Antimicrob Agents Chemother, 1983 Sep, 24(3), 413 - 7 Clindamycin enhances opsonization of Staphylococcus aureus; Milatovic D et al.; Staphylococcus aureus 502A was grown in the presence of one-third of the minimal inhibitory concentration of clindamycin . Phagocytosis of the antibiotic-treated bacteria by human polymorphonuclear leukocytes was significantly enhanced, compared with that of the untreated control (P less than 0.001) . Study of opsonization kinetics by a chemiluminescence assay demonstrated that clindamycin-treated staphylococci were opsonized more rapidly than control bacteria and that the serum concentration required for sufficient opsonization was lower . Complement was consumed much faster, and the opsonic fragment C3b was fixed more rapidly to the bacterial surface when the staphylococci were preincubated with clindamycin . Electron micrographs showed an alteration of the staphylococcal cell wall after clindamycin treatment. Anaesthesist, 1983 Sep, 32(9), 445 - 9 {The anesthetist and operating room hygiene}; Ohgke H et al.; Environmental contamination with bacteria in the course of extubation was shown to be minimal as compared to contamination of the hands and gowns . 7 out of 21 anaesthesiologists were carriers of staphylococcus aureus . Two persons spread staphylococci to their patients and the operating room environment in spite of strict adherence to conventional hygienic policies. Zh Mikrobiol Epidemiol Immunobiol, 1983 Sep, (9), 37 - 40 {Species characteristics of coagulase-negative staphylococci of animal origin}; Akatov AK et al.; The specific identification of 271 strains of coagulase-negative staphylococci isolated from different animals (cows, sheep, swine, hens, monkeys, minks, sables, foxes, etc.) was carried out according to the scheme of Akatov--Devriese . Species could be determined in 77.5% of the strains . The representatives of S . sciuri (55.5%) and S . xylosus (11.4%), very seldom occurring in humans, prevailed among the identified cultures . In 31.4% of coagulase-negative strains of animal origin the presence of protein A was established . The study of the time of glucose fermentation in the cultures and the type of colonies formed on agar with crystalline violet permitted the additional characterization of the majority of the strains of coagulase-negative staphylococci . Only in 4.8% of cases the strains under study could be lyzed by typing phages Holmberg and belonged to 6 phage types; of these, 117 A was the most numerous one (7 out of 13 typed cultures) . No relationship between the phage type and the species of the strains was established. J Gen Microbiol, 1983 Sep, 129 (Pt 9), 2959 - 68 Adhesion of coagulase-negative staphylococci to biomaterials; Hogt AH et al.; The adhesion of two Staphylococcus epidermidis strains and one Staphylococcus saprophyticus strain on to poly(tetrafluorethylene-co-hexafluorpropylene) (FEP)-fluorocarbon and cellulose acetate was studied in vitro . Both S . epidermidis strains showed a more hydrophobic character than the encapsulated S . saprophyticus as determined by the bacterial affinity towards xylene . Staphylococcus epidermidis showed a significantly higher adhesion on to the hydrophobic FEP than S . saprophyticus . The adhesion of staphylococci on to the more hydrophilic cellulose acetate was always low . Treatment of S . epidermidis with pepsin or extraction with aqueous phenol yielded cells with a decreased hydrophobicity, which resulted in a decreased adhesion on to FEP . Cells with a decreased hydrophobicity showed a lower rate of reaggregation in suspension . The hydrophobicity and the adhesion on the FEP of S . epidermidis were not affected by exposure to a subminimal inhibitory concentration of penicillin . The strong interaction between S . epidermidis and FEP, which appeared not to be influenced by the age or the metabolic stage of the bacteria, is mainly caused by hydrophobic bonding. J Clin Microbiol, 1983 Sep, 18(3), 722 - 4 Rapid identification of Staphylococcus aureus in blood cultures by thermonuclease testing; Madison BM et al.; The detection of thermonuclease activity in 86 blood culture samples containing gram-positive cocci showed 100% correlation with the subsequent identification of the isolate as Staphylococcus aureus by the coagulase test . No positive thermonuclease results were found with 66 samples containing coagulase-negative staphylococci and 56 samples containing other gram-positive organisms . The thermonuclease test provides a rapid, reliable method to identify S . aureus in blood cultures. J Clin Microbiol, 1983 Sep, 18(3), 592 - 5 Effect of different media on determination of novobiocin resistance for differentiation of coagulase-negative staphylococci; Goldstein J et al.; Species identification of coagulase-negative staphylococci often requires the determination of novobiocin susceptibility . Although previous investigators have recommended the use of P agar for this purpose, most clinical laboratories do not routinely utilize this medium . For this reason, studies were performed to compare novobiocin susceptibility results obtained with 11 different species of staphylococci (10 isolates of each species), using P agar, Trypticase soy agar with 5% sheep blood, and Mueller-Hinton agar . Tests performed on 70 susceptible isolates (minimal inhibitory concentration less than 1.6 micrograms/ml) resulted in zones of inhibition around 5-micrograms novobiocin disks ranging from 19.6 to 33.9, 16.2 to 26.6, and 21.3 to 36.4 mm on P agar, Trypticase soy agar with 5% sheep blood, and Mueller-Hinton agar, respectively . Forty resistant isolates (minimal inhibitory concentration greater than or equal to 1.6 micrograms/ml) exhibited zones of inhibition ranging from 6.0 to 11.3 mm on P agar, 6.0 to 11.6 mm on Trypticase soy agar with 5% sheep blood, and 6.0 to 13.5 mm on Mueller-Hinton agar . Using the established cut off of 16 mm to define novobiocin resistance for the identification of coagulase-negative staphylococci, we correctly identified 100% of the strains tested, regardless of the media utilized. J Clin Microbiol, 1983 Sep, 18(3), 719 - 21 Differentiation of Staphylococcus and Micrococcus spp . with the Taxo A bacitracin disk; Falk D et al.; Taxo A bacitracin disks (BBL Microbiology Systems, Cockeysville, Md.) were evaluated as a test for differentiating staphylococci from micrococci in clinical laboratories . All staphylococci tested were resistant to the disks, with no zone of growth inhibition . Zones of growth inhibition ranging from 10.5 to 25.0 mm in diameter were observed with all micrococci except two isolates which failed to grow on the test medium . These findings were confirmed by minimal inhibitory concentrations to bacitracin . Staphylococci had minimal inhibitory concentrations significantly higher than those of micrococci, with no overlap in the ranges of values. Am J Dis Child, 1983 Sep, 137(9), 899 - 901 Exfoliative dermatitis in an infant . Association with enterotoxin F-producing staphylococci; Chesney PJ et al.; A 2-month-old premature infant had an extensive exfoliative dermatitis with flaccid bullae, mucous membrane involvement, thrombocytopenia, and an elevated creatinine kinase level . A subepidermal cleavage plane with numerous necrotic epidermal cells and a polymorphonuclear cell infiltrate were present on a skin biopsy specimen . The isolates of Staphylococcus aureus obtained at the onset of her disease had a 29/52 bacteriophage lysis pattern and produced enterotoxins C and F and epidermal toxin, but no exfolliatins . In toxic shock syndrome (TSS), subepidermal blister formation has been described and a new toxin, epidermal toxin, which causes subepidermal cleavage in the newborn mouse model, has been identified . In some infants, exfoliative dermatitis may be a variant of the well-described TSS in older children and adults. Am J Med, 1983 Aug 29, 75(2A), 4 - 8 Rationale for use of antimicrobial combinations; Moellering RC Jr; In most cases antimicrobial combinations are employed to broaden the spectrum of coverage . This clinical application is likely to be successful as long as the combinations are not antagonistic . Most examples of antibiotic antagonism are those in which a bacteriostatic agent renders a bactericidal agent "static." Another type of antagonism occurs when cefoxitin (which has a propensity to induce beta-lactamase production) is combined with another beta-lactam antibiotic . Combination drug therapy prevents emergence of resistant strains in mycobacterial infections and in infections due to methicillin-resistant staphylococci and certain other resistant organisms . Synergistic combinations should allow the use of lower concentrations of drugs in combination and thus diminish the incidence of dose-related antibiotic toxicity, but the concept has met with only limited success so far . Three types of antimicrobial combination or interaction result in enhanced (synergistic) antimicrobial activity . These types include combinations of agents that inhibit bacterial cell wall synthesis with aminoglycosidic aminocyclitols, the use of beta-lactamase inhibitors in combination with beta-lactam antibiotics, and the administration of agents that act on sequential steps in one of the bacterial metabolic or synthetic pathways . Combinations of two beta-lactam antibiotics that bind to complementary penicillin-binding proteins may represent an analogous situation . Amdinocillin binds specifically to penicillin-binding protein 2, and in vitro studies have clearly demonstrated synergism when amdinocillin is combined with other penicillins and cephalosporins that have higher affinity for other penicillin-binding proteins. J Immunol Methods, 1983 Aug 26, 62(2), 241 - 5 Different protein A immunosorbents may have different binding specificity for rat immunoglobulins; Nilsson R et al.; Purified polyclonal immunoglobulin preparations representing the 4 rat IgG subclasses were tested for binding to Staphylococcus aureus protein A attached to 3 different solid phases (Staphylococcus aureus Cowan I bacteria, Sepharose CL4B and Sepharose 6MB) . Protein A Sepharose CL4B showed higher reactivity with IgG1 and IgG2b than the staphylococci, whereas protein A Sepharose 6MB showed a lower uptake of these subclasses . No differences were seen for IgG2a and IgG2c . Protein A on different solid phases cannot be used interchangeably without confirmation of binding specificity. Lancet, 1983 Aug 6, 2(8345), 299 - 301 Rapid diagnosis of obscure pneumonia in immunosuppressed renal patients by cytology of alveolar lavage fluid; Hopkin JM et al.; 16 episodes of pneumonia of obscure origin in 15 immunosuppressed renal patients were investigated without complication by fibreoptic bronchoscopy with alveolar lavage under local anaesthesia . Cytological examination and culture of lavage fluid produced a rapid definitive diagnosis in 15 episodes of pneumonia caused by infections with Pneumocystis, fungi, tuberculosis and staphylococci, or by pulmonary haemorrhage . This led to successful treatment of 10 of the 13 infective episodes. Biochemistry, 1983 Aug 2, 22(16), 3907 - 12 Purification and some physicochemical properties of toxic-shock toxin; Reiser RF et al.; A procedure for the purification of a protein marker for the staphylococci isolated from toxic-shock syndrome patients has been developed . The purification procedure involves the removal of the toxic protein from culture supernatant fluids of toxic-shock syndrome associated Staphylococcus aureus strains FRI-1169 and FRI-1183 by batch absorption with CG-50 resin, ion-exchange chromatography on CM-Sepharose CL-6B, and gel permeation chromatography on Sephacryl S-200 . The purified toxin is a simple protein with a molecular weight of 24 000 +/- 500 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . The isoelectric point of the major band is 7.0 as determined by isoelectric focusing in polyacrylamide gels . The TS-toxin's reactivity with its specific antibody is not affected by tryptic digestion at pH 8.0 but is slowly reduced by treatment with pepsin at pH 4.5 . The TS-toxin consists of 188 amino acid residues . Serine was shown to be the NH2-terminal amino acid residue by end-group analysis . Initial studies indicated the protein was emetic; thus tentatively it was called staphylococcal enterotoxin F . In this paper it is called TS-toxin because the emetic action in monkeys has not been confirmed. J Hyg (Lond), 1983 Aug, 91(1), 7 - 16 Gentamicin-resistant staphylococci: genetics of an outbreak in a dermatology department; Naidoo J et al.; The genetics of gentamicin resistance in Staphylococcus aureus strains isolated during an outbreak of infection in dermatology department have been studied . The predominant strain of S . aureus did not appear to possess a plasmid mediating gentamicin resistance though one isolate yielded a plasmid coding for penicillin and gentamicin . Three distinct plasmids were isolated from other phage types of S . aureus which appeared towards the end of the epidemic . There appeared to be a stepwise loss of gentamicin resistance in the predominant strain. J Med Microbiol, 1983 Aug, 16(3), 309 - 16 Effect of low intraphagolysosomal pH on antimicrobial activity of antibiotics against ingested staphylococci; Lam C et al.; The ability of aminoglycoside antibiotics and rifampicin to kill Staphylococcus aureus that had been ingested by blood polymorphonuclear leukocytes (PMNs) in vitro was investigated . Gentamicin and streptomycin failed to kill intracellular staphylococci, possibly because they could not penetrate PMNs or were inactivated by the low intraphagolysosomal pH . Rifampicin accumulated within the leukocytes in a form that killed staphylococci in a cell-free medium, but the bactericidal activity of intracellular rifampicin against ingested staphylococci was much less than that in a cell-free system . Investigations with granules isolated from PMNs, at various pH-values, revealed that the impairment of rifampicin activity was a result of limitation of the staphylococcal growth rate by a low pH . These observations indicate that the inhibition of intraphagocytic bacterial growth by the low intraphagolysosomal pH and other phagolysosomal bacteristatic factors determines the antimicrobial activity of accumulated antibiotics. J Lab Clin Med, 1983 Aug, 102(2), 298 - 305 The influence of lysostaphin on phagocytosis, intracellular bactericidal activity, and chemotaxis of human polymorphonuclear cells; Pruzanski W et al.; Lysostaphin, a microbicidal enzyme that lyses Staphylococcus aureus, was introduced to study phagocytosis and ICBA (Tan et al.3) on the presumption that it does not penetrate into the phagocytic cells . It was recently suggested, however, that LS enters the cells and kills ingested bacteria . By using two methods to study phagocytosis and bactericidal activity, the old one based on disruption of PMNs and plating technique and a new one that does not require disruption, we found that LS did not influence phagocytosis or phagocytic index but altered intracellular kill of Staphylococcus . LS eliminated almost completely extracellular bacteria, but centrifugation and washing of PMN at the end of phagocytic assay were almost equally efficient . Since the method of disruption of PMN and plating of bacteria cannot distinguish penetration of LS to the cells from its adherence to the outer wall of PMN, we employed a new, recently described acridine orange/crystal violet method, which can measure simultaneously phagocytosis and ICBA and eliminates completely extracellular microorganisms . This method has shown that in the presence of LS, a significantly higher proportion of staphylococci were killed intracellularly--91% +/- 2.7 vs . 74% +/- 2.9 (p less than 0.001), i.e., that LS either penetrated to the cells or enhanced ICBA . It was also found that trypsin, which was used as an inhibitor of LS, was unable to abolish bactericidal activity of LS . It is suggested that LS should not be used for assessment of ICBA but may be employed for studies of phagocytosis over short incubation periods . A new method based on acridine orange/crystal violet staining was found to be useful for investigation of phagocytosis and ICBA of human PMNs. Antibiotiki, 1983 Aug, 28(8), 622 - 5 {Treatment of staphylococcal pneumonias}; Bronnikov IuN; Sensitivity of 129 strains of pathogenic staphylococci isolated from patients with pneumonia was studied with respect to a large number of drugs in the Bacteriological Laboratory of Konstantiny in the Algerian People's Democratic Republic . The method of paper discs and the Muller-Hinton solid nutrient medium were used . The staphylococcal strains were highly sensitive to cephalosporins, some of aminoglycosides (neomycin, gentamicin, tobramycin), nitrofurans, rifampicin, some antibiotics of other groups . Minocycline proved to be the most active among the tetracycline antibiotics . The number of the strains sensitive to it amounted to 82 per cent . 74--76 per cent of the isolates were resistant to tetracycline and oxytetracycline . 40--77 per cent of the isolates were resistant to sulfanilamides. J Clin Microbiol, 1983 Aug, 18(2), 395 - 9 Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections; Archer GL et al.; An outbreak of nosocomial infections was caused by a single strain of methicillin-resistant (MR) Staphylococcus aureus . This strain was followed as it was transmitted from the index case to 17 patients, 3 hospital personnel, and 12 items in the hospital environment . The MR S . aureus strain was traced by using four specific epidemiological markers: antibiogram, phage type, production of aminoglycoside-inactivating enzymes, and plasmid pattern . These markers were assessed for their reliability in differentiating the epidemic S . aureus strain from resident nonepidemic strains and for the ease and rapidity with which they determined differences . The epidemic strain was resistant to beta-lactam antibiotics, gentamicin, erythromycin, clindamycin, and rifampin . Resistance to rifampin was the only unique marker in the antibiogram which distinguished the epidemic strain from the indigenous strains, and it was the easiest marker to use for screening isolates from culture surveys . Phage typing was poorly reproducible and did not yield results rapidly enough to be useful for ongoing epidemiology . The epidemic strain produced a unique aminoglycoside-inactivating enzyme (3'-phosphotransferase) which distinguished it from indigenous gentamicin-resistant staphylococci, but this marker was not easily identified, nor was identification helpful during the course of the investigation . Plasmid pattern analysis was rapidly performed (in less than 24 h), allowed many isolates to be examined at a time, was stable and reproducible, and yielded a unique fingerprint which distinguished the epidemic strain from all indigenous isolates . Plasmid pattern analysis is a promising epidemiological tool for MR S . aureus outbreaks in which epidemic strains lack unique antibiotic resistance markers. J Clin Microbiol, 1983 Aug, 18(2), 372 - 5 Toxic shock syndrome: modification and comparison of methods for detecting marker proteins in Staphylococcus aureus; Cohen ML et al.; Development of a new medium and modification of incubation conditions increased production of toxic shock syndrome marker proteins and enabled detection of small volumes of pyrogenic exotoxin C (PEC) by isoelectric focusing and staphylococcal enterotoxin F (SEF) by a newly developed solid-phase radioimmunoassay . The results were compared with those obtained with previously described methods . The results were identical, and all PEC-positive isolates were SEF positive . In a second study of 262 randomly selected Staphylococcus aureus isolates examined by isoelectric focusing and solid-phase radioimmunoassay but grown in fresh beef heart medium, 47 (17.9%) isolates were PEC and SEF positive; however, 9 (3.4%) were PEC positive and SEF negative, and 3 (1.1%) were SEF positive and PEC negative . When grown in buffered beef heart yeast extract medium, six of the previously PEC-positive and SEF-negative isolates were PEC negative . Autoradiographic analysis of selected isolates demonstrated that PEC- and SEF-positive strains bound SEF antitoxin to the protein at isoelectric point 7.2, suggesting that in staphylococci from patients with toxic shock syndrome, PEC and SEF are the same protein . In screening staphylococci for toxic shock syndrome marker proteins, isoelectric focusing to identify PEC may detect false-positive proteins and may be more susceptible to technical variation than immunological methods to detect SEF. Z Urol Nephrol, 1983 Aug, 76(8), 511 - 7 {Immunoadsorption using Staphylococcus aureus, COWAN I strain}; Behm E et al.; Immunoadsorbents bind immunoglobulins, immunocomplexes or immunocytes . Their clinical use could become a new therapeutic principle for diseases in the pathogenesis of which antibodies or immunocomplexes play an important part . Immunoadsorbents are also being tested in the hope that they can at least partially replace the plasmapheresis-plasma exchange therapy at present practised . A report is given on in-vitro studies using protein-A-bearing staphylococci, strain COWAN I . The bacteria bind IgG selectively, IgM to a small extent, IgA, IgD and IgE hardly . The majority of the other plasma proteins tested (e.g . albumin, transferrin, ceruloplasmin, alpha-2-macroglobulin, beta-lipoprotein, alpha-2-glycoprotein, alpha-1-antitrypsin) are bound only non-specifically and in small quantities . The staphylococci can react with acid solutions (glycin-HCl buffer, acetic acid) in several ways . The activation of the complement system by IgG binding to protein A is one of the problems to be solved before immunoadsorbents an be used clinically. J Clin Microbiol, 1983 Aug, 18(2), 438 - 9 Evaluation of the automicrobic system gram-positive identification card for species identification of coagulase-negative staphylococci; Almeida RJ et al.; The AutoMicrobic system Gram-Positive Identification Card (Vitek Systems, Inc., Hazelwood, Mo.) was evaluated for identification of a group of 150 isolates of coagulase-negative staphylococci . Identifications obtained with the Gram-Positive Identification Card were compared with reference identifications derived from 15 conventional biochemical tests . The AutoMicrobic system correctly identified only 67.3% (101 of 150) of the test isolates . The greatest accuracy was achieved with Staphylococcus epidermidis isolates (95.7%), whereas Staphylococcus hominis isolates were least often correctly identified (26.7%). J Clin Microbiol, 1983 Aug, 18(2), 254 - 7 Identification of coagulase-negative staphylococci with the API STAPH-IDENT system; Almeida RJ et al.; A group of 300 clinically derived isolates of coagulase-negative staphylococci were tested in parallel with the API STAPH-IDENT system (Analytab Products) and 14 conventional biochemical tests contained in Kloos and Schleifer's simplified scheme for identification of human Staphylococcus species . STAPH-IDENT is a miniaturized biochemical test strip that incorporates four synthetic chromogenic substrates, urea, arginine, and four carbohydrates and that requires only a 5-h test period . Use of the STAPH-IDENT system alone allowed correct or partly correct classification of 67% (201 of 300) of the study isolates . However, if a supplemental test was performed (most often novobiocin susceptibility), correct classification of an additional 25.7% (77) was possible, for a total of 92.7% of isolates identified to the species level . Species correctly identified included 94% (116 of 123) of Staphylococcus epidermidis isolates, 98% (63 of 64) of S . saprophyticus, 71% (34 of 48) of S . hominis, 100% (22) of S . simulans, 100% (18) of S . haemolyticus, 100% (17) of S . warneri, and 100% (8) of S . capitis . Fourteen percent (42 of 300) of profile codes encountered in this study were not included in the STAPH-IDENT profile register, but were included in Analytab Products' expanded computer data base. J Am Acad Dermatol, 1983 Aug, 9(2), 285 - 94 The staphylococcal scalded skin syndrome in historical perspective: emergence of dermopathic strains of Staphylococcus aureus and discovery of the epidermolytic toxin . A review of events up to 1970; Lyell A; The gradual recognition of dermopathic strains of Staphyloccus aureus, which cause staphylococcal impetigo, pemphigus neonatorum, Ritter's disease, and what was originally called staphylococcal toxic epidermal necrolysis, is described . Obstacles delaying their recognition included an entrenched belief that staphylococci should produce pus, the striking dissimilarity of their main clinical effects (impetigo and scalding), the strongly held opinions of von Rittershain, and controversy over the cause of impetigo . Phage typing and histopathology confirmed the common etiology of these diseases and established the existence of dermopathic strains securely . The important contributions made by Melish and Glasgow were to provide an experimental model for these strains and to discover the epidermolytic toxin, whose action of splitting the epidermis underlies the pathogenesis of all these diseases (which have become known collectively as the staphylococcal scalded skin syndrome) . Clinically, however, the impetigo effects and the scalding effects differ markedly, so it is proposed that staphylococcal impetigo should be retained as a separate clinical entity, and that staphylococcal impetigo and the modified staphylococcal scalded skin syndrome should be known collectively as the staphylococcal epidermolytic toxin syndrome. J Clin Microbiol, 1983 Aug, 18(2), 258 - 69 Characterization of clinically significant strains of coagulase-negative staphylococci; Christensen GD et al.; On occasion, a patient may have two or more clinical cultures yielding a coagulase-negative staphylococcus If these multiple isolates have the same phenotype, one might conclude that the same strain was reisolated from the patient, indicating its persistent and pathological presence . We examined the validity of this conclusion when we applied a number of characterizing systems to a collection of 143 isolates of coagulase-negative staphylococci collected during an outbreak of intravascular catheter-associated sepsis . The probability of classifying two random isolates as the same phenotype or species was as follows: P = 0.356 for phage typing, P = 0.348 for Baird-Parker biotyping, P = 0.346 for the API STAPH-IDENT (Analytab Products) system, P = 0.327 for Bentley et al . biotyping, and P = 0.077 for antimicrobial susceptibility patterns . Although antimicrobial susceptibility patterns had the lowest probability, a variability in test results of 7.7% and a tendency for strains to have similar antibiograms effectively raised