30 episodes.

J Med Microbiol, 1984 Jun, 17(3), 325 - 34
Plasmids of phage-Group-II Staphylococcus aureus; Dyke KG et al.; Most phage-Group-II Staphylococcus aureus have been shown to carry at least one plasmid . The proportion of strains that are resistant to tetracycline appears to have increased during the last 17 years . Restriction maps of several of the small plasmids isolated from Group-II strains are presented and compared with those known for staphylococcal plasmids . These small plasmids are similar to previously characterised plasmids from staphylococci of other phage groups.

J Leukoc Biol, 1984 Jun, 35(6), 573 - 82
In vitro release of lysozyme from monocytes and granulocytes; Haneberg B et al.; When exposed to zymosan or latex particles or heat-inactivated staphylococci, freshly prepared human blood monocytes and granulocytes rapidly released a large fraction of their lysozyme content . Within 24 hours the total lysozyme activity in the monocyte suspensions tripled, while it doubled in the granulocyte suspensions, indicating synthesis of the enzyme following release . The monocytes in particular seemed to release and synthesize lysozyme without any other stimulus than contact with lymphocytes and the tube walls . Potassium caseinate in solution did not influence the lysozyme release . Myeloperoxidase and beta-glucuronidase, which in the granulocytes are kept in lysosomal fractions separate from most of the lysozyme, were neither released nor synthesized to a significant degree . Moreover, the minute amount of lactate dehydrogenase released indicated that the lysozyme release was not the result of cell lysis . Accordingly, the monocytes, which are not already stimulated by adherence to nonphagocytosable surfaces, are capable of selective enzyme release similar to that of the granulocytes.

J Antimicrob Chemother, 1984 Jun, 13 Suppl C, 7 - 16
Activity of rifampicin against staphylococci, with special reference to multiresistant strains; Dixson S et al.; Antibiotic-sensitive and multiply-resistant isolates of Staphylococcus aureus and Staph . epidermidis were all sensitive to rifampicin (MIC less than or equal to 0.015) mg/l) and to novobiocin, vancomycin and teicoplanin (MICs less than 1 mg/l) . No tolerance was observed . Resistance sometimes developed in bactericidal tests on rifampicin or novobiocin alone, but not with vancomycin or teicoplanin, or with combinations . The implications of these findings are discussed in the context of serious infections with staphylococci, especially those resistant to beta-lactams and aminoglycosides.

J Hosp Infect, 1984 Jun, 5(2), 164 - 71
Characters of coagulase-negative staphylococci and micrococci from cases of endocarditis; Richardson JF et al.; Strains of coagulase-negative staphylococci and micrococci submitted to a reference laboratory from 137 cases of endocarditis over a 5 year period were reviewed . Staphylococcus epidermidis biotype 1 (SII) was the commonest biotype in all groups of patients but exceeded 80 per cent in the 61 patients who had undergone prosthetic valve surgery and the 16 patients who had undergone other forms of surgery . Biotype 4 (SVI) was recovered from 10 of the 34 patients without surgery . Strains from prosthetic valve endocarditis were frequently resistant to many antibiotics while strains from natural valve endocarditis were frequently sensitive to all, or resistant only to penicillin . The value of bacteriophage typing was confirmed.

Diagn Microbiol Infect Dis, 1984 Jun, 2(3 Suppl), 37S - 46S
The activity of cefotaxime and desacetylcefotaxime alone and in combination against anaerobes and staphylococci; Jones RN et al.; Cefotaxime (CTX) and desacetylcefotaxime (des-CTX) alone and in combination were tested against anaerobic bacteria collected from clinical infections from several geographically diverse medical centers . The CTX minimum inhibitory concentration (MIC) inhibiting 50% of tested Bacteroides fragilis strains was in the moderately susceptible range (32 micrograms/ml), but when placed in combination with des-CTX it had a potency compatible to cefoxitin (MIC50, 8.0 micrograms/ml) . Other B . fragilis group species (B . distasonis and B . vulgatus) were also susceptible to CTX and des-CTX alone at the MIC50 level . MIC90 statistics for CTX, cefoxitin, and ticarcillin were generally in the resistant range . Synergy studies showed that 80% of tested anaerobes were synergistically killed by the combination of CTX and des-CTX . Most of these strains had their synergy occur at drug levels that could be achieved in vivo . A large number of the B . thetaiotaomicron strains must be considered resistant to the combination because of the very high levels of des-CTX required to produce synergistic killing . Other drugs routinely used for anaerobic infections (clindamycin, chloramphenicol, and metronidazole) also had elevated B . thetaiotaomicron MICs . Endemic difference in susceptibility to the beta-lactam drugs were observed, especially the CTX-des-CTX combination . The combination and other beta-lactams were most usable for strains isolated from the Portland metropolitan area, were moderately active against those from Cleveland, and were rarely usable on Bacteroides isolates at Northwestern in Chicago . Laboratories are urged to monitor the cephalosporin and semisynthetic penicillin in vitro efficacy and not rely on published statistics . Staphylococcus aureus strains were susceptible to CTX alone, but were even more susceptible (two- to fourfold reduction in MICs) when used in combination with des-CTX . These data show CTX to be the most active antistaphylococcal compound among the new cephalosporins and to be comparable to cefamandole and cefuroxime, but superior to the anaerobe-active cefoxitin.

Am J Med, 1984 May 15, 76(5A), 53 - 60
Microbiology of pneumonia in the patient at risk; Palmer DL; Microorganisms causing pulmonary infections in high risk patients vary considerably with the predisposing illness (immunosuppression, alcoholism, or diabetes), the setting (nosocomial or community-acquired), and previous therapy (antibiotics, surgery, and inhalation therapy) . Even in the immunocompromised patient, conventional bacteria are the most prevalent opportunistic pathogens, and gram-positive cocci such as staphylococci and gram-negative bacilli such as Escherichia coli cause most pneumonias . Fungi, viruses, and protozoa also cause pulmonary infections, but they vary in frequency from one institution to another . Diagnostic proof of the etiology of pulmonary infection is often difficult to obtain . The microbial flora of sputum is not definitive and must be confirmed by blood or pleural fluid culture, antigen or serologic response in body fluids, or morphologic presence in lung tissue . Resistance to antimicrobial therapy is increasing, especially among nosocomially acquired gram-negative bacilli and methicillin-resistant staphylococci . A potential for increased resistance exists in pneumococcal, viral, and fungal infection but is not yet apparent in pulmonary infections due to protozoal pathogens . Tests to predict antibiotic response such as serum bactericidal assay, repeated cultures, and serologic studies are helpful but correlate imperfectly with clinical outcome.

Am J Med, 1984 May 15, 76(5A), 187 - 90
Prevention of infections of skin and skin structures; Wheat LJ et al.; Treatment of nasal carriers of coagulase-positive staphylococci with a wide variety of topical systemic antibiotics suppressed these organisms only during treatment . Treatment of methicillin-sensitive or methicillin-resistant staphylococci with oral rifampin plus cloxacillin, vancomycin, fusidic acid, or trimethoprim-sulfamethoxazole eradicated the colonizing Staphylococcus aureus in approximately 80 percent of studies . An alternative approach is replacement of virulent S.aureus with the 502 A S . aureus strain . The latter approach has aborted epidemics of staphylococcal diseases in newborn nurseries and has prevented recurrent furunculosis.

Am J Med, 1984 May 15, 76(5A), 166 - 71
Skin and skin structure infections in the patient at risk: carrier state of Staphylococcus aureus; Tuazon CU; Staphylococcus aureus is a ubiquitous organism that is normally carried on the skin and body surfaces of man . The nares are sites frequently colonized, and patients and hospital personnel represent the major source of infection . The occurrence of staphylococcal infection depends on the availability of staphylococci and the host resistance to infection . Factors that influence the carrier rate of S . aureus include minimal colonizing dose, effects of antimicrobial therapy, disinfectants in the environment, coincidental respiratory infections, possible effect of immune factors, duration of hospital stay, and regular needle injections . Certain patients such as drug abusers, patients with diabetes, and patients with chronic renal failure are at high risk of S . aureus infections . although underlying immune deficiencies are present, increased carrier rate also might be related to regular needle use, as shown among allergy patients . The significance of carrier state has been defined in outbreaks in hospital nurseries, postoperative patients, and systemic infections such as endocarditis in the drug abuser, the toxic shock syndrome, and dermatologic infections.

Sem Hop, 1984 May 3, 60(19), 1329 - 32
{In vitro study of strains of Staphylococcus: choice of an antibiotic}; Messmer JC et al.; The aim of this study is to determine the best antibiotic in presumptive staphylococcal infection and/or bacteriologically established staphylococcal infection before results of antibiotic sensitivity tests are available . 382 strains were analyzed . Only sensitivity or resistance to antibiotics were considered . Vancomycin is the best antistaphylococcal agent (3% resistance rate on the 382 strains), (11% resistance rate on Methicillin-resistant Staphylococcus aureus strains) . Pristinamycin and Virginiamycin also yield excellent scores but are less efficient against Methicillin-resistant staphylococci (21%) . Cefalotin is still an excellent antistaphylococcal agent (7%) . Fosfomycin is especially valuable against polyresistant staphylococci, with a 26% resistance rate on Methicillin-resistant Staphylococcus aureus . Lastly, significant increases in resistance rates relative to 1966 staphylococci strains are found only for penicillin (68% versus 78%) and rifamycin (3.6% versus 8%).

Appl Environ Microbiol, 1984 May, 47(5), 942 - 6
Improved system for floor cleaning in health care facilities; Schmidt EA et al.; A new system has been developed for sanitizing floors in hospitals; this system replaces the traditional procedure of daily dusting and wet mopping with a disinfectant-detergent solution and periodic buffing . This new system relies on a sequence of procedures consisting of dust mopping using a chemically treated dust mop, machine buffing of a sprayed-on polymer treatment, and a second dust mopping . The effectiveness of the procedures was evaluated by means of surface sampling for bacterial contamination and air sampling for airborne bacteria and dust . The level of bacterial contamination on the floors was reduced by 93.6% by using the new system, compared with 79.8% by using the conventional process of dust mopping and wet mopping with a disinfectant solution . The levels of airborne bacteria during and after the individual procedures did not vary significantly from the initial level (123.6 CFU/per m3 of air) . A survey of representative colonies from air samples revealed staphylococci, gram-positive bacilli, gram-positive diplococci, yeast cells, and infrequent gram-negative rods . The distribution at the conclusion of the sanitizing process was similar to that at the outset . Similarly, the levels of airborne dust measured during and after the individual procedures did not vary significantly from the initial level . When compared with the traditional method of cleaning by wet mopping , the new method was significantly more effective in removal of microbial contamination and required less labor.

Zh Mikrobiol Epidemiol Immunobiol, 1984 May, (5), 74 - 7
{Effect of interferon type I on staphylococcal persistence and indices of body immunoreactivity}; Spivak NIa et al.; After the subcutaneous injection of type I (alpha) interferon into mice their survival rate in staphylococcal infection greatly increased . At the same time duration of staphylococcal persistence in these animals and the number of persisting staphylococci were found to decrease . After the injection of interferon the splenocytes of the treated animals showed a higher capacity for interferon production . During the whole experiment the characteristics of delayed hypersensitivity in these animals showed a tendency towards normalization in comparison with those in infected mice receiving no interferon.

Am J Clin Pathol, 1984 May, 81(5), 643 - 6
Detection of bacteremia with the BACTEC 16B resin blood culture medium; DeGirolami PC et al.; A new blood culture medium (16B) containing adsorbent and cationic exchange resins has become available for use with the BACTEC instrument (Johnston Laboratories, Towson, MD) . Its purpose is to enhance the detection of bacteremia through binding of antimicrobials . The performance of the BACTEC 16B resin medium was compared with the routine BACTEC 6B medium in patients with suspected sepsis receiving antibiotics . A total of 1,227 blood specimens were inoculated in 6B and 16B media and yielded 93 positive cultures from 43 clinically septic patients . Of 103 bacterial isolates recovered, 63 (61.2%) were recovered in both media, 14 (13.6%) in the routine 6B medium only, and 26 (25.2%) in the resin medium only (P greater than 0.05) . Staphylococci, both coagulase positive and negative, were recovered much more frequently in resin medium (P less than 0.01) . When the results of all the blood culture sets collected for each patient on any given day were considered, the routine 6B medium was the only source of isolation for seven bacterial species in six patients, and the resin medium was the only source of isolation for nine species in nine patients . However, of the nine organisms whose sole isolation source was the resin medium, eight were recovered early in the course of antibiotic therapy (6 within 24 to 36 hours and 2 within 36 to 48 hours of the first antibiotic dose) and had been isolated previously in routine 6B medium . In no instance was the antibiotic regimen changed as a result of the persistence of the organism in resin medium in the early phases of treatment . The use of resin medium did not improve overall detection time for 63 isolates recovered in both media . In conclusion, although the 16B resin medium did recover a greater number of bacterial isolates, it contributed very little information that might be of use in modifying and improving the treatment of septic patients receiving antimicrobials.

Antimicrob Agents Chemother, 1984 May, 25(5), 666 - 8
Cross-resistance between methicillin and cephalosporins for staphylococci: a general assumption not true for cefamandole; Frongillo RF et al.; The antibacterial activity of cefamandole was evaluated against 120 methicillin-susceptible and methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococcal strains, using both large (10(8) CFU per ml) and small (10(4) CFU per ml) inocula . Cefamandole appeared superior to cephalothin against methicillin-resistant strains, displaying at 10 micrograms/ml a bacteriostatic and for some strains a bactericidal action against a large inoculum of bacteria.

J Bacteriol, 1984 May, 158(2), 513 - 6
Low-affinity penicillin-binding protein associated with beta-lactam resistance in Staphylococcus aureus; Hartman BJ et al.; Methicillin resistance in Staphylococcus aureus has been associated with alterations in the penicillin-binding proteins (PBPs) . An intriguing property of all methicillin-resistant staphylococci is the dependence of resistance on the pH value of the growth medium . Growth of such bacteria at pH 5.2 completely suppressed the expression of methicillin resistance . We have examined the PBP patterns of methicillin-resistant staphylococci grown at pH 7.0 . We detected a high-molecular-weight PBP (PBP-2a; approximate size, 78,000 daltons) that was only present in the resistant bacteria but not in the isogenic sensitive strain . In cultures grown at pH 5.2, the extra PBP was not detectable.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 May, 257(1), 1 - 5
Colony-formation of staphylococci in fibronectin-soft-agar; Lammler C et al.; Colony-formation of 50 staphylococcal cultures was examined in fibronectin-, fibrinogen- and serum-soft-agar and compared with the respective fibronectin- and fibrinogen-clumping-reactions . Forty-two of the 50 cultures formed compact colonies in fibronectin-soft-agar undistinguishable from those in fibrinogen- or serum-soft-agar and gave distinct clumping-reactions with fibronectin and fibrinogen . The remaining 8 cultures (7 Staphylococcus aureus and 1 Staphylococcus epidermidis ATCC 14990) grew diffusely and gave no clumping-reactions with fibronectin or fibrinogen . Thus, fibronectin could elicit compact colony-formation of the staphylococci.

J Clin Microbiol, 1984 May, 19(5), 610 - 5
Species distribution of coagulase-positive staphylococci in animals; Biberstein EL et al.; A total of 268 isolates of coagulase-positive staphylococci from a variety of animal species, including dogs, horses, cats, monkeys, goats, and cows, were assigned to species on the basis of the API Staph- Ident system (Analytab Products, Inc., Plainview , N.Y.) . Of 195 isolates from dogs, 179 (91.8%) were Staphylococcus intermedius, as were 9 of 25 (36%) isolates from horses, 7 of 15 (46.6%) isolates from cats, and 4 of 6 (66.6%) isolates from goats . Only 1 of 10 isolates from monkeys and none of 7 isolates from cows were S . intermedius . Of the remaining 68 cultures, 63 were identified as Staphylococcus aureus and 5 as Staphylococcus hyicus . The latter identifications were rendered doubtful on the basis of conventional tests . Identification appeared to be more certain in the S . aureus sample than in the S . intermedius sample . Distribution of biotypes within the two bacterial species as represented by different API profile numbers and reactivity on test substrates showed no significant variations among the host species, except for the S . aureus biotypes in dogs . Both Staphylococcus species were represented about equally among samples from different tissues and lesions, apart from skin-related infections in dogs, which were associated exclusively with S . intermedius (P less than 0.01) . Differences between S . aureus and S . intermedius in antimicrobial susceptibility patterns, prevalence of clumping factor, and occurrence of beta-toxin were found to be not significant.

