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. A