the probability to P = 0.897 . The combination of the API STAPH-IDENT with antibiograms resulted in a probability of P = 0.037 to P = 0.147 . When all of the above methods were used together a probability of P = 0.014 was achieved . Five patients had isolates from two or more blood cultures spaced more than 1 day apart that were identical by all of the above criteria, thus confirming prolonged bacteremia . The collection was also examined for the incidence of slime production . Slime production was not associated with any of the above groups, but was associated with symptomatic infections (P less than 0.05) and gentamicin resistance (P less than 0.01) . Slime production was strain stable and was of assistance in typing strains of coagulase-negative staphylococci. Clin Exp Immunol, 1983 Aug, 53(2), 482 - 90 Pre-incubation of human monocytes results in loss of effector activity and diminished stimulation of the autologous mixed lymphocyte reaction; Lederman MM et al.; Human monocytes were cultured at 37 degrees C for 72 h, washed, adjusted for viability and compared to freshly prepared monocytes for stimulation of the autologous mixed lymphocyte reaction (AMLR) and effector function . Pre-incubated monocytes were less potent AMLR stimulators than were freshly prepared cells . Pre-incubated monocytes demonstrated less antibody-dependent tumour killing of CCRF-CEM, less killing of Staphylococci and less spontaneous tumour killing of K-562 than did fresh monocytes . Pre-incubated monocytes produced less prostaglandin E2, demonstrated less surface Ia antigen and were less efficient accessory cells for antigen presentation than were fresh monocytes . AMLR stimulation correlated with monocyte killing (r = 0.95) and PGE2 production (r = 0.98) . Thus, monocytes pre-incubated for 3 days are less active effector cells, display less surface Ia antigen and are less potent stimulators of the AMLR than fresh monocytes . Moreover, in this system, monocyte effector activity correlates with ability to stimulate the AMLR. Equine Vet J, 1983 Jul, 15(3), 263 - 5 Staphylococcus hyicus in skin lesions of horses; Devriese LA et al.; Staphylococcus hyicus (subspecies hyicus) was isolated as the only pathogenic organism from two independent cases of dermatitis of the lower parts of the limbs (grease heel) in horses . The organism was recovered together with other pathogenic staphylococci from similar conditions in two other horses of different origins . These conditions were characterised by epidermolysis, alopecia and crust formation . They responded quickly to antibiotic treatment . The organism was also isolated from a long standing case of "summer eczema" which healed without antibiotic treatment, and from a horse with dermatophilosis (streptotrichosis, Dermatophilus congolensis infection) . Experimentally, Staph hyicus caused epidermolysis, exudation and inflammation in the superficial layers of the skin. Infect Immun, 1983 Jul, 41(1), 145 - 53 Role of granulocytes and monocytes in experimental Staphylococcus epidermidis endocarditis; Meddens MJ et al.; The role of granulocytes and monocytes during the induction and course of Staphylococcus epidermidis endocarditis was investigated by the selective depletion of monocytes with the drug VP16-213 and of both granulocytes and monocytes with nitrogen mustard . The induction of endocarditis was influenced only by the depletion of monocytes: the 50% infective dose differed significantly, being 3.4 X 10(5) CFU in control rabbits and 3.4 X 10(4) CFU in the monocyte-depleted rabbits, whereas no significant differences were found between the latter and those depleted of both granulocytes and monocytes . Also, control rabbits injected with 10(6) or 10(7) CFU had a significantly higher incidence of sterile vegetations than did rabbits selectively depleted of granulocytes or monocytes . Compared with baseline values, mean monocyte numbers at the time of bacterial inoculation were significantly increased in control rabbits whose vegetations remained sterile, whereas this effect was not seen in rabbits whose vegetations became infected . The course of the endocarditis appeared to be significantly influenced by both granulocytes and monocytes . Comparison showed that a decrease of the same numbers of these cells per microliter of blood was accompanied for the monocytes by an approximately fourfold higher increase of the number of staphylococci in the vegetations . The correlation between the number of granulocytes and of monocytes on the one hand and the number of staphylococci in the vegetations on the other was not substantially influenced by the duration of the disease or the number of staphylococci injected to induce the endocarditis . The number injected proved to be significantly correlated with the number of staphylococci in the vegetations . In rabbits with numbers of CFU per gram of vegetation exceeding 10(7), blood cultures were usually positive . This finding applied rarely to control rabbits, but generally to drug-treated rabbits . In the latter animals a significant correlation between the number of staphylococci in the vegetations and in the circulation was found . We conclude that only monocytes have a measurable effect on the induction of Staphylococcus epidermidis endocarditis but during its course both granulocytes and monocytes keep the endocardial infection in check. Rev Infect Dis, 1983 Jul-Aug, 5 Suppl 3, S491 - 4 Experimental chronic staphylococcal osteomyelitis in rabbits: treatment with rifampin alone and in combination with other antimicrobial agents; Norden CW; The efficacy of rifampin alone and in combination with sisomicin, cephalothin, sisomicin and cephalothin, or trimethoprim was measured in an experimental model of chronic osteomyelitis due to Staphylococcus aureus in rabbits . Single-drug regimens used for 28 days were relatively ineffective (bone sterilization rate, 5%-55%) . Combinations of rifampin with other agents were more effective (bone sterilization rate, 75%-100%) . The combination of rifampin, sisomicin, and cephalothin given for only 14 days sterilized the bones of all treated rabbits . Staphylococci isolated from the bones of rabbits that had received rifampin alone or in combination with other antibiotics were highly resistant to rifampin; in contrast, these organisms remained sensitive to the other agents used . Results of in vitro studies of synergy correlated with in vivo results in some but not all instances . The results obtained with rifampin in the treatment of experimental chronic osteomyelitis caused by S . aureus suggest that clinical trials of this agent for the treatment of osteomyelitis in humans are warranted. Rev Infect Dis, 1983 Jul-Aug, 5 Suppl 3, S459 - 62 Long-term studies of the effect of rifampin on nasal carriage of coagulase-positive staphylococci; Wheat LJ et al.; Eighty healthy men with nasal carriage of coagulase-positive staphylococci were given cloxacillin, rifampin, cloxacillin plus rifampin, or no drug . Treatment with rifampin alone or with rifampin plus cloxacillin eradicated the original strain from 80% of the men for 12 weeks after treatment; 15%-20% of the 80 subjects acquired a strain of a different phage type . Treatment with cloxacillin alone did not significantly alter the rate of carriage . Only one of 40 men receiving rifampin (either alone or with cloxacillin) acquired rifampin-resistant, coagulase-positive staphylococci; seven of the 40 acquired rifampin-resistant, coagulase-negative staphylococci . Rifampin-resistant organisms did not persist in repeat nasal cultures five months after treatment . Of the 40 subjects given rifampin alone or rifampin plus cloxacillin, 60% had repeat nasal cultures done one year later . Only 50% were found to be carriers of coagulase-positive staphylococci . In another study, coagulase-positive staphylococci were eradicated from 70% of 20 carriers undergoing renal dialysis who received rifampin plus cloxacillin. Antimicrob Agents Chemother, 1983 Jul, 24(1), 70 - 7 Self-transmissible plasmids in staphylococci that encode resistance to aminoglycosides; Archer GL et al.; High-level resistance to gentamicin, tobramycin, and kanamycin was transferred between staphylococci of the same and different species by filter mating . Resistance and transfer proficiency were mediated by plasmids ranging from 38 to 54 kilobases in size . All of the plasmids encoded intermediate resistance to amikacin and netilmicin and resistance to ethidium bromide; some encoded beta-lactamase production . None of these plasmids carried resistance to other antibiotics or heavy metals . Transfer of antibiotic resistance occurred by a mechanism similar to that of conjugation, because it was DNase resistant, required cell-to-cell contact, and did not appear to involve phage . The participation of phage in transfer appeared to be unlikely because mijtomicin C-induced lysates of donor isolates did not mediate transfer, filter mating transfer proceeded at high frequency between nonlysogenic donor and recipient cells, and transfer of the aminoglycoside resistance plasmid mobilized the transfer of as many as five additional plasmids . All 17 gentamicin-resistant Staphylococcus aureus and all 6 Staphylococcus epidermidis isolates obtained from an outbreak of staphylococcal infections in a newborn nursery contained conjugative plasmids, as did all 6 gentamicin-resistant S . aureus isolates from bacteremic adults . However, only 3 of 10 gentamicin-resistant S . epidermidis isolates from colonized cardiac surgery patients and 1 of 2 S . epidermidis isolates from patients with prosthetic valve endocarditis transferred gentamicin resistance by filter mating . The recent increase in nosocomial infections caused by gentamicin-resistant staphylococci may be partially explained by the evolution of self-transmissible plasmids in these isolates. Zh Mikrobiol Epidemiol Immunobiol, 1983 Jul, (7), 43 - 7 {Comparison of the spectra of the extracellular proteins in differentiating staphylococcal cultures}; Degteva GK et al.; The study of the spectra of the extracellular proteins of 45 museum cultures and 391 newly isolated cultures has demonstrated that these spectra are the strain characteristic of staphylococci . A method for the identification of staphylococci by the spectra of their extracellular proteins is proposed. Int J Biomed Comput, 1983 Jul, 14(4), 345 - 52 Application of deterministic epidemic theory to nasal carriage of Staphylococcus aureus; Goonatilake PC; Nasal carriage of antibiotic-resistant Staphylococcus aureus is often used as an index of cross-infection in hospitals . In this paper, a deterministic model of the epidemiology of Staphylococcal nasal carriage was derived employing the concepts of epidemic theory . This theoretical model was tested against experimental data gathered from a large survey . When the association between nasal carriage of tetracycline-resistant Staphylococci and length of stay in hospital derived from the survey was compared with theoretical figures derived from the model, the validity of the model in a real situation was confirmed. Antimicrob Agents Chemother, 1983 Jul, 24(1), 61 - 9 Occurrence and expression of imipemide (N-formimidoyl thienamycin) resistance in clinical isolates of coagulase-negative staphylococci; Blumenthal RM et al.; More than 500 clinical isolates were screened for resistance to a number of antibiotics, including imipemide (N-formimidoyl thienamycin {MK0787}) . Of the 25 coagulase-negative staphylococcal isolates present in the screening sample, almost one-third showed one of two patterns of imipemide resistance . One pattern apparently involves constitutive expression of drug resistance, whereas the other pattern seems to result from an inducible resistance having an apparent induction threshold higher than the minimal inhibitory concentration of imipemide . The mechanism(s) responsible for this imipemide resistance is unclear, but may be distinct from the more common staphylococcal mechanisms of resistance to beta-lactam antibiotics . Only two of the patients from whom imipemide-resistant staphylococci were cultured had actually been treated with the antibiotic. Rev Infect Dis, 1983 Jul-Aug, 5 Suppl 3, S418 - 27 Effect of rifampin and oxacillin on the ultrastructure and growth of Staphylococcus aureus; Lorian V et al.; The minimal inhibitory concentrations (MICs) of rifampin for 12 strains of Staphylococcus aureus ranged from 0.005 microgram/ml to 0.02 microgram/ml, and the minimal antibiotic concentrations (i.e., those that inhibited growth by 90% in comparison with control values) ranged from one-fifth to one-half the MICs . Rifampin alone produced a 1-log (90%) decrease in the staphylococcal population after incubation for 6.5 hr, and the inhibitory effect after removal of the antibiotic lasted for 5 hr . Regardless of whether rifampin was used simultaneously with, before, or after exposure to oxacillin, the latter drug partially or totally prevented the overgrowth of rifampin-resistant staphylococci . The use of this combination in therapy is therefore justified . Staphylococci exposed to rifampin at concentrations equal to three or 20 times the MIC developed a cell wall that was four times thicker than normal and had a peripheral undulated dense layer . The cross walls were also two to 10 times thicker than normal but had a normal central dense zone . Exposure of staphylococci to oxacillin produced large cells with multiple cross walls that underwent autolysis when the organisms were transferred to drug-free medium . When exposure to oxacillin was preceded by exposure to rifampin, cells did not become enlarged . When the large cells produced by oxacillin were transferred to medium containing rifampin, the cross walls did not lyse. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Jul, 254(4), 452 - 8 Lipolytic and proteolytic properties of staphylococci; Tyski S et al.; Lipolytic and proteolytic activities were estimated in coagulase-positive and coagulase-negative strains of human origin . Several different substrates were used for determination of these activities . Staphylococcus aureus strains were very frequently lipolytic (95%) and proteolytic (87.5%) . Among coagulase-negative strains, 85.4% were proteolytic and 10.25% exhibited lipolytic activity. Rev Infect Dis, 1983 Jul-Aug, 5 Suppl 3, S463 - 7 The antimicrobial activity of rifampin: emphasis on the relation to phagocytes; Mandell GL; Rifampin appears to be a uniquely effective antibiotic for the treatment of certain infections . Only rifampin, of nine antimicrobial agents studied, killed staphylococci inside polymorphonuclear neutrophils or Escherichia coli inside macrophages . Rifampin, unlike penicillin, penetrated living, intact neutrophils . Rifampin was more effective than other antistaphylococcal antibiotics for the treatment of staphylococcal infections induced by subcutaneous, intraperitoneal, or intravenous injection of the organisms into mice . Rifampin-resistant variants occur in low numbers among clinical isolates (frequency, 10(-8)), and some of these variants are diminished in virulence for mice . Treatment of infected mice with rifampin plus another antimicrobial agent prevented the emergence of resistant variants . Thus, there is firm in vitro and in vivo support for studies of the clinical efficacy of rifampin for staphylococcal infections. Am J Clin Pathol, 1983 Jul, 80(1), 75 - 84 Phagocytic, lambda light chain, plasma cell myeloma; Wirt DP et al.; A case of phagocytic, lambda light chain, plasma cell myeloma was characterized by its clinical, morphologic, cytochemical, immunologic, and cell kinetic features . A 40-year-old man presented with Coombs-negative hemolytic anemia, hepatosplenomegaly, lytic bone lesions, lambda light chain monoclonal gammopathy, and infiltration of the bone marrow by dysplastic plasma cells, 10% of which demonstrated phagocytosis of erythroid cells . Electron microscopy demonstrated myeloma cells with prominent cytoplasmic microfilaments and erythroid cells in intracytoplasmic vacuoles . The myeloma cells did not phagocytose staphylococci in vitro . Phagocytic and nonphagocytic myeloma cells were tartrate-sensitive, acid-phosphatase positive, alpha-napthyl butyrate esterase negative, and did not form E rosettes or EAox(IgG) rosettes . The tumor cells were Tdt, Ia antigen, and SIg negative . Immunofluorescent staining for cytoplasmic light chains showed a monoclonal lambda pattern in nonphagocytic myeloma cells, and a probable monoclonal lambda pattern in phagocytic myeloma cells . These findings characterize the neoplasm as a monoclonal proliferation of differentiated plasma cells with the capability of erythrophagocytosis . Erythrophagocytosis by myeloma cells may have been responsible for the hemolytic anemia . The tritiated thymidine labeling index (LI%) was high (8%), suggesting a poor prognosis, despite a dramatic initial response to chemotherapy. Antibiotiki, 1983 Jun, 28(6), 429 - 34 {Antibiotic sensitivity of various Staphylococcus species isolated from newborn infants with purulent septic infections}; Givental' NI et al.; Sensitivity of 120 staphylococcal strains belonging to different species isolated from newborn infants with pyoseptic infections was studied with respect to 13 antibiotics . Methicillin, cephaloridin, rifampicin, ristomycin, gentamicin and novobiocin were mainly highly active against the isolates, while some of the strains were resistant . The coagulase negative species were as a whole characterized by higher resistance levels with respect to some antibiotics, as compared to Staph . aureus . The predominant part of the coagulase negative strains with exceedingly high resistance levels did not belong to Staph . epidermidis . The sensitivity of staphylococci depended on the source of their isolation . At large the strains isolated from purulent excretions of localized foci were characterized by lower levels of resistance to a number of antibiotics (benzylpenicillin, tetracycline, erythromycin, methicillin and others) as compared to the strains isolated from the blood. Antibiotiki, 1983 Jun, 28(6), 412 - 7 {Characteristics of the composition of higher fatty acids in methicillin-resistant and methicillin-sensitive Staphylococci}; Pinchuk LM et al.; The composition of fatty acids of methicillin-resistant (MR) and methicillin-sensitive (MS) strains of Staph . aureus and Staph . epidermidis was determined with the method of reactive gas liquid chromatography . The MS staphylococci of the above species differed by the content of acids with branched chains of iso- and anteisostructures and straight chains . Anteisoacids in the cells of Staph . epidermidis amounted almost to 80 per cent of the total number of the acids, while in the cells of Staph . aureus, their total number amounted only to a half of the fatty acid pool . Comparison of the composition of the fatty acids of the MS and MR strains of Staph . aureus revealed differences in the proportions of the anteiso- and isoacids . The total number of the long-chain C20.0 acid in the cells of Staph . epidermidis resistant to methicillin was lower as compared to that in the sensitive cells. Acta Pathol Microbiol Immunol Scand {B}, 1983 Jun, 91(3), 169 - 73 Trioleoylglycerol lipolysis by Staphylococcus aureus strains from recurrent furunculosis, pyomyositis, impetigo and osteomyelitis; Hedstrom SA et al.; Staphylococcus aureus strains isolated from 94 patients with recurrent furunculosis, chronic osteomyelitis, tropical pyomyositis and impetigo were investigated for lipase activity after growth 1, 2 and 5 days in aerated casein hydrolysate-yeast extract . As substrate for lipase activity a tri-3H-oleoylglycerol emulsion was used . Phage group II staphylococci isolated from furunculosis had the highest lipase activity and on day 5 these strains differed significantly in activity from strains isolated from the other infections . Strains isolated from impetigo had a remarkably low lipase production . The quantitative difference in lipase production of various S . aureus strains may reflect the localization of the lesion. Antimicrob Agents Chemother, 1983 Jun, 23(6), 932 - 4 Synergy of combinations of vancomycin, gentamicin, and rifampin against methicillin-resistant, coagulase-negative staphylococci; Lowy FD et al.; The activity of combinations of vancomycin (2 or 10 micrograms/ml), gentamicin (0.3 micrograms/ml), and rifampin (0.03 micrograms/ml) against methicillin-resistant, coagulase-negative staphylococcal isolates was determined by the time-kill method . Combinations of rifampin with gentamicin or with vancomycin 2 micrograms/ml demonstrated enhanced killing against 13 of 17 and 13 of 25 strains, respectively . However, rifampin-resistant strains were selected with the latter combination in the remaining 12 of 25 studies. Infect Immun, 1983 Jun, 40(3), 1030 - 7 Two inhibitors of neutrophil chemotaxis are produced by hyperimmunoglobulin E recurrent infection syndrome mononuclear cells exposed to heat-killed staphylococci; Donabedian H et al.; Mononuclear cells from normal volunteers and from patients with the hyperimmunoglobulin E recurrent infection syndrome (HIE) were cultured for 18 h with and without opsonized, heat-killed Staphylococcus aureus (OS) . The supernatants from normal mononuclear cell cultures without OS revealed no inhibitory activity for neutrophil chemotaxis, whereas those from HIE patients revealed the previously reported 61,000-dalton factor . However, when normal cells were cultured with OS, they produced a proteinaceous, 56 degrees C-stable, 30,000- to 45,000-dalton factor which preferentially inhibited neutrophil versus monocyte chemotaxis . When HIE cells were exposed to OS, they produced the same 30,000- to 45,000-dalton factor as normal cells, as well as the 61,000-dalton factor that they produced spontaneously . Assay of 1,000-fold dilutions of supernatants from cultures of normal mononuclear cells with OS revealed a mean production of 7.8 +/- 5.4% inhibition of chemotaxis, whereas assay of 1,000-fold dilutions of supernatants from cultures of HIE mononuclear cells (spontaneously producing the 61,000-dalton factor) with OS revealed a 26.6 +/- 3.6% inhibition (P less than 0.02) . The data indicate that in short-term culture both normal and HIE mononuclear cells produce an inhibitor of neutrophil chemotaxis when exposed to particulate heat-killed staphylococci but that HIE cells produce qualitatively and quantitatively more inhibitory activity. J Antimicrob Chemother, 1983 Jun, 11(6), 543 - 54 Effect of two antibiotics on human granulocyte activities; Grant M et al.; As part of a study of the effects of antibiotic therapy upon human phagocytes, ampicillin and cefaclor were each administered orally to nine healthy adult subjects in a single dose of 500 mg . There was a significant difference in their effects on neutrophil myeloperoxidase (MPO) (EC.1.11.1.7) activity (P less than 0.05) in that ampicillin depressed, but cefaclor enhanced, the measured enzyme activity . Concomitantly ampicillin decreased but cefaclor increased, the rate of phagocytosis of staphylococci, the effects of the two antibiotics also being significantly different (P less than 0.05) . Direct measurements of intracellular killing of staphylococci did not change . In four patients with chronic bacterial infections who had low levels of neutrophil MPO activity, treatment with cefaclor led to a significant increase in the MPO levels to within the normal range . Three patients responded satisfactorily to cefaclor despite having previously filed to respond to antibiotics which were similarly active in vitro against the causative bacteria . These findings lead us to suggest that, in patients with chronic refractory infections, attention must be given to the effect of drugs on the host defences in addition to a careful choice of the most active antibacterial agent. Acta Pathol Microbiol Immunol Scand {B}, 1983 Jun, 91(3), 157 - 61 Polymyxin susceptibility in staphylococci differentiating coagulase-positive and coagulase-negative strains; Heltberg O et al.; 47 staphylococcal reference strains representing 13 species were tested for polymyxin sensitivity using tablet and disc diffusion methods . Corresponding MIC and IC50 values were determined with a plate dilution assay . Coagulase-positive strains were found to be more resistant towards polymyxin, and could thereby be separated from coagulase-negative strains . Furthermore, 100 recently isolated staphylococci from clinical specimens were tested, and again the coagulase-positive strains could be identified by their smaller tablet inhibition zones . We conclude that the polymyxin test is an aid in the fast differentiation of staphylococci in laboratories performing primary sensitivity tests. Pathol Biol (Paris), 1983 Jun, 31(6), 515 - 8 {Combination between fosfomycin and oxacillin or cefotaxime against methicillin-resistant Staphylococci and Enterococci}; Duez JM et al.; The resistance of Gram positive cocci to oxacillin and cephalosporins do not appear to be in relation with the synthesis of a beta-lactamase, thus fosfomycin (FOS) could enhance the action of beta-lactam antibiotics by blocking another stage of the peptidoglycan synthesis . When FOS is combined with oxacillin (OXA) or cefotaxime (CTX) against fosfomycin sensitive strains (25 S . aureus 4-16 mg/l, 20 S . epidermidis 2-32 mg/l and 20 Enterococci 16-64 mg/l) one can see a dramatic synergistic effect of these two combinations . Respectively with S . aureus, S . epidermidis and Enterococci, FIC indices are 0.17-0.39 and 0.43 for FOS-OXA and 0.29-0.47 and 0.29 for FOS-CTX . If one considers the CSF concentrations of these three antibiotics, the combination of fosfomycin with oxacillin or cefotaxime may be used in the treatment of meningitis due to methicillin resistant Staphylococci. J Immunol Methods, 1983 May 27, 60(1-2), 125 - 40 The kinetic measurement of phagocyte function in whole blood; Boghossian SH et al.; A technique has been developed for the kinetic measurement on the same blood sample of a variety of functions of phagocytic cells . Adherence to glass, the clearance of a mixture of microorganisms and their subsequent solubilisation, and the secretion of granule contents from the cells were determined . The numbers of residual viable intracellular staphylococci were measured at the completion of the study . These methods were used to investigate phagocyte function in 33 normal subjects and 6 patients with chronic granulomatous disease. S Afr Med J, 1983 May 21, 63(21), 822 - 4 Toxic shock syndrome caused by staphylococcal enterotoxin B . A report of 2 cases in children; Milner LS et al.; Two children with osteomyelitis, staphylococcal septicaemia and toxic shock syndrome (TSS) are reported . Both patients presented with fever, shock, scarlatiniform rash and