J Clin Microbiol, 1984 May, 19(5), 703 - 4
Comparison of rapid identification assays for Staphylococcus aureus; Aldridge KE et al.; A total of 137 strains of Staphylococcus species were blindly tested by four rapid serological assays, and the results were compared with those of the tube coagulase assay . For the S . aureus isolates, the Sero-STAT Staph assay gave six false-negative results, four of which were for methicillin-resistant strains . The Accu -Staph, Staphylatex , and Staphyloslide assays identified all the coagulase-positive strains as Staphylococcus aureus . Among the coagulase-negative staphylococci, false-positive results were seen with strains of S . capitis . S . saprophyticus, and S . cohnii . The overall accuracy of the kits compared with the tube coagulase test ranged from 95.1 to 100%.

Zh Mikrobiol Epidemiol Immunobiol, 1984 Apr, (4), 30 - 2
{Neuraminidase activity of staphylococci}; Ternovskaia LN et al.; 141 S . aureus and S . epidermidis strains, isolated from the personnel of obstetric wards by taking smears from the anterior sections of the nose, have been tested for their capacity for neuraminidase production . The test has been carried out by the thiobarbiturate method in a medium with ovomucin added . Neuraminidase activity has been found to be characteristic mostly of S . aureus strains isolated from constant carriers.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Apr, 256(4), 479 - 89
Attachment of staphylococci to various synthetic polymers; Ludwicka A et al.; Attachment of staphylococci to different synthetic polymers used for medical purposes was studied in applying the bioluminescent technique . The number of attached bacterial cells was determined by measuring the light emission resulting from the reaction between firefly luciferase and ATP present in adhered staphylococcal cells . It was shown that staphylococci attach to synthetic polymers within a few minutes, although one hour incubation is required to reach a constant maximum value of attached cells . Ten different synthetic polymers and five Staphyloccocus epidermidis strains were investigated in our study . The relationship between surface properties of polymers and bacterial attachment was studied . Various physicochemical parameters of synthetic polymers and bacteria were determined (contact angle, surface tension) . It was demonstrated that bacterial attachment decreases with decreasing contact angle and with increasing surface tension of synthetic materials . Modifications of surface charge and hydrophobicity of solid materials were also investigated . It could be proved that especially negatively charged and hydrophilic synthetic polymers show very decreased staphylococcal attachment.

Antimicrob Agents Chemother, 1984 Apr, 25(4), 502 - 3
Bactericidal activities of five antibiotics during short-term exposure to coagulase-negative staphylococci; Fischer PR et al.; After a 1-h exposure to concentrations used for topical prophylaxis in neurosurgical procedures, bacitracin, vancomycin, and oxacillin were bactericidal against more than 90% of 48 body fluid isolates of coagulase-negative staphylococci . More than 10% of isolates survived despite exposure for 4 h to concentrations of gentamicin and streptomycin greater than those employed for topical prophylaxis.

Antimicrob Agents Chemother, 1984 Apr, 25(4), 422 - 6
Effect of rifampin and bacitracin on nasal carriers of Staphylococcus aureus; McAnally TP et al.; Anterior nares cultures from 664 hospital personnel identified 165 (24.8%) as carriers of Staphylococcus aureus . Persistent carriers (17.8%) were identified and randomly assigned to one of four treatment groups: rifampin (600 mg once a day for 5 days), bacitracin ointment (topically applied three times a day for 10 days), combined rifampin and bacitracin, and control (no treatment) . Bacitracin ointment was ineffective in eliminating S . aureus from the anterior nares and had a postreatment carrier rate equal to the control rate . Rifampin therapy caused a highly significant reduction (79%) in carriage; however, combined therapy was not as effective as treatment with rifampin alone . Of 132 strains of staphylococci isolated before and after treatment, all were susceptible to less than 0.016 micrograms of rifampin per ml . This study demonstrates that rifampin may be an effective antistaphylococcal antibiotic and could be used to control the carrier state in high-risk situations.

Vet Microbiol, 1984 Apr, 9(2), 131 - 7
Udder infection of goats by coagulase-negative staphylococci; Poutrel B; Infection of udder halves by coagulase-negative staphylococci in seven commercial goat herds was studied in conjunction with the California Mastitis Test (CMT) . Nine different species were identified and only 10% of strains belonged to groups which could not be identified with any of the known Staphylococcus species . The most prevalent species were Staphylococcus epidermidis (47.7%) and Staphylococcus caprae (19.7%) . About half of the coagulase-negative staphylococcal infections gave negative CMT scores . The score was independent of the species of staphylococci involved and the stage of lactation . About 60% of the coagulase-negative staphylococcal species isolated were reisolated in the identical half udder during the following lactation.

Can J Comp Med, 1984 Apr, 48(2), 223 - 4
Evaluation of latex agglutination tests for establishing coagulase status of staphylococci from milk; Jasper DE et al.; A total number of 640 staphylococci isolated from cows' milk were tested by latex agglutination and coagulase tests . About 50% of coagulase positive and 5% of coagulase negative staphylococci were positive to the latex agglutination tests . Latex agglutination tests were found to be not satisfactory for determining the coagulase status of staphylococci isolated from cows' milk.

Am Rev Respir Dis, 1984 Apr, 129(4), 597 - 601
The fifth component of complement is not required for the clearance of Staphylococcus aureus; Toews GB et al.; Both resident alveolar macrophages and recruited polymorphonuclear leukocytes (PMN) are required for pulmonary clearance of large inoculums of Staphylococcus aureus . We have evaluated the role of the C5 molecule in the recruitment of PMN to the lung after challenges with S . aureus using congenic C5-sufficient B10.D2/nSn (C5+) and C5-deficient B10.D2/oSn (C5-) mice . The C5+ and C5- mice were injected with water and varying inoculums of staphylococci via an endobronchial catheter . Bronchoalveolar lavage (BAL) was performed on the inoculated lung at 0 and 4 h after inoculation . Cellular response was measured and chemotactic activity was assayed in BAL supernatants at each time interval using human PMN in modified Boyden chambers by the leading front technique . Clearance of bacteria was studied by quantitative lung culture . The C5+ and C5- mice recruited similar numbers of PMN after challenges with both 10(4), 10(8), and 10(7) organisms (p = NS) . The C5+ and C5- mice also generated similar amounts of chemotactic activity in BAL (p = NS) . Additionally, clearance of bacteria was not impaired in C5- mice when compared with that in C5+ mice (p = NS) . Our results indicate that intraalveolar chemotaxins other than C5 are of primary importance in the early recruitment of PMN after staphylococcal challenge and demonstrate that the inflammatory response within the lung is mediated by differing pathways dependent on the initiating stimulus.

Acta Orthop Scand, 1984 Apr, 55(2), 156 - 9
Pharmacokinetics of topical gentamicin in total hip arthroplasty; Sorensen TS et al.; Two different ways of administering topical gentamicin were examined in patients undergoing total hip arthroplasty . 160 mg gentamicin, dissolved in isotonic saline, was instilled into the wounds of five out of ten patients . In the other five patients, the components of the prostheses were inserted by means of gentamicin-containing cement, 0.5 g per 40 g powder . Both the serum concentrations and the wound concentrations of gentamicin were determined constantly during the postoperative period . The average half-lives of gentamicin in the surgical wounds of the two groups of patients were found to be 3 1/2 and 25h, respectively . The average wound concentration was found to be higher than the minimum inhibitory concentration for staphylococci and aerobic Gram-negative rods for 18 and 11 h, respectively, in the group of patients treated with gentamicin solution compared with 160 and 67 h, respectively, in the group treated with the gentamicin-containing cement.

J Hyg (Lond), 1984 Apr, 92(2), 183 - 92
Mechanisms of resistance of staphylococci grown in plasma to polymorph bactericidins; Kolawole DO; The mechanisms whereby staphylococcal strains grown in plasma assume increased resistance to polymorph bactericidins were investigated . Observations reported here showed that cultural conditions could determine the path of conversion to resistance . Staphylococcal strains and mutants lacking either free coagulase or clumping factor or both all showed enhanced resistance after 10 h incubation in plasma proteins, thus giving no clear indication that these factors were involved in the interactions . In fact, prolonged incubation in bovine serum albumin (22 h) and ordinary broth medium (24 h) also resulted in increased resistance . A distinction between staphylococcal factors interacting specifically with plasma proteins and such non-specific conversions was obtained in two different ways . Stripping of a hypothetical surface protein by treatment with trypsin or 2 M potassium bromide rendered plasma- but not 24 h-broth organisms susceptible, indicating protein coating of plasma-grown organisms . Also free coagulase-positive strains and mutants incubated in plasma for 30 min were converted while those lacking both or possessing clumping factor alone were not . It therefore appears that one of the mechanisms of acquiring resistance involves a rapid interaction between staphylococcal-free coagulase and fibrinogen, resulting in the deposition of fibrin or fibrin derivatives on the bacterial surface.

Zh Mikrobiol Epidemiol Immunobiol, 1984 Apr, (4), 101 - 4
{Therapy of experimental staphylococcal infection by the transfusion of allogeneic leukocytes}; Snastina TI et al.; Severe nonlethal generalized staphylococcal infection was induced in guinea pigs by the intramuscular injection of S . aureus . On days 1, 3 and 5 after the infection the animals received intracardiac injections of leukocytes from intact donors . On any day of investigation following the injection of staphylococci (up to day 14) the number of colonies in the spleen of the animals subjected to immunotherapy was considerably lower than that in the spleen of the control animals . The treated animals showed a higher percentage of neutrophils with receptors for Fc-fragments of immunoglobulins and for complement, as well as higher levels of active T- and B-lymphocytes . The data thus obtained correspond to the results of clinical treatment and examination.

Can J Microbiol, 1984 Apr, 30(4), 488 - 90
Rapid detection of methicillin-resistant staphylococci with the MS-2 system; Flournoy DJ et al.; The ability of the updated Abbott MS-2 system to detect methicillin-resistant Staphylococcus aureus (MRSA) was compared with disk agar diffusion and broth microdilution . Of the 87 MRSA isolates tested, the MS-2 system correctly detected 85 (97.7%) in 5 h . Seventy-two of the isolates were detected by disk agar diffusion within 24 h, and 15 more by 48 h . Broth microdilution detected 71 MRSA by 24 h of incubation and 11 more by 48 h . The updated MS-2 system yielded reliable results that were highly comparable with the standard techniques.

Eur J Clin Microbiol, 1984 Apr, 3(2), 144 - 6
Activity of cephalosporins against methicillin-resistant coagulase-negative staphylococci; Mouton RP et al.; Using a dilution method (37 degrees C, 42 h), six of ten methicillin-resistant strains of coagulase-negative staphylococci were found to be resistant to cephalothin . Of 20 variations in the method for detection of resistance to methicillin and cephalothin, broth dilution tests at 30 degrees C for 42 h were the most sensitive . Differences are explained by low percentages of cephalothin-resistant clones in methicillin-resistant strains.

J Clin Microbiol, 1984 Apr, 19(4), 482 - 8
New recommendations for disk diffusion antimicrobial susceptibility tests for methicillin-resistant (heteroresistant) staphylococci; McDougal LK et al.; The agar disk diffusion susceptibility test was reevaluated for its ability to discriminate between susceptible and resistant Staphylococcus aureus (128 strains) and coagulase-negative staphylococci (19 strains) when tested with methicillin, oxacillin, and nafcillin . The results show that the current recommendations for disk potencies and interpretive zone diameters do not fit well with MIC correlates that we now recommend . Based on data from this study, we suggest that these parameters of the test be changed . For methicillin, we recommend a 10-micrograms disk with breakpoints of less than or equal to 11 mm (greater than or equal to 16 micrograms/ml) to indicate resistance and greater than or equal to 15 mm (less than or equal to 4 micrograms/ml) to indicate susceptibility . For oxacillin and nafcillin, we recommend 4-micrograms disks with breakpoints of less than or equal to 12 mm (greater than or equal to 8 micrograms/ml) to indicate resistance and greater than or equal to 16 mm (less than or equal to 2 micrograms/ml) to indicate susceptibility . MIC breakpoints were from a broth microdilution system which used a medium containing salt . If one of these three penicillins were to be selected for routine tests, we would recommend oxacillin, based on our data, but we recognize that this may depend upon the population of staphylococci within a particular hospital.

Cornell Vet, 1984 Apr, 74(2), 124 - 35
Species of Staphylococcus isolated from animal infections; Cox HU et al.; One hundred randomly selected clinical strains of staphylococci were identified by species using a commercial micromethod system . Eight species of staphylococci were identified . Staphylococcus intermedius was the most frequent (n = 74) species identified and accounted for 70/74 (94.6%) of the coagulase-positive strains and 70/79 (88.6%) of the total isolates from dogs . Other species identified, in order of their frequency, included S . epidermidis (8), S . aureus (7), S . simulans (4), S . sciuri (2), S . xylosus (2), S . hyicus (2) and S . saprophyticus (1) . These results show that at least 8 different species of staphylococci can be recovered from animal infections and that coagulase-positive species such as S . intermedius may be more common than S . aureus . The relative significance of these other species in animal infections needs to be assessed.

J Gen Microbiol, 1984 Apr, 130 ( Pt 4), 797 - 801
The follicular distribution and abundance of resident bacteria on human skin; Kearney JN et al.; A cryostat sectioning procedure was used to determine quantitative viable counts of microorganisms both on the surface and in successive layers of human cadaver skin biopsies . Also, using a previously described xenograft model, we investigated the dependence of microorganisms on the presence of sebaceous glands by using full thickness (1.5-2.0 mm) and split thickness (0.6 mm, ensuring sebaceous gland exclusion) human skin . Our results show substantial variation in the distribution and abundance of skin bacteria, even amongst biopsies from the same cadaver . In general, propionibacteria were distributed within a narrow band at varying depths beneath the skin surface whereas staphylococci were more broadly distributed . The importance of this with respect to topically applied antiseptics and antimicrobial agents is indicated . The xenograft studies demonstrated that propionibacteria were dependent on the presence of sebaceous glands whereas staphylococci were not.

J Infect Dis, 1984 Apr, 149(4), 538 - 43
Isolation and virulence of a caseinase- and bound coagulase-deficient mutant of Staphylococcus aureus BB; Hasegawa N et al.; A caseinase - and bound coagulase-negative mutant was isolated from Staphylococcus aureus BB by treatment with N-methyl-N'-nitro-N-nitrosoguanidine . The virulence of the mutant strain was compared with that of the parental strain in mice infected by the intravenous and intraperitoneal routes . The ratio between the LD50 of the mutant and that of the parent was 1,841 for intravenous infection and 106 for intraperitoneal infection . Viable staphylococci were counted in renal tissue three days after intravenous infection with 3 X 10(6) bacteria; the count was 8 X 10(7) cfu/100 mg of tissue for the parental strain and 1.2 X 10(2) cfu/100 mg for the mutant strain.

Am J Public Health, 1984 Apr, 74(4), 366 - 7
Prevalence of Staphylococcus aureus, phage type 29/52/80, in Michigan; Martin R et al.; Staphylococcus aureus, phage type 29/52/80, caused an outbreak of infections in Michigan over a period of two years and continues to be the most prevalent type seen . Of 3,752 isolates typed in 1980-81, 25 per cent were this phage type, which was strongly associated with methicillin resistance . Using this phage type as an indicator, we could demonstrate the spread of methicillin resistant staphylococci from Detroit metropolitan hospitals to suburban and, to a lesser extent, to hospitals outside the Detroit area.

Presse Med, 1984 Mar 10, 13(10), 597 - 9
{Acute spinal epidural infections due to common pathogens . 23 cases}; Leys D et al.; Twenty-three cases of acute spinal epidural infection due to common pathogens were retrospectively studied . Pain is not always present initially and usually appears 15 to 32 days after the primary infection, which is only found in one-half of the cases . When established, the condition is characterized by spinal rigidity, signs of infection, and compression of the cord or cauda equina . The diagnosis is confirmed by surgery, radiology (myelographic blockade, spondylodiscitis) or the finding of pus in the epidural space at lumbar puncture . A frequently delayed diagnosis explains the poor prognosis of these infections . Treatment should always include an antibiotic active against staphylococci, which are by far the most common pathogens . The indications for surgery are discussed in the light of published data compared to the authors' own experience.

Antibiotiki, 1984 Mar, 29(3), 188 - 91
{Combined action of nitrofuran preparations and bile acids on staphylococci}; Tkachuk NI; The effect of cholic, glycocholic and deoxycholic bile acids on the antimicrobial activity of furacin, furadonin, furagin and furoxone was studied with the use of collection strains and fresh isolates of staphylococci . The method of dilutions in liquid media was used . Cholic and glycocholic acids lowered the MIC of furacin, furadonin, furoxone and furagin with respect to the collection strains by 4-16, 5, 4-6 and 22-37 times, respectively . The potentiating effect of deoxycholic acid on the nitrofuran drugs was even more pronounced . Thus, when the nitrofurans were used in combination with deoxycholic acid, their MIC dropped by 16-114 times . A significant increase in the antimicrobial activity of the nitrofurans under the effect of the bile acids was also observed with respect to the fresh isolates of Staphylococcus, while it was somewhat lower . The subbacteriostatic doses of cholic, glycocholic and deoxycholic bile acids also increased the bactericidal effect of the nitrofuran drugs . The minimum bactericidal concentrations (MBC) of furacin, furoxone, furadonin and furagin decreased from 12.5, 2.08, 25.0 and 1.82 to 0.78, 0.26, 2.34 and 0.032 micrograms/ml, respectively . The most pronounced decrease in the MBC was observed under the effect of deoxycholic acid . Therefore, the bile acids potentiated the nitrofuran antistaphylococcal activity . The combinations of deoxycholic acid with furagin or furoxone were the most effective.

J Antibiot (Tokyo), 1984 Mar, 37(3), 267 - 74
A simple system for studying antibiotic binding to leukocytes; Gray GD et al.; Studies on the interaction between antibiotics and polymorphonuclear leukocytes (PMLs) usually require the availability of radiolabeled antibiotic, that the antibiotic kill intraleukocyte pathogens, or that the antibiotic affect some function of the leukocyte . The system described here does not have the requirements above but depends instead upon anti-staphylococci activity . The key features of the system are that, following incubation, extracellular antibiotic was removed from PMLs by centrifugation, contact between Staphylococcus aureus 502A and the phagocyte-antibiotic complex was assured by centrifugation at 4 degrees C in 96 well tissue culture dishes, phagocytosis was induced by incubation at 37 degrees C, and assessment of surviving bacteria was accomplished by collecting {3H}thymidine labeled bacteria using a cell harvester . Antibiotics that were active in this system included naphthalenic ansamycins (rifamycins and streptovaricins ), lincosaminides ( clindamycins and pirlimycins ), coumarins (novobiocin), erythromycin, tetracycline, tyrocidine and paulomycin .

Can J Microbiol, 1984 Mar, 30(3), 419 - 22
Effects of fibronectin on the compact colony formation in staphylococci; Usui Y et al.; Fifty-two unencapsulated strains of Staphylococcus aureus, including strains of Wood 46 and Cowan I, formed compact colonies in fibronectin -soft agar . However, 20 encapsulated strains of Staphylococcus aureus and 50 strains of Staphylococcus epidermidis showed diffuse growth in the medium . The results suggest that another possible cellular factor, other than protein A, is involved in the binding of the cell surface with fibronectin and that it would be one of factors in forming compact colonies in serum-soft agar.

Arch Microbiol, 1984 Mar, 137(3), 272 - 80
Determination of cell wall teichoic acid structure of staphylococci by rapid chemical and serological screening methods; Endl J et al.; Investigations of cell wall teichoic acid structures of various staphylococci were carried out by a rapid method based on the gas-liquid chromatographic separation of products obtained after treatment of phenol-extracted cells with 70% hydrofluoric acid . In most of the strains teichoic acids of the poly(glycerolphosphate) and/or poly(ribitol-phosphate) type were found . Teichoic acids of the poly(glycerolphosphate-N-acetylglucosaminephosphate) type and polymers consisting of N-acetylglucosaminephosphate were present in few strains . The results obtained by the rapid chemical screening method were compared with data obtained by serological analysis of teichoic acid structures using specific antisera and the lectin wheat germ agglutinin . Teichoic acid components occurring in low concentrations could only be detected with the chemical and not with the serological method . A number of strains of species of the genus Staphylococcus have been studied using these rapid methods . With a few exceptions, the teichoic acid structure proved to be a constant marker within a given species.

Antimicrob Agents Chemother, 1984 Mar, 25(3), 311 - 5
Staphylococcal endocarditis in rabbits treated with a low dose of cloxacillin; Lorian V et al.; Rabbits with established staphylococcal endocarditis, injected twice at an interval of 2 h with either 0.5 mg of cloxacillin per kg or saline, were sacrificed 2.5 h after the second injection . Vegetations were excised, weighed, and cultured, and ultrathin sections were prepared and examined by light microscopy, transmission electron microscopy, and scanning electron microscopy . Several affected valves were examined histologically . Concentrations of cloxacillin in serum were determined 1 and 3 h after dosage . Staphylococci grown on membranes placed on agar containing 0.09 micrograms of cloxacillin per ml and in broth at the same cloxacillin concentration (one-third of the MIC) were examined by transmission electron microscopy . The mean numbers of CFU per gram of vegetations from control and treated rabbits were 2.28 X 10(10) and 1.31 X 10(10), respectively . Vegetations of treated rabbits contained staphylococci of normal size and form as well as organisms two to six times larger than normal with multiple cross walls . Larger bacterial cells were usually located in areas close to blood; cells of normal size were usually embedded in fibrin . The structures of these staphylococci and those grown on membranes in the presence of 0.09 micrograms of cloxacillin per ml were comparable but were different from those grown in broth containing this concentration of cloxacillin . Concentrations of cloxacillin in serum were 0.166 micrograms/ml at 1 h and 0.286 micrograms/ml at 3 h after dosage . The similarities in ultrastructure between staphylococci in vegetations of treated rabbits and staphylococci grown on membranes suggest that the vegetations contained approximately 0.09 micrograms of cloxacillin per g . Thus, antibiotic penetration from blood into vegetations and diffusion into fibrin were limited.

Ann Microbiol (Paris), 1984 Mar-Apr, 135A(2), 239 - 47
{Fosfomycin resistance in Staphylococcus saprophyticus and other species of coagulase-negative staphylococci}; Loulergue J et al.; Susceptibility of 121 isolates of coagulase-negative staphylococci to two antimicrobial agents, novobiocin and fosfomycin, was determined using the agar dilution method . Isolates included 45 strains of Staphylococcus saprophyticus, 26 strains of S . cohnii and S . xylosus, 24 strains of S . epidermidis and 26 strains of S . hominis, S . capitis, S . warneri and S . auricularis . The minimal inhibitory concentration average of fosfomycin for S . saprophyticus differed (p less than 0.001) from that other for novobiocin-resistant staphylococci (S . cohnii and S . xylosus) and for S . epidermidis (p less than 0.001) . Out of 45 isolates of S . saprophyticus, 42 were resistant to fosfomycin . The results were very heterogeneous with regard to fosfomycin for all of the other coagulase-negative staphylococci . Resistance to fosfomycin, like resistance to novobiocin, could be used as a presumptive test for the identification of S . saprophyticus.

Am J Clin Pathol, 1984 Mar, 81(3), 345 - 8
An evaluation of three rapid coagglutination tests: Sero-STAT, Accu-Staph, and Staphyloslide, for differentiating Staphylococcus aureus from other species of staphylococci; Woolfrey BF et al.; Three commercial coagglutination tests--Sero-STAT, Accu-Staph, and Staphyloslide--were performed in parallel with slide coagulase, tube coagulase, and thermostable nuclease tests on 100 methicillin-susceptible Staphylococcus aureus (MSS) strains, 100 methicillin-resistant S . aureus (MRS) strains, and 100 non-S . aureus staphylococcal strains (NSA) . All three coagglutination tests showed sensitivities of 100% for MSS strains . For MRS strains, sensitivities were, respectively, 99%, 100%, and 99% . False-positive reactions were, respectively, 10%, 2%, and 2% . A marked difference in slide coagulase test sensitivity was found for MSS strains (79%) and MRS strains (14%) . These findings suggest that the coagglutination tests may be less sensitive for detecting MRS strains than for detecting MSS strains and that these properties may be related to clumping factor reactivity . The high false-positive rate for Sero-STAT and even the 2% false-positive rate for Accu-Staph and Staphyloslide make clinical usefulness at this time somewhat problematic and debatable . In view of these findings, the authors prefer to retain the tube coagulase test and thermostable nuclease test for differentiation of S . aureus from non-S . aureus strains in their laboratory.

J Invest Dermatol, 1984 Mar, 82(3), 294 - 7
The bacterial flora of the forehead and back of Alaskan native villagers in summer and in winter; Evans CA et al.; The bacterial flora of the forehead and back of Eskimo and Indian villagers in arctic Alaska was determined in midsummer and in winter (temperature -29 degrees to -46 degrees C) . Specimens collected by the wet swab method were transported overnight, chilled, to Seattle in buffered diluent with Triton X-100 . Control tests showed good survival of principal skin organisms with moderate or large initial populations and a disproportionately greater loss with an initial sparse population . Results of these studies are compared with earlier studies of the forehead flora of a Seattle urban population . On most Alaskan subjects Propionibacterium acnes was more abundant than staphylococci on both sites and both organisms had greater population densities on the forehead than on the back . Population densities for P . acnes varied from none detected to more than 10(6) per cm2 on the forehead and 10(5) per cm2 on the back . For coagulase-negative staphylococci the range was from none detected to more than 10(5) per cm2 on the forehead and the back . The proportion of subjects with relatively abundant or relatively sparse populations of P . acnes and of staphylococci did not change seasonally . Of 51 staphylococcal isolates, 65% were S . epidermidis, 22% S . capitis, and 10% S . hominis . P . saccharolyticus was found on a minority of subjects on both sites . The kinds of organisms found on the forehead and their variable individual population densities were essentially the same on the Alaskan villagers and the Seattle subjects.

Pediatr Infect Dis, 1984 Mar-Apr, 3(2), 110 - 3
The management of central intravenous catheter infections; Wang EE et al.; Catheter-associated infection is a frequent complication in patients with indwelling intravenous catheters used for administration of total parenteral nutrition and/or cancer chemotherapy . Thirty-seven catheter-associated infections in 19 patients were identified in our retrospective survey conducted for the period from January 1, 1982, through December 31, 1982 . Fourteen patients were receiving total parenteral nutrition for gastrointestinal disorders, and five were receiving total parenteral nutrition and chemotherapy for underlying malignancy . Coagulase-negative staphylococci were isolated from 65% of catheter-associated bacteremias, as a single species (18 cases) or as one of multiple species (6 cases) . Ten of 33 coagulase-negative staphylococcal isolates (30%) were methicillin-resistant . Twenty-one infections (57%) were initially treated with antibiotics administered through the central venous catheter . There were three failures with this treatment; in two cases the catheter was removed because of continued fever and positive blood cultures despite antibiotics, and one patient developed a pyogenic granuloma . The remaining 18 (86%) catheter-associated infections were cured without catheter removal . However, a new infection occurred subsequently in two of these patients . We recommend that vancomycin and an aminoglycoside be the initial empiric therapy for suspected catheter-associated sepsis . Lack of defervescence or continued positive blood cultures for 2 to 4 days despite antibiotics are indications for catheter removal . Otherwise antibiotics should be continued for 14 to 21 days.

Proc Natl Acad Sci U S A, 1984 Mar, 81(5), 1519 - 23
Isolation and partial characterization of concanavalin A receptors on cloned cytotoxic T lymphocytes; Sitkovsky MV et al.; A small set of concanavalin A (Con A)-binding glycoproteins was isolated from the surface membrane of cloned cytotoxic T lymphocytes (CTL) and partly identified using monoclonal antibodies . The binding of Con A by these glycoproteins on the CTL surface results in the secretion of gamma-interferon and in blocking the effector functions of the cells-namely, antigen-specific and lectin-dependent cytotoxicity . The Con A is evidently bound tightly to some surface structures ("Con A-receptors") that are required for the activation and cytotoxic activity of CTL . To isolate and identify these receptors, antibodies to Con A were used . After Con A was allowed to bind to radiolabeled cloned CTL (labeled with 125I or {35S}methionine or 3H-labeled amino acids), the cells were washed thoroughly, lysed in detergents and anti-Con A antibodies were added to bind to the Con A-receptor complexes . The resulting aggregates were adsorbed with protein A-bearing Staphylococci and the receptors were then specifically released from the pelleted bacteria by alpha-methyl-D-mannoside and analyzed by polyacrylamide gel electrophoresis under reducing conditions . Eight to nine labeled components were seen by autoradiography and with the aid of monoclonal antibodies to known T-cell surface molecules, four were identified as T200, lymphocyte function-associated antigen (LFA)-1, alpha- and beta-chains, and (on some clones) Lyt-2 . Other components with Mr congruent to 160,000, 120,000, 46,000, 42,000, and 23,000 have not been identified . The procedures described here may have general application in the studies of the functional properties of other cell surface molecules.

Clin Exp Immunol, 1984 Mar, 55(3), 509 - 15
Unusual acidic light chains in murine SLE serum; Cohen PL et al.; The sera of autoimmune and other mouse strains were analysed by high resolution two dimensional gel electrophoresis and silver staining . The most striking finding was the presence of unusually acidic immunoglobulin light chains in sera from 4-5 month old MRL/Mp-lpr/lpr mice . Similar light chains were found in lesser amounts in NZB/NZW and BXSB sera, and traces were observed in MRL/Mp-+/+, NZB, and in normal sera . The intensity of the acidic light chain spots increased with age in MRL/Mp-lpr/lpr mice, coincident with the development of autoimmunity . These acidic light chains circulated as components of complete IgG molecules, as they were no longer demonstrable in serum which had been rendered free of IgG by absorption with Cowans strain staphylococci . Because both cryoglobulins and glomerular eluates from MRL/Mp-lpr/lpr mice contained acidic immunoglobulin light chains, these molecules may be involved in immune complex formation and resultant injury.

J Vasc Surg, 1984 Mar, 1(2), 372 - 80
Simple methods for direct antibiotic protection of synthetic vascular grafts; White JV et al.; Two simple methods for direct antibacterial protection of synthetic vascular grafts were investigated . In the first protocol the highly protein-bound antibiotics nafcillin (90% protein bound), cefazolin (80%), and cefamandole (70%) were added directly to preclotting blood . Knitted Dacron grafts preclotted in the presence of one of these drugs absorbed significant amounts . Although at high concentrations these antibiotics exhibited anticoagulant effects, significant antibacterial protection was obtained at lower antibiotic levels . Washing treated grafts for 6 hours failed to eliminate the antibacterial activity . Antibiotics remained on the grafts for at least 96 hours . In the second protocol knitted Dacron grafts were soaked in a suspension of silver-pefloxacin, a silver-nalidixic acid analogue with intense antistaphylococcic activity . Using 110Ag-labeled complexes, significant antibiotic activity was documented on the graft after 19 days of washing . Four nafcillin-treated prostheses, six silver-pefloxacin-coated grafts, and 11 control grafts were interposed in the infrarenal aorta of dogs and immediately challenged with an intravenous infusion of 1 X 10(7) Staphylococcus aureus . None of the four nafcillin-treated grafts was infected at 3 weeks . One of the six silver-pefloxacin-coated grafts grew staphylococci, and 9 of 11 controls had positive graft cultures for Staphylococcus when harvested . These studies suggest that prosthetic grafts can be simply coated at the time of implantation with antibiotics selected for appropriate binding and antibacterial characteristics to obtain an infection-resistant prosthesis.

J Clin Microbiol, 1984 Mar, 19(3), 417 - 20
Epidemiological investigation of exfoliative toxin-producing Staphylococcus aureus strains in hospitalized patients; Piemont Y et al.; The incidence of exfoliative toxin-producing strains of Staphylococcus aureus was studied . Samples from hospitalized patients of all ages and samples from infants less than 6 weeks old were screened; out of 2,632 coagulase-positive S . aureus strains tested, 6.2% synthesized exfoliative toxin . The clinical features could be assessed in 86 patients harboring exfoliative toxin-producing staphylococci . Skin lesions (pustules, blisters, and bullous impetigo) could be observed only when the exfoliative toxin-positive strains were isolated from the skin . Phage nongroup II strains seemed less skin pathogenic than phage group II strains . Outbreaks and sporadic cases were observed.

Zh Mikrobiol Epidemiol Immunobiol, 1984 Feb, (2), 40 - 2
{Comparison of the spectra of membrane proteins in differentiating coagulase-negative staphylococci}; Degteva GK et al.; The comparison of the spectra of the membrane proteins of 12 typing strains of coagulase negative staphylococci has revealed differences which probably reflect the distinctive features of membrane proteins, intrinsic to individual bacterial species.