diffuse mucositis . The multi-organ dysfunction which characterizes this syndrome was apparent in both patients, who had jaundice, functional renal impairment, diffuse myalgia and non-localizing neurological signs . One child developed toxic myocarditis and the other thrombocytopenia . Both showed a significant rise in antibody titre to enterotoxin B produced by the offending staphylococci, suggesting that this toxin was responsible for the TSS. J Immunol Methods, 1983 May 13, 59(3), 327 - 37 A general study of the binding and separation in partition affinity ligand assay . Immunoassay of beta 2-microglobulin; Ling TG et al.; Partitioning in aqueous 2-phase systems was used to separate free and bound ligand in an immunoassay for beta 2-microglobulin . In order to get efficient separation in the phase system, the antibodies were modified to favour their partition in a different phase from that of antigen . However such modification of antibodies significantly decreased their binding capacity . This was overcome by using antibodies bound to previously modified staphylococci, which had proper partitioning behaviour . Alternatively, antibodies conjugated with biotin could be used in combination with modified avidin . This paper presents a method for the evaluation of data from immunoassays whereby 2-phase systems have been used to separate free and bound antigen. Antibiotiki, 1983 May, 28(5), 362 - 5 {Changes in the structure and antibiotic sensitivity of the wound microflora in suppurative surgical infection of the soft tissues}; Gamaleia LA et al.; The results of the study on the composition, properties and antibiotic sensitivity of pathogenic microbes isolated from purulent wounds of the soft tissues of patients treated in the Institute clinic in 1977-1980 are presented . The frequency of secondary infection of the purulent wounds was estimated . During this period the percentage of gram-negative bacteria isolated from opened purulent foci increased . In some cases investigation of the time course of the purulent processes revealed new microbial strains, such as pathogenic staphylococci or opportunistic gram-negative bacteria . Sometimes replacement of the causative agent by new organisms was observed . The new strains were high- and multiple-resistant to the antibiotics. Am J Dis Child, 1983 May, 137(5), 461 - 3 Sepsis with coagulase-negative staphylococci in critically ill newborns; Baumgart S et al.; Coagulase-negative staphylococci are infrequently recognized as pathogens responsible for life-threatening nosocomial infections in high-risk neonates . To determine the incidence, appearance, and antibiotic sensitivity of infections with these organisms, 416 infants were surveyed . Fifty infants (12%) had blood cultures positive for coagulase-negative Staphylococcus . Fourteen cultures (13 infants; mean birth weight +/- SD, 1.91 +/- 1.13 kg; gestational age +/- SD, 34 +/- 6 weeks) were identified as representing true bacteremia (pure growth of the organism in both bottles of one or more blood cultures exhibiting identical antibiotic sensitivities) . Twelve cultures exhibited clinical signs of sepsis, and WBC counts were suggestive of sepsis in seven cases . Thirteen organisms were penicillin resistant, eight were oxacillin resistant, and all were sensitive to vancomycin . Coagulase-negative staphylococci are currently the most common nosocomial pathogens at our hospital . Therapy for suspected coagulase-negative staphylococcal sepsis should include vancomycin hydrochloride. Immunol Lett, 1983 Apr, 6(4), 231 - 7 Correlation between the triggering of proliferation and the potentiation of NK activity induced by protein A in human lymphocytes; Olinescu A et al.; Various preparations of Staphylococci protein A (SpA) obtained either from strain Cowan-1 or strain A676 and two SpA low molecular fragments (AB and B) were tested for their mitogenic and NK-stimulating activity on human peripheral blood lymphocytes . Though all 4 preparations of SpA and both of its fragments were able to react with human IgG, apparently with both Fab and Fc sites of IgG, only the SpA preparations derived from A676 strain triggered the proliferation and potentiated the NK-activity of treated cells . The parallelism between the mitogenic and NK-stimulating activities of SpA suggests that both activities might be under the control of the same portion of the SpA molecule located in the non-immunoglobulin binding region of the molecule. Acta Ophthalmol (Copenh), 1983 Apr, 61(2), 292 - 9 Histopathology in botryomycosis-like panophthalmitis due to Staphylococcus aureus . A light microscopic and electron microscopic study . A case report; Andersen SR et al.; A Swedish farmer's wife aged 46 developed a unilateral panophthalmitis 6 weeks after a visit to Gambia in Africa . Vitreous puncture revealed growth of Staphylococcus aureus, but in spite of adequate treatment the eye had to be enucleated 5 weeks after the onset of symptoms . Gram-positive microorganisms in botryomycosis-like granules in the vitreal abscesses were at first suspected to be Histoplasma capsulatum . Electron microscopic examination revealed microorganisms, consistent with staphylococci . There was extensive proliferation of mesosomes, most probably due to the intense treatment . The poor nutrition and slow resorption of the dead microorganisms from the avascular vitreous did possibly also play a part in the proliferation of the mesosomes. J Chir (Paris), 1983 Apr, 120(4), 221 - 8 {Prevention of bacterial grafts on revascularization of the arteries of the leg . Apropos of 18 infections in 1000 surgically treated cases}; Melliere D et al.; The incidence of vascular and prosthetic infections was compared during two successive periods, each involving approximately 500 surgical acts, a strict protocol of infection prophylaxis being applied during the second period: infection was reduced from 2.7 to 1.5 p . cent (2.3 to 0.5 p . cent after aorto-ilio-femoral grafts) . Failure to respond to treatment during the second period occurred under two circumstances: when prophylaxis was insufficient to cover emergency procedures, and when antibiotic therapy was directed against staphylococci only, resulting in persistence of a high level of infections due to Gram-negative bacilli . Analysis of different epidemiological factors, including the germs, the patient, the treating team, and the prosthesis, led to the adoption of numerous specific measures . Their respect implies collective awareness, assisted by analysis of weekly complications and annual results with the involvement of the total team . Prophylactic antibiotic therapy should be of short duration, the antibiotics being selected in reference to the sensitivity of the germs included in the hospital statistics, and of the antibiotic policy which reserves recently developed molecules for curative purposes. Acta Pathol Microbiol Immunol Scand {B}, 1983 Apr, 91(2), 97 - 9 Coagulase-negative staphylococci and cloxacillin prophylaxis in pacemaker surgery; Jacobson B et al.; In a prospective study of cloxacillin prophylaxis at pacemaker surgery per- and post-operative cultures were made . The most commonly isolated organisms from the wound were coagulase-negative staphylococci . These were typed by the scheme devised by Kloos and Schleifer . The routinely performed per-operative culture was of very little prognostic value . However, the typing was found to be useful in cases with suspected infection, as repeated isolation of the same species of coagulase-negative staphylococci with the same antibiotic susceptibility pattern may indicate pathogenicity . Incubation in enrichment medium for 2-4 days was needed in one patient who received antibiotic therapy when the specimen for culture was taken . The antibiotic prophylaxis did not eradicate even susceptible bacteria from the wound, but the infection rate was significantly lower in the prophylaxis group. Cutis, 1983 Apr, 31(4), 421 - 4 Criteria for the diagnosis of staphylococcal scalded skin syndrome in adults; Falk DK et al.; The diagnosis of staphylococcal scalded skin syndrome is usually made upon the bases of characteristic skin lesions and the isolation of toxin-producing staphylococci . However, these criteria are not always reliable . An adult patient with characteristic skin lesions was colonized with phage group 2 staphylococci . The patient was subsequently found to have a drug-induced toxic epidermal necrolysis . The criteria necessary for the diagnosis of staphylococcal scalded skin syndrome are reviewed. J Infect Dis, 1983 Apr, 147(4), 729 - 32 Stimulation of particle-induced chemiluminescence in human polymorphonuclear leukocytes by staphylococcal alpha toxin; Gemmell CG et al.; Staphylococcal alpha toxin is known to be involved in the pathogenicity of Staphylococcus aureus, although the mode of action is not clearly understood . In the present investigation the interaction of alpha toxin with human polymorphonuclear leukocytes (PMNLs) has been followed in vitro by measuring the ability of these cells to trigger a chemiluminescence response in the presence and absence of active phagocytosis . The alpha toxin does not stimulate chemiluminescence when added to nonphagocytizing PMNLs . At low concentrations alpha toxin stimulates chemiluminescence of PMNLs actively phagocytizing opsonized staphylococci . The increased chemiluminescence has two phases, one being immediate and short lived and the other delayed and longer lasting . These responses are dose-related and suggest an action of alpha toxin on the plasma membrane of PMNLs. Br J Exp Pathol, 1983 Apr, 64(2), 211 - 4 The selection of penicillin-resistant staphylococci on murine skin; Noble WC; The survival of staphylococci on mouse skin and on glass has been studied using paired isolates, isogenic but for a penicillinase plasmid . In general, there is a slight tendency for the penicillin-resistant isolates to survive better than the sensitive variants . In one staphylococcus it was possible to compare the effect of two different penicillinase plasmids . One gave a slightly enhanced survival but the other was detrimental to the host cell's survival . The effect seems not to be related to desiccation or to the effect of lipid. J Infect Dis, 1983 Apr, 147(4), 642 - 9 Alteration of staphylococcal flora in cardiac surgery patients receiving antibiotic prophylaxis; Archer GL et al.; The changes in staphylococcal flora induced by antibiotic prophylaxis with rifampin and nafcillin in combination among patients undergoing cardiac valve surgery were compared to those in patients undergoing coronary artery bypass surgery concurrently, who received only cefazolin . Rifampin-nafcillin prophylaxis eradicated carriage of Staphylococcus aureus at a significantly higher rate than did cefazolin (eradicated carriage of 89% vs . 48%, respectively; P less than 0.01); however, by the seventh postoperative day, 75% of the patients receiving rifampin and nafcillin had rifampin-resistant, coagulase-negative staphylococcal perianal floras, compared to 19% of those who received cefazolin (P less than 0.001) . Patients receiving rifampin-nafcillin were colonized as frequently (66%) with coagulase-negative staphylococci resistant to gentamicin and methicillin as were those receiving cefazolin (68%) . Patients in the coronary intensive care unit who received no antibiotics were infrequently colonized with either rifampin-resistant (none) or gentamicin- and methicillin-resistant (11%) staphylococci . Antibiotic prophylaxis may, therefore, be an important factor in perpetuating the hospital reservoir for antibiotic-resistant, coagulase-negative staphylococci. Am J Vet Res, 1983 Apr, 44(4), 709 - 12 Antibiotic activity against intraleukocytic Staphylococcus aureus in vitro and in experimental mastitis in mice; Craven N et al.; The activities of a range of antibiotics on Staphylococcus aureus organisms that survive within bovine neutrophils in vitro were studied in mice . Cloxacillin, floxacillin, and cephradine failed to kill intracellular staphylococci but increased the organisms' sensitivity to killing by lysostaphin after neutrophil disruption . Fusidate and clindamycin caused an apparent small reduction in viable intraleukocytic S aureus, whereas novobiocin did not demonstrate intracellular activity . Substantial intracellular bactericidal effects were shown in vitro by rifampin and rifamycin SV, even at concentrations in slight excess of the minimum inhibitory concentration . In a mouse model of chronic mastitis, intramammary therapy with rifampin was more effective in reducing viable S aureus in infected glands than was therapy with rifamycin SV. J Antimicrob Chemother, 1983 Apr, 11(4), 361 - 7 Vancomycin therapy of oxacillin-resistant Staphylococcus aureus infections; Klastersky J et al.; Infections caused by oxacillin-resistant staphylococci were studied in 27 patients, who received vancomycin therapy as soon as the resistance of the pathogenic staphylococcal strain to oxacillin was documented . Therapy with vancomycin was usually started not later than 48 h after the onset of empiric therapy with oxacillin or cefamandole . In spite of high bactericidal activity in the serum of the patients receiving vancomycin, only 16 (59%) out of 27 patients responded to the treatment . Favourable clinical responses were usually associated with bacteriological cure, but super-infection by Gram-negative bacillary