Antibiotiki, 1984 Feb, 29(2), 95 - 9
{Microbiological aspects of the elaboration of effective antibiotic therapy of bacterial lesions of the biliary tract}; Sytnik IA; Sensitivity of staphylococci of different origin to desoxycholic, cholic and choleic bile acids was studied . On this basis a system for differentiation of the staphylococcal bilicultures from the staphylococcal cultures of the other origin was developed . It was shown that the bile and bile acids potentiated the activity of some antibiotics and inhibited the action of the others . Such a strictly individual property of synergism or antagonism of the cholates and antibiotics depended on the properties of the causative agent and the type of the antibiotics and bile acids . The results of the study provided the development of a method for determination of the biliculture antibiotic sensitivity on a medium containing the patient's bile . The antibiotic which induced the maximum inhibition of the bacterial growth in the presence of the patient's bile should be recommended for the treatment of this patient.

J Infect Dis, 1984 Feb, 149(2), 271 - 6
Influence of bacterial-antibiotic interactions on subsequent antimicrobial activity of alveolar macrophages; Hand WL et al.; The efficacy of an antibiotic in the treatment of bacterial infections depends upon the interactions of drug, bacteria, and phagocytes . In an examination of certain of these interactions, overnight cultures of 3H-labeled Staphylococcus aureus were briefly incubated in the presence or absence of various antibiotics prior to phagocytosis by rabbit alveolar macrophages . Preincubation of organisms with an inhibitor of bacterial protein synthesis (clindamycin, erythromycin, chloramphenicol, or rifampin) but not with a cell wall-active drug (penicillin G or cefazolin) led to an increase in phagocytosis and early intracellular killing by alveolar macrophages . Antibiotic-mediated susceptibility of S aureus to ingestion by alveolar macrophages correlated with the inhibition of bacterial protein synthesis . Clindamycin-treated staphylococci were more efficiently opsonized by heat-inactivated serum and bound larger amounts of specific antibody than did control organisms . Thus, compromise of one or more antiphagocytic surface components secondary to decreased protein synthesis is the means by which certain antibiotics influence bacterial susceptibility to the antimicrobial mechanisms of phagocytes . This effect may be an important determinant in the success of treatment with inhibitors of bacterial protein synthesis.

J Clin Microbiol, 1984 Feb, 19(2), 279 - 80
Five-hour novobiocin test for differentiation of coagulase-negative staphylococci; Harrington BJ et al.; A 5-h broth disk test, read visually for growth or no growth to determine resistance of coagulase-negative staphylococci to 1.6 micrograms of novobiocin per ml, was evaluated as a rapid test for the presumptive identification of Staphylococcus saprophyticus . The correlation with an overnight disk diffusion test was 100%.

Chemioterapia, 1984 Feb, 3(1), 19 - 24
Infection in immunosuppressed patients; Sadek Sabbour M et al.; The infective complications were studied in a group of 30 immunosuppressed patients with proven derangement of their immune responses . Twenty-four patients had underlying neoplastic diseases and 6 patients non-neoplastic diseases . Twenty patients were under cytotoxic drugs and/or prednisolone, while 14 patients received radiotherapy either alone or in combination with chemotherapy . Seventy-nine individual pathogens were identified during the 59 episodes of infections . Bacteria accounted for more than 75% of the infectious episodes . Gram-negative bacilli were the most frequently encountered pathogens specially during the attacks of pneumonia, while staphylococci (especially coagulase-negative) were the commonest isolated pathogens from blood cultures during attacks of septicaemia . Fungal infections were also not uncommon, being responsible for 25% of the infectious episodes . Candida spp . were the most commonly isolated fungi, responsible for 70% of all deep fungal infections.

Antibiotiki, 1984 Feb, 29(2), 117 - 20
{Drug resistance of coagulase-negative staphylococci of animal origin depending on the source of the isolation and species classification of the strains}; Akatov AK et al.; Drug resistance of 271 strains of coagulase negative staphylococci isolated mainly from the upper respiratory tract and skin of healthy animals (cows, sheep, swine, hen, monkey, mink, sable and fox) was studied . Benzylpenicillin, streptomycin, tetracycline, chloramphenicol, erythromycin, oleandomycin, neomycin, monomycin, kanamycin and novobiocin and heavy metal salts, such as mercurous chloride and cadmium sulfate were used in the study . Unlike coagulase positive staphylococci isolated from the same sources, the coagulase negative strains were more frequently resistant to novobiocin (a specific feature of a number of the strains) and tetracycline and much less frequently resistant to benzylpenicillin and streptomycin . The differences in the drug resistance of the coagulase negative staphylococci were more often associated with the species taxonomic position than with the source of their isolation . The highest number of the strains resistant to all the antibiotics tested except novobiocin belonged to Staph . epidermidis and the lowest number of the strains resistant to all the antibiotics tested except novobiocin belonged to Staph . xylosus, Staph . sciuri, Staph . simulans and Staph . hyicus.

Br Med J (Clin Res Ed), 1984 Jan 28, 288(6413), 300 - 3
Staphylococcus aureus bacteraemia: 400 episodes in St Thomas's Hospital; Gransden WR et al.; Four hundred episodes of Staphylococcus aureus bacteraemia occurred in St Thomas's Hospital from 1969 to 1983, accounting for 17.5% of all episodes of bacteraemia . The mortality was 24%, half attributable to underlying disease, and was highest in patients over 50 . Almost 60% of the bacteraemias were acquired in hospital, and the source of the organism was generally obvious, with vascular access sites the most common (37%) . Bone and joint infections accounted for 11.5% of episodes and endocarditis for 7% . Most staphylococci were resistant to penicillin only; three isolates were resistant to methicillin and five to fusidic acid . Microbiologists seldom influenced directly the choice of initial antibiotic treatment (though this usually conformed to the hospital's antibiotic prescribing policy) but had considerable influence over definitive treatment, usually cloxacillin or flucloxacillin alone or in combination with fusidic acid . S aureus bacteraemia is easy to identify and treat, though underlying disease may influence the outcome . Efforts should be made to prevent the largely iatrogenic disease.

JAMA, 1984 Jan 27, 251(4), 487 - 9
Staphylococcal food poisoning in the United States . New facts and old misconceptions; Holmberg SD et al.; To determine the current epidemiologic characteristics of staphylococcal food-borne disease (SFD), we reviewed 131 outbreaks reported to the Centers for Disease Control, Atlanta, from 1977 through 1981 . Staphylococcal food-borne disease was the second most common cause of reported food-borne illness, affecting more than 7,000 persons during the five-year period; 10% of these patients visited or were admitted to hospitals for their illnesses . The proportion of outbreaks attributable to Staphylococcus aureus enterotoxins A through E has changed, with enterotoxin A being the only toxin incriminated during the last three years of this review . Milk--the most common source of enterotoxin C- and D-producing strains--and commercially packed foods are less common causes of SFD outbreaks now than they were before 1960 . However, previously cooked, proteinaceous foods remain preeminent in causing SFD . The presence or absence of fever in infected persons, skin lesions in food handlers, or large numbers of staphylococci in food were unreliable as diagnostic criteria . Thorough epidemiologic investigation remains crucial to identifying SFD and its sources.

J Immunol Methods, 1984 Jan 20, 66(1), 171 - 8
Selective affinity of protein A containing staphylococci for monomeric and polymeric IgG; Dobre MA et al.; Protein A containing staphylococci were saturated with human monomeric IgG (mIgG) and cross-linked with glutaraldehyde . The resulting material (SMG) preferentially bound aggregated IgG (aIgG) and soluble immune complexes (CIC) . One milliliter of a 10% suspension of SMG bound approximately 30 micrograms of mIgG and 1000 micrograms of aIgG and CIC . The binding of aIgG to SMG was reduced to approximately 50% at a 20-fold excess of mIgG over aIgG . CIC and aIgG could be released from SMG by elution with 3 M KSCN . The results indicate that SMG can be used for identification and removal of CIC in patient plasma.

Med J Aust, 1984 Jan 7, 140(1), 26 - 7
Staphylococcus hominis septicaemia in patients with cancer; Bowman RA et al.; We report two cases of Staphylococcus hominis septicaemia associated with the use of intravenous catheters . Both patients had advanced malignant disease, but infection was eliminated rapidly with antibiotic treatment administered via the catheters . This report confirms the pathogenicity of Staph . hominis, particularly in immunocompromised patients . We recommend the wider use of an effective scheme for the correct identification of blood culture isolates of coagulase-negative staphylococci.

Scand J Infect Dis, 1984, 16(2), 187 - 94
Peritonitis in patients on continuous ambulatory peritoneal dialysis . A changing scene; Grefberg N et al.; Peritonitis is a serious and common complication in patients treated with continuous ambulatory peritoneal dialysis (CAPD) . This work reports the experiences of this complication in 50 patients treated with CAPD for a total time of 844 months . 129 episodes were observed . Coagulase-negative staphylococci were found to be the causative organisms in 57% of the cases . Most episodes were acquired without any evident cause when CAPD was performed at home . Nine episodes were suspected to be the result of bacterial leakage through the intestinal wall . Six of them occurred in patients receiving corticosteroids . During the study period an increasing number of episodes of peritonitis were caused by organisms with multiple resistance to antibiotics . Thus, the microbiological spectrum in CAPD-related peritonitis must constantly be surveyed so that proper measures, e.g . regarding the choice of antibiotics used, can be taken when a change is observed.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1984 Jan, 178(5-6), 551 - 61
Staphylococci isolated from abscesses in slaughtered animals: characterization and epidemiological studies; Menes I et al.; A total of 71 strains of Gram positive, catalase positive cocci were isolated from 112 abscesses observed during inspection of slaughtered animals (sheep, cattle, pigs and goats) . On the basis of lysostaphin sensitivity, all strains were identified as staphylococci . However, 4 of them did not ferment glucose anaerobically . Classification at the species level was accomplished by complete characterization of the strains . Amongst the 35 coagulase positive isolates, 30 were classified as S . aureus, 2 as S . intermedius and 3 could not be classified . Of the 36 coagulase negative cultures, 1 was classed as S . hyicus subsp . hyicus, 3 as S . simulans, 2 as S . haemolyticus, 5 as S . hominis, 3 as S . epidermidis, 2 as S . capitis, 3 as S . warneri, 4 as S . xylosus, 1 as S . cohnii and 1 as S . saprophyticus . The remaining 11 strains could not be classified . Seventeen of the 30 S . aureus strains belonged to biotype C, 7 were classified as intermediate (shared properties of biotypes A and C), 3 as similar to bitype C, 1 as similar to biotype A and 2 could not be biotyped . Twelve of the 16 biotype C strains showed characteristic properties of ovine S . aureus . The number of strains lysed by phages of human and bovine origin was 11 and 18, respectively . As many as 25 strains (23 S . aureus and 2 coagulase positive, unclassified cultures) produced enterotoxins . The enterotoxins produced were: C (14 strains), D (2 strains), A (1 strain), E (1 strain), A + C (1 strain) and A + D (6 strains) . A good correlation between the type of enterotoxin produced, biotype and phage type was observed.

J Hyg Epidemiol Microbiol Immunol, 1984, 28(1), 103 - 6
Classification of coagulase-negative staphylococci in diagnostic practice; Kuz'minskii SN et al.; When the Schleifer and Kloos classification was used for the identification of 300 clinical isolates of coagulase-negative staphylococci (CNS), S . epidermidis together with S . saprophyticus was found to amount to 21.1% . A total of 48% of the cultures under test were identified . On the basis of these results and with respect to literary data the present authors propose to subdivide, in diagnostic studies, the mentioned microorganisms into groups of related species, i.e., the epidermidis group and the saprophyticus group, instead of classifying the CNS according to species . By means of the tests proposed (determination of phosphatase, fermentation of glucose, oxidation of mannitol, behaviour towards novobiocin), typical S . epidermidis and S . saprophyticus as well as cultures similar to them can be isolated within the groups . The method is easy to perform in diagnostic laboratories and, in contrast to methods practised up to now, enables us to characterize virtually all CNS variants isolated from patients, including the coagulase-negative S . aureus.

Antibiotiki, 1984 Jan, 29(1), 52 - 6
{Microflora of the gallbladder in chronic calculous cholecystitis and its antibiotic sensitivity}; Veselov AIa et al.; The microflora of 100 gallbladders removed from patients operated for chronic calculous cholecystitis was studied . Eighty-two of them contained microorganisms: monocultures and associations in 42 and 40 gallbladders, respectively . The associations included 2 (22 per cent) or 3-6 microbial species (18 per cent) . Gram-positive bacteria predominated in the microflora (72.9 per cent): staphylococci (30 per cent), bifid and lactic acid bacteria (26 per cent), and spore-forming aerobic bacteria (21 per cent) . The number of gram-negative bacteria amounted to 27.1 per cent . Among them the number of E . coli amounted to 21 per cent . On the whole the isolates were sensitive to neomycin, monomycin, carbenicillin and tetracycline . 91.1 per cent of the strains were sensitive to 2-18 antibiotics.

Antibiotiki, 1984 Jan, 29(1), 33 - 5
{Chemotherapeutic effectiveness of antibiotics in combination with papain in experimental septicemia}; Baskanchiladze GSh et al.; The efficacy of papain, a proteolytic enzyme made in the USSR, was studied alone and in combination with antibiotics, such as benzylpenicillin, streptomycin, chloramphenicol, tetracycline, erythromycin and novobiocin in treatment of mice with septicemia caused by antibiotic-resistant staphylococci . It was shown that the enzyme increased the chemotherapeutic efficacy of the antibiotics on the average by 50 per cent . When used alone in a dose of 0.1 mg per mouse papain prevented death in 20 per cent of animals . The high chemotherapeutic efficacy of the antibiotic combinations with papain allowed recommending it for use in clinical practice for the treatment of infections caused by antibiotic-resistant staphylococci.

Mikrobiyol Bul, 1984 Jan, 18(1), 15 - 22
{The enzyme penicillinase and plasmid penicillinase in Staphylococcus aureus strains}; Cerikcioglu N et al.; Penicillinase enzyme activities and resistance to some heavy metal ions in 25 S . aureus strains isolated in various hospitals in Ankara were investigated . We also tried to find out whether the controlling genes for penicillinase activity were on the plasmids or not . By the assays that were performed, this enzyme was detected in 22 out of 25 S . aureus strains . All of the strains were found to be resistant to mercury (Hg) and lead (Pb), but only 5 of them were sensitive to cadmium (Cd) . We were not able to determine the source of the penicillinase in all strains of staphylococci.

Antimicrob Agents Chemother, 1984 Jan, 25(1), 125 - 7
Importance of extracellular and cell-bound beta-lactamase in mediating resistance of Staphylococcus aureus to mezlocillin; Haller I; Most penicillin-resistant staphylococci release a considerable portion of their beta-lactamase into the surrounding medium . Accumulation of this exoenzyme in conventional susceptibility test systems may result in a rapid inactivation of hydrolyzable antibiotics . Since under in vivo conditions the concentration of extracellular beta-lactamase should depend on the site of infection, susceptibility of Staphylococcus aureus to mezlocillin, a broad-spectrum penicillin, was measured in an open test model which prevented build-up of exoenzyme . The staphylococcal cells were immobilized and incubated between two membrane filters, and the excreted beta-lactamase was washed out by a constant flow of broth containing the antibiotic . Two test strains which produced large amounts of extracellular beta-lactamase and which were found to be resistant in the broth dilution test proved to be susceptible to mezlocillin in the open test model . This indicates that resistance to mezlocillin as measured by the broth dilution method was mediated predominantly by the extracellular enzyme fraction . Experiments performed with small infective doses in a model of peritoneal infection in leukopenic mice suggest that mezlocillin exhibits a therapeutic effect against beta-lactamase-producing staphylococci under certain in vivo conditions in which build-up of extracellular beta-lactamase does not occur.

Vet Med Nauki, 1984, 21(9), 86 - 92
{Enterotoxic staphylococci in the milk of cows and sheep with mastitis}; Gogov I et al.; Studied were the occurrence and the biochemical and phage characteristic of enterotoxic staphylococci in cow and sheep milk from animals with mastitis . Milk samples taken from 150 cows and 120 ewes were investigated for the presence of Staphylococcus aureus . This organism was found in 88 per cent of the cow milk samples and in 89.2 per cent of the sheep milk ones . The count of bacteria was within the 10(1) to 10(5)/cm3 range . A total of 239 strains of Staphylococcus aureus were isolated from both kinds of milk . They were tested for enterotoxigenicity after Ouchterlony . It was shown that 28.8 per cent of those isolated from mastitis cow milk and 7.5 per cent of those isolated from mastitis ewe milk produced an enterotoxin . Those from the cow milk samples produced enterotoxin A in 65.8 per cent of the cases, enterotoxin B in 13.1 per cent, and enterotoxin C in 5.3 per cent . Simultaneous production of A and D toxin was found in 15.8 per cent of the strains . Those isolated from the ewe milk samples produced enterotoxin C in 75 per cent of the cases, and enterotoxins A and C in 25 per cent . The enterotoxigenic Staphylococcus strains were distinguished by high biochemical and enzyme activity, however, none of the methods tested proved specific for enterotoxic Staphylococci only . The enterotoxic staphylococci of cow milk were typed by II and IV phages and by a mixed group of phages (II/M, III/M, IV/M, II/IV) . Most spread were the 116 and 116/118 phage types.(ABSTRACT TRUNCATED AT 250 WORDS)

Vet Med Nauki, 1984, 21(9), 52 - 6
{Comparative studies of protein A from staphylococci isolated from sheep}; Vitkov M; The passive hemagglutination test was employed to establish the presence of protein A in a total of 133 strains of coagulase-positive and coagulase-negative staphylococci isolated from sheep with mastitis . Defined were also the antigen structure, phage behaviour, and some biologic properties of these staphylococci . It was found that 91 per cent out of 110 strains of Staphylococcus aureus studied produced protein A . At the same time not one of the 23 strains of Staphylococcus epidermidis showed the presence of this surface antigen . This data showed the necessity of introducing the hemagglutination test in routine microbiologic work for the demonstration of protein A in staphylococci isolated in the cases of pathologic processes in animals.

G Batteriol Virol Immunol, 1984 Jan-Jun, 77(1-6), 54 - 62
{Incidence and antibiotic resistance of various species of staphylococci in a hospital environment in eastern Sicily}; Geraci C et al.; In this work we carry out an epidemiologic investigation of the incidence of Staphylococci in some hospitals of east Sicily, in relation with hospitalized patients . The tests were performed every ten days for a period of four months, by using Fisher technique . The strains were isolated from clinical specimens from hospitalized patients, and after identification, we made antibiotics-resistance essays . The results show a correlation between Staphylococcus strains isolated from patients and that of environmental origin, also for the antibiotics resistance spectrum.

Clin Invest Med, 1984, 7(4), 281 - 6
The immune response of human neonates to Listeria monocytogenes infection; Issekutz TB et al.; Infection with Listeria monocytogenes during pregnancy has a high fetal and neonatal mortality . In rodents, it has been shown that resistance to Listeria infection is dependent upon a T cell-mediated immune response to the bacteria . The immune humoral and cell-mediated response to L . monocytogenes was studied in seven mother infant pairs who had documented evidence of L . monocytogenes sepsis . All studies were carried out 1 year following the initial infection as part of a clinical and immunological follow-up, and compared to an appropriate control group . The microagglutination titre and opsonizing activity of mothers previously infected with Listeria was significantly greater than that of the control mothers or their infected infants . There was no difference between the babies previously infected with L . monocytogenes when compared to control infants . The in vitro lymphoblastogenic response to Listeria, staphylococci, tetanus toxoid, and phytohemagglutinin was assessed . Infected mothers had a significantly greater proliferative response in the presence of Listeria than the control mothers, while the response of the previously infected infants was not different from that of the control infants . The response to the other antigens and PHA was similar in all groups . In conclusion, infants infected with L . monocytogenes during the perinatal period demonstrated neither a specific antibody response nor exhibited a cell-mediated immune response to this bacteria . These data support the idea that perinatally-infected infants have a markedly impaired immune response to L . monocytogenes and may, thus, explain their increased susceptibility to this infection.

Vet Med Nauki, 1984, 21(10), 46 - 50
{Cold resistance of S . aureus and staphylococcal enterotoxins A and C2 in ice cream}; Gogov I et al.; Studied was the cold resistance of enterotoxinogenic strains of Staphylococcus aureus and of A and C2 staphylococcus enterotoxins in milk and cream icecream kept under refrigerator conditions for 7 months at -18 degrees C . The S . aureus strains were shown to have high resistance in icecream . The survival rate of the organisms depended both on the specific peculiarities of the individual strains and on the composition of the icecream mixture . Staphylococci were found to survive longer in milk icecream . A and C2 enterotoxin retained fully their activity in the two types of icecream over the entire period of storing . The data obtained is important for the elucidation of the epidemiology of alimentary staphylococcus intoxications.

Microbios, 1984, 41(165-166), 191 - 203
A modified medium for the recovery of Staphylococcus from water; Stengren SR et al.; Various contemporary methods available for recovering staphylococci from water were evaluated as to quantitative recovery and degree of selectivity . Each of the methods tested was found to be somewhat inadequate for the selective isolation of staphylococci from water in this area . A modified medium is being proposed which incorporates 0.005% sodium azide into a mannitol salt agar base . This medium when used with a membrane filter procedure and incubated at 32 degrees C for 48 h recovers 85% of Staphylococcus aureus, 88% of Staphylococcus epidermidis, and 100% of Staphylococcus saprophyticus present . Environmental testing in this area indicates that this modified procedure will recover only Gram-positive, catalase-positive cocci . Ninety percent of these cocci are Staphylococcus as ascertained by the lysostaphin susceptibility test.

Scand J Infect Dis, 1984, 16(4), 345 - 8
Antimicrobial susceptibility of 200 blood isolates of coagulase-negative staphylococci to 20 antimicrobial agents; Watanakunakorn C; The in vitro susceptibility of 200 strains of coagulase-negative staphylococci isolated from blood cultures to 20 antimicrobial agents including the newer beta-lactam compounds was compared . Rifampicin, vancomycin, nafcillin and gentamicin were the most active drugs . The newer cephalosporins and related beta-lactam antibiotics did not exhibit superior activity.

Med Microbiol Immunol (Berl), 1984, 173(4), 233 - 40
Substitution of anti-human globulin by protein A-bearing staphylococci in the detection of Brucella antibodies; Ansorg RA et al.; A coagglutination test using protein A-bearing staphylococci has been developed for the detection of Brucella antibodies . Comparing the results of a random sample of 57 sera collected from Malta fever patients, suggestive titers of 1: greater than or equal to 160 were found in 8 sera (14%) with the standard agglutination test, in 22 sera (39%) with the Coombs test, and in 23 sera (40%) with the coagglutination test . The titers in the Coombs test and the coagglutination test coincided in 54 (95%) of the 57 sera, in 3 sera (5%) the difference was no more than one dilution step . Sera from healthy subjects and patients with infections other than brucellosis showed titers up to 1:40 in all three tests . Because of its sensitivity and specificity in detecting non-agglutinating antibodies, the Brucella-antibody coagglutination test may replace the Coombs test as a complementary assay to the standard agglutination . Native sera from Malta fever patients frequently show a prozone phenomenon in the standard agglutination test and a reduced agglutinate formation in both the Coombs test and the coagglutination test . The inhibitors of agglutination lattice formation are apparently serum beta-lipoproteins which become attached to the Brucella antigen and can be removed from the serum by treatment with MnCl2-heparin.

Microbiol Immunol, 1984, 28(9), 987 - 95
Tumoricidal adsorption of Staphylococcus aureus organisms on Ehrlich ascites tumor cells sensitized with rabbit antibody; Masuda S et al.; A tumoricidal effect was observed when protein A-bearing Staphylococcus aureus organisms were adsorbed on Ehrlich ascites tumor cells previously sensitized with antiserum from a rabbit immunized with Ehrlich ascites tumor cells . Electron micrographs showed that staphylococci were firmly attached to the tumor cells, which might explain how effectively the attached cocci killed the tumor cells . The tumoricidal effect was confirmed not only by an in vitro experiment but also by an in vivo one . The possible applications of the tumoricidal adsorption as an indicator for staphylococcal virulence or for selective anti-tumor action was discussed.

J Hyg Epidemiol Microbiol Immunol, 1984, 28(3), 303 - 8
A rapid coagglutination test for the detection and serogrouping of Legionellae; Tsanev N et al.; The applicability of coagglutination for the rapid detection and serogrouping of Legionellae has been investigated . The coagglutination reaction is carried out with the aid of self-made preparations of protein A containing staphylococci, sensitized with specific antibodies against the antigens of L . pneumophila (serogroups I to 6), L . bozemanii and L . micdadei . Preliminary heating of Legionella suspensions at 100% C for 15 min was used to prevent cross coagglutination reactions and ensure greater safety of laboratory personnel during the performance of the test . The results obtained demonstrate a high specificity of coagglutination . With the aid of the coagglutination reactions it has been shown that L . pneumophila strains isolated in Bulgaria belong to serogroup I . The coagglutination method is characterized by its rapidity, simplicity and feasibility . It is a useful and convenient means for the rapid detection and serogrouping of Legionellae.

Int J Immunopharmacol, 1984, 6(1), 43 - 50
The influence of lipoxygenase inhibitors on the in vitro production of human leukocytic pyrogen and lymphocyte activating factor (interleukin-1); Dinarello CA et al.; Leukocytic pyrogen (LP), the endogenous mediator of fever, is synthesized and released from mononuclear phagocytes following activation by several microbial and immunologically-derived substances . Purified fractions of LP also stimulate thymocyte proliferation and LP seems to be indistinguishable from lymphocyte activating factor (LAF) otherwise known as interleukin-1 (IL-1) . In the present investigation, we have examined the effect on IL-1 production of drugs inhibiting both cyclooxygenase- and lipoxygenase-mediated transformations of arachidonic acid (ETYA, 5,8,11,14-eicosatetraynoic acid and compound BW755C, 3-amino-1-3-trifluoromethylphenyl-2-pyrazoline) . Ibuprofen inhibited the production of PGE2 from stimulated human monocytes but had no effect on LP and LAF release . ETYA prevented LP production from human monocytes when added to the incubation fluid prior to activation by Staphylococcus albus . When added after cell activation, ETYA was ineffective . Similar results were obtained using BW755C . Prostaglandin E2 (PGE2) levels in cell supernates were markedly decreased in the presence of either drug when compared to supernates from untreated, stimulated cells . Low PGE2 levels were also demonstrated in supernates of cells in which either ETYA or BW755C were added 1 hour after stimulation . Pretreatment with BW755C also resulted in decreased LAF activity in the supernates of mononuclear cells stimulated with staphylococci, endotoxin, or muramyl dipeptide . Other experiments demonstrated that crude or purified human LP retains its activity following treatment with soybean lipoxidase . These findings indicate that a product of arachidonate lipoxygenase is important in the sequence of events underlying cell activation for the production of human LP/LAF/IL-1 . The possibility that LP might be an eicosanoid-peptide conjugate structurally resembling the leukotrienes was ruled out.

Pathol Biol (Paris), 1984 Jan, 32(1), 29 - 34
{Comparative multicenter study of 2 methods of determining sensitivity to antibiotics . Gel diffusion method and semiautomatic method in fluid ABAC medium}; Brun Y et al.; Susceptibility of 60 bacterial isolates to 15 antibiotics was determined by two methods in three laboratories: 48 Gram negative bacilli and 12 Staphylococci were selected because of "intermediate" susceptibility to at least one antibiotic . Results show a good correlation between the two methods: more than 90% for carbenicillin, cefazolin, cefoxitin, cefamandole, kanamycin, tobramycin, amikacin, erythromycin, pristinamycin and fusidic acid, between 80 and 90% for penicillin G, ampicillin, oxacillin, gentamicin, doxycycline, chloramphenicol, spiramycin and clindamycin, less than 80% for neomycin, tetracycline, minocycline and oleandomycin . Interpretation criteria are different in the two methods for rifampicin, colistin and cotrimoxazole . Between the three laboratories, correlation was 90,3% and 88,6% for disc diffusion method and ABAC system respectively.

Antonie Van Leeuwenhoek, 1984, 50(5-6), 729 - 44
New aspects of staphylococcal infections: emergence of coagulase-negative staphylococci as pathogens; Fleer A et al.; In contrast to the well-established pathogen Staphylococcus aureus, the coagulase-negative staphylococci, formerly collectively called S . 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 carrying artificial devices, such as prosthetic heart valves, hip prostheses and cerebrospinal fluid shunts, and in patients with compromised host defenses such as premature neonates and cancer and transplant patients . The present paper reviews current insights on classification, bacteriology, pathogenic potential and virulence factors of coagulase-negative staphylococci . In addition, the role of host defense factors in resistance to staphylococcal infection is summarized as well as the main features of the clinical syndromes in which coagulase-negative staphylococci are involved.

Ann Rech Vet, 1984, 15(1), 105 - 12
Characteristics of non-clinical mammary infections of goats; Lerondelle C et al.; This study, carried out on 1217 milk goats (2428 milk samples), sampled at two different periods of lactation, showed that non-clinical mammary infections of the goat were due to major pathogens (7.5%) and coagulase-negative staphylococci (24.1%) . Among major pathogens, Staphylococcus aureus was the most frequently isolated species (75.2%) . However, great variations were observed between herds, in levels of infection by major pathogens . The intensity of the inflammatory response, measured by the cell count, depended on the pathogen present in the mammary gland . Evidence was found that 75% of infections persisted throughout the lactation and 61% during the dry-period . The arithmetic mean cell counts for milk samples from halves infected with major pathogens was 6.77 X 10(6) cells/ml, determined by Coulter Counter . It was 1.78 and 1.54 X 10(6) cells/ml respectively for halves infected with coagulase-negative staphylococci and non-infected halves . The arithmetic mean cell counts were higher at drying-off than in lactation . The threshold of 1 X 10(6) cells/ml was reliable for diagnosis in mid-lactation and permitted to diagnose 72% of major pathogen infections.

Acta Obstet Gynecol Scand, 1984, 63(3), 207 - 16
A longitudinal study of Actinomyces israelii in the female genital tract; Persson E et al.; PIP: A prospective, longitudinal study was conducted to study variations in the occurrence of Actinomyces israelii with reference to 4 microorganisms, staphylococci, E . coli, P . acnes, and C . albicans, in the female genital tract . 1k healthy women were studied during all phases of the menstrual Sampling was made from the cervix, vagina, and perineal area 3 times/week during 2 consecutive menstrual periods and during menstruation from napkins and tampons . Altogether, 1108 samples were taken on 349 sampling occasions for different cultural procedures . A . israelii was identified in all woman, in varying frequencies (range 4-74% of sampling occasions) . As a mean, A . israelli was recovered in 24% of the perineal samples, 13% of the vaginal, and 6% of the cervical samples . The occurrence of A . israelii was related neither to the recovery of reference microorganisms nor to the phase of the menstrual cycle, the amount of bleeding or discharge, the pH of the vaginal specimens, the cntraceptive method used, or to the use of different sanitary products . It is the conculsion of these authors that A . israelii apperars to be a part of the indigeonous genital flora of healthy women . author's modified

J Clin Microbiol, 1984 Jan, 19(1), 68 - 72
Comparison of the API Staph-Ident and DMS Staph-Trac systems with conventional methods used for the identification of coagulase-negative staphylococci; Giger O et al.; Two commercial kit systems, the API Staph-Ident system (Analytab Products, Inc., Plainview, N.Y.) and the DMS Staph-Trac system (DMS Laboratories, Inc., Flemington, N.J.), were compared with conventional methods for the identification of nine species of coagulase-negative staphylococci . The API Staph-Ident system, a biochemical and chromogenic substrate micromethod, correctly identified 95 of 120 (79.2%) clinical isolates of coagulase-negative staphylococci after 5 h of incubation . The DMS Staph-Trac system, a miniaturized biochemical test system which requires a 24-h incubation period, correctly identified 106 (88.3%) of the same isolates . Both commercial systems were similar in cost and amount of technologist time required to inoculate and read each system . The clinical value of routine species identification of coagulase-negative staphylococci has not yet been established . The decision by clinical laboratories of whether to adopt this practice will be greatly facilitated by the availability of commercial kit systems which are both rapid and accurate.