rods was a common complication in this series; it occurred in eight (30%) of the 27 patients studied . The overall death rate was 33% (9/27); death was associated in six patients with persisting staphylococcal infection and in three patients with Gram-negative bacillary superinfection of the bronchopulmonary tract, with or without persistent staphylococcal infection. Cornell Vet, 1983 Apr, 73(2), 109 - 16 Biotypes of Staphylococcus epidermidis and Micrococcus organisms, isolated from intramammary infections, reclassified into species of the genus Staphylococcus (epidermidis, hyicus, xylosus, and sciuri); Brown RW; In a previous report (5), strains of Staphylococcus epidermidis and Micrococcus isolated from bovine intramammary infections were classified by the Baird-Parker (B-P) system and by serologic typing of the proteolytic enzymes . Since then, newer methods for distinguishing the genera Staphylococcus and Micrococcus and for defining new species have been reported . By utilizing these methods, the organisms from the original study were reclassified as follows: S . epidermidis B-P subgroup II, proteinase group F strains as S . epidermidis; S . epidermidis B-P subgroup III, proteinase group B strains as Staphylococcus hyicus subsp . chromogenes (pigmented) or subsp . hyicus (nonpigmented) and proteinase groups H and BH strains that were coagulase positive and nonpigmented as subsp . hyicus; B-P Micrococcus subgroup 6, proteinase group NR strains as Staphylococcus xylosus and subgroup 6, proteinase group G strains as Staphylococcus sciuri and S . xylosus . The reclassification of the strains increased the percentage of intramammary infections attributed to staphylococci from 62%, as first reported, to at least 86%. J Vet Pharmacol Ther, 1983 Mar, 6(1), 41 - 7 Concentrations of methicillin in blood, normal milk and mastitic milk of cows after intramuscular injection of methicillin and tamethicillin; Ziv G et al.; Tamethicillin (TAM) is a basic ester pro-drug of methicillin (MET) which is converted in the body by non-specific esterases to MET . Equal doses of MET and TAM were administered intramuscularly in a crossover trial involving four dairy cows . Acute mastitis was induced in each cow by infusing two quarters of the udder with Escherichia coli endotoxin 3 h before antibiotic administration . Peak serum MET concentrations after MET injection were significantly (P less than 0.001) higher than peak serum drug concentrations after TAM injection . The t1/2 of MET in serum after MET and TAM treatments were 18 min and 2 h, respectively . Normal milk MET concentrations during the first 8 h after TAM administration were significantly (P less than 0.05) higher than after MET treatment . Mastitic milk MET concentrations during the period 2-6 after MET injection were significantly (P less than 0.01) higher than after TAM administration . However, MET concentrations which were equal to or higher than the minimal inhibitory concentrations for penicillin G-resistant staphylococci were maintained in the mastitic milk for 8 h after treatment with MET and TAM. Am J Kidney Dis, 1983 Mar, 2(5), 548 - 52 Comparison of 4% chlorhexidine gluconate in a detergent base (Hibiclens) and povidone-iodine (Betadine) for the skin preparation of hemodialysis patients and personnel; Goldblum SE et al.; The abnormal cutaneous flora of hemodialysis (HD) patients might contribute to their frequent septic complications . We compared the effects of 13 wk of Betadine and 13 wk of Hibiclens on the skin flora of HD patients and personnel . Skin cultures were obtained weekly immediately prior to the disinfection, preceding each triweekly HD treatment, and monthly, at 2 and 4 hr postdisinfection . Total bacterial counts from predisinfection cultures were not significantly altered over either 13-wk treatment period . Hibiclens reduced total bacterial counts (p less than 0.01) and eradicated cutaneous staphylococci (p = 0.032) at both 2 and 4 hr postdisinfection significantly more than did Betadine . No reduction of staphylococcal sensitivity to either germicidal agent could be demonstrated . Neither agent was associated with severe adverse reactions and Hibiclens could not be detected in the blood . Hibiclens appears to offer short-term advantages over Betadine in the HD setting because of significantly longer duration of antibacterial activity. Ann Immunol (Paris), 1983 Mar-Apr, 134C(2), 281 - 91 {Detection of hybrid cells secreting monoclonal immunoglobulins using Staphylococcus aureus agglutination}; La Bonnardiere C et al.; A quantitative assay for mouse monoclonal immunoglobulins (Ig) was made possible by a very simple and sensitive co-agglutination test . Staphylococci which were rich in protein A were used in the presence of sheep anti-mouse IgG (H + L) antibodies . The assay was conducted in a single step using micro-haemagglutination plates . Plates were scored after over-night incubation . This method could detect as little as 0.006 microgram of IgG/ml . One set of hybrids was screened both by this method and by an immunoenzymatic assay (ELISA): with one exception, all clones which were found to produce Ig by ELISA were also positive by co-agglutination . Moreover, the co-agglutination method detected 7 additional Ig-secreting cultures . The level of secretion of each positive hybridoma ranged from 0.2 to 2 micrograms/ml . Thus, when compared to ELISA, the co-agglutination test was not only just as sensitive, but was also much simpler and faster. Diagn Microbiol Infect Dis, 1983 Mar, 1(1), 1 - 24 Antimicrobial susceptibility testing (AST): a review of changing trends, quality control guidelines, test accuracy, and recommendation for the testing of beta-lactam drugs; Jones RN; The review that follows presents the changing trends in antimicrobial susceptibility testing observed from the author's clinical laboratory experience and the proficiency testing surveys of the College of American Pathologists (CAP) . The CAP Microbiology Surveys show a clear trend toward standardized test methods of the National Committee for Clinical Laboratory Standard (NCCLS) and greater compliance with specified methods' technical steps . This has favorably influenced the laboratory performance on proficiency challenges where a 3-5% improvement has been noted over the last 5 years for the disk tests (overall acceptable rate of 95.2% in 1981) . A concurrent increase in dilution test use, mainly broth microdilution methods, has resulted in greater than 25% of larger hospital laboratories reporting results as MICs (overall acceptable or good performance = 98%) . Automated systems use also continues to increase, with user performance being monitored at an acceptable level . Quality control frequency may be reduced to once weekly without compromising test accuracy or patient care, but only after adequate daily or concurrent QC performance has been documented . Most methods continue to have problems in testing enterococci, methicillin-resistant staphylococci, and the class-disk concept appears to be less applicable . Recommendations are made for the testing of the newer semisynthetic penicillins and cephalosporins based on their spectrum comparability and cross-resistance studies with bacteria possessing known susceptibility or resistance mechanisms . The concept of "spectrum-class" is introduced with peer drugs within classes . The general trends and quality of antimicrobial susceptibility tests seem outstanding and point toward continued excellent intra- and interlaboratory reproducibility at the national level, primarily due to the efforts of the inspection and accreditation agencies, CAP, CDC, and other concerned professional groups. Pathol Biol (Paris), 1983 Mar, 31(3), 214 - 6 {Differentiation between micrococci and staphylococci by the study of the sensitivity to nitrofurantoin {N(5 nitro - 2-furfurylidene - 1-amino - hydantoin)}}; Hebert JP et al.; The authors have studied the sensitivity to the nitrofurantoine of 3 328 strains of staphylococci and of 232 strains of micrococci . They have noticed that 100% staphylococci strains are sensitive and that 100% micrococci strains are resistant . They propose this sensitivity test as a simple means of differentiation between micrococci and staphylococci. J Surg Res, 1983 Mar, 34(3), 213 - 8 In vitro quantitative adherence of bacteria to intravascular catheters; Sheth NK et al.; Adapting standard techniques, a simple in vitro system was devised to compare quantitative bacterial adherence to iv catheters of different compositions . Upon brief immersion of catheters in suspensions of Staphylococcus aureus, coagulase-negative staphylococci, and Escherichia coli, organisms adhered to catheter surfaces . After overnight growth in broth, organisms remained adherent and formed colonies, as shown by light and scanning electron microscopy . In addition, quantitative adherence using a blood agar roll technique, expressed as bacteria per square centimeter of catheter surface area per 10(6) colonies per milliliter inoculum, was calculated . Adherence was greater on polyvinylchloride (PVC) catheters (geometric mean 342) than on Teflon catheters (geometric mean 49.6) for coagulase-negative staphylococci (P less than 0.005) . Also, the number of coagulase-negative staphylococci adherent to PVC catheters was significantly greater than for E . coli (geometric mean 70.6) at analogous inocula (P less than 0.02) . Differences in bacterial adherence to the surface of iv devices may be important in the pathogenesis of catheter-associated infections . This in vitro method could prove useful in testing bacterial adherence properties of newly developed catheter materials, and allow development of catheters less prone to be associated with bacterial adherence and catheter-related infections. Plasmid, 1983 Mar, 9(2), 159 - 81 Characterization of plasmids in aminocyclitol-resistant Staphylococcus aureus: electron microscopic and restriction endonuclease analysis; Gray GS; Plasmid species isolated from aminocyclitol-resistant Staphylococcus aureus have been analyzed by restriction endonuclease digestion and electron microscopy . These plasmids can be divided into two interrelated groups; intergroup variability is due to the gain or loss of defined DNA sequences . Plasmids pSJ1 and pSJ24 are related to staphylococcal penicillinase plasmid pI524 which was first described over 20 years ago . Both pSJ1 and pSJ24 differ from pI524 by the acquisition of 8 and 4 kbp, respectively, and encode additional resistance to the antibiotics erythromycin and kanamycin . The gain of these resistance determinants suggests that the evolution of staphylococcal resistance plasmids parallels that observed for plasmids of gram-negative bacteria and has serious implications for the spread of antibiotic resistance among the staphylococci. J Hosp Infect, 1983 Mar, 4(1), 75 - 9 Staphylococcal nasal carriage in medical students with varying clinical exposure; Kingdom JC et al.; Nasal carriage and antibiotic sensitivities of coagulase-positive and coagulase-negative staphylococci were assessed among medical students of three different years . Although carriage rates did not change, there was a trend towards multiple resistance with increasing hospital exposure . Gentamicin resistance in Staphylococcus albus showed a similar trend . The relevance of these findings to current views on the origin of gentamicin resistance is discussed. Arch Dis Child, 1983 Mar, 58(3), 198 - 200 Antimicrobial properties of preterm breast milk cells; Murphy JF et al.; The antimicrobial properties of preterm and term breast milk cells were compared . They were similar in cell numbers and in the capacity to phagocytose and kill staphylococci . Interferon production on endotoxin challenge appeared to be higher in preterm cells . The antibacterial activity of breast milk cells was retained after storage at 4 degrees C for 24-48 hours . Cell numbers were unaffected by passage through a standard oral paediatric feeding set. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Feb, 253(4), 462 - 5 {Evaluation of a new latex agglutination test for identification of staphylococcus aureus}; Emmerling P et al.; 286 clinical isolates of staphylococci and 19 Micrococcus spp . were tested in a new latex agglutinating test to detect bound coagulase and protein A simultaneously . Coagulase-positive strains of staphylococci (n = 119) were all found to be latex-positive . Negative latex agglutination test results were obtained with 154 out of 167 coagulase-negative strains, the other 13 (7.8%) strains gave positive latex tests . Furthermore 3 out of 19 Micrococcus strains yielded positive agglutinating results . According to the results presented a negative latex test allows a rapid exclusion of S . aureus . A positive latex test requires the determination of further typical characteristics to differentiate among the staphylococcal isolates. J Antimicrob Chemother, 1983 Feb, 11(2), 163 - 7 Frequency of resistance to trimethoprim among isolates of Staphylococcus epidermidis and Staphylococcus saprophyticus; Richardson JF; Four hundred and forty-nine strains of staphylococci, 386 Staphylococcus epidermidis and 63 Staph . saprophyticus were tested by MIC and disc for susceptibility to trimethoprim . About 30% of clinically significant strains of Staph . epidermidis were resistant to trimethoprim; this fell to 12.6% in strains from normal flora . The frequency of resistance among clinically significant strains did not alter from 1976 to 1980 . Strains of Staph . saprophyticus were uniformly sensitive to trimethoprim. Appl Environ Microbiol, 1983 Feb, 45(2), 591 - 7 Bacteriological quality of fabrics washed at lower-than-standard temperatures in a hospital laundry facility; Christian RR et al.; We determined whether the bacteriological quality of fabrics cleaned in a hospital laundry could be maintained at wash temperatures lower than 75 degrees C by the use of economically reasonable formulas and wash conditions . Three groups of bacteria were examined to determine bacteriological quality: aerobic, nonexacting chemoorganotrophs, staphylococci, and total coliforms . The distribution of bacteria on soiled fabric was patchy, with staphylococci and total coliforms ranging from less than 0.1 to greater than 4 X 10(3) CFU/cm2 and chemoorganotrophs ranging from less than 0.1 to greater than 5 X 10(5) CFU/cm2 . The washing process routinely produced fabric containing less than 1 CFU/cm2 . Low-temperature (47.8 to 60.0 degrees C) wash procedures eliminated all bacterial groups at least as effectively as did high-temperature procedures . The effectiveness of bacterial density reduction at low temperature was augmented by increased concentrations of bleach . Successful low-temperature washing such as that shown here may save both energy and money for hospitals. Am J Vet Res, 1983 Feb, 44(2), 244 - 6 Intramammary inoculation of the dairy cow with Staphylococcus aureus and Staphylococcus epidermidis during the nonlactating period; McDonald JS et al.; The susceptibility of nonlactating mammary glands to intramammary inoculation with staphylococci was determined . Susceptibility was determined by inoculation of bacteria through the teat canal directly into the gland sinus . In experiment 1, Staphylococcus aureus (Newbould 305, ATCC 29740) was inoculated into glands at various intervals throughout the nonlactating period . During the first month, 35 of 52 inoculated glands became infected (67.3%) . During the month before parturition when 37 glands were inoculated, 36 became infected (97.3%) . In experiment 2, Staphylococcus epidermidis (A-44) was inoculated into mammary glands . During the first month of the nonlactating period, 35 glands were inoculated and only 6 glands became infected (17%) . During the month before parturition, 36 of 38 inoculated glands became infected (94%) . It appears that the mammary gland is susceptible to staphylococcal infection during the nonlactating period, because all glands became infected when they were inoculated during the month before parturition. J Clin Microbiol, 1983 Feb, 17(2), 260 - 3 Species identification and biotyping of staphylococci by the API staph-ident system; Doern GV et al.; The API Staph-Ident system, a commercially available biochemical and chromogenic substrate micromethod, was evaluated as a means for identifying the species and determining the biotypes of human strains of staphylococci routinely encountered in a clinical microbiology laboratory . The species identity of 152 of 188 (80.9%) unique clinical isolates of staphylococci was correctly predicted by this method after 5 h of incubation according to the recommendations of the manufacturer . When results were determined after 24 h of incubation, the overall accuracy of this procedure was 90.4% . The API Staph-Ident system was not an adequate procedure for assessing strain biotypes since the patterns of biochemical reactivity observed with 53 of 54 (98.2%) unique isolates of Staphylococcus aureus were identical . Similarly, 58 of 62 (93.6%) different strains of S . epidermidis yielded the same biochemical profile. Scand J Clin Lab Invest, 1983 Feb, 43(1), 67 - 72 Use of protein A-positive Staphylococci as adsorbent in a radioimmunoassay for cyclic AMP and cyclic GMP; Svenson M et al.; A reproducible (SD less than 4%), sensitive (in the 5 to 50 fmoles range) and inexpensive radioimmunoassay has been set up for the quantitation of cyclic . AMP and cyclic GMP based on acetylation or succinylation of the test sample . Separation of antibody-bound from free ligand was achieved by adsorption to formalinized protein A-positive Staphylococci of the Cowan 1 strain . The quantity of adsorbent (5% suspension) needed per 300 microliters of antiserum (diluted 24 x 10(4)) was 10 microliters . The blank value was below 2% and separation could be run at room temperature or at 4 degrees C as convenient . The acetylation or succinylation procedure of the sample totally eliminated interference of test sample immunoglobulins with antiserum binding to the absorbent. Clin Pharm, 1983 Jan-Feb, 2(1), 58 - 61 Effect of inline filtration on postinfusion phlebitis; Maddox RR et al.; The effect of inline i.v . filters on postinfusion phlebitis (PIP) and bacterial colonization of i.v . catheters was evaluated . The subjects of the prospective double-blind study were 195 men undergoing elective surgery . Polyethylene i.v . catheters of varying sizes were inserted the morning of surgery . Before catheterization, each site was shaved and cleansed with 1% povidone-iodine solution . In the experimental group, all i.v . fluids, additives, and medications were administered through a 0.22-micron micropore inline final filter . In the control group, no membrane filter was present in the filter housing . Drug and fluid therapy were determined by the physician, and flow rates were maintained at 40 ml/hr if not specified . Every 12 hours, sites were inspected and observations were graded according to criteria adapted from an earlier study . The incidence of phlebitis in the two groups was compared . At the termination of i.v . therapy, catheters were removed and cultured . The incidence of PIP in the experimental group (38/95) and the control group (39/100) was not significantly different . There were no differences between groups in variables possibly related to the occurrence of PIP, such as patient age, i.v . flow rate, catheter size, and use of potassium chloride i.v . additive . Of 141 i.v . catheters that were cultured, 25 yielded 10 or more colonies per plate; 21 were coagulase-negative staphylococci . Positive cultures occurred as frequently in patients without filters as in those with filters . No patient had clinical evidence of bacteremia . In these general surgical patients, inline filters did not affect the incidence of PIP or bacterial colonization of i.v . catheters . While the use of inline filters to prevent infusion of microorganisms deserves consideration, their routine use as a means of reducing PIP is unwarranted. Chir Pediatr, 1983, 24(2), 152 - 5 {Wound infection in pediatric surgery}; Eizaguirre I et al.; During the five-year period 1977-1982, 97 (3,37%) out of 2,898 pediatric surgical wounds became infected, 23 out of 2,140 (1,07%) corresponded to "clean" wounds, 18/475 (3,8%) belonged to the "clean-contaminated", 14/91 (15,4%) to the "contaminated" and 42/192 (21,8%) to the "dirty" groups . These rates were somewhat lower than those found in similar studies carried out in adults . The bacteriologic studies revealed that the source of infection of "clean" wounds was exogenous and almost exclusively due to --Staphylococci, whereas that of most of the remaining wounds was the patient's own enteric flora, with aerobic and anaerobic bacteria and very constant presence of E . coli and B . fragilis . Our antibiotic policies were guided by this evidence . In spite of the lack of mortality related to this minor complication, the risk and uncomfort incurred by the patients aside with the higher cost of hospital stay justify every effort to prevent this complication. Arch Intern Med, 1983 Jan, 143(1), 32 - 6 Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy; Winston DJ et al.; From January 1977 to June 1980, coagulase-negative staphylococci caused bacteremia in 22 (17%) of 130 patients receiving immunosuppressive therapy and were the most common cause of all bacteremias . Sixteen (73%) of the 22 patients had granulocytopenia, and eight were isolated in a laminar air-flow room . A Broviac or Hickman central intravenous (IV) catheter was present in 20 (91%) of 22 patients, and soft-tissue inflammation at the catheter exit site was a significant risk factor for bacteremia . Except for debilitating fevers and local mucocutaneous infections, there were no distinguishing clinical features in patients with bacteremia . Most infections responded to cefazolin sodium or vancomycin hydrochloride therapy; catheter removal was necessary in only seven patients . These data show that coagulase-negative staphylococci can be important pathogens in patients receiving immunosuppressive therapy, even when the patients are isolated in a laminar air-flow room, if normal mucocutaneous, host-defence barriers are interrupted by IV catheter-insertion or chemotherapy. Br J Haematol, 1983 Jan, 53(1), 23 - 30 Granulocyte function in untreated pernicious anaemia; Katka K et al.; Neutrophil granulocyte functions were evaluated in nine patients with pernicious anaemia (PA) . Membrane potential, oxygen consumption, nitroblue tetrozolium reduction, and phagocytosis and killing of staphylococci were determined prior to the institution of vitamin B12 therapy . There were no significant alterations in these granulocyte functions as compared with normal controls, although in several patients low values were seen . We conclude that in PA the oxidative metabolism and microbicidal functions of granulocytes in general are normal, even in severely anaemic patients. Andrologia, 1983 Jan-Feb, 15(1), 90 - 6 Is low titre agglutination seen when testing male sera for antisperm antibodies an immunological phenomenon? Hargreave TB, Hjort T. The gelatin agglutination test (GAT) and the tray slide agglutination test (TAT) for antisperm antibodies may yield equivocal titres in a number of cases when sera from infertile men are tested . The question is whether these equivocal titres represent true immunological activity or whether other factors such as beta-spermagglutinins are responsible . The sera from 24 infertile men with moderate or equivocal titres were tested using the TAT after absorption with protein A-producing staphylococci to remove IgG . Only two of the 24 sera showed activity which may have been due to beta-spermagglutinins; the majority of the sera showed no activity following absorption . These results mean that even at low titres the GAT and TAT are detecting immunological agglutination when male sera are tested and by inference that antisperm antibodies in male sera only become clinically significant at higher titres, as it is well known that men may father children in the presence of lower or equivocal serum GAT or TAT titres. Zh Mikrobiol Epidemiol Immunobiol, 1983 Jan, (1), 29 - 33 {Classification and biological characteristics of coagulase-positive Staphylococci isolated from animals}; Akatov AK et al.; A total of 165 coagulase-positive staphylococcal strains of different origin (142 S . aureus strains and 23 S . intermedius strains) were subjected to biological typing in accordance with the schemes of Hajek-Marsalek and Meyer-Witte . The former of these schemes permitted to identify 68% and the latter 18% of S . aureus strains . The cultures isolated from swine and chickens had the most uniform composition: 85-86% of the strains belonged to biotype B . 44% of the strains isolated from cows and sheep belonged to biotypes C (ecovars bovis and ovis) and A (ecovar hominis); the rest of the strains could not be identified . 96% of the strains isolated from minks were made up of S . intermedius, more than a half of them belonging to biotype E (ecovar canis) . In 80% of S . aureus strains and 48% S . intermedius cultures protein A was detected . Only 9% of S . aureus strains of animal origin were found capable of producing enterotoxins (A-D) . The expediency of working out a unified scheme for the biotyping of coagulase-positive staphylococci is discussed. J Cardiovasc Surg (Torino), 1983 Jan-Feb, 24(1), 63 - 8 Infected false femoral artery aneurysms secondary to monitoring catheters; Soderstrom CA et al.; Six patients who developed infected false femoral artery aneurysms secondary to monitoring catheters are reported . All aneurysms were infected and resulted in systemic sepsis . Initially the origin of the sepsis was not obvious . Findings which suggest this lesion include staphylococci . Appearance of distal petechial hemorrhages should lend a strong suspicion to the possibility of the lesion . Appearance of the pulsatile groin mass completes the diagnosis . Only aneurysmal resection combined with appropriate antimicrobial therapy is curative . For necessary revascularization procedures, autogenous vein grafts should be used when available. Chemotherapy, 1983, 29(1), 28 - 36 Antibiotic resistance in staphylococci from a hospital environment; Bergan T et al.; The antibiotic resistance of Staphylococcus aureus and coagulase-negative staphylococci has been followed over 4 years (1977-1980) . 