Infect Control, 1984 Jan, 5(1), 23 - 7
Surgical scrub and skin disinfection; Ayliffe GA; The role of pre-operative disinfection of the surgeon's hands and the skin of the operative site in the prevention of wound infection remains uncertain . The normal resident skin flora, consisting mainly of coagulase-negative staphylococci and aerobic and anaerobic diphtheroids, is an uncommon cause of infection except in prosthetic operations . Staphylococcus aureus is rarely a resident on normal skin other than the perineum, and is mostly present on the hands as a transient acquired from the nose . Nevertheless, it seems rational to kill or remove all transients on the hands of the surgeon and reduce residents to low levels . Surgical skin disinfection is usually assessed by measuring the reduction in organisms on the hands immediately after disinfection, after repeated applications of the disinfectant and after wearing gloves for two to three hours . The hands are commonly sampled in a bowl or plastic bag containing Ringer's or a similar solution and relevant neutralizers, or by the use of glove washings . A standardized technique is necessary to provide a statistical comparison between agents . Antiseptic detergents, chlorhexidine or povidone iodine show immediate reductions in bacterial counts of 70% to 80%, increasing to 99% after repeated application . Hexachloraphene and triclosan detergents show a lower immediate reduction but a good residual effect . Seventy percent ethyl or 60% propyl alcohol, with or without an antiseptic, show an immediate reduction of over 95%, and in excess of 99% on repeated application . Residual levels of organisms tend to be lower after repeated alcohol treatment than following the use of antiseptic detergents.(ABSTRACT TRUNCATED AT 250 WORDS)

Arch Immunol Ther Exp (Warsz), 1984, 32(4), 389 - 96
Immunoglobulin production in cultures of human peripheral blood lymphocytes upon stimulation with various killed staphylococci; Pryjma J et al.; Formalin killed Staphylococci (S . epidermidis, S . saprophyticus and six different strains of S . aureus) were used as inducers of immunoglobulin production in cultures of human peripheral blood lymphocytes . These strains differed in cell wall composition which raised a question what cell wall constituent is responsible for induction of the response . All strains except S . epidermidis induced the response in cultures of unseparated peripheral blood lymphocytes but only some of them were able to trigger immunoglobulin production in T-cell depleted cultures . The obtained results suggest that peptidoglycan is most likely responsible for stimulatory activity of Staphylococci while the presence of protein A reduces the T-cell dependency of the response.

Scand J Infect Dis Suppl, 1984, 42, 64 - 71
Mechanisms of resistance to beta-lactam antibiotics in Staphylococcus aureus; Lacey RW; In vitro, Staphylococcus aureus expresses resistance to beta-lactam antibiotics by beta-lactamase production, methicillin resistance, penicillin tolerance, and deficiency in penicillin binding protein number 3 . The clinical significance of all these phenomena is not fully defined . Methicillin resistance is due to a large chromosomal linkage group . The reason for the very high proportion of cultures that produce beta-lactamase is still enigmatic . Selection pressure by penicillins may not be the entire explanation . Plasmids determining beta-lactamase have spread between cultures in vivo . Staphylococcal plasmids can transfer between cells in vitro by transduction, transformation and conjugation . The latter is likely to be the most efficient, occurring without death of the donor nor need to protect the recipient from lysis by normal bacteriophage particles . Conjugation in S . aureus requires bacteriophage genome to be present in either the donor or recipient . We have recently identified distinct genes with donor and recipient function in typing phage 55 . Staphylococcal beta-lactamase varies in serotype, extra-cellularity, amount, control of production and substrate specificity . The latter has rarely been reported because it is not detected by routine sensitivity testing for methicillin or penicillin resistance . Of the isoxazolylpenicillins, flucloxacillin was found generally to be most labile to beta-lactamase, and dicloxacillin the most stable with cloxacillin intermediate . However, a few exceptions occurred, and it may be prudent to test specific sensitivity in patients infected with staphylococci . Even methicillin may sometimes be hydrolysed to a significant extent.

J Hyg Epidemiol Microbiol Immunol, 1984, 29(3), 317 - 22
Typing coagulase-positive staphylococci of different origin with Blouse and Meekins' phages; Hajek V et al.; Making use of four experimental Blouse and Meekins' (I) phages 06, 40, 58, and 93, derived from Staphylococcus intermedius strains of canine origin, 631 strains of three coagulase-positive staphylococcal species were typed . The typability was in a great extent dependent on the origin of the tested strains . Of 310 S . aureus strains 23 (7%) at RTD and 45 (15%) at 100 X RTD were typable, all without exception of C biotype from cows and sheep . Of 281 S . intermedius strains 208 (74%) at RTD and 14 (5%) at 100 X RTD were lyzed with the above-mentioned I phages . The typability of the isolates in the nine groups from buzzards, pigeons, rooks, dogs, wild ducks, pheasants, foxes, horses, and mink ranged from 59 to 90% . No special relationship was recorded between the origin of the strains and the phage patterns . When testing 135 S . hyicus subsp . hyicus strains nearly one fifth (19%) of them were typable, for the most part at RTD . On the contrary, all 36 S . hyicus subsp . chromogenes strains were resistant to the used phages . The usefulness of the I phages for classificatory aims was discussed.

Allerg Immunol (Leipz), 1984, 30(4), 212 - 21
{Effect of carrageenan, galactose and 2,4-dinitrophenol on leukocyte phagocytosis of Staphylococcus aureus and E . coli}; Stelzner A et al.; The influence of carrageenan (0.1, 0.05 and 0.01%), galactose (1 X 10(-1), 1 X 10(-2) and 5 X 10(-2) mol/l) and 2,4-dinitrophenol (5 X 10(-4), 1 X 10(-4), 5 X 10(-5) and 1 X 10(-5) mol/l) on the phagocytosis of Staphylococcus aureus SG 511 and E . coli 04/K31 by polymorphonuclear neutrophil granulocytes was studied.At the same time the capacity of the germs to grow and multiply in presence of different concentrations of the analysed compounds was tested . The phagocytosis of Staphylococcus aureus SG 511 was not inhibited by carrageenan, galactose and 2,4-dinitrophenol, but an influence on the phagocytosis of E . coli 04/K31 could be clearly demonstrated (0.1 and 0.05% carrageenan, 1 X 10(-1) mol/l galactose, 5 X 10(-4) and 1 X 10(-4) mol/l 2,4-dinitrophenol) . The multiplication of Staphylococci and E . coli was not influenced by all three compounds.

Biol Cell, 1984, 51(2), 239 - 45
Carbohydrates as recognition determinants in phagocytosis and in lectin-mediated killing of target cells; Sharon N; Carbohydrate-lectin interactions serve as the basis of recognition by phagocytic cells of particles and of various target cells . Such interactions occur in the following systems: between sugars on the surface of the phagocytic cells and lectins on the surface of other cells--the best studied example is the binding of mannose-specific Escherichia coli and related organisms via their surface lectins to oligo-mannose residues on macrophages; between lectins on the surface of phagocytic cells and sugars on particles or other cells--phagocytosis of zymosan and of sialidase-treated erythrocytes, mediated respectively by mannose-specific and galactose-specific lectins on macrophages, belongs to this category; by extracellular lectins that form bridges between sugars on both types of cell--as shown by enhancement of phagocytosis of staphylococci by wheat germ agglutinin, and by lectin-dependent killing of target cells by macrophages . These interactions may play an important role in the activities of phagocytic cells in vivo . They may provide an initial host defense mechanism immediately after microbial infection, operate in tissues where phagocytic activity is poor, and participate in tumor rejection.

Rev Chir Orthop Reparatrice Appar Mot, 1984, 70(6), 423 - 8
{Postoperative infectious risk in traumatic bone surgery and protocol for antibiotic therapy}; Andreu J et al.; Eleven hundred and sixty eight traumatic cases have been operated on under constant conditions in a conventional operating room with filtered air and positive pressure using absolute filters of 99.999 efficiency . Two hundred and five were submitted to post-operative prophylactic administration of Cephalosporin (Cefazolin) for 2 days . The overall results showed 0.6 p . 100 of infection but 4 cases of severe sepsis were seen in the group of patients who had received prophylactic antibiotics . The authors have compared these results with those obtained during the previous period when the operating room was less modern . They conclude that this factor is of paramount importance . On the other hand, they have observed 2.1 p . 100 of contaminated drains without subsequent infection . They are concerned at the increase of gram-negative organisms resistant to Cefazolin (60 p . 100) and of Staphylococci resistant to Methicillin (30 p . 100) . They conclude that the peroperative flash technique of the administration of Penicillin M is worthwhile.

Arkh Patol, 1984, 46(9), 16 - 24
{Electron radioautographic study of a human infected wound}; Sarkisov DS et al.; Biopsies from burn (IIIa-IV degree, 20-55% of body surface) and large traumatic wounds of 18 patients were studied . The use of electron-microscopic radioautography made it possible to determine the viability and functional activity of bacteria and host cells in various wound areas . In the necrotic area, apart from a number of viable bacterial cells (intensely labelled with 3H-uridine), unlabelled bacterial cells with various structural alterations were found . Bacteria were found less frequently in the demarcation area; they were detected occasionally in the granulation tissue and only in macrophages . Phagosomes with viable or dead bacteria were observed in few neutrophils of the demarcation area . Here, the majority of neutrophils did not contain bacteria, but degranulation and many phagosomes with tissue detritus were observed . Correlation between the rate of RNA synthesis and functional activity of neutrophils was observed . In the blood neutrophils the RNA synthesis was not detected at all . In the blood neutrophils which were cultivated in vitro with staphylococci and in the wound neutrophils phagocytizing bacteria, the RNA synthesis became evident but slow . The authors established that a sharp increase of the RNA synthesis rate occurs in the neutrophils phagocytizing the dead tissues.

Z Hautkr, 1983 Dec 15, 58(24), 1754 - 60
{External erythromycin therapy of acne}; Schmidt JB et al.; 24 patients suffering from papulo-pustular acne were treated with mono-therapy with 2% erythromycin-containing alcoholic solution for eight weeks . Pustular lesions responded promptly, followed by inflammatory papules . Microbiological investigations revealed a lack of propionibacteria as well as reduction of pathogenic staphylococci . Patients after extended local erythromycin treatment did not show any erythromycin serum levels.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Dec, 256(2), 162 - 7
Staphylococcal lipase: intracellular enzyme production; Tyski S et al.; It is well known that staphylococci produce extracellular lipase which has been isolated, purified and characterized . Existence of intracellular lipase has not been yet established . In this investigation, cellular content liberated by lysostaphin digestion of cell wall revealed presence of lipolytic activity . This has been observed with living staphylococcal cells only . Presence of intracellular lipase was not observed in young bacterial cells, and the enzyme was appearing rapidly in the late phase of the culture . Highest level of enzyme was observed on the 3rd day of culture in described conditions . Accumulation of lipase inside cells followed by its liberation was not observed.

Z Hautkr, 1983 Dec 1, 58(23), 1712 - 7
{Dermatoses with localization in the mucous membranes of the mouth and lips - various recommendations}; Mashkilleyson AL; Review of some observations in the Department of Dermatology of the Medical-Stomatological Institute of the Ministry of Health, Moscow . From 1200 patients with lichen planus, 32% had lichen only on the mouth and lips . 5 types have been distinguished: the typical type, the exsudative hyperaemic type, the erosive ulcerous type, the bullous type and the atrophic type . In 55% of the patients with lupus erythematosus, only the lips were involved . A pemphigoid-like condition of the mucous membranes is mentioned, but without skin lesions and without scar formation . 33% of 100 patients with erythema multiforme had only lesions on the mucous membranes . In Behcet-disease, circulating IgE seems to be of importance . In cheilitis exfoliativa, physical factors are of importance . In Melkersson-Rosenthal-syndrome, the active-T-lymphocytes and the lymphocytes with staphylococci antigene receptors are elevated in the peripheral blood.

J Antimicrob Chemother, 1983 Dec, 12(6), 587 - 97
Regulation of protein A biosynthesis in Staphylococcus aureus by certain antibiotics: its effect on phagocytosis by leukocytes; Gemmell CG et al.; Protein A, a component of the outer layer of the cell wall of Staphylococcus aureus impairs opsonization by serum complement and thereby delays phagocytosis by polymorphonuclear leukocytes . Two antibiotics with modes of action on bacterial protein biosynthesis, have been used at sub-growth inhibitory concentrations to regulate the production of protein A . Both clindamycin and fusidic acid (either at 1/2 or 1/4 MIC) reduced the amount of protein A on the cell surface . Such drug-grown cells became more susceptible to phagocytic uptake and killing . Chemiluminescence (CL) of PMN when presented with preopsonized drug-grown staphylococci was potentiated and correlated with the enhanced phagocytosis seen earlier . The level of CL appeared to depend upon the amount of human serum used to opsonize the bacteria . Reduced protein A content on the cell surface probably resulted in the exposure of a greater number of receptor sites for C3b, rendering the bacterium more susceptible to attachment and ingestion by the polymorphonuclear leukocyte.

Appl Environ Microbiol, 1983 Dec, 46(6), 1318 - 22
Comparison of Vogel-Johnson and Baird-Parker media for membrane filtration recovery of staphylococci in swimming pool water; Klapes NA; Previous studies have indicated that the coagulase-positive Staphylococcus (Staphylococcus aureus) has potential as a useful indicator of the infection hazard associated with the use of swimming pools and other recreational waters . However, before this indicator system can be used effectively, a recovery system that is sufficiently selective, accurate, and reliable for the enumeration of S . aureus must be developed . In this study, Vogel-Johnson (VJ) and Baird-Parker (BP) agars were compared for efficacy in the primary isolation and recovery of S . aureus from swimming pool water . For equal sample volumes of pool water containing adequate free chlorine residual, VJ agar was found to be more selective for staphylococcal species and less inhibitory to general cell growth than was BP agar . However, neither medium was found to be sufficiently differential to permit the accurate identification of S . aureus . In contrast, water samples obtained from a swimming pool containing very low levels of chlorine (none of which was in the free form) showed abundant growth of staphylococci on both test media, with both VJ and BP agars showing increased sensitivity for the detection of S . aureus . Thus, VJ and BP agars show increased sensitivity for the detection of coagulase-positive staphylococci from unchlorinated versus chlorinated waters.

J Infect Dis, 1983 Dec, 148(6), 1040 - 8
Human peritoneal macrophage cytotoxicity mediated by cytophilic IgG; Peterson PK et al.; Cells of the human mononuclear phagocyte system have recently been shown to possess cytophilic IgG molecules that promote phagocytosis of staphylococci bearing cell-wall protein A . In the present study, the possible mediation of a cytotoxic response to 51Cr-labeled sheep erythrocytes coated with protein A by cytophilic antibodies on human peritoneal macrophages was evaluated . The target cells were readily lysed by peritoneal macrophages . Cytotoxicity was blocked by pretreatment of macrophages with soluble protein or with anti-Fc F(ab')2 fragments . In contrast, cytotoxicity was not affected by cytochalasin B; this finding suggests that cytolysis is an extracellular event . Perturbation of cytophilic IgG with particle-bound protein A elicited a chemiluminescent response from peritoneal macrophages; however, experiments with scavengers of reactive oxygen species indicated that toxic oxygen radicals may not be required for cytotoxicity . The results indicate that cytophilic antibody-mediated cytotoxicity may contribute to cellular injury as well as host-defense aspects of the inflammatory process.

Infect Immun, 1983 Dec, 42(3), 1102 - 8
Tracheal function during influenza infections; Nugent KM et al.; Studies with animal models have demonstrated that viral respiratory tract infections suppress bacterial clearance processes in the lung and that this alteration in host defenses appears to explain the excessive mortality from bacterial pneumonia during influenza epidemics . However, since the pathogenesis of postinfluenza pneumonia and other pneumonias probably involves the aspiration of normal nasopharyngeal flora, injury to major airways associated with influenza infections could also contribute to the development of bacterial pneumonia by increasing bacterial deposition in the peripheral lung . We investigated this possibility by evaluating tracheal clearance processes and spontaneous changes in the tracheal flora in a murine model for acute influenza . During fine-particle aerosol exposures to Staphylococcus aureus, influenza-infected mice retained the same number of bacteria on their proximal tracheal surfaces as did control mice, and the relative adherence of the staphylococci to the trachea was similar in both groups of mice . However, the clearance of viable staphylococci from the trachea was significantly delayed in influenza-infected mice . Control and influenza-infected mice were also evaluated for changes in their normal tracheal flora . Mice with established influenza infections had more frequent spontaneous colonization with gram-negative bacteria, more bacterial isolates per animal, and higher bacterial concentrations in tracheal homogenates than control mice . These changes in tracheal flora were most pronounced on day 7 after virus inoculation and persisted after virus titers were undetectable, but eventually resolved by day 14 after virus infection . Tetracycline therapy started 2 days after virus inoculation prevented the increased colonization . This impaired clearance function and increased spontaneous colonization were associated with morphological evidence of mucosal regeneration . We conclude that spontaneous changes in tracheal flora occur during influenza infections, that these changes reflect, in part, impaired clearance functions, and that such changes could contribute to the development of pneumonia regardless of the clearance capacity of the lung parenchyma.

Infect Immun, 1983 Dec, 42(3), 1020 - 6
Detection of anti-teichoic acid immunoglobulin G antibodies in experimental Staphylococcus epidermidis endocarditis; West TE et al.; An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of rabbit immunoglobulin G (IgG) antibodies to purified cell wall teichoic acids from the Staphylococcus aureus Lafferty strain and three strains of coagulase-negative staphylococci . Significant immunological cross-reactivity occurred only between the teichoic acid of S . aureus and one coagulase-negative preparation . The ELISA was used to determine the serum IgG response to Staphylococcus epidermidis in a rabbit model of aortic valve endocarditis . Blood samples were drawn before inoculation and then every 5 days until death or sacrifice at 32 to 35 days postinoculation . Valve vegetations were culture positive at autopsy in 16 (59%) of the 27 catheterized rabbits . Antibody titers in this culture-positive group and the culture-negative group began to rise as early as day 6 . Although both groups demonstrated an antibody response, the culture-positive group attained a significantly higher titer on days 26 and 31 . Antibodies also rose in a control group of rabbits without a heart catheter but which were inoculated with bacteria . Again, the antibody titer was significantly less than that for the culture-positive group . This ELISA may be useful for the diagnosis of coagulase-negative staphylococcal infections in humans.

Onderstepoort J Vet Res, 1983 Dec, 50(4), 291 - 3
The application of numerical taxonomy in the classification of staphylococci from bovine milk; Erasmus JA; One-hundred-and-two isolates of staphylococci from bovine milk were each subjected to a battery of 19 different tests . With the application of numerical taxonomy these isolates could be classified into 1 genus and 3 different species . Although the majority of the coagulase negative organisms were grouped as 1 species, the biochemical differences within this group indicated that they should belong to at least 2 species . About 50% of these isolates could be designated Staphylococcus epidermidis . Possibly because of the small number of tests, a finer division into different species could not be made.

J Dairy Sci, 1983 Dec, 66(12), 2575 - 9
Cell content of goat milk: California mastitis test, Coulter counter , and fossomatic for predicting half infection; Poutrel B et al.; The mean cell count of goat milk collected in early and midlactation from udder halves free of infection was 1404 X 10(3) cells/ml and 614 X 10(3) cells/ml estimated by Coulter Counter and Fossomatic . Arithmetic means of cell count by Fossomatic method for samples within California Mastitis Test scores were similar to results from cow milk . Results by the three methods were closely correlated .7 . Means of cell counts were 2858 X 10(3) cells/ml and 1293 X 10(3) cells/ml by Coulter Counter and Fossomatic methods for udder halves harboring coagulase-negative staphylococci and 8946 X 10(3) cells/ml and 4804 X 10(3) cells/ml for halves infected by major pathogens . Of the thresholds examined, 1000 X 10(3) cells/ml was most satisfactory for both Coulter Counter and Fossomatic methods, because it detected about 80% of major infections and gave an acceptable proportion of errors.

Eur J Clin Microbiol, 1983 Dec, 2(6), 581 - 7
Rapid and direct detection of herpes simplex virus and varicella-zoster virus antigens in clinical specimens by staphylococcal reagent and membrane filtration; Dishon T et al.; Herpes simplex virus was detected rapidly and directly in 31 and varicella-zoster virus in two of 50 clinical specimens using specific antisera, stabilized staphylococci rich in protein A and membrane filtration . Microscopical examination of the cells retained on the filter membrane revealed attached staphylococci only on cells harbouring viral antigens but not on non-infected cells or cells from healthy donors . Infected cells treated with negative control sera and stabilized staphylococci and subsequently subjected to membrane filtration were also devoid of the marker . It was also possible to detect herpes simplex virus antigens in three specimens which were culture negative . Similar results were obtained with staphylococci specifically sensitized with anti-herpes simplex rabbit serum . No interfering, non-specific background of unattached staphylococci was observed on the filter membrane . The results were confirmed by the direct immunofluorescent test . The method is sensitive, specific, and provides results within 3 h . It could be employed for the rapid screening of populations at risk, e.g . pregnant women, medical personnel, and societies with a growing incidence of genital herpes . Since no special, expensive equipment is required, the method is also suitable for modestly equipped clinical laboratories.

S Afr Med J, 1983 Nov 19, 64(22), 865 - 7
{The use of a chlorhexidine-alcohol mixture as a hand rinse in a neonatal department}; Maarschalk T; Regular handwashing is considered to be a most important measure in the prevention of nosocomial infection . However, for practical reasons routine handwashing, before and after handling babies, is not strictly adhered to in the maternity nursery . As an alternative, more readily performed measure, regular handrinsing with an alcoholic chlorhexidine solution has been introduced . The results of a small study (performed as a student project), to evaluate the efficacy thereof in reducing the number of bacteria on the hands of nurses working in the nursery, are presented . Before and during use specimens were obtained from 10 nurses' hands using a sterile glove technique . The repeated use of the 0,5% chlorhexidine in 95% alcohol hand rinse was associated with significant short-term and long-term decreases in the number of Gram-negative and Gram-positive bacilli and staphylococci cultured from hands.

Presse Med, 1983 Nov 17, 12(41), 2595 - 602
{Replacement therapy with immunoglobulins in neonatology}; de Muralt G et al.; Eighty-two neonates suffering from widespread infection detected at an early stage were treated either with antibiotics alone or with antibiotics combined with immunoglobulins administered intravenously . In 35 children, haemocultures demonstrated septicaemia due to E . coli, Klebsiella spp., staphylococci or anaerobes . Following a 6 days' treatment with immunoglobulins i.v . (0.5 g/day in prematures and 1.0 g/day in children born at term) serum IgG levels were considerably increased . Already in children born in the 28 th week of gestation IgG levels were similar to those of children born at term . This increase in serum IgG's resulted in a 26% to 10% (p = 0.16) overall fall in death rate . In prematures, the death rate, which was 44% in children who had not received IgG's, fell to 8% . In 47 neonates without septicaemia the death rate was 15% without, and 10% with IgG . Immunoglobulin infusions were well tolerated . Clinical and immunological investigations performed between the ages of 1 and 4 years showed no difference in growth rate, psychomotor development, susceptibility to infections and immune functions between children who had received immunoglobulin during the neonatal period and those who had not . After intravenous administration of immunoglobulins in high doses (12 g/24 h) to mothers 1 to 3 weeks before premature delivery (33 rd to 35 th week of gestation rise in serum IgG levels was observed in either mothers or children . Higher i.v . doses (120 g over 5 days) given between the 27 th and 32 nd weeks of gestation resulted in an increase of serum IgG levels in mothers but had no influence on serum IgG levels in their children.

Res Vet Sci, 1983 Nov, 35(3), 310 - 7
Generation of neutrophil chemoattractants by phagocytosing bovine mammary macrophages; Craven N; Macrophages from bovine mammary gland were cultured in vitro and the growth medium collected at intervals . Using an in vitro system in which neutrophils migrated under agarose, both chemotactic and chemokinetic activity for bovine neutrophils was detected in supernatants of macrophage cultures to which heat killed preopsonised Staphylococcus aureus had been added . The suspensions of killed bacteria were not themselves chemotactic for neutrophils and no chemotactic activity was present either in supernatants from unstimulated macrophage cultures or in sonicated macrophages . The chemotaxin(s) was generated within two hours of the addition of staphylococci to the cultures and was largely stable to heating at 56 degrees C for 45 minutes, although its activity was reduced by boiling for 15 minutes . Traces of proteolytic activity were also detected in some supernatants . Substantial proteolytic activity was found in lysates of neutrophils . Unlike chemotaxis, proteolytic activity was suppressed by addition of milk from early lactation and containing high natural levels of protease inhibitors . Proteolytic activity was destroyed by boiling for 15 minutes.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Nov, 256(1), 7 - 24
Numerical taxonomy of staphylococci; Goodfellow M et al.; Over two hundred staphylococci from human and animal sources and representatives of established species of Staphylococcus, Micrococcus and Planococcus were compared in a numerical phenetic survey using 115 unit characters . Data were analyzed using the Jaccard coefficient and the unweighted pair group method with averages algorithm . Cluster composition was not markedly affected by test error, estimated as 3.49% . The staphylococci were assigned to eighteen clusters containing four or more strains and to three single member clusters . Most of the clusters were distinct and homogeneous though two were divided into subclusters . Some of the clusters and subclusters were equated with the established taxa S . aureus, S . capitis, S . cohnii, S . epidermidis, S . haemolyticus, S . hominis, S . hyicus, S . saprophyticus, S . sciuri subspecies lentus, S . sciuri subspecies sciuri, S . simulans, S . warneri and S . xylosus, the remaining ones may represent the nuclei of additional centres of variation . The numerical data also cast doubts upon the reliability of some of the tests recommended for the identification of coagulase-negative staphylococci.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Nov, 256(1), 25 - 36
Cell wall analysis and taxonomy of staphylococci; Schumacher-Perdreau F et al.; 50 representative staphylococcal strains were selected from 18 clusters of a previous numerical taxonomy study (2) . The types of peptidoglycan and teichoic acid were investigated in these strains . The results of this cell wall analysis were compared with the data of the numerical taxonomy study (2) and the Kloos and Schleifer-classification system.

J Dairy Sci, 1983 Nov, 66(11), 2426 - 33
Effect of parity, stage of lactation, and intramammary infection on concentration of somatic cells and cytoplasmic particles in goat milk; Dulin AM et al.; Aseptic foremilk samples (about 15 ml) were collected biweekly for four samplings and then monthly throughout lactation from 35 does in three herds on Dairy Herd Improvement test . Bacteriology, direct microscopic somatic cell counts, and cytospin differential cell counts were performed on all samples . Milk yield was obtained from monthly Dairy Herd Improvement records . Thirty-nine percent of udder halves were infected, and coagulase negative staphylococci were the most frequent isolates (201 of 205) . Somatic cell counts were influenced by lactation number, stage of lactation, and intramammary infection . Also, infection of one udder half increased somatic cells in the corresponding uninfected mammary half of the same animal . Cytoplasmic particles were not affected by stage of lactation or by intramammary infection but were greater for goats in first lactation . Milk yield was influenced by lactation number, stage of lactation, and intramammary infection.

Pediatr Res, 1983 Nov, 17(11), 916 - 9
Activity of antibiotics in chronic granulomatous disease leukocytes; Jacobs RF et al.; Patients with chronic granulomatous disease (CGD) have recurrent infections with catalase-producing organisms, particularly staphylococci, that survive within their leukocytes . To be most effective, antibiotics used to treat infections in CGD patients may need to kill both intracellular and extracellular organisms . We studied the ability of certain antibiotics to penetrate normal and CGD neutrophils and to kill intracellular staphylococci . Trimethoprim and clindamycin were concentrated in normal and in CGD neutrophils; maximum cellular-to-extracellular concentration ratios of clindamycin and of trimethoprim were approximately 30 and approximately 4, respectively . In contrast, penicillin was excluded from normal neutrophils . Clindamycin, trimethoprim/sulfamethoxazole, rifampin, and trimethoprim/rifampin significantly reduced the number of viable intracellular staphylococci in normal and CGD neutrophils . After 24 h of incubation in the presence of these antibiotics, the number of viable intracellular staphylococci in normal and CGD neutrophils was similar . In contrast, dicloxacillin, gentamicin, and cephalothin had no significant effect on the number of intracellular staphylococci in normal or CGD neutrophils.

J Med Microbiol, 1983 Nov, 16(4), 483 - 95
Identification of staphylococci by pyrolysis gas-liquid chromatography; Magee JT et al.; The identification of bacteria by pyrolysis gas-liquid chromatography (PGLC) was evaluated with the genus Staphylococcus . A matrix containing the characteristics of seven species of Staphylococcus was constructed from the results obtained with 42 named strains identified by biochemical methods . An identification program based upon this database was evaluated in tests with 100 isolates of catalase-positive oxidase-negative gram-positive cocci identified by biochemical and PGLC systems . Agreement between the two systems was 90% . Pure cultures of unknown isolates were identified within 30 min by PGLC using a microcomputer data acquisition and analysis program . A taxonomic analysis of the data is presented, and methods for quality control of PGLC, prolongation of column life, and data analysis are described and discussed.

J Clin Microbiol, 1983 Nov, 18(5), 1212 - 9
Identification of Staphylococcus species of bovine origin with the API Staph-Ident system; Langlois BE et al.; The API Staph-Ident system was evaluated as a means for identifying the species of bovine strains of staphylococci routinely isolated from quarter-milk samples . The species identity of 314 of 581 (54%) isolates of staphylococci was correctly determined by this method . The API Staph-Ident system was more accurate in correctly identifying Staphylococcus aureus (93.9%) than in correctly identifying non-S . aureus species (41.8%) . False identifications of Staphylococcus epidermidis and Staphylococcus hominis were the main reasons for the incorrect identifications of the non-S . aureus species.

J Clin Microbiol, 1983 Nov, 18(5), 1098 - 101
Differentiation of staphylococci on the basis of nuclease properties; Gudding R; The quantity, thermostability, and serological pattern of nucleases produced by different staphylococci were studied . Staphylococcal strains were isolated from nine different species of animals or from humans . Staphylococcus aureus, Staphylococcus intermedius, and Staphylococcus hyicus subsp . hyicus were vigorous producers of nuclease, whereas the coagulase-negative staphylococci, except S . hyicus subsp . hyicus, produced significantly less nuclease . The nucleases of all strains were found to be thermostable . S . aureus, S . intermedius, and S . hyicus subsp . hyicus could be distinguished from each other and from coagulase-negative staphylococci on the basis of inhibition of nuclease activity by specific antibodies.

J Clin Microbiol, 1983 Nov, 18(5), 1061 - 3
Colonization of bacteria on polyvinyl chloride and Teflon intravascular catheters in hospitalized patients; Sheth NK et al.; During an 8-month period all intravascular catheters were removed by sterile technique upon completion of use and submitted to the hospital microbiology laboratory . All catheters were routinely cultured by the semiquantitative culture technique, with greater than or equal to 15 colonies being defined as a positive result . Of the 687 Teflon catheters cultured, 6.9% were positive by culture, compared with 24.6% of 77 polyvinyl chloride catheters (P less than 0.001) . Also, colonization of coagulase-negative staphylococci on polyvinyl chloride was more than on Teflon . These data suggest that polyvinyl chloride catheters are colonized more frequently with organisms than are Teflon catheters; additionally, there is an increased affinity of coagulase-negative staphylococci for polyvinyl chloride as compared with Teflon, substantiating our previous observations with an in vitro system . We conclude that the type of catheter material may be important in determining the incidence of catheter-related infections and in selective colonization by coagulase-negative staphylococci.

J Clin Microbiol, 1983 Nov, 18(5), 1205 - 11
Detection of oxacillin-resistant staphylococci by the AutoMicrobic system; Stotler RW et al.; The AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) is an automated instrument designed for rapid microbiological identification and susceptibility reporting in the clinical laboratory . The reliability of a rapid, automated approach to testing methicillin-resistant staphylococci was evaluated . To determine the accuracy in detecting oxacillin-methicillin resistance by the AutoMicrobic system, 746 staphylococci from seven different geographical areas were tested . Results were compared with the Bauer-Kirby agar disk diffusion technique as the reference method . Of the 304 staphylococci, 209 coagulase-positive and 95 coagulase-negative strains were resistant to oxacillin-methicillin . These organisms fell into three categories of resistance detection . The first category had resistance levels high enough for initial detection, the second category had low resistance levels requiring modified data analysis techniques for detection, and the third category had resistance levels too low for detection . Of the resistant strains tested, 21% showed a category two resistant growth pattern . Major errors, as a result of hetero-resistant growth patterns of the tested strains, were resolved by computer analysis of growth curves . These data analysis applications enabled detection of 96% of the oxacillin-methicillin-resistant organisms . Results for all resistant staphylococci tested were available in an average time of 5.5 h.