90% of the strains produced beta-lactamase . Coagulase-negative staphylococci were more resistant than S . aureus, although beta-lactamase production occurred more rarely . Strains from the sputum of children with cystic fibrosis (CF) were more multiresistant than isolates from other sources . The strains from hospitalized patients (HP) were more resistant than isolates from out-patients . A higher frequency of beta-lactamase production occurred among strains from CF and HP patients compared to out-patients . This occurred in samples from pus and wounds in 66% of the strains derived from non-hospitalized patients compared with 93% from surgical patients. Vet Med Nauki, 1983, 20(8), 81 - 4 {Effect of heavy metals and pesticides on the antigenic behavior of mastitis staphylococci isolated from cows and sheep}; Karadzhov Ia et al.; Evaluated was the effect produced by some heavy metals and pesticides on the antigenic behaviour of Staphylococcus aureus strains isolated from cows and sheep with mastitis . The experiments were carried out with 9 strains, their antigenic structure being determined with the use of 16 factor sera prior to and after being gradually acted upon with lead acetate, copper sulfate, zinc sulfate, cadmium, and herbazin-50 . It was found that under the effect of these chemical factors the capsule-resembling layer grew . In connection with this the staphylococci grew within the nutrient media, forming mucoid colonies . The serologic analysis revealed lower agglutinin ability due to the release of deeply set antigens . The growth of the capsular layer was associated with the increase in the virulence of staphylococci, which was established in the conditions of the practice on a dairy farm adjacent to a Copper producing Works. Arzneimittelforschung, 1983, 33(8), 1081 - 3 {The current state of staphylococcal resistance to chemotherapeutics}; Busch U et al.; 62 Staphylococci strains classified according to their ability to produce coagulase and their hemolytic activity were tested on susceptibility to 21 antibacterial substances . The tests were carried out with the agar diffusion and agar dilution methods (mostly ADATAB-System: Breakpoint-method with prefabricated tablets) . The majority of the investigated strains showed sufficient susceptibility towards the tested substances . For treatment of multi-resistant strains narrow-spectrum antibiotics are recommended . The antibacterial activity of the combination metronidazol with mezlocillin or oxacillin was exclusively determined by the penicillins used. Vutr Boles, 1983, 22(4), 63 - 6 {Functional criteria for differentiating blast cells in acute leukemia}; Nedialkova M et al.; Eighty nine patients were examined that had various clinical-morphological forms of acute leukosis, the phagocytic activity of leukosis cells being determined and the synthesis and secretion of lysozyme by them followed up, reflected in its serum level . Leukosis cells of monoblast type were established to have the ability to ingest staphylococci, candida and particles of latex, as well as to synthesize lysozyme, confirmed by the highly elevated enzyme quantity in the sera of the patients . Those functional manifestations are proposed to be used as additional criteria in the determination of cellular type of leukosis proliferation. Infection, 1983, 11 Suppl 2, S109 - 11 Infections caused by staphylococci; Jeljaszewicz J; Staphylococci are not highly virulent bacteria . They require a predisposing factor in the host to initiate an infectious process . Primary infections are rare . Typical staphylococcal infections develop on the basis of a locus minoris resistentiae with the subsequent participation of multiple cellular and extracellular staphylococcal factors . A hypothetical view of the development of staphylococcal infection is briefly presented. Clin Invest Med, 1983, 6(4), 301 - 4 Latex agglutination test to identify coagulase, clumping factor and protein A produced by staphylococci; Wang D et al.; Since a rapid latex agglutination method for identifying Staphylococcus aureus has recently been described, we attempted to identify which factors in staphylococci produce a positive reaction so as to indicate the possible applications and limitations of the test . Latex particles prepared with human plasma (latex-plasma), immune serum globulin (ISG) (latex-ISG) or bovine fibrinogen (latex-fibrinogen) were evaluated . Purified protein A or staphylococcal colonies possessing protein A caused latex-ISG and latex-plasma to agglutinate . Colonies which had clumping factor (CF) caused latex-fibrinogen and latex-plasma to agglutinate . A factor, with molecular weight and physical properties identical to staphylococcal coagulase, present in the supernatant of overnight broth inoculated with S . aureus caused latex-fibrinogen and latex-plasma to agglutinate but not latex-ISG . Thus, when latex particles are prepared using plasma, the preparation appears to identify coagulase, CF and protein A. Arkh Patol, 1983, 45(11), 51 - 8 {Several regularities of the interrelation of blood leukocytes and microbes in the infectious process}; Sarkisov DS et al.; The rate of absorption by polymorphonuclear leukocytes of different strains of staphylococci present in a homogeneous mixture was studied . The cells of one of the strains were radiolabeled and this made it possible to differentiate them from the cells of another strain by means of electron microscopic autoradiography . Different rates of absorption of cocci belonging to different strains by leukocytes of normal subjects and by those from patients with sepsis resulting from burn or wound were observed . The seizing capacity of leukocytes of such patients in relation to the autostrains of S . aureus and epidermal staphylococcus cultivated from the blood did not differ significantly from normal in numerous tests . The electron-autoradiographic examinations of the synthesis of nucleic acids in cultures of S . aureus and epidermal staphylococcus revealed different functional status of individual cells. Vopr Onkol, 1983, 29(9), 37 - 41 {Microflora of the tracheal mucosa in laryngeal cancer patients following laryngectomy}; Kharitonova NI et al.; Bacterial flora of the trachea was studied in 19 patients at various stages (one month-3 years) after laryngectomy . Inflammatory lesions of the trachea and bronchi were detected in 15 cases . Tracheal flora comprised mostly staphylococci mixed with other bacteria . The best treatment results were secured in patients in whom cannula was removed at least 2 months after surgery and who received an adequate antibacterial therapy. Scan Electron Microsc, 1983, (Pt 1), 255 - 61 Adherence and growth of bacteria on bone cement in vitro and in chronologically infected artificial joints; Draenert K et al.; Low grade infections following total hip replacements manifest themselves late after surgery . These infections seem to be sterile; there are major problems in identifying the causative organism by cultivation . SEM investigation of small samples of the bone cement, the task of which is to anchor the prosthesis in the bone, is a suitable method for identifying the bacterial origin of these infections . During conventional histological preparation polymethacrylates are dissolved . Freeze-drying techniques, however, allow the preparation of bone cement samples for the SEM . The growth of staphylococci on cement particles shows that these resins can no longer be considered biologically inert . The surface is attacked by the bacteria. Wien Klin Wochenschr Suppl, 1983, 142, 7 - 11 {Mechanism of action of beta-lactam antibiotics and problems concerning the development of resistance in antibacterial chemotherapy}; Semenitz E; Beta-lactam antibiotics influence the metabolism of bacteria in very low concentrations by blocking the activity of penicillin binding proteins of gram-negative rods . Dependent on the type of binding protein affected bacteria form filaments or sphaeroblasts . The most important resistance mechanism is the formation of beta lactamases, which cleave the beta-lactam ring and inactivate the antimicrobially active molecule . Gram-positive bacteria like Staphylococci excrete the enzymes into the environment; as long as the antibiotic is not destroyed by the enzyme, activity antimicrobial effectiveness is present and prevents bacterial proliferation . In gram-negative bacteria the beta lactamases are formed in the periplasmic space and inactivate the antibiotic after penetration into the bacterial organism . This type of beta-lactamase formation is transferred to the organism by transduction, transformation or conjugation . Bacterial resistance against beta-lactam antibiotics need not only be due to inactivation of the antimicrobial substance by beta lactamases, but can also be due to mechanisms independent of enzyme activity . We call this intrinsic resistance . Prior to clinical application of beta-lactam antibiotics the susceptibility of the organism should be determined by an antibiogram. Zh Mikrobiol Epidemiol Immunobiol, 1983 Jan, (1), 64 - 7 {Effect of hyperbaric oxygenation on the course of experimental staphylococcal infection and on the immune status of the animal body}; Vvedenskii ML et al.; In guinea pigs infected with staphylococci by subcutaneous injection a decreased content of T-lymphocytes, an increased number of B-lymphocytes and lower levels of lysozyme and complement were observed . When subjected to the action of hyperbaric oxygenation, the animals, both intact or infected with staphylococci, showed the aggravation of staphylococcal infection, a decrease in the number of T-lymphocytes and an increase in the content of B-lymphocytes . In the intact animals hyperbaric oxygenation stimulated the production of complement and lysozyme, produced a decrease in the number of T-lymphocytes and an increase in the number of B-lymphocytes. Scand J Infect Dis Suppl, 1983, 41, 56 - 64 Staphylococcus epidermidis endocarditis and Staphylococcus epidermidis infection in an intensive care unit; Verhoef J et al.; Staphylococcus epidermidis are the most common agents of prosthetic valve endocarditis (PVE) . S . epidermidis isolated from the blood stream of patients with PVE are almost invariably multiple resistant to antibiotics . Antibiotic treatment alone gives unsatisfactory results and carries a mortality rate of 70-80% . That is why early surgical treatment is recommended . S . epidermidis is a less common cause of endocarditis in non-surgical patients, accounting for approximately 5% of the cases, which are mostly patients with pre-existent valvular heart disease . Generally, isolates from the latter patients are sensitive to most antibiotics, and the mortality rate is considerably lower . Recently coagulase-negative staphylococci have emerged as causative agents of septicaemia in patients hospitalized in intensive care units . Especially premature infants of very low-birth weight (less than 1500 g) receiving parenteral nutrition appear to carry a high risk of acquiring this kind of septicaemia . Although the staphylococci isolated from the blood of these patients are the same as in patients with PVE, generally multiple resistant to antibiotics, prognosis is far better than in cases of PVE . In our study carried out in a neonatal intensive care unit, two risk factors for coagulase-negative staphylococcal septicaemia were identified . First, nearly 20% of parenteral nutrition fluids used in the unit were found to be contaminated with coagulase-negative staphylococci, and a significant association was established between septicaemia and the infusion of contaminated fluids . Moreover, opsonization of staphylococci in infant serum proved to be severely deficient . Since host defence to staphylococci is dependent on optimal opsonization of these microorganisms, this defence may be severely compromised in the premature neonate.(ABSTRACT TRUNCATED AT 250 WORDS) Scand J Urol Nephrol Suppl, 1983, 72, 1 - 46 Clinical aspects of continuous ambulatory peritoneal dialysis; Grefberg N; Clinical aspects of Continuous Ambulatory Peritoneal Dialysis (CAPD) were studied in the first fifty patients started on CAPD at our hospital . CAPD was found to achieve good control of the uremic symptoms and of the biochemical values studied . Hypertension became less pronounced . The costs were found to be low . Twenty-four diabetic subjects were studied in detail . Intraperitoneal administration of insulin resulted in good metabolic control of the diabetes . The two catheters used for peritoneal access were compared . Because of problems related to the removal of the Toronto Western Hospital catheter it was concluded that the Tenckhoff catheter was to be preferred . Peritonitis was found to be the worst complication . Coagulase negative staphylococci accounted for 57% of the cases . During the study an increasing percentage of infections were caused by bacteria with multiple resistance to antibiotics . Netilmicin, a new aminoglycoside, was evaluated for the treatment of CAPD-related peritonitis . 84% of the cases responded . One of the nineteen patients treated sustained reversible vestibular toxicity . No other side effects were noted . In two patients right-sided hydrothorax was found to be a complication of peritoneal dialysis . In one case it was demonstrated that defects in the right diaphragm was the cause of the complication . In the other CAPD was continued despite the complication. Antimicrob Agents Chemother, 1983 Jan, 23(1), 36 - 41 Therapy of staphylococcal infections with cefamandole or vancomycin alone or with a combination of cefamandole and tobramycin; Coppens L et al.; Eighty adult patients with microbiologically demonstrated staphylococcal infections were included in a comparative trial of cefamandole and cefamandole plus tobr