Pediatr Infect Dis, 1983 Nov-Dec, 2(6), 426 - 31
Septicemia due to coagulase-negative staphylococci in a neonatal intensive care unit: clinical and bacteriological features and contaminated parenteral fluids as a source of sepsis; Fleer A et al.; During the years 1979 to 1981 we experienced an increasing incidence of septicemia due to coagulase-negative staphylococci in the neonatal intensive care unit (NICU) . A detailed analysis was performed for the 1981 NICU population . More than 90% of cases occurred in premature infants of low birth weight (less than 2500 g) . All septicemic infants were receiving intravenous therapy and total parenteral nutrition (TPN) solutions had been administered to nearly 80% just before or during the septic episode . A case-control study performed for the 1981 NICU population, which included 26 proved cases of coagulase-negative staphylococcal septicemia and 26 matched controls, did not uncover any differences in underlying diseases or modes of treatment between cases and controls . However, the infusion of contaminated TPN fluids was identified as a significant risk factor . Random bacteriological checks of TPN fluids revealed that nearly 20% of these solutions were contaminated, mainly with coagulase-negative staphylococci . The incidence of staphylococcal septicemia in infants who had received contaminated TPN fluids was 10-fold higher than in infants who had received sterile solutions (P less than 0.0005) . The majority of coagulase-negative staphylococci isolated from the blood cultures from the NICU were multiply resistant to antibiotics although all isolates were susceptible to cephalothin . Treatment, consisting of removal or replacement of the intravenous devices and the administration of cephalothin and fresh plasma, was universally successful.

Infect Immun, 1983 Nov, 42(2), 628 - 33
Binding of fibronectin to Staphylococcus strains; Switalski LM et al.; Fibronectin, a major protein component of plasma and loose connective tissue has previously been shown to bind to several strains of Staphylococcus aureus . We examined a large number of strains of different species of Staphylococcus with respect to their ability to bind fibronectin . The relative numbers of strains defined as fibronectin-binders among the different species were as follows: S . aureus (22 of 23), S . haemolyticus (5 of 5), S . warneri (8 of 11), S . hyicus (5 of 6), S . hominis (13 of 17), S . saprophyticus (11 of 20), S . epidermidis (4 of 7), and S . simulans (8 of 10) . Only three species showed a predominance of nonbinders over binders: S . capitis (4 of 14), S . xylosus (0 of 4), and S . cohnii (3 of 11) . These data indicate that staphylococcal species isolated from soft tissue infections frequently have the ability to bind fibronectin and suggest that the ability to bind to this protein may contribute to the virulence of coagulase-positive and coagulase-negative staphylococci.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Nov, (11), 13 - 6
{Phage typing of the coagulase-positive staphylococci isolated from various species of animals}; Samsonova TM et al.; More than 200 coagulase-positive strains of animal origin have been studied by means of Staphylococcus aureus typing phages, belonging to two international sets and intended for typing staphylococci isolated from large cattle and humans, and experimental "chicken" phage A 1591 . Among S . aureus strains the cultures isolated from swine, cows, chickens, and belonging to biotypes B1, C1, B2, respectively, have been mostly (in 78.5-90.0% of cases) determined by phage typing . The strains belonging to one biotype have proved to be sensitive predominantly to the same phages . In this connection further differentiation of staphylococci within individual biotypes by means of the phages used in these experiments seems to be impracticable . S . intermedius strains have been found to be completely resistant to the above phages, which confirms that S . intermedius is rightly considered to be an independent species of coagulase-positive staphylococci.

Vet Microbiol, 1983 Oct, 8(5), 459 - 68
Isolation of enterotoxigenic strains of staphylococci from dogs; Adesiyun AA et al.; The ability of 309 staphylococcal isolates from household dogs to produce enterotoxin, coagulase, thermonuclease and hemolysin was investigated . A total of 52 (16.8%) isolates from 45 out of 150 dogs examined were enterotoxigenic when tested for enterotoxin types A, B and C . Based on sites sampled, 33 (20.5%) out of 161 isolates from the anterior nares were enterotoxigenic while from dorsal skins 19 (12.8%) out of 148 isolates were enterotoxigenic . Staphylococcal enterotoxin C(SEC) was predominantly produced as 21 (6.8%) isolates elaborated it and also accounted for 40.4% of all enterotoxins produced by isolates . Staphylococcal enterotoxins A(SEA) and B(SEB) were produced by 10 (3.2%) and 16 (5.2%) strains, respectively . Mixed enterotoxin types AB, AC and BC were produced by 1,3 and 1 strains, respectively . With human plasma, 17.1% of coagulase-positive and 15.0% of coagulase-negative strains were enterotoxigenic . However, using canine plasma, 19.1% and 6.9% of the coagulase-positive and negative isolates, respectively, were enterotoxigenic . The incidence of enterotoxigenicity was 16.9% amongst thermonuclease-positive isolates and 16.3% for thermonuclease-negative strains . Alpha hemolysin was predominantly produced by 180 (60.2%) isolates and 19.9% of these were enterotoxigenic . Beta hemolysin was produced by 36 (11.7%) isolates with 13.9% enterotoxigenic, while 87 (28.2%) exhibited gamma hemolytic pattern amongst which 11.5% were enterotoxigenic . Based on data provided on coagulation of human and canine plasmas and hemolytic patterns, it is concluded that a large proportion of canine isolates from this environment are not of canine biotypes, but are most probably human biotypes.

J Hyg (Lond), 1983 Oct, 91(2), 211 - 22
Evaluation and use of the drug inhibition method of measuring intracellular killing in differentiating between staphylococci grown in vivo and in vitro; Kolawole DO; A Staphylococcus aureus strain grown once in vivo in rabbit pleural cavities was appreciably more resistant to killing by soluble polymorph bactericidins than its broth-grown counterpart . Parallel results were obtained using an adaptation of Solberg's drug-inhibition method of measuring intracellular killing after critical aspects of it had been evaluated and modified . Individual in vivo grown organisms were surrounded by a layer of less dense material which was not capsular in nature but which made the organisms clump together . This surface coating was lost on subculture in vitro, resulting in a reversion to broth-like susceptibility, thus indicating that the surface coating was largely responsible for the enhanced resistance and that it resulted from interactions between staphylococci and components of the rabbits' natural body fluids . Consequently, growth in plasma produced organisms which mimicked in vivo grown organisms in clumping, surface coating and in resistance to killing . The use of plasma-grown staphylococci in further studies of likely resistance mechanisms in vivo is discussed.

Am J Vet Res, 1983 Oct, 44(10), 1856 - 60
Effect of the intramammary device on milk infection status, yield, and somatic cell count and on the morphological features of the lactiferous sinus of the bovine udder; Huston GE et al.; Twenty primiparous heifers were fitted intramammarily with polyethylene coils in both quarters of one random right or left udder half at 5 days after parturition . Foremilk samples were collected and udder-half milk yields were measured at the afternoon milking on days - 1, 3, 7, and 14 and on every 14th day for 8 months after the device was inserted . Three weeks after the heifers were fitted with the intramammary device, 6 were euthanatized for gross observation of devices and tissues and cytologic evaluation of the gland cistern epithelium . There were significantly fewer bacterial isolations (P less than 0.01) and less clinical mastitis (P less than 0.05) in treated quarters than in the control quarters . Coagulase-negative staphylococci were isolated at frequencies of 0 and 15.2% for treated and control quarters . The reduction in isolation frequency for treated, compared with control, quarters was less marked with other organisms . Intramammary devices in no way interfered with the milking process . Milk yields per milking were 4.2 kg for treated udder halves compared with 4.4 kg for control halves; however, this 0.2 kg difference was not significant . Mean milk somatic cell counts, as determined by electronic counter, were 34 X 10(3) and 81 X 10(3) cells/ml for control and treated quarters (P less than 0.05) . Mean bovine serum albumin values were 0.160 and 0.175 mg/ml for control and treated udder halves (P less than 0.05), indicating an increased capillary permeability due to the device . Quantitative morphologic analysis of gland cisterns showed a significant (P less than 0.05) change toward a single layer of epithelial cells in treated quarters compared with a double layer in control quarters.(ABSTRACT TRUNCATED AT 250 WORDS)

J Clin Microbiol, 1983 Oct, 18(4), 789 - 92
Characterization of coagulase-positive Staphylococcus intermedius and Staphylococcus aureus isolated from veterinary clinical specimens; Raus J et al.; Staphylococci were the most frequent isolates from clinical specimens submitted from a large referral and teaching veterinary hospital . In this study a total of 160 isolates were examined by a wide range of biochemical tests and modifications of basic procedures . An attempt was made to test the validity of these procedures for use in characterization of clinical isolates of coagulase-positive staphylococci . Of the isolates examined, some 27 were Staphylococcus aureus, 115 were Staphylococcus intermedius, and the rest were coagulase-negative staphylococci and were not characterized further . The most useful discriminatory tests were acid production from maltose incubated overnight on maltose purple agar (W . E . Kloos and K . H . Schleifer, J . Clin . Microbiol., 1:82-88, 1975), acetoin production detected by the Barritt method, and detection of hyaluronidase activity . These gave accurate and fast results . Supplemented with the tellurite reduction test and the direct staphylocoagulase assay using Chromozym TH (Engels et al.; J . Clin . Microbiol . 14:496-500, 1981), these tests should eliminate the possibility of false identifications of these two species.

J Am Diet Assoc, 1983 Oct, 83(4), 430 - 5
Slow cooker vs . oven preparation of meat loaves and chicken; Peters CR et al.; Meat loaves and chickens prepared by recommended methods for a slow electric cooker were not in the hazardous temperature zone long enough to allow appreciable growth of bacteria that might cause food-borne illness . Total plate counts were reduced to a greater extent than they were when meat loaves and chickens were prepared by conventional methods in a gas oven . Presumptive coliforms, C . perfringens, and coagulase positive staphylococci were not detected after either method of cooking . Other parameters of quality indicated that conventional methods of baking meat loaves and roasting chickens were superior to preparation in a slow electric cooker . Drip losses were significantly greater, as were total cooking losses (except for total losses for chickens in Experiment 2), when a slow electric cooker was used . All mean palatability scores except for interior color in meat loaves and tenderness in chickens were significantly higher after preparation in an oven . Significantly more thiamin was retained in oven-cooked meat loaves and chickens.

Jpn J Antibiot, 1983 Oct, 36(10), 2683 - 7
{Clinical studies of cefotiam in otorhinolaryngologic infections}; Satake K et al.; Cefotiam (CTM) was intravenously or intramuscularly given to 14 patients with infections in the field of otorhinolaryngology including 5 cases with chronic suppurative otitis media . Daily doses of CTM were 1 to 3 g and its administration period was 3 to 10 days . Clinical responses were excellent in 1 patient, good in 8, fair in 2 and poor in 3, the rate of satisfactory clinical responses (excellent and good) being 64.3% (9/14) . Staphylococci were most frequently isolated from the clinical materials . As for side effects, elevation of GOT and GPT was observed in 1 patient.

J Antimicrob Chemother, 1983 Oct, 12 Suppl C, 75 - 83
Influence of clindamycin on fibronectin-staphylococcal interactions; Doran JE et al.; This report examines the effects of subinhibitory concentrations of of clindamycin on fibronectin-staphylococcal interactions . Using in-vitro binding assays, exposure of staphylococci to subinhibitory concentrations of clindamycin results in a dose-dependent decrease in fibronectin's ability to bind to treated organisms . Concomitant with decreased fibronectin binding is a decreased ability for fibronectin to mediate the phagocytosis of treated organisms by human polymorphonuclear leukocytes . Serum-mediated phagocytosis of clindamycin-treated organisms remained effective despite the reduction in fibronectin binding capabilities . These results suggest that the clinical use of clindamycin has the potential to affect bacterial binding of fibronectin, thus modifying the adherence of organisms to host surfaces without adversely effecting their clearance by the reticuloendothelial system.

Sem Hop, 1983 Sep 29, 59(34), 2389 - 92
{In vitro comparison of the antibacterial activity of 1st, 2d, and 3d generation cephalosporins}; Messmer JC et al.; The purpose of this study is to compare the effect of first, second and third generation cephalosporins on bacterial strains . 1 920 strains are analyzed . Results establish that Cefalotin remains valuable against Gram positive pathogens, especially staphylococci . Lamoxactam is the most potent cephalosporin against Gram-negative bacteria.

Minerva Med, 1983 Sep 15, 74(35), 2047 - 9
{Behavior of staphylococci of the nasal cavity in subjects exposed to hyperbaric oxygen}; Ulewicz K et al.; A careful qualitative and quantitative study revealed a significant decrease in bacterial, and especially staphylococcal, cultures from nasal swabs 24 hr after exposure to oxygen at 2.5 atm for 30', followed by a gradual return to initial values after a further four days . It is felt that this picture was ascribable to the influence of hyperbaric O2 on the microorganisms and their metabolism, and on the body's defence mechanisms.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1983 Sep, 177(6), 527 - 32
Microbial colonization of prosthetic devices . V . attachment of coagulase-negative staphylococci and "slime"-production on chemically pure synthetic polymers; Ludwicka A et al.; On 12 different, chemically pure polymers attachment and "slime"-production of the coagulase-negative staphylococcal strain KH 11 were studied . According to their behaviour the polymers investigated could be arranged into three groups: Group 1 with good attachment of staphylococci, but missing "slime"-production; group 2 with good attachment and moderate "slime"-production; group 3 with both properties strongly developed . According to the results presented, attachment of staphylococci and "slime"-production seem to be independent of the presence of organic additives in biomaterials.

Arch Microbiol, 1983 Sep, 135(3), 215 - 23
Chemical composition and structure of cell wall teichoic acids of staphylococci; Endl J et al.; The cell wall teichoic acid structures of 22 staphylococci including 13 type strains were determined . Most of the strains contain a poly(polyolphosphate) teichoic acid with glycerol and/or ribitol as polyol component . The polyolphosphate backbone is partially substituted with various combinations of sugars and/or amino sugars . Most of the substituents occur in a monomeric form but some strains also contain dimers of N-acetylglucosamine as substituents . Staphylococcus hyicus subsp . hyicus NCTC 10350 and S . sciuri DSM 20352 revealed rather complex cell wall teichoic acids . They consist of repeating sequences of phosphate-glycerol-phosphate-N-acetylglucosamine . The amino sugar component is present in this case as a monomer or an oligomer (n less than or equal to 3) . Moreover, the glycerol residues are partially substituted with N-acetylglucosamine . The cell wall teichoic acid of S . auricularis is a poly(N-acetylglucosaminyl-phosphate) polymer similar to that found in S . caseolyticus ATCC29750 . The cell wall teichoic acid structures for type strains of S . auricularis, S . capitis, S . cohnii, S . haemolyticus, S . hominis, S . hyicus subsp . hyicus, S . sciuri, S . xylosus and S . warneri were determined for the first time in detail . The structures of some of the previously described teichoic acids had to be revised (S . epidermidis, S . simulans, S . aureus phage type 187).

Appl Environ Microbiol, 1983 Sep, 46(3), 649 - 60
Characterization of staphylococci; Hoover DG et al.; A total of 158 Staphylococcus strains from various sources were characterized by biochemical, physiological, and morphological tests . Numerical taxonomy was applied by using these features . Taxonomic analysis was done with programs run under the MVS-TSO system of the IBM 370 complex and PDP-10 system of the National Institutes of Health . DNA-DNA hybridization with nitrocellulose filters was done to compare selected atypical cultures with American Type Culture Collection reference strains . We found that the use of the nomenclature of Bergey's Manual (8th edition) to identify these strains by species was not adequate . DNA homology values supported the formation of Staphylococcus hyicus subsp . hyicus separate from Staphylococcus aureus, Staphylococcus epidermidis, and Staphylococcus saprophyticus . The three tests that best separated these strains into four species were (i) tube coagulase (6-h or 24-h porcine plasma or 24-h Difco rabbit plasma), (ii) production of acetoin or acid aerobically from ribose, maltose, or trehalose, and (iii) growth in the presence of novobiocin . Four strains of S . hyicus subsp . hyicus (VII76, VII113, VII131, and VA519) gave typical enterotoxigenic responses in monkey-feeding tests but were negative for enterotoxins A through E, suggesting the presence of one or more new enterotoxins . Two coagulase-negative, heat-stable DNase-positive strains (D143 and ARM) could not be classified by either DNA-DNA hybridization or numerical taxonomy, and D143 was enterotoxigenic as measured by the monkey-feeding bioassay . DNA homology showed that strain FRI-698M was more closely related to S . epidermidis than to S . aureus, yet it produced enterotoxin D . These data suggest the occurrence of coagulase-negative enterotoxigenic strains that are not S . aureus; nonetheless, a positive tube coagulase test and heat-stable DNase test should together be useful for routine screening of most potentially enterotoxigenic staphylococci in